Sample records for ebeltoft health study

  1. The International Symposium on Music in Medicine, Education, and Therapy for the Handicapped (3rd, Ebeltoft, Denmark, July 31-August 5, 1983).

    ERIC Educational Resources Information Center

    Pratt, Rosalie Rebollo, Ed.

    Eighteen author-contributed papers are presented from a 1983 Ebeltoft, Denmark conference on clinical uses of music for disabled and chronically ill persons. The following authors and titles are represented: "Music Perception" (J. Davies); "Central Auditory Dysfunction: Implications for Music and the Handicapped" (C. DeFosse and R. Price);…

  2. Health effects of caregiving: the caregiver health effects study: an ancillary study of the Cardiovascular Health Study.

    PubMed

    Schulz, R; Newsom, J; Mittelmark, M; Burton, L; Hirsch, C; Jackson, S

    1997-01-01

    We propose that two related sources of variability in studies of caregiving health effects contribute to an inconsistent pattern of findings: the sampling strategy used and the definition of what constitutes caregiving. Samples are often recruited through self-referral and are typically comprised of caregivers experiencing considerable distress. In this study, we examine the health effects of caregiving in large population-based samples of spousal caregivers and controls using a wide array of objective and self-report physical and mental health outcome measures. By applying different definitions of caregiving, we show that the magnitude of health effects attributable to caregiving can vary substantially, with the largest negative health effects observed among caregivers who characterize themselves as being strained. From an epidemiological perspective, our data show that approximately 80% of persons living with a spouse with a disability provide care to their spouse, but only half of care providers report mental or physical strain associated with caregiving.

  3. Health visitor or public health nurse? A Scottish study.

    PubMed

    Wilson, Susan

    2006-09-01

    The Scottish Executive and the National Health Service (NHS) have been consistently promoting 'public health nursing' as a new way forward in the community. In addition, since 2001 traditional health visitor and school nurse education programmes have been replaced by a single public health nurse training curriculum. However, many of the roles, responsibilities and job descriptions of clinical health visiting staff have remained unchanged within health board areas. This has led to apparent confusion among staff, both newly qualified and those already in post. This lack of clarity in policy and role prompted this research study, which set out to investigate the perceptions of the public health role of the health visitor within a health board area in Scotland. Initially, a review of the relevant literature was undertaken to provide in-depth background information on the topic, to enable a critical analysis of the current public health role of the health visitor. This analysis was further informed by obtaining qualitative and quantitative data via a questionnaire sent to 89 health visitors, to determine the attitudes and opinions of health visitors currently working within a Scottish health board area. Results from the study indicate that, despite the plethora of public health-related Scottish Executive publications and the changes in educational programmes, many health visitors still carry out what is perceived as a traditional role with mainly the under-five age group. The study also identified the need for clear direction in the public health role for health visitors, with many health visitors expressing a willingness to make changes to their current role.

  4. Health communication in primary health care -a case study of ICT development for health promotion.

    PubMed

    Mahmud, Amina Jama; Olander, Ewy; Eriksén, Sara; Haglund, Bo Ja

    2013-01-30

    Developing Information and Communication Technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health communication channel could facilitate

  5. Health communication in primary health care -A case study of ICT development for health promotion

    PubMed Central

    2013-01-01

    Background Developing Information and Communication Technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. Methods A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Results Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Conclusions Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health

  6. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Conduct of health assessments and health effects studies. 90.8 Section 90.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

  7. A future without health? Health dimension in global scenario studies.

    PubMed Central

    Martens, Pim; Huynen, Maud

    2003-01-01

    This paper reviews the health dimension and sociocultural, economic, and ecological determinants of health in existing global scenario studies. Not even half of the 31 scenarios reviewed gave a good description of future health developments and the different scenario studies did not handle health in a consistent way. Most of the global driving forces of health are addressed adequately in the selected scenarios, however, and it therefore would have been possible to describe the future developments in health as an outcome of these multiple driving forces. To provide examples on how future health can be incorporated in existing scenarios, we linked the sociocultural, economic, and environmental developments described in three sets of scenarios (special report on emission scenarios (SRES), global environmental outlook-3 (GEO3), and world water scenarios (WWS)) to three potential, but imaginary, health futures ("age of emerging infectious diseases", "age of medical technology", and "age of sustained health"). This paper provides useful insights into how to deal with future health in scenarios and shows that a comprehensive picture of future health evolves when all important driving forces and pressures are taken into account. PMID:14997242

  8. Health, health behaviors, and health dissimilarities predict divorce: results from the HUNT study.

    PubMed

    Torvik, Fartein Ask; Gustavson, Kristin; Røysamb, Espen; Tambs, Kristian

    2015-01-01

    Poor health and health behaviors are associated with divorce. This study investigates the degree to which six health indicators and health behaviors among husbands and wives are prospectively related to divorce, and whether spousal similarities in these factors are related to a reduced risk of marital dissolution. Theoretically, a reduced risk is possible, because spousal similarity can help the couple's adaptive processes. The data come from a general population sample (19,827 couples) and 15 years of follow-up data on marital dissolution. The following characteristics were investigated: Poor subjective health, obesity, heavy drinking, mental distress, lack of exercise, and smoking. Associations between these characteristics among husbands and wives and later divorce were investigated with Cox proportional hazards regression analyses. All the investigated characteristics except obesity were associated with marital dissolution. Moreover, spousal similarities in four of these characteristics (heavy drinking, mental distress, no exercise, and smoking) reduced the risk of divorce, compared to the combined main effects of husbands and wives. Nevertheless, couples concordant in these health issues still had higher risks of divorce than couples without these characteristics. Couples with similar health and health behavior are at a lower risk of divorce than are couples who are dissimilar in health. Health differences may thus be seen as vulnerabilities or stressors, supporting a health mismatch hypothesis. This study demonstrates that people who are similar to each other are more likely to stay together. Harmonizing partners' health behaviors may be a target in divorce prevention.

  9. Study Guide in Health Economics.

    ERIC Educational Resources Information Center

    Dawson, George; Jablon, Bert

    Prepared to assist students at Empire State College in developing learning contracts for the study of the economics of health care delivery, this study guide discusses various aspects of the topic, suggests student projects, and provides an extensive bibliography. First, introductory material discusses the relationship of economics to health care…

  10. Alabama Allied Health Needs Assessment Study.

    ERIC Educational Resources Information Center

    Morris, Libby V.

    This study assessed the supply of and demand for allied health professionals in Alabama, focusing on the relationship between supply and demand in various workplace settings in the context of Alabama's demographics, current educational programs, and projected changes in health care. The health care professions included in the study were all fields…

  11. Ombudsmen in health care: case study of a municipal health ombudsman

    PubMed Central

    da Silva, Rita de Cássia Costa; Pedroso, Marcelo Caldeira; Zucchi, Paola

    2014-01-01

    OBJECTIVE To analyze the role of a Municipal Health Ombudsman and its contribution to the public health management from the perspective of the public health system users and the municipal health counselors. METHODS Qualitative research approach using the case study, descriptive and transversal methods. The unit of analysis was a Municipal Health Ombudsman, in the state of Minas Gerais, Southeastern Brazil, between May and August 2010. The study was observational in nature and data were collected through interviews with two groups of stakeholders: users and municipal health counselors. We interviewed 44 Brazilian Unified Health System users who had made direct use of the Municipal Health Ombudsman and all 20 municipal health counselors. The data obtained were analyzed based on three issues: (1) nature of the data obtained; (2) discussion of subsidies to qualify the ombudsman’s functioning as a management tool; (3) proposals for actions to improve democratic management in the area of public health. RESULTS The complaints to the ombudsman denoted difficulties in access to health care services running the risk of their being perceived as shortcuts to gaining accessibility, disregarding the principle of social justice. The role of the ombudsman has the citizens’ approval. Users reported the following main functions of the ombudsman: to support the resolution of health problems, to listen and to clarify issues regarding Brazilian Unified Health System operations and procedures. Information was emphasized by health counselors as an instrument of power and access to the rights of Brazilian Unified Health System users. They highlighted that the ombudsman has the role of ensuring justice to foster an effective health policy, besides playing an important mediating role between the board of the municipal health system, its managers and citizens. Furthermore, the ombudsman was shown to have an execution role that transcends its regular functions. CONCLUSIONS The study found

  12. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Reporting of results of health assessments and health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

  13. Physical health monitoring in mental health settings: a study exploring mental health nurses' views of their role.

    PubMed

    Mwebe, Herbert

    2017-10-01

    To explore nurses' views of their role in the screening and monitoring of the physical care needs of people with serious mental illness in a mental health service provider. There is increasing awareness through research that people with serious mental illness disproportionately experience and die early from physical health conditions. Mental health nurses are best placed as front-line workers to offer screening, monitoring and interventions; however, their views on physical care interventions are not studied often. Qualitative exploratory study. The study was carried out in a mental health inpatient centre in England. Volunteer sampling was adopted for the study with a total target sample of (n = 20) nurses from three inpatient wards. Semistructured interviews were conducted with (n = 10) registered mental health nurses who had consented to take part in the study. Inductive data analysis and theme development were guided by a thematic analytic framework. Participants shared a clear commitment regarding their role regarding physical health screening and monitoring in mental health settings. Four themes emerged as follows: features of current practice and physical health monitoring; perceived barriers to physical health monitoring; education and training needs; and strategies to improve physical health monitoring. Nurses were unequivocal in their resolve to ensure good standard physical health monitoring and screening interventions in practice. However, identified obstacles have to be addressed to ensure that physical health screening and monitoring is integrated adequately in everyday clinical activities. Achieving this would require improvements in nurses' training, and an integrated multiservice and team-working approach. Attending to the physical health needs of people with serious mental illness has been associated with multiple improvements in both mental and physical health; nurses have a vital role to play in identifying and addressing causes of poor

  14. eHealth and mHealth initiatives in Bangladesh: a scoping study.

    PubMed

    Ahmed, Tanvir; Lucas, Henry; Khan, Azfar Sadun; Islam, Rubana; Bhuiya, Abbas; Iqbal, Mohammad

    2014-06-16

    The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O'Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully

  15. eHealth and mHealth initiatives in Bangladesh: A scoping study

    PubMed Central

    2014-01-01

    Background The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. Methods This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O’Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Results Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. Conclusion This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth

  16. Agricultural Health Study

    MedlinePlus

    ... members of the farming community. The National Institute for Occupational Safety and Health joined the study in 2000. The AHS is also providing an opportunity to assess the effects of diet, cooking methods, and other lifestyle and genetic factors on the ...

  17. Embedding health literacy into health systems: a case study of a regional health service.

    PubMed

    Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly

    2017-12-01

    Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period. Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care. Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites. Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems. What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual's ability to access, understand and apply the health-related information and services available to them

  18. AGRICULTURAL HEALTH STUDY/PESTICIDE EXPOSURE STUDY: STUDY DESIGN AND PRELIMINARY BIOMARKER RESULTS

    EPA Science Inventory

    The Agricultural Health Study (AHS) is a collaborative effort between the National Cancer Institute, the National Institute of Environmental Health Sciences, and the U.S. Environmental Protection Agency to quantify cancer and non-cancer health risks in the agricultural communit...

  19. Physical fitness, health behaviour and health among nursing students: A descriptive correlational study.

    PubMed

    Klainin-Yobas, Piyanee; He, Hong-Gu; Lau, Ying

    2015-12-01

    Health behaviour is of great importance for nursing students to achieve optimal health. Healthy students tend to complete their study and remain in the nursing workforce. They will also serve as a role model of for patients. However, there is limited research concerning physical fitness and health behaviour (such as sleep problems) in this population. This study aims to examine the relationships among health behaviour, personal variables, physical fitness, perceived physical health and psychological health. A cross-sectional descriptive correlational study was used. A total of 335 nursing students who were enrolled in a university in Thailand. Data were collected by self-administered questionnaires and physical fitness tests. Independent variables were personal variables and health behaviour. Outcome variables included physical fitness, perceived physical health and psychological health. Descriptive statistics and path analyses were used to analyse data. Nursing students had poor to moderate levels of total physical fitness, with cardiovascular fitness and body flexibility components having the lowest scores. Students who exercised regularly tended to have better physical fitness, perceived physical health and psychological health. Those who did not have sleep problems had better psychological health. Some personal variables and health behaviours were associated with health among nursing students. Appropriate interventions are required to promote positive health behaviour in this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Cohort studies in health sciences librarianship

    PubMed Central

    Eldredge, Jonathan

    2002-01-01

    Question: What are the key characteristics of the cohort study design and its varied applications, and how can this research design be utilized in health sciences librarianship? Data Sources: The health, social, behavioral, biological, library, earth, and management sciences literatures were used as sources. Study Selection: All fields except for health sciences librarianship were scanned topically for either well-known or diverse applications of the cohort design. The health sciences library literature available to the author principally for the years 1990 to 2000, supplemented by papers or posters presented at annual meetings of the Medical Library Association. Data Extraction: A narrative review for the health, social, behavioral, biological, earth, and management sciences literatures and a systematic review for health sciences librarianship literature for the years 1990 to 2000, with three exceptions, were conducted. The author conducted principally a manual search of the health sciences librarianship literature for the years 1990 to 2000 as part of this systematic review. Main Results: The cohort design has been applied to answer a wide array of theoretical or practical research questions in the health, social, behavioral, biological, and management sciences. Health sciences librarianship also offers several major applications of the cohort design. Conclusion: The cohort design has great potential for answering research questions in the field of health sciences librarianship, particularly evidence-based librarianship (EBL), although that potential has not been fully explored. PMID:12398244

  1. Men's health studies: origins and trends.

    PubMed

    Sabo, D

    2000-11-01

    This article provides a brief outline of the development of men's health studies in the United States. Research on men's health is discussed within critical feminist theories that highlight the reciprocality of gender relations as well as power differences between men and women and among male subgroups. A relational theory of gender and health is used to identify both positive-gendered and negative-gendered health synergies that influence the health processes and outcomes of men and women. Several examples of gendered health synergies are presented to illustrate key concepts. Finally, some directions for future research and advocacy with reference to men's health are outlined.

  2. Associations between health culture, health behaviors, and health-related outcomes: A cross-sectional study

    PubMed Central

    Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin

    2017-01-01

    Background To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. Methods A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. Results The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). Conclusions The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion. PMID:28746400

  3. Associations between health culture, health behaviors, and health-related outcomes: A cross-sectional study.

    PubMed

    Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin; Fu, Hua

    2017-01-01

    To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion.

  4. Women's political participation and health: a health capability study in rural India.

    PubMed

    Feldman, Candace H; Darmstadt, Gary L; Kumar, Vishwajeet; Ruger, Jennifer Prah

    2015-02-01

    Understanding the relationship between women's political participation and health has eluded researchers and cannot be adequately studied using traditional epidemiological or social scientific methodologies. We employed a health capability framework to understand dimensions of health agency to illuminate how local political economies affect health. Exploiting a cluster-randomized controlled trial of a community-based behavior change management intervention in northern India, we conducted a qualitative study with semistructured, in-depth focus groups in both intervention and nonintervention villages. We presented scenarios to each group regarding the limitations and motivations involved in women's political participation and health. Thematic analysis focused on four domains of health agency -- participation, autonomy, self-efficacy, and health systems -- relevant for understanding the relationship between political participation and health. Elder women demonstrated the greatest sense of self-efficacy and as a group cited the largest number of successful health advocacy efforts. Participation in an associated community-based neonatal intervention had varying effects, showing some differences in self-efficacy, but only rare improvements in participation, autonomy, or health system functioning. Better understanding of cultural norms surrounding autonomy, the local infrastructure and health system, and male and female perceptions of political participation and self-efficacy are needed to improve women's health agency. For a community-based participatory health intervention to improve health capability effectively, explicit strategies focused on health agency should be as central as health indicators. Copyright © 2015 by Duke University Press.

  5. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... site visit in connection with a health assessment or health effects study. The ATSDR representative may... release for the limited purpose of determining the existence of current or potential health problems. ...

  6. Quantitative Outcomes of a One Health approach to Study Global Health Challenges.

    PubMed

    Falzon, Laura C; Lechner, Isabel; Chantziaras, Ilias; Collineau, Lucie; Courcoul, Aurélie; Filippitzi, Maria-Eleni; Laukkanen-Ninios, Riikka; Peroz, Carole; Pinto Ferreira, Jorge; Postma, Merel; Prestmo, Pia G; Phythian, Clare J; Sarno, Eleonora; Vanantwerpen, Gerty; Vergne, Timothée; Grindlay, Douglas J C; Brennan, Marnie L

    2018-03-01

    Having gained momentum in the last decade, the One Health initiative promotes a holistic approach to address complex global health issues. Before recommending its adoption to stakeholders, however, it is paramount to first compile quantitative evidence of the benefit of such an approach. The aim of this scoping review was to identify and summarize primary research that describes monetary and non-monetary outcomes following adoption of a One Health approach. An extensive literature search yielded a total of 42,167 references, of which 85 were included in the final analysis. The top two biotic health issues addressed in these studies were rabies and malaria; the top abiotic health issue was air pollution. Most studies described collaborations between human and animal (n = 42), or human and environmental disciplines (n = 41); commonly reported interventions included vector control and animal vaccination. Monetary outcomes were commonly expressed as cost-benefit or cost-utility ratios; non-monetary outcomes were described using disease frequency or disease burden measurements. The majority of the studies reported positive or partially positive outcomes. This paper illustrates the variety of health challenges that can be addressed using a One Health approach, and provides tangible quantitative measures that can be used to evaluate future implementations of the One Health approach.

  7. Air Pollution Exposure Modeling for Health Studies | Science ...

    EPA Pesticide Factsheets

    Dr. Michael Breen is leading the development of air pollution exposure models, integrated with novel personal sensor technologies, to improve exposure and risk assessments for individuals in health studies. He is co-investigator for multiple health studies assessing the exposure and effects of air pollutants. These health studies include participants with asthma, diabetes, and coronary artery disease living in various U.S. cities. He has developed, evaluated, and applied novel exposure modeling and time-activity tools, which includes the Exposure Model for Individuals (EMI), GPS-based Microenvironment Tracker (MicroTrac) and Exposure Tracker models. At this seminar, Dr. Breen will present the development and application of these models to predict individual-level personal exposures to particulate matter (PM) for two health studies in central North Carolina. These health studies examine the association between PM and adverse health outcomes for susceptible individuals. During Dr. Breen’s visit, he will also have the opportunity to establish additional collaborations with researchers at Harvard University that may benefit from the use of exposure models for cohort health studies. These research projects that link air pollution exposure with adverse health outcomes benefit EPA by developing model-predicted exposure-dose metrics for individuals in health studies to improve the understanding of exposure-response behavior of air pollutants, and to reduce participant

  8. Enabling Health Reform through Regional Health Information Exchange: A Model Study from China

    PubMed Central

    Wen, Dong; Meng, Qun

    2017-01-01

    Objective. To investigate and share the major challenges and experiences of building a regional health information exchange system in China in the context of health reform. Methods. This study used interviews, focus groups, a field study, and a literature review to collect insights and analyze data. The study examined Xinjin's approach to developing and implementing a health information exchange project, using exchange usage data for analysis. Results. Within three years and after spending approximately $2.4 million (15 million RMB), Xinjin County was able to build a complete, unified, and shared information system and many electronic health record components to integrate and manage health resources for 198 health institutions in its jurisdiction, thus becoming a model of regional health information exchange for facilitating health reform. Discussion. Costs, benefits, experiences, and lessons were discussed, and the unique characteristics of the Xinjin case and a comparison with US cases were analyzed. Conclusion. The Xinjin regional health information exchange system is different from most of the others due to its government-led, government-financed approach. Centralized and coordinated efforts played an important role in its operation. Regional health information exchange systems have been proven critical for meeting the global challenges of health reform. PMID:29065565

  9. Mobile Health Initiatives in Vietnam: Scoping Study

    PubMed Central

    Lam, Jeffrey A; Dang, Linh Thuy; Phan, Ngoc Tran; Trinh, Hue Thi; Vu, Nguyen Cong

    2018-01-01

    Background Mobile health (mHealth) offers a promising solution to the multitude of challenges the Vietnamese health system faces, but there is a scarcity of published information on mHealth in Vietnam. Objective The objectives of this scoping study were (1) to summarize the extent, range, and nature of mHealth initiatives in Vietnam and (2) to examine the opportunities and threats of mHealth utilization in the Vietnamese context. Methods This scoping study systematically identified and extracted relevant information from 20 past and current mHealth initiatives in Vietnam. The study includes multimodal information sources, including published literature, gray literature (ie, government reports and unpublished literature), conference presentations, Web-based documents, and key informant interviews. Results We extracted information from 27 records from the electronic search and conducted 14 key informant interviews, allowing us to identify 20 mHealth initiatives in Vietnam. Most of the initiatives were primarily funded by external donors (n=15), while other initiatives were government funded (n=1) or self-funded (n=4). A majority of the initiatives targeted vulnerable and hard-to-reach populations (n=11), aimed to prevent the occurrence of disease (n=12), and used text messaging (short message service, SMS) as part of their intervention (n=14). The study revealed that Vietnamese mHealth implementation has been challenged by factors including features unique to the Vietnamese language (n=4) and sociocultural factors (n=3). Conclusions The largest threats to the popularity of mHealth initiatives are the absence of government policy, lack of government interest, heavy dependence on foreign funding, and lack of technological infrastructure. Finally, while current mHealth initiatives have already demonstrated promising opportunities for alternative models of funding, such as social entrepreneurship or private business models, sustainable mHealth initiatives outside of

  10. The Korea Nurses' Health Study: A Prospective Cohort Study.

    PubMed

    Kim, Oksoo; Ahn, Younjhin; Lee, Hea-Young; Jang, Hee Jung; Kim, Sue; Lee, Jung Eun; Jung, Heeja; Cho, Eunyoung; Lim, Joong-Yeon; Kim, Min-Ju; Willett, Walter C; Chavarro, Jorge E; Park, Hyun-Young

    2017-08-01

    The Korea Nurses' Health Study (KNHS) is a prospective cohort study of female nurses, focusing on the effects of occupational, environmental, and lifestyle risk factors on the health of Korean women. Female registered nurses aged 20-45 years and living in the Republic of Korea were invited to join the study, which began in July 2013. They were asked to complete a web-based baseline survey. The study protocols and questionnaires related to the KNHS are based on the Nurses' Health Study 3 (NHS3) in the United States, although they were modified to reflect the Korean lifestyle. Participants were asked about demographic, lifestyle factors, disease history, occupational exposure, reproductive factors, and dietary habits during their adolescence: Follow-up questionnaires were/will be completed at 6-8 month intervals after the baseline survey. If a participant became pregnant, she answered additional questionnaires containing pregnancy-related information. Among 157,569 eligible female nurses, 20,613 (13.1%) completed the web-based baseline questionnaire. The mean age of the participants was 29.4 ± 5.9 years, and more than half of them were in their 20s. Eighty-eight percent of the participants had worked night shifts as a nurse (mean, 5.3 ± 4.3 nights per month). Approximately 80% of the participants had a body mass index below 23 kg/m 2 . Gastrointestinal diseases were the most prevalent health issues (25.9%). The findings from this prospective cohort study will help to identify the effects of lifestyle-related and occupational factors on reproductive health and development of chronic diseases in Korean women.

  11. Healthy sex and sexual health: new directions for studying outcomes of sexual health.

    PubMed

    Lefkowitz, Eva S; Vasilenko, Sara A

    2014-01-01

    Sexual behavior is an important aspect of adolescent development with implications for well-being. These chapters highlight important perspectives on studying sexual health from a normative, developmental perspective, such as viewing a range of sexual behaviors as life events; considering potentially positive physical health, mental health, social health, and identity outcomes; examining both intraindividual and interindividual differences in outcomes; recognizing the romantic relationship context of sexual behavior; and understanding how sexual media may impact sexual health outcomes. We suggest new directions for studying sexual health outcomes, such as studying behaviors beyond vaginal sex and condom use, new methodologies such as latent class analysis, sophisticated longitudinal designs, and collection and analysis of dyadic data. We recommend research on populations underrepresented in sexual health research such as late adolescents who do not attend traditional universities and adolescents from ethnic/racial minorities. Finally, we consider future directions for sexuality education and prevention efforts. © 2014 Wiley Periodicals, Inc.

  12. HEALTH AND EXPOSURE RESEARCH FOR THE AGRICULTURAL COMMUNITY: THE AGRICULTURAL HEALTH STUDY

    EPA Science Inventory

    The Agricultural Health Study (AHS) is a collaborative effort between the National Cancer Institute, the National Institute of Environmental Health Sciences, the U.S. Environmental Protection Agency, and the National Institute for Occupational Safety and Health. The AHS is the...

  13. Health Literacy Practices and Educational Competencies for Health Professionals: A Consensus Study

    PubMed Central

    Coleman, Clifford A.; Hudson, Stan; Maine, Lucinda L.

    2013-01-01

    Health care professionals often lack adequate knowledge about health literacy and the skills needed to address low health literacy among patients and their caregivers. Many promising practices for mitigating the effects of low health literacy are not used consistently. Improving health literacy training for health care professionals has received increasing emphasis in recent years. The development and evaluation of curricula for health professionals has been limited by the lack of agreed-upon educational competencies in this area. This study aimed to identify a set of health literacy educational competencies and target behaviors, or practices, relevant to the training of all health care professionals. The authors conducted a thorough literature review to identify a comprehensive list of potential health literacy competencies and practices, which they categorized into 1 or more educational domains (i.e., knowledge, skills, attitudes) or a practice domain. The authors stated each item in operationalized language following Bloom's Taxonomy. The authors then used a modified Delphi method to identify consensus among a group of 23 health professions education experts representing 11 fields in the health professions. Participants rated their level of agreement as to whether a competency or practice was both appropriate and important for all health professions students. A predetermined threshold of 70% agreement was used to define consensus. After 4 rounds of ratings and modifications, consensus agreement was reached on 62 out of 64 potential educational competencies (24 knowledge items, 27 skill items, and 11 attitude items), and 32 out of 33 potential practices. This study is the first known attempt to develop consensus on a list of health literacy practices and to translate recommended health literacy practices into an agreed-upon set of measurable educational competencies for health professionals. Further work is needed to prioritize the competencies and practices in

  14. Mobile Health Initiatives in Vietnam: Scoping Study.

    PubMed

    Lam, Jeffrey A; Dang, Linh Thuy; Phan, Ngoc Tran; Trinh, Hue Thi; Vu, Nguyen Cong; Nguyen, Cuong Kieu

    2018-04-24

    Mobile health (mHealth) offers a promising solution to the multitude of challenges the Vietnamese health system faces, but there is a scarcity of published information on mHealth in Vietnam. The objectives of this scoping study were (1) to summarize the extent, range, and nature of mHealth initiatives in Vietnam and (2) to examine the opportunities and threats of mHealth utilization in the Vietnamese context. This scoping study systematically identified and extracted relevant information from 20 past and current mHealth initiatives in Vietnam. The study includes multimodal information sources, including published literature, gray literature (ie, government reports and unpublished literature), conference presentations, Web-based documents, and key informant interviews. We extracted information from 27 records from the electronic search and conducted 14 key informant interviews, allowing us to identify 20 mHealth initiatives in Vietnam. Most of the initiatives were primarily funded by external donors (n=15), while other initiatives were government funded (n=1) or self-funded (n=4). A majority of the initiatives targeted vulnerable and hard-to-reach populations (n=11), aimed to prevent the occurrence of disease (n=12), and used text messaging (short message service, SMS) as part of their intervention (n=14). The study revealed that Vietnamese mHealth implementation has been challenged by factors including features unique to the Vietnamese language (n=4) and sociocultural factors (n=3). The largest threats to the popularity of mHealth initiatives are the absence of government policy, lack of government interest, heavy dependence on foreign funding, and lack of technological infrastructure. Finally, while current mHealth initiatives have already demonstrated promising opportunities for alternative models of funding, such as social entrepreneurship or private business models, sustainable mHealth initiatives outside of those funded by external donors have not yet been

  15. Comparing mental health literacy and physical health literacy: an exploratory study.

    PubMed

    Wickstead, Robert; Furnham, Adrian

    2017-10-01

    This study compared mental health and physical health literacy using five health problems from each area. The aim was to determine whether the same group had better physical than mental health literacy Method: A sample of 263 participants completed an online questionnaire requiring them to name a problem/illness described in 10 vignettes and suggest treatment options. Five vignettes described mental health problems (anxiety, bipolar-disorder, depression, OCPD and schizophrenia) and five physical problems (angina, COPD, diabetes, a heart attack, and sinusitis). Participants were also asked to rate their sympathy and estimates of prevalence for each disorder. Recognition of the mental health disorders was superior compared recognition of the physical disorders. Analysis of treatment beliefs, sympathy and prevalence ratings also showed significant differences between disorders. Results highlight the importance of education and the lack of public knowledge regarding major physical health conditions.

  16. Rigor, vigor, and the study of health disparities

    PubMed Central

    Adler, Nancy; Bush, Nicole R.; Pantell, Matthew S.

    2012-01-01

    Health disparities research spans multiple fields and methods and documents strong links between social disadvantage and poor health. Associations between socioeconomic status (SES) and health are often taken as evidence for the causal impact of SES on health, but alternative explanations, including the impact of health on SES, are plausible. Studies showing the influence of parents’ SES on their children’s health provide evidence for a causal pathway from SES to health, but have limitations. Health disparities researchers face tradeoffs between “rigor” and “vigor” in designing studies that demonstrate how social disadvantage becomes biologically embedded and results in poorer health. Rigorous designs aim to maximize precision in the measurement of SES and health outcomes through methods that provide the greatest control over temporal ordering and causal direction. To achieve precision, many studies use a single SES predictor and single disease. However, doing so oversimplifies the multifaceted, entwined nature of social disadvantage and may overestimate the impact of that one variable and underestimate the true impact of social disadvantage on health. In addition, SES effects on overall health and functioning are likely to be greater than effects on any one disease. Vigorous designs aim to capture this complexity and maximize ecological validity through more complete assessment of social disadvantage and health status, but may provide less-compelling evidence of causality. Newer approaches to both measurement and analysis may enable enhanced vigor as well as rigor. Incorporating both rigor and vigor into studies will provide a fuller understanding of the causes of health disparities. PMID:23045672

  17. Canadian Institutes of Health Research funding of prison health research: a descriptive study.

    PubMed

    Kouyoumdjian, Fiona G; McIsaac, Kathryn E; Foran, Jessica E; Matheson, Flora I

    2017-01-01

    Health research provides a means to define health status and to identify ways to improve health. Our objective was to define the proportion of grants and funding from the Government of Canada's health research investment agency, the Canadian Institutes of Health Research (CIHR), that was awarded for prison health research, and to describe the characteristics of funded grants. In this descriptive study, we defined prison health research as research on the health and health care of people in prisons and at the time of their release. We searched the CIHR Funding Decisions Database by subject and by investigator name for funded grants for prison health research in Canada in all competitions between 2010 and 2014. We calculated the proportion of grants and funding awarded for prison health research, and described the characteristics of funded grants. During the 5-year study period, 21 grants were awarded that included a focus on prison health research, for a total of $2 289 948. Six of these grants were operating grants and 6 supported graduate or fellowship training. In total, 0.13% of all grants and 0.05% of all funding was for prison health research. A relatively small proportion of CIHR grants and funding were awarded for prison health research between 2010 and 2014. If prison health is a priority for Canada, strategic initiatives that include funding opportunities could be developed to support prison health research in Canada.

  18. North Korean refugee health in South Korea (NORNS) study: study design and methods

    PubMed Central

    2012-01-01

    Background Understanding the health status of North Korean refugees (NKRs), and changes in health during the resettlement process, is important from both the humanitarian standpoint and the scientific perspective. The NOrth Korean Refugee health iN South Korea (NORNS) study aims to document the health status and health determinants of North Korean refugees, to observe various health outcomes as they occur while adapting to the westernized lifestyle of South Korea, and to explain the mechanisms of how health of migrants and refugees changes in the context of new environmental risks and opportunities. Methods The NORNS study was composed of an initial survey and a follow-up survey 3.5 years apart. Participants were recruited voluntarily among those aged 30 or more living in Seoul. The survey consists of a health questionnaire and medical examination. The health questionnaire comprises the following six domains: 1) demographic and migration information 2) disease history, 3) mental health, 4) health-related lifestyle, 5) female reproductive health, and 6) sociocultural adaptation. The medical examination comprises anthropometric measurements, blood pressure and atherosclerosis, and various biochemical measurements. Prevalence of several diseases able to be diagnosed from the medical examination, the changes between the two surveys, and the association between the outcome and other measurements, such as length of stay and extent of adaptation in South Korea will be investigated. Furthermore, the outcome will be compared to a South Korean counterpart cohort to evaluate the relative health status of NKRs. Discussion The NORNS study targeting adult NKRs in South Korea is a valuable study because various scales and medical measurements are employed for the first time. The results obtained from this study are expected to be utilized for developing a health policy for NKRs and North Korean people after unification. Additionally, since NKRs are an immigrant group who are the

  19. North Korean refugee health in South Korea (NORNS) study: study design and methods.

    PubMed

    Lee, Yo Han; Lee, Won Jin; Kim, Yun Jeong; Cho, Myong Jin; Kim, Joo Hyung; Lee, Yun Jeong; Kim, Hee Young; Choi, Dong Seop; Kim, Sin Gon; Robinson, Courtland

    2012-03-08

    Understanding the health status of North Korean refugees (NKRs), and changes in health during the resettlement process, is important from both the humanitarian standpoint and the scientific perspective. The NOrth Korean Refugee health iN South Korea (NORNS) study aims to document the health status and health determinants of North Korean refugees, to observe various health outcomes as they occur while adapting to the westernized lifestyle of South Korea, and to explain the mechanisms of how health of migrants and refugees changes in the context of new environmental risks and opportunities. The NORNS study was composed of an initial survey and a follow-up survey 3.5 years apart. Participants were recruited voluntarily among those aged 30 or more living in Seoul. The survey consists of a health questionnaire and medical examination. The health questionnaire comprises the following six domains: 1) demographic and migration information 2) disease history, 3) mental health, 4) health-related lifestyle, 5) female reproductive health, and 6) sociocultural adaptation. The medical examination comprises anthropometric measurements, blood pressure and atherosclerosis, and various biochemical measurements. Prevalence of several diseases able to be diagnosed from the medical examination, the changes between the two surveys, and the association between the outcome and other measurements, such as length of stay and extent of adaptation in South Korea will be investigated. Furthermore, the outcome will be compared to a South Korean counterpart cohort to evaluate the relative health status of NKRs. The NORNS study targeting adult NKRs in South Korea is a valuable study because various scales and medical measurements are employed for the first time. The results obtained from this study are expected to be utilized for developing a health policy for NKRs and North Korean people after unification. Additionally, since NKRs are an immigrant group who are the same race and have the same

  20. eHealth in Denmark: a case study.

    PubMed

    Kierkegaard, Patrick

    2013-12-01

    Denmark is widely regarded as a leading country in terms of eHealth integration and healthcare delivery services. The push for eHealth adoption over that past 20 years in the Danish health sector has led to the deployment of multiple eHealth technologies. However, in reality the Danish healthcare suffers from eHealth system fragmentation which has led to eHealth's inability to reach full potential in delivering quality healthcare service. This paper will presents a case study of the current state of eHealth in the Danish healthcare system and discuss the current challenges the country is facing today.

  1. Air Pollution Exposure Modeling for Health Studies

    EPA Science Inventory

    Dr. Michael Breen is leading the development of air pollution exposure models, integrated with novel personal sensor technologies, to improve exposure and risk assessments for individuals in health studies. He is co-investigator for multiple health studies assessing the exposure ...

  2. HEALTH AND RETIREMENT STUDY (HRS)

    EPA Science Inventory

    HRS is a national panel study based on biennial interviews. The study provides a portrait of an aging America's physical and mental health, insurance coverage, financial status, family support systems, labor market status, and retirement planning.

  3. A qualitative study of health information technology in the Canadian public health system.

    PubMed

    Zinszer, Kate; Tamblyn, Robyn; Bates, David W; Buckeridge, David L

    2013-05-25

    Although the adoption of health information technology (HIT) has advanced in Canada over the past decade, considerable challenges remain in supporting the development, broad adoption, and effective use of HIT in the public health system. Policy makers and practitioners have long recognized that improvements in HIT infrastructure are necessary to support effective and efficient public health practice. The objective of this study was to identify aspects of health information technology (HIT) policy related to public health in Canada that have succeeded, to identify remaining challenges, and to suggest future directions to improve the adoption and use of HIT in the public health system. A qualitative case study was performed with 24 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology. Identified benefits of HIT in public health included improved communication among jurisdictions, increased awareness of the need for interoperable systems, and improvement in data standardization. Identified barriers included a lack of national vision and leadership, insufficient investment, and poor conceptualization of the priority areas for implementing HIT in public health. The application of HIT in public health should focus on automating core processes and identifying innovative applications of HIT to advance public health outcomes. The Public Health Agency of Canada should develop the expertise to lead public health HIT policy and should establish a mechanism for coordinating public health stakeholder input on HIT policy.

  4. Crowdsourced health research studies: an important emerging complement to clinical trials in the public health research ecosystem.

    PubMed

    Swan, Melanie

    2012-03-07

    Crowdsourced health research studies are the nexus of three contemporary trends: 1) citizen science (non-professionally trained individuals conducting science-related activities); 2) crowdsourcing (use of web-based technologies to recruit project participants); and 3) medicine 2.0 / health 2.0 (active participation of individuals in their health care particularly using web 2.0 technologies). Crowdsourced health research studies have arisen as a natural extension of the activities of health social networks (online health interest communities), and can be researcher-organized or participant-organized. In the last few years, professional researchers have been crowdsourcing cohorts from health social networks for the conduct of traditional studies. Participants have also begun to organize their own research studies through health social networks and health collaboration communities created especially for the purpose of self-experimentation and the investigation of health-related concerns. The objective of this analysis is to undertake a comprehensive narrative review of crowdsourced health research studies. This review will assess the status, impact, and prospects of crowdsourced health research studies. Crowdsourced health research studies were identified through a search of literature published from 2000 to 2011 and informal interviews conducted 2008-2011. Keyword terms related to crowdsourcing were sought in Medline/PubMed. Papers that presented results from human health studies that included crowdsourced populations were selected for inclusion. Crowdsourced health research studies not published in the scientific literature were identified by attending industry conferences and events, interviewing attendees, and reviewing related websites. Participatory health is a growing area with individuals using health social networks, crowdsourced studies, smartphone health applications, and personal health records to achieve positive outcomes for a variety of health

  5. Crowdsourced Health Research Studies: An Important Emerging Complement to Clinical Trials in the Public Health Research Ecosystem

    PubMed Central

    2012-01-01

    Background Crowdsourced health research studies are the nexus of three contemporary trends: 1) citizen science (non-professionally trained individuals conducting science-related activities); 2) crowdsourcing (use of web-based technologies to recruit project participants); and 3) medicine 2.0 / health 2.0 (active participation of individuals in their health care particularly using web 2.0 technologies). Crowdsourced health research studies have arisen as a natural extension of the activities of health social networks (online health interest communities), and can be researcher-organized or participant-organized. In the last few years, professional researchers have been crowdsourcing cohorts from health social networks for the conduct of traditional studies. Participants have also begun to organize their own research studies through health social networks and health collaboration communities created especially for the purpose of self-experimentation and the investigation of health-related concerns. Objective The objective of this analysis is to undertake a comprehensive narrative review of crowdsourced health research studies. This review will assess the status, impact, and prospects of crowdsourced health research studies. Methods Crowdsourced health research studies were identified through a search of literature published from 2000 to 2011 and informal interviews conducted 2008-2011. Keyword terms related to crowdsourcing were sought in Medline/PubMed. Papers that presented results from human health studies that included crowdsourced populations were selected for inclusion. Crowdsourced health research studies not published in the scientific literature were identified by attending industry conferences and events, interviewing attendees, and reviewing related websites. Results Participatory health is a growing area with individuals using health social networks, crowdsourced studies, smartphone health applications, and personal health records to achieve positive

  6. Social participation, health literacy, and health and well-being: A cross-sectional study in Ghana.

    PubMed

    Amoah, Padmore Adusei

    2018-04-01

    Numerous studies attest to the salubriousness of social participation across contexts. Factors such as health-related behaviour, health risk aversion, and psychosocial traits partly explain this association. While a study of these factors contributes to an understanding of the role that social participation plays in health-related outcomes, significant gaps still exist in this field of investigation. In particular, existing studies have not explored the relationship between social participation and health literacy and how it affects health and well-being adequately. This paper addresses this gap by examining the responses of some 779 rural and urban residents in Ashanti Region in Ghana. The study used path analyses within structural equation modelling (SEM) to assess the mediational role of health literacy in the association between social participation (religious participation, volunteer activities and group membership), and health status and subjective well-being. All the proxies of social participation significantly predicted health literacy. It was also evident that social participation influences health and well-being substantially. After controlling for socio-demographic variables, religious participation and group membership indirectly predicted well-being and health status through health literacy. Volunteer activities showed a negative indirect effect; thus, social participation does not always have a favourable effect on health and well-being. However, the findings suggest that overall, enhancing social participation may be promising for effective health promotion.

  7. Qingdao Port Cardiovascular Health Study: a prospective cohort study.

    PubMed

    Spatz, Erica S; Jiang, Xianyan; Lu, Jiapeng; Masoudi, Frederick A; Spertus, John A; Wang, Yongfei; Li, Xi; Downing, Nicholas S; Nasir, Khurram; Du, Xue; Li, Jing; Krumholz, Harlan M; Liu, Xiancheng; Jiang, Lixin

    2015-12-09

    In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. For this study, from 2000 through 2013, 32,404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221,923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4-39.4%; diabetes: 3.3-8.9%; hyperlipidaemia: 5.0-33.6%; body mass index >28 m/kg(2): 14.1-18.6%). We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge generated will be disseminated in the peer-reviewed literature, and will

  8. Qingdao Port Cardiovascular Health Study: a prospective cohort study

    PubMed Central

    Spatz, Erica S; Jiang, Xianyan; Lu, Jiapeng; Masoudi, Frederick A; Spertus, John A; Wang, Yongfei; Li, Xi; Downing, Nicholas S; Nasir, Khurram; Du, Xue; Li, Jing; Krumholz, Harlan M; Liu, Xiancheng; Jiang, Lixin

    2015-01-01

    Purpose In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Participants For this study, from 2000 through 2013, 32 404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221 923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Findings to date Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4–39.4%; diabetes: 3.3–8.9%; hyperlipidaemia: 5.0–33.6%; body mass index >28 m/kg2: 14.1–18.6%). Future Plans We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge

  9. Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran.

    PubMed

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

    2016-02-01

    There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran.

  10. Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran

    PubMed Central

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

    2016-01-01

    Background: There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. Objectives: The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. Materials and Methods: This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. Results: The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. Conclusions: It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran. PMID:27186383

  11. Comparison of health risk behavior, awareness, and health benefit beliefs of health science and non-health science students: An international study.

    PubMed

    Peltzer, Karl; Pengpid, Supa; Yung, Tony K C; Aounallah-Skhiri, Hajer; Rehman, Rehana

    2016-06-01

    This study determines the differences in health risk behavior, knowledge, and health benefit beliefs between health science and non-health science university students in 17 low and middle income countries. Anonymous questionnaire data were collected in a cross-sectional survey of 13,042 undergraduate university students (4,981 health science and 8,061 non-health science students) from 17 universities in 17 countries across Asia, Africa, and the Americas. Results indicate that overall, health science students had the same mean number of health risk behaviors as non-health science university students. Regarding addictive risk behavior, fewer health science students used tobacco, were binge drinkers, or gambled once a week or more. Health science students also had a greater awareness of health behavior risks (5.5) than non-health science students (4.6). Linear regression analysis found a strong association with poor or weak health benefit beliefs and the health risk behavior index. There was no association between risk awareness and health risk behavior among health science students and an inverse association among non-health science students. © 2015 Wiley Publishing Asia Pty Ltd.

  12. Pathway Linking Internet Health Information Seeking to Better Health: A Moderated Mediation Study.

    PubMed

    Jiang, Shaohai; Street, Richard L

    2017-08-01

    The Internet increasingly has been recognized as an important medium with respect to population health. However, little is known about the mechanisms that underlie the potential impact of health-related Internet use on health outcomes. Based on the three-stage model of health promotion using interactive media, this study empirically tested a moderated mediation pathway model. Results showed that the effect of Internet health information seeking on three health outcomes (general, emotional, and physical) was completely mediated by respondents' access to social support resources. In addition, users' online health information seeking experience positively moderated this mediation path. The findings have significant theoretical and practical implications for the design of Internet-based health promotion resources to improve health outcomes.

  13. Tea and Health: Studies in Humans

    PubMed Central

    Khan, Naghma; Mukhtar, Hasan

    2014-01-01

    Tea, next to water is the cheapest beverage humans consume. Drinking the beverage tea has been considered a health-promoting habit since ancient times. The modern medicinal research is providing a scientific basis for this belief. The evidence supporting the health benefits of tea drinking grows stronger with each new study that is published in the scientific literature. Tea plant Camellia sinensis has been cultivated for thousands of years and its leaves have been used for medicinal purposes. Tea is used as a popular beverage worldwide and its ingredients are now finding medicinal benefits. Encouraging data showing cancer-preventive effects of green tea from cell-culture, animal and human studies have emerged. Evidence is accumulating that black tea may have similar beneficial effects. Tea consumption has also been shown to be useful for prevention of many debilitating human diseases that include maintenance of cardiovascular and metabolic health. Various studies suggest that polyphenolic compounds present in green and black tea are associated with beneficial effects in prevention of cardiovascular diseases, particularly of atherosclerosis and coronary heart disease. In addition, anti-aging, antidiabetic and many other health beneficial effects associated with tea consumption are described. Evidence is accumulating that catechins and theaflavins, which are the main polyphenolic compounds of green and black tea, respectively, are responsible for most of the physiological effects of tea. This article describes the evidences from clinical and epidemiological studies in the prevention of chronic diseases like cancer and cardiovascular diseases and general health promotion associated with tea consumption. PMID:23448443

  14. Studying Health Outcomes in Farmworker Populations Exposed to Pesticides

    PubMed Central

    McCauley, Linda A.; Anger, W. Kent; Keifer, Matthew; Langley, Rick; Robson, Mark G.; Rohlman, Diane

    2006-01-01

    A major goal of studying farmworkers is to better understand how their work environment, including exposure to pesticides, affects their health. Although a number of health conditions have been associated with pesticide exposure, clear linkages have yet to be made between exposure and health effects except in cases of acute pesticide exposure. In this article, we review the most common health end points that have been studied and describe the epidemiologic challenges encountered in studying these health effects of pesticides among farmworkers, including the difficulties in accessing the population and challenges associated with obtaining health end point data. The assessment of neurobehavioral health effects serves as one of the most common and best examples of an approach used to study health outcomes in farmworkers and other populations exposed to pesticides. We review the current limitations in neurobehavioral assessment and strategies to improve these analytical methods. Emerging techniques to improve our assessment of health effects associated with pesticide exposure are reviewed. These techniques, which in most cases have not been applied to farmworker populations, hold promise in our ability to study and understand the relationship between pesticide exposure and a variety of health effects in this population. PMID:16760000

  15. Mental Health Services in Pilot Study Areas: Report on a European Study.

    ERIC Educational Resources Information Center

    World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

    The World Health Organization (WHO) conducted a study to collect data on mental health resources of pilot areas within several European countries. This report presents data from the study and provides a detailed and reliable description of the development of mental health services within the WHO European Region. Part I of the report describes the…

  16. Cohort studies in health sciences librarianship.

    PubMed

    Eldredge, Jonathan

    2002-10-01

    What are the key characteristics of the cohort study design and its varied applications, and how can this research design be utilized in health sciences librarianship? The health, social, behavioral, biological, library, earth, and management sciences literatures were used as sources. All fields except for health sciences librarianship were scanned topically for either well-known or diverse applications of the cohort design. The health sciences library literature available to the author principally for the years 1990 to 2000, supplemented by papers or posters presented at annual meetings of the Medical Library Association. A narrative review for the health, social, behavioral, biological, earth, and management sciences literatures and a systematic review for health sciences librarianship literature for the years 1990 to 2000, with three exceptions, were conducted. The author conducted principally a manual search of the health sciences librarianship literature for the years 1990 to 2000 as part of this systematic review. The cohort design has been applied to answer a wide array of theoretical or practical research questions in the health, social, behavioral, biological, and management sciences. Health sciences librarianship also offers several major applications of the cohort design. The cohort design has great potential for answering research questions in the field of health sciences librarianship, particularly evidence-based librarianship (EBL), although that potential has not been fully explored.

  17. [Stewardship of public health surveillance in the health system in Colombia: a case study].

    PubMed

    López, Yolanda Lucía; González, Claudia; Gallego, Berta Natalia; Moreno, Ana Lida

    2009-12-01

    With the reform of the Colombian health system in 1993, public health surveillance continued to be a governmental responsibility under the stewardship of the Ministry of Social Protection along with state and local health authorities. The effectiveness of the development and organization of state and municipality public health surveillance programs will be studied as they have evolved under the general social security system in Colombia. Qualitative study and case-study method are applied to several institutions as they function in 5 states and 11 counties, ten years after the health system reforms. Public health authorities have reduced resources for providing advice, technical assistance, supervision and control of the process of the public health surveillance. Weaknesses in administrative control are common. Quantity and quality of human resources, as well as, staffing and financial resources are inadequate to meet the responsibilities that have been assigned to each state and county. The public health surveillance has prioritized the notification and registration of cases, and the strength of development of particular areas occasionally has been subject to the particular interests of officials in charge, particularly in the public hospitals. Little commitment or interest is shown by mayors, insurance companies, and institutions providing health services that are supposed to be involved with monitoring. A lack of cross-institutional collaboration is apparent in the development of health services surveillance. The implementation of public health surveillance at state and local levels is weak due to problems with the governmental stewardship. These weaknesses are manifested in the lack of regulation, financing and control of the health system.

  18. A systematic review of health promotion intervention studies in the police force: study characteristics, intervention design and impacts on health.

    PubMed

    MacMillan, Freya; Karamacoska, Diana; El Masri, Aymen; McBride, Kate A; Steiner, Genevieve Z; Cook, Amelia; Kolt, Gregory S; Klupp, Nerida; George, Emma S

    2017-12-01

    To systematically review studies of health promotion intervention in the police force. Four databases were searched for articles reporting on prepost single and multigroup studies in police officers and trainees. Data were extracted and bias assessed to evaluate study characteristics, intervention design and the impact of interventions on health. Database searching identified 25 articles reporting on 21 studies relevant to the aims of this review. Few studies (n=3) were of long duration (≥6 months). Nine of 21 studies evaluated structured physical activity and/or diet programmes only, 5 studies used education and behaviour change support-only interventions, 5 combined structured programmes with education and behaviour change support, and 2 studies used computer prompts to minimise sedentary behaviour. A wide array of lifestyle behaviour and health outcomes was measured, with 11/13 multigroup and 8/8 single-group studies reporting beneficial impacts on outcomes. High risk of bias was evident across most studies. In those with the lowest risk of bias (n=2), a large effect on blood pressure and small effects on diet, sleep quality, stress and tobacco use, were reported. Health promotion interventions can impact beneficially on health of the police force, particularly blood pressure, diet, sleep, stress and tobacco use. Limited reporting made comparison of findings challenging. Combined structured programmes with education and behaviour change support and programmes including peer support resulted in the most impact on health-related outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study

    PubMed Central

    McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

    2018-01-01

    Background The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. Objective This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. Methods A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Results Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. Conclusions The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development

  20. Health visiting assessment--unpacking critical attributes in health visitor needs assessment practice: a case study.

    PubMed

    Appleton, Jane V; Cowley, Sarah

    2008-02-01

    Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.

  1. Healthy Sex and Sexual Health: New Directions for Studying Outcomes of Sexual Health

    ERIC Educational Resources Information Center

    Lefkowitz, Eva S.; Vasilenko, Sara A.

    2014-01-01

    Sexual behavior is an important aspect of adolescent development with implications for well-being. These chapters highlight important perspectives on studying sexual health from a normative, developmental perspective, such as viewing a range of sexual behaviors as life events; considering potentially positive physical health, mental health, social…

  2. Situating mobile health: a qualitative study of mHealth expectations in the rural health district of Nouna, Burkina Faso.

    PubMed

    Duclos, Vincent; Yé, Maurice; Moubassira, Kagoné; Sanou, Hamidou; Sawadogo, N Hélène; Bibeau, Gilles; Sié, Ali

    2017-07-12

    The implementation of mobile health (mHealth) projects in low- and middle-income countries raises high and well-documented expectations among development agencies, policymakers and researchers. By contrast, the expectations of direct and indirect mHealth users are not often examined. In preparation for a proposed intervention in the Nouna Health District, in rural Burkina Faso, this study investigates the expected benefits, challenges and limitations associated with mHealth, approaching these expectations as a form of situated knowledge, inseparable from local conditions, practices and experiences. The study was conducted within the Nouna Health District. We used a qualitative approach, and conducted individual semi-structured interviews and group interviews (n = 10). Participants included healthcare workers (n = 19), godmothers (n = 24), pregnant women (n = 19), women with children aged 12-24 months (n = 33), and women of childbearing age (n = 92). Thematic and content qualitative analyses were conducted. Participants expect mHealth to help retrieve patients lost to follow-up, improve maternal care monitoring, and build stronger relationships between pregnant women and primary health centres. Expected benefits are not reducible to a technological realisation (sending messages), but rather point towards a wider network of support. mHealth implementation is expected to present considerable challenges, including technological barriers, organisational challenges, gender issues, confidentiality concerns and unplanned aftereffects. mHealth is also expected to come with intrinsic limitations, to be found as obstacles to maternal care access with which pregnant women are confronted and on which mHealth is not expected to have any significant impact. mHealth expectations appear as situated knowledges, inseparable from local health-related experiences, practices and constraints. This problematises universalistic approaches to mHealth knowledge, while nevertheless hinting at

  3. Employee health benefit redesign at the academic health center: a case study.

    PubMed

    Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L

    2013-03-01

    The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign.

  4. Associations between Self-medication, Health Literacy, and Self-perceived Health Status: A Community-Based Study.

    PubMed

    Kamran, Aziz; Sharifirad, Gholamreza; Shafaeei, Yousef; Mohebi, Siamak

    2015-01-01

    Although the frequency of self-medication has been well-documented in the public health literature, but no study has examined the relationship between health literacy and self-medication yet. This study was aimed to investigating the relationship between health literacy and self-medication in a community-based study. This cross-sectional study was conducted on 924 adults to survey association between health literacy and self-medication among peoples in Ardabil city in 2014 who were selected using a multi-stage random sampling method. Health literacy was measured by the test of functional health literacy in adults and general health status was measured by the 12-item General Health Questionnaire, and self-reported self-medication (overall, sedative, antibiotic and herbal) in last 3 months was assessed. All statistical analysis was performed using the SPSS version 18 and a P < 0.05 was considered significant. The mean age and weight of respondents were 37 years and 74.7 kg, respectively. The prevalence of self-medication was 61.6%, and the percentage of self-administering antibiotics, sedative, and herbal medicines were 40%, 54.4%, and 59.1% in the last 3 months, respectively. Significant relationship was found between of total health literacy and general health status with self-medication. The prevalence of self-medication among participants with poor and very poor self-rated physical and mental health was significantly higher than other participants (P < 0.001). Self-medication had a significant relationship with health literacy and health status. Therefore, the design and implementation of training programs are necessary to increase the perception on the risk of self-medication.

  5. Health in older cat and dog owners: The Nord-Trondelag Health Study (HUNT)-3 study.

    PubMed

    Enmarker, Ingela; Hellzén, Ove; Ekker, Knut; Berg, Ann-Grethe

    2012-12-01

    The main objective was to compare older male and female cat, dog, and non-owners with regard to demographic and health-related characteristics. Data in the present cross-sectional population study were drawn from HUNT-3 in Norway. A total of 12,297 persons (5631 men; 6666 women) between the ages of 65 and 101 years were included, of whom 2358 were pet owners. The main finding was that owning a dog demonstrated several health-related characteristics to a higher positive degree than both non-pet and cat ownership among the participants. Cat owners showed higher body mass index values and higher systolic blood pressure, and reported worse general health status. They also exercised to a lower degree than the others. As the result implies that older cat owners are negatively outstanding in many aspects of health compared with the dog owners, in the future, more focus must be put on the worse health of those. Further, there were more married male than female cat and dog owners. This probably depends on traditional cultural thinking; the man is the owner of the pet even if the woman lives with and cares about it. It is important to point out that different groups in the population might select different pets. Consequently, the findings showing a correlation between pet ownership and health may be owing to unrelated confounding factors.

  6. Women Empowerment through Health Information Seeking: A Qualitative Study

    PubMed Central

    Nikbakht Nasrabadi, Alireza; Sabzevari, Sakineh; Negahban Bonabi, Tayebeh

    2015-01-01

    Background Today, women empowering is an important issue.  Several methods have been introduced to empower women. Health information seeking is one of the most important activities in this regard. A wide range of capabilities have been reported as outcomes of health information seeking in several studies. As health information seeking is developed within personal-social interactions and also the health system context, it seems that the qualitative paradigm is appropriate to use in studies in this regard. This study aimed to explore how women’s empowerment through health information seeking is done. Methods In this qualitative content analysis study, data collection was done with regard to inclusion criteria, through purposive sampling by semi-structured interviews with 17 women and using documentation and field notes until data saturation. Qualitative data analysis was done constantly and simultaneous with data collection. Results Four central themes were emerged to explain women’s empowerment through health information seeking that included: a) Health concerns management with three subcategories of Better coping, Stress management, Control of situation, b) Collaborative care with two subcategories of Effective interaction with health professions and Participation in health decision making c) Individual development d) Self-protection with four sub- categories of Life style modification,  Preventive behaviors promoting, Self-care promoting, and  medication adherence. Conclusion The results of this study indicate the importance of women empowerment through foraging their health information seeking rights and comprehensive health information management. PMID:26005690

  7. Health promotion activities of sports clubs and coaches, and health and health behaviours in youth participating in sports clubs: the Health Promoting Sports Club study

    PubMed Central

    Kokko, Sami; Selänne, Harri; Alanko, Lauri; Heinonen, Olli J; Korpelainen, Raija; Savonen, Kai; Vasankari, Tommi; Kannas, Lasse; Kujala, Urho M; Aira, Tuula; Villberg, Jari; Parkkari, Jari

    2015-01-01

    Introduction Sports clubs form a potential setting for health promotion, but the research is limited. The aim of the Health Promoting Sports Club (HPSC) study was to elucidate the current health promotion activities of youth sports clubs and coaches, and to investigate the health behaviours and health status of youth participating in sports clubs compared to non-participants. Methods and analysis The study design employs cross-sectional multilevel and multimethod research with aspirations to a prospective cohort study in the next phase. The setting-based variables at sports clubs and coaching levels, and health behaviour variables at the individual level, are investigated using surveys; and total levels of physical activity are assessed using objective accelerometer measurements. Health status variables will be measured by preparticipation screening. The health promotion activity of sports clubs (n=154) is evaluated by club officials (n=313) and coaches (n=281). Coaches and young athletes aged 14–16 (n=759) years evaluate the coaches’ health promotion activity. The survey of the adolescents’ health behaviours consist of two data sets—the first is on their health behaviours and the second is on musculoskeletal complaints and injuries. Data are collected via sports clubs (759 participants) and schools 1650 (665 participants and 983 non-participants). 591 (418 athletes and 173 non-athletes) youth, have already participated in preparticipation screening. Screening consists of detailed personal medical history, electrocardiography, flow-volume spirometry, basic laboratory analyses and health status screening, including posture, muscle balance, and static and dynamic postural control tests, conducted by sports and exercise medicine specialists. Ethics and dissemination The HPSC study is carried out conforming with the declaration of Helsinki. Ethical approval was received from the Ethics Committee of Health Care District of Central Finland. The HPSC study is

  8. Health promotion activities of sports clubs and coaches, and health and health behaviours in youth participating in sports clubs: the Health Promoting Sports Club study.

    PubMed

    Kokko, Sami; Selänne, Harri; Alanko, Lauri; Heinonen, Olli J; Korpelainen, Raija; Savonen, Kai; Vasankari, Tommi; Kannas, Lasse; Kujala, Urho M; Aira, Tuula; Villberg, Jari; Parkkari, Jari

    2015-01-01

    Sports clubs form a potential setting for health promotion, but the research is limited. The aim of the Health Promoting Sports Club (HPSC) study was to elucidate the current health promotion activities of youth sports clubs and coaches, and to investigate the health behaviours and health status of youth participating in sports clubs compared to non-participants. The study design employs cross-sectional multilevel and multimethod research with aspirations to a prospective cohort study in the next phase. The setting-based variables at sports clubs and coaching levels, and health behaviour variables at the individual level, are investigated using surveys; and total levels of physical activity are assessed using objective accelerometer measurements. Health status variables will be measured by preparticipation screening. The health promotion activity of sports clubs (n=154) is evaluated by club officials (n=313) and coaches (n=281). Coaches and young athletes aged 14-16 (n=759) years evaluate the coaches' health promotion activity. The survey of the adolescents' health behaviours consist of two data sets-the first is on their health behaviours and the second is on musculoskeletal complaints and injuries. Data are collected via sports clubs (759 participants) and schools 1650 (665 participants and 983 non-participants). 591 (418 athletes and 173 non-athletes) youth, have already participated in preparticipation screening. Screening consists of detailed personal medical history, electrocardiography, flow-volume spirometry, basic laboratory analyses and health status screening, including posture, muscle balance, and static and dynamic postural control tests, conducted by sports and exercise medicine specialists. The HPSC study is carried out conforming with the declaration of Helsinki. Ethical approval was received from the Ethics Committee of Health Care District of Central Finland. The HPSC study is close-to-practice, which generates foundations for development work

  9. Methodological issues in oral health research: intervention studies.

    PubMed

    O'Mullane, Denis; James, Patrice; Whelton, Helen; Parnell, Carmel

    2012-02-01

    To provide a broad overview of methodological issues in the design and evaluation of intervention studies in dental public health, with particular emphasis on explanatory trials, pragmatic trials and complex interventions. We present a narrative summary of selected publications from the literature outlining both historical and recent challenges in the design and evaluation of intervention studies and describe some recent tools that may help researchers to address these challenges. It is now recognised that few intervention studies in dental public health are purely explanatory or pragmatic. We describe the PRECIS tool which can be used by trialists to assess and display the position of their trial on a continuum between the extremes of explanatory and pragmatic trials. The tool aims to help trialists make design decisions that are in line with their stated aims. The increasingly complex nature of dental public health interventions presents particular design and evaluation challenges. The revised Medical Research Council (MRC) guidance for the development and evaluation of complex interventions which emphasises the importance of planning and process evaluation is a welcome development. We briefly describe the MRC guidance and outline some examples of complex interventions in the field of oral health. The role of observational studies in monitoring public health interventions when the conduct of RCTs is not appropriate or feasible is acknowledged. We describe the STROBE statement and outline the implications of the STROBE guidelines for dental public health. The methodological challenges in the design, conduct and reporting of intervention studies in oral health are considerable. The need to provide reliable evidence to support innovative new strategies in oral health policy is a major impetus in these fields. No doubt the 'Methodological Issues in Oral Health Research' group will have further opportunities to highlight this work. © 2012 John Wiley & Sons A/S.

  10. Epidemiological Study of Greek University Students' Mental Health

    ERIC Educational Resources Information Center

    Kounenou, Kalliope; Koutra, Aikaterini; Katsiadrami, Aristea; Diacogiannis, Georgios

    2011-01-01

    In the present study, 805 Greek students participated by filling in self-report questionnaires studying depression (Center for Epidemiological Studies Depression Scale), general health status (General Health Questionnaire), general psychopathology (Symptom Checklist-90-R), and personal demographic features. Some of the more prevalent findings…

  11. The Norwegian Institute of Public Health Twin Study of Mental Health: Examining Recruitment and Attrition Bias

    PubMed Central

    Tambs, Kristian; Rønning, Torbjørn; Prescott, C. A.; Kendler, Kenneth S.; Reichborn-Kjennerud, Ted; Torgersen, Svenn; Harris, Jennifer R.

    2009-01-01

    All Norwegian twin pairs born 1967–1974 and still living in Norway in 1992 were invited to a health questionnaire study (Q1). 2,570 pairs (65%) participated. These cohorts and the twin cohorts born 1967–1979 were invited to a new questionnaire study (Q2) in 1998. This time 3,334 pairs (53%) participated. Almost all pairs having participated in the 1998 study were invited to an interview study of mental health (MHS), taking place 1999–2004. 1,391 complete pairs (44%) participated. The questionnaire studies included extensive data on somatic health with fewer items on mental health and demography. Health-related and demographic information available from the Medical Birth Registry on all invited twins was applied to predict participation to the first study. A few registry variables indicating poor health predicted nonparticipation in Q1. Health information and demography from Q1 were tested as predictors of participation in the follow-up study (Q2). Monozygosity, female sex, being unmarried, having no children, and high education predicted participation, whereas few indicators of poor mental and somatic health and unhealthy lifestyle moderately predicted nonparticipation in Q2. No health indicators reported in Q2 predicted further participation. Standard genetic twin analyses of indicators of various mental disorders from Q2, validated by diagnostic data from the MHS, did not indicate differences in genetic/environmental covariance structures between participants and nonparticipants in MHS. In general the results show a moderate selection towards good mental and somatic health. Attrition from Q2 to the MHS does not appear to affect twin analyses of mental health related variables. PMID:19335186

  12. Health literacy among Saudi population: a cross-sectional study.

    PubMed

    Abdel-Latif, Mohamed M M; Saad, Sherif Y

    2017-09-12

    Health literacy is a major problem worldwide and adversely affects an individual's health. The aim of the present study was to assess health literacy level among Saudi population. A cross-sectional study was conducted among a randomly selected population (n = 500) in Saudi Arabia. The questionnaire comprised of questions pertaining to demographic characteristics, health literacy and health information. Health literacy was measured by REALM-R test. Internal reliability was determined using Cronbach's alpha coefficient. The majority of the respondents had intermediate (43.8%) and basic (34.4%) health literacy levels. A higher percentage among men had intermediate (59.8%) and basic (70.93%) health literacy levels compared with women. About 30% of respondents had difficulty in understanding health screening tests and disease treatment. More than half of participants (52.4%) had difficulty in finding health information. The REALM-R test revealed that about 42.6% of individuals with score of >6 had adequate health literacy compared with 57.4% with score of ≤6 had inadequate health literacy. The present study demonstrated that a majority of Saudi individuals had inadequate health literacy that associated with poor knowledge of health information. Our findings highlighted the importance of understanding the status of health literacy among Saudis and the need for educational programs to raise the health literacy awareness among Saudi population. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. [Health literacy of adults in Germany: Findings from the German Health Update (GEDA) study].

    PubMed

    Jordan, Susanne; Hoebel, Jens

    2015-09-01

    In today's information society, health literacy (HL) is considered important for health maintenance and disease management. In this context, dealing with health information is fundamental and requires different cognitive and social skills. The aim of this study was to investigate the distribution of HL levels in the adult population of Germany, and to identify associations with health behaviours and health status. The analyses were based on data from the German Health Update (GEDA) study, a cross-sectional survey of the German-speaking adult population of Germany, which was conducted from October 2013 to June 2014. Health literacy was assessed with the short form of the European Health Literacy Questionnaire (HLS EU-Q16), along with questions about socio-demographics, health behaviours, and health status. The HLS-EU-Q16 index could be calculated for 4845 respondents. According to the criteria of the HLS-EU-Q16, more than half of the adults had "adequate" HL (55.8 %). Every third person (31.9 %) had "problematic" and almost every eighth person (12.3 %) had "inadequate" HL. We found significant differences in HL by educational level, but no differences in HL by sex and age group. Certain health behaviours were positively associated with health literacy. A low HL level was associated with poorer physical and mental health. The results point to a need for action to improve HL in the adult population. The strengthening of health literacy should not solely aim at the promotion of individual skills, but also give high priority to the development of health-literate settings.

  14. Health workers cohort study: methods and study design.

    PubMed

    Denova-Gutiérrez, Edgar; Flores, Yvonne N; Gallegos-Carrillo, Katia; Ramírez-Palacios, Paula; Rivera-Paredez, Berenice; Muñoz-Aguirre, Paloma; Velázquez-Cruz, Rafael; Torres-Ibarra, Leticia; Meneses-León, Joacim; Méndez-Hernández, Pablo; Hernández-López, Rubí; Salazar-Martínez, Eduardo; Talavera, Juan O; Tamayo, Juan; Castañón, Susana; Osuna-Ramírez, Ignacio; León-Maldonado, Leith; Flores, Mario; Macías, Nayeli; Antúnez, Daniela; Huitrón-Bravo, Gerardo; Salmerón, Jorge

    2016-01-01

    To examine different health outcomes that are associated with specific lifestyle and genetic factors. From March 2004 to April 2006, a sample of employees from three different health and academic institutions, as well as their family members, were enrolled in the study after providing informed consent. At baseline and follow-up (2010-2013), participants completed a self-administered questionnaire, a physical examination, and provided blood samples. A total of 10 729 participants aged 6 to 94 years were recruited at baseline. Of these, 70% were females, and 50% were from the Mexican Social Security Institute. Nearly 42% of the adults in the sample were overweight, while 20% were obese. Our study can offer new insights into disease mechanisms and prevention through the analysis of risk factor information in a large sample of Mexicans.

  15. Public health preparedness in Alberta: a systems-level study.

    PubMed

    Moore, Douglas; Shiell, Alan; Noseworthy, Tom; Russell, Margaret; Predy, Gerald

    2006-12-28

    Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  16. An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study.

    PubMed

    Brunner, Melissa; McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

    2018-05-15

    The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs. ©Melissa Brunner, Deborah Mc

  17. The Porto Alegre Early Life Nutrition and Health Study.

    PubMed

    Chaffee, Benjamin Wilk; Vítolo, Márcia Regina; Feldens, Carlos Alberto

    2014-12-01

    Early childhood caries is a persistent worldwide problem. The etiologic contribution of feeding practices has been less frequently investigated in prospective studies of young children. The Porto Alegre Early Life Nutrition and Health Study has followed a birth cohort of 715 mother-child pairs, recruited from municipal health centers, originally involved in a cluster-randomized controlled trial of healthcare worker training. The birth cohort links prospectively collected socio-demographic, infant feeding, and general and oral health information. To date, oral health data, including caries status and oral health-related quality of life, have been collected for 458 children at the age of 2-3 years. Studies are underway to investigate possible determinants and consequences of oral health among these children.

  18. Sociodemographic and health-(care-)related characteristics of online health information seekers: a cross-sectional German study.

    PubMed

    Nölke, Laura; Mensing, Monika; Krämer, Alexander; Hornberg, Claudia

    2015-01-29

    Although the increasing dissemination and use of health-related information on the Internet has the potential to empower citizens and patients, several studies have detected disparities in the use of online health information. This is due to several factors. So far, only a few studies have examined the impact of socio-economic status (SES) on health information seeking on the Internet. This study was designed to identify sociodemographic and health-(care-)related differences between users and non-users of health information gleaned from the Internet with the aim of detecting hard-to-reach target groups. This study analyzed data from the NRW Health Survey LZG.NRW 2011 (n = 2,000; conducted in North Rhine-Westphalia, Germany, via telephone interviews). Logistic regression analysis was used to examine the determinants of online health information seeking behavior. 68% of Internet users refer to the Internet for health-related purposes. Of the independent variables tested, SES proved to exert the strongest influence on searching the Internet for health information. The final multivariate regression model shows that people from the middle (OR: 2.2, 95% CI: 1.6-3.2) and upper (OR: 4.0, 95% CI: 2.7-6.2) social classes are more likely to seek health information on the Internet than those from the lower class. Also, women are more likely to look for health information on the Internet than men (OR: 1.5, 95% CI: 1.1-2.1). Individuals with a migration background are less likely to conduct health searches on the Internet (OR: 0.6, 95% CI: 0.4-0.8). Married people or individuals in a stable relationship search the Internet more often for health information than do singles (OR: 1.9, 95% CI: 1.2-2.9). Also, heavy use of health-care services compared to non-use is associated with a higher likelihood of using the Internet for health-related matters (OR: 1.7, 95% CI: 1.2-2.5). In order to achieve equity in health, health-related Internet use by the socially deprived should be

  19. Health-Promoting Lifestyles Among Health Care Workers in a Postdisaster Area: A Cross-sectional Study.

    PubMed

    Yang, Wanqiu; Sim, Timothy; Cui, Ke; Zhang, Jun; Yang, Yanchun; Ma, Xiaohong

    2018-06-18

    Health care workers performing rescue tasks in large-scale disaster areas are usually challenged in terms of physical and mental endurance, which can affect their lifestyles. Nevertheless, data on whether health care workers tend to adopt healthy lifestyles after disasters are limited. This paper compares the adoption of healthy lifestyle behaviors among health care workers with that among non-health care workers in a postdisaster area. This cross-sectional observational study was conducted in August 2016. The Health-Promoting Lifestyle Profile II questionnaire was used to interview 261 health care workers and 848 non-health care workers. Results of the multivariable linear models showed that health care workers had lower physical activity levels (ß=-1.363, P<.0001), worse stress management (ß=-1.282, P<.0001), slower spiritual growth (ß=-1.228, P=.002), and poorer interpersonal relationships (ß=-0.814, P=.019) than non-health care workers. However, no significant differences were found in either nutrition (ß=-0.362, P=.319) or health responsibility (ß=-0.421, P=.283). Health care workers had less healthy lifestyle behaviors, including physical activity, stress management, spiritual growth, and interpersonal relationships. Further studies are needed to develop health-improving interventions for health care workers in postdisaster areas. (Disaster Med Public Health Preparedness. 2018;page 1 of 6).

  20. 42 CFR 90.7 - Decision to conduct health effects study.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Decision to conduct health effects study. 90.7... ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES § 90.7 Decision to conduct health effects study. (a) ATSDR may decide...

  1. 42 CFR 90.7 - Decision to conduct health effects study.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Decision to conduct health effects study. 90.7... ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES § 90.7 Decision to conduct health effects study. (a) ATSDR may decide...

  2. Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations.

    PubMed

    Bronkhorst, Babette; Tummers, Lars; Steijn, Bram; Vijverberg, Dominique

    2015-01-01

    In recent years, the high prevalence of mental health problems among health care workers has given rise to great concern. The academic literature suggests that employees' perceptions of their work environment can play a role in explaining mental health outcomes. We conducted a systematic review of the literature in order to answer the following two research questions: (1) how does organizational climate relate to mental health outcomes among employees working in health care organizations and (2) which organizational climate dimension is most strongly related to mental health outcomes among employees working in health care organizations? Four search strategies plus inclusion and quality assessment criteria were applied to identify and select eligible studies. As a result, 21 studies were included in the review. Data were extracted from the studies to create a findings database. The contents of the studies were analyzed and categorized according to common characteristics. Perceptions of a good organizational climate were significantly associated with positive employee mental health outcomes such as lower levels of burnout, depression, and anxiety. More specifically, our findings indicate that group relationships between coworkers are very important in explaining the mental health of health care workers. There is also evidence that aspects of leadership and supervision affect mental health outcomes. Relationships between communication, or participation, and mental health outcomes were less clear. If health care organizations want to address mental health issues among their staff, our findings suggest that organizations will benefit from incorporating organizational climate factors in their health and safety policies. Stimulating a supportive atmosphere among coworkers and developing relationship-oriented leadership styles would seem to be steps in the right direction.

  3. The Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) Study: Self-Reported Health Effects.

    PubMed

    Croisant, Sharon A; Lin, Yu-Li; Shearer, Joseph J; Prochaska, John; Phillips-Savoy, Amanda; Gee, James; Jackson, Daniel; Panettieri, Reynold A; Howarth, Marilyn; Sullivan, John; Black, Bishop James; Tate, Joi; Nguyen, Dustin; Anthony, Amber; Khan, Asim; Fernando, Harshica; Ansari, G A Shakeel; Rowe, Gilbert; Howrey, Bret; Singleton, Chantele; Elferink, Cornelis

    2017-10-31

    The Deepwater Horizon (DWH) explosion in 2010 is the largest oil spill (Macondo) in U.S. We focused on gaining an understanding of the physical health and mental health effects attributable to the Macondo oil spill. This is a report of a cross-sectional cohort study (wave 1) to establish 'baseline' findings and meant to provide descriptive information to be used for a multi-wave, longitudinal study. Gulf Coast Health Alliance: health Risks related to the Macondo Spill (GC-HARMS) uses a Community-Based Participatory Research approach, thus including multi-disciplinary, multi-institutional academic partners and representatives of three communities impacted by the spill. Three research sites were selected for human sampling along the Gulf of Mexico coast including two from Mississippi and one from Louisiana, with Galveston, Texas, serving as a comparison site, given that it was not directly impacted by the spill. One hundred participants were selected from each community, representing adults, seniors and children, with approximately equal numbers of males and females in each group. Participants completed initial assessments including completion of a 'baseline' survey and, rigorous physical assessments. Results from wave 1 data collection reported herein reveal changes in self-reported physical health and mental health status following the oil spill, disparities in access to healthcare, and associations between mental health and emotional conditions related to displacement/unemployment. Few environmental health studies have been conducted in communities impacted by significant oil spills. Results imply potential prolonged effects on mental health and community vulnerability.

  4. Headteachers' prior beliefs on child health and their engagement in school based health interventions: a qualitative study.

    PubMed

    Todd, Charlotte; Christian, Danielle; Davies, Helen; Rance, Jaynie; Stratton, Gareth; Rapport, Frances; Brophy, Sinead

    2015-04-18

    Schools play an important role in promoting the health of children. However, little consideration is often given to the influence that headteachers' and school staff's prior beliefs have on the implementation of public health interventions. This study examined primary school headteachers' and school health co-ordinators' views regarding child health in order to provide greater insights on the school's perspective for those designing future school-based health interventions. A qualitative study was conducted using 19 semi-structured interviews with headteachers, deputy headteachers and school health co-ordinators in the primary school setting. All transcripts were analysed using thematic analysis. Whilst many participants in this study believed good health was vital for learning, wide variance was evident regarding the perceived health of school pupils and the magnitude of responsibility schools should take in addressing child health behaviours. Although staff in this study acknowledged the importance of their role, many believed the responsibility placed upon schools for health promotion was becoming too much; suggesting health interventions need to better integrate school, parental and societal components. With mental health highlighted as an increasing priority in many schools, incorporating wellbeing outcomes into future school based health interventions is advocated to ensure a more holistic understanding of child health is gained. Understanding the health beliefs of school staff when designing interventions is crucial as there appears to be a greater likelihood of interventions being successfully adopted if staff perceive a health issue as important among their pupils. An increased dependability on schools for addressing health was expressed by headteachers in this study, highlighting a need for better understanding of parental, child and key stakeholder perspectives on responsibility for child health. Without this understanding, there is potential for certain

  5. Health-care users, key community informants and primary health care workers' views on health, health promotion, health assets and deficits: qualitative study in seven Spanish regions.

    PubMed

    Pons-Vigués, Mariona; Berenguera, Anna; Coma-Auli, Núria; Pombo-Ramos, Haizea; March, Sebastià; Asensio-Martínez, Angela; Moreno-Peral, Patricia; Mora-Simón, Sara; Martínez-Andrés, Maria; Pujol-Ribera, Enriqueta

    2017-06-13

    Although some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention. A descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out. Health-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants' profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having

  6. From the School Health Education Study to the National Health Education Standards: Concepts Endure

    ERIC Educational Resources Information Center

    Nobiling, Brandye D.; Lyde, Adrian R.

    2015-01-01

    Background: The landmark School Health Education Study (SHES) project influenced by the conceptual approach to teaching and learning provides perspective on modern school health instruction. Conceptual education, the cornerstone of the SHES curriculum framework (CF), "Health Education: A Conceptual Approach to Curriculum Design," fosters…

  7. ASSESSING EXPOSURE CLASSIFICATION IN THE AGRICULTURAL HEALTH STUDY

    EPA Science Inventory

    The Agricultural Health Study (AHS) is a prospective epidemiologic study examining cancer and non-cancer health outcomes for over 55,000 pesticide applicators and 34,000 spouses in Iowa and North Carolina. Questionnaires were used to collect information about the use of specific ...

  8. Prioritising public health: a qualitative study of decision making to reduce health inequalities.

    PubMed

    Orton, Lois C; Lloyd-Williams, Ffion; Taylor-Robinson, David C; Moonan, May; O'Flaherty, Martin; Capewell, Simon

    2011-10-20

    The public health system in England is currently facing dramatic change. Renewed attention has recently been paid to the best approaches for tackling the health inequalities which remain entrenched within British society and across the globe. In order to consider the opportunities and challenges facing the new public health system in England, we explored the current experiences of those involved in decision making to reduce health inequalities, taking cardiovascular disease (CVD) as a case study. We conducted an in-depth qualitative study employing 40 semi-structured interviews and three focus group discussions. Participants were public health policy makers and planners in CVD in the UK, including: Primary Care Trust and Local Authority staff (in various roles); General Practice commissioners; public health academics; consultant cardiologists; national guideline managers; members of guideline development groups, civil servants; and CVD third sector staff. The short term target- and outcome-led culture of the NHS and the drive to achieve "more for less", combined with the need to address public demand for acute services often lead to investment in "downstream" public health intervention, rather than the "upstream" approaches that are most effective at reducing inequalities. Despite most public health decision makers wishing to redress this imbalance, they felt constrained due to difficulties in partnership working and the over-riding influence of other stakeholders in decision making processes. The proposed public health reforms in England present an opportunity for public health to move away from the medical paradigm of the NHS. However, they also reveal a reluctance of central government to contribute to shifting social norms. It is vital that the effectiveness and cost effectiveness of all new and existing policies and services affecting public health are measured in terms of their impact on the social determinants of health and health inequalities. Researchers

  9. Prioritising public health: a qualitative study of decision making to reduce health inequalities

    PubMed Central

    2011-01-01

    Background The public health system in England is currently facing dramatic change. Renewed attention has recently been paid to the best approaches for tackling the health inequalities which remain entrenched within British society and across the globe. In order to consider the opportunities and challenges facing the new public health system in England, we explored the current experiences of those involved in decision making to reduce health inequalities, taking cardiovascular disease (CVD) as a case study. Methods We conducted an in-depth qualitative study employing 40 semi-structured interviews and three focus group discussions. Participants were public health policy makers and planners in CVD in the UK, including: Primary Care Trust and Local Authority staff (in various roles); General Practice commissioners; public health academics; consultant cardiologists; national guideline managers; members of guideline development groups, civil servants; and CVD third sector staff. Results The short term target- and outcome-led culture of the NHS and the drive to achieve "more for less", combined with the need to address public demand for acute services often lead to investment in "downstream" public health intervention, rather than the "upstream" approaches that are most effective at reducing inequalities. Despite most public health decision makers wishing to redress this imbalance, they felt constrained due to difficulties in partnership working and the over-riding influence of other stakeholders in decision making processes. The proposed public health reforms in England present an opportunity for public health to move away from the medical paradigm of the NHS. However, they also reveal a reluctance of central government to contribute to shifting social norms. Conclusions It is vital that the effectiveness and cost effectiveness of all new and existing policies and services affecting public health are measured in terms of their impact on the social determinants of health

  10. Improving work functioning and mental health of health care employees using an e-mental health approach to workers' health surveillance: pretest-posttest study.

    PubMed

    Ketelaar, Sarah M; Nieuwenhuijsen, Karen; Bolier, Linda; Smeets, Odile; Sluiter, Judith K

    2014-12-01

    Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p < 0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26). The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

  11. Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest–Posttest Study

    PubMed Central

    Ketelaar, Sarah M.; Nieuwenhuijsen, Karen; Bolier, Linda; Smeets, Odile; Sluiter, Judith K.

    2014-01-01

    Background Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. Methods We applied a pretest–posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. Results One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p < 0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26). Conclusion The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement. PMID:25516815

  12. The Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) Study: Self-Reported Health Effects

    PubMed Central

    Croisant, Sharon A.; Lin, Yu-li; Shearer, Joseph J.; Prochaska, John; Phillips-Savoy, Amanda; Gee, James; Jackson, Daniel; Panettieri, Reynold A.; Howarth, Marilyn; Sullivan, John; Black, Bishop James; Tate, Joi; Nguyen, Dustin; Anthony, Amber; Khan, Asim; Fernando, Harshica; Ansari, G. A. Shakeel; Rowe, Gilbert; Singleton, Chantele; Elferink, Cornelis

    2017-01-01

    The Deepwater Horizon (DWH) explosion in 2010 is the largest oil spill (Macondo) in U.S. history. We focused on gaining an understanding of the physical health and mental health effects attributable to the Macondo oil spill. This is a report of a cross-sectional cohort study (wave 1) to establish ‘baseline’ findings and meant to provide descriptive information to be used for a multi-wave, longitudinal study. Gulf Coast Health Alliance: health Risks related to the Macondo Spill (GC-HARMS) uses a Community-Based Participatory Research approach, thus including multi-disciplinary, multi-institutional academic partners and representatives of three communities impacted by the spill. Three research sites were selected for human sampling along the Gulf of Mexico coast including two from Mississippi and one from Louisiana, with Galveston, Texas, serving as a comparison site, given that it was not directly impacted by the spill. One hundred participants were selected from each community, representing adults, seniors and children, with approximately equal numbers of males and females in each group. Participants completed initial assessments including completion of a ‘baseline’ survey and, rigorous physical assessments. Results from wave 1 data collection reported herein reveal changes in self-reported physical health and mental health status following the oil spill, disparities in access to healthcare, and associations between mental health and emotional conditions related to displacement/unemployment. Few environmental health studies have been conducted in communities impacted by significant oil spills. Results imply potential prolonged effects on mental health and community vulnerability. PMID:29088124

  13. Children's views of health: a developmental study.

    PubMed Central

    Natapoff, J N

    1978-01-01

    Two hundred and sixty-four first, fourth, and seventh grade children were asked to define health, state what it felt like to be healthy and not healthy, and to give criteria they would use to judge another person's health status. A chi square analysis was done to compare differences for age, sex, intelligence, and socioeconomic status. Results indicated that children saw health as a positive attribute which enabled them to participate in desired activities, that a person was healthy if he could do what he wanted to do, and that health and illness were two different cncepts rather than on a continuum as is often cited in the literature. Mental health was not considered as part of being healthy except by a few of the oldest children. There were both qualitative and quantitative changes with age which were consistent with theories of concept development. It is recommended that future studies be conducted with both adults and health workers. (There is some evidence that consumers and health professionals do not have the same ideas about health.) PMID:717611

  14. Structural issues affecting mixed methods studies in health research: a qualitative study

    PubMed Central

    2009-01-01

    Background Health researchers undertake studies which combine qualitative and quantitative methods. Little attention has been paid to the structural issues affecting this mixed methods approach. We explored the facilitators and barriers to undertaking mixed methods studies in health research. Methods Face-to-face semi-structured interviews with 20 researchers experienced in mixed methods research in health in the United Kingdom. Results Structural facilitators for undertaking mixed methods studies included a perception that funding bodies promoted this approach, and the multidisciplinary constituency of some university departments. Structural barriers to exploiting the potential of these studies included a lack of education and training in mixed methods research, and a lack of templates for reporting mixed methods articles in peer-reviewed journals. The 'hierarchy of evidence' relating to effectiveness studies in health care research, with the randomised controlled trial as the gold standard, appeared to pervade the health research infrastructure. Thus integration of data and findings from qualitative and quantitative components of mixed methods studies, and dissemination of integrated outputs, tended to occur through serendipity and effort, further highlighting the presence of structural constraints. Researchers are agents who may also support current structures - journal reviewers and editors, and directors of postgraduate training courses - and thus have the ability to improve the structural support for exploiting the potential of mixed methods research. Conclusion The environment for health research in the UK appears to be conducive to mixed methods research but not to exploiting the potential of this approach. Structural change, as well as change in researcher behaviour, will be necessary if researchers are to fully exploit the potential of using mixed methods research. PMID:20003210

  15. Structural issues affecting mixed methods studies in health research: a qualitative study.

    PubMed

    O'Cathain, Alicia; Nicholl, Jon; Murphy, Elizabeth

    2009-12-09

    Health researchers undertake studies which combine qualitative and quantitative methods. Little attention has been paid to the structural issues affecting this mixed methods approach. We explored the facilitators and barriers to undertaking mixed methods studies in health research. Face-to-face semi-structured interviews with 20 researchers experienced in mixed methods research in health in the United Kingdom. Structural facilitators for undertaking mixed methods studies included a perception that funding bodies promoted this approach, and the multidisciplinary constituency of some university departments. Structural barriers to exploiting the potential of these studies included a lack of education and training in mixed methods research, and a lack of templates for reporting mixed methods articles in peer-reviewed journals. The 'hierarchy of evidence' relating to effectiveness studies in health care research, with the randomised controlled trial as the gold standard, appeared to pervade the health research infrastructure. Thus integration of data and findings from qualitative and quantitative components of mixed methods studies, and dissemination of integrated outputs, tended to occur through serendipity and effort, further highlighting the presence of structural constraints. Researchers are agents who may also support current structures - journal reviewers and editors, and directors of postgraduate training courses - and thus have the ability to improve the structural support for exploiting the potential of mixed methods research. The environment for health research in the UK appears to be conducive to mixed methods research but not to exploiting the potential of this approach. Structural change, as well as change in researcher behaviour, will be necessary if researchers are to fully exploit the potential of using mixed methods research.

  16. Is Health Education at University Associated with Students' Health Literacy? Evidence from Cross-Sectional Study Applying HLS-EU-Q

    PubMed Central

    Ossowsky, Zbigniew Marcin

    2017-01-01

    Background Despite the large number of studies assessing health literacy, little research has been conducted with young adults. Since health literacy is related to the setting in which health information is provided, our study aim was to measure health literacy competencies in a sample of university students and to evaluate the relationships between these competencies and their university health education. Methods A total of 912 university students (aged 18–24 years) completed the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). Results Perceived difficulties with health information were related to gender, with male students reporting significantly lower health literacy scores. Studying more health education-related subjects was associated with a higher health literacy competency, due to these students' higher rates of accessing and understanding health information in the health promotion domain. Conclusion Health literacy among young adult university students is insufficient. The subjects they study are related to their university health education; in particular, the number of health-related subjects they study is positively related to students' health promotion domain-based competencies. PMID:29130048

  17. Employment status and perceived health in the Hordaland Health Study (HUSK)

    PubMed Central

    Overland, Simon; Glozier, Nicholas; Mæland, John Gunnar; Aarø, Leif Edvard; Mykletun, Arnstein

    2006-01-01

    Background Most western countries have disability benefit schemes ostensibly based upon requiring (1) a work inhibiting functional limitation that (2) can be attributed to a diagnosable condition, injury or disease. The present paper examines to what extent current practice matches the core premises of this model by examining how much poorer the perceived health of disability benefit recipients is, compared to the employed and the unemployed, and further to examine to what extent any poorer perceived health among benefit recipients can be attributed to mental or somatic illness and symptoms. Methods Information on disability benefit recipiency was obtained from Norwegian registry data, and merged with health information from the Hordaland Health Study (HUSK) in Western Norway, 1997–99. Participants (N = 14 946) aged 40–47 were assessed for perceived physical and mental health (Short Form-12), somatic symptoms, mental health, and self reported somatic conditions and diseases treated with medication. Differences associated with employment status were tested in chi-square and t-tests, as well as multivariate and univariate regression models to adjust for potential confounders. Results Recipients of disability benefits (n = 1 351) had poorer perceived physical and mental health than employees (n = 13 156); group differences were 1.86 and 0.74 pooled standard deviations respectively. Self reported somatic diagnoses, mental health and symptoms accounted for very little of this difference in perceived health. The unemployed (n = 439) were comparable to the employed rather than the recipients of disability benefits. Conclusion Recipients of disability benefits have poor perceived health compared to both the employed and the unemployed. Surprisingly little of this difference can be ascribed to respondents' descriptions of their illnesses and symptoms. Even allowing for potential underascertainment of condition severity, this finding supports the increasing focus on non

  18. Linkage of the Canadian Study of Health and Aging to provincial administrative health care databases in Nova Scotia.

    PubMed

    Yip, A M; Kephart, G; Rockwood, K

    2001-01-01

    The Canadian Study of Health and Aging (CSHA) was a cohort study that included 528 Nova Scotian community-dwelling participants. Linkage of CSHA and provincial Medical Services Insurance (MSI) data enabled examination of health care utilization in this subsample. This article discusses methodological and ethical issues of database linkage and explores variation in the use of health services by demographic variables and health status. Utilization over 24 months following baseline was extracted from MSI's physician claims, hospital discharge abstracts, and Pharmacare claims databases. Twenty-nine subjects refused consent for access to their MSI file; health card numbers for three others could not be retrieved. A significant difference in healthcare use by age and self-rated health was revealed. Linkage of population-based data with provincial administrative health care databases has the potential to guide health care planning and resource allocation. This process must include steps to ensure protection of confidentiality. Standard practices for linkage consent and routine follow-up should be adopted. The Canadian Study of Health and Aging (CSHA) began in 1991-92 to explore dementia, frailty, and adverse health outcomes (Canadian Study of Health and Aging Working Group, 1994). The original CSHA proposal included linkage to provincial administrative health care databases by the individual CSHA study centers to enhance information on health care utilization and outcomes of study participants. In Nova Scotia, the Medical Services Insurance (MSI) administration, which drew the sampling frame for the original CSHA, did not retain the list of corresponding health card numbers. Furthermore, consent for this access was not asked of participants at the time of the first interview. The objectives of this study reported here were to examine the feasibility and ethical considerations of linking data from the CSHA to MSI utilization data, and to explore variation in health

  19. Marriage and Health in the Transition to Adulthood: Evidence for African Americans in the Add Health Study

    ERIC Educational Resources Information Center

    Harris, Kathleen Mullan; Lee, Hedwig; DeLeone, Felicia Yang

    2010-01-01

    This article explores the relationships among early marriage (before age 26 years), cohabitation, and health for African Americans and Whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). The study examines three categories of health outcomes relevant to young adulthood: physical…

  20. The Kilauea Volcano adult health study.

    PubMed

    Longo, Bernadette M

    2009-01-01

    Millions of people reside near active volcanoes, yet data are limited on effects to human health. The Kilauea Volcano is the largest point source for sulfur dioxide in the United States, releasing air pollution on nearby communities since 1983. : The objectives of this study were to provide the first population-based epidemiological estimates and qualitative descriptions of cardiorespiratory health effects associated with volcanic air pollution. An environmental-epidemiological design was used. Exposure levels of Kilauea's air pollutants were determined by environmental sampling. Prevalence estimates of cardiorespiratory health effects in adults were measured (N = 335) and compared between an exposed and nonexposed reference community. Descriptions of the human-environment interaction with the long-standing eruption were recorded from informants in the natural setting. Ambient and indoor concentrations of volcanic air pollution were above the World Health Organization's recommended exposure levels. There were statistically significant increased odds associated with exposure for self-reported cough, phlegm, rhinorrhea, sore and dry throat, sinus congestion, wheezing, eye irritation, and diagnosed bronchitis. Thirty-five percent of the informants perceived that their health was affected by the eruption, mainly current and former smokers and those with chronic respiratory disease. Hypotheses were supported regarding particulate air pollution and the association with adverse cardiovascular functioning. This emerging environmental health issue is under continuing investigation.

  1. Does involvement in a cohort study improve health and affect health inequalities? A natural experiment.

    PubMed

    Quick, Annie; Böhnke, Jan R; Wright, John; Pickett, Kate E

    2017-01-25

    Evidence suggests that the process of taking part in health research can improve participants' health, independent of any intended intervention. However, no research has yet explored whether these effects differ across socioeconomic groups. If the effect of mere participation in health research also has a social gradient this could increase health inequalities and bias research results. This study used the Born in Bradford family cohort (BIB) to explore whether simply taking part in BIB had improved participants' health and, if so, whether this effect was mediated by socioeconomic status. Survey data on self-reported health behaviours were collected between 2007 and 2010 as part of BIB. These were augmented by clinical data on birth weight. Pregnant women on their second pregnancy, joining BIB for the first time formed the control group. Their health was compared to women on their second pregnancy who had both pregnancies within the study, who formed the exposed group. In order to limit the inherent bias in a non-randomised study, propensity score analysis was used, matching on age, ethnicity, education and date of questionnaire. The results were then compared according to mothers' education. Of six outcomes tested, only alcohol consumption showed a statistically significant reduction with exposure to BIB (OR: 0.35, 95% CIs 0.13, 0.92). Although effect estimates were larger for women with higher education compared to lower education, these effects were not statistically significant. Despite one significant finding, these results overall are insufficient to conclude that simply taking part in BIB affected participants' health. We recommend that socioeconomic status is considered in future studies testing effects of research participation, and that randomised studies with larger sample sizes are conducted.

  2. The Georgia Health Education Study: A Summary Report.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. Dept. of Health and Safety.

    This summary review of the Georgia Health Education Study is a statistical presentation of scores achieved by over four thousand freshman college students in the university system of Georgia to questions on health knowledge. Data compiled from the administration of the Fast-Tyson Health Knowledge Test (1975 revision) indicates that subject…

  3. Health Literacy among Adults: A Study from Turkey

    ERIC Educational Resources Information Center

    Ozdemir, H.; Alper, Z.; Uncu, Y.; Bilgel, N.

    2010-01-01

    Patients' health literacy is increasingly recognized as a critical factor affecting health communication and outcomes. We performed this study to assess the levels of health literacy by using Rapid Estimate of Adult Literacy in Medicine (REALM) and Newest Vital Sign (NVS) instruments. Patients (n = 456) at a family medicine clinic completed…

  4. The Impact of an eHealth Portal on Health Care Professionals’ Interaction with Patients: Qualitative Study

    PubMed Central

    Faxvaag, Arild; Svanæs, Dag

    2015-01-01

    Background People who undergo weight loss surgery require a comprehensive treatment program to achieve successful outcomes. eHealth solutions, such as secure online portals, create new opportunities for improved health care delivery and care, but depend on the organizational delivery systems and on the health care professionals providing it. So far, these have received limited attention and the overall adoption of eHealth solutions remains low. In this study, a secure eHealth portal was implemented in a bariatric surgery clinic and offered to their patients. During the study period of 6 months, 60 patients and 5 health care professionals had access. The portal included patient information, self-management tools, and communication features for online dialog with peers and health care providers at the bariatric surgery clinic. Objective The aim of this study was to characterize and assess the impact of an eHealth portal on health care professionals’ interaction with patients in bariatric surgery. Methods This qualitative case study involved a field study consisting of contextual interviews at the clinic involving observing and speaking with personnel in their actual work environment. Semi-structured in-depth interviews were conducted with health care professionals who interacted with patients through the portal. Analysis of the collected material was done inductively using thematic analysis. Results The analysis revealed two main dimensions of using an eHealth portal in bariatric surgery: the transparency it represents and the responsibility that follows by providing it. The professionals reported the eHealth portal as (1) a source of information, (2) a gateway to approach and facilitate the patients, (3) a medium for irrevocable postings, (4) a channel that exposes responsibility and competence, and (5) a tool in the clinic. Conclusions By providing an eHealth portal to patients in a bariatric surgery program, health care professionals can observe patients

  5. The Impact of an eHealth Portal on Health Care Professionals' Interaction with Patients: Qualitative Study.

    PubMed

    Das, Anita; Faxvaag, Arild; Svanæs, Dag

    2015-11-24

    People who undergo weight loss surgery require a comprehensive treatment program to achieve successful outcomes. eHealth solutions, such as secure online portals, create new opportunities for improved health care delivery and care, but depend on the organizational delivery systems and on the health care professionals providing it. So far, these have received limited attention and the overall adoption of eHealth solutions remains low. In this study, a secure eHealth portal was implemented in a bariatric surgery clinic and offered to their patients. During the study period of 6 months, 60 patients and 5 health care professionals had access. The portal included patient information, self-management tools, and communication features for online dialog with peers and health care providers at the bariatric surgery clinic. The aim of this study was to characterize and assess the impact of an eHealth portal on health care professionals' interaction with patients in bariatric surgery. This qualitative case study involved a field study consisting of contextual interviews at the clinic involving observing and speaking with personnel in their actual work environment. Semi-structured in-depth interviews were conducted with health care professionals who interacted with patients through the portal. Analysis of the collected material was done inductively using thematic analysis. The analysis revealed two main dimensions of using an eHealth portal in bariatric surgery: the transparency it represents and the responsibility that follows by providing it. The professionals reported the eHealth portal as (1) a source of information, (2) a gateway to approach and facilitate the patients, (3) a medium for irrevocable postings, (4) a channel that exposes responsibility and competence, and (5) a tool in the clinic. By providing an eHealth portal to patients in a bariatric surgery program, health care professionals can observe patients' writings and revelations thereby capturing patient

  6. One Health and EcoHealth in Ontario: a qualitative study exploring how holistic and integrative approaches are shaping public health practice in Ontario

    PubMed Central

    2012-01-01

    Background There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario. The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Methods Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Results Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Conclusions Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health

  7. One Health and EcoHealth in Ontario: a qualitative study exploring how holistic and integrative approaches are shaping public health practice in Ontario.

    PubMed

    Leung, Zee; Middleton, Dean; Morrison, Karen

    2012-05-16

    There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario.The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health actors interviewed in this study. This

  8. Telecourse Study Guide to "Here's to Your Health."

    ERIC Educational Resources Information Center

    Richards, Donna

    This study guide was prepared to accompany "Here's to Your Health," a telecourse focusing on lifestyle factors influencing health, which was designed to provide the tools necessary for achieving and maintaining an optimal, healthy lifestyle. For each of 27 lessons, the study guide presents learning objectives, an overview of content, study…

  9. Income and health in Accra, Ghana: results from a time use and health study.

    PubMed

    Fink, Günther; Weeks, John R; Hill, Allan G

    2012-10-01

    This paper uses newly collected household survey data from Accra, Ghana, to investigate whether incomes affect acute and chronic health outcomes in settings that can be considered representative for the large and rapidly growing urban centers of sub-Saharan Africa. The Time Use and Health Study in Accra collected information on incomes, current health status, and health care use from 5,484 persons in 1,250 households, each repeatedly sampled on a rolling basis for a period of 13 weeks. Data collection took place during September 2008-March 2010 to capture seasonal variations. The study found that incomes varied widely between households, and that a high fraction of persons lived below the poverty line. Despite this level of income poverty and an overall remarkably high burden of treatable disease, no systematic differences in self-reported and objectively measured health conditions were detected across socioeconomic groups.

  10. Social Capital and Health: A Review of Prospective Multilevel Studies

    PubMed Central

    Murayama, Hiroshi; Fujiwara, Yoshinori; Kawachi, Ichiro

    2012-01-01

    Background This article presents an overview of the concept of social capital, reviews prospective multilevel analytic studies of the association between social capital and health, and discusses intervention strategies that enhance social capital. Methods We conducted a systematic search of published peer-reviewed literature on the PubMed database and categorized studies according to health outcome. Results We identified 13 articles that satisfied the inclusion criteria for the review. In general, both individual social capital and area/workplace social capital had positive effects on health outcomes, regardless of study design, setting, follow-up period, or type of health outcome. Prospective studies that used a multilevel approach were mainly conducted in Western countries. Although we identified some cross-sectional multilevel studies that were conducted in Asian countries, including Japan, no prospective studies have been conducted in Asia. Conclusions Prospective evidence from multilevel analytic studies of the effect of social capital on health is very limited at present. If epidemiologic findings on the association between social capital and health are to be put to practical use, we must gather additional evidence and explore the feasibility of interventions that build social capital as a means of promoting health. PMID:22447212

  11. Social capital and health: a review of prospective multilevel studies.

    PubMed

    Murayama, Hiroshi; Fujiwara, Yoshinori; Kawachi, Ichiro

    2012-01-01

    This article presents an overview of the concept of social capital, reviews prospective multilevel analytic studies of the association between social capital and health, and discusses intervention strategies that enhance social capital. We conducted a systematic search of published peer-reviewed literature on the PubMed database and categorized studies according to health outcome. We identified 13 articles that satisfied the inclusion criteria for the review. In general, both individual social capital and area/workplace social capital had positive effects on health outcomes, regardless of study design, setting, follow-up period, or type of health outcome. Prospective studies that used a multilevel approach were mainly conducted in Western countries. Although we identified some cross-sectional multilevel studies that were conducted in Asian countries, including Japan, no prospective studies have been conducted in Asia. Prospective evidence from multilevel analytic studies of the effect of social capital on health is very limited at present. If epidemiologic findings on the association between social capital and health are to be put to practical use, we must gather additional evidence and explore the feasibility of interventions that build social capital as a means of promoting health.

  12. Health Auctions: a Valuation Experiment (HAVE) study protocol.

    PubMed

    Kularatna, Sanjeewa; Petrie, Dennis; Scuffham, Paul A; Byrnes, Joshua

    2016-04-07

    Quality-adjusted life years are derived using health state utility weights which adjust for the relative value of living in each health state compared with living in perfect health. Various techniques are used to estimate health state utility weights including time-trade-off and standard gamble. These methods have exhibited limitations in terms of complexity, validity and reliability. A new composite approach using experimental auctions to value health states is introduced in this protocol. A pilot study will test the feasibility and validity of using experimental auctions to value health states in monetary terms. A convenient sample (n=150) from a population of university staff and students will be invited to participate in 30 auction sets with a group of 5 people in each set. The 9 health states auctioned in each auction set will come from the commonly used EQ-5D-3L instrument. At most participants purchase 2 health states, and the participant who acquires the 2 'best' health states on average will keep the amount of money they do not spend in acquiring those health states. The value (highest bid and average bid) of each of the 24 health states will be compared across auctions to test for reliability across auction groups and across auctioneers. A test retest will be conducted for 10% of the sample to assess reliability of responses for health states auctions. Feasibility of conducting experimental auctions to value health states will also be examined. The validity of estimated health states values will be compared with published utility estimates from other methods. This pilot study will explore the feasibility, reliability and validity in using experimental auction for valuing health states. Ethical clearance was obtained from Griffith University ethics committee. The results will be disseminated in peer-reviewed journals and major international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

  13. SHPPS 2006: School Health Policies and Programs Study--Food Safety

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of food safety, covering the following topics: (1) Health Education; (2) Health Services; and (3)…

  14. The German Young Olympic Athletes' Lifestyle and Health Management Study (GOAL Study): design of a mixed-method study

    PubMed Central

    2011-01-01

    Background In order to perform at top levels, elite athletes have to both protect and risk their health at the same time. Adolescent elite athletes have the additional challenge of coping with substantial physical, psychological and social transformations. The contradictory phenomenon of protecting and risking the adolescent athletes' health in sports challenges the development of health promotion and protection strategies. The GOAL Study (German Young Olympic Athletes' Lifestyle and Health Management Study) analyzes the individual and organizational management of health in adolescent elite sports. Methods/design We combine quantitative and qualitative approaches in a mixed-method study. This allows us to gather a broad range of representative information on squad athletes from all Olympic disciplines as well as in-depth information on four selected Olympic disciplines (artistic gymnastics, biathlon, handball and wrestling). Within the quantitative section we attempt to identify the young athletes' health and nutrition behavior, their subjective health state and their lay health representations, health-related social networks, and structures of medical attendance. 1138 national team level athletes born between 1992 and 1995 from 51 Olympic disciplines responded to the questionnaire (response rate: 61,75%). The qualitative section investigates the meaning and relevance of health and nutrition within the athletes' sports specific surroundings, the impact of biographic backgrounds on individual health behavior, and sports specific cultures of health, nutrition and risk. We interviewed 24 athletes and 28 coaching and medical experts, and carried out 14 multi-day participant observations at training sessions and competitions. Conclusions The studies' results will serve as the basis for developing tailored health promotion strategies to be in cooperation with German elite sports associations. PMID:21627777

  15. Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study

    PubMed Central

    Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

    2018-01-01

    Background The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. Objective We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. Methods We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. Results This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was

  16. INTERIM RESULTS FROM THE AGRICULTURAL HEALTH STUDY/PESTICIDE EXPOSURE STUDY

    EPA Science Inventory

    The Agricultural Health Study (AHS) is a prospective epidemiological study of pesticide applicators and their spouses in Iowa and North Carolina. Exposure to 2,4-D or chlorpyrifos is being measured for a subset of applicators in the AHS Pesticide Exposure Study to assess expos...

  17. Gaps in studies of global health education: an empirical literature review

    PubMed Central

    Liu, Yan; Zhang, Ying; Liu, Zhaolan; Wang, JianLi

    2015-01-01

    Background Global health has stimulated a lot of students and has attracted the interest of many faculties, thereby initiating the establishment of many academic programs on global health research and education. global health education reflects the increasing attention toward social accountability in medical education. Objective This study aims to identify gaps in the studies on global health education. Design A critical literature review of empirical studies was conducted using Boolean search techniques. Results A total of 238 articles, including 16 reviews, were identified. There had been a boom in the numbers of studies on global health education since 2010. Four gaps were summarized. First, 94.6% of all studies on global health education were conducted in North American and European countries, of which 65.6% were carried out in the United States, followed by Canada (14.3%) and the United Kingdom (9.2%). Only seven studies (2.9%) were conducted in Asian countries, five (2.1%) in Oceania, and two (0.8%) in South American/Caribbean countries. A total of 154 studies (64.4%) were qualitative studies and 64 studies (26.8%) were quantitative studies. Second, elective courses and training or programs were the most frequently used approach for global health education. Third, there was a gap in the standardization of global health education. Finally, it was mainly targeted at medical students, residents, and doctors. It had not granted the demands for global health education of all students majoring in medicine-related studies. Conclusions Global health education would be a potentially influential tool for achieving health equity, reducing health disparities, and also for future professional careers. It is the time to build and expand education in global health, especially among developing countries. Global health education should be integrated into primary medical education. Interdisciplinary approaches and interprofessional collaboration were recommended. Collaboration

  18. Gaps in studies of global health education: an empirical literature review.

    PubMed

    Liu, Yan; Zhang, Ying; Liu, Zhaolan; Wang, JianLi

    2015-01-01

    Global health has stimulated a lot of students and has attracted the interest of many faculties, thereby initiating the establishment of many academic programs on global health research and education. global health education reflects the increasing attention toward social accountability in medical education. This study aims to identify gaps in the studies on global health education. A critical literature review of empirical studies was conducted using Boolean search techniques. A total of 238 articles, including 16 reviews, were identified. There had been a boom in the numbers of studies on global health education since 2010. Four gaps were summarized. First, 94.6% of all studies on global health education were conducted in North American and European countries, of which 65.6% were carried out in the United States, followed by Canada (14.3%) and the United Kingdom (9.2%). Only seven studies (2.9%) were conducted in Asian countries, five (2.1%) in Oceania, and two (0.8%) in South American/Caribbean countries. A total of 154 studies (64.4%) were qualitative studies and 64 studies (26.8%) were quantitative studies. Second, elective courses and training or programs were the most frequently used approach for global health education. Third, there was a gap in the standardization of global health education. Finally, it was mainly targeted at medical students, residents, and doctors. It had not granted the demands for global health education of all students majoring in medicine-related studies. Global health education would be a potentially influential tool for achieving health equity, reducing health disparities, and also for future professional careers. It is the time to build and expand education in global health, especially among developing countries. Global health education should be integrated into primary medical education. Interdisciplinary approaches and interprofessional collaboration were recommended. Collaboration and support from developed countries in global

  19. 76 FR 48872 - Proposed Collection; Comment Request; The Hispanic Community Health Study (HCHS)/Study of Latinos...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... Request; The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) SUMMARY: In compliance with the...: Hispanic Community Health Study (HCHS)/ Study of Latinos (SOL). Type of Information Collection Request... Health Study (HCHS)/Study of Latinos (SOL) will identify risk factors for cardiovascular and lung disease...

  20. 40 CFR 720.90 - Data from health and safety studies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Data from health and safety studies... Data from health and safety studies. (a) Information other than specific chemical identity. Except as... information included in a health and safety study, unless the information would disclose confidential business...

  1. 40 CFR 720.90 - Data from health and safety studies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Data from health and safety studies... Data from health and safety studies. (a) Information other than specific chemical identity. Except as... information included in a health and safety study, unless the information would disclose confidential business...

  2. 40 CFR 720.90 - Data from health and safety studies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Data from health and safety studies... Data from health and safety studies. (a) Information other than specific chemical identity. Except as... information included in a health and safety study, unless the information would disclose confidential business...

  3. 40 CFR 720.90 - Data from health and safety studies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Data from health and safety studies... Data from health and safety studies. (a) Information other than specific chemical identity. Except as... information included in a health and safety study, unless the information would disclose confidential business...

  4. Study Guide for TCT in Health Education.

    ERIC Educational Resources Information Center

    Wilks, Barbara

    This study guide was specifically designed for individuals preparing to take the Georgia Teacher Certification Test (TCT) in health education. The test covers eight subareas: (1) personal health; (2) nutrition; (3) human growth and development; (4) human sexuality and family living; (5) drugs; (6) safety, first aid, and emergency treatment; (7)…

  5. Social mobility and health in the Turin longitudinal study.

    PubMed

    Cardano, Mario; Costa, Giuseppe; Demaria, Moreno

    2004-04-01

    One of the most controversial explanations of class inequalities in health is the health selection hypothesis or drift hypothesis which suggests there is a casual link between the health status of individuals and their chances of social mobility, both inter- and intra-generational. This study tests this hypothesis, and tries to answer three related questions: (a) to what extent does health status influence the chances of intra-generational mobility of individuals? (b) what is the impact on health inequalities of the various kinds of social mobility (both mobility in the labour market and exit from employment)-do they increase or reduce inequalities? (c) to what extent does health-related intra-generational social mobility contribute to the production of health inequalities? The data analysed in this paper were drawn from the records of the Turin Longitudinal Study, which was set up to monitor health inequality of the Turin population by combining census data, population registry records and medical records. Occupational mobility was observed during the decade 1981-1991. To evaluate the impact of the various processes of social mobility on health inequalities, mortality was observed over the period 1991-1999. The study population consists of men and women aged 25-49 at the beginning of mortality follow-up (1991), and registered as resident in Turin at both the 1981 and the 1991 censuses (N = 127,384). Health status was determined by observing hospital admission. For the purpose of the study healthy individuals were those with no hospital admissions during the period 1984-1986, while those admitted were classed as unhealthy. Social mobility in the labour market was measured via an interval data index of upward and downward movements on a scale of social desirability of occupations, designed for the Italian labour force via an empirical study carried out by de Lillo and Schizzerotto (La valutazione sociale delle occupazioni. Una scala di stratificazione occupazionale

  6. Health coaching for glaucoma care: a pilot study using mixed methods

    PubMed Central

    Vin, Anita; Schneider, Suzanne; Muir, Kelly W; Rosdahl, Jullia A

    2015-01-01

    Introduction Adherence to glaucoma medications is essential for successful treatment of the disease but is complex and difficult for many of our patients. Health coaching has been used successfully in the treatment of other chronic diseases. This pilot study explores the use of health coaching for glaucoma care. Methods A mixed methods study design was used to assess the health coaching intervention for glaucoma patients. The health coaching intervention consisted of four to six health coaching sessions with a certified health coach via telephone. Quantitative measures included demographic and health information, adherence to glaucoma medications (using the visual analog adherence scale and medication event monitoring system), and an exit survey rating the experience. Qualitative measures included a precoaching health questionnaire, notes made by the coach during the intervention, and an exit interview with the subjects at the end of the study. Results Four glaucoma patients participated in the study; all derived benefits from the health coaching. Study subjects demonstrated increased glaucoma drop adherence in response to the coaching intervention, in both visual analog scale and medication event monitoring system. Study subjects’ qualitative feedback reflected a perceived improvement in both eye and general health self-care. The subjects stated that they would recommend health coaching to friends or family members. Conclusion Health coaching was helpful to the glaucoma patients in this study; it has the potential to improve glaucoma care and overall health. PMID:26604666

  7. Army Study Shows Decline In Behavioral Health Stigma

    DTIC Science & Technology

    2012-01-01

    Army Study Shows Decline in Behavioral Health Stigma By Rob McIlvaine Army News Service WASHINGTON, Jan. 20, 2012 - A newly released Army study on...conference yesterday. The three-year study outlines the problem of suicide in the Army and related issues of substance abuse, spouse abuse and child abuse...REPORT TYPE 3. DATES COVERED 00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Army Study Shows Decline In Behavioral Health Stigma 5a. CONTRACT

  8. Review of health information technology usability study methodologies

    PubMed Central

    Bakken, Suzanne

    2011-01-01

    Usability factors are a major obstacle to health information technology (IT) adoption. The purpose of this paper is to review and categorize health IT usability study methods and to provide practical guidance on health IT usability evaluation. 2025 references were initially retrieved from the Medline database from 2003 to 2009 that evaluated health IT used by clinicians. Titles and abstracts were first reviewed for inclusion. Full-text articles were then examined to identify final eligibility studies. 629 studies were categorized into the five stages of an integrated usability specification and evaluation framework that was based on a usability model and the system development life cycle (SDLC)-associated stages of evaluation. Theoretical and methodological aspects of 319 studies were extracted in greater detail and studies that focused on system validation (SDLC stage 2) were not assessed further. The number of studies by stage was: stage 1, task-based or user–task interaction, n=42; stage 2, system–task interaction, n=310; stage 3, user–task–system interaction, n=69; stage 4, user–task–system–environment interaction, n=54; and stage 5, user–task–system–environment interaction in routine use, n=199. The studies applied a variety of quantitative and qualitative approaches. Methodological issues included lack of theoretical framework/model, lack of details regarding qualitative study approaches, single evaluation focus, environmental factors not evaluated in the early stages, and guideline adherence as the primary outcome for decision support system evaluations. Based on the findings, a three-level stratified view of health IT usability evaluation is proposed and methodological guidance is offered based upon the type of interaction that is of primary interest in the evaluation. PMID:21828224

  9. Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study.

    PubMed

    Stein, D J; Koen, N; Donald, K A; Adnams, C M; Koopowitz, S; Lund, C; Marais, A; Myers, B; Roos, A; Sorsdahl, K; Stern, M; Tomlinson, M; van der Westhuizen, C; Vythilingum, B; Myer, L; Barnett, W; Brittain, K; Zar, H J

    2015-08-30

    Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS). We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes. Baseline psychosocial data is presented for mothers (n=634) and fathers (n=75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV. These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Investigating the psychosocial determinants of child health in Africa: the Drakenstein Child Health Study

    PubMed Central

    Stein, DJ; Koen, N; Donald, KA; Adnams, CM; Koopowitz, S; Lund, C; Marais, A; Myers, B; Roos, A; Sorsdahl, K; Stern, M; Tomlinson, M; van der Westhuizen, C; Vythilingum, B; Myer, L; Barnett, W; Brittain, K; Zar, HJ

    2015-01-01

    Background Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS). Methods We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes. Results Baseline psychosocial data is presented for mothers (n = 634) and fathers (n = 75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV. Discussion These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts. PMID:25797842

  11. Study on Situational Influences Perceived in Nursing Discipline on Health Promotion: A Qualitative Study

    PubMed Central

    Hosseini, Meimanat; Ashk Torab, Tahereh; Taghdisi, Mohammad Hossein; Esmaeili Vardanjani, Safar Ali

    2013-01-01

    Introduction and Objectives. Nurses, as behavioral models, play a key role in health promotion, and their attitudes towards health promotion highly influence their health and performance. The aim of this study is to explore nursing students' perception of studies in nursing discipline as a situational influence on health promotion. Materials and Methods. This study was conducted using directed content analysis, by means of 20 deep semistructured interviews with nursing students. The participants were selected on purposive sampling. Data was analyzed by the qualitative content analysis method. All interviews were recorded, transcribed, and reviewed, and all codes were extracted and summarized. The codes were subcategorized on the basis of centralization and were categorized after review of subcategories, and finally, a theme was determined. Findings. The theme of nursing discipline's situational influence on nursing students' health promotion was revealed. This theme consisted of “choosing the field,” “unfavorable environmental factors,” “negative impacts of studies in nursing discipline on health,” “positive effects of studies in nursing discipline on health”, “needs,” “attractiveness (aesthetics),” and “coping with negative situational influences in nursing discipline.” Conclusion. The perception of studies in nursing discipline as a health-promoting behavior is under influence of social environment. Considering the importance of the students' positive perception of the existing situation, it is essential to pay attention to their attitudes and perceptions so that they can provide better services to patients. PMID:24078880

  12. Health promotion in local churches in Victoria: an exploratory study.

    PubMed

    Ayton, Darshini; Manderson, Lenore; Smith, Ben J; Carey, Gemma

    2016-11-01

    Church-based health promotion has increasingly gained attention in strategies to address health disparities. In Australia, we have limited understanding of the role of local churches in health promotion and without this, how they might be involved in meaningful partnerships to tackle public health challenges. The objective of this qualitative study was to explore how churches are involved in health promotion in the state of Victoria. The research involved in-depth interviews with ministers from 30 churches in urban and rural Victoria, and case studies with 10 of these churches to enable further exploration. These case studies, conducted in 2010, included interviews with church staff, focus groups with volunteers, participant observation and document analysis. Analysis was iterative, utilising open, axial and thematic coding. Three different expressions of church - traditional, new modern and emerging - were identified and found to differentiate the levels and types of health promotion activity. Case studies illustrate the different expressions of how church mission influences health promotion activity. The traditional churches were involved particularly in disease screening and health education activities with their own, predominantly older congregation members. The new modern churches tended to have the material and human resources to be harnessed in health promotion activities involving congregation members and others. Emerging churches, in contrast, engaged in broad health-promoting activities, including disease prevention, lifestyle activities and socio-ecological approaches at a community level. These research findings highlight the opportunities and challenges of engaging with local churches in health promotion efforts and public health programmes to address health inequities. © 2015 John Wiley & Sons Ltd.

  13. A report on economic studies of Australian mental health issues.

    PubMed

    Williams, Ruth; Doessel, Darrel

    2006-06-01

    To report on economic studies of Australian mental health issues. Although the international literature on the economics of mental health issues is increasing, and although many Australian studies exist on one comorbid condition of mental illness, namely substance abuse, there are very few empirical studies by economists of Australia's mental health issues.

  14. Social Health Status in Iran: An Empirical Study

    PubMed Central

    AMINI RARANI, Mostafa; RAFIYE, Hassan; KHEDMATI MORASAE, Esmaeil

    2013-01-01

    Background: As social health is a condition-driven, dynamic and fluid concept, it seems necessary to construct and obtain a national and relevant concept of it for every society. Providing an empirical back up for Iran’s concept of social health was the aim of the present study. Methods: This study is an ecologic study in which available data for 30 provinces of Iran in 2007 were analyzed. In order to prove construct validity and obtain a social health index, an exploratory factor analysis was conducted on six indicators of population growth, willful murder, poverty, unemployment, insurance coverage and literacy. Results: Following the factor analysis, two factors of Diathesis (made up of high population growth, poverty, low insurance coverage and illiteracy) and Problem (made up of unemployment and willful murder) were extracted. The diathesis and problem explained 48.6 and 19.6% of social health variance respectively. From provinces, Sistan & Baluchistan had the highest rate of poverty and violence and the lowest rate of literacy and insurance coverage. In terms of social health index, Tehran, Semnan, Isfahan, Bushehr and Mazandaran had the highest ranks while Sistan and Baluchistan, Lurestan, Kohkiloyeh and Kermanshah occupied the lowest ones. Conclusion: There are some differences and similarities between Iranian concept of social health and that of other societies. However, a matter that makes our concept special and different is its attention to population. The increase in literacy rate and insurance coverage along with reduction of poverty, violence and unemployment rates can be the main intervention strategies to improve social health status in Iran. PMID:23515572

  15. Social health status in iran: an empirical study.

    PubMed

    Amini Rarani, Mostafa; Rafiye, Hassan; Khedmati Morasae, Esmaeil

    2013-01-01

    As social health is a condition-driven, dynamic and fluid concept, it seems necessary to construct and obtain a national and relevant concept of it for every society. Providing an empirical back up for Iran's concept of social health was the aim of the present study. This study is an ecologic study in which available data for 30 provinces of Iran in 2007 were analyzed. In order to prove construct validity and obtain a social health index, an exploratory factor analysis was conducted on six indicators of population growth, willful murder, poverty, unemployment, insurance coverage and literacy. Following the factor analysis, two factors of Diathesis (made up of high population growth, poverty, low insurance coverage and illiteracy) and Problem (made up of unemployment and willful murder) were extracted. The diathesis and problem explained 48.6 and 19.6% of social health variance respectively. From provinces, Sistan & Baluchistan had the highest rate of poverty and violence and the lowest rate of literacy and insurance coverage. In terms of social health index, Tehran, Semnan, Isfahan, Bushehr and Mazandaran had the highest ranks while Sistan and Baluchistan, Lurestan, Kohkiloyeh and Kermanshah occupied the lowest ones. There are some differences and similarities between Iranian concept of social health and that of other societies. However, a matter that makes our concept special and different is its attention to population. The increase in literacy rate and insurance coverage along with reduction of poverty, violence and unemployment rates can be the main intervention strategies to improve social health status in Iran.

  16. Health literacy, health empowerment and health information search in the field of MMR vaccination: a cross-sectional study protocol

    PubMed Central

    Diviani, Nicola; Camerini, Anne-Linda; Reinholz, Danuta; Galfetti, Alessandra; Schulz, Peter J

    2012-01-01

    Objectives Although public health offices have a detailed record of the vaccination coverage among adolescents in Switzerland, little is known about the factors that determine the decisions of parents to get their children vaccinated. Based on Schulz & Nakamoto's Extended Health Empowerment Model, the present study aims at surveying parents of adolescents in Ticino (Switzerland) to get insights into the role of health literacy, health empowerment, information search behaviour and potential confounding variables that influence whether adolescents are not at all vaccinated, undervaccinated or fully covered against measles, mumps and rubella (MMR). Methods and analysis A survey including concepts of the Extended Health Empowerment Model will be administered to all families with adolescents attending the third year of middle school in Ticino. Subsequently, survey responses will be matched with actual data on MMR vaccination coverage of adolescents collected from the Cantonal Office of Public Health in Ticino. Discussion The results of this study will allow one to draw more comprehensive conclusions about the factors that play a role in parents’ decisions regarding the vaccination of their children. At the same time, the study will provide useful insights on which are the main issues to be considered when addressing parents (on an interpersonal as well as a mass communication level) regarding the vaccination of their children. PMID:23166139

  17. Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.

    PubMed

    von Thiele Schwarz, Ulrica; Augustsson, Hanna; Hasson, Henna; Stenfors-Hayes, Terese

    2015-02-01

    To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence). Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%). There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity. Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.

  18. The Tuskegee Syphilis Study and women's health.

    PubMed

    Gamble, V N

    1997-01-01

    In May 1997, President Bill Clinton apologized for the Tuskegee Syphilis Study. The President's action underscores that in the 25 years since its public revelation, the study has moved from a singular historical event to a powerful metaphor that symbolizes racism in medicine, misconduct in human research, the arrogance of physicians, and government abuse of black people. The Tuskegee Syphilis Study also has implications for women's health. Discussion of the study usually ignores its impact on the wives of the victims. In addition, African-American women may be more reluctant to participate in clinical trials because of the shadow cast by the syphilis study and other incidents of medical abuse. Finally, the Tuskegee Syphilis Study reminds us that the battle against racism must be an integral part of the campaign to improve women's health.

  19. A mixed methods study of Canadian adolescents’ perceptions of health

    PubMed Central

    Pickett, William; Vandemeer, Eleanor; Taylor, Brian; Davison, Colleen

    2016-01-01

    Health perceptions adopted during childhood lay foundations for adult health trajectories and experiences. This study used a sequential mixed methods design to generate new evidence about child perceptions of health in two samples of Canadian children. A core qualitative study was followed by a complementary quantitative analysis to aid interpretation. Generational theory was used as a lens through which to interpret all data. Findings suggested that good health is perceived as customized and subjective. The strengths and liabilities of these perceptions are discussed, as well as implications for health promotion and prevention strategies. Through intentional consideration of the perspectives of this population group, this study makes both empirical and theoretical contributions to appreciating how cultural environments shape health perceptions. PMID:27741955

  20. Age, mode of conception, health service use and pregnancy health: a prospective cohort study of Australian women

    PubMed Central

    2013-01-01

    Background There is limited evidence about the ways in which maternal age and mode of conception interact with psychological, sociodemographic, health and health service factors in governing pregnancy health. The aim of this study was to establish in what ways maternal age and mode of conception are associated with, health behaviours, health service use and self-rated physical and mental health during pregnancy. Method A prospective cohort study was conducted in a collaboration between universities, infertility treatment services and public and private obstetric hospitals in Melbourne and Sydney, Australia,. Consecutive cohorts of nulliparous English-literate women at least 28 weeks pregnant who had conceived through ART (ARTC) or spontaneously (SC) in three age-groups: 20–30; 31–36 and at least 37 years were recruited. Data were obtained via structured individual telephone interviews and self-report postal questionnaires at recruitment and four months postpartum. Study-specific questions assessed: sociodemographic characteristics; reproductive health; health behaviours and health service use. Standardized instruments assessed physical health: SF 12 Physical Component Score (PCS) and mental health: SF12 Mental Component Score (MCS); State Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale. The main outcome measures were the SF 12 PCS, SF12 MCS scores and pregnancy-related hospital admissions. Results Of 1179 eligible women 791 (67%) participated, 27 had fertility treatment without oocyte retrieval and were excluded and 592/764 (78%) completed all pregnancy assessments. When other factors were controlled speaking a language other than English, having private health insurance and multiple gestation were associated with worse physical health and having private health insurance and better physical health were associated with better mental health. Pregnancy-related hospital admissions were associated with worse physical health and multiple gestation

  1. Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

    PubMed

    Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

    2018-04-18

    The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a

  2. An international Delphi study examining health promotion and health education in nursing practice, education and policy.

    PubMed

    Whitehead, Dean

    2008-04-01

    To arrive at an expert consensus in relation to health promotion and health education constructs as they apply to nursing practice, education and policy. Nursing has often been maligned and criticized, both inside and outside of the profession, for its ability to understand and conduct effective health promotion and health education-related activities. In the absence of an expert-based consensus, nurses may find it difficult to progress beyond the current situation. In the absence of any previously published nursing-related consensus research, this study seeks to fill that knowledge-gap. A two-round Delphi technique via email correspondence. A first-round qualitative questionnaire used open-ended questions for defining health promotion and health education. This was both in general terms and as participants believed these concepts related to the clinical, theoretical (academic/educational) and the policy (political) setting in nursing. Line-by-line qualitative content and thematic analysis of the first-round data generated 13 specific categories. These categories contained 134 statement items. The second-round questionnaire comprised the identified 134 statements. Using a five-point Likert scale (ranging from 1 = strongly disagree to 5 = strongly agree) participants scored and rated their level of agreement/disagreement against the listed items. Data from the second-round was descriptively analysed according to distribution and central tendency measures. An expert consensus was reached on 65 of the original 134 statements. While some minor contradiction was demonstrated, strong consensus emerged around the issues of defining health promotion and health education and the emergence of a wider health promotion and health education role for nursing. No consensus was reached on only one of the 13 identified topic categories - that of 'nurses working with other disciplines and agencies in a health education and health promotion role.' This study provides a hitherto

  3. mHealth Intervention Promoting Cardiovascular Health Among African-Americans: Recruitment and Baseline Characteristics of a Pilot Study

    PubMed Central

    2018-01-01

    Background Mobile health (mHealth) interventions are promising avenues to promote cardiovascular (CV) health among African-Americans (AAs) and culturally tailored technology-based interventions are emerging for this population. Objective The objectives of this study were to use a community-based participatory research (CBPR) approach to recruit AAs into a pilot intervention study of an innovative mHealth CV health promotion program and to characterize technology use patterns and eHealth literacy (EHL). Methods Community partners from five predominately AA churches in southeast Minnesota collaborated with our academic institution to recruit AA congregants into the pilot study. Field notes as well as communications between the study team and community partners were used to design the recruitment strategy and its implementation with a goal of enrolling 50 participants. At its core, the recruitment strategy included community kickoff events to detail the state-of-the-art nature of the mHealth intervention components, the utility of CV health assessments (physical examination, laboratory studies and surveys) and the participants’ role in advancing our understanding of the efficacy of mHealth interventions among racial/ethnic minority groups. Detailed recruitment data were documented throughout the study. A self-administered, electronic survey measured sociodemographics, technology use and EHL (eHEALS scale). Results A total of 50 participants (70% women) from five AA churches were recruited over a one-month period. The majority (>90%) of participants reported using some form of mobile technology with all utilizing these technologies within their homes. Greater than half (60% [30/50]) reported being “very comfortable” with mobile technologies. Overall, participants had high EHL (84.8% [39/46] with eHEALS score ≥26) with no differences by sex. Conclusions This study illustrates the feasibility and success of a CBPR approach in recruiting AAs into mHealth

  4. Health beliefs about bottled water: a qualitative study.

    PubMed

    Ward, Lorna A; Cain, Owen L; Mullally, Ryan A; Holliday, Kathryn S; Wernham, Aaron G H; Baillie, Paul D; Greenfield, Sheila M

    2009-06-19

    There has been a consistent rise in bottled water consumption over the last decade. Little is known about the health beliefs held by the general public about bottled water as this issue is not addressed by the existing quantitative literature. The purpose of this study was to improve understanding of the public's health beliefs concerning bottled mineral water, and the extent to which these beliefs and other views they hold, influence drinking habits. A qualitative study using semi-structured interviews, with 23 users of the Munrow Sports Centre on the University of Birmingham campus. Health beliefs about bottled water could be classified as general or specific beliefs. Most participants believed that bottled water conferred general health benefits but were unsure as to the nature of these. In terms of specific health beliefs, the idea that the minerals in bottled water conferred a health benefit was the most commonly cited. There were concerns over links between the plastic bottle itself and cancer. Participants believed that bottled water has a detrimental effect on the environment. Convenience, cost and taste were influential factors when making decisions as to whether to buy bottled water; health beliefs were unimportant motivating factors. The majority of participants believed that bottled water has some health benefits. However, these beliefs played a minor role in determining bottled water consumption and are unlikely to be helpful in explaining recent trends in bottled water consumption if generalised to the UK population. The health beliefs elicited were supported by scientific evidence to varying extents. Most participants did not feel that bottled water conferred significant, if any, health benefits over tap water.

  5. Health beliefs about bottled water: a qualitative study

    PubMed Central

    Ward, Lorna A; Cain, Owen L; Mullally, Ryan A; Holliday, Kathryn S; Wernham, Aaron GH; Baillie, Paul D; Greenfield, Sheila M

    2009-01-01

    Background There has been a consistent rise in bottled water consumption over the last decade. Little is known about the health beliefs held by the general public about bottled water as this issue is not addressed by the existing quantitative literature. The purpose of this study was to improve understanding of the public's health beliefs concerning bottled mineral water, and the extent to which these beliefs and other views they hold, influence drinking habits. Methods A qualitative study using semi-structured interviews, with 23 users of the Munrow Sports Centre on the University of Birmingham campus. Results Health beliefs about bottled water could be classified as general or specific beliefs. Most participants believed that bottled water conferred general health benefits but were unsure as to the nature of these. In terms of specific health beliefs, the idea that the minerals in bottled water conferred a health benefit was the most commonly cited. There were concerns over links between the plastic bottle itself and cancer. Participants believed that bottled water has a detrimental effect on the environment. Convenience, cost and taste were influential factors when making decisions as to whether to buy bottled water; health beliefs were unimportant motivating factors. Conclusion The majority of participants believed that bottled water has some health benefits. However, these beliefs played a minor role in determining bottled water consumption and are unlikely to be helpful in explaining recent trends in bottled water consumption if generalised to the UK population. The health beliefs elicited were supported by scientific evidence to varying extents. Most participants did not feel that bottled water conferred significant, if any, health benefits over tap water. PMID:19545357

  6. Study protocol for a longitudinal study evaluating the impact of rape on women's health and their use of health services in South Africa.

    PubMed

    Abrahams, Naeemah; Seedat, Soraya; Lombard, Carl; Kengne, Andre P; Myers, Bronwyn; Sewnath, Alesha; Mhlongo, Shibe; Ramjee, Gita; Peer, Nasheeta; Garcia-Moreno, Claudia; Jewkes, Rachel

    2017-09-29

    South Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care. This longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied. The South African Medical Research Council's Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  7. The Boston Puerto Rican Health Study, a longitudinal cohort study on health disparities in Puerto Rican adults: challenges and opportunities

    PubMed Central

    2010-01-01

    Background The Boston Puerto Rican Health Study is an ongoing longitudinal cohort study designed to examine the role of psychosocial stress on presence and development of allostatic load and health outcomes in Puerto Ricans, and potential modification by nutritional status, genetic variation, and social support. Methods Self-identified Puerto Ricans, aged 45-75 years and residing in the Boston, MA metro area, were recruited through door-to-door enumeration and community approaches. Participants completed a comprehensive set of questionnaires and tests. Blood, urine and salivary samples were extracted for biomarker and genetic analysis. Measurements are repeated at a two-year follow-up. Results A total of 1500 eligible participants completed baseline measurements, with nearly 80% two-year follow-up retention. The majority of the cohort is female (70%), and many have less than 8th grade education (48%), and fall below the poverty level (59%). Baseline prevalence of health conditions is high for this age range: considerable physical (26%) and cognitive (7%) impairment, obesity (57%), type 2 diabetes (40%), hypertension (69%), arthritis (50%) and depressive symptomatology (60%). Conclusions The enrollment of minority groups presents unique challenges. This report highlights approaches to working with difficult to reach populations, and describes some of the health issues and needs of Puerto Rican older adults. These results may inform future studies and interventions aiming to improve the health of this and similar communities. PMID:20193082

  8. Provider payment methods and health worker motivation in community-based health insurance: a mixed-methods study.

    PubMed

    Robyn, Paul Jacob; Bärnighausen, Till; Souares, Aurélia; Traoré, Adama; Bicaba, Brice; Sié, Ali; Sauerborn, Rainer

    2014-05-01

    In a community-based health insurance (CBHI) introduced in 2004 in Nouna health district, Burkina Faso, poor perceived quality of care by CBHI enrollees has been a key factor in observed high drop-out rates. The poor quality perceptions have been previously attributed to health worker dissatisfaction with the provider payment method used by the scheme and the resulting financial risk of health centers. This study applied a mixed-methods approach to investigate how health workers working in facilities contracted by the CBHI view the methods of provider payment used by the CBHI. In order to analyze these relationships, we conducted 23 in-depth interviews and a quantitative survey with 98 health workers working in the CBHI intervention zone. The qualitative in-depth interviews identified that insufficient levels of capitation payments, the infrequent schedule of capitation payment, and lack of a payment mechanism for reimbursing service fees were perceived as significant sources of health worker dissatisfaction and loss of work-related motivation. Combining qualitative interview and quantitative survey data in a mixed-methods analysis, this study identified that the declining quality of care due to the CBHI provider payment method was a source of significant professional stress and role strain for health workers. Health workers felt that the following five changes due to the provider payment methods introduced by the CBHI impeded their ability to fulfill professional roles and responsibilities: (i) increased financial volatility of health facilities, (ii) dissatisfaction with eligible costs to be covered by capitation; (iii) increased pharmacy stock-outs; (iv) limited financial and material support from the CBHI; and (v) the lack of mechanisms to increase provider motivation to support the CBHI. To address these challenges and improve CBHI uptake and health outcomes in the targeted populations, the health care financing and delivery model in the study zone should be

  9. Faculty and staff health promotion: results from the School Health Policies and Programs Study 2006.

    PubMed

    Eaton, Danice K; Marx, Eva; Bowie, Sara E

    2007-10-01

    US schools employ an estimated 6.7 million workers and are thus an ideal setting for employee wellness programs. This article describes the characteristics of school employee wellness programs in the United States, including state-, district-, and school-level policies and programs. The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in 49 states plus the District of Columbia and among a nationally representative sample of school districts (n=445). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=873). During the 2 years preceding the study, 67.3% of states provided assistance to districts or schools on how to develop or implement faculty and staff health promotion activities or services. Although nearly all schools offered at least 1 health promotion service or activity, few schools offered coordinated activities and services within a comprehensive employee wellness program. During the 12 months preceding the study, none of the health screenings were offered by more than one third of schools; only a few of the health promotion activities and services were offered by more than one third of schools; about one third of schools offered physical activity programs, employee assistance programs, and subsidies or discounts for off-site health promotion activities; and only 1 in 10 schools provided health-risk appraisals for faculty and staff. More schools should implement comprehensive employee wellness programs to improve faculty and staff health behaviors and health status.

  10. Association Between a Wider Availability of Health Information and Health Care Utilization in Vietnam: Cross-Sectional Study

    PubMed Central

    Nguyen, Hoang Thuy Linh; Seino, Kaoruko; Vo, Van Thang

    2017-01-01

    Background The rapid and widespread development of mass media sources including the Internet is occurring worldwide. Users are being confronted with a flood of health information through a wide availability of sources. Studies on how the availability of health information has triggered users’ interest in utilizing health care services remain limited within the Vietnamese population. Objective This study examined the associations between the wider availability of sources for health information and health care utilization in Vietnam after adjusting for potential confounding variables. Methods The data for this study were drawn from a cross-sectional study conducted over a 6-month period in Hue, a city in central Vietnam. The participants were 993 randomly selected adults aged between 18 and 60 years. Information was collected through face-to-face interviews on the types of information sources that were consulted, including traditional media (television), Internet, and health education courses, as well as the impact of such information on health care use (emergency department visits, hospitalizations, doctor visits). Multivariable logistic regression analyses were performed at a 95% confidence level. Results The prevalence of watching television, using the Internet, and attending health education courses to obtain health information were 50.9% (505/993), 32.9% (327/993), and 8.7% (86/993), respectively. After further adjustments for self-reported health status, the presence of health insurance, and monthly income, respondents who watched television and used the Internet to obtain health information were 1.7 times more likely to visit a doctor (television: adjusted odds ratio [AOR] 1.69, 95% CI 1.30-2.19; Internet: AOR 1.64, 95% CI 1.23-2.19), and also significantly associated with inpatient hospitalization (P=.003). Conclusions The use of widely available mass media sources (eg, television and the Internet) to obtain health information was associated with higher

  11. Adolescents Confusion in Receiving Health Services: A Qualitative Study

    PubMed Central

    Azh, Nezal; Ozgoli, Giti; Ardalan, Gelayol

    2017-01-01

    Introduction Providing health services for adolescents requires exploration of hidden factors from the perspective of adolescents, providers, and key individuals. Understanding the process of providing health services from adolescents point of view will help receiving and continuation of services. Although many studies have been conducted in Iran on adolescents health needs, few studies have dealt with provision of these services to adolescents. Aim The present study aimed to explain the adolescents and key informants’ perception of healthcare provision. Materials and Methods The present qualitative study was conducted according to grounded theory. Data were collected using deep semi-structured individual interviews and group discussion. Participants were selected through purposive sampling followed by theoretical sampling. Participants in present study were 65 adolescents, nine youths (19-24-year-old), and 19 parents and key people involved in providing health services. Adolescents and their parents were selected from different parts of Tehran. Data collection continued until data saturation, and was analysed using Corbin-Strauss (2008) method. Results Issues relating to adolescents perception of the process of providing services included health concerns, society’s inappropriate behaviours, and weakness of the health services system in responding to adolescents needs, which as underlying factors contributed to adolescents confusion in receiving services and their proper coping with puberty. Conclusion Due to lack of education on how to manage puberty by parents, schools, society, and the health system, participating adolescents from Tehran were confused about receiving information and unable to manage puberty problems. Solving this problem requires continuity of services and interaction of family, school and community. PMID:28658809

  12. Study protocol for a longitudinal study evaluating the impact of rape on women’s health and their use of health services in South Africa

    PubMed Central

    Seedat, Soraya; Lombard, Carl; Kengne, Andre P; Myers, Bronwyn; Sewnath, Alesha; Mhlongo, Shibe; Ramjee, Gita; Peer, Nasheeta; Garcia-Moreno, Claudia; Jewkes, Rachel

    2017-01-01

    Introduction South Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care. Methods and analysis This longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied. Ethics and dissemination The South African Medical Research Council’s Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published. PMID:28965098

  13. Internet Use and Preventive Health Behaviors Among Couples in Later Life: Evidence from the Health and Retirement Study.

    PubMed

    Nam, Sangbo; Han, Sae Hwang; Gilligan, Megan

    2018-05-22

    The aim of this study was to examine the link between internet use and preventive health behaviors. We focused on couples to examine whether there were cross-partner associations between internet use and preventive health behaviors. The data for this study came from the 2010 and 2012 waves of the Health and Retirement Study and the sample consisted of 5,143 pairs of coupled-individuals. Preventive health behaviors included cancer screenings (mammogram and prostate tests), cholesterol tests, and flu shots. Logistic multilevel actor-partner interdependence models were employed to test the study hypotheses. Internet use was associated with a higher likelihood of receiving prostate exams and cholesterol tests for husbands, net of demographic and health characteristics, and insurance status. We found that wives' internet use was associated with a higher likelihood of receiving flu shots and prostate exams for husbands, but husbands' internet use was not associated with wives' preventive health behaviors. Research linking internet use and preventive health behaviors is important because such behaviors are associated not only with health of the older population but also with substantial reductions in health care expenditures. Our findings suggested that internet use of older adults is associated with their own preventive health behaviors, as well as their spouses' preventive health behaviors. Interventions and programs to facilitate older adults' preventive health behaviors should consider couple-based approaches.

  14. Self-Esteem, Oral Health Behaviours, and Clinical Oral Health Status in Chinese Adults: An Exploratory Study

    ERIC Educational Resources Information Center

    Chin, Luzy Siu-Hei; Chan, Joanne Chung-Yan

    2013-01-01

    Objectives: This is an exploratory study to examine the relations among self-esteem, oral health behaviours and clinical oral health status in Chinese adults. In addition, gender differences in clinical oral health status and oral health behaviours were explored. Methods: Participants were 192 patients from a private dental clinic in Hong Kong…

  15. Socioeconomic inequalities, health damaging behavior, and self-perceived health in Serbia: a cross-sectional study

    PubMed Central

    Janković, Janko; Janević, Teresa; von dem Knesebeck, Olaf

    2012-01-01

    Aim To analyze the association of socioeconomic factors with self-perceived health in Serbia and examine whether this association can be partly explained by health behavior variables. Methods We used data from the 2007 Living Standards Measurement Study for Serbia. A representative sample of 13 831 persons aged ≥20 years was interviewed. The associations between demographic factors (age, sex, marital status, and type of settlement), socioeconomic factors (education, employment status, and household consumption tertiles), and health behavior variables (smoking, alcohol consumption) and self-perceived health were examined using logistic regression analyses. Results A stepwise gradient was found between education and self-perceived health for the total sample, men, and women. Compared to people with high education, people with low education had a 4.5 times higher chance of assessing their health as poor. Unemployed (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.29-2.10), inactive (OR, 2.82; 95% CI, 2.49-3.19), and the most deprived respondents (OR, 1.17; 95% CI, 1.02-1.34) were more likely to report poor self-perceived health than employed persons and the most affluent group. After adjustment for demographic and health behavior variables, the magnitudes of all associations decreased but remained clearly and significantly graded. Conclusions This study revealed inequalities in self-perceived health by socioeconomic position, in particular educational and employment status. The reduction of such inequalities through wisely tailored interventions that benefit people’s health should be a target of a national health policy in Serbia. PMID:22661139

  16. Health Information Technology Usability Evaluation Scale (Health-ITUES) for Usability Assessment of Mobile Health Technology: Validation Study

    PubMed Central

    Cho, Hwayoung; Liu, Jianfang

    2018-01-01

    Background Mobile technology has become a ubiquitous technology and can be particularly useful in the delivery of health interventions. This technology can allow us to deliver interventions to scale, cover broad geographic areas, and deliver technologies in highly tailored ways based on the preferences or characteristics of users. The broad use of mobile technologies supports the need for usability assessments of these tools. Although there have been a number of usability assessment instruments developed, none have been validated for use with mobile technologies. Objective The goal of this work was to validate the Health Information Technology Usability Evaluation Scale (Health-ITUES), a customizable usability assessment instrument in a sample of community-dwelling adults who were testing the use of a new mobile health (mHealth) technology. Methods A sample of 92 community-dwelling adults living with HIV used a new mobile app for symptom self-management and completed the Health-ITUES to assess the usability of the app. They also completed the Post-Study System Usability Questionnaire (PSSUQ), a widely used and well-validated usability assessment tool. Correlations between these scales and each of the subscales were assessed. Results The subscales of the Health-ITUES showed high internal consistency reliability (Cronbach alpha=.85-.92). Each of the Health-ITUES subscales and the overall scale was moderately to strongly correlated with the PSSUQ scales (r=.46-.70), demonstrating the criterion validity of the Health-ITUES. Conclusions The Health-ITUES has demonstrated reliability and validity for use in assessing the usability of mHealth technologies in community-dwelling adults living with a chronic illness. PMID:29305343

  17. Health Information Technology Usability Evaluation Scale (Health-ITUES) for Usability Assessment of Mobile Health Technology: Validation Study.

    PubMed

    Schnall, Rebecca; Cho, Hwayoung; Liu, Jianfang

    2018-01-05

    Mobile technology has become a ubiquitous technology and can be particularly useful in the delivery of health interventions. This technology can allow us to deliver interventions to scale, cover broad geographic areas, and deliver technologies in highly tailored ways based on the preferences or characteristics of users. The broad use of mobile technologies supports the need for usability assessments of these tools. Although there have been a number of usability assessment instruments developed, none have been validated for use with mobile technologies. The goal of this work was to validate the Health Information Technology Usability Evaluation Scale (Health-ITUES), a customizable usability assessment instrument in a sample of community-dwelling adults who were testing the use of a new mobile health (mHealth) technology. A sample of 92 community-dwelling adults living with HIV used a new mobile app for symptom self-management and completed the Health-ITUES to assess the usability of the app. They also completed the Post-Study System Usability Questionnaire (PSSUQ), a widely used and well-validated usability assessment tool. Correlations between these scales and each of the subscales were assessed. The subscales of the Health-ITUES showed high internal consistency reliability (Cronbach alpha=.85-.92). Each of the Health-ITUES subscales and the overall scale was moderately to strongly correlated with the PSSUQ scales (r=.46-.70), demonstrating the criterion validity of the Health-ITUES. The Health-ITUES has demonstrated reliability and validity for use in assessing the usability of mHealth technologies in community-dwelling adults living with a chronic illness. ©Rebecca Schnall, Hwayoung Cho, Jianfang Liu. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 05.01.2018.

  18. AGRICULTURAL HEALTH STUDY/PESTICIDE EXPOSURE STUDY: YEAR 1 MEASUREMENT RESULTS

    EPA Science Inventory

    The Agricultural Health Study (AHS) is a prospective epidemiologic study of pesticide applicators and their spouses in Iowa and North Carolina. Exposure to targeted applied pesticides (2,4-D or chlorpyrifos) is being measured for a subset of applicators and their families in t...

  19. Tangible evidence, trust and power: public perceptions of community environmental health studies.

    PubMed

    Scammell, Madeleine Kangsen; Senier, Laura; Darrah-Okike, Jennifer; Brown, Phil; Santos, Susan

    2009-01-01

    Communities with environmental health concerns in the USA frequently request studies from their local or state departments of public health. This paper presents findings from three focus groups conducted in communities north of Boston that have been the subject of two different environmental health studies. The focus groups were designed to elicit residents' perceptions of environmental health, and of the particular studies conducted in their communities. In all focus groups, participants had difficulty accepting the findings of health studies that contradicted their own experiences of environmental exposures and illness. Our results suggest that lay knowledge, informed in varying degrees by the experience of what we term "tangible evidence," creates a lens through which communities interpret a health study's findings. The differences in reliance on tangible evidence were related to participants' sense of trust in public officials, and the institutions responsible for conducting health studies. Participants from the wealthier, predominantly white communities discussed trust in study design and methodologies used. In contrast, participants from the lower-income, higher-minority communities assessed health studies with reference to their trust (or lack thereof) in study sponsors and public health institutions. Participants' experience of tangible evidence, trust or distrust in health agencies and research institutions, and a sense of relative community power, influence how they assess the findings of environmental health studies and may have implications for pubic health.

  20. Health effects of employment: a systematic review of prospective studies.

    PubMed

    van der Noordt, Maaike; IJzelenberg, Helma; Droomers, Mariël; Proper, Karin I

    2014-10-01

    The purpose of this review was to systematically summarise the literature on the health effects of employment. A search for prospective studies investigating the effect of employment on health was executed in several electronic databases, and references of selected publications were checked. Subsequently, the methodological quality of each study was assessed by predefined criteria. To draw conclusions about the health effect of employment, a best evidence synthesis was used, and if possible, data were pooled. 33 prospective studies were included, of which 23 were of high quality. Strong evidence was found for a protective effect of employment on depression and general mental health. Pooled effect sizes showed favourable effects on depression (OR=0.52; 95% CI 0.33 to 0.83) and psychological distress (OR=0.79; 95% CI 0.72 to 0.86). Insufficient evidence was found for general health, physical health and mortality due to lack of studies or inconsistent findings. This systematic review indicates that employment is beneficial for health, particularly for depression and general mental health. There is a need for more research on the effects of employment on specific physical health effects and mortality to fill the knowledge gaps. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. EVA Health and Human Performance Benchmarking Study

    NASA Technical Reports Server (NTRS)

    Abercromby, A. F.; Norcross, J.; Jarvis, S. L.

    2016-01-01

    Multiple HRP Risks and Gaps require detailed characterization of human health and performance during exploration extravehicular activity (EVA) tasks; however, a rigorous and comprehensive methodology for characterizing and comparing the health and human performance implications of current and future EVA spacesuit designs does not exist. This study will identify and implement functional tasks and metrics, both objective and subjective, that are relevant to health and human performance, such as metabolic expenditure, suit fit, discomfort, suited postural stability, cognitive performance, and potentially biochemical responses for humans working inside different EVA suits doing functional tasks under the appropriate simulated reduced gravity environments. This study will provide health and human performance benchmark data for humans working in current EVA suits (EMU, Mark III, and Z2) as well as shirtsleeves using a standard set of tasks and metrics with quantified reliability. Results and methodologies developed during this test will provide benchmark data against which future EVA suits, and different suit configurations (eg, varied pressure, mass, CG) may be reliably compared in subsequent tests. Results will also inform fitness for duty standards as well as design requirements and operations concepts for future EVA suits and other exploration systems.

  2. Mortality in the Agricultural Health Study: 1993 - 2007

    EPA Science Inventory

    Comparing agricultural cohorts with the general population is challenging because the general healthiness of farmers may mask potential adverse health effects of farming. Using data from the Agricultural Health Study, a cohort of 89,656 pesticide applicators and their spouses (

  3. RESPIRATORY HEALTH OF RURAL AND FARM WOMEN IN THE KEOKUK COUNTY RURAL HEALTH STUDY

    EPA Science Inventory

    RESPIRATORY HEALTH OF RURAL AND FARM WOMEN IN THE KEOKUK COUNTY RURAL HEALTH STUDY
    Allison L. Naleway*, Nancy L. Sprince?, Erik R. Svendsen?, Ann M. Stromquist?, James A. Merchant?
    *Marshfield Medical Research and Education Foundation, Marshfield, WI; ?University of Iowa Co...

  4. Cohort profile: the Western Australian Sleep Health Study.

    PubMed

    Mukherjee, Sutapa; Hillman, David; Lee, Jessica; Fedson, Annette; Simpson, Laila; Ward, Kim; Love, Gregory; Edwards, Cass; Szegner, Bernadett; Palmer, Lyle John

    2012-03-01

    Epidemiologic and genetic studies of obstructive sleep apnoea (OSA) are limited by a lack of large-scale, well-characterized OSA cohorts. These studies require large sample size to provide adequate power to detect differences between groups. This study describes the development of such a cohort (The Western Australian Sleep Health Study) in OSA patients of Caucasian-European origin attending the only public sleep clinic in Western Australia (WA). The main aim of the study is to phenotype 4,000 OSA patients in order to define the genetics of OSA and its co-morbidities. Almost all underwent laboratory-based attended polysomnography (PSG). Currently complete data (questionnaire, biochemistry, DNA, and PSG) has been obtained on over 3,000 individuals and will reach the target of 4,000 individuals by the end of 2010. In a separate but related study, we have developed a sleep study database containing data from all patients who have undergone PSG at the sleep laboratory since its inception in 1988 until the present day (over 30,000 PSG studies representing data from approximately 20,000 individuals). In addition, data from both cohorts have been linked prospectively to statutory health data collected by the WA Department of Health. This study will be the largest sleep clinic cohort database internationally with access to genetic and epidemiological data. It is unique among sleep clinic cohorts because of its size, the breadth of data collected and the ability to link prospectively to statutory health data. It will be a major tool to comprehensively assess genetic and epidemiologic factors determining OSA and its co-morbidities.

  5. Do governance choices matter in health care networks?: an exploratory configuration study of health care networks.

    PubMed

    Willem, Annick; Gemmel, Paul

    2013-06-24

    Health care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness. The study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for. Neither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors. Although the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness.

  6. Tangible Evidence, Trust and Power: Public Perceptions of Community Environmental Health Studies

    PubMed Central

    Scammell, Madeleine Kangsen; Senier, Laura; Darrah-Okike, Jennifer; Brown, Phil; Santos, Susan

    2009-01-01

    Communities with environmental health concerns in the USA frequently request studies from their local or state departments of public health. This paper presents findings from three focus groups conducted in communities north of Boston that have been the subject of two different environmental health studies. The focus groups were designed to elicit residents’ perceptions of environmental health, and of the particular studies conducted in their communities. In all focus groups, participants had difficulty accepting the findings of health studies that contradicted their own experiences of environmental exposures and illness. Our results suggest that lay knowledge, informed in varying degrees by the experience of what we term “tangible evidence,” creates a lens through which communities interpret a health study’s findings. The differences in reliance on tangible evidence were related to participants’ sense of trust in public officials, and the institutions responsible for conducting health studies. Participants from the wealthier, predominantly white communities discussed trust in study design and methodologies used. In contrast, participants from the lower income, higher minority communities assessed health studies with reference to their trust (or lack thereof) in study sponsors and public health institutions. Participants’ experience of tangible evidence, trust or distrust in health agencies and research institutions, and a sense of relative community power, influence how they assess the findings of environmental health studies and may have implications for pubic health. PMID:18995942

  7. What do mental health workers in the bush think about mental health nurse prescribing? A cross-sectional study.

    PubMed

    Muyambi, Kuda; McPhail, Ruth; Cronin, Kathryn; Gillam, Marianne; Martinez, Lee; Dennis, Shaun; Bressington, Daniel; Gray, Richard; Jones, Martin

    2018-06-04

    Relatively few psychiatrists live and work in rural South Australia. The rural GP is an essential component of support for people with mental health problems. However, considerable GP maldistribution between rural and metropolitan Australia still exists. Thus, accessing health services, including medication, becomes challenging for rural communities. Extending mental health nurse prescribing could be a strategy to build additional capacity to complement the GPs and psychiatrists who practice in rural South Australia. Until now, no studies have examined mental health workers' attitudes towards nurse prescribing in rural Australia. To examine the attitudes of rural and remote South Australian mental health workers about mental health nurse prescribing. A cross-sectional survey assessing mental health workers' attitudes to mental health nurse prescribing. The study was conducted across South Australia, excluding metropolitan Adelaide. Mental health workers employed by the Country Health South Australia Local Health Network for Mental Health. Of the 289 potential participants, 93 (32%) responded and were included in this study. All the respondents reported positive attitudes towards mental health nurse prescribing. However, they expressed concerns about safety, educational preparation and supervision structures. The attitudes of rural South Australian mental health workers are not a barrier to mental health nurse prescribing. The implementation and sustainability of mental health nurse prescribing will require additional staff training in psychopharmacology and a governance framework to assure quality and safety. Policy-makers need to focus their attention on the uptake of mental health nurse prescribing in parts of Australia that struggle to attract and retain psychiatrists. © 2018 National Rural Health Alliance Ltd.

  8. mHealth Intervention Promoting Cardiovascular Health Among African-Americans: Recruitment and Baseline Characteristics of a Pilot Study.

    PubMed

    Brewer, LaPrincess C; Jenkins, Sarah; Lackore, Kandace; Johnson, Jacqueline; Jones, Clarence; Cooper, Lisa A; Radecki Breitkopf, Carmen; Hayes, Sharonne N; Patten, Christi

    2018-01-31

    Mobile health (mHealth) interventions are promising avenues to promote cardiovascular (CV) health among African-Americans (AAs) and culturally tailored technology-based interventions are emerging for this population. The objectives of this study were to use a community-based participatory research (CBPR) approach to recruit AAs into a pilot intervention study of an innovative mHealth CV health promotion program and to characterize technology use patterns and eHealth literacy (EHL). Community partners from five predominately AA churches in southeast Minnesota collaborated with our academic institution to recruit AA congregants into the pilot study. Field notes as well as communications between the study team and community partners were used to design the recruitment strategy and its implementation with a goal of enrolling 50 participants. At its core, the recruitment strategy included community kickoff events to detail the state-of-the-art nature of the mHealth intervention components, the utility of CV health assessments (physical examination, laboratory studies and surveys) and the participants' role in advancing our understanding of the efficacy of mHealth interventions among racial/ethnic minority groups. Detailed recruitment data were documented throughout the study. A self-administered, electronic survey measured sociodemographics, technology use and EHL (eHEALS scale). A total of 50 participants (70% women) from five AA churches were recruited over a one-month period. The majority (>90%) of participants reported using some form of mobile technology with all utilizing these technologies within their homes. Greater than half (60% [30/50]) reported being "very comfortable" with mobile technologies. Overall, participants had high EHL (84.8% [39/46] with eHEALS score ≥26) with no differences by sex. This study illustrates the feasibility and success of a CBPR approach in recruiting AAs into mHealth intervention research and contributes to the growing body of

  9. Current Trends in the study of Gender Norms and Health Behaviors

    PubMed Central

    Fleming, Paul J.; Agnew-Brune, Christine

    2015-01-01

    Gender norms are recognized as one of the major social determinants of health and gender norms can have implications for an individual’s health behaviors. This paper reviews the recent advances in research on the role of gender norms on health behaviors most associated with morbidity and mortality. We find that (1) the study of gender norms and health behaviors is varied across different types of health behaviors, (2) research on masculinity and masculine norms appears to have taken on an increasing proportion of studies on the relationship between gender norms and health, and (3) we are seeing new and varied populations integrated into the study of gender norms and health behaviors. PMID:26075291

  10. Association Between a Wider Availability of Health Information and Health Care Utilization in Vietnam: Cross-Sectional Study.

    PubMed

    Nguyen, Hoang Thuy Linh; Nakamura, Keiko; Seino, Kaoruko; Vo, Van Thang

    2017-12-18

    The rapid and widespread development of mass media sources including the Internet is occurring worldwide. Users are being confronted with a flood of health information through a wide availability of sources. Studies on how the availability of health information has triggered users' interest in utilizing health care services remain limited within the Vietnamese population. This study examined the associations between the wider availability of sources for health information and health care utilization in Vietnam after adjusting for potential confounding variables. The data for this study were drawn from a cross-sectional study conducted over a 6-month period in Hue, a city in central Vietnam. The participants were 993 randomly selected adults aged between 18 and 60 years. Information was collected through face-to-face interviews on the types of information sources that were consulted, including traditional media (television), Internet, and health education courses, as well as the impact of such information on health care use (emergency department visits, hospitalizations, doctor visits). Multivariable logistic regression analyses were performed at a 95% confidence level. The prevalence of watching television, using the Internet, and attending health education courses to obtain health information were 50.9% (505/993), 32.9% (327/993), and 8.7% (86/993), respectively. After further adjustments for self-reported health status, the presence of health insurance, and monthly income, respondents who watched television and used the Internet to obtain health information were 1.7 times more likely to visit a doctor (television: adjusted odds ratio [AOR] 1.69, 95% CI 1.30-2.19; Internet: AOR 1.64, 95% CI 1.23-2.19), and also significantly associated with inpatient hospitalization (P=.003). The use of widely available mass media sources (eg, television and the Internet) to obtain health information was associated with higher health care utilization. How this interest in health

  11. Study protocol for the Fukushima Health Management Survey.

    PubMed

    Yasumura, Seiji; Hosoya, Mitsuaki; Yamashita, Shunichi; Kamiya, Kenji; Abe, Masafumi; Akashi, Makoto; Kodama, Kazunori; Ozasa, Kotaro

    2012-01-01

    The accidents that occurred at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on 11 March 2011 have resulted in long-term, ongoing anxiety among the residents of Fukushima, Japan. Soon after the disaster, Fukushima Prefecture launched the Fukushima Health Management Survey to investigate long-term low-dose radiation exposure caused by the accident. Fukushima Medical University took the lead in planning and implementing this survey. The primary purposes of this survey are to monitor the long-term health of residents, promote their future well-being, and confirm whether long-term low-dose radiation exposure has health effects. This report describes the rationale and implementation of the Fukushima Health Management Survey. This cohort study enrolled all people living in Fukushima Prefecture after the earthquake and comprises a basic survey and 4 detailed surveys. The basic survey is to estimate levels of external radiation exposure among all 2.05 million residents. It should be noted that internal radiation levels were estimated by Fukushima Prefecture using whole-body counters. The detailed surveys comprise a thyroid ultrasound examination for all Fukushima children aged 18 years or younger, a comprehensive health check for all residents from the evacuation zones, an assessment of mental health and lifestyles of all residents from the evacuation zones, and recording of all pregnancies and births among all women in the prefecture who were pregnant on 11 March. All data have been entered into a database and will be used to support the residents and analyze the health effects of radiation. The low response rate (<30%) to the basic survey complicates the estimation of health effects. There have been no cases of malignancy to date among 38 114 children who received thyroid ultrasound examinations. The importance of mental health care was revealed by the mental health and lifestyle survey and the pregnancy and birth survey. This long

  12. Study Protocol for the Fukushima Health Management Survey

    PubMed Central

    Yasumura, Seiji; Hosoya, Mitsuaki; Yamashita, Shunichi; Kamiya, Kenji; Abe, Masafumi; Akashi, Makoto; Kodama, Kazunori; Ozasa, Kotaro

    2012-01-01

    Background The accidents that occurred at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on 11 March 2011 have resulted in long-term, ongoing anxiety among the residents of Fukushima, Japan. Soon after the disaster, Fukushima Prefecture launched the Fukushima Health Management Survey to investigate long-term low-dose radiation exposure caused by the accident. Fukushima Medical University took the lead in planning and implementing this survey. The primary purposes of this survey are to monitor the long-term health of residents, promote their future well-being, and confirm whether long-term low-dose radiation exposure has health effects. This report describes the rationale and implementation of the Fukushima Health Management Survey. Methods This cohort study enrolled all people living in Fukushima Prefecture after the earthquake and comprises a basic survey and 4 detailed surveys. The basic survey is to estimate levels of external radiation exposure among all 2.05 million residents. It should be noted that internal radiation levels were estimated by Fukushima Prefecture using whole-body counters. The detailed surveys comprise a thyroid ultrasound examination for all Fukushima children aged 18 years or younger, a comprehensive health check for all residents from the evacuation zones, an assessment of mental health and lifestyles of all residents from the evacuation zones, and recording of all pregnancies and births among all women in the prefecture who were pregnant on 11 March. All data have been entered into a database and will be used to support the residents and analyze the health effects of radiation. Conclusions The low response rate (<30%) to the basic survey complicates the estimation of health effects. There have been no cases of malignancy to date among 38 114 children who received thyroid ultrasound examinations. The importance of mental health care was revealed by the mental health and lifestyle survey and the pregnancy

  13. Feasibility and Preliminary Outcomes From a Pilot Study of an Integrated Health-Mental Health Promotion Program in School Mental Health Services

    PubMed Central

    George, Melissa W.; Trumpeter, Nevelyn N.; Wilson, Dawn K.; McDaniel, Heather L.; Schiele, Bryn; Prinz, Ron; Weist, Mark D.

    2014-01-01

    The prevalence of unmet health and mental health needs among youth has spurred the growing consensus to develop strategies that integrate services to promote overall well-being. This pilot study reports on the feasibility and outcomes of a theory-driven, family-focused, integrated health-mental health promotion program for underserved adolescents receiving school mental health services. Parent and adolescent assessments conducted prior to and following the brief, 6-session promotion program showed significant improvements in family support, youth self-efficacy, health behaviors, and mental health outcomes. Clinician reports contributed to a characterization of the feasibility, acceptability, and future recommendations for the integrated program. PMID:24297005

  14. 10 CFR 602.5 - Epidemiology and Other Health Studies Financial Assistance Program.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Epidemiology and Other Health Studies Financial Assistance... AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.5 Epidemiology and Other Health Studies... toxic substances; (5) Epidemiology and other health studies relating to energy production, transmission...

  15. 10 CFR 602.5 - Epidemiology and Other Health Studies Financial Assistance Program.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Epidemiology and Other Health Studies Financial Assistance... AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.5 Epidemiology and Other Health Studies... toxic substances; (5) Epidemiology and other health studies relating to energy production, transmission...

  16. 10 CFR 602.5 - Epidemiology and Other Health Studies Financial Assistance Program.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Epidemiology and Other Health Studies Financial Assistance... AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.5 Epidemiology and Other Health Studies... toxic substances; (5) Epidemiology and other health studies relating to energy production, transmission...

  17. 10 CFR 602.5 - Epidemiology and Other Health Studies Financial Assistance Program.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Epidemiology and Other Health Studies Financial Assistance... AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.5 Epidemiology and Other Health Studies... toxic substances; (5) Epidemiology and other health studies relating to energy production, transmission...

  18. A delphi study on health in future India.

    PubMed

    Rohatgi, K; Rohatgi, P K

    1980-07-01

    A delphi study was conducted to identify or envision health scenarios in India by the year 2000. Questionnaires consisting of 48 questions on 5 areas (diagnosis and therapy; family planning; pharmaceuticals and drugs; biochemical and biomedical research; health services) were mailed to 250 experts in India. 36 responded. Results were compiled and mailed back to the respondents for changes and comments. 17 people responded. Results of the delphi study shows that policy decisions with respect to compulsory family planning as well as health education at secondary school level will precede further breakthroughs in birth control technology. Non operation reversible sterilization procedures, immunological birth control, Ayurvedic medicines for contraception and abortion, and selection of baby's sex are all possible by 2000 thereafter. Complete eradication of infectious diseases, malnutrition and associated diseases is considered unlikely before 2000, as are advances in biomedical research. Changes in health services (e.g., significant increases in hospital beds and doctors, cheap bulk drugs), particularly in rural areas, are imminent, leading to prolonging of life expectancy to 70 years. Genetic engineering may provide significant breakthroughs in the prevention of malignancies and cardiac disorders. The India delphi study is patterned after a similar delphi study conducted in the U.S. by Smith, Kline and French (SKF) Laboratories in 1968. The SKF study was able to predict some breakthroughs with basic research which have been realized.

  19. Education-based health inequalities in 18,000 Norwegian couples: the Nord-Trøndelag Health Study (HUNT).

    PubMed

    Nilsen, Sara Marie; Bjørngaard, Johan Håkon; Ernstsen, Linda; Krokstad, Steinar; Westin, Steinar

    2012-11-19

    Education-based inequalities in health are well established, but they are usually studied from an individual perspective. However, many individuals are part of a couple. We studied education-based health inequalities from the perspective of couples where indicators of health were measured by subjective health, anxiety and depression. A sample of 35,980 women and men (17,990 couples) was derived from the Norwegian Nord-Trøndelag Health Study 1995-97 (HUNT 2). Educational data and family identification numbers were obtained from Statistics Norway. The dependent variables were subjective health (four-integer scale), anxiety (21-integer scale) and depression (21-integer scale), which were captured using the Hospital Anxiety and Depression Scale. The dependent variables were rescaled from 0 to 100 where 100 was the worst score. Cross-sectional analyses were performed using two-level linear random effect regression models. The variance attributable to the couple level was 42% for education, 16% for subjective health, 19% for anxiety and 25% for depression. A one-year increase in education relative to that of one's partner was associated with an improvement of 0.6 scale points (95% confidence interval = 0.5-0.8) in the subjective health score (within-couple coefficient). A one-year increase in a couple's average education was associated with an improvement of 1.7 scale points (95% confidence interval = 1.6-1.8) in the subjective health score (between-couple coefficient). There were no education-based differences in the anxiety or depression scores when partners were compared, whereas there were substantial education-based differences between couples in all three outcome measures. We found considerable clustering of education and health within couples, which highlighted the importance of the family environment. Our results support previous studies that report the mutual effects of spouses on education-based inequalities in health, suggesting that couples develop

  20. A Qualitative Study of the Development of Health Literacy Capacities of Participants Attending a Community-Based Cardiovascular Health Programme.

    PubMed

    McKenna, Verna B; Sixsmith, Jane; Barry, Margaret M

    2018-06-02

    Health literacy is a critical determinant of health, which can empower individuals and lead to engagement in collective health promotion action and is also a crucial component in the self-management of illness. The current study moves beyond a focus on functional health literacy and presents findings from a longitudinal qualitative (LQ) study consisting of three phases. This paper presents findings from the second phase of the study, which assessed the development of health literacy capacities of individuals attending a structured cardiovascular risk reduction programme in Ireland. The study objectives were to: explore perceptions of changes in interactions and information exchange within health consultations; identify the facilitators associated with changes in health literacy capacities; assess developments in engagement with broader contexts for health literacy capacities. A LQ study design was undertaken, which employed repeat interview methodology with 19 participants (aged 36⁻76 years) 12 weeks after beginning a structured cardiovascular risk reduction programme. Health literacy levels were assessed using the HLS-EU 47 item instrument in phase 1 (68% limited health literacy (HL), 32% adequate health literacy). A semi-structured interview guide, (informed by Sørensen's conceptual model of health literacy), was used to explore the development of health literacy and to identify changes in knowledge, attitudes and experiences over time. Thematic analysis was used, informed by aspects of Saldaña's framework for longitudinal qualitative data analysis. All participants reported having acquired increased understanding of issues relevant to their health and self-care. Participants described health literacy capacities that incorporate aspects of all levels of health literacy (functional, interactive and critical). Core themes were identified corresponding to changes in these levels: re-engagement with health information and increased understanding of risk and

  1. Consumer Health Information Behavior in Public Libraries: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Yi, Yong Jeong

    2012-01-01

    Previous studies indicated inadequate health literacy of American adults as one of the biggest challenges for consumer health information services provided in public libraries. Little attention, however, has been paid to public users' health literacy and health information behaviors. In order to bridge the research gap, the study aims to…

  2. Upper Ottawa street landfill site health study.

    PubMed Central

    Hertzman, C; Hayes, M; Singer, J; Highland, J

    1987-01-01

    This report describes the design and conduct of two sequential historical prospective morbidity surveys of workers and residents from the Upper Ottawa Street Landfill Site in Hamilton, Ontario. The workers study was carried out first and was a hypothesis-generating study. Workers and controls were administered a health questionnaire, which was followed by an assessment of recall bias through medical chart abstraction. Multiple criteria were used to identify health problems associated with landfill site exposure. Those problems with highest credibility included clusters of respiratory, skin, narcotic, and mood disorders. These formed the hypothesis base in the subsequent health study of residents living adjacent to the landfill site. In that study, the association between mood, narcotic, skin, and respiratory conditions with landfill site exposure was confirmed using the following criteria: strength of association; consistency with the workers study; risk gradient by duration of residence and proximity to the landfill; absence of evidence that less healthy people moved to the area; specificity; and the absence of recall bias. The validity of these associations were reduced by three principal problems: the high refusal rate among the control population; socioeconomic status differences between the study groups; and the fact that the conditions found in excess were imprecisely defined and potentially interchangeable with other conditions. Offsetting these problems were the multiple criteria used to assess each hypothesis, which were applied according to present rules. Evidence is presented that supports the hypothesis that vapors, fumes, or particulate matter emanating from the landfill site, as well as direct skin exposure, may have lead to the health problems found in excess. Evidence is also presented supporting the hypothesis that perception of exposure and, therefore, of risk, may explain the results of the study. However, based on the analyses performed, it is

  3. E-Health literacy of medical and health sciences university students in Mashhad, Iran in 2016: a pilot study

    PubMed Central

    Dashti, Sareh; Peyman, Nooshin; Tajfard, Mohammad; Esmaeeli, Habibollah

    2017-01-01

    Background In order to provide a better healthcare education to the society, health care students should have an acceptable electronic health (E-Health) literacy. Objective The aim of this study was to assess the level of E-Health literacy of Medicine and Health Sciences university students in Mashhad, Iran. Methods This cross-sectional study was performed on 192 students of Mashhad University of Medical Sciences using a validated Persian translate of the E-Health literacy scale (P-EHEALS) questionnaire in 2016. Demographic data including age, monthly income, level of education, preference of website for obtaining health related information and minutes of Internet use per day were obtained from the subjects. Independent-samples t-test and analysis of variance (ANOVA) were used for comparison between groups, and Pearson correlation coefficient and linear regression were used to assess the correlation between study parameters and EHEALS score using SPSS version 21. Results A total of 192 (67.2% female and 32.8% male) subjects with mean age of 24.71±5.30 years participated in the study. Mean P-EHEALS score of the subjects was 28.21±6.95. There was a significant difference in P-EHEALS score between genders (p<0.001), department (p=0.001), education level (p<0.001) and health status (p=0.003) as well as monthly income (p=0.03), website preference categories (p=0.02). Male students were significantly more likely to gain higher P-EHEALS scores. Conclusion The level of E-Health literacy was low in Medical and Health Sciences university students in Mashhad. More studies are needed to assess the contributors to E-Health literacy. PMID:28461871

  4. Association of health literacy with health information-seeking preference in older people: A correlational, descriptive study.

    PubMed

    Kim, Su Hyun; Utz, Sonja

    2018-02-28

    Low health literacy has been recognized as a potential barrier to obtaining knowledge and maintaining self-care in older people. However, little is known about information-seeking preference in relation to health literacy among older people. The aim of the present study was to understand the influence of health literacy on the information-seeking preference of older people. A total of 129 community-residing Korean older people completed a survey in 2016. The findings revealed that health literacy was a significant predictor of information-seeking preference in older people after controlling for demographic and illness variables. Our study highlights the important need to incorporate strategies to increase the desire for information seeking in older people, in addition to adopting communication strategies that address low health literacy. © 2018 John Wiley & Sons Australia, Ltd.

  5. Implementation partnerships in a community-based intergenerational oral health study.

    PubMed

    Huebner, C E; Milgrom, P; Mancl, L A; Smolen, D; Sutherland, M; Weinstein, P; Riedy, C A

    2014-12-01

    University-community partnerships are a common strategy used in implementing community-based health promotion trials, yet few published studies report these interactions in detail. "Baby Smiles" was a five-year intervention study in Oregon, USA. The study involved 400 low-income women during and after pregnancy across four rural counties. In this report, we describe and assess four university-community health partnerships formed to support the intervention. A community health partnership advisory group for the study was established in each of the four participating counties. Group membership ranged from 9 to 23 individuals. A survey was administered to the groups five times in a 2.5 year period. The survey asked members' opinions of the intervention's goals, scientific basis and relevance to their organisation. Questions also asked about members' knowledge of oral health, beliefs about access to dental care for low-income pregnant women and children in their county and how their organisation functioned. There was strong overall support by each partnership group despite differences in the groups' structure, foci and turnover in membership during intervention period. Responses to specific survey items indicating misinformation or negative opinions about oral health care were used to address weaknesses in study implementation throughout the conduct of the study. Systematic monitoring of community support for a multi-year oral health intervention is feasible and can identify potential barriers to address while the study is underway.

  6. Data resource profile: the World Health Organization Study on global AGEing and adult health (SAGE).

    PubMed

    Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties

    2012-12-01

    Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata).

  7. AGRICULTURAL HEALTH STUDY/PESTICIDE EXPOSURE STUDY: STATUS UPDATE AND PRELIMINARY RESULTS

    EPA Science Inventory

    The Agricultural Health Study (AHS) is a prospective epidemiological study of pesticide applicators and their spouses in Iowa and North Carolina. Exposure to 2,4-D or chlorpyrifos is being measured for a subset of applicators in the AHS Pesticide Exposure Study to assess expos...

  8. The Impact of Online Social Networks on Health and Health Systems: A Scoping Review and Case Studies.

    PubMed

    Griffiths, Frances; Dobermann, Tim; Cave, Jonathan A K; Thorogood, Margaret; Johnson, Samantha; Salamatian, Kavé; Gomez Olive, Francis X; Goudge, Jane

    2015-12-01

    Interaction through online social networks potentially results in the contestation of prevailing ideas about health and health care, and to mass protest where health is put at risk or health care provision is wanting. Through a review of the academic literature and case studies of four social networking health sites (PatientsLikeMe, Mumsnet, Treatment Action Campaign, and My Pro Ana), we establish the extent to which this phenomenon is documented, seek evidence of the prevalence and character of health-related networks, and explore their structure, function, participants, and impact, seeking to understand how they came into being and how they sustain themselves. Results indicate mass protest is not arising from these established health-related networking platforms. There is evidence of changes in policy following campaigning activity prompted by experiences shared through social networking such as improved National Health Service care for miscarriage (a Mumsnet campaign). Platform owners and managers have considerable power to shape these campaigns. Social networking is also influencing health policy indirectly through increasing awareness and so demand for health care. Transient social networking about health on platforms such as Twitter were not included as case studies but may be where the most radical or destabilizing influence on health care policy might arise.

  9. Concepts for NASA longitudinal health studies

    NASA Technical Reports Server (NTRS)

    Nicogossian, A. E.; Pool, S. L.; Leach, C. S.; Moseley, E.; Rambaut, P. C.

    1983-01-01

    Clinical data collected from a 15-year study of the homogenous group of pre-Shuttle astronauts have revealed no significant long-term effects from spaceflight. The current hypothesis suggests that repeated exposures to the space environment in the Shuttle era will similarly have no long-term health effects. However, a much more heterogenous group of astronauts and non-astronaut scientists will fly in Shuttle, and data on this group's adaptation to the space environment and readaptation to earth are currently sparse. In addition, very little information is available concerning the short- and long-term medical consequences of long duration exposure to space and subsequent readaptation to the earth environment. In this paper, retrospective clinical information on astronauts is reviewed and concepts for conducting epidemiological studies examining long-term health effects of spaceflight on humans, including associated occupational risks factors, are presented.

  10. Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study.

    PubMed

    Busch, Vincent; Van Stel, Henk F; Schrijvers, Augustinus J P; de Leeuw, Johannes R J

    2013-12-04

    Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial and physical health. These findings have

  11. Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study

    PubMed Central

    2013-01-01

    Background Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Methods Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Results Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. Conclusions The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial

  12. Do governance choices matter in health care networks?: an exploratory configuration study of health care networks

    PubMed Central

    2013-01-01

    Background Health care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness. Methods The study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for. Results Neither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors. Conclusions Although the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness. PMID:23800334

  13. eHealth Literacy and Health Behaviors Affecting Modern College Students: A Pilot Study of Issues Identified by the American College Health Association

    PubMed Central

    Collins, William Bart; Wilson, Kari; Linnemeier, Georgiann; Englebert, Andrew Mark

    2017-01-01

    Background The eHealth Literacy Scale (eHEALS) has been widely adopted by researchers to understand how eHealth literacy can be put into context. eHealth researchers need to know how to promote positive health behavior changes across college students, given the importance of the Internet to acquire and use health information. The American College Health Association identified a set of key health issues that affect college students today. By understanding how eHEALS might be related to college students’ maintenance of their health and their use of online health resources, researchers will be provided with a better understanding of eHealth literacy and its pragmatic implications for health campaigns and future interventions. Objective The goal of the study was to examine what eHEALS reveals about college student health behaviors identified by the American College Health Association. To understand college student current health maintenance and their intentions to maintain their health and use online resources, the theory of planned behavior was used as the theoretical framework for the study. Methods Data were collected via a survey of 422 college students that included the eHEALS measure and questions about health issues based on the recommendations of the American College Health Association. These questions asked about college student current health, subsequent use of online health resources, and their intention to maintain their health and make use of such resources in the future. Results eHEALS was positively and significantly associated with all 8 areas of health issues identified by the American College Health Association for college student current maintenance of health and use of online health resources and for future intention of health maintenance and use of online resources. Key issues that emerged with eHealth literacy were maintaining safe sex practices and seeking out related information, seeking out information on an exercise regime, information on

  14. How adolescents use technology for health information: implications for health professionals from focus group studies.

    PubMed

    Skinner, Harvey; Biscope, Sherry; Poland, Blake; Goldberg, Eudice

    2003-12-18

    Adolescents present many challenges in providing them effective preventive services and health care. Yet, they are typically the early adopters of new technology (eg, the Internet). This creates important opportunities for engaging youths via eHealth. To describe how adolescents use technology for their health-information needs, identify the challenges they face, and highlight some emerging roles of health professionals regarding eHealth services for adolescents. Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 participants (55% female, 45% male; median age 16 years) were selected to reflect diversity in age, sex, geographic location, cultural identity, and risk. An 8-person team analyzed and coded the data according to major themes. Study participants most-frequently sought or distributed information related to school (89%), interacting with friends (85%), social concerns (85%), specific medical conditions (67%), body image and nutrition (63%), violence and personal safety (59%), and sexual health (56%). Finding personally-relevant, high-quality information was a pivotal challenge that has ramifications on the depth and types of information that adolescents can find to answer their health questions. Privacy in accessing information technology was a second key challenge. Participants reported using technologies that clustered into 4 domains along a continuum from highly-interactive to fixed information sources: (1) personal communication: telephone, cell phone, and pager; (2) social communication: e-mail, instant messaging, chat, and bulletin boards; (3) interactive environments: Web sites, search engines, and computers; and (4) unidirectional sources: television, radio, and print. Three emerging roles for health professionals in eHealth include: (1) providing an interface for adolescents with technology and assisting them in finding pertinent information sources; (2) enhancing connection to youths by

  15. Perceptions of the concept of health among nurses working in mental health services: a phenomenographic study.

    PubMed

    Jormfeldt, Henrika; Svedberg, Petra; Fridlund, Bengt; Arvidsson, Barbro

    2007-02-01

    A new understanding of the concept of health is needed to meet the goal of mental health nursing, which besides reducing disease is to strengthen the patient's health. The aim of the present study was to describe perceptions of the concept of health among nurses working in mental health services. Twelve Swedish nurses working in mental health services were interviewed and data were analysed with a phenomenographic approach. The nurses expressed 10 perceptions, which constituted three description categories: autonomy, process, and participation. The result showed that health was more than absence of disease. Simultaneously, perceptions were expressed indicating that health was viewed as absence of disease, which implies that the concept is not sufficiently defined. The result emphasizes the need to clarify the concept of health if it is to be used as a goal in mental health nursing and to integrate a clarified definition of health at all hierarchical levels in mental health care services.

  16. The opinions of Turkish mental health nurses on physical health care for individuals with mental illness: A qualitative study.

    PubMed

    Çelik Ince, S; Partlak Günüşen, N; Serçe, Ö

    2018-05-01

    Individuals with mental illness have significantly higher mortality and morbidity than the general population due to physical illnesses. Mental health nurses play a key role in providing care for common physical problems and protecting and promoting healthy lifestyles. Little is known from previous studies in the international literature about the attitudes, behaviours and thoughts of mental health nurses on providing physical health care. Mental health nurses mostly focus on the existing physical health problems of individuals with mental illness. However, mental health nurses do not include practices of disease prevention and physical health promotion for individuals with mental illness. The desire to see positive changes in individuals with mental illness, receiving positive feedback, feeling useful and happy, and feeling satisfied with their profession motivate mental health nurses in terms of providing physical health care. The knowledge and skill required of mental health nurses to provide physical health care need to be increased. Institutions should employ expert nurses who are able to guide mental health nurses to provide physical health care. It is important to provide adequate physical infrastructure and human resources to provide better physical health care in mental health services. Background Mental health nurses play an important role in improving the physical health of individuals with mental illnesses. However, there are limited studies of their attitudes and practices about physical health. Therefore, there is a need for qualitative studies to clarify the issue. The aim of this study was to determine mental health nurses' opinions about physical health care for individuals with mental illness. This study was carried out in Turkey. A qualitative descriptive approach was taken in the study. The sample consisted of twelve mental health nurses selected by purposeful sampling. In-depth interviews were conducted using a semi-structured interview format

  17. Public sector health financing in Pakistan: a retrospective study.

    PubMed

    Mohammad, Khalif Bile; Hafeez, Assad; Nishter, Sania

    2007-06-01

    To assess the existing situation relating to investments made by development partners in the health sector in Pakistan. This was a retrospective study completed over a period of 6 months in which financial data for the year July 2004 to June 2005 was collected. A uniform matrix was circulated to all the stakeholders in public sector and international donors who had a stake in health. Details of expenses in health over the last 5 years and plans for the next 10 years were requested. Initial draft was shared with all concerned for concurrence before finalization. Simple analysis was carried out on the collected data. About 80% of the financial resources in the public sector are provided by the Government of Pakistan with non-development and recurring expenses predominating in these allocations. The study shows that Pakistan's per capita spending on health by the public sector is Rs 375.00 (US$ 6.4) out of which Rs 80 (US$ 1.3) is being contributed by the partners. Majority of the partners contributions are used for development projects. The study concludes that an additional amount of about 250 billion rupees per year (keeping in mind the recommendations of Commission for Macroeconomics and Health) are required by the health sector. This can only be achieved by allocating at least 50% more for health every year for next 10 years in order to catch up on the lagging targets set by Millennium Development Goals for Pakistan.

  18. A Follow-Up Study of Former Student Health Advocates

    ERIC Educational Resources Information Center

    Streng, Nancy J.

    2007-01-01

    Student health advocates (SHAs) are high school students who, under the supervision of the school nurse, provide health education and health promotion activities to other students via a peer education model. This 3-year follow-up study explored how the SHA experience influences career choice and attitudes of the participants. It also examined what…

  19. [Study of self-reported health of people living near point sources of environmental pollution: a review. First part: health indicators].

    PubMed

    Daniau, C; Dor, F; Eilstein, D; Lefranc, A; Empereur-Bissonnet, P; Dab, W

    2013-08-01

    Epidemiological studies have investigated the health impacts of local sources of environmental pollution using as an outcome variable self-reported health, reflecting the overall perception interviewed people have of their own health. This work aims at analyzing the advantages and the results of this approach. A first step focused on describing the indicators. The literature on indicators of self-reported health was reviewed, leading to a discussion on data collection, selection of health effects, data processing, and construction of indicators. The literature review concerned 51 articles. The use of self-reported health indicators allowed the studies to take into account the health concerns and complaints of populations exposed to environmental pollution. Various indicators of self-reported health were used in the studies. They measured physical, psychological and general dimensions of health. Standardized questionnaires were used less often than ad hoc questionnaires (78% of studies) developed to fit the needs of a given study. Three standardized questionnaires were used more frequently: the MOS Short-Form Health Survey (SF-36) to measure general health perceptions, the General Health Questionnaire (GHQ), and the Symptoms Checklist (SCL-90) to measure psychological distress. The choice of self-reported health indicators is a compromise between specificity of the studied health issues within a given environment and standardization of the questionnaires used to measure them. Such standardization is necessary to ensure the validity and the reliability of the information collected across time and situations. The psychometric properties of the measuring questionnaires are rarely estimated or verified when they are used. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. Enhancing the quality of case studies in health services research.

    PubMed Central

    Yin, R K

    1999-01-01

    OBJECTIVE: To provide guidance on improving the quality of case studies in health services research. DATA SOURCES: Secondary data, drawing from previous case study research. RESEARCH DESIGN: Guidance is provided to two audiences: potential case study investigators (eight items) and reviewers of case study proposals (four additional items). PRINCIPAL FINDINGS: The guidance demonstrates that many operational steps can be undertaken to improve the quality of case studies. These steps have been a hallmark of high-quality case studies in related fields but have not necessarily been practiced in health services research. CONCLUSIONS: Given higher-quality case studies, the case study method can become a valuable tool for health services research. Images Figure 3 PMID:10591280

  1. CANCER INCIDENCE IN THE AGRICULTURAL HEALTH STUDY

    EPA Science Inventory

    The Agricultural Health Study (AHS) was undertaken to ascertain the etiology of cancers observed to be elevated in agricultural populations. Methods: The AHS is a large prospective, cohort study of private applicators and commercial applicators licensed to apply restricted use ...

  2. Evaluations of health promoting schools: a review of nine studies.

    PubMed

    Mũkoma, Wanjirũ; Flisher, Alan J

    2004-09-01

    The concept of 'health promoting schools' has been embraced internationally as an effective way of promoting the health of children, adolescents, and the wider school community. It is only recently that attempts have been made to evaluate health promoting schools. This paper reviews evaluations of health promoting schools and draws useful evaluation methodology lessons. The review is confined to school-based interventions that are founded explicitly on the concept of the health promoting school and employ the concept beyond one school domain. We included nine evaluations in this review. Seven of these were published in the peer reviewed scientific literature. Two were unpublished reports. One study was a randomized controlled trial, while a quasi-experimental research design with comparison schools was used in three studies. With three exceptions, combinations of quantitative and qualitative data were collected. There was evidence that the health promoting school has some influence on various domains of health for the school community. It is also possible to integrate health promotion into the school curriculum and policies successfully. However, the evaluation of health promoting schools is complex. We discuss some of the methodological challenges of evaluating health promoting schools and make suggestions for improving future evaluations.

  3. The Effect of a Community Health Worker Utilized Mobile Health Application on Maternal Health Knowledge and Behavior: A Quasi-Experimental Study.

    PubMed

    Ilozumba, Onaedo; Van Belle, Sara; Dieleman, Marjolein; Liem, Loan; Choudhury, Murari; Broerse, Jacqueline E W

    2018-01-01

    Mobile technology (mHealth) is increasingly being used to achieve improved access and quality of maternal care, particularly in rural areas of low- and middle-income countries. In 2011, a mobile application-Mobile for Mothers (MfM)-was implemented in Jharkhand, India to support home visits by community health workers. The objective of this study is to assess the impact of the mHealth intervention on maternal health. Households from three subdistricts in the Deoghar district of Jharkhand were selected using a multistage cluster sampling approach. Households from the Sarwan subdistrict received the MfM intervention, those from Devipur subdistrict received other interventions asides MfM from the implementing non-governmental organization (NGO), while households from Mohanpur subdistrict received the current standard of care. Women ( n  = 2,200) between the ages of 18 and 45 who had delivered a baby in the past 1 year were enrolled into the study. The primary outcomes of interest were maternal health knowledge, antenatal care (ANC) attendance, and delivery in a health facility. Post-intervention, women in the MfM group had higher maternal health knowledge, were more likely to attend four or more ANC visits, and deliver at the health facility when compared with the NGO and standard care group. After controlling for predictors, women in the intervention group significantly performed better than both the NGO and standard care groups on all three-outcome variables (all P  > 0.05). The results indicate that although the MfM mHealth intervention could influence adherence and practice of recommended maternal health behaviors, it could not overcome key sociocultural determinants of maternal health such as caste and educational status, which are specific to the Indian context. mHealth holds continued promise for maternal health but implementers and policy makers must additionally address health system and sociocultural factors that play a significant role in the

  4. NCSALL Health Literacy Study Circle+ Facilitators Training. Training Guide

    ERIC Educational Resources Information Center

    National Center for the Study of Adult Learning and Literacy (NCSALL), 2007

    2007-01-01

    This training guide was created by the National Center for the Study of Adult Learning and Literacy (NCSALL) to help connect research and practice in the field of adult education and family literacy. A Health and Adult Literacy and Learning (HALL)/NCSALL Health Literacy Study Circle+ is a professional development activity for adult basic education…

  5. Turning health research into health promotion: a study of causality and 'critical insights' in a United Kingdom health campaign.

    PubMed

    Piggin, Joe

    2012-10-01

    This article examines how important decisions about health can alter between public health policy formulation and eventual marketing implementation. Specifically, the article traces the development and production of a major United Kingdom social marketing campaign named Change4Life, and examines how ideas about the causes of and solutions to the obesity epidemic are produced in differing ways throughout the health promotion process. This study examines a variety of United Kingdom health research, policy, marketing strategy and marketing messages between 2008 and 2011. This research demonstrates that claims about causality oscillate and alter throughout the research, policy and Change4Life marketing process. These oscillations are problematic, since the Department of Health described the original consumer research as 'critical'. Given both the importance of the health issues being addressed and the amount of funding dedicated to Change4Life, that 'critical' research was directly contradicted in the campaign requires urgent review. To conclude, the article discusses the utility of social marketing when considering causal claims in health promotion. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Genetic and environmental origins of health anxiety: a twin study

    PubMed Central

    TAYLOR, STEVEN; THORDARSON, DANA S; JANG, KERRY L; ASMUNDSON, GORDON J.G

    2006-01-01

    Excessive health anxiety - which is anxiety about one's health that is disproportionate to the person's medical status - is a common and often debilitating problem. Little is known about its etiology. The present study investigated the role of genetic and environmental factors using a classic twin study method. Results indicated that, after controlling for medical morbidity, environmental influences accounted for most of individual differences in health anxiety. These findings underscore the importance of psychosocial interventions, which have been shown to be among the most effective interventions for excessive health anxiety. PMID:16757996

  7. Black Families' Lay Views on Health and the Implications for Health Promotion: A Community-Based Study in the UK

    ERIC Educational Resources Information Center

    Ochieng, Bertha

    2012-01-01

    Many studies focusing on beliefs about health and health promotion have paid little attention to the life experiences of Black and other visible minority ethnic families in western societies. This paper is a report of a study exploring Black families' beliefs about health and the implications of such beliefs for health promotion. Ten Black…

  8. Data Resource Profile: The World Health Organization Study on global AGEing and adult health (SAGE)

    PubMed Central

    Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties; Yawson, A.; Mensah, G.; Yong, J.; Guo, Y.; Zheng, Y.; Parasuraman, P.; Lhungdim, H.; Sekher, TV.; Rosa, R.; Belov, VB.; Lushkina, NP; Peltzer, K.; Makiwane, M.; Zuma, K.; Ramlagan, S.; Davids, A.; Mbelle, N.; Matseke, G.; Schneider, M.; Tabane, C.; Tollman, S.; Kahn, K.; Ng, N.; Juvekar, S.; Sankoh, O.; Debpuur, CY.; Nguyen, TK Chuc; Gomez-Olive, FX.; Hakimi, M.; Hirve, S.; Abdullah, S.; Hodgson, A.; Kyobutungi, C.; Egondi, T.; Mayombana, C.; Minh, HV.; Mwanyangala, MA.; Razzaque, A.; Wilopo, S.; Streatfield, PK.; Byass, P.; Wall, S.; Scholten, F.; Mugisha, J.; Seeley, J.; Kinyanda, E.; Nyirenda, M.; Mutevedzi, P.; Newell, M-L.

    2012-01-01

    Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization’s Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18–49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007–2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18–49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO’s SAGE website (www.who.int/healthinfo/systems/sage) and WHO’s archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata). PMID:23283715

  9. eHealth Literacy and Health Behaviors Affecting Modern College Students: A Pilot Study of Issues Identified by the American College Health Association.

    PubMed

    Britt, Rebecca Katherine; Collins, William Bart; Wilson, Kari; Linnemeier, Georgiann; Englebert, Andrew Mark

    2017-12-19

    The eHealth Literacy Scale (eHEALS) has been widely adopted by researchers to understand how eHealth literacy can be put into context. eHealth researchers need to know how to promote positive health behavior changes across college students, given the importance of the Internet to acquire and use health information. The American College Health Association identified a set of key health issues that affect college students today. By understanding how eHEALS might be related to college students' maintenance of their health and their use of online health resources, researchers will be provided with a better understanding of eHealth literacy and its pragmatic implications for health campaigns and future interventions. The goal of the study was to examine what eHEALS reveals about college student health behaviors identified by the American College Health Association. To understand college student current health maintenance and their intentions to maintain their health and use online resources, the theory of planned behavior was used as the theoretical framework for the study. Data were collected via a survey of 422 college students that included the eHEALS measure and questions about health issues based on the recommendations of the American College Health Association. These questions asked about college student current health, subsequent use of online health resources, and their intention to maintain their health and make use of such resources in the future. eHEALS was positively and significantly associated with all 8 areas of health issues identified by the American College Health Association for college student current maintenance of health and use of online health resources and for future intention of health maintenance and use of online resources. Key issues that emerged with eHealth literacy were maintaining safe sex practices and seeking out related information, seeking out information on an exercise regime, information on vaccinations, and maintaining a balanced

  10. A mismatch between population health literacy and the complexity of health information: an observational study.

    PubMed

    Rowlands, Gillian; Protheroe, Joanne; Winkley, John; Richardson, Marty; Seed, Paul T; Rudd, Rima

    2015-06-01

    Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population skills in relation to these. An English observational study comparing health materials with national working-age population skills. Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified. The proportion of the population above and below these thresholds, and the sociodemographic variables associated with a greater risk of being below the thresholds, were described. Sixty-four health materials were sampled. Two competency thresholds were identified: text (literacy) only, and text + numeracy; 2515/5795 participants (43%) were below the text-only threshold, while 2905/4767 (61%) were below the text + numeracy threshold. Univariable analyses of social determinants of health showed that those groups more at risk of socioeconomic deprivation had higher odds of being below the health literacy competency threshold than those at lower risk of deprivation. Multivariable analysis resulted in some variables becoming non-significant or reduced in effect. Levels of low health literacy mirror those found in other industrialised countries, with a mismatch between the complexity of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information. © British Journal of General Practice 2015.

  11. Job Strain, Health and Sickness Absence: Results from the Hordaland Health Study

    PubMed Central

    Wang, Min-Jung; Mykletun, Arnstein; Møyner, Ellen Ihlen; Øverland, Simon; Henderson, Max; Stansfeld, Stephen; Hotopf, Matthew; Harvey, Samuel B.

    2014-01-01

    Objectives While it is generally accepted that high job strain is associated with adverse occupational outcomes, the nature of this relationship and the causal pathways involved are not well elucidated. We aimed to assess the association between job strain and long-term sickness absence (LTSA), and investigate whether any associations could be explained by validated health measures. Methods Data from participants (n = 7346) of the Hordaland Health Study (HUSK), aged 40–47 at baseline, were analyzed using multivariate Cox regression to evaluate the association between job strain and LTSA over one year. Further analyses examined whether mental and physical health mediated any association between job strain and sickness absence. Results A positive association was found between job strain and risk of a LTSA episode, even controlling for confounding factors (HR = 1.64 (1.36–1.98); high job strain exposure accounted for a small proportion of LTSA episodes (population attributable risk 0.068). Further adjustments for physical health and mental health individually attenuated, but could not fully explain the association. In the fully adjusted model, the association between high job strain and LTSA remained significant (HR = 1.30 (1.07–1.59)). Conclusion High job strain increases the risk of LTSA. While our results suggest that one in 15 cases of LTSA could be avoided if high job strain were eliminated, we also provide evidence against simplistic causal models. The impact of job strain on future LTSA could not be fully explained by impaired health at baseline, which suggests that factors besides ill health are important in explaining the link between job strain and sickness absence. PMID:24755878

  12. Investigating the associations among overtime work, health behaviors, and health: a longitudinal study among full-time employees.

    PubMed

    Taris, Toon W; Ybema, Jan Fekke; Beckers, Debby G J; Verheijden, Marieke W; Geurts, Sabine A E; Kompier, Michiel A J

    2011-12-01

    It has often been suggested that high levels of overtime lead to adverse health outcomes. One mechanism that may account for this association is that working overtime leads to elevated levels of stress, which could affect worker's behavioral decisions or habits (such as smoking and lack of physical activity). In turn, this could lead to adverse health. The present study examined this reasoning in a prospective longitudinal design. Data from the prospective 2-year Study on Health at Work (N = 649) were used to test our hypotheses. Structural equation analysis was used to examine the relationships among overtime, beneficial (exercising, intake of fruit and vegetables) and risky (smoking and drinking) health behaviors, and health indicators (BMI and subjective health). Working overtime was longitudinally related with adverse subjective health, but not with body mass. Moreover, working overtime was associated with lower levels of physical activity and intake of fruit and vegetables, but not with smoking and drinking. Finally, higher levels of risky and lower levels of beneficial health behaviors were longitudinally associated with ill health. The relation between overtime and ill health is partly accounted for by the unhealthy lifestyle in which overworkers tend to engage. However, a direct longitudinal effect of overtime on health suggested that the effects of overtime on health may also partly be due to the sustained physiological activation that results from working overtime. Whereas working a moderate amount of overtime does not usually entail major health risks, these will increase with increasing overtime.

  13. Education-based health inequalities in 18,000 Norwegian couples: the Nord-Trøndelag Health Study (HUNT)

    PubMed Central

    2012-01-01

    Background Education-based inequalities in health are well established, but they are usually studied from an individual perspective. However, many individuals are part of a couple. We studied education-based health inequalities from the perspective of couples where indicators of health were measured by subjective health, anxiety and depression. Methods A sample of 35,980 women and men (17,990 couples) was derived from the Norwegian Nord-Trøndelag Health Study 1995–97 (HUNT 2). Educational data and family identification numbers were obtained from Statistics Norway. The dependent variables were subjective health (four-integer scale), anxiety (21-integer scale) and depression (21-integer scale), which were captured using the Hospital Anxiety and Depression Scale. The dependent variables were rescaled from 0 to 100 where 100 was the worst score. Cross-sectional analyses were performed using two-level linear random effect regression models. Results The variance attributable to the couple level was 42% for education, 16% for subjective health, 19% for anxiety and 25% for depression. A one-year increase in education relative to that of one’s partner was associated with an improvement of 0.6 scale points (95% confidence interval = 0.5–0.8) in the subjective health score (within-couple coefficient). A one-year increase in a couple’s average education was associated with an improvement of 1.7 scale points (95% confidence interval = 1.6–1.8) in the subjective health score (between-couple coefficient). There were no education-based differences in the anxiety or depression scores when partners were compared, whereas there were substantial education-based differences between couples in all three outcome measures. Conclusions We found considerable clustering of education and health within couples, which highlighted the importance of the family environment. Our results support previous studies that report the mutual effects of spouses on education

  14. Psychedelics and mental health: a population study.

    PubMed

    Krebs, Teri S; Johansen, Pål-Ørjan

    2013-01-01

    The classical serotonergic psychedelics LSD, psilocybin, mescaline are not known to cause brain damage and are regarded as non-addictive. Clinical studies do not suggest that psychedelics cause long-term mental health problems. Psychedelics have been used in the Americas for thousands of years. Over 30 million people currently living in the US have used LSD, psilocybin, or mescaline. To evaluate the association between the lifetime use of psychedelics and current mental health in the adult population. Data drawn from years 2001 to 2004 of the National Survey on Drug Use and Health consisted of 130,152 respondents, randomly selected to be representative of the adult population in the United States. Standardized screening measures for past year mental health included serious psychological distress (K6 scale), mental health treatment (inpatient, outpatient, medication, needed but did not receive), symptoms of eight psychiatric disorders (panic disorder, major depressive episode, mania, social phobia, general anxiety disorder, agoraphobia, posttraumatic stress disorder, and non-affective psychosis), and seven specific symptoms of non-affective psychosis. We calculated weighted odds ratios by multivariate logistic regression controlling for a range of sociodemographic variables, use of illicit drugs, risk taking behavior, and exposure to traumatic events. 21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems. We did not find use of psychedelics to be an independent risk factor for mental health problems.

  15. Inequalities in health and health service utilisation among reproductive age women in St. Petersburg, Russia: a cross-sectional study.

    PubMed

    Dubikaytis, Tatiana; Larivaara, Meri; Kuznetsova, Olga; Hemminki, Elina

    2010-11-11

    Russian society has faced dramatic changes in terms of social stratification since the collapse of the Soviet Union. During this time, extensive reforms have taken place in the organisation of health services, including the development of the private sector. Previous studies in Russia have shown a wide gap in mortality between socioeconomic groups. There are just a few studies on health service utilisation in post-Soviet Russia and data on inequality of health service use are limited. The aim of the present study was to analyse health (self-rated health and self-reported chronic diseases) and health care utilisation patterns by socioeconomic status (SES) among reproductive age women in St. Petersburg. The questionnaire survey was conducted in 2004 (n = 1147), with a response rate of 67%. Education and income were used as dimensions of SES. The association between SES and health and use of health services was assessed by logistic regression, adjusting for age. As expected low SES was associated with poor self-rated health (education: OR = 1.48; personal income: OR = 1.42: family income: OR = 2.31). University education was associated with use of a wider range of outpatient medical services and increased use of the following examinations: Pap smear (age-adjusted OR = 2.06), gynaecological examinations (age-adjusted OR = 1.62) and mammography among older (more than 40 years) women (age-adjusted OR = 1.98). Personal income had similar correlations, but family income was related only to the use of mammography among older women. Our study suggests a considerable inequality in health and utilisation of preventive health service among reproductive age women. Therefore, further studies are needed to identify barriers to health promotion resources.

  16. The Impact of Online Social Networks on Health and Health Systems: A Scoping Review and Case Studies

    PubMed Central

    Griffiths, Frances; Dobermann, Tim; Cave, Jonathan A. K.; Thorogood, Margaret; Johnson, Samantha; Salamatian, Kavé; Gomez Olive, Francis X.; Goudge, Jane

    2015-01-01

    Interaction through online social networks potentially results in the contestation of prevailing ideas about health and health care, and to mass protest where health is put at risk or health care provision is wanting. Through a review of the academic literature and case studies of four social networking health sites (PatientsLikeMe, Mumsnet, Treatment Action Campaign, and My Pro Ana), we establish the extent to which this phenomenon is documented, seek evidence of the prevalence and character of health‐related networks, and explore their structure, function, participants, and impact, seeking to understand how they came into being and how they sustain themselves. Results indicate mass protest is not arising from these established health‐related networking platforms. There is evidence of changes in policy following campaigning activity prompted by experiences shared through social networking such as improved National Health Service care for miscarriage (a Mumsnet campaign). Platform owners and managers have considerable power to shape these campaigns. Social networking is also influencing health policy indirectly through increasing awareness and so demand for health care. Transient social networking about health on platforms such as Twitter were not included as case studies but may be where the most radical or destabilizing influence on health care policy might arise. PMID:27134699

  17. Study protocol: longitudinal study of the transition of young people with complex health needs from child to adult health services

    PubMed Central

    2013-01-01

    Background Young people with complex health needs have impairments that can limit their ability to carry out day-to-day activities. As well as coping with other developmental transitions, these young people must negotiate the transfer of their clinical care from child to adult services. The process of transition may not be smooth and both health and social outcomes may suffer. Increasingly, policy-makers have recognised the need to ensure a smoother transition between children’s and adult services, with processes that are holistic, individualised, and person-centred; however, there is little outcome data to support proposed models of care. This study aims to identify the features of transitional care that are potentially effective and efficient for young people with complex health needs making their transition. Methods/Design Longitudinal cohort study. 450 young people aged 14 years to 18 years 11 months (with autism spectrum disorder and an additional mental health problem, cerebral palsy or diabetes) will be followed through their transition from child to adult services and will contribute data at baseline, 12, 24 and 36 months. We will collect data on: health and wellbeing outcomes (participation, quality of life, satisfaction with services, generic health status (EQ-5D-Y) and condition specific measure of disease control or management); exposure to proposed beneficial features of services (such as having a key worker, appropriate involvement of parents); socio-economic characteristics of the sample; use of condition-related health and personal social services; preferences for the characteristics of transitional care. We will us regression techniques to explore how outcomes vary by exposure to service features and by characteristics of the young people. These data will populate a decision-analytic model comparing the costs and benefits of potential alternative ways of organising transition services. In order to better understand mechanisms and aid

  18. Public health accreditation and metrics for ethics: a case study on environmental health and community engagement.

    PubMed

    Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan

    2013-01-01

    As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.

  19. How Adolescents Use Technology for Health Information: Implications for Health Professionals from Focus Group Studies

    PubMed Central

    Biscope, Sherry; Poland, Blake; Goldberg, Eudice

    2003-01-01

    Background Adolescents present many challenges in providing them effective preventive services and health care. Yet, they are typically the early adopters of new technology (eg, the Internet). This creates important opportunities for engaging youths via eHealth. Objective To describe how adolescents use technology for their health-information needs, identify the challenges they face, and highlight some emerging roles of health professionals regarding eHealth services for adolescents. Methods Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 participants (55% female, 45% male; median age 16 years) were selected to reflect diversity in age, sex, geographic location, cultural identity, and risk. An 8-person team analyzed and coded the data according to major themes. Results Study participants most-frequently sought or distributed information related to school (89%), interacting with friends (85%), social concerns (85%), specific medical conditions (67%), body image and nutrition (63%), violence and personal safety (59%), and sexual health (56%). Finding personally-relevant, high-quality information was a pivotal challenge that has ramifications on the depth and types of information that adolescents can find to answer their health questions. Privacy in accessing information technology was a second key challenge. Participants reported using technologies that clustered into 4 domains along a continuum from highly-interactive to fixed information sources: (1) personal communication: telephone, cell phone, and pager; (2) social communication: e-mail, instant messaging, chat, and bulletin boards; (3) interactive environments: Web sites, search engines, and computers; and (4) unidirectional sources: television, radio, and print. Three emerging roles for health professionals in eHealth include: (1) providing an interface for adolescents with technology and assisting them in finding pertinent information sources; (2

  20. [Study protocol on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain].

    PubMed

    Pérez, Glòria; Gotsens, Mercè; Palència, Laia; Marí-Dell'Olmo, Marc; Domínguez-Berjón, M Felicitas; Rodríguez-Sanz, Maica; Puig, Vanessa; Bartoll, Xavier; Gandarillas, Ana; Martín, Unai; Bacigalupe, Amaia; Díez, Elia; Ruiz, Miguel; Esnaola, Santiago; Calvo, Montserrat; Sánchez, Pablo; Luque Fernández, Miguel Ángel; Borrell, Carme

    The aim is to present the protocol of the two sub-studies on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain. Substudy 1: describe the evolution of mortality and reproductive health between 1990 and 2013 through a longitudinal ecological study in the Autonomous Communities. This study will identify changes caused by the economic crisis in trends or reproductive health and mortality indicators using panel data (17 Autonomous Communities per study year) and adjusting Poisson models with random effects variance. Substudy 2: analyse inequalities by socioeconomic deprivation in mortality and reproductive health in several areas of Spain. An ecological study analysing trends in the pre-crisis (1999-2003 and 2004-2008) and crisis (2009-2013) periods will be performed. Random effects models Besag York and Mollié will be adjusted to estimate mortality indicators softened in reproductive health and census tracts. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. A Qualitative Study of How Health Coaches Support Patients in Making Health-Related Decisions and Behavioral Changes

    PubMed Central

    Thom, David H.; Wolf, Jessica; Gardner, Heather; DeVore, Denise; Lin, Michael; Ma, Andy; Ibarra-Castro, Ana; Saba, George

    2016-01-01

    PURPOSE Although health coaches are a growing resource for supporting patients in making health decisions, we know very little about the experience of health. We undertook a qualitative study of how health coaches support patients in making decisions and implementing changes to improve their health. METHODS We conducted 6 focus groups (3 in Spanish and 3 in English) with 25 patients and 5 friends or family members, followed by individual interviews with 42 patients, 17 family members, 17 health coaches, and 20 clinicians. Audio recordings were transcribed and analyzed by at least 2 members of the study team in ATLAS.ti using principles of grounded theory to identify themes and the relationship between them. RESULTS We identified 7 major themes that were related to each other in the final conceptual model. Similarities between health coaches and patients and the time health coaches spent with patients helped establish the health coach–patient relationship. The coach-patient relationship allowed for, and was further strengthened by, 4 themes of key coaching activities: education, personal support, practical support, and acting as a bridge between patients and clinicians. CONCLUSIONS We identified a conceptual model that supports the development of a strong relationship, which in turn provides the basis for effective coaching. These results can be used to design health coach training curricula and to support health coaches in practice. PMID:28376437

  2. A correlation study of social network usage among health care students.

    PubMed

    Suit, Louise; Winkler, Patricia; Campbell, Linda; Pennington, Karen; Szutenbach, Mary Pat; Haight, Robert; Roybal, Deborah; McCollum, Marianne

    2015-04-01

    Due to anecdotal concerns about adequacy of health professions students' communication skills, health professions faculty at a private university formed an interprofessional research team. The study was designed to explore whether the use of social networking services (SNS) influenced health care students' written and oral communication skills. One hundred thirty-two students participated in the study. Communication skills were assessed by using assignments from a health care ethics course required of all students. Use of SNS was measured with an information technology questionnaire. Contrary to expected findings, this exploratory correlation study found no meaningful relationship between the frequency of SNS usage and oral and written communication skills in health professions students. Future studies of SNS would benefit from a younger and more homogeneous study population to assess the use of SNS for learning versus leisure. Copyright 2015, SLACK Incorporated.

  3. Chemical and biological sensing needs for health effects studies

    NASA Astrophysics Data System (ADS)

    Breysse, Patrick N.

    2012-06-01

    Exposure assessment is an integral component of occupational and environmental epidemiology, risk assessment and management, as well as regulatory compliance. For the most part, air sampling and analysis tools used in occupational and environmental exposure assessments are based on technologies that have changed little since the 1970s. In many cases the lack of simple, inexpensive, exposure assessment technologies has limited epidemiologists' and risk assessors' ability to evaluate the environmental and occupational causes of disease. While there have been tremendous investments and advances in medical diagnostic and biomonitoring technologies (e.g., glucose testing, human genetics), there has been less effort invested in advancing the science of exposure assessment. Recent developments in sensor technology have focused on medical and homeland security applications. Developing and applying new sensors to health effects studies can revolutionize the way epidemiologic studies are conducted. Time-series studies that investigate short-term (hours to days) changes in exposure that are linked to changes in health care encounters, symptoms, and biological markers of preclinical disease and/or susceptibility are needed to more fully evaluate the impact of chemicals and other agents on health. Current sampling technology limits our ability to assess time-varying concentrations. The purpose of this paper is to discuss the current state of air sampling and health assessment and the potential application of novel sensor technology for use in health effects studies.

  4. Health promoting Behaviors Among Adolescents: A Cross-sectional Study.

    PubMed

    Musavian, Azra Sadat; Pasha, Afsaneh; Rahebi, Seyyedeh-Marzeyeh; Atrkar Roushan, Zahra; Ghanbari, Atefeh

    2014-04-01

    Health maintenance and promotion are the fundamental prerequisites to community development. The best time for establishing healthy lifestyle habits is during adolescence. Due to importance of health promotion behaviors in adolescents, this study was conducted to investigate health-promoting behaviors and its associated factors among high school students in Rasht, Iran. A cross-sectional descriptive study was conducted on 424 students during the first semester of the year 2012. We employed the multistage sampling design to recruit from private and public high schools in Rasht, Iran. The data collection instrument was a self-report questionnaire consisting of two parts. The first part of instrument was consisted of demographic questionnaire and the second part was adolescent health promotion scale (AHPS) questionnaire. AHPS questionnaire was consisted of six dimensions (nutrition, social support, health responsibility, life appreciation, physical activity, and stress management) to measure health promoting lifestyles. Statistical analysis was performed by SPSS 16 software employing ANOVA (analysis of variance) test, t-test, Mann-Whitney, and the Kruskal-Wallis. The score of total Adolescent Health Promotion Scale were 3.58 ± 0.52 (possible range was 1-5). The highest score was in life appreciation dimension (3.99 ± 0.068) and the lowest score was in health responsibility dimension. Moreover, Significant associations were found between the adolescent health promotion Scale with age (P < 0.001), gender (P < 0.003), school grade (P < 0.011), father's educational level (P < 0.045), mother's educational level (P < 0.021), and mother's occupation (P < 0.008). Female and older students are at higher risk of developing unhealthy lifestyle. Consequently, healthcare providers, health instructors, schoolteachers, and families must pay more attention to these students. Moreover, as most of lifelong healthy and unhealthy lifestyle habits are established during adolescence

  5. CONSIDERATION OF CHILDREN'S DISTINCTIVE SUSCEPTIBILITY IN ENVIRONMENTAL HEALTH STUDIES

    EPA Science Inventory

    Consideration of children's distinctive susceptibility in environmental health studies.
    Pauline Mendola (US EPA, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC 27711)

    Children are a particularly susceptible subpopulation with ...

  6. Mental health promotion competencies in the health sector in Finland: a qualitative study of the views of professionals.

    PubMed

    Tamminen, Nina; Solin, Pia; Stengård, Eija; Kannas, Lasse; Kettunen, Tarja

    2017-07-01

    In this study, we aimed to investigate what competencies are needed for mental health promotion in health sector practice in Finland. A qualitative study was carried out to seek the views of mental health professionals regarding mental health promotion-related competencies. The data were collected via two focus groups and a questionnaire survey of professionals working in the health sector in Finland. The focus groups consisted of a total of 13 professionals. Further, 20 questionnaires were received from the questionnaire survey. The data were analysed using the qualitative data analysis software ATLAS.ti Scientific Software Development GmbH, Berlin. A content analysis was carried out. In total, 23 competencies were identified and clustered under the categories of theoretical knowledge, practical skills, and personal attitudes and values. In order to promote mental health, it is necessary to have a knowledge of the principles and concepts of mental health promotion, including methods and tools for effective practices. Furthermore, a variety of skills-based competencies such as communication and collaboration skills were described. Personal attitudes and values included a holistic approach and respect for human rights, among others. The study provides new information on what competencies are needed to plan, implement and evaluate mental health promotion in health sector practice, with the aim of contributing to a more effective workforce. The competencies provide aid in planning training programmes and qualifications, as well as job descriptions and roles in health sector workplaces related to mental health promotion.

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

    PubMed

    Woodward, Aniek; Fyfe, Molly; Handuleh, Jibril; Patel, Preeti; Godman, Brian; Leather, Andrew; Finlayson, Alexander

    2014-04-23

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

  8. Cardiovascular Health and Arterial Stiffness: The Maine Syracuse Longitudinal Study

    PubMed Central

    Crichton, Georgina E; Elias, Merrill F; Robbins, Michael A

    2014-01-01

    Ideal cardiovascular health is a recently defined construct by the American Heart Association (AHA) to promote cardiovascular disease reduction. Arterial stiffness is a major risk factor for cardiovascular disease. The extent to which the presence of multiple prevalent cardiovascular risk factors and health behaviors is associated with arterial stiffness is unknown. The aim of this study was to examine the association between the AHA construct of cardiovascular health and arterial stiffness, as indexed by pulse wave velocity and pulse pressure. The AHA health metrics, comprising of four health behaviors (smoking, body mass index, physical activity, and diet) and three health factors (total cholesterol, blood pressure, and fasting plasma glucose) were evaluated among 505 participants in the Maine-Syracuse Longitudinal Study. Outcome measures were carotid-femoral pulse wave velocity (PWV) and pulse pressure measured at 4 to 5-year follow-up. Better cardiovascular health, comprising both health factors and behaviors, was associated with lower arterial stiffness, as indexed by pulse wave velocity and pulse pressure. Those with at least five health metrics at ideal levels had significantly lower PWV (9.8 m/s) than those with two or less ideal health metrics (11.7 m/s) (P<0.001). This finding remained with the addition of demographic and PWV-related variables (P=0.004). PMID:24384629

  9. Cardiovascular health and arterial stiffness: the Maine-Syracuse Longitudinal Study.

    PubMed

    Crichton, G E; Elias, M F; Robbins, M A

    2014-07-01

    Ideal cardiovascular health is a recently defined construct by the American Heart Association (AHA) to promote cardiovascular disease reduction. Arterial stiffness is a major risk factor for cardiovascular disease. The extent to which the presence of multiple prevalent cardiovascular risk factors and health behaviors is associated with arterial stiffness is unknown. The aim of this study was to examine the association between the AHA construct of cardiovascular health and arterial stiffness, as indexed by pulse wave velocity (PWV) and pulse pressure. The AHA health metrics, comprising of four health behaviors (smoking, body mass index, physical activity and diet) and three health factors (total cholesterol, blood pressure and fasting plasma glucose), were evaluated among 505 participants in the Maine-Syracuse Longitudinal Study. Outcome measures were carotid-femoral PWV and pulse pressure measured at 4- to 5-year follow-up. Better cardiovascular health, comprising both health factors and behaviors, was associated with lower arterial stiffness, as indexed by PWV and pulse pressure. Those with at least five health metrics at ideal levels had significantly lower PWV (9.8 m s(-1)) than those with two or less ideal health metrics (11.7 m s(-1)) (P < 0.001). This finding remained with the addition of demographic and PWV-related variables (P = 0.004).

  10. Beacon Communities’ Public Health Initiatives: A Case Study Analysis

    PubMed Central

    Massoudi, Barbara L.; Marcial, Laura H.; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

    2014-01-01

    Introduction: The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. Background: The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Methods: Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Findings: Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7–14) present for each Beacon compared to barriers (range = 4–6). Discussion: Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. Conclusions: A common weakness was the lack of a framework or model for

  11. Beacon communities' public health initiatives: a case study analysis.

    PubMed

    Massoudi, Barbara L; Marcial, Laura H; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

    2014-01-01

    The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7-14) present for each Beacon compared to barriers (range = 4-6). Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach

  12. A nationally representative study of emotional competence and health.

    PubMed

    Mikolajczak, Moïra; Avalosse, Hervé; Vancorenland, Sigrid; Verniest, Rebekka; Callens, Michael; van Broeck, Nady; Fantini-Hauwel, Carole; Mierop, Adrien

    2015-10-01

    Emotional competence (EC; also called "emotional intelligence"), which refers to individual differences in the identification, understanding, expression, regulation, and use of one's emotions and those of others, has been found to be an important predictor of individuals' adaptation to their environment. Higher EC is associated with greater happiness, better mental health, more satisfying social and marital relationships, and greater occupational success. Whereas a considerable amount of research has documented the significance of EC, 1 domain has been crucially under investigated: the relationship between EC and physical health. We examined the relationship between EC and objective health indicators in 2 studies (N1 = 1,310; N2 = 9,616) conducted in collaboration with the largest Mutual Benefit Society in Belgium. These studies allowed us (a) to compare the predictive power of EC with other well-known predictors of health such as age, sex, Body Mass Index, education level, health behaviors (diet, physical activity, smoking and drinking habits), positive and negative affect, and social support; (b) to clarify the relative weight of the various EC dimensions in predicting health; and (c) to determine to what extent EC moderates the effect of already known predictors on health. Results show that EC is a significant predictor of health that has incremental predictive power over and above other predictors. Findings also show that high EC significantly attenuates (and sometimes compensates for) the impact of other risk factors. Therefore, we argue that EC deserves greater interest and attention from health professionals and governments. (c) 2015 APA, all rights reserved).

  13. Air Pollution Exposure Model for Individuals (EMI) in Health Studies

    EPA Science Inventory

    In health studies, traffic-related air pollution is associated with adverse respiratory effects. Due to cost and participant burden of personal measurements, health studies often estimate exposures using local ambient air monitors. Since outdoor levels do not necessarily reflect ...

  14. Searching for religion and mental health studies required health, social science, and grey literature databases.

    PubMed

    Wright, Judy M; Cottrell, David J; Mir, Ghazala

    2014-07-01

    To determine the optimal databases to search for studies of faith-sensitive interventions for treating depression. We examined 23 health, social science, religious, and grey literature databases searched for an evidence synthesis. Databases were prioritized by yield of (1) search results, (2) potentially relevant references identified during screening, (3) included references contained in the synthesis, and (4) included references that were available in the database. We assessed the impact of databases beyond MEDLINE, EMBASE, and PsycINFO by their ability to supply studies identifying new themes and issues. We identified pragmatic workload factors that influence database selection. PsycINFO was the best performing database within all priority lists. ArabPsyNet, CINAHL, Dissertations and Theses, EMBASE, Global Health, Health Management Information Consortium, MEDLINE, PsycINFO, and Sociological Abstracts were essential for our searches to retrieve the included references. Citation tracking activities and the personal library of one of the research teams made significant contributions of unique, relevant references. Religion studies databases (Am Theo Lib Assoc, FRANCIS) did not provide unique, relevant references. Literature searches for reviews and evidence syntheses of religion and health studies should include social science, grey literature, non-Western databases, personal libraries, and citation tracking activities. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. A family health case study. Stillbirth.

    PubMed

    Edmands, E M

    1982-01-01

    This is an example of a case study written to describe the physical and psychological impact of stillbirth on the patient and the family, and how it can be used in the teaching of family health. It is suggested that the teacher prepare the students by reviewing the known causes of stillbirth and the physiology of labor and delivery. The patient, her family, and her community are described in detail. The situation and events are given in the form of a story. After the presentation, questions are put to the students that require their assessment of the requirements of the patient and her family in terms of nursing-midwifery management. A number of follow-ups are suggested for the teacher and students. This material was prepared by INTRAH staff members. Other materials prepared include training exercise in group dynamics, how to use tracing techniques to create visual aids, how to evaluate teaching and how to create a family health case study.

  16. The impact of both spousal caregivers' and care recipients' health on relationship satisfaction in the Caregiver Health Effects Study.

    PubMed

    Monin, Joan K; Levy, Becca; Doyle, Margaret; Schulz, Richard; Kershaw, Trace

    2017-03-01

    This study examined, with a sample of older adult, caregiving couples, whether each spouse's health was associated with their own and their partner's relationship satisfaction. Dyads ( n = 233; age = 64-99 years) in the Caregiver Health Effects Study, ancillary to the Cardiovascular Health Study, reported relationship satisfaction, depressive symptoms, disability, and self-reported health. The cross-sectional Actor-Partner Interdependence Model showed that for both caregivers and care recipients, greater depressive symptoms and lower self-reported health related to lower relationship satisfaction (actor effects). Caregivers had lower relationship satisfaction when they were more disabled (actor effect) and when care recipients were more depressed (partner effect).

  17. State funding for local public health: observations from six case studies.

    PubMed

    Potter, Margaret A; Fitzpatrick, Tiffany

    2007-01-01

    The purpose of this study is to describe state funding of local public health within the context of state public health system types. These types are based on administrative relationships, legal structures, and relative proportion of state funding in local public health budgets. We selected six states representing various types and geographic regions. A case study for each state summarized available information and was validated by state public health officials. An analysis of the case studies reveals that the variability of state public health systems--even within a given type--is matched by variability in approaches to funding local public health. Nevertheless, some meaningful associations appear. For example, higher proportions of state funding occur along with higher levels of state oversight and the existence of local service mandates in state law. These associations suggest topics for future research on public health financing in relation to local accountability, local input to state priority-setting, mandated local services, and the absence of state funds for public health services in some local jurisdictions.

  18. Occupational health management system: A study of expatriate construction professionals.

    PubMed

    Chan, I Y S; Leung, M Y; Liu, A M M

    2016-08-01

    Due to its direct impact on the safety and function of organizations, occupational health has been a concern of the construction industry for many years. The inherent complexity of occupational health management presents challenges that make a systems approach essential. From a systems perspective, health is conceptualized as an emergent property of a system in which processes operating at the individual and organizational level are inextricably connected. Based on the fundamental behavior-to-performance-to-outcome (B-P-O) theory of industrial/organizational psychology, this study presents the development of an I-CB-HP-O (Input-Coping Behaviors-Health Performance-Outcomes) health management systems model spanning individual and organizational boundaries. The model is based on a survey of Hong Kong expatriate construction professionals working in Mainland China. Such professionals tend to be under considerable stress due not only to an adverse work environment with dynamic tasks, but also the need to confront the cross-cultural issues arising from expatriation. A questionnaire was designed based on 6 focus groups involving 44 participants, and followed by a pilot study. Of the 500 questionnaires distributed in the main study, 137 valid returns were received, giving a response rate of 27.4%. The data were analyzed using statistical techniques such as factor analysis, reliability testing, Pearson correlation analysis, multiple regression modeling, and structural equation modeling. Theories of coping behaviors and health performance tend to focus on the isolated causal effects of single factors and/or posits the model at single, individual level; while industrial practices on health management tend to focus on organizational policy and training. By developing the I-CB-HP-O health management system, incorporating individual, interpersonal, and organizational perspectives, this study bridges the gap between theory and practice while providing empirical support for a

  19. Association between parity and dentition status among Japanese women: Japan public health center-based oral health study.

    PubMed

    Ueno, Masayuki; Ohara, Satoko; Inoue, Manami; Tsugane, Shoichiro; Kawaguchi, Yoko

    2013-10-22

    Several studies have shown that parity is associated with oral health problems such as tooth loss and dental caries. In Japan, however, no studies have examined the association. The purpose of this study was to determine whether parity is related to dentition status, including the number of teeth present, dental caries and filled teeth, and the posterior occlusion, in a Japanese population by comparing women with men. A total of 1,211 subjects, who participated both in the Japan Public Health Center-Based (JPHC) Study Cohort I in 1990 and the dental survey in 2005, were used for the study. Information on parity or number of children was collected from a self-completed questionnaire administered in 1990 for the JPHC Study Cohort I, and health behaviors and clinical dentition status were obtained from the dental survey in 2005. The association between parity or number of children and dentition status was analyzed, by both unadjusted-for and adjusted-for socio-demographic and health behavioral factors, using a generalized linear regression model. Parity is significantly related to the number of teeth present and n-FTUs (Functional Tooth Units of natural teeth), regardless of socio-demographic and health behavioral factors, in female subjects. The values of these variables had a significantly decreasing trend with the rise of parity: numbers of teeth present (p for trend = 0.046) and n-FTUs (p for trend = 0.026). No relationships between the number of children and dentition status were found in male subjects. Higher-parity women are more likely to lose teeth, especially posterior occluding relations. These results suggest that measures to narrow the discrepancy by parity should be taken for promoting women's oral health. Delivery of appropriate information and messages to pregnant women as well as enlightenment of oral health professionals about dental management of pregnant women may be an effective strategy.

  20. Consumer Health-Related Activities on Social Media: Exploratory Study.

    PubMed

    Benetoli, Arcelio; Chen, Timothy F; Aslani, Parisa

    2017-10-13

    Although a number of studies have investigated how consumers use social media for health-related purposes, there is a paucity of studies in the Australian context. This study aimed to explore how Australian consumers used social media for health-related purposes, specifically how they identified social media platforms, which were used, and which health-related activities commonly took place. A total of 5 focus groups (n=36 participants), each lasting 60 to 90 minutes, were conducted in the Sydney metropolitan area. The group discussions were audiorecorded and transcribed verbatim. The transcripts were coded line-by-line and thematically analyzed. Participants used general search engines to locate health-related social media platforms. They accessed a wide range of social media on a daily basis, using several electronic devices (in particular, mobile phones). Although privacy was a concern, it did not prevent consumers from fully engaging in social media for health-related purposes. Blogs were used to learn from other people's experiences with the same condition. Facebook allowed consumers to follow health-related pages and to participate in disease-specific group discussions. Wikipedia was used for factual information about diseases and treatments. YouTube was accessed to learn about medical procedures such as surgery. No participant reported editing or contributing to Wikipedia or posting YouTube videos related to health topics. Twitter was rarely used for health-related purposes. Social media allowed consumers to obtain and provide disease and treatment-related information and social and emotional support for those living with the same condition. Most considered their participation as observational, but some also contributed (eg, responded to people's questions). Participants used a wide range of social media for health-related purposes. Medical information exchange (eg, disease and treatment) and social and emotional support were the cornerstones of their online

  1. Consumer Health-Related Activities on Social Media: Exploratory Study

    PubMed Central

    Chen, Timothy F; Aslani, Parisa

    2017-01-01

    Background Although a number of studies have investigated how consumers use social media for health-related purposes, there is a paucity of studies in the Australian context. Objective This study aimed to explore how Australian consumers used social media for health-related purposes, specifically how they identified social media platforms, which were used, and which health-related activities commonly took place. Methods A total of 5 focus groups (n=36 participants), each lasting 60 to 90 minutes, were conducted in the Sydney metropolitan area. The group discussions were audiorecorded and transcribed verbatim. The transcripts were coded line-by-line and thematically analyzed. Results Participants used general search engines to locate health-related social media platforms. They accessed a wide range of social media on a daily basis, using several electronic devices (in particular, mobile phones). Although privacy was a concern, it did not prevent consumers from fully engaging in social media for health-related purposes. Blogs were used to learn from other people’s experiences with the same condition. Facebook allowed consumers to follow health-related pages and to participate in disease-specific group discussions. Wikipedia was used for factual information about diseases and treatments. YouTube was accessed to learn about medical procedures such as surgery. No participant reported editing or contributing to Wikipedia or posting YouTube videos related to health topics. Twitter was rarely used for health-related purposes. Social media allowed consumers to obtain and provide disease and treatment-related information and social and emotional support for those living with the same condition. Most considered their participation as observational, but some also contributed (eg, responded to people’s questions). Conclusions Participants used a wide range of social media for health-related purposes. Medical information exchange (eg, disease and treatment) and social and

  2. Air pollution and health in Sri Lanka: a review of epidemiologic studies.

    PubMed

    Nandasena, Yatagama Lokuge S; Wickremasinghe, Ananda R; Sathiakumar, Nalini

    2010-06-02

    Air pollution is increasingly documented as a threat to public health in most developing countries. Evaluation of current air quality levels, regulatory standards and scientific literature on outdoor and indoor air pollution, and health effects are important to identify the burden, develop and implement interventions and to fill knowledge gaps in Sri Lanka. PUBMED and Medline databases, local journals and conference proceedings were searched for epidemiologic studies pertaining to air pollution and health effects in Sri Lanka. All the studies pertaining to air pollution and health effects were considered. Sixteen studies investigated the association between exposure to ambient or indoor air pollution (IAP) and various health outcomes ranging from respiratory symptoms, low birth weight and lung cancers. Of the sixteen, three used a case control design. Half of the studies collected exposure data only through questionnaires. There were positive associations between air pollution and adverse health effects in all studies. Methodological limitations in most of the studies resulted in poor quantification of risk estimates. A limited number of epidemiological studies in Sri Lanka have investigated the health effects of air pollution. Based on findings of studies and reported air quality levels, air pollution may be considered a neglected public health problem in Sri Lanka.

  3. Health and aging: development of the Irish Longitudinal Study on Ageing health assessment.

    PubMed

    Cronin, Hilary; O'Regan, Clare; Finucane, Ciaran; Kearney, Patricia; Kenny, Rose Anne

    2013-05-01

    To assist researchers planning studies similar to The Irish Longitudinal Study on Ageing (TILDA), concerning the development of the health assessment component, to promote use of the archived data set, to inform researchers of the methods employed, and to complement the accompanying article on normative values. Prospective, longitudinal study of older adults. Republic of Ireland. Eight thousand five hundred four community-dwelling adults who participated in wave 1 of the TILDA study. The main areas of focus for the TILDA health assessments are neurocardiovascular instability, locomotion, and vision. The article describes the scientific rationale for the choice of assessments and seeks to determine the potential advantages of incorporating novel biomeasures and technologies in population-based studies to advance understanding of aging-related disorders. The detailed description of the physical measures will facilitate cross-national comparative research and put into context the normative values outlined in the subsequent article. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  4. The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health.

    PubMed

    Fink, Per; Ørnbøl, Eva; Christensen, Kaj Sparle

    2010-03-24

    Hypochondriasis is prevalent in primary care, but the diagnosis is hampered by its stigmatizing label and lack of valid diagnostic criteria. Recently, new empirically established criteria for Health anxiety were introduced. Little is known about Health anxiety's impact on longitudinal outcome, and this study aimed to examine impact on self-rated health and health care costs. 1785 consecutive primary care patients aged 18-65 consulting their family physicians (FPs) for a new illness were followed-up for two years. A stratified subsample of 701 patients was assessed by the Schedules for Clinical Assessment in Neuropsychiatry interview. Patients with mild (N = 21) and severe Health anxiety (N = 81) and Hypochondriasis according to the DSM-IV (N = 59) were compared with a comparison group of patients who had a well-defined medical condition according to their FPs and a low score on the screening questionnaire (N = 968). Self-rated health was measured by questionnaire at index and at three, 12, and 24 months, and health care use was extracted from patient registers. Compared with the 968 patients with well-defined medical conditions, the 81 severe Health anxiety patients and the 59 DSM-IV Hypochondriasis patients continued during follow-up to manifest significantly more Health anxiety (Whiteley-7 scale). They also continued to have significantly worse self-rated functioning related to physical and mental health (component scores of the SF-36). The severe Health anxiety patients used about 41-78% more health care per year in total, both during the 3 years preceding inclusion and during follow-up, whereas the DSM-IV Hypochondriasis patients did not have statistically significantly higher total use. A poor outcome of Health anxiety was not explained by comorbid depression, anxiety disorder or well-defined medical condition. Patients with mild Health anxiety did not have a worse outcome on physical health and incurred significantly less health care costs than the group of

  5. The Neighbourhood Effects on Health and Well-being (NEHW) study.

    PubMed

    O'Campo, Patricia; Wheaton, Blair; Nisenbaum, Rosane; Glazier, Richard H; Dunn, James R; Chambers, Catharine

    2015-01-01

    Many cross-sectional studies of neighbourhood effects on health do not employ strong study design elements. The Neighbourhood Effects on Health and Well-being (NEHW) study, a random sample of 2412 English-speaking Toronto residents (age 25-64), utilises strong design features for sampling neighbourhoods and individuals, characterising neighbourhoods using a variety of data sources, measuring a wide range of health outcomes, and for analysing cross-level interactions. We describe here methodological issues that shaped the design and analysis features of the NEHW study to ensure that, while a cross-sectional sample, it will advance the quality of evidence emerging from observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Psychedelics and Mental Health: A Population Study

    PubMed Central

    Krebs, Teri S.; Johansen, Pål-Ørjan

    2013-01-01

    Background The classical serotonergic psychedelics LSD, psilocybin, mescaline are not known to cause brain damage and are regarded as non-addictive. Clinical studies do not suggest that psychedelics cause long-term mental health problems. Psychedelics have been used in the Americas for thousands of years. Over 30 million people currently living in the US have used LSD, psilocybin, or mescaline. Objective To evaluate the association between the lifetime use of psychedelics and current mental health in the adult population. Method Data drawn from years 2001 to 2004 of the National Survey on Drug Use and Health consisted of 130,152 respondents, randomly selected to be representative of the adult population in the United States. Standardized screening measures for past year mental health included serious psychological distress (K6 scale), mental health treatment (inpatient, outpatient, medication, needed but did not receive), symptoms of eight psychiatric disorders (panic disorder, major depressive episode, mania, social phobia, general anxiety disorder, agoraphobia, posttraumatic stress disorder, and non-affective psychosis), and seven specific symptoms of non-affective psychosis. We calculated weighted odds ratios by multivariate logistic regression controlling for a range of sociodemographic variables, use of illicit drugs, risk taking behavior, and exposure to traumatic events. Results 21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems. Conclusion We did not find use of psychedelics to be an independent risk factor for mental health problems. PMID:23976938

  7. Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study

    PubMed Central

    Gerritsen, Annette AM; Bramsen, Inge; Devillé, Walter; van Willigen, Loes HM; Hovens, Johannes E; van der Ploeg, Henk M

    2004-01-01

    Background This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services. Methods/Design The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands. The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose. This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees. PMID:15070416

  8. Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study.

    PubMed

    Gerritsen, Annette A M; Bramsen, Inge; Devillé, Walter; van Willigen, Loes H M; Hovens, Johannes E; van der Ploeg, Henk M

    2004-03-10

    This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services. The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands. The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose. This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees.

  9. The Health and Retirement Study: Analysis of Associations Between Use of the Internet for Health Information and Use of Health Services at Multiple Time Points.

    PubMed

    Shim, Hyunju; Ailshire, Jennifer; Zelinski, Elizabeth; Crimmins, Eileen

    2018-05-25

    The use of the internet for health information among older people is receiving increasing attention, but how it is associated with chronic health conditions and health service use at concurrent and subsequent time points using nationally representative data is less known. This study aimed to determine whether the use of the internet for health information is associated with health service utilization and whether the association is affected by specific health conditions. The study used data collected in a technology module from a nationally representative sample of community-dwelling older Americans aged 52 years and above from the 2012 Health and Retirement Study (HRS; N=991). Negative binomial regressions were used to examine the association between use of Web-based health information and the reported health service uses in 2012 and 2014. Analyses included additional covariates adjusting for predisposing, enabling, and need factors. Interactions between the use of the internet for health information and chronic health conditions were also tested. A total of 48.0% (476/991) of Americans aged 52 years and above reported using Web-based health information. The use of Web-based health information was positively associated with the concurrent reports of doctor visits, but not over 2 years. However, an interaction of using Web-based health information with diabetes showed that users had significantly fewer doctor visits compared with nonusers with diabetes at both times. The use of the internet for health information was associated with higher health service use at the concurrent time, but not at the subsequent time. The interaction between the use of the internet for health information and diabetes was significant at both time points, which suggests that health-related internet use may be associated with fewer doctor visits for certain chronic health conditions. Results provide some insight into how Web-based health information may provide an alternative health care

  10. Mental health service users' experiences of diabetes care by Mental Health Nurses: an exploratory study.

    PubMed

    Nash, M

    2014-10-01

    This paper is a report of a study exploring mental health service users' (MHSUs') experiences of diabetes care. Diabetes is a growing clinical concern in mental health nursing practice. However, little is known about MHSUs' experience of diabetes care. This is a descriptive qualitative study. Semi-structured telephone interviews were held between June and October 2011, with seven MHSUs who had diabetes. Participants reported experiences of stigma and diagnostic overshadowing (DO) when reporting symptoms of diabetes or when feeling unwell. Participants also encountered a split between their mental health and diabetes care needs, which resulted in a lack of holistic or integrated care. All participants mentioned experiencing complications of diabetes even to the extent of diabetic ketoacidosis. Mental health nurses (MHNs) must critically reflect on their attitudes towards service users that report physical symptoms to ensure that stigma and DO do not constitute barriers to appropriate screening and treatment. The complex relationship that exists between mental illness and diabetes requires MHNs to ensure physical and mental health care are wholly integrated and not split. Education needs are apparent so that symptoms and complications can be recognized and treated accordingly. © 2014 John Wiley & Sons Ltd.

  11. Organisational justice and mental health: a systematic review of prospective studies.

    PubMed

    Ndjaboué, Ruth; Brisson, Chantal; Vézina, Michel

    2012-10-01

    The models most commonly used, to study the effects of psychosocial work factors on workers' health, are the demand-control-support (DCS) model and Effort-Reward Imbalance (ERI) model. An emerging body of research has identified Organisational Justice as another model that can help to explain deleterious health effects. This review aimed: (1) to identify prospective studies of the associations between organisational justice and mental health in industrialised countries from 1990 to 2010; (2) to evaluate the extent to which organisational justice has an effect on mental health independently of the DCS and ERI models; and (3) to discuss theoretical and empirical overlap and differences with previous models. The studies had to present associations between organisational justice and a mental health outcome, be prospective, and be entirely available in English or in French. Duplicated papers were excluded. Eleven prospective studies were selected for this review. They provide evidence that procedural justice and relational justice are associated with mental health. These associations remained significant even after controlling for the DCS and ERI models. There is a lack of prospective studies on distributive and informational justice. In conclusion, procedural and relational justice can be considered a different and complementary model to the DCS and ERI models. Future studies should evaluate the effect of change in exposure to organisational justice on employees' mental health over time.

  12. Adolescent health--a descriptive study of a school doctor clinic.

    PubMed

    Chavasse, M; North, D; McAvoy, B

    1995-07-14

    To describe a school doctor clinic at a New Zealand secondary school. A three phase study was designed and conducted at a coeducational secondary school in Auckland. Firstly, a health questionnaire was developed to assess adolescents' perceptions of their health status and use of primary health care services. The second phase was descriptive study of a newly established school doctor clinic. The doctor clinic was run twice weekly over a 3 month period in 1993. The third phase of the study was a clinic-based satisfaction survey. A 75% response rate was achieved, with a total of 221 health questionnaires completed from 292. Although the majority of students (n = 184, 84%) considered themselves healthy, 16% (n = 36) described their health as only 'fair' or 'poor'. Seventy one percent (n = 157) of students had seen their general practitioner in the preceeding twelve months. Thirteen percent (n = 142) of the school population consulted the school doctor clinic. Significantly more female, Maori and European students attended the school doctor clinic compared with the school demography. The commonest diagnoses for the doctor clinic were respiratory, skin and musculoskeletal problems. Thirty one percent of the diagnoses related to recognised adolescent health needs such as contraception, sexual health, nutrition, and psychosocial problems. Over two thirds of students at the first consultation had not seen another health provider. Students perceived that the doctor clinic overcame barriers such as access, cost and confidentiality. The school doctor clinic was well utilised, overcame some barriers to access and addressed many recognised adolescent health needs.

  13. Public Health Dental Hygienists in Massachusetts: A Qualitative Study.

    PubMed

    Rainchuso, Lori; Salisbury, Helen

    2017-06-01

    Purpose: The aim of this qualitative, phenomenological study was to explore the attitudes and perceptions of public health dental hygienists on providing preventive care to underserved populations in Massachusetts. Methods: Non-probability purposive sampling was used for initial participant recruitment, and snowball sampling occurred thereafter. Data collection occurred through semi-structured interviews. Qualitative analysis was conducted using Pitney and Parker's eight-step CREATIVE process. Results: Data saturation occurred with 10 participants (n=10), one-third of the public health dental hygienists who are practicing in Massachusetts. The majority of practice settings included school-based programs (70%), while programs for children with special needs (10%) were the least common. Two major themes emerged from the data; (a) the opportunity to be an oral health change agent and (b) barriers to practice. Six subcategories emerged from the data and are reviewed within the context of their associated themes. Additionally, career satisfaction emerged as an unintended theme, and was reported as the driving force for the majority of participants. Conclusion: This study revealed a better understanding of the public health dental hygiene workforce model in Massachusetts. Public health dental hygienists in Massachusetts perceive themselves as change agents within the health care profession, and although barriers to practice are plentiful, these oral health care professionals are committed to improving access to dental care. Copyright © 2017 The American Dental Hygienists’ Association.

  14. Comparative Study of Preschool Children's Current Health Issues and Health Education in New Zealand and Japan

    ERIC Educational Resources Information Center

    Watanabe, Kanae; Dickinson, Annette

    2017-01-01

    In New Zealand and Japan, despite health education on food, exercise, and hygiene, children's health is an important concern in preschools. This study investigated the relationship between children's health and health education in New Zealand and Japan using a qualitative interpretative descriptive design method and semi-structured interviews with…

  15. Improving the Mental Health, Healthy Lifestyle Choices, and Physical Health of Hispanic Adolescents: A Randomized Controlled Pilot Study

    ERIC Educational Resources Information Center

    Melnyk, Bernadette M.; Jacobson, Diana; Kelly, Stephanie; O'Haver, Judith; Small, Leigh; Mays, Mary Z.

    2009-01-01

    Background: Obesity and mental health disorders are 2 major public health problems in American adolescents, with prevalence even higher in Hispanic teens. Despite the rapidly increasing incidence and adverse health outcomes associated with overweight and mental health problems, very few intervention studies have been conducted with adolescents to…

  16. The effects of an urban renewal project on health and health inequalities: a quasi-experimental study in Barcelona.

    PubMed

    Mehdipanah, Roshanak; Rodríguez-Sanz, Maica; Malmusi, Davide; Muntaner, Carles; Díez, Elia; Bartoll, Xavier; Borrell, Carme

    2014-09-01

    In the last decade, the Neighbourhoods Law in Catalonia (Spain) funded municipalities that presented urban renewal projects within disadvantaged neighbourhoods focusing on physical, social and economic improvements. The objective of the study was to evaluate the effects of this law on the health and health inequalities of residents in the intervened neighbourhoods in the city of Barcelona. A quasi-experimental predesign and postdesign was used to compare adult residents in five intervened neighbourhoods with eight non-intervened comparison neighbourhoods with similar socioeconomic characteristics. The Barcelona Health Survey was used for studying self-rated and mental health in pre (2001, 2006) and post (2011) years. Poisson regression models stratified by sex were used to compute prevalence ratios comparing 2011 with 2006, and later stratified by social class, to study health inequalities. The intervened neighbourhoods had a significant decrease in poor self-rated health in both sexes while no significant changes occurred in the comparison group. When stratified by social class, a significant improvement was observed in poor self-rated health in the manual group of the intervened neighbourhoods in both sexes, resulting in a decrease in self-rated health inequalities. Similar results were observed in poor mental health of women, while in men, poor mental health worsens in both neighbourhood groups but mostly in the comparison group. The Neighbourhoods Law had a positive effect on self-rated health and seems to prevent poor mental health increases in both sexes and especially among manual social classes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. [Factors Influencing Participation in Financial Incentive Programmes of Health Insurance Funds. Results of the Study 'German Health Update'].

    PubMed

    Jordan, S; von der Lippe, E; Starker, A; Hoebel, J; Franke, A

    2015-11-01

    The statutory health insurance can offer their insured incentive programmes that will motivate for healthy behaviour through a financial or material reward. This study will show results about what factors influence financial incentive programme participation (BPT) including all sorts of statutory health insurance funds and taking into account gender differences. For the cross-sectional analysis, data were used from 15,858 participants in the study 'Germany Health Update' (GEDA) from 2009, who were insured in the statutory health insurance. The selection of potential influencing variables for a BPT is based on the "Behavioural Model for Health Service Use" of Andersen. Accordingly, various factors were included in logistic regression models, which were calculated separately by gender: predisposing factors (age, education, social support, and health awareness), enabling factors (income, statutory health insurance fund, and family physician), and need factors (smoking, fruit and vegetable consumption, sports, body mass index, and general health status). In consideration of all factors, for both sexes, BPT is associated with age, health awareness, education, use of a family physician, smoking, and sports activities. In addition, income, body mass index, and diet are significant in women and social support and kind of statutory health insurance fund in men. It is found that predisposing, enabling and need factors are relevant. Financial incentive programmes reach population groups with greatest need less than those groups who already have a health-conscious behaviour, who receive a reward for this. In longitudinal studies, further research on financial incentive programmes should investigate the existence of deadweight effects and whether incentive programmes can contribute to the reduction of the inequity in health. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Mental health affects future employment as job loss affects mental health: findings from a longitudinal population study.

    PubMed

    Olesen, Sarah C; Butterworth, Peter; Leach, Liana S; Kelaher, Margaret; Pirkis, Jane

    2013-05-24

    Workforce participation is a key feature of public mental health and social inclusion policies across the globe, and often a therapeutic goal in treatment settings. Understanding the reciprocal relationship between participation and mental health has been limited by inadequate research methods. This is the first study to simultaneously examine and contrast the relative effects of unemployment on mental health and mental health on employment status in a single general population sample. Data were from working-age respondents (20 to 55 years at baseline) who completed nine waves of the Household, Income and Labour Dynamics in Australia (HILDA) Survey (N=7176). Cross-lagged path analyses were used to test the lagged and concurrent associations between unemployment and mental health over time, adjusting for sociodemographic characteristics. Mental health was shown to be both a consequence of and risk factor for unemployment. Thus, the poorer mental health observed amongst people who are not working is attributable to both the impact of unemployment and existing mental health problems. While the strength of these two effects was similar for women, the results for men suggested that the effect of unemployment on subsequent mental health was weaker than the effect of mental health on subsequent risk of unemployment. Disentangling the reciprocal links between mental health and workforce participation is central to the development and success of clinical goals and health and social policies that aim to promote either aspect. This study demonstrates that both effects are important and supports concurrent responses to prevent a cycle of disadvantage and entrenched social exclusion.

  19. Mental health affects future employment as job loss affects mental health: findings from a longitudinal population study

    PubMed Central

    2013-01-01

    Background Workforce participation is a key feature of public mental health and social inclusion policies across the globe, and often a therapeutic goal in treatment settings. Understanding the reciprocal relationship between participation and mental health has been limited by inadequate research methods. This is the first study to simultaneously examine and contrast the relative effects of unemployment on mental health and mental health on employment status in a single general population sample. Method Data were from working-age respondents (20 to 55 years at baseline) who completed nine waves of the Household, Income and Labour Dynamics in Australia (HILDA) Survey (N=7176). Cross-lagged path analyses were used to test the lagged and concurrent associations between unemployment and mental health over time, adjusting for sociodemographic characteristics. Results Mental health was shown to be both a consequence of and risk factor for unemployment. Thus, the poorer mental health observed amongst people who are not working is attributable to both the impact of unemployment and existing mental health problems. While the strength of these two effects was similar for women, the results for men suggested that the effect of unemployment on subsequent mental health was weaker than the effect of mental health on subsequent risk of unemployment. Conclusion Disentangling the reciprocal links between mental health and workforce participation is central to the development and success of clinical goals and health and social policies that aim to promote either aspect. This study demonstrates that both effects are important and supports concurrent responses to prevent a cycle of disadvantage and entrenched social exclusion. PMID:23705753

  20. Quality and Importance of Health Policy, Reform, and Public Health Topics: A Study in Physician Assistant Education.

    PubMed

    Angerer-Fuenzalida, Frances M

    2018-06-01

    As key players in a changing US health care system, physician assistants (PAs) must be prepared to act with a clear understanding of health policy as reform changes are enacted. The purpose of this study was to assess the perceptions of graduating PA students about the importance of health policy, reform, and public health and their perception of their preparedness in these areas. The research question was: Do PA students identify these topic areas as important, and, for each topic area, do they feel adequately prepared with sufficient knowledge for clinical practice? Participants in the study included 352 PA students from 14 PA programs randomly selected from 4 geographic regions of the continental United States. A 20-item instrument, the Health Policy Perception Tool, was developed and validated for data collection. Physician assistant students rated content items high on the importance scale and displayed a wide range of ratings on their perceived preparedness in each content area. Health policy/reform items demonstrated the highest disparity, with students indicating that they were least prepared in content areas relating to the Affordable Care Act, such as patient-centered medical home and accountable care organizations. They also rated health system structure/function items as moderately important, but indicated that they were ill prepared on this topic. Public health topics were rated highly on both scales. Physician assistant programs appear to be addressing public health issues well; however, PA education leaders must address the low levels of preparedness in the other areas of health care, specifically those related to health structure/function and health reform.

  1. Reorienting health services with capacity building: a case study of the Core Skills in Health Promotion Project.

    PubMed

    Yeatman, H R; Nove, T

    2002-12-01

    This paper presents a case study of the application of a framework for capacity building [Hawe, P., King, L., Noort, M., Jordens, C. and Lloyd, B. (2000) Indicators to Help with Capacity Building in Health Promotion. NSW Health, Sydney] to describe actions aimed at building organizational support for health promotion within an area health service in New South Wales, Australia. The Core Skills in Health Promotion Project (CSHPP) arose from an investigation which reported that participants of a health promotion training course had increased health promotion skills but that they lacked the support to apply their skills in the workplace. The project was action-research based. It investigated and facilitated the implementation of a range of initiatives to support community health staff to apply a more preventive approach in their practice and it contributed to the establishment of new organizational structures for health promotion. An evaluation was undertaken 4 years after the CSHPP was established, and 2 years after it had submitted its final report. Interviews with senior managers, document analysis of written reports, and focus groups with middle managers and service delivery staff were undertaken. Change was achieved in the three dimensions of health infrastructure, program maintenance and problem solving capacity of the organization. It was identified that the critically important elements in achieving the aims of the project-partnership, leadership and commitment-were also key elements of the capacity building framework. This case study provides a practical example of the usefulness of the capacity building framework in orienting health services to be supportive of health promotion.

  2. Factors associated with self-reported health: implications for screening level community-based health and environmental studies

    EPA Science Inventory

    BACKGROUND: Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based heath indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mort...

  3. Fathers and their children's health: a telephone interview study.

    PubMed

    Hallberg, A-C; Kristiansson, R; Beckman, A; Petersson, K; Råstam, L; Håkansson, A

    2007-07-01

    To study fathers' perception of, and involvement in, their children's health. Telephone interviews according to a structured guide. County of Skåne, Sweden. Answers regarding care and upbringing of child, child's health and ill health, and role of father. 237 fathers of small children. Fathers seem to be involved in their children to a large extent, both in caring and playing activities with their children. Most of them (82%) think that the child's health is good, and half of them (55%) have, at some time, contacted a doctor. The fathers mention security, love and commitment as important factors for being a good father, and almost all (97%) think that they are good fathers. Yet, only slightly more than half of them (54%) state that they have sufficient time for the child. Today, fathers are subject to quite different expectations to participate actively in their children's everyday life than was the case for previous generations. Therefore, more studies of fathers' involvement in their children are needed, as well as a new approach within the health care system to fathers' participation.

  4. Academic-health department collaborative relationships are reciprocal and strengthen public health practice: results from a study of academic research centers.

    PubMed

    Neri, Elizabeth M; Ballman, Marie R; Lu, Hua; Greenlund, Kurt J; Grunbaum, Jo Anne

    2014-01-01

    Collaborations between academic institutions and state and local health departments have been shown to enhance the public health core functions of Assurance by improving the public health workforce's knowledge and skills. Few studies have analyzed how academic-health department collaborations enhance Assessment and Policy Development core functions. This qualitative study explores types of collaborations between health departments and Prevention Research Centers (PRCs) and how they align with the core functions. Prevention Research Centers are academic institutions funded by the Centers for Disease Control and Prevention to conduct public health research and translate research results for policies and practices. We reviewed each PRC's annual report from fiscal year 2011 and abstracted descriptions of PRC-health department collaborations. We identified 14 themes of PRC-health department collaborations and conducted a qualitative analysis to describe the dimensions and distribution of themes. Of the 37 PRCs, 36 reported 215 collaborations with 19 city, 97 county, 31 state, and 46 tribal health departments. Themes of research, survey, and surveillance aligned with the Assessment core function and evaluation, strategic planning, technical assistance, and program implementation supported the Policy Development and Assurance core functions. Overall, health departments provided on-the-ground expertise to inform PRC research, ensuring its applicability to public health practice. Reciprocally, PRCs improved data quality, increased the scientific rigor of health department processes and programs, and filled knowledge gaps within health departments. Both PRCs and health departments enhanced the relevance of public health programs and practices by grounding implementation and evaluation in community needs and views. Findings from this study demonstrate that PRC-health department collaborations often enhanced multiple core functions that could lead to implementation of evidence

  5. Mediterranean diet and telomere length in Nurses' Health Study: population based cohort study.

    PubMed

    Crous-Bou, Marta; Fung, Teresa T; Prescott, Jennifer; Julin, Bettina; Du, Mengmeng; Sun, Qi; Rexrode, Kathryn M; Hu, Frank B; De Vivo, Immaculata

    2014-12-02

    To examine whether adherence to the Mediterranean diet was associated with longer telomere length, a biomarker of aging. Population based cohort study. Nurses' Health Study, an ongoing prospective cohort study of 121,700 nurses enrolled in 1976; in 1989-90 a subset of 32,825 women provided blood samples. 4676 disease-free women from nested case-control studies within the Nurses' Health Study with telomere length measured who also completed food frequency questionnaires. Association between relative telomere lengths in peripheral blood leukocytes measured by quantitative real time polymerase chain reaction and Alternate Mediterranean Diet score calculated from self reported dietary data. Greater adherence to the Mediterranean diet was associated with longer telomeres after adjustment for potential confounders. Least squares mean telomere length z scores were -0.038 (SE 0.035) for the lowest Mediterranean diet score groups and 0.072 (0.030) for the highest group (P for trend = 0.004). In this large study, greater adherence to the Mediterranean diet was associated with longer telomeres. These results further support the benefits of adherence to the Mediterranean diet for promoting health and longevity. © Crous-Bou et al 2014.

  6. Help seeking by health professionals for addiction: A mixed studies review.

    PubMed

    Kunyk, Diane; Inness, Michelle; Reisdorfer, Emilene; Morris, Heather; Chambers, Thane

    2016-08-01

    When health professionals practice with active and untreated addiction, it is a complex occupational and professional issue impacting numerous stakeholders. Health professionals are responsive to evidence-based addiction interventions and their return-to-work has been demonstrated to be achievable, sustainable and safe. Facilitating help seeking in health professionals with addiction is a priority for reducing associated risks to their health and to patient safety. The purpose of this study was to identify the process by which health professionals seek help for addiction, and factors that facilitate and deter help seeking, through a review of the qualitative and quantitative literature. Both phases of this sequential mixed studies review followed the standard systematic review steps of: (1) identifying the review question, (2) defining eligibility criteria, (3) applying an extensive search strategy, (4) independent screening of titles and abstracts, (5) selecting relevant studies based on reviewing the full text, (6) appraising the quality of included studies, and (7) synthesizing the study findings. Our two searches of five databases from 1995 to 2015 resulted in the inclusion of eight qualitative and twenty-three quantitative studies. We first conducted a meta-synthesis of the qualitative literature to garner an understanding of the help seeking process for health professionals for addiction. We then conducted a narrative synthesis of the quantitative studies to generalize these findings through examining the data for convergent, complementary or divergent results. Synthesis of the included qualitative studies revealed that the professional and experiential context of healthcare compromised the health professional's readiness to seek help for addiction. Typically, a pivotal event initiated the help seeking process. The studies in the quantitative review identified that help seeking most often resulted from reports of adverse events to formal organizations such as

  7. Evaluating the impact of equity focused health impact assessment on health service planning: three case studies.

    PubMed

    Harris-Roxas, Ben; Haigh, Fiona; Travaglia, Joanne; Kemp, Lynn

    2014-09-05

    Health impact assessment has been identified internationally as a mechanism to ensure potential health impacts and health equity impacts of proposals are considered before implementation. This paper looks at the impact of three equity focused health impact assessments (EFHIAs) of health service plans on subsequent decision-making and implementation, and then utilises these findings to test and refine an existing conceptual framework for evaluating the impact and effectiveness of health impact assessments for use in relation to EFHIAs. Case study analysis of three EFHIAs conducted on health sector plans in New South Wales, Australia. Data was drawn from 14 semi-structured interviews and the analysis of seven related documents (draft plans and EFHIA reports). The case studies showed that the EFHIAs all had some impact on the decision-making about the plans and their implementation, most clearly in relation to participants' understandings of equity and in the development of options for modifying service plans to ensure this was addressed. The timing of the EFHIA and individual responses to the EFHIA process and its recommendations were identified as critical factors influencing the impact of the EFHIAs. Several modifications to the conceptual framework are identified, principally adding factors to recognise the role individuals play in influencing the impact and effectiveness of EFHIAs. EFHIA has the potential to improve the consideration of health equity in health service planning processes, though a number of contextual and individual factors affect this. Current approaches can be strengthened by taking into account personal and organisational responses to the EFHIA process.

  8. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    PubMed

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-04

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Building Collaborative Health Promotion Partnerships: The Jackson Heart Study.

    PubMed

    Addison, Clifton C; Campbell Jenkins, Brenda W; Odom, Darcel; Fortenberry, Marty; Wilson, Gregory; Young, Lavon; Antoine-LaVigne, Donna

    2015-12-22

    Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR) involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to include groups of diverse community representatives who can develop a vision for long-term change. This project sought to enumerate processes used by the Jackson Heart Study (JHS) Community Outreach Center (CORC) to create strong, viable partnerships that produce lasting change. JHS CORC joined with community representatives to initiate programs that evolved into comprehensive strategies for addressing health disparities and the high prevalence of cardiovascular disease (CVD). This collaboration was made possible by first promoting an understanding of the need for combined effort, the desire to interact with other community partners, and the vision to establish an effective governance structure. The partnership between JHS CORC and the community has empowered and inspired community members to provide leadership to other health promotion projects. Academic institutions must reach out to local community groups and together address local health issues that affect the community. When a community understands the need for change to respond to negative health conditions, formalizing this type of collaboration is a step in the right direction.

  10. Prevalence of Health Behaviors among a University Staff: An Exploratory Study

    ERIC Educational Resources Information Center

    Torabi, Mohammad; Thiagarajah, Krisha; Jeng, Ifeng

    2010-01-01

    This study assessed the prevalence of health behaviors among non-academic staff at a Midwestern U.S. university. A sample of 627 women and 237 men completed a web survey for the study. Most of the health behaviors showed no sex difference. Health behaviors of drinking, smoking, and irregular breakfast eating were significantly associated with…

  11. Concepts of health and well-being in managers: An organizational study

    PubMed Central

    Boness, Christian

    2011-01-01

    Global changes and new managerial challenges require new concepts of health and well-being in organizational contexts. In the South African context, health and well-being of managers have gained relevance in organizations and in management sciences. International organizations, in particular, attempt to address the increasing demand for health care and the delivery of health services to their managers. Careful and appropriate health management requires research to evaluate context-specific health concepts and strategies. The purpose and aim of this article is to assess managerial concepts on health and well-being that could be used by the organization to contribute to managerial well-being by implementing health promotion according to managerial needs. At the same time, this article contributes to salutogenetic health research that is very rare with regard to the South African organizational management research. This study is a multi-method research study conducted in a selected international organization in South Africa. However, in this article, selected qualitative findings will only be presented. This organizational study presents selected research findings on health concepts and strategies employed by managers. Findings demonstrate that the managerial concepts of health and strategies mainly refer to not only physical but also to mental and spiritual aspects, with a priority on physical health and well-being. The findings presented are based on qualitative research methods and their research criteria. This assessment serves as a foundation for new approaches to health management within the international work context in South Africa. It also contributes to a paradigm shift from pathogenetic to salutogenetic concepts of health and well-being within the South African organizational work context. The article produces new insights into the qualitative health concepts of South African managers and expatriates and contributes to promoting salutogenesis in

  12. THE AGRICULTURAL HEALTH STUDY: COLLABORATIVE HEALTH AND EXPOSURE RESEARCH FOR THE AGRICULTURAL COMMUNITY

    EPA Science Inventory

    The abstract describes the collaborative effort between the NCI, the NIEHS, the U.S. EPA, and NIOSH to conduct the Agricultural Health Study (AHS). The AHS is a prospective epidemiological study to identify factors that may affect the rate of cancer and other diseases among farme...

  13. Design and Implementation of the Hispanic Community Health Study / Study of Latinos

    PubMed Central

    Sorlie, Paul D.; Avilés-Santa, Larissa M.; Wassertheil-Smoller, Sylvia; Kaplan, Robert C.; Daviglus, Martha L.; Giachello, Aida L.; Schneiderman, Neil; Raij, Leopoldo; Talavera, Gregory; Allison, Matthew; LaVange, Lisa; Chambless, Lloyd E.; Heiss, Gerardo

    2010-01-01

    PURPOSE The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a comprehensive multi-center community based cohort study of Hispanics/Latinos in the United States. Its rationale, objectives, design and implementation are described in this paper. METHODS The HCHS/SOL will recruit 16,000 men and women who self-identify as Hispanic or Latino, age 18-74 years, from a random sample of households in defined communities in the Bronx, Chicago, Miami and San Diego. The sites were selected so that the overall sample would consist of at least 2000 persons in each of the following origin designations: Mexican, Puerto Rican and Dominican, Cuban, and Central and South American. The study includes research in the prevalence of and risk factors for heart, lung, blood and sleep disorders, kidney and liver function, diabetes, cognitive function, dental conditions, and hearing disorders. CONCLUSIONS The HCHS/SOL will 1) characterize the health status and disease burden in the largest minority population in the U.S; 2) describe the positive and negative consequences of immigration and acculturation of Hispanics/Latinos to the mainstream U.S. life-styles, environment and health care opportunities; and 3) identify likely causal factors of many diseases in a population with diverse environmental exposures, genetic backgrounds and early life experiences. PMID:20609343

  14. Pathways through which health influences early retirement: a qualitative study.

    PubMed

    de Wind, Astrid; Geuskens, Goedele A; Reeuwijk, Kerstin G; Westerman, Marjan J; Ybema, Jan Fekke; Burdorf, Alex; Bongers, Paulien M; van der Beek, Allard J

    2013-04-03

    Due to the aging of the population, there is a societal need for workers to prolong their working lives. In the Netherlands, many employees still leave the workforce before the official retirement age of 65. Previous quantitative research showed that poor self-perceived health is a risk factor of (non-disability) early retirement. However, little is known on how poor health may lead to early retirement, and why poor health leads to early retirement in some employees, but not in others. Therefore, the present qualitative study aims to identify in which ways health influences early retirement. Face-to-face semi-structured interviews were conducted with 30 employees (60-64 years) who retired before the official retirement age of 65. Participants were selected from the Study on Transitions in Employment, Ability and Motivation. The interviews were transcribed verbatim, a summary was made including a timeline, and the interviews were open coded. In 15 of the 30 persons, health played a role in early retirement. Both poor and good health influenced early retirement. For poor health, four pathways were identified. First, employees felt unable to work at all due to health problems. Second, health problems resulted in a self-perceived (future) decline in the ability to work, and employees chose to retire early. Third, employees with health problems were afraid of a further decline in health, and chose to retire early. Fourth, employees with poor health retired early because they felt pushed out by their employer, although they themselves did not experience a reduced work ability. A good health influenced early retirement, since persons wanted to enjoy life while their health still allowed to do so. The financial opportunity to retire sometimes triggered the influence of poor health on early retirement, and often triggered the influence of good health. Employees and employers barely discussed opportunities to prolong working life. Poor and good health influence early

  15. Study protocol. The Childhood Health, Activity, and Motor Performance School Study Denmark (The CHAMPS-study DK)

    PubMed Central

    2012-01-01

    Background An increasingly passive life-style in the Western World has led to a rise in life-style related disorders. This is a major concern for all segments of society. The county council of the municipality of Svendborg in Denmark, created six Sport Schools with increased levels of suitable physical activities, which made it possible to study the health outcomes in these children whilst comparing them to children who attended the ‘normal’ schools of the region using the design of a “natural experiment”. Methods Children from the age of 6 till the age of 10, who accepted to be included in the monitoring process, were surveyed at baseline with questionnaires, physical examinations and physical and biological testing, including DXA scans. The physical examination and testing was repeated during the early stage of the study. Every week over the whole study period, the children will be followed with an automated mobile phone text message (SMS-Track) asking questions on their leisure time sports activities and the presence of any musculoskeletal problems. Children who report any such problems are monitored individually by health care personnel. Data are collected on demography, health habits and attitudes, physical characteristics, physical activity using accelerometers, motor performance, fitness, bone health, life-style disorders, injuries and musculoskeletal problems. Data collection will continue at least once a year until the children reach grade 9. Discussion This project is embedded in a local community, which set up the intervention (The Sport Schools) and thereafter invited researchers to provide documentation and evaluation. Sport schools are well matched with the ‘normal’ schools, making comparisons between these suitable. However, subgroups that would be specifically targeted in lifestyle intervention studies (such as the definitely obese) could be relatively small. Therefore, results specific to minority groups may be diluted. Nonetheless, the

  16. SHPPS 2006: School Health Policies and Programs Study--Injury Prevention and Safety

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of injury prevention and safety, covering the following topics: (1) Health Education; (2) Health Services…

  17. Musculoskeletal health and work ability in physically demanding occupations: study protocol for a prospective field study on construction and health care workers.

    PubMed

    Lunde, Lars-Kristian; Koch, Markus; Knardahl, Stein; Wærsted, Morten; Mathiassen, Svend Erik; Forsman, Mikael; Holtermann, Andreas; Veiersted, Kaj Bo

    2014-10-16

    Musculoskeletal disorders have a profound impact on individual health, sickness absence and early retirement, particularly in physically demanding occupations. Demographics are changing in the developed countries, towards increasing proportions of senior workers. These senior workers may have particular difficulties coping with physically demanding occupations while maintaining good health. Previous studies investigating the relationship between physical work demands and musculoskeletal disorders are mainly based on self-reported exposures and lack a prospective design. The aim of this paper is to describe the background and methods and discuss challenges for a field study examining physical demands in construction and health care work and their prospective associations with musculoskeletal disorders, work ability and sickness absence. This protocol describes a prospective cohort study on 1200 construction and health care workers. Participants will answer a baseline questionnaire concerning musculoskeletal complaints, general health, psychosocial and organizational factors at work, work demands, work ability and physical activity during leisure. A shorter questionnaire will be answered every 6th months for a total of two years, together with continuous sickness absence monitoring during this period. Analysis will prospectively consider associations between self-reported physical demands and musculoskeletal disorders, work ability and sickness absence. To obtain objective data on physical exposures, technical measurements will be collected from two subgroups of N = 300 (Group A) and N = 160 (Group B) during work and leisure. Both group A and B will be given a physical health examination, be tested for physical capacity and physical activity will be measured for four days. Additionally, muscle activity, ground reaction force, body positions and physical activity will be examined during one workday for Group B. Analysis of associations between objectively measured

  18. Performing piety in sexual health research: gender, health and evangelical Christianities in a Mexican human papillomavirus (HPV) study.

    PubMed

    Wentzell, Emily

    2017-12-01

    Recent research suggests that health surveillance experiences like clinical trial participation might have unanticipated social consequences. I investigate how evangelical Christians participating in longitudinal, observational sexual health research incorporate that long-term medical surveillance into their religious practice. This exploratory research focuses on Mexican Cristianos' participation in the Cuernavaca arm of the multinational 'Human Papillomavirus in Men' ('HIM') study, which tested men for the common and usually asymptomatic sexually transmitted infection human papillomavirus (HPV) over time. I draw on interviews with heterosexual male research participants and their female partners throughout their medical research involvement, and data from church-based participant observation, to understand how couples framed the HIM study as an arena for performing piety. I argue that evangelical understandings of piety as moral practice encouraged participants to view long-term sexual health surveillance as assistance for living out the health, gender, and marital behaviors promoted by their congregations. This finding suggests that health research designers and ethics committees should consider the health and social outcomes of research participants' agentive incorporation of religious observance into study protocols.

  19. The Outcome of Health Anxiety in Primary Care. A Two-Year Follow-up Study on Health Care Costs and Self-Rated Health

    PubMed Central

    Fink, Per; Ørnbøl, Eva; Christensen, Kaj Sparle

    2010-01-01

    Background Hypochondriasis is prevalent in primary care, but the diagnosis is hampered by its stigmatizing label and lack of valid diagnostic criteria. Recently, new empirically established criteria for Health anxiety were introduced. Little is known about Health anxiety's impact on longitudinal outcome, and this study aimed to examine impact on self-rated health and health care costs. Methodology/Principal Findings 1785 consecutive primary care patients aged 18–65 consulting their family physicians (FPs) for a new illness were followed-up for two years. A stratified subsample of 701 patients was assessed by the Schedules for Clinical Assessment in Neuropsychiatry interview. Patients with mild (N = 21) and severe Health anxiety (N = 81) and Hypochondriasis according to the DSM-IV (N = 59) were compared with a comparison group of patients who had a well-defined medical condition according to their FPs and a low score on the screening questionnaire (N = 968). Self-rated health was measured by questionnaire at index and at three, 12, and 24 months, and health care use was extracted from patient registers. Compared with the 968 patients with well-defined medical conditions, the 81 severe Health anxiety patients and the 59 DSM-IV Hypochondriasis patients continued during follow-up to manifest significantly more Health anxiety (Whiteley-7 scale). They also continued to have significantly worse self-rated functioning related to physical and mental health (component scores of the SF-36). The severe Health anxiety patients used about 41–78% more health care per year in total, both during the 3 years preceding inclusion and during follow-up, whereas the DSM-IV Hypochondriasis patients did not have statistically significantly higher total use. A poor outcome of Health anxiety was not explained by comorbid depression, anxiety disorder or well-defined medical condition. Patients with mild Health anxiety did not have a worse outcome on physical health and

  20. Users' views of prison health services: a qualitative study.

    PubMed

    Condon, Louise; Hek, Gill; Harris, Francesca; Powell, Jane; Kemple, Terry; Price, Sally

    2007-05-01

    This paper is a report of a study of the views of prisoners about health services provided in prisons. Prison provides an opportunity for a 'hard to reach' group to access health services, primarily those provided by nurses. Prisoners typically have high health and social needs, but the views and experiences of prisoners about health services in prison have not been widely researched. Semi-structured interviews were carried out with 111 prisoners in purposively selected 12 prisons in England in 2005. Interviews covered both prisoners' views of health services and their own ways of caring for their health in prison. Interviews were analysed to develop a conceptual framework and identify dominant themes. Prisoners considered health services part of a personal prison journey, which began at imprisonment and ended on release. For those who did not access health services outside prison, imprisonment improved access to both mental and physical health services. Prisoners identified accessing services, including those provided by nurses, confidentiality, being seen as a 'legitimate' patient and living with a chronic condition as problems within the prison healthcare system. At all points along the prison healthcare journey, the prison regime could conflict with optimal health care. Lack of autonomy is a major obstacle to ensuring that prisoners' health needs are fully met. Their views should be considered when planning, organizing and delivering prison health services. Further research is needed to examine how nurses can ensure a smooth journey through health care for prisoners.

  1. Unmet needs in health training among nurses in rural Chinese township health centers: a cross-sectional hospital-based study.

    PubMed

    Mo, Yan; Hu, Guijie; Yi, Yanhua; Ying, Yanping; Huang, Huiqiao; Huang, Zhongxian; Lin, Jiafeng

    2017-01-01

    Maintaining a sufficient and competent rural nursing workforce is an important goal of the Chinese health delivery system. However, few studies have investigated the health training status or conducted a needs assessment of rural Chinese nurses during this time of great transformations in health policy. This study was conducted to explore the current health training status of nurses working in rural Chinese township health centers (THCs) and to ascertain their perceived needs. A cross-sectional survey using a self-administered structured questionnaire was conducted among 240 THC nurses in Guangxi Zhuang Autonomous Region, China from March 2014 to August 2014. The survey questionnaire was adapted from the Second Chinese Survey of Demographic Data and Training Demand for Health Professionals in THCs developed by the Ministry of Education. The nurses in THCs were young, with a low educational level. Their perceived needs for health training included further clinical studies at city-level hospitals to improve their skills and theoretical studies at medical universities in emergency medicine and general practice. Overall, 71.9% of the nurses with a secondary technical school background expected to pursue junior college studies, and 68.5% of the nurses with a junior college education expected to pursue a bachelor's degree. A decentralized program with theoretical studies at medical universities and practical studies at county hospitals was regarded as feasible by 66.9% of the respondents. Health-training programs for nurses in Chinese THCs must be improved in terms of coverage, delivery mode, and content. A decentralized degree-linked training program in which medical universities and city hospitals collaborate would be an appropriate mode of delivery.

  2. Characteristics associated with self-rated health in the CARDIA study: Contextualising health determinants by income group.

    PubMed

    Nayak, Shilpa; Hubbard, Alan; Sidney, Stephen; Syme, S Leonard

    2016-12-01

    An understanding of factors influencing health in socioeconomic groups is required to reduce health inequalities. This study investigated combinations of health determinants associated with self-rated health (SRH), and their relative importance, in income-based groups. Cross-sectional data from year 15 (2000 - 2001) of the CARDIA study (Coronary Artery Risk Development in Young Adults, USA) - 3648 men and women (mean 40 years) - were split into 5 income-based groups. SRH responses were categorized as 'higher'/'lower'. Health determinants (medical, lifestyle, and social factors, living conditions) associated with SRH in each group were analyzed using classification tree analysis (CTA). Income and SRH were positively associated (p < 0.05). Data suggested an income-based gradient for lifestyle/medical/social factors/living conditions. Profiles, and relative importance ranking, of multi-domain health determinants, in relation to SRH, differed by income group. The highest ranking variable for each income group was chronic burden-personal health problem (<$25,000); physical activity ($25-50,000; $50-75,000; $100,000 +); and cigarettes/day ($75-100,000). In lower income groups, more risk factors and chronic burden indicators were associated with SRH. Social support, control over life, optimism, and resources for paying for basics/medical care/health insurance were greater (%) with higher income. SRH is a multidimensional measure; CTA is useful for contextualizing risk factors in relation to health status. Findings suggest that for lower income groups, addressing contributors to chronic burden is important alongside lifestyle/medical factors. In a proportionate universalism context, in addition to differences in intensity of public health action across the socioeconomic gradient, differences in the type of interventions to improve SRH may also be important.

  3. A study of Minnesota's high-risk health insurance pool.

    PubMed

    Zellner, B B; Haugen, D K; Dowd, B

    1993-01-01

    This is a report of a study of Minnesota's high-risk health insurance pool for "medically uninsurable" persons. The study consisted of a survey of current and past enrollees carried out in the Spring of 1990 and an analysis of the claims and membership files for 1988 and 1989. The main policy conclusion we reached is that Minnesota's high-risk pool is an adequate approach to the problem raised by risk segmentation on the basis of health status, providing that enrollment remains a small fraction of the population. The recent high, enrollment growth rates the Minnesota risk pool has experienced raise the possibility that basic structural reforms of the nongroup and small-group health insurance markets are needed.

  4. Divorce and Death: A Case Study for Health Psychology

    PubMed Central

    Sbarra, David A.; Hasselmo, Karen; Nojopranoto, Widyasita

    2012-01-01

    Marital separation and divorce are associated with increased risk for early death, and the magnitude of this association rivals that of many well-established public health factors. In the case of divorce, however, the mechanisms explaining precisely why and how some people are at risk for early death remain unclear. This paper reviews what is known about the association between divorce and risk for all-cause mortality, then discusses four emerging themes in this area of research: the biological intermediaries linking divorce to pathophysiology and disease onset, moving beyond the statistical mean, focusing research on the diathesis-stress model, and studying how opportunity foreclosures may place people on a trajectory toward poor distal health outcomes. These ideas are grounded in a set of public lay commentaries about the association between divorce and death; in this way, the paper seeks to integrate current research ideas with how the general public thinks about divorce and its correlates. Although this paper focuses on divorce, many of the emerging themes are applicable to the study of psychosocial stress and health more generally. Therefore, the study of divorce and death provides a good case study for health psychology and considers new questions that can be pursued in a variety of research areas. PMID:23284588

  5. Divorce and Death: A Case Study for Health Psychology.

    PubMed

    Sbarra, David A; Hasselmo, Karen; Nojopranoto, Widyasita

    2012-12-01

    Marital separation and divorce are associated with increased risk for early death, and the magnitude of this association rivals that of many well-established public health factors. In the case of divorce, however, the mechanisms explaining precisely why and how some people are at risk for early death remain unclear. This paper reviews what is known about the association between divorce and risk for all-cause mortality, then discusses four emerging themes in this area of research: the biological intermediaries linking divorce to pathophysiology and disease onset, moving beyond the statistical mean, focusing research on the diathesis-stress model, and studying how opportunity foreclosures may place people on a trajectory toward poor distal health outcomes. These ideas are grounded in a set of public lay commentaries about the association between divorce and death; in this way, the paper seeks to integrate current research ideas with how the general public thinks about divorce and its correlates. Although this paper focuses on divorce, many of the emerging themes are applicable to the study of psychosocial stress and health more generally. Therefore, the study of divorce and death provides a good case study for health psychology and considers new questions that can be pursued in a variety of research areas.

  6. Health Sciences Library Closings; A Context Sensitive Pilot Study.

    PubMed

    Schwartz, Diane G; Elkin, Peter L

    2017-01-01

    A significant number of U.S. health sciences libraries have closed since the mid-1990's. A pilot study was conducted with academic physicians to understand the impact of closing the health sciences library in the teaching hospital with which they were affiliated. A brief survey was designed and distributed to fourteen faculty members with thirteen useable responses received. The study elicited a context-sensitive perspective on the closing of the library with the most noteworthy outcome being the additional time required by attending physicians and trainees to perform the work that previously was performed by library staff. The loss of the expert literature search, instructional services, journal request, and interlibrary loan services had the most significant impact on study participants. Further research is needed to understand the long term consequences of closing hospital-based health sciences library on the education of physicians.

  7. Lessons from Initiating the First Veterans Health Administration (VA) Women's Health Practice-based Research Network (WH-PBRN) Study.

    PubMed

    Pomernacki, Alyssa; Carney, Diane V; Kimerling, Rachel; Nazarian, Deborah; Blakeney, Jill; Martin, Brittany D; Strehlow, Holly; Yosef, Julia; Goldstein, Karen M; Sadler, Anne G; Bean-Mayberry, Bevanne A; Bastian, Lori A; Bucossi, Meggan M; McLean, Caitlin; Sonnicksen, Shannan; Klap, Ruth; Yano, Elizabeth M; Frayne, Susan M

    2015-01-01

    The Veterans Health Administration (VA) Women's Health Practice-Based Research Network (WH-PBRN) was created to foster innovations for the health care of women veterans. The inaugural study by the WH-PBRN was designed to identify women veterans' own priorities and preferences for mental health services and to inform refinements to WH-PBRN operational procedures. Addressing the latter, this article reports lessons learned from the inaugural study. WH-PBRN site coordinators at the 4 participating sites convened weekly with the study coordinator and the WH-PBRN program manager to address logistical issues and identify lessons learned. Findings were categorized into a matrix of challenges and facilitators related to key study elements. Challenges to the conduct of PBRN-based research included tracking of regulatory documents; cross-site variability in some regulatory processes; and troubleshooting logistics of clinic-based recruitment. Facilitators included a central institutional review board, strong relationships between WH-PBRN research teams and women's health clinic teams, and the perception that women want to help other women veterans. Our experience with the inaugural WH-PBRN study demonstrated the feasibility of establishing productive relationships between local clinicians and researchers, and of recruiting a special population (women veterans) in diverse sites within an integrated health care system. This identified strengths of a PBRN approach. © Copyright 2015 by the American Board of Family Medicine.

  8. Empathy in health professional students: A comparative cross-sectional study.

    PubMed

    Petrucci, Cristina; La Cerra, Carmen; Aloisio, Federica; Montanari, Paola; Lancia, Loreto

    2016-06-01

    It has been shown that empathy strengthens the relationship between patients and health professionals and also improves patient and health professional satisfaction, which helps promote the best clinical outcomes. Empathy is considered an essential prerequisite for a nurse to effectively care for a patient and for a holistic understanding of a patient's perspective in a student population. The main aim was to compare empathy levels between health professional students attending different university courses. A comparative study with a cross-sectional approach was conducted in two successive academic year cohorts of 1st year health professional students at a public Italian university. A sample of 1st year health professional students at a public Italian university was investigated using the Jefferson Scale of Empathy Health Professional Students version (JSE-HPS). Overall, 502 health professional students were included in the study. The students in nursing showed significantly higher empathy levels than the students in other health professions. Furthermore, the female students were found to exhibit significantly more overall empathy than the male students were. The undergraduate nursing students showed a significantly higher mean score of empathy measured by the Jefferson Scale of Empathy Health Professional Students version (JSE-HPS) than the students attending other health undergraduate courses. This could mean that a particular aptitude in establishing a help-relationship with other people exists among the students that choose to become a nurse. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Health literacy in familial hypercholesterolemia: A cross-national study.

    PubMed

    Hagger, Martin S; Hardcastle, Sarah J; Hu, Miao; Kwok, See; Lin, Jie; Nawawi, Hapizah M; Pang, Jing; Santos, Raul D; Soran, Handrean; Su, Ta-Chen; Tomlinson, Brian; Watts, Gerald F

    2018-06-01

    Background High rates of inadequate health literacy are associated with maladaptive health outcomes in chronic disease including increased mortality and morbidity rates, poor treatment adherence and poor health. Adequate health literacy may be an important factor in the effective treatment and management of familial hypercholesterolemia, and may also be implicated in genetic screening for familial hypercholesterolemia among index cases. The present study examined the prevalence and predictors of health literacy in familial hypercholesterolemia patients attending clinics in seven countries. Design Cross-sectional survey. Methods Consecutive FH patients attending clinics in Australia, Brazil, China, Hong Kong, Malaysia, Taiwan and the UK completed measures of demographic variables (age, gender, household income and highest education level) and a brief three-item health literacy scale. Results Rates of inadequate health literacy were lowest in the UK (7.0%), Australia (10.0%), Hong Kong (15.7%) and Taiwan (18.0%) samples, with higher rates in the Brazil (22.0%), Malaysia (25.0%) and China (37.0%) samples. Income was an independent predictor of health literacy levels, accounting for effects of age. Health literacy was also independently related to China national group membership. Conclusions Findings indicate non-trivial levels of inadequate health literacy in samples of familial hypercholesterolemia patients. Consistent with previous research in chronic illness, inadequate health literacy is related to income as an index of health disparities. Chinese familial hypercholesterolemia patients are more likely to have high rates of inadequate health literacy independent of income. Current findings highlight the imperative of education interventions targeting familial hypercholesterolemia patients with inadequate health literacy.

  10. The training for health equity network evaluation framework: a pilot study at five health professional schools.

    PubMed

    Ross, Simone J; Preston, Robyn; Lindemann, Iris C; Matte, Marie C; Samson, Rex; Tandinco, Filedito D; Larkins, Sarah L; Palsdottir, Bjorg; Neusy, Andre-Jacques

    2014-01-01

    The Training for Health Equity Network (THEnet), a group of diverse health professional schools aspiring toward social accountability, developed and pilot tested a comprehensive evaluation framework to assess progress toward socially accountable health professions education. The evaluation framework provides criteria for schools to assess their level of social accountability within their organization and planning; education, research and service delivery; and the direct and indirect impacts of the school and its graduates, on the community and health system. This paper describes the pilot implementation of testing the evaluation framework across five THEnet schools, and examines whether the evaluation framework was practical and feasible across contexts for the purposes of critical reflection and continuous improvement in terms of progress towards social accountability. In this pilot study, schools utilized the evaluation framework using a mixed method approach of data collection comprising of workshops, qualitative interviews and focus group discussions, document review and collation and analysis of existing quantitative data. The evaluation framework allowed each school to contextually gather evidence on how it was meeting the aspirational goals of social accountability across a range of school activities, and to identify strengths and areas for improvement and development. The evaluation framework pilot study demonstrated how social accountability can be assessed through a critically reflective and comprehensive process. As social accountability focuses on the relationship between health professions schools and health system and health population outcomes, each school was able to demonstrate to students, health professionals, governments, accrediting bodies, communities and other stakeholders how current and future health care needs of populations are addressed in terms of education, research, and service learning.

  11. 75 FR 42455 - Safety and Occupational Health Study Section: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-21

    ... Occupational Health Study Section: Notice of Charter Renewal This gives notice under the Federal Advisory Committee Act (Pub. L. 92-463) of October 6, 1972, that the Safety and Occupational Health Study Section... Secretary, Safety and Occupational Health Study Section, Department of Health and Human Services, 1600...

  12. District health information system assessment: a case study in iran.

    PubMed

    Raeisi, Ahmad Reza; Saghaeiannejad, Sakineh; Karimi, Saeed; Ehteshami, Asghar; Kasaei, Mahtab

    2013-03-01

    Health care managers and personnel should be aware and literate of health information system in order to increase the efficiency and effectiveness in their organization. Since accurate, appropriate, precise, timely, valid information and interpretation of information is required and is the basis for policy planning and decision making in various levels of the organization. This study was conducted to assess the district health information system evolution in Iran according to WHO framework. This research is an applied, descriptive cross sectional study, in which a total of twelve urban and eight rural facilities, and the district health center at Falavarjan region were surveyed by using a questionnaire with 334 items. Content and constructive validity and reliability of the questionnaire were confirmed with correlation coefficient of 0.99. Obtained data were analyzed with SPSS 16 software and descriptive statistics were used to examine measures of WHO compliance. The analysis of data revealed that the mean score of compliance of district health information system framework was 35.75 percent. The maximum score of compliance with district health information system belonged to the data collection process (70 percent). The minimum score of compliance with district health information system belonged to information based decision making process with a score of 10 percent. District Health Information System Criteria in Isfahan province do not completely comply with WHO framework. Consequently, it seems that health system managers engaged with underlying policy and decision making processes at district health level should try to restructure and decentralize district health information system and develop training management programs for their managers.

  13. Illness and risk behaviour in health care students studying abroad.

    PubMed

    Angelin, Martin; Evengård, Birgitta; Palmgren, Helena

    2015-07-01

    The numbers of university students studying abroad increase every year. These students are not tourists as their studies require different types of travel that expose them to different risks. Moreover, health care students (HCSs) may be exposed to even greater risks according to their travel destinations and itineraries. Clearly, research-based pre-travel advice is needed. This study reports on a prospective survey conducted from April 2010 to January 2014 of health care and non-health care students from Swedish universities in Umeå, Stockholm and Gothenburg studying abroad. Of the 393 students included in the study, 85% responded. Over half (55%) were HCSs. Pre-travel health information was received by 79% and information on personal safety by 49% of HCSs. The rate of illness during travel was 52%. Health care students more often travelled to developing regions and were at increased risk for travellers' diarrhoea. One in 10 experienced theft and 3% were involved in traffic accidents. One in five met a new sexual partner during travel and 65% of these practised safe sex. Half of all participants increased their alcohol consumption while abroad; high alcohol consumption was associated with increased risk for being a victim of theft, as well as for meeting a new sexual partner during travel. University authorities are responsible for the safety and well-being of students studying abroad. This study supplies organisers and students with epidemiological data that will help improve pre-travel preparation and increase student awareness of the potential risks associated with studying abroad. © 2015 John Wiley & Sons Ltd.

  14. 75 FR 20606 - The Agricultural Health Study: A Prospective Cohort Study of Cancer and Other Disease Among Men...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health The Agricultural Health Study: A Prospective Cohort Study of Cancer and Other Disease Among Men and Women in Agriculture (NCI... Study of Cancer and Other Disease Among Men and Women in Agriculture (NCI)'' was submitted with errors...

  15. A pilot study of health and wellness coaching for fibromyalgia.

    PubMed

    Hackshaw, Kevin V; Plans-Pujolras, Marcal; Rodriguez-Saona, Luis E; Moore, Margaret A; Jackson, Erika K; Sforzo, Gary A; Buffington, C A Tony

    2016-11-08

    The purpose of this study was to test the hypothesis that a health and wellness coaching (HWC)-based intervention for fibromyalgia (FM) would result in sustained improvements in health and quality of life, and reductions in health care utilization. Nine female subjects meeting American College of Rheumatology criteria for a diagnosis of primary FM were studied. The HWC protocol had two components, which were delivered telephonically over a twelve-month period. First, each patient met individually with a coach during the 12 month study at the patient's preference of schedule and frequency (Range:22-32 × 45-min sessions). Coaches were health professionals trained in health and wellness coaching tasks, knowledge, and skills. Second, each patient participated in bimonthly (first six months) and monthly (second six months) group classes on self-coaching strategies during the 12 month study. Prior to the intervention, and after 6 months and 12 months of coaching, the Revised Fibromyalgia Impact Questionnaire (FIQR) was used to measure health and quality of life, and the Brief Pain Inventory-Short Form (BPI) was used to measure pain intensity and interference with function. Total and rheumatology-related health encounters were documented using electronic medical records. Data were analyzed using repeated measures ANOVA. All nine patients finished the HWC protocol. FIQR scores improved by 35 % (P = 0.001). BPI scores decreased by 32 % overall (P = 0.006), 31 % for severity (P = 0.02), and 44 % for interference (P = 0.006). Health care utilization declined by 86 % (P = 0.006) for total and 78 % (P < 0.0001) for rheumatology-related encounters. The HWC program added to standard FM therapy produced clinically significant improvements in quality of life measures (FIQR), pain (BPI), and marked reductions in health care utilization. Such improvements do not typically occur spontaneously in FM patients, suggesting that HWC deserves further

  16. A Study of Health Education and Its Needs for Elementary School Students

    ERIC Educational Resources Information Center

    Hussain, Irshad; Alamgir, Muhammad Ahmad; Shahzad, Muhammad

    2015-01-01

    Health Education, particularly in elementary schools, appears to be a neglected area in Pakistan. This study investigated the health education needs of elementary school students. The purpose of the present study is to assess health education needs of elementary school students. The study adopted mix approach of (qualitative and quantitative)…

  17. Re-Imagining School Health in Education and Health Programmes: A Study across Selected Municipal Schools in Delhi

    ERIC Educational Resources Information Center

    Deshpande, Mita; Baru, Rama V.; Nundy, Madhurima

    2014-01-01

    The idea of school health is re-imagined with an emphasis on the need for children's health programmes to be rooted in an understanding of the social context. Such programmes must address health, nutrition and education in a comprehensive manner. The article details findings and insights emerging from a qualitative study conducted in municipal…

  18. Linking exposures and health outcomes to a large population-based longitudinal study: the Millennium Cohort Study.

    PubMed

    Smith, Tyler C

    2011-07-01

    To describe current efforts and future potential for understanding long-term health of military service members by linking the Millennium Cohort Study data to exposures and health outcomes. The Millennium Cohort Study launched in 2001, before September 11 and the start of combat operations in Afghanistan and Iraq. Other substantial Department of Defense (DoD) health, personnel, and exposure databases are maintained in electronic form and may be linked by personal identifiers. More than 150,000 consenting members comprise the Millennium Cohort from all services, and include active duty, Reserve, and National Guard current and past members, and represent demographic, occupational, military, and health characteristics of the U.S. military. These prospective data offer symptom assessment, behavioral health, and self-reported exposures that may complement and fill gaps in capability presented by other DoD electronic health and exposure data. In conjunction with Millennium Cohort survey data, prospective individual-level exposure and health outcome assessment is crucial to understand and quantify any long-term health outcomes potentially associated with unique military occupational exposures.

  19. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hosptal

    PubMed Central

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M.

    2015-01-01

    Health service delivery is a key pillar of the health system management .The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014 .The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

  20. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hospital.

    PubMed

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M

    2015-03-25

    Health service delivery is a key pillar of the health system management. The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014. The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

  1. A mixed-methods study of health worker migration from Jamaica.

    PubMed

    Tomblin Murphy, Gail; MacKenzie, Adrian; Waysome, Benjamin; Guy-Walker, Joan; Palmer, Rowena; Elliott Rose, Annette; Rigby, Janet; Labonté, Ronald; Bourgeault, Ivy Lynn

    2016-06-30

    This study sought to better understand the drivers of migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries-Jamaica, India, the Philippines, and South Africa-that have historically been 'sources' of health workers migrating to other countries. The aim of this paper is to present the findings from the Jamaica portion of the study. Data were collected using surveys of Jamaica's generalist and specialist physicians, nurses, midwives, and dental auxiliaries, as well as structured interviews with key informants representing government ministries, professional associations, regional health authorities, healthcare facilities, and educational institutions. Quantitative data were analyzed using descriptive statistics and regression models. Qualitative data were analyzed thematically. Multiple stakeholder engagement workshops were held across Jamaica to share and validate the study findings and discuss implications for the country. Migration of health workers from Jamaica continues to be prevalent. Its causes are numerous, long-standing, and systemic, and are largely based around differences in living and working conditions between Jamaica and 'destination' countries. There is minimal formal tracking of health worker migration from Jamaica, making scientific analysis of its consequences difficult. Although there is evidence of numerous national and international efforts to manage and mitigate the negative impacts of migration, there is little evidence of the implementation or effectiveness of such efforts. Potential additional strategies for better managing the migration of Jamaica's health workers include the use of information systems to formally monitor migration, updating the national cadre system for employment of health personnel, ensuring existing personnel management policies, such as bonding, are both clearly understood and equitably enforced, and providing greater

  2. 'An exploration of the health beliefs of Chinese nurses' and nurse academics' health beliefs: A Q-methodology study'.

    PubMed

    Cai, Dan; Stone, Teresa E; Petrini, Marcia A; McMillan, Margaret

    2016-03-01

    Q-methodology was used to investigate the health beliefs of Chinese clinical nurses and nurse academics. Twenty-eight participants from one hospital and nursing school in China were involved. The four stages of this study included: (i) concourse development from literature review, Internet searches, and key informant interviews; (ii) A pilot study to develop the Q-sample from the concourse; (iii) participants sorted the Q-sample statements along a continuum of preference (Q-sorting); and (iv) PQ data analysis using principal component analysis and varimax rotation. Five viewpoints were revealed: (i) factor 1--health management and the importance of evidence; (ii) factor 2--challenging local cultural belief, and Eastern and Western influences; (iii) factor 3--commonsense; (iv) factor 4--health and clinical practice; and (v) factor 5--health and nursing education. This study presents a need for nurses and nurse academics to think critically, examine their long-held health beliefs, and promote the use of evidence-based practice. © 2016 Wiley Publishing Asia Pty Ltd.

  3. Cross-national health comparisons using the Rasch model: findings from the 2012 US Health and Retirement Study and the 2012 Mexican Health and Aging Study.

    PubMed

    Hong, Ickpyo; Reistetter, Timothy A; Díaz-Venegas, Carlos; Michaels-Obregon, Alejandra; Wong, Rebeca

    2018-05-10

    Cross-national comparisons of patterns of population aging have emerged as comparable national micro-data have become available. This study creates a metric using Rasch analysis and determines the health of American and Mexican older adult populations. Secondary data analysis using representative samples aged 50 and older from 2012 U.S. Health and Retirement Study (n = 20,554); 2012 Mexican Health and Aging Study (n = 14,448). We developed a function measurement scale using Rasch analysis of 22 daily tasks and physical function questions. We tested psychometrics of the scale including factor analysis, fit statistics, internal consistency, and item difficulty. We investigated differences in function using multiple linear regression controlling for demographics. Lastly, we conducted subgroup analyses for chronic conditions. The created common metric demonstrated a unidimensional structure with good item fit, an acceptable precision (person reliability = 0.78), and an item difficulty hierarchy. The American adults appeared less functional than adults in Mexico (β = - 0.26, p < 0.0001) and across two chronic conditions (arthritis, β = - 0.36; lung problems, β = - 0.62; all p < 0.05). However, American adults with stroke were more functional than Mexican adults (β = 0.46, p = 0.047). The Rasch model indicates that Mexican adults were more functional than Americans at the population level and across two chronic conditions (arthritis and lung problems). Future studies would need to elucidate other factors affecting the function differences between the two countries.

  4. Longitudinal study of health, disease and access to care in rural Victoria: the Crossroads-II study: methods.

    PubMed

    Glenister, Kristen M; Bourke, Lisa; Bolitho, Leslie; Wright, Sian; Roberts, Stuart; Kemp, William; Rhode, Leigh; Bhat, Ravi; Tremper, Sönke; Magliano, Dianna J; Morgan, Mike; Mariño, Rodrigo; Adam, William; Simmons, David

    2018-05-30

    High quality, contemporary data regarding patterns of chronic disease is essential for planning by health services, policy makers and local governments, but surprisingly scarce, including in rural Australia. This dearth of data occurs despite the recognition that rural Australians live with high rates of ill health, poor health behaviours and restricted access to health services. Crossroads-II is set in the Goulburn Valley, a rural region of Victoria, Australia 100-300 km north of metropolitan Melbourne. It is primarily an irrigated agricultural area. The aim of the study is to identify changes in the prevalence of key chronic health conditions including the extent of undiagnosed and undermanaged disease, and association with access to care, over a 15 year period. This study is a 15 year follow up from the 2000-2003 Crossroads-I study (2376 households participated). Crossroads-II includes a similar face to face household survey of 3600 randomly selected households across four towns of sizes 6300 to 49,800 (50% sampled in the larger town with the remainder sampled equally from the three smaller towns). Self-reported health, health behaviour and health service usage information is verified and supplemented in a nested sub-study of 900 randomly selected adult participants in 'clinics' involving a range of additional questionnaires and biophysical measurements. The study is expected to run from October 2016 to December 2018. Besides providing epidemiological and health service utilisation information relating to different diseases and their risk factors in towns of different sizes, the results will be used to develop a composite measure of health service access. The importance of access to health services will be investigated by assessing the correlation of this measure with rates of undiagnosed and undermanaged disease at the mesh block level. Results will be shared with partner organisations to inform service planning and interventions to improve health outcomes

  5. Building Collaborative Health Promotion Partnerships: The Jackson Heart Study

    PubMed Central

    Addison, Clifton C.; Campbell Jenkins, Brenda W.; Odom, Darcel; Fortenberry, Marty; Wilson, Gregory; Young, Lavon; Antoine-LaVigne, Donna

    2015-01-01

    Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Background: Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR) involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to include groups of diverse community representatives who can develop a vision for long-term change. This project sought to enumerate processes used by the Jackson Heart Study (JHS) Community Outreach Center (CORC) to create strong, viable partnerships that produce lasting change. Methods: JHS CORC joined with community representatives to initiate programs that evolved into comprehensive strategies for addressing health disparities and the high prevalence of cardiovascular disease (CVD). This collaboration was made possible by first promoting an understanding of the need for combined effort, the desire to interact with other community partners, and the vision to establish an effective governance structure. Results: The partnership between JHS CORC and the community has empowered and inspired community members to provide leadership to other health promotion projects. Conclusion: Academic institutions must reach out to local community groups and together address local health issues that affect the community. When a community understands the need for change to respond to negative health conditions, formalizing this type of collaboration is a step in the right direction. PMID:26703681

  6. A Study of Health Policies in Public School Administration.

    ERIC Educational Resources Information Center

    Lasch, Henry A.

    This study was undertaken to identify, classify, and interpret extant written school health policies. Furthermore, it was planned to ascertain whether schools were using standardized forms or systematic procedures to formulate school health policies. Administrators in school districts representing every geographical area of the U.S. were asked to…

  7. 75 FR 3237 - Proposed Collection; Comment Request; Women's Health Initiative Observational Study

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request; Women's Health Initiative Observational Study SUMMARY: In compliance with the requirement of... Initiative (WHI) Observational Study. Type of Information Collection Request: Revision OMB 0925- 0414. Need...

  8. Health Manpower Study of Selected Health Professions in California. 1976.

    ERIC Educational Resources Information Center

    Wong, John C., Comp.

    The need for health personnel in California and recommended targets for expansion of health sciences programs are presented in this report prepared for the California PostsecondarV Education Commission. The report focuses on the role of physicians, mid-level practitioners, nurses, pharmacists, dentists, optometrists, and health sciences education.…

  9. Negotiating health and chronic illness in Filipino-Australians: a qualitative study with implications for health promotion.

    PubMed

    Maneze, Della; Ramjan, Lucie; DiGiacomo, Michelle; Everett, Bronwyn; Davidson, Patricia Mary; Salamonson, Yenna

    2018-08-01

    In spite of the healthy immigrant effect, the prevalence of lifestyle-related chronic diseases among migrants is reported to approximate that of the host country with longer duration of stay. For example, higher rates of chronic diseases such as Type 2 diabetes and hypertension have been observed among Filipino migrants and these have been linked to acculturation. The aim of this study was to explore the experiences of Filipino-Australian migrants in managing their chronic health conditions in a Western host country. This paper reports on qualitative findings of a mixed methods study that used an explanatory sequential design. Nine focus group discussions were undertaken with 58 Filipino-Australian migrants with chronic disease. Thematic analysis was undertaken using a five-stage general purpose thematic framework ensuring that themes closely identified key participants' experiences . Findings revealed that health benefits provided by the health system in Australia were considered advantageous. However, a lack of social and instrumental support compounded isolation and disempowerment, limiting self-management strategies for chronic illnesses. Cultural beliefs and practices influenced their knowledge, attitude to and management of chronic disease, which health service providers overlooked because of perceived acculturation and English language skills. Overall this study has clearly identified recognition of cultural beliefs, language needs and support as three core needs of Filipino-Australian migrants with the elderly the most vulnerable. This paper highlights that self-management of chronic disease among elderly Filipino immigrants may be adversely affected by host language difficulties, a lack of social support and cultural issues, impacting on access to services, health-seeking behaviours and participation in health promotion initiatives. Language, culture-specific health interventions and resources and enhancing social support are likely important strategies in

  10. Medical health care professionals' assessments of oral health needs in children with disabilities: a qualitative study.

    PubMed

    Hallberg, Ulrika; Klingberg, Gunilla

    2005-10-01

    Good collaboration between medical and dental care is essential to provide not only good oral health care, but also more holistic care for children with disabilities. The aim was to explore and describe medical health care professionals' assessments and considerations of orofacial problems and treatment needs in children with disabilities and in their families. In-depth interviews focusing on orofacial function were carried out with 17 medical health care employees. Interviews were transcribed verbatim and analysed in open and focused (selective) coding processes according to grounded theory. A core category was identified and named focusing on basic needs, showing that oral health care assessment was not on the agenda of medical health care professionals, but was instead viewed as a responsibility of parents or dentists. This study shows that oral health issues are not fully integrated in the medical care of children with disabilities. The omission of oral health issues from the medical agenda implies a risk of oral health problems in children with disabilities. To put the oral cavity and oral health on the medical agenda, dentists need to influence the undergraduate training of medical professionals and to initiate co-operation with the medical care system.

  11. Cohort Profile: the Health and Retirement Study (HRS)

    PubMed Central

    Sonnega, Amanda; Faul, Jessica D; Ofstedal, Mary Beth; Langa, Kenneth M; Phillips, John WR; Weir, David R

    2014-01-01

    The Health and Retirement Study (HRS) is a nationally representative longitudinal survey of more than 37 000 individuals over age 50 in 23 000 households in the USA. The survey, which has been fielded every 2 years since 1992, was established to provide a national resource for data on the changing health and economic circumstances associated with ageing at both individual and population levels. Its multidisciplinary approach is focused on four broad topics—income and wealth; health, cognition and use of healthcare services; work and retirement; and family connections. HRS data are also linked at the individual level to administrative records from Social Security and Medicare, Veteran’s Administration, the National Death Index and employer-provided pension plan information. Since 2006, data collection has expanded to include biomarkers and genetics as well as much greater depth in psychology and social context. This blend of economic, health and psychosocial information provides unprecedented potential to study increasingly complex questions about ageing and retirement. The HRS has been a leading force for rapid release of data while simultaneously protecting the confidentiality of respondents. Three categories of data—public, sensitive and restricted—can be accessed through procedures described on the HRS website (hrsonline.isr.umich.edu). PMID:24671021

  12. Racial differences in self-rated health at similar levels of physical functioning: an examination of health pessimism in the health, aging, and body composition study.

    PubMed

    Spencer, S Melinda; Schulz, Richard; Rooks, Ronica N; Albert, Steven M; Thorpe, Roland J; Brenes, Gretchen A; Harris, Tamara B; Koster, Annemarie; Satterfield, Suzanne; Ayonayon, Hilsa N; Newman, Anne B

    2009-01-01

    The health pessimism hypothesis suggests that Black elders are more pessimistic about health than Whites and therefore tend to report lower self-rated health (SRH) at comparable health status. The current analysis examined the factors associated with SRH and tested the health pessimism hypothesis among older adults at similar levels of physical functioning. The study example included 2,729 Health, Aging, and Body Composition study participants aged 70-79 years. We used hierarchical logistic regression to examine the association between race and SRH while adjusting for demographic, physical health, and psychosocial factors. The analyses were repeated for participants at similar levels of objective functioning to test the health pessimism hypothesis. The association between race and SRH remained independent of physical and psychosocial health variables, with Whites being 3.7 times more likely than Black elders to report favorable SRH. This association was significant at each level of physical functioning and greater at the higher (odds ratio [OR] = 5.5) versus lower (OR = 2.2) levels of functioning. The results suggest greater health pessimism among Black elders and expand previous work by including objective functioning in multidimensional models to deconstruct race variations in the SRH of older adults.

  13. Vision for a Global Registry of Anticipated Public Health Studies

    PubMed Central

    Choi, Bernard C.K.; Frank, John; Mindell, Jennifer S.; Orlova, Anna; Lin, Vivian; Vaillancourt, Alain D.M.G.; Puska, Pekka; Pang, Tikki; Skinner, Harvey A.; Marsh, Marsha; Mokdad, Ali H.; Yu, Shun-Zhang; Lindner, M. Cristina; Sherman, Gregory; Barreto, Sandhi M.; Green, Lawrence W.; Svenson, Lawrence W.; Sainsbury, Peter; Yan, Yongping; Zhang, Zuo-Feng; Zevallos, Juan C.; Ho, Suzanne C.; de Salazar, Ligia M.

    2007-01-01

    In public health, the generation, management, and transfer of knowledge all need major improvement. Problems in generating knowledge include an imbalance in research funding, publication bias, unnecessary studies, adherence to fashion, and undue interest in novel and immediate issues. Impaired generation of knowledge, combined with a dated and inadequate process for managing knowledge and an inefficient system for transferring knowledge, mean a distorted body of evidence available for decisionmaking in public health. This article hopes to stimulate discussion by proposing a Global Registry of Anticipated Public Health Studies. This prospective, comprehensive system for tracking research in public health could help enhance collaboration and improve efficiency. Practical problems must be discussed before such a vision can be further developed. PMID:17413073

  14. Case study of the integration of a local health department and a community health center.

    PubMed Central

    Lambrew, J M; Ricketts, T C; Morrissey, J P

    1993-01-01

    As rural communities struggle to sustain health services locally, innovative alternatives to traditional programs are being developed. A significant adaptation is the rural health network or alliance that links local health departments and community health centers. The authors describe how a rural local health department and community health center, the core organizations in publicly sponsored primary care, came to share a building and administrative and service activities. Both the details of this alliance and its development are examined. The case history reveals that circumstance and State involvement were the catalysts for service integration, more so than the need for or the benefits of the arrangement. The closure of a county-owned hospital created a situation in which State officials were able to broker a cooperative agreement between the two agencies. This case study suggests two hypotheses: that need for integrated services alone may not be sufficient to catalyze the development of primary care alliances and that strong policy support may override any local and internal resistance to integration. PMID:8434093

  15. Self-rated health status and subjective health complaints associated with health-promoting lifestyles among urban Chinese women: a cross-sectional study.

    PubMed

    Cheng, Jingru; Wang, Tian; Li, Fei; Xiao, Ya; Bi, Jianlu; Chen, Jieyu; Sun, Xiaomin; Wu, Liuguo; Wu, Shengwei; Liu, Yanyan; Luo, Ren; Zhao, Xiaoshan

    2015-01-01

    This study aimed to investigate whether self-rated health status (SRH) and subjective health complaints (SHC) of urban Chinese women are associated with their health-promoting lifestyles (HPL). We conducted a cross-sectional study on 8142 eligible Chinese participants between 2012 and 2013. Demographic and SHC data were collected. Each subject completed the SRH questionnaire and the Chinese version of the Health-Promoting Lifestyle Profile-II (HPLP-II). Correlation and binary regression analyses were performed to examine the associations of SRH and SHC with HPL. Both SRH and HPL of urban Chinese women were moderate. The most common complaints were fatigue (1972, 24.2%), eye discomfort (1571, 19.3%), and insomnia (1542, 18.9%). Teachers, highly educated subjects and elderly women had lower SRH scores, while college students and married women had better HPL. All items of HPLP-II were positively correlated with SRH (r = 0.127-0.533, P = 0.000) and negatively correlated with SHC to a significant extent (odds ratio [OR] = 1.40-11.37). Aspects of HPL, particularly stress management and spiritual growth, are associated with higher SRH and lower SHC ratings among urban Chinese women. Physical activity and health responsibility are additionally related to reduced fatigue and nervousness. We believe that these findings will be instrumental in encouraging researchers and urban women to adopt better health-promoting lifestyles with different priorities in their daily lives.

  16. Case Study of a Participatory Health-Promotion Intervention in School

    ERIC Educational Resources Information Center

    Simovska, Venka

    2012-01-01

    This article discusses the findings from a case study focusing on processes involving pupils to bring about health-promotion changes. The study is related to an EU intervention project aiming to promote health and well-being among children (4-16 years). Qualitative research was carried out in a school in the Netherlands. Data sources include…

  17. Pet ownership and adolescent health: cross-sectional population study.

    PubMed

    Mathers, Megan; Canterford, Louise; Olds, Tim; Waters, Elizabeth; Wake, Melissa

    2010-12-01

    To determine whether adolescent health and well-being are associated with having a pet in the household (any pet, or specifically dogs, cats or horses/ponies) or average daily time spent caring for/playing with pet(s). Design, setting and participants--Cross-sectional data from the third wave of the Health of Young Victorians Study (HOYVS), a school-based population study in Victoria, Australia. Predictors--Adolescent-reported pet ownership and average daily time spent caring for/playing with pet(s). Outcomes--Self-reported quality of life (KIDSCREEN); average 4-day daily physical activity level from a computerised diary; parent-proxy and self-reported physical and psychosocial health status (PedsQL); measured BMI status (not overweight, overweight, obese) and blood pressure. Statistical Analysis--Regression methods, adjusted for socio-demographic factors, and non-parametric methods. Household pet data were available for 928 adolescents (466 boys; mean age of 15.9 (SD 1.2) years). Most adolescents (88.7%) reported having a pet in their household. Of these, 75.1% reported no activity involving pets over the surveyed days. It appeared that neither owning a pet nor time spent caring for/playing with a pet was related, positively or negatively, to adolescent health or well-being. Despite high rates of pet ownership, adolescents had little interaction with pets. It appears that owning a pet and time spent caring for/playing with a pet was not clearly associated with adolescents' health or well-being. © 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  18. Impact of Home Health Care on Health Care Resource Utilization Following Hospital Discharge: A Cohort Study.

    PubMed

    Xiao, Roy; Miller, Jacob A; Zafirau, William J; Gorodeski, Eiran Z; Young, James B

    2018-04-01

    As healthcare costs rise, home health care represents an opportunity to reduce preventable adverse events and costs following hospital discharge. No studies have investigated the utility of home health care within the context of a large and diverse patient population. A retrospective cohort study was conducted between 1/1/2013 and 6/30/2015 at a single tertiary care institution to assess healthcare utilization after discharge with home health care. Control patients discharged with "self-care" were matched by propensity score to home health care patients. The primary outcome was total healthcare costs in the 365-day post-discharge period. Secondary outcomes included follow-up readmission and death. Multivariable linear and Cox proportional hazards regression were used to adjust for covariates. Among 64,541 total patients, 11,266 controls were matched to 6,363 home health care patients across 11 disease-based Institutes. During the 365-day post-discharge period, home health care was associated with a mean unadjusted savings of $15,233 per patient, or $6,433 after adjusting for covariates (p < 0.0001). Home health care independently decreased the hazard of follow-up readmission (HR 0.82, p < 0.0001) and death (HR 0.80, p < 0.0001). Subgroup analyses revealed that home health care most benefited patients discharged from the Digestive Disease (death HR 0.72, p < 0.01), Heart & Vascular (adjusted savings of $11,453, p < 0.0001), Medicine (readmission HR 0.71, p < 0.0001), and Neurological (readmission HR 0.67, p < 0.0001) Institutes. Discharge with home health care was associated with significant reduction in healthcare utilization and decreased hazard of readmission and death. These data inform development of value-based care plans. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Pathways through which health influences early retirement: a qualitative study

    PubMed Central

    2013-01-01

    Background Due to the aeging of the population, there is a societal need for workers to prolong their working lives. In the Netherlands, many employees still leave the workforce before the official retirement age of 65. Previous quantitative research showed that poor self-perceived health is a risk factor of (non-disability) early retirement. However, little is known on how poor health may lead to early retirement, and why poor health leads to early retirement in some employees, but not in others. Therefore, the present qualitative study aims to identify in which ways health influences early retirement. Methods Face-to-face semi-structured interviews were conducted with 30 employees (60–64 years) who retired before the official retirement age of 65. Participants were selected from the Study on Transitions in Employment, Ability and Motivation. The interviews were transcribed verbatim, a summary was made including a timeline, and the interviews were open coded. Results In 15 of the 30 persons, health played a role in early retirement. Both poor and good health influenced early retirement. For poor health, four pathways were identified. First, employees felt unable to work at all due to health problems. Second, health problems resulted in a self-perceived (future) decline in the ability to work, and employees chose to retire early. Third, employees with health problems were afraid of a further decline in health, and chose to retire early. Fourth, employees with poor health retired early because they felt pushed out by their employer, although they themselves did not experience a reduced work ability. A good health influenced early retirement, since persons wanted to enjoy life while their health still allowed to do so. The financial opportunity to retire sometimes triggered the influence of poor health on early retirement, and often triggered the influence of good health. Employees and employers barely discussed opportunities to prolong working life. Conclusions

  20. Study Guide for TCT in Health and Physical Education.

    ERIC Educational Resources Information Center

    Mullan, Marie R.

    This study guide is designed for those individuals preparing to take the Georgia Teacher Certification Test (TCT) in health and physical education. The test covers nine broad subareas: (1) health, body systems, disease; (2) tennis, handball, fencing, bowling, track, and recreational games; (3) development, hygiene, safety, nutrition; (4) softball,…

  1. Health workforce development: a needs assessment study in French speaking African countries.

    PubMed

    Chastonay, Philippe; Moretti, Roberto; Zesiger, Véronique; Cremaschini, Marco; Bailey, Rebecca; Pariyo, George; Kabengele, Emmanuel Mpinga

    2013-05-01

    In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential trainees and training institutions in nine French-speaking African countries. A needs assessment was conducted in the target countries according to four approaches: (1) Review at national level of health challenges. (2) Semi-directed interviews with heads of relevant training institutions. (3) Focus group discussions with key-informants. (4) A questionnaire-based study targeting health professionals identified as potential trainees. A needs assessment showed important public health challenges in the field of health workforce development among the target countries (e.g. unequal HRH distribution in the country, ageing of HRH, lack of adequate training). It also showed a demand for education and training institutions that are able to offer a training programme in health workforce development, and identified training objectives and core competencies useful to potential employers and future trainees (e.g. leadership, planning/evaluation, management, research skill). In combining various approaches our study was able to show a general demand for health managers who are able to plan, develop and manage a nation's health workforce. It also identified specific competencies that should be developed through an education and training program in public health with a focus on health workforce development.

  2. Mental health and behaviour of students of public health and their correlation with social support: a cross-sectional study

    PubMed Central

    2011-01-01

    Background Future public health professionals are especially important among students partly because their credibility in light of their professional messages and activities will be tested daily by their clients; and partly because health professionals' own lifestyle habits influence their attitudes and professional activities. A better understanding of public health students' health and its determinants is necessary for improving counselling services and tailoring them to demand. Our aim was to survey public health students' health status and behaviour with a focus on mental health. Methods A cross-sectional study was carried out among public health students at 1-5-years (N = 194) with a self-administered questionnaire that included standardized items on demographic data, mental wellbeing characterized by sense of coherence (SoC) and psychological morbidity, as well as health behaviour and social support. Correlations between social support and the variables for mental health, health status and health behaviour were characterized by pairwise correlation. Results The response rate was 75% and represented students by study year, sex and age in the Faculty. Nearly half of the students were non-smokers, more than one quarter smoked daily. Almost one-fifth of the students suffered from notable psychological distress. The proportion of these students decreased from year 1 to 5. The mean score for SoC was 60.1 and showed an increasing trend during the academic years. 29% of the students lacked social support from their student peers. Significant positive correlation was revealed between social support and variables for mental health. Psychological distress was greater among female public health students than in the same age female group of the general population; whereas the lack of social support was a more prevalent problem among male students. Conclusions Health status and behaviour of public health students is similar to their non-students peers except for their

  3. Socio-economic inequalities in health and health service use among older adults in India: results from the WHO Study on Global AGEing and adult health survey.

    PubMed

    Brinda, E M; Attermann, J; Gerdtham, U G; Enemark, U

    2016-12-01

    The objectives of this study were to measure socio-economic inequalities in self-reported health (SRH) and healthcare visits and to identify factors contributing to health inequalities among older people aged 50-plus years. This study is based on a population-based, cross-sectional survey. We accessed data of 7150 older adults from the World Health Organization's Study on Global AGEing and adult health Indian survey. We used multivariate logistic regression to assess the correlates of poor SRH. We estimated the concentration index to measure socio-economic inequalities in SRH and healthcare visits. Regression-based decomposition analysis was employed to explore the correlates contributing to poor SRH inequality. About 19% (95% CI: 18%, 20%) reported poor health (n = 1368) and these individuals were significantly less wealthy. In total, 5134 (71.8%) participants made at least one health service visit. Increasing age, female gender, low social caste, rural residence, multimorbidity, absence of pension support, and health insurance were significant correlates of poor SRH. The standardized concentration index of poor SRH -0.122 (95% CI: -0.102; -0.141) and healthcare visits 0.364 (95% CI: 0.324, 0.403) indicated pro-poor and pro-rich inequality, respectively. Economic status (62.3%), pension support (11.5%), health insurance coverage (11.5%), social caste (10.7%) and place of residence (4.1%) were important contributors to inequalities in poor health. Socio-economic disparities in health and health care are major concerns in India. Achievement of health equity demand strategies beyond health policies, to include pro-poor, social welfare policies among older Indians. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. Police and mental health clinician partnership in response to mental health crisis: A qualitative study.

    PubMed

    McKenna, Brian; Furness, Trentham; Oakes, Jane; Brown, Steve

    2015-10-01

    Police officers as first responders to acute mental health crisis in the community, commonly transport people in mental health crisis to a hospital emergency department. However, emergency departments are not the optimal environments to provide assessment and care to those experiencing mental health crises. In 2012, the Northern Police and Clinician Emergency Response (NPACER) team combining police and mental health clinicians was created to reduce behavioural escalation and provide better outcomes for people with mental health needs through diversion to appropriate mental health and community services. The aim of this study was to describe the perceptions of major stakeholders on the ability of the team to reduce behavioural escalation and improve the service utilization of people in mental health crisis. Responses of a purposive sample of 17 people (carer or consumer advisors, mental health or emergency department staff, and police or ambulance officers) who had knowledge of, or had interfaced with, the NPACER were thematically analyzed after one-to-one semistructured interviews. Themes emerged about the challenge created by a stand-alone police response, with the collaborative strengths of the NPACER (communication, information sharing, and knowledge/skill development) seen as the solution. Themes on improvements in service utilization were revealed at the point of community contact, in police stations, transition through the emergency department, and admission to acute inpatient units. The NPACER enabled emergency department diversion, direct access to inpatient mental health services, reduced police officer 'down-time', improved interagency collaboration and knowledge transfer, and improvements in service utilization and transition. © 2015 Australian College of Mental Health Nurses Inc.

  5. Health literacy among Danish university students enrolled in health-related study programmes.

    PubMed

    Elsborg, Lea; Krossdal, Fie; Kayser, Lars

    2017-12-01

    It is important to address people's health literacy when providing health care. Health professionals should be aware of, and have insight into, people's health literacy when they provide health services. Health professionals need to be health literate themselves. We examined the level of health literacy in students in Denmark attending one of four full university programmes related to health and investigated how their health literacy was associated with their sociodemographic background. The health literacy level of the students was measured using the multi-dimensional Health Literacy Questionnaire (HLQ) supplemented with sociodemographic questions. The questionnaire was administrated through the students' Facebook groups. The students were enrolled in courses on health informatics, medicine, molecular biomedicine or public health. Out of a total of 7663 students, 630 responded to the questionnaire. No sex difference was found although female students scored higher than male students in domain 4 (social support for health). Students attending the public health programme tended to score higher and those attending molecular biomedicine tended to score lower in the HLQ. There was a positive correlation between HLQ scores and the educational level of the students' parents. If one of their parents was employed in the health care sector, the HLQ score tended to be higher in domains 1 and 4. Students who had been hospitalized also tended to score higher in domains 1, 5 and 6. Students' health literacy relates to their personal background and educational path. This may be of importance when planning curricula and educational activities, including cross-disciplinary courses.

  6. California Diploma Project Technical Report III: Validity Study--Validity Study of the Health Sciences and Medical Technology Standards

    ERIC Educational Resources Information Center

    McGaughy, Charis; Bryck, Rick; de Gonzalez, Alicia

    2012-01-01

    This study is a validity study of the recently revised version of the Health Science Standards. The purpose of this study is to understand how the Health Science Standards relate to college and career readiness, as represented by survey ratings submitted by entry-level college instructors of health science courses and industry representatives. For…

  7. Maternal Health: A Case Study of Rajasthan

    PubMed Central

    Iyengar, Kirti; Gupta, Vikram

    2009-01-01

    This case study has used the results of a review of literature to understand the persistence of poor maternal health in Rajasthan, a large state of north India, and to make some conclusions on reasons for the same. The rate of reduction in Rajasthan's maternal mortality ratio (MMR) has been slow, and it has remained at 445 per 1000 livebirths in 2003. The government system provides the bulk of maternal health services. Although the service infrastructure has improved in stages, the availability of maternal health services in rural areas remains poor because of low availability of human resources, especially midwives and clinical specialists, and their non-residence in rural areas. Various national programmes, such as the Family Planning, Child Survival and Safe Motherhood and Reproductive and Child Health (phase 1 and 2), have attempted to improve maternal health; however, they have not made the desired impact either because of an earlier emphasis on ineffective strategies, slow implementation as reflected in the poor use of available resources, or lack of effective ground-level governance, as exemplified by the widespread practice of informally charging users for free services. Thirty-two percent of women delivered in institutions in 2005-2006. A 2006 government scheme to give financial incentives for delivering in government institutions has led to substantial increase in the proportion of institutional deliveries. The availability of safe abortion services is limited, resulting in a large number of informal abortion service providers and unsafe abortions, especially in rural areas. The recent scheme of Janani Suraksha Yojana provides an opportunity to improve maternal and neonatal health, provided the quality issues can be adequately addressed. PMID:19489421

  8. A Prospective Analysis of Meat Mutagens and Colorectal Cancer in the Nurses’ Health Study and Health Professionals Follow-up Study

    PubMed Central

    Le, Ngoan Tran; Michels, Fernanda Alessandra Silva; Song, Mingyang; Zhang, Xuehong; Bernstein, Adam M.; Giovannucci, Edward L.; Fuchs, Charles S.; Ogino, Shuji; Chan, Andrew T.; Sinha, Rashmi; Willett, Walter C.; Wu, Kana

    2016-01-01

    Background: Heterocyclic amines (HCAs) in cooked meats may play a role in colorectal cancer (CRC) development. Objectives: We aimed to prospectively examine the association between estimated intakes of HCAs and meat-derived mutagenicity (MDM) in two cohorts of health professionals, the Health Professionals Follow-up Study (HPFS) and the Nurses’ Health Study (NHS). Methods: In 29,615 men and 65,875 women, intake of the HCAs 2-amino-3,8-dimethylimidazo(4,5-j)quinoxaline (MeIQx), 2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine (PhIP), 2-amino-3,4,8-trimethylimidazo(4,5-f)quinoxaline (DiMeIQx), and MDM was estimated using a 1996 cooking questionnaire, the 1994 food frequency questionnaire, and an online database. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) and to adjust for potential confounders. Estimates for both cohorts were pooled using random-effects meta-analysis. Results: Between 1996 and 2010, 418 male and 790 female CRC cases were identified. Meat mutagen intake was not statistically significantly associated with risk of CRC [highest vs. lowest quintile, pooled HR (95% CI) for MeIQx: 1.12 (0.93, 1.34), p for trend 0.23; PhIP: 1.10 (0.90, 1.33), p for trend 0.35; MDM: 1.03 (0.86, 1.24), p for trend 0.75] or subtypes of CRC defined by tumor location (proximal or distal colon, or rectum). When analyzed by source of meat, PhIP from red but not from white meat was nonsignificantly positively associated with CRC and significantly positively associated with proximal cancers [HR (95% CI) per standard deviation increase of log-transformed intake: PhIP red meat: CRC: 1.06 (0.99, 1.12), proximal: 1.11 (1.02, 1.21); PhIP white meat: CRC: 0.99 (0.94, 1.04), proximal: 1.00 (0.93, 1.09)]. Conclusions: Estimated intakes of meat mutagens were not significantly associated with CRC risk over 14 years of follow-up in the NHS and HPFS cohorts. Results for PhIP from red but not from white meat warrant further

  9. A Prospective Analysis of Meat Mutagens and Colorectal Cancer in the Nurses' Health Study and Health Professionals Follow-up Study.

    PubMed

    Le, Ngoan Tran; Michels, Fernanda Alessandra Silva; Song, Mingyang; Zhang, Xuehong; Bernstein, Adam M; Giovannucci, Edward L; Fuchs, Charles S; Ogino, Shuji; Chan, Andrew T; Sinha, Rashmi; Willett, Walter C; Wu, Kana

    2016-10-01

    Heterocyclic amines (HCAs) in cooked meats may play a role in colorectal cancer (CRC) development. We aimed to prospectively examine the association between estimated intakes of HCAs and meat-derived mutagenicity (MDM) in two cohorts of health professionals, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS). In 29,615 men and 65,875 women, intake of the HCAs 2-amino-3,8-dimethylimidazo(4,5-j)quinoxaline (MeIQx), 2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine (PhIP), 2-amino-3,4,8-trimethylimidazo(4,5-f)quinoxaline (DiMeIQx), and MDM was estimated using a 1996 cooking questionnaire, the 1994 food frequency questionnaire, and an online database. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) and to adjust for potential confounders. Estimates for both cohorts were pooled using random-effects meta-analysis. Between 1996 and 2010, 418 male and 790 female CRC cases were identified. Meat mutagen intake was not statistically significantly associated with risk of CRC [highest vs. lowest quintile, pooled HR (95% CI) for MeIQx: 1.12 (0.93, 1.34), p for trend 0.23; PhIP: 1.10 (0.90, 1.33), p for trend 0.35; MDM: 1.03 (0.86, 1.24), p for trend 0.75] or subtypes of CRC defined by tumor location (proximal or distal colon, or rectum). When analyzed by source of meat, PhIP from red but not from white meat was nonsignificantly positively associated with CRC and significantly positively associated with proximal cancers [HR (95% CI) per standard deviation increase of log-transformed intake: PhIP red meat: CRC: 1.06 (0.99, 1.12), proximal: 1.11 (1.02, 1.21); PhIP white meat: CRC: 0.99 (0.94, 1.04), proximal: 1.00 (0.93, 1.09)]. Estimated intakes of meat mutagens were not significantly associated with CRC risk over 14 years of follow-up in the NHS and HPFS cohorts. Results for PhIP from red but not from white meat warrant further investigation. Le NT, Michels FA, Song M, Zhang X, Bernstein AM

  10. Best practices in intercultural health: five case studies in Latin America

    PubMed Central

    Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

    2007-01-01

    The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria. PMID:17803820

  11. Best practices in intercultural health: five case studies in Latin America.

    PubMed

    Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

    2007-09-05

    The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria.

  12. Towards National eHealth Implementation--a comparative study on WHO/ITU National eHealth Strategy Toolkit in Iran.

    PubMed

    Riazi, Hossein; Jafarpour, Maryam; Bitaraf, Ehsan

    2014-01-01

    Experiences has shown that utilization of ICT in health sector requires national commitment and planned efforts to make the best use of existing capacity. Establishing the main directions as well as planning the detailed steps needed are key to achieving longer-term goals such as health sector efficiency, reform or more fundamental transformation. Collaboration between the health and ICT sectors, both public and private, is central to this effort. As the major United Nations agencies for health and telecommunications respectively, the World Health Organization (WHO) and the International Telecommunication Union (ITU) have recognized the importance of collaboration for eHealth in their global resolutions, which encourage countries to develop national eHealth strategies; the National eHealth Strategy Toolkit is the proof of these recommendations. In this study a mapping of eHealth components in WHO/ITU National eHealth Strategy Toolkit and our national eHealth vision is presented.

  13. Cultural events - does attendance improve health? Evidence from a Polish longitudinal study.

    PubMed

    Węziak-Białowolska, Dorota; Białowolski, Piotr

    2016-08-05

    Although there is strong advocacy for uptake of both the arts and creative activities as determinants of individual health conditions, studies evaluating causal influence of attendance at cultural events on population health using individual population data on health are scarce. If available, results are often only of an associative nature. In this light, this study investigated causative impact of attendance at cultural events on self-reported and physical health in the Polish population. Four recent waves (2009, 2011, 2013 and 2015) of the biennial longitudinal Polish household panel study, Social Diagnosis, were analysed. The data, representative for the Polish population aged over 16, with respect to age, gender, classes of place of residence and NUTS 2 regions, were collected from self-report questionnaires. Causative influence of cultural attendance on population health was established using longitudinal population representative data. To account for unobserved heterogeneity of individuals and to mitigate issues caused by omitted variables, a panel data model with a fixed effects estimator was applied. The endogeneity problem (those who enjoy good health are more likely to participate in cultural activities more frequently) was circumvented by application of instrumental variables. Results confirmed positive association between cultural attendance and self-reported health. However, in contrast to the often suggested positive causative relationship, such a link was not confirmed by the study. Additionally, no evidence was found to corroborate a positive impact from cultural attendance on physical health. Both findings were substantiated by augmentation in the longitudinal perspective and causal link. We showed the relation between attendance at cultural events and self-reported health could only be confirmed as associational. Therefore, this study provided little justification to encourage use of passive cultural participation as a measure of health promotion

  14. Japanese Study on Stratification, Health, Income, and Neighborhood: Study Protocol and Profiles of Participants

    PubMed Central

    Takada, Misato; Kondo, Naoki; Hashimoto, Hideki

    2014-01-01

    Background The Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) aims to clarify the complex associations between social factors and health from an interdisciplinary perspective and to provide a database for use in various health policy evaluations. Methods J-SHINE is an ongoing longitudinal panel study of households of adults aged 25–50 years. The wave 1 survey was carried out in 2010 among adults randomly selected from the resident registry of four urban and suburban municipalities in the greater Tokyo metropolitan area, Japan. In 2011, surveys for the participants’ spouse/partner and child were additionally conducted. The wave 2 survey was conducted in 2012 for the wave 1 participants and will be followed by the wave 2 survey for spouse/partner and child in 2013. Results Wave 1 sample sizes were 4357 for wave 1 participants (valid response rate: 31.3%; cooperation rate: 51.8%), 1873 for spouse/partner (response rate: 61.9%), and 1520 for child (response rate: 67.7%). Wave 2 captured 69.0% of wave 1 participants. Information gathered covered socio-demographics, household economy, self-reported health conditions and healthcare utilization, stress and psychological values, and developmental history. A subpopulation underwent physiological (n = 2468) and biomarker (n = 1205) measurements. Conclusions Longitudinal survey data, including repeated measures of social factors evaluated based on theories and techniques of various disciplines, like J-SHINE, should contribute toward opening a web of causality for society and health, which may have important policy implications for recent global health promotion strategies such as the World Health Organization’s Social Determinants of Health approach and the second round of Japan’s Healthy Japan 21. PMID:24814507

  15. Japanese study on stratification, health, income, and neighborhood: study protocol and profiles of participants.

    PubMed

    Takada, Misato; Kondo, Naoki; Hashimoto, Hideki

    2014-01-01

    The Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) aims to clarify the complex associations between social factors and health from an interdisciplinary perspective and to provide a database for use in various health policy evaluations. J-SHINE is an ongoing longitudinal panel study of households of adults aged 25-50 years. The wave 1 survey was carried out in 2010 among adults randomly selected from the resident registry of four urban and suburban municipalities in the greater Tokyo metropolitan area, Japan. In 2011, surveys for the participants' spouse/partner and child were additionally conducted. The wave 2 survey was conducted in 2012 for the wave 1 participants and will be followed by the wave 2 survey for spouse/partner and child in 2013. Wave 1 sample sizes were 4357 for wave 1 participants (valid response rate: 31.3%; cooperation rate: 51.8%), 1873 for spouse/partner (response rate: 61.9%), and 1520 for child (response rate: 67.7%). Wave 2 captured 69.0% of wave 1 participants. Information gathered covered socio-demographics, household economy, self-reported health conditions and healthcare utilization, stress and psychological values, and developmental history. A subpopulation underwent physiological (n = 2468) and biomarker (n = 1205) measurements. Longitudinal survey data, including repeated measures of social factors evaluated based on theories and techniques of various disciplines, like J-SHINE, should contribute toward opening a web of causality for society and health, which may have important policy implications for recent global health promotion strategies such as the World Health Organization's Social Determinants of Health approach and the second round of Japan's Healthy Japan 21.

  16. APPROACHES FOR MEASURING APPLICATOR EXPOSURE IN THE AGRICULTURAL HEALTH STUDY/PESTICIDE EXPOSURE STUDY

    EPA Science Inventory

    The Agricultural Health Study (AHS) is a prospective epidemiologic study of a large cohort of pesticide applicators and their spouses in Iowa and North Carolina. The Pesticide Exposure Study is a sub-study to evaluate exposure factors and to provide data to assess exposure cla...

  17. Forming ideas about health: a qualitative study of Ontario adolescents.

    PubMed

    Michaelson, Valerie; McKerron, Margaret; Davison, Colleen

    2015-01-01

    Adolescence is a crucial period of child development during which one's ideas about health are formed. However, little is known about the different contexts, experiences, and potential other factors that contribute to shaping the health ideas of adolescent populations, particularly when they are not seeking out the information for a particular purpose. In this Ontario-based qualitative study, grounded theory methods were used to explore ways that health knowledge is obtained in adolescents (age 10-16). A purposeful, criterion-based sampling strategy was used, and data were collected through seven focus groups (n=40). Findings indicate that while young people get their ideas about health through both didactic and organic learning contexts, the significant impact of organic learning is often overlooked. Categories of organic learning that emerged include self-reflective experience, the experience of close contacts, casually observing others, and common discourse. This study suggests that one central way that young people get their ideas about health is from living life: from the people they watch, the conversations that they have, and the experiences they live. Findings support the development of effective health promotion messages and also contribute to considering the place of some aspects of organic learning in the development of health-related resources that target adolescent populations.

  18. Forming ideas about health: A qualitative study of Ontario adolescents

    PubMed Central

    Michaelson, Valerie; McKerron, Margaret; Davison, Colleen

    2015-01-01

    Adolescence is a crucial period of child development during which one's ideas about health are formed. However, little is known about the different contexts, experiences, and potential other factors that contribute to shaping the health ideas of adolescent populations, particularly when they are not seeking out the information for a particular purpose. In this Ontario-based qualitative study, grounded theory methods were used to explore ways that health knowledge is obtained in adolescents (age 10–16). A purposeful, criterion-based sampling strategy was used, and data were collected through seven focus groups (n=40). Findings indicate that while young people get their ideas about health through both didactic and organic learning contexts, the significant impact of organic learning is often overlooked. Categories of organic learning that emerged include self-reflective experience, the experience of close contacts, casually observing others, and common discourse. This study suggests that one central way that young people get their ideas about health is from living life: from the people they watch, the conversations that they have, and the experiences they live. Findings support the development of effective health promotion messages and also contribute to considering the place of some aspects of organic learning in the development of health-related resources that target adolescent populations. PMID:26015404

  19. Meanings of Health for Iranian Diabetic Patients: A qualitative study

    PubMed Central

    Moridi, Golrokh; Valiee, Sina; Nasrabadi, Alireza Nikbakht; Nasab, Golnaz Esmaeil; Khaledi, Shahnaz

    2016-01-01

    Introduction Health is an exclusive and subjective phenomenon, and one of the most important situations with regard to perception of health, arises when patients suffer from a chronic disease. This study was conducted within the qualitative research framework and aimed to explore the meanings of health as perceived by a group of Iranian diabetic patients. Methods A descriptive qualitative analysis design was used. Data were collected through semi-structured interviews with 20 participants among diabetic patients, who were admitted to the diabetes care centre of Tohid Hospital of the Kurdistan University of Medical Sciences, Sanandaj, Iran during a ten-month period in 2014. Interviews were transcribed and analysed through conventional content analysis. Results Based on the findings of the study, three major health-related themes emerged: 1) the syndrome of the healthy body and the happy heart (physical well-being vivacity, satisfaction, and calmness of the mind), 2) life without compulsory limitations (lack of dietary limitations, No activity limitations, lack of social limitations), and 3) exalted spirituality (satisfying self and others, trusting God, remembering God). Conclusion Health care providers should consider the meaning of health in special groups, chiefly in patients with chronic diseases. It facilitates the development of appropriate programmes to improve desirable health levels among diabetic patients. PMID:27790342

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

    PubMed Central

    2014-01-01

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

  1. Does the density of the health workforce predict adolescent health? A cross-sectional, multilevel study of 38 countries.

    PubMed

    Riehm, Kira E; Latimer, Eric; Quesnel-Vallée, Amélie; Stevens, Gonneke W J M; Gariépy, Geneviève; Elgar, Frank J

    2018-06-11

    Scant evidence exists on the relation between the availability of health professionals and adolescent health, and whether the size of the health workforce equally benefits adolescents across socioeconomic strata. We conducted a cross-sectional analysis of adolescent health in 38 countries. Data from 218 790 adolescents were drawn from the 2013/2014 Health Behavior in School-aged Children survey. We used multilevel regression analyses to examine the association between the density of the health workforce and psychosomatic and mental health symptoms with differences in country wealth and income inequality controlled. A higher density of psychologists was associated with better self-reported mental health in adolescents (P = 0.047); however, this finding was not robust to sensitivity analyses. The densities of physicians and psychiatrists were not significantly associated with better adolescent psychosomatic or mental health. Cross-level interactions between the health workforce and socioeconomic status did not relate to health, indicating that larger health workforces did not reduce socioeconomic differences in adolescent health. This study found that adolescents in countries with a higher density of health providers do not report better psychosomatic or mental health. Other social or structural factors may play larger roles in adolescent health.

  2. Health literacy and the Internet: a study on the readability of Australian online health information.

    PubMed

    Cheng, Christina; Dunn, Matthew

    2015-08-01

    Almost 80% of Australian Internet users seek out health information online so the readability of this information is important. This study aimed to evaluate the readability of Australian online health information and determine if it matches the average reading level of Australians. Two hundred and fifty-one web pages with information on 12 common health conditions were identified across sectors. Readability was assessed by the Flesch-Kincaid (F-K), Simple Measure of Gobbledygook (SMOG) and Flesch Reading Ease (FRE) formulas, with grade 8 adopted as the average Australian reading level. The average reading grade measured by F-K and SMOG was 10.54 and 12.12 respectively. The mean FRE was 47.54, a 'difficult-to-read' score. Only 0.4% of web pages were written at or below grade 8 according to SMOG. Information on dementia was the most difficult to read overall, while obesity was the most difficult among government websites. The findings suggest that the readability of Australian health websites is above the average Australian levels of reading. A quantifiable guideline is needed to ensure online health information accommodates the reading needs of the general public to effectively use the Internet as an enabler of health literacy. © 2015 Public Health Association of Australia.

  3. Unfairness and health: evidence from the Whitehall II Study.

    PubMed

    De Vogli, Roberto; Ferrie, Jane E; Chandola, Tarani; Kivimäki, Mika; Marmot, Michael G

    2007-06-01

    To examine the effects of unfairness on incident coronary events and health functioning. Prospective cohort study. Unfairness, sociodemographics, established coronary risk factors (high serum cholesterol, hypertension, obesity, exercise, smoking and alcohol consumption) and other psychosocial work characteristics (job strain, effort-reward imbalance and organisational justice) were measured at baseline. Associations between unfairness and incident coronary events and health functioning were determined over an average follow-up of 10.9 years. 5726 men and 2572 women from 20 civil service departments in London (the Whitehall II Study). Incident fatal coronary heart disease, non-fatal myocardial infarction and angina (528 events) and health functioning. Low employment grade is strongly associated with unfairness. Participants reporting higher levels of unfairness are more likely to experience an incident coronary event (HR 1.55, 95% CI 1.11 to 2.17), after adjustment for age, gender, employment grade, established coronary risk factors and other work-related psychosocial characteristics. Unfairness is also associated with poor physical (OR 1.46, 95% CI 1.20 to 1.77) and mental (OR 1.54, 95% CI 1.19 to 1.99) functioning at follow-up, controlling for all other factors and health functioning at baseline. Unfairness is an independent predictor of increased coronary events and impaired health functioning. Further research is needed to disentangle the effects of unfairness from other psychosocial constructs and to investigate the societal, relational and biological mechanisms that may underlie its associations with health and heart disease.

  4. One Health and the Environment: Toxic Cyanobacteria, a Case Study

    EPA Science Inventory

    The study of environmental health typically focuses on human populations. However, companion animals, livestock and wildlife also experience adverse health effects from environmental pollutants. Animals may experience direct exposure to pollutants in ambient exposure situations. ...

  5. Nursing III. A Course of Study. Health Occupations Education.

    ERIC Educational Resources Information Center

    Rogers, Helen V.

    This curriculum guide for instructors provides a course of study (Nursing III) requisite for the third and concluding portion of a 1-year practical nursing curriculum designed to continue opportunities for career mobility in the health occupations. Content is in three sections: (1) Medical Surgical Nursing II, (2) Mental Health Nursing, and (3)…

  6. Measurement of health system performance at district level: A study protocol

    PubMed Central

    Sharma, Atul; Prinja, Shankar; Aggarwal, Arun Kumar

    2018-01-01

    Background Limited efforts have been observed in low and middle income countries to undertake health system performance assessment at district level. Absence of a comprehensive data collection tool and lack of a standardised single summary measure defining overall performance are some of the main problems. Present study has been undertaken to develop a summary composite health system performance index at district level. Methods A broad range of indicators covering all six domains as per building block framework were finalized by an expert panel. The domains were classified into twenty sub-domains, with 70 input and process indicators to measure performance. Seven sub-domains for assessing health system outputs and outcomes were identified, with a total of 28 indicators. Districts in Haryana state from north India were selected for the study. Primary and secondary data will be collected from 378 health facilities, district and state health directorate headquarters. Indicators will be normalized, aggregated to generate composite performance index at district level. Domain specific scores will present the quality of individual building block domains in the public health system. Robustness of the results will be checked using sensitivity analysis. Expected impact for public health: The study presents a methodology for comprehensive assessment of all health system domains on basis of input, process, output and outcome indicators which has never been reported from India. Generation of this index will help identify policy and implementation areas of concern and point towards potential solutions. Results may also help understand relationships between individual building blocks and their sub-components. Significance for public health Measuring performance of health system is important to understand progress and challenges, and create systems that are efficient, equitable and patient-focused. However, very few assessments of such nature have been observed in low and middle

  7. The relationship between health literacy and quality of life among frequent users of health care services: a cross-sectional study.

    PubMed

    Couture, Éva Marjorie; Chouinard, Maud-Christine; Fortin, Martin; Hudon, Catherine

    2017-07-06

    Although health literacy and quality of life are important concepts in health care, the link between them is unclear, especially for a population of frequent users of health care services with chronic diseases. Low health literacy is a common problem that has been linked to several negative health outcomes. Quality of life is an important health outcome in patient-centered care. Frequent users of health care services are a vulnerable population that deserves attention due to high costs and negative outcomes such as lower quality of life and higher mortality. The objective of this study was to examine the relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services with chronic diseases. This study presents the cross-sectional analysis of data collected through the V1SAGES project, a randomized controlled trial on the effectiveness of a case management intervention in primary care in Quebec, Canada. Participants (n = 247) were frequent users of health care services presenting at least one chronic condition. Health literacy was measured by the Newest Vital Sign (NVS), and the physical and mental components of quality of life were evaluated by the Short Form Health Survey Version 2 (SF-12v2). The association between health literacy (independent variable) and the physical and mental components of quality of life was examined using biserial correlation. No association was found between health literacy and quality of life (physical component: r = 0.108, ρ = 0.11; mental component: r = 0.147, ρ = 0.15). This study suggests that there is no relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services. NCT01719991 . Registered October 25, 2012.

  8. Skylab oral health studies

    NASA Technical Reports Server (NTRS)

    Brown, L. R.; Frome, W. J.; Handler, S.; Wheatcroft, M. G.; Rider, L. J.

    1977-01-01

    Evaluation of Skylab crewmembers for mission related effects on oral health in relation to possible dental injuries provided the following distinctive changes: (1) increased counts of specific anaerobic and streptococcal components; (2) elevations in levels of secretory IgA concurrent with diminutions of salivary lysozyme; and (3) increases in dental calculus and gingival inflammations. The clinical changes are considered to be more influenced by the preexisting state of dental health than by any mission related effects.

  9. Women's mental health during pregnancy: A participatory qualitative study.

    PubMed

    Franks, Wendy L M; Crozier, Kenda E; Penhale, Bridget L M

    2017-08-01

    British public health and academic policy and guidance promotes service user involvement in health care and research, however collaborative research remains underrepresented in literature relating to pregnant women's mental health. The aim of this participatory research was to explore mothers' and professionals' perspectives on the factors that influence pregnant women's mental health. This qualitative research was undertaken in England with the involvement of three community members who had firsthand experience of mental health problems during pregnancy. All members of the team were involved in study design, recruitment, data generation and different stages of thematic analysis. Data were transcribed for individual and group discussions with 17 women who self-identified as experiencing mental health problems during pregnancy and 15 professionals who work with this group. Means of establishing trustworthiness included triangulation, researcher reflexivity, peer debriefing and comprehensive data analysis. Significant areas of commonality were identified between mothers' and professionals' perspectives on factors that undermine women's mental health during pregnancy and what is needed to support women's mental health. Analysis of data is provided with particular reference to contexts of relational, systemic and ecological conditions in women's lives. Women's mental health is predominantly undermined or supported by relational, experiential and material factors. The local context of socio-economic deprivation is a significant influence on women's mental health and service requirements. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  10. OHIO RIVER BASIN ENERGY STUDY: HEALTH ASPECTS

    EPA Science Inventory

    This report was prepared as part of the Ohio River Basin Energy Study (ORBES), a multi-disciplinary program supported by the Environmental Protection Agency. It attempts to establish health damage functions for energy resource extraction, conversion (i.e., burning of coal to prod...

  11. Findings from a prospective cohort study evaluating the effects of International Health Advisors' work on recently settled migrants' health.

    PubMed

    Lecerof, Susanne Sundell; Stafström, Martin; Emmelin, Maria; Westerling, Ragnar; Östergen, Per-Olof

    2017-04-28

    Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA) in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a) assess the impact of the IHA on recently settled migrants' self-reported health status, and received health information; b) determine the moderating role of educational level and social capital; and c) critically discuss the outcomes and suggest implications for health promotion practice. The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references. The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02-5.22), after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24-0.92). No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found. Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the observed negative association between low social participation and

  12. Satellites as Shared Resources for Caribbean Climate and Health Studies

    NASA Technical Reports Server (NTRS)

    Maynard, Nancy G.

    2002-01-01

    Remotely-sensed data and observations are providing powerful new tools for addressing climate and environment-related human health problems through increased capabilities for monitoring, risk mapping, and surveillance of parameters useful to such problems as vector-borne and infectious diseases, air and water quality, harmful algal blooms, UV (ultraviolet) radiation, contaminant and pathogen transport in air and water, and thermal stress. Remote sensing, geographic information systems (GIS), global positioning systems (GPS), improved computational capabilities, and interdisciplinary research between the Earth and health science communities are being combined in rich collaborative efforts resulting in more rapid problem-solving, early warning, and prevention in global health issues. Collaborative efforts among scientists from health and Earth sciences together with local decision-makers are enabling increased understanding of the relationships between changes in temperature, rainfall, wind, soil moisture, solar radiation, vegetation, and the patterns of extreme weather events and the occurrence and patterns of diseases (especially, infectious and vector-borne diseases) and other health problems. This increased understanding through improved information and data sharing, in turn, empowers local health and environmental officials to better predict health problems, take preventive measure, and improve response actions. This paper summarizes the remote sensing systems most useful for climate, environment and health studies of the Caribbean region and provides several examples of interdisciplinary research projects in the Caribbean currently using remote sensing technologies. These summaries include the use of remote sensing of algal blooms, pollution transport, coral reef monitoring, vectorborne disease studies, and potential health effects of African dust on Trinidad and Barbados.

  13. Child incarceration and long-term adult health outcomes: a longitudinal study.

    PubMed

    Barnert, Elizabeth S; Abrams, Laura S; Tesema, Lello; Dudovitz, Rebecca; Nelson, Bergen B; Coker, Tumaini; Bath, Eraka; Biely, Christopher; Li, Ning; Chung, Paul J

    2018-03-12

    Purpose Although incarceration may have life-long negative health effects, little is known about associations between child incarceration and subsequent adult health outcomes. The paper aims to discuss this issue. Design/methodology/approach The authors analyzed data from 14,689 adult participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health) to compare adult health outcomes among those first incarcerated between 7 and 13 years of age (child incarceration); first incarcerated at>or=14 years of age; and never incarcerated. Findings Compared to the other two groups, those with a history of child incarceration were disproportionately black or Hispanic, male, and from lower socio-economic strata. Additionally, individuals incarcerated as children had worse adult health outcomes, including general health, functional limitations (climbing stairs), depressive symptoms, and suicidality, than those first incarcerated at older ages or never incarcerated. Research limitations/implications Despite the limitations of the secondary database analysis, these findings suggest that incarcerated children are an especially medically vulnerable population. Practical implications Programs and policies that address these medically vulnerable children's health needs through comprehensive health and social services in place of, during, and/or after incarceration are needed. Social implications Meeting these unmet health and social service needs offers an important opportunity to achieve necessary health care and justice reform for children. Originality/value No prior studies have examined the longitudinal relationship between child incarceration and adult health outcomes.

  14. Bridging barriers to health promotion: a feasibility pilot study of the 'Promoting Aging Migrants' Capabilities study'.

    PubMed

    Lood, Qarin; Gustafsson, Susanne; Dahlin Ivanoff, Synneve

    2015-08-01

    Improving the possibilities for ageing persons to take control over their health is an increasingly important public health issue. Health promotion has previously been visualized to succeed with this goal, but research has primarily focused on ageing persons who are native-born, leaving the generalizability to persons who are foreign-born unexplored. Therefore, as part of the development of a larger health promotion initiative for ageing persons who have experienced migration, this study aimed to assess the feasibility of an adapted protocol. The specific feasibility objectives were to assess recruitment procedure, retention rates, study questionnaire administration and variability of collected data. Forty persons who were ≥70 years, and who had migrated from Finland, Bosnia and Herzegovina, Croatia, Montenegro or Serbia to Sweden were randomly allocated to a health promotion programme or a control group. The programme was linguistically adapted with regard to translated information material, bilingual health professionals and evaluators, and a person-centred approach was applied to both programme development and provision. The data analysis was explorative and descriptive. The results visualized structural and linguistic barriers to recruitment and study questionnaire administration, and describe strategies for how to bridge them. Retention rates and data variability were satisfying. Calling for iterative and pragmatic programme design, the findings describe how to move towards a more inclusive health care environment. Person-centred and bilingual approaches with attention to the possibilities for building authentic relationships between participants and providers are emphasized, and a structured methodology for developing study questionnaires is suggested. © 2015 John Wiley & Sons, Ltd.

  15. Relationship between mental health and spiritual wellbeing among hemodialysis patients: a correlation study.

    PubMed

    Martínez, Beatriz Bertolaccini; Custódio, Rodrigo Pereira

    2014-01-01

    The stress of living with a terminal disease has a negative impact on the mental health of hemodialysis (HD) patients. Spirituality is a potential coping mechanism for stressful experiences. Studies on the relationship between spirituality and mental health among HD patients are scarce. The purpose of this study was to evaluate the relationship between mental health and spiritual well-being among HD patients. Cross-sectional observational study on hemodialysis patients at a single center in Brazil, between January and December 2011. Mental health was assessed using the General Health Questionnaire and spiritual wellbeing was assessed using the Spiritual Wellbeing Scale; 150 HD patients participated in the study. A significant correlation was found between mental health and spiritual wellbeing (P = 0.001). Spiritual wellbeing was the strongest predictor of mental health, psychological distress, sleep disturbance and psychosomatic complaints. Poor mental health was associated with lower spiritual wellbeing. This has important implications for delivery of palliative care to HD patients.

  16. Health behaviours of young, rural residents: a case study.

    PubMed

    Bourke, Lisa; Humphreys, John; Lukaitis, Fiona

    2009-04-01

    To analyse self-reported health behaviours of young people from a rural community and the factors influencing their behaviours. Interviews were conducted with 19 young people, 11 parents and 10 key informants from a small rural Victorian community, asking about teenage health behaviours and the factors influencing these behaviours. Young people ate both healthy and unhealthy foods, most participated in physical activity, few smoked and most drank alcohol. The study found that community level factors, including community norms, peers, access issues and geographic isolation, were particularly powerful in shaping health behaviours, especially alcohol consumption. Smoking was influenced by social participation in the community and national media health campaigns. Diet and exercise behaviour were influenced by access and availability, convenience, family, peers and local and non-local cultural influences. The rural context, including less access to and choice of facilities and services, lower incomes, lack of transport and local social patterns (including community norms and acceptance), impact significantly on young people's health behaviours. Although national health promotion campaigns are useful aspects of behaviour modification, much greater focus on the role and importance of the local contexts in shaping health decisions of young rural people is required.

  17. Mental Health Nurses as therapists in a rehabilitation setting: A phenomenological study.

    PubMed

    Browne, Graeme; Hurley, John

    2018-06-01

    Mental Health Nurses have a long tradition of delivering talk-based interventions across a range of clinical settings. Despite this, Mental Health Nurses receive limited recognition of this contribution. This paper presents findings from a study that explored Mental Health Nurses' experience of delivering talk-based therapies in an inpatient rehabilitation setting. This study uses semistructured interviews and a phenomenological approach to explore eight Mental Health Nurses' experience. Themes emerging included that: mental health nursing is a talk-based therapy in its own right, talk-based therapy was part of everyday nursing care on the floor and integrated talk-based therapy enhanced recovery opportunities for consumers. However, a further theme was that there were tensions around providing talk-based therapy conflicted with other roles including unit management and the role of nurses in controlling challenging behaviours. This study found that Mental Health Nurses, in this setting, are offering talk-based therapy to the people they care for. The findings of this study have implications for research: there needs to be a larger study investigating nurses' use of talk-based therapy in inpatient settings. If, as the authors expect that, it is found that mental health nurses are offering these therapies generally in inpatient settings, this has serious implications for postgraduate education in Mental Health Nursing policy in terms of recognition that this is happening and finding ways to support nurses to do this well. There also needs to be further research in the best ways to offer talk-based therapy in these settings. © 2017 Australian College of Mental Health Nurses Inc.

  18. One Health and the Environment: Toxic Cyanobacteria A Case Study

    EPA Science Inventory

    The study of environmental health typically focuses on human populations. However, companion animals, livestock and wildlife also experience adverse health effects from environmental pollutants. Animals may experience direct exposure to pollutants unlike people in most ambient ex...

  19. Key Health Information Technologies and Related Issues for Iran: A Qualitative Study.

    PubMed

    Hemmat, Morteza; Ayatollahi, Haleh; Maleki, Mohammadreza; Saghafi, Fatemeh

    2018-01-01

    Planning for the future of Health Information Technology (HIT) requires applying a systematic approach when conducting foresight studies. The aim of this study was to identify key health information technologies and related issues for Iran until 2025. This was a qualitative study and the participants included experts and policy makers in the field of health information technology. In-depth semi-structured interviews were conducted and data were analyzed by using framework analysis and MAXQDA software. The findings revealed that the development of national health information network, electronic health records, patient health records, a cloud-based service center, interoperability standards, patient monitoring technologies, telehealth, mhealth, clinical decision support systems, health information technology and mhealth infrastructure were found to be the key technologies for the future. These technologies could influence the economic, organizational and individual levels. To achieve them, the economic and organizational obstacles need to be overcome. In this study, a number of key technologies and related issues were identified. This approach can help to focus on the most important technologies in the future and to priorities these technologies for better resource allocation and policy making.

  20. Key Health Information Technologies and Related Issues for Iran: A Qualitative Study

    PubMed Central

    Hemmat, Morteza; Ayatollahi, Haleh; Maleki, Mohammadreza; Saghafi, Fatemeh

    2018-01-01

    Background and Objective: Planning for the future of Health Information Technology (HIT) requires applying a systematic approach when conducting foresight studies. The aim of this study was to identify key health information technologies and related issues for Iran until 2025. Methods: This was a qualitative study and the participants included experts and policy makers in the field of health information technology. In-depth semi-structured interviews were conducted and data were analyzed by using framework analysis and MAXQDA software. Results: The findings revealed that the development of national health information network, electronic health records, patient health records, a cloud-based service center, interoperability standards, patient monitoring technologies, telehealth, mhealth, clinical decision support systems, health information technology and mhealth infrastructure were found to be the key technologies for the future. These technologies could influence the economic, organizational and individual levels. To achieve them, the economic and organizational obstacles need to be overcome. Conclusion: In this study, a number of key technologies and related issues were identified. This approach can help to focus on the most important technologies in the future and to priorities these technologies for better resource allocation and policy making. PMID:29854016

  1. Machine learning approaches to the social determinants of health in the health and retirement study.

    PubMed

    Seligman, Benjamin; Tuljapurkar, Shripad; Rehkopf, David

    2018-04-01

    Social and economic factors are important predictors of health and of recognized importance for health systems. However, machine learning, used elsewhere in the biomedical literature, has not been extensively applied to study relationships between society and health. We investigate how machine learning may add to our understanding of social determinants of health using data from the Health and Retirement Study. A linear regression of age and gender, and a parsimonious theory-based regression additionally incorporating income, wealth, and education, were used to predict systolic blood pressure, body mass index, waist circumference, and telomere length. Prediction, fit, and interpretability were compared across four machine learning methods: linear regression, penalized regressions, random forests, and neural networks. All models had poor out-of-sample prediction. Most machine learning models performed similarly to the simpler models. However, neural networks greatly outperformed the three other methods. Neural networks also had good fit to the data ( R 2 between 0.4-0.6, versus <0.3 for all others). Across machine learning models, nine variables were frequently selected or highly weighted as predictors: dental visits, current smoking, self-rated health, serial-seven subtractions, probability of receiving an inheritance, probability of leaving an inheritance of at least $10,000, number of children ever born, African-American race, and gender. Some of the machine learning methods do not improve prediction or fit beyond simpler models, however, neural networks performed well. The predictors identified across models suggest underlying social factors that are important predictors of biological indicators of chronic disease, and that the non-linear and interactive relationships between variables fundamental to the neural network approach may be important to consider.

  2. Perceptions About Disseminating Health Information Among Mommy Bloggers: Quantitative Study

    PubMed Central

    2018-01-01

    Background Social media are potentially powerful channels for communicating relevant health information in culturally sensitive and influential ways to key audiences. Moreover, these channels hold promise for promoting awareness and knowledge of health risks, prevention, and treatment by utilizing opinion leaders for message dissemination. Despite limited empirical evidence to-date, early promising results suggest that blogs are a form of social media that should be examined as worthy channels for health communication. Objectives This formative study explored mommy bloggers’ perceptions about sharing health-related information on their blogs with their readers. It also sought to analyze which topics would be of most interest to mommy bloggers, what motivates them to write about health issues, and how they perceive interest in these topics among their readers. Methods This study employed survey methodology, including the use of open-ended questions, the responses to which were coded for analysis. Specifically, a 14-item survey was fielded with mommy bloggers between October 1 and October 28, 2016. Bloggers were recruited through The Motherhood network. A total of 461 mommy bloggers responded to the survey; 163 were removed for low quality responses and incomplete data. As a result, 298 eligible participants completed the survey. For open-ended questions in the survey, a sample of responses were coded and analyzed. Results The majority of the respondents (87.2%, 260/298) reported that they have written about health issues in the past; 97.3% (290/298) of the respondents reported that they would consider writing about health issues sometime in the future, and 96.3% (287/298) of the respondents reported that their readers like to read about health issues on their blogs. In terms of content priorities for this sample of bloggers, Nutrition and Physical Activity dominate the current conversation and similarly, Physical Activity and Nutrition remain top content

  3. Iran's Experience of Health Cooperatives as a Public-Private Partnership Model in Primary Health Care: A Comparative Study in East Azerbaijan.

    PubMed

    Farahbakhsh, Mostafa; Sadeghi-Bazargani, Homayoun; Nikniaz, Alireza; Tabrizi, Jafar Sadegh; Zakeri, Akram; Azami, Saber

    2012-01-01

    Iran started a new public-private partnership model in form of health coopera¬tives which is somehow different from other types of health cooperatives throughout the world. In this study we compared the performance and quality of health services in public health cen¬ters (PHCs) and cooperative health centers (CHCs). In this comparative study performance quality of two cohorts of public and coopera¬tive health centers were compared in several health service delivery programs over the time pe¬riod of 2001- 2002. Screening program: the rate of visited population during screening program was higher in CHCs. Maternal health care program: In some of studied programs CHCs had better results. Child health care: Most indicators were better or similar in CHCs. School health program and Health education: All indices were better or similar in CHCs. Environmental health: population based positive function was not significantly different for the population covered by CHCs compared to population covered by PHCs. Client and staff satisfaction as well as participation and attitudes of personnel towards management was better in CHCs. Mean annual cost per capita of the covered population by PHCs was higher. CHCs as a public private partnership model in Iran may deliver preventive health care services as effective as PHCs in many fields and even better in some areas.

  4. Iran's Experience of Health Cooperatives as a Public-Private Partnership Model in Primary Health Care: A Comparative Study in East Azerbaijan

    PubMed Central

    Farahbakhsh, Mostafa; Sadeghi-Bazargani, Homayoun; Nikniaz, Alireza; Tabrizi, Jafar Sadegh; Zakeri, Akram; Azami, Saber

    2012-01-01

    Background: Iran started a new public-private partnership model in form of health coopera¬tives which is somehow different from other types of health cooperatives throughout the world. In this study we compared the performance and quality of health services in public health cen¬ters (PHCs) and cooperative health centers (CHCs). Methods: In this comparative study performance quality of two cohorts of public and coopera¬tive health centers were compared in several health service delivery programs over the time pe¬riod of 2001- 2002. Results: Screening program: the rate of visited population during screening program was higher in CHCs. Maternal health care program: In some of studied programs CHCs had better results. Child health care: Most indicators were better or similar in CHCs. School health program and Health education: All indices were better or similar in CHCs. Environmental health: population based positive function was not significantly different for the population covered by CHCs compared to population covered by PHCs. Management: Client and staff satisfaction as well as participation and attitudes of personnel towards management was better in CHCs. Mean annual cost per capita of the covered population by PHCs was higher. Conclusion: CHCs as a public private partnership model in Iran may deliver preventive health care services as effective as PHCs in many fields and even better in some areas. PMID:24688945

  5. A training tool on how to create a family health case study. Creating a family health case study.

    PubMed

    Naimoli, J; Edmands, E M

    1982-01-01

    1 way of teaching family health is through a case study, which can focus on common situations that occur during the family life cycle. Case studies can also be used to teach students about factors to consider in uncommon situations, or can be designed from the trainer's own experience for a specific group of health workers to make them aware of local customs, beliefs, and practices. The general guidelines are the following: 1) determine specifice objectives; 2) outline the content to be covered; 3) develop the case study; 4) test and revise it. In developing the study it is useful to focus on 1 member in a community, providing information about social, physical, and personal history. Make a point of telling a story, and select a format that is suitable for one's purposes. It is important to obtain the reaction and critique of more than 1 colleague and to evaluate the study after it has been presented to students. There should be enough information to stimulate the students' thinking and to give them something to work with, and, at the same time, certain data should be omitted so that they can identify what is missing and needed. The material was prepared by INTRAH staff members. Other materials include training in group dynamics, how to use tracing techniques to create visual aids, and how to evaluate teaching. A case study on stillbirth is presented in an adjacent article.

  6. The interplay between sleep and mood in predicting academic functioning, physical health and psychological health: a longitudinal study.

    PubMed

    Wong, Mark Lawrence; Lau, Esther Yuet Ying; Wan, Jacky Ho Yin; Cheung, Shu Fai; Hui, C Harry; Mok, Doris Shui Ying

    2013-04-01

    Existing studies on sleep and behavioral outcomes are mostly correlational. Longitudinal data is limited. The current longitudinal study assessed how sleep duration and sleep quality may be causally linked to daytime functions, including physical health (physical well-being and daytime sleepiness), psychological health (mood and self-esteem) and academic functioning (school grades and study effort). The mediation role of mood in the relationship between sleep quality, sleep duration and these daytime functions is also assessed. A sample of 930 Chinese students (aged 18-25) from Hong Kong/Macau completed self-reported questionnaires online across three academic semesters. Sleep behaviors are assessed by the sleep timing questionnaire (for sleep duration and weekday/weekend sleep discrepancy) and the Pittsburgh sleep quality index (sleep quality); physical health by the World Health Organization quality of life scale-brief version (physical well-being) and Epworth Sleepiness Scale (daytime sleepiness); psychological health by the depression anxiety stress scale (mood) and Rosenberg Self-esteem Scale (self-esteem) and academic functioning by grade-point-average and the college student expectation questionnaire (study effort). Structural equation modeling with a bootstrap resample of 5000 showed that after controlling for demographics and participants' daytime functions at baseline, academic functions, physical and psychological health were predicted by the duration and quality of sleep. While some sleep behaviors directly predicted daytime functions, others had an indirect effect on daytime functions through negative mood, such as anxiety. Sleep duration and quality have direct and indirect (via mood) effects on college students' academic function, physical and psychological health. Our findings underscore the importance of healthy sleep patterns for better adjustment in college years. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. [Informational analysis of global health equity studies based on database of Web of Science].

    PubMed

    Zhao, Bo; Cui, Lei; Guo, Yan

    2011-06-18

    To present the history of global health equity studies and provide reference for the selection of topics of China's health equity study. In this article citations on the subject of health equity from Web of Science (WOS) were analyzed and 60 papers concerned which were cited more than 30 times selected. Through the co-citation cluster analysis combined with the content analysis of the highly-cited papers, this article attempted to cluster them into several significant categories. Then we analyzed their strategic importance in the field of health equity by drawing citation strategic diagrams. Six hot topics in health equity studies were as follows: health service equity, the relationship between health service demand and utilization; definitions of health equity; socioeconomic status and mortality, income distribution and health, and the measurement of health inequity. Income distribution and health was the biggest concern and the measurement of health inequity was of the greatest novelty. Conducting empirical analyses on the effect of social determinants (including socioeconomic status, social network and psychosocial status etc.) on health by means of health equity measurements marks the development trend of health equity study.

  8. Adult day health care evaluation study: methodology and implementation. Adult Day Health Care Evaluation Development Group.

    PubMed Central

    Hedrick, S C; Rothman, M L; Chapko, M; Inui, T S; Kelly, J R; Ehreth, J

    1991-01-01

    The Adult Day Health Care Evaluation Study was developed in response to a congressional mandate to study the medical efficacy and cost effectiveness of the Adult Day Health Care (ADHC) effort in the Department of Veterans Affairs (VA). Four sites providing ADHC in VA facilities are participating in an ongoing randomized controlled trial. Three years of developmental work prior to the study addressed methodological issues that were problematic in previous studies. This developmental work resulted in the methodological approaches described here: (1) a patient recruitment process that actively recruits and screens all potential candidates using empirically developed admission criteria based on predictors of nursing home placement in VA; (2) the selection and development of measures of medical efficacy that assess a wide range of patient and caregiver outcomes with sufficient sensitivity to detect small but clinically important changes; and (3) methods for detailed, accurate, and efficient measurement of utilization and costs of health care within and outside VA. These approaches may be helpful to other researchers and may advance the methodological sophistication of long-term care program evaluation. PMID:1991678

  9. 40 CFR 725.92 - Data from health and safety studies of microorganisms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Data from health and safety studies of... Public Access to Information § 725.92 Data from health and safety studies of microorganisms. (a..., EPA will deny any claim of confidentiality with respect to information included in a health and safety...

  10. 40 CFR 725.92 - Data from health and safety studies of microorganisms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Data from health and safety studies of... Public Access to Information § 725.92 Data from health and safety studies of microorganisms. (a..., EPA will deny any claim of confidentiality with respect to information included in a health and safety...

  11. 40 CFR 725.92 - Data from health and safety studies of microorganisms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Data from health and safety studies of... Public Access to Information § 725.92 Data from health and safety studies of microorganisms. (a..., EPA will deny any claim of confidentiality with respect to information included in a health and safety...

  12. 40 CFR 725.92 - Data from health and safety studies of microorganisms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Data from health and safety studies of... Public Access to Information § 725.92 Data from health and safety studies of microorganisms. (a..., EPA will deny any claim of confidentiality with respect to information included in a health and safety...

  13. 40 CFR 725.92 - Data from health and safety studies of microorganisms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Data from health and safety studies of... Public Access to Information § 725.92 Data from health and safety studies of microorganisms. (a..., EPA will deny any claim of confidentiality with respect to information included in a health and safety...

  14. Prevalence of ideal cardiovascular health in European adolescents: The HELENA study.

    PubMed

    Henriksson, Pontus; Henriksson, Hanna; Gracia-Marco, Luis; Labayen, Idoia; Ortega, Francisco B; Huybrechts, Inge; España-Romero, Vanesa; Manios, Yannis; Widhalm, Kurt; Dallongeville, Jean; González-Gross, Marcela; Marcos, Ascensión; Moreno, Luis A; Castillo, Manuel J; Ruiz, Jonatan R

    2017-08-01

    The ideal cardiovascular health (iCVH) construct consists of 4 health behaviours and 3 health factors and is strongly related to later cardiovascular disease. However, the prevalence of iCVH in European adolescents is currently unknown. The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional, multicentre study conducted in 9 European countries during 2006-2007 and included 3528 adolescents (1683 boys and 1845 girls) between 12.5 and 17.5years of age. Status (ideal vs. non-ideal) for the health behaviours (smoking status, body mass index, physical activity and diet) and health factors (total cholesterol, blood pressure and fasting glucose) were determined. Overall, the prevalence of ideal health behaviours was low; non-smoking (60.9% ideal), body mass index (76.8%), physical activity (62.1%), and diet (1.7%). The prevalence of ideal health factors was; total cholesterol (65.8%), blood pressure (62.0%) and plasma glucose (88.8%). The low prevalence of iCVH behaviours, especially diet and physical activity, identified in European adolescents is likely to influence later cardiovascular health which strongly motivates efforts to increase ideal health behaviours in this population. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Neighborhood socioeconomic status, depression, and health status in the Look AHEAD (Action for Health in Diabetes) study.

    PubMed

    Gary-Webb, Tiffany L; Baptiste-Roberts, Kesha; Pham, Luu; Wesche-Thobaben, Jacquline; Patricio, Jennifer; Pi-Sunyer, F Xavier; Brown, Arleen F; Jones-Corneille, LaShanda; Brancati, Frederick L

    2011-05-19

    Depression and diminished health status are common in adults with diabetes, but few studies have investigated associations with socio-economic environment. The objective of this manuscript was to evaluate the relationship between neighborhood-level SES and health status and depression. Individual-level data on 1010 participants at baseline in Look AHEAD (Action for Health in Diabetes), a trial of long-term weight loss among adults with type 2 diabetes, were linked to neighborhood-level SES (% living below poverty) from the 2000 US Census (tracts). Dependent variables included depression (Beck Inventory), and health status (Medical Outcomes Study (SF-36) scale). Multi-level regression models were used to account simultaneously for individual-level age, sex, race, education, personal yearly income and neighborhood-level SES. Overall, the % living in poverty in the participants' neighborhoods varied, mean =11% (range 0-67%). Compared to their counterparts in the lowest tertile of neighborhood poverty (least poverty), those in the highest tertile (most poverty) had significantly lower scores on the role-limitations(physical), role limitations(emotional), physical functioning, social functioning, mental health, and vitality sub-scales of the SF-36 scale. When evaluating SF-36 composite scores, those living in neighborhoods with more poverty had significantly lower scores on the physical health (beta-coefficient [beta]= -1.90 units, 95% CI: -3.40,-0.039), mental health (beta= -2.92 units, -4.31,-1.53) and global health (beta= -2.77 units, -4.21,-1.33) composite scores. In this selected group of weight loss trial participants, lower neighborhood SES was significantly associated with poorer health status. Whether these associations might influence response to the Look AHEAD weight loss intervention requires further investigation.

  16. Participatory public health systems research: value of community involvement in a study series in mental health emergency preparedness.

    PubMed

    McCabe, O Lee; Marum, Felicity; Semon, Natalie; Mosley, Adrian; Gwon, Howard; Perry, Charlene; Moore, Suzanne Straub; Links, Jonathan M

    2012-01-01

    Concerns have arisen over recent years about the absence of empirically derived evidence on which to base policy and practice in the public health system, in general, and to meet the challenge of public health emergency preparedness, in particular. Related issues include the challenge of disaster-caused, behavioral health surge, and the frequent exclusion of populations from studies that the research is meant to aid. To characterize the contributions of nonacademic collaborators to a series of projects validating a set of interventions to enhance capacity and competency of public mental health preparedness planning and response. Urban, suburban, and rural communities of the state of Maryland and rural communities of the state of Iowa. Study partners and participants (both of this project and the studies examined) were representatives of academic health centers (AHCs), local health departments (LHDs), and faith-based organizations (FBOs) and their communities. A multiple-project, case study analysis was conducted, that is, four research projects implemented by the authors from 2005 through 2011 to determine the types and impact of contributions made by nonacademic collaborators to those projects. The analysis involved reviewing research records, conceptualizing contributions (and providing examples) for government, faith, and (nonacademic) institutional collaborators. Ten areas were identified where partners made valuable contributions to the study series; these "value-areas" were as follows: 1) leadership and management of the projects; 2) formulation and refinement of research topics, aims, etc; 3) recruitment and retention of participants; 4) design and enhancement of interventions; 5) delivery of interventions; 6) collection, analysis, and interpretation of data; 7) dissemination of findings; 8) ensuring sustainability of faith/government preparedness planning relationships; 9) optimizing scalability and portability of the model; and 10) facilitating

  17. Perceptions of the neighbourhood environment and self rated health: a multilevel analysis of the Caerphilly Health and Social Needs Study

    PubMed Central

    Poortinga, Wouter; Dunstan, Frank D; Fone, David L

    2007-01-01

    Background In this study we examined whether (1) the neighbourhood aspects of access to amenities, neighbourhood quality, neighbourhood disorder, and neighbourhood social cohesion are associated with people's self rated health, (2) these health effects reflect differences in socio-demographic composition and/or neighbourhood deprivation, and (3) the associations with the different aspects of the neighbourhood environment vary between men and women. Methods Data from the cross-sectional Caerphilly Health and Social Needs Survey were analysed using multilevel modelling, with individuals nested within enumeration districts. In this study we used the responses of people under 75 years of age (n = 10,892). The response rate of this subgroup was 62.3%. All individual responses were geo-referenced to the 325 census enumeration districts of Caerphilly county borough. Results The neighbourhood attributes of poor access to amenities, poor neighbourhood quality, neighbourhood disorder, lack of social cohesion, and neighbourhood deprivation were associated with the reporting of poor health. These effects were attenuated when controlling for individual and collective socio-economic status. Lack of social cohesion significantly increased the odds of women reporting poor health, but did not increase the odds of men reporting poor health. In contrast, unemployment significantly affected men's health, but not women's health. Conclusion This study shows that different aspects of the neighbourhood environment are associated with people's self rated health, which may partly reflect the health impacts of neighbourhood socio-economic status. The findings further suggest that the social environment is more important for women's health, but that individual socio-economic status is more important for men's health. PMID:17925028

  18. [Stranger isolated minors and the french health care system: qualitative study].

    PubMed

    Guégan, Marion; Rivollier, Elisabeth

    2017-01-01

    While waiting for health insurance coverage, unaccompanied foreign minors (UFM) can attend PASS healthcare access clinics in French hospitals. The aim of this study was to identify UFM's representations and perceptions of the French health care system. This qualitative study was based on a series of individual, semi-structured interviews of UFMs attending a PASS clinic. The methodology was approved by the French data protection authority and an ethics committee. A total of 21 UFMs were interviewed. Participants expressed their satisfaction with health care, although the health care system was perceived as a complex system. The prescription is essential, as it enables the patient to obtain medications, the ultimate goal of health care access. Not all participants knew about the existence of national health insurance. They were unable to distinguish between PASS clinics and the hospital in general and the screening role of PASS clinics was often poorly understood. The general practitioner was not always identified and his role was poorly understood. Educators were perceived as playing a decisive role in health care access. Heath is essential for all UFMs. None of them referred to mental health issues. UFMs need better information about the health care system and their rights. The educators' health care support training, their knowledge of the rights of UFMs and the role of healthcare professionals need to be improved. Screening of mental illness needs to be developed.

  19. Women's Reported Health Behaviours before and during Pregnancy: A Retrospective Study

    ERIC Educational Resources Information Center

    Smedley, Jenna; Jancey, Jonine M.; Dhaliwal, Satvinder; Zhao, Yun; Monteiro, Sarojini M. D. R.; Howat, Peter

    2014-01-01

    Objective: This study aimed to determine women's reported health behaviours (physical activity, diet, weight management) before and during pregnancy, and to identify sources of health information. Design: Retrospective study incorporating quantitative (a self-completed survey) and qualitative (one-on-one interviews) methods. Methodology:…

  20. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran.

    PubMed

    Piroozi, Bakhtiar; Moradi, Ghobad; Nouri, Bijan; Mohamadi Bolbanabad, Amjad; Safari, Hossein

    2016-03-14

    One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE) after the implementation of HSEP and the factors that determine CHE. A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO) definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of recent reform, thus financially protecting public against

  1. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

    PubMed Central

    Piroozi, Bakhtiar; Moradi, Ghobad; Nouri, Bijan; Mohamadi Bolbanabad, Amjad; Safari, Hossein

    2016-01-01

    Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE) after the implementation of HSEP and the factors that determine CHE. Methods: A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO) definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. Results: The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. Conclusion: The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of recent reform

  2. Hazardous Health Behaviour among Medical Students: a Study from Turkey.

    PubMed

    Nacar, Melis; Cetinkaya, Fevziye; Baykan, Zeynep; Yilmazel, Gulay; Elmali, Ferhan

    2015-01-01

    Hazardous health behaviour in young people is an important factor that affects the individual risk for non-communicable diseases and other disorders later in life. This study aimed to determine the hazardous health behaviour of first and last class medical students of Erciyes University. This descriptive study was carried out with 240 medical students from the first and 130 students from the last (sixth) class. Data were obtained by questionnaire between March-April 2012. In total, 339 students were included with a response rate of 91.6%. Socio-demographic characteristics, school success, self-reported economic difficulties, health perceptions, hazardous health behaviour related to chronic disease, tobacco, alcohol, substance use, body weight, height, traffic, violence and nutrition were assessed in line with the literature. Of the participants; 64.0% were from first and 36.0% were from the last class. Mean ages for the first and last classes were 19.4 ± 1.5 and 24.0 ± 1.5 years, respectively. In the current study, males exhibited more hazardous behaviour than females. Sime 19.8% of the students in the study group used alcohol, 35.4% used a waterpipe, and 24.8% used tobacco at least once. These rates increased in both genders in the last class and the increase in males was significant. Some 3.8% of the students in the current study used pleasure-inducing illegal substances at least once. All the students participating in the current study were single, the number of males reported not using condoms (8.6%) was 4.56 times higher compared to females. Some 64.0% of the students did not perform physical activity lasting at least 30 minutes for five times a week, 13.0% did not sleep for mean 7-8 hours daily, males having a 2.9 times higher risk. More than 1/3 of the students did not consume cooked vegetable dishes and 1/4 did not consume fresh fruits and salads, the rates were higher among males. In the current study, hazardous health behaviour was prevalent among

  3. The health and wellbeing of Australian farmers: a longitudinal cohort study.

    PubMed

    Brew, Bronwyn; Inder, Kerry; Allen, Joanne; Thomas, Matthew; Kelly, Brian

    2016-09-15

    Isolation, long work days, climate change and globalization are just some of the many pressures that make farming a vulnerable occupation for incurring mental health issues. The objective of this study was to determine whether farming in Australia is associated with poorer wellbeing, physical and mental health, and less health service use. The Australian Rural Mental Health Study, a longitudinal cohort study was analysed over four time points comparing farmers with non-farming workers (n = 1184 at baseline). Participants were recruited from rural NSW, Australia. A number of physical, mental health, wellbeing, service use outcomes were assessed using generalised estimating equations including all waves in each model. Barriers to seeking help were also assessed. Farmers who lived remotely reported worse mental health (β -0.33, 95 % CI -0.53, -0.13) and wellbeing (β -0.21(95 % CI -0.35, -0.06) than remote non-farm workers regardless of financial hardship, rural specific factors eg drought worry, or recent adverse events. All farmers were no different to non-farming workers on physical health aspects except for chronic illnesses, where they reported fewer illnesses (OR 0.66, 95 % CI 0.44, 0.98). All farmers were half as likely to visit a general practitioner (GP) or a mental health professional in the last 12 months as compared to non-farm workers regardless of location (OR 0.59, 95 % CI 0.35, 0.97). Rural workers felt that they preferred to manage themselves rather than access help for physical health needs (50 %) or mental health needs (75 %) and there was little difference between farmers and non-farm workers in reasons for not seeking help. Remoteness is a significant factor in the mental health and wellbeing of farmers, more so than financial stress, rural factors and recent adverse events. Creative programs and policies that improve access for farmers to GPs and mental health professionals should be supported.

  4. Health Workforce Development: A Needs Assessment Study in French Speaking African Countries

    ERIC Educational Resources Information Center

    Chastonay, Philippe; Moretti, Roberto; Zesiger, Veronique; Cremaschini, Marco; Bailey, Rebecca; Pariyo, George; Kabengele, Emmanuel Mpinga

    2013-01-01

    In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential…

  5. Sociodemographic and socioeconomic determinants of health services utilization in Greece: the Hellas Health I study.

    PubMed

    Tountas, Yannis; Oikonomou, Nikolaos; Pallikarona, Georgia; Dimitrakaki, Christine; Tzavara, Chara; Souliotis, Kyriakos; Mariolis, Anargiros; Pappa, Evelina; Kontodimopoulos, Nick; Niakas, Dimitris

    2011-02-01

    The purpose of the study was to estimate the demographic and socioeconomic determinants of utilization of the Greek primary and hospital health care services. Data were obtained from the cross-sectional nationwide household survey Hellas Health I (2006). The sample (N = 1005) was representative of the Greek adult population in terms of age and residency, and was selected by means of a three-stage, proportional-to-size sampling design. The presence of a family doctor was reported in a higher degree by participants of higher social classes and private insurance. After adjusting for self-perceived general health and chronic illness, contacts with health care professionals during the past four weeks were found less for residents of rural areas, while contacts with health care professionals during the past 12 months were found less for men than women, for individuals without private insurance and for individuals of lower education. More out-of-pocket payments were reported by the 34-44 age group, rural area residents and individuals with private insurance. Higher use of private health care services was reported by participants of higher social classes and residents of rural areas and private insurance. Only hospital admissions were not directly influenced by demographic and socioeconomic factors. The findings imply the existence of inequities in access and use of primary health services with clear implications to related policies.

  6. Neighborhood socioeconomic status, depression, and health status in the Look AHEAD (Action for health in diabetes) study

    USDA-ARS?s Scientific Manuscript database

    Depression and diminished health status are common in adults with diabetes, but few studies have investigated associations with socio-economic environment. The objective of this manuscript was to evaluate the relationship between neighborhood-level SES and health status and depression. Individual-le...

  7. Health Impact of Domestic Violence against Saudi Women: Cross Sectional Study.

    PubMed

    Al Dosary, Ahmad Hamad

    2016-04-01

    Domestic violence is a major public health problem. A wide range of health hazards result from violence against women directly, or from its long-term consequences. The objective of this study is to determine health related consequences of domestic violence against women. A community based cross-sectional study was carried through online survey; convenience sample was taken during the period between December 2013 and February 2014. 421 women completed the survey, who met the inclusion criteria and accepted willing to be a part of this study. The data was collected through online survey website. A validated Arabic version of NorVold Domestic Abuse Questionnaire (NOVAQ) was used as a tool to assess domestic violence among the study sample. Analysis was performed using SPSS, version 18.0. A total of 421 women participated in the survey. There was no significant correlation between socio-demographic characteristics and being abused or not. However, by further analysis we found more sexual abuse among non-working women P=0.048. There was significant correlation between abused women and general health status, doctor visits, depression, insomnia, and somatic symptoms. The consequences of abuse are profound, extending beyond the health of individual to affect the well-being of entire community. So, we recommend to increase community awareness through national awareness campaign, national prevalence survey of domestic violence and well trained health professionals for assessing domestic violence cases.

  8. Let's dance: Organization studies, medical sociology and health policy.

    PubMed

    Currie, Graeme; Dingwall, Robert; Kitchener, Martin; Waring, Justin

    2012-02-01

    This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a 'generative dance', between organization studies (OS), and two of the journal's traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. A Neighborhood Wealth Metric for Use in Health Studies

    PubMed Central

    Moudon, Anne Vernez; Cook, Andrea J.; Ulmer, Jared; Hurvitz, Philip M.; Drewnowski, Adam

    2011-01-01

    Background Measures of neighborhood deprivation used in health research are typically based on conventional area-based SES. Purpose The aim of this study is to examine new data and measures of SES for use in health research. Specifically, assessed property values are introduced as a new individual-level metric of wealth and tested for their ability to substitute for conventional area-based SES as measures of neighborhood deprivation. Methods The analysis was conducted in 2010 using data from 1922 participants in the 2008– 2009 survey of the Seattle Obesity Study (SOS). It compared the relative strength of the association between the individual-level neighborhood wealth metric (assessed property values) and area-level SES measures (including education, income, and percentage above poverty as single variables, and as the composite Singh index) on the binary outcome fair/poor general health status. Analyses were adjusted for gender, categoric age, race, employment status, home ownership, and household income. Results The neighborhood wealth measure was more predictive of fair/poor health status than area-level SES measures, calculated either as single variables or as indices (lower DIC measures for all models). The odds of having a fair/poor health status decreased by 0.85 [0.77, 0.93] per $50,000 increase in neighborhood property values after adjusting for individual-level SES measures. Conclusions The proposed individual-level metric of neighborhood wealth, if replicated in other areas, could replace area-based SES measures, thus simplifying analyses of contextual effects on health. PMID:21665069

  10. Trajectories of Mental Health over 16 Years amongst Young Adult Women: The Australian Longitudinal Study on Women's Health

    ERIC Educational Resources Information Center

    Holden, Libby; Ware, Robert S.; Lee, Christina

    2016-01-01

    This article used data from 5,171 young women participating in the Australian Longitudinal Study on Women's Health, a nationally representative longitudinal cohort study, to identify longitudinal trajectory patterns of mental health across 6 surveys over 16 years of early adulthood, from age 18-23 to age 34-39. In addition, we identified both…

  11. The Unit Manning System Family Health Study

    DTIC Science & Technology

    1988-08-01

    American Public Health Association, Los Angeles, CA. Durkheim , Emile . (1951). Suicide: A study in sociology. trans. J. A. Spaulding and G. Simpson. New York...originate in social interaction, while Durkheim (1951) proposed that belonging to a socially cohesive group promotes a sense of certainty and purpose in

  12. Building community and public health nursing capacity: a synthesis report of the National Community Health Nursing Study.

    PubMed

    Underwood, Jane M; Mowat, David L; Meagher-Stewart, Donna M; Deber, Raisa B; Baumann, Andrea O; MacDonald, Mary B; Akhtar-Danesh, Noori; Schoenfeld, Bonnie M; Ciliska, Donna K; Blythe, Jennifer M; Lavoie-Tremblay, Mélanie; Ehrlich, Anne S; Knibbs, Kristin M; Munroe, Valerie J

    2009-01-01

    1) To describe the community health nursing workforce in Canada; 2) To compare, across political jurisdictions and community health sectors, what helps and hinders community nurses to work effectively; 3) To identify organizational attributes that support one community subsector--public health nurses--to practise the full scope of their competencies. Our study included an analysis of the Canadian Institute for Health Information nursing databases (1996-2007), a survey of over 13,000 community health nurses across Canada and 23 focus groups of public health policy-makers and front-line public health nurses. Over 53,000 registered and licensed practical nurses worked in community health in Canada in 2007, about 16% of the nursing workforce. Community nurses were older on average than the rest of their profession. Typical practice settings for community nurses included community health centres, home care and public health units/departments. To practise effectively, community nurses need professional confidence, good team relationships, supportive workplaces and community support. Most community nurses felt confident in their practice and relationships with other nurses and professionals, though less often with physicians. Their feelings about salary and job security were mixed, and most community nurses would like more learning opportunities, policy and practice information and chances to debrief about work. They needed their communities to do more to address social determinants of health and provide good quality resources. Public health nursing needs a combination of factors to succeed: sound government policy, supportive organizational culture and good management practices. Organizational attributes identified as supports for optimal practice include: flexibility in funding, program design and job descriptions; clear organizational vision driven by shared values and community needs; coordinated public health planning across jurisdictions; and strong leadership that

  13. An exploratory qualitative study of Otago adolescents' views of oral health and oral health care.

    PubMed

    Fitzgerald, Ruth P; Thomson, W Murray; Schafer, Cyril T; Loose, Moragh A T H

    2004-09-01

    To investigate Otago adolescents' views of oral health and oral health care, in order to increase understanding of the influences on their use or non-use of free care. The study employed a qualitative approach, using focus groups and grounded theory analysis. Participants ranged in age from 13 to 18, and included both genders and a variety of educational attainments, ethnicities and family incomes. Focus groups were conducted in schools, training centres, a place of employment, a CYF (Child, Youth and Family) Home, and a University Hall of Residence. While aware of the normative pressure to attend for free dental care and engage in oral health care, Otago adolescents consider doing so to be "just so gay". They exhibit strongly held preconceptions about the expense of dentistry and the respective competence of dentists and dental therapists. The dental surgery environment was viewed as a major disincentive. Adolescent oral health beliefs centred on two models: the medicalised, pragmatic view of oral health (which valued the function of teeth); and the cosmetic view of oral health (which valued the aesthetics of teeth); or a combination of these two models. In both models, media advertising for oral health care products was a significant source of oral health information. The preferred oral health behaviour associated with the medicalised model was frequent use of chewing gum and rapid toothbrushing, and, for the cosmetic model frequent use of chewing gum and breath fresheners. These findings support the international literature on the use/non-use of dental services even when the financial barriers to seeking such services has been removed. New Zealand dental care has developed without reference to the changing norms of youth culture, and the conventional dental practice setting is not viewed by adolescents as being inviting or appropriate. Increasing the uptake of free oral health care by that group will require some innovative approaches.

  14. Organizational capacity and implementation change: a comparative case study of heart health promotion in Ontario public health agencies.

    PubMed

    Riley, Barbara L; Taylor, S Martin; Elliott, Susan J

    2003-12-01

    This paper reports the results of a comparative case study that examines factors influencing changes in implementation of heart health promotion activities in Ontario public health units. The study compared two cases that experienced large changes in implementation from 1994 to 1996, but in opposite directions. Multiple data sources were used, with an emphasis on secondary analyses of quantitative surveys of health units and other community agencies, and in-depth interviews of public health staff, collected as part of the Canadian Heart Health Initiative Ontario Project. Guided by social ecological and organizational theories, changes in implementation were explained by examining changes in (1) organizational predisposition to undertake heart health promotion activities, (2) organizational practices to undertake these activities, (3) other internal organizational factors and (4) external system factors. Findings show that in communities with diverse characteristics, implementation change was most strongly influenced by an interplay of changes in internal features of public health agencies; notably, leadership, structure and staff skills. Findings support a social ecological approach to health promotion by demonstrating the importance of the institutional context in the implementation change process, the interaction of individual (skills) and organizational (structure) levels in explaining implementation change, and community context in shaping the change process. Findings also reinforce the value of strengthening capacity within public health agencies and suggest further research on the implementation change process, especially in different systems and over longer periods of time.

  15. School differences in adolescent health and wellbeing: findings from the Canadian Health Behaviour in School-aged Children Study.

    PubMed

    Saab, Hana; Klinger, Don

    2010-03-01

    The goal of this study was to assess the relationship between student- and school-level factors and student health and wellbeing outcomes, and to estimate the variability present at each of the student and school levels for each of three selected health-related outcomes. The data are from the 2006 Canadian Health Behaviour in School-aged children (HBSC) study in which Grades 6-10 students (N=9670) and administrators (N=187) were surveyed. The three outcome measures are Self-Rated Health (SRH), Emotional Wellbeing (EWB), and Subjective Health Complaints (SHC). Individual and school-level effects on the three outcomes were estimated using multi-level modeling. Both individual and school-level factors were associated with students' health. Gender, family wealth, family structure, academic achievement and neighbourhood were significant student-level predictors. We identified random associations between the student-level variables and reported health outcomes. These random effects indicate that the relationships between these student variables and health are not consistent across schools. Student Problem Behaviours at the school were significant predictors of SRH and SHC, while Student Aggression and the school's average socioeconomic standing were significant school-level predictors of EWB. Findings suggest that the environment and disciplinary climate in schools can predict student health and wellbeing outcomes, and may have important implications for school initiatives aimed at students who are struggling both emotionally and academically. Copyright 2009 Elsevier Ltd. All rights reserved.

  16. Health and productivity as a business strategy: a multiemployer study.

    PubMed

    Loeppke, Ronald; Taitel, Michael; Haufle, Vince; Parry, Thomas; Kessler, Ronald C; Jinnett, Kimberly

    2009-04-01

    To explore methodological refinements in measuring health-related lost productivity and to assess the business implications of a full-cost approach to managing health. Health-related lost productivity was measured among 10 employers with a total of 51,648 employee respondents using the Health and Work Performance Questionnaire combined with 1,134,281 medical and pharmacy claims. Regression analyses were used to estimate the associations of health conditions with absenteeism and presenteeism using a range of models. Health-related productivity costs are significantly greater than medical and pharmacy costs alone (on average 2.3 to 1). Chronic conditions such as depression/anxiety, obesity, arthritis, and back/neck pain are especially important causes of productivity loss. Comorbidities have significant non-additive effects on both absenteeism and presenteeism. Executives/Managers experience as much or more monetized productivity loss from depression and back pain as Laborers/Operators. Testimonials are reported from participating companies on how the study helped shape their corporate health strategies. A strong link exists between health and productivity. Integrating productivity data with health data can help employers develop effective workplace health human capital investment strategies. More research is needed to understand the impacts of comorbidity and to evaluate the cost effectiveness of health and productivity interventions from an employer perspective.

  17. The use of smartphone health apps and other mobile health (mHealth) technologies in dietetic practice: a three country study.

    PubMed

    Chen, J; Lieffers, J; Bauman, A; Hanning, R; Allman-Farinelli, M

    2017-08-01

    Smartphone health applications (apps) and other mobile health (mHealth) technologies may assist dietitians in improving the efficiency of patient care. The present study investigated the use of health apps and text messaging in dietetic practice and formulated intervention recommendations for supporting app uptake by dietitians based on the behavioural 'COM-B' system, where interactions between capability, opportunity and motivation influence behaviour. A 52-item online survey tool, taking 20 min to complete, was developed and piloted, with questions exploring the use of health apps and text messaging in dietetic practice, types of apps dietitians recommended and that patients used, and barriers and enablers to app use in dietetic practice. The Australian, New Zealand and British dietetic associations distributed the survey to their members. A 5% response rate was achieved internationally, with 570 completed responses included for further analysis. Health apps, namely nutrition apps, were used by 62% of dietitians in their practice, primarily as an information resource (74%) and for patient self-monitoring (60%). The top two nutrition apps recommended were MyFitnessPal ® (62%) and the Monash University Low FODMAP Diet ® (44%). Text messaging was used by 51% of respondents, mainly for appointment-related purposes (84%). Although the reported use of smartphone health apps in dietetic practice is high, health apps and other mHealth technologies are not currently being used for behaviour change, nor are they an integral part of the nutrition care process. Dietetic associations should provide training, education and advocacy to enable the profession to more effectively engage with and implement apps into their practice. © 2017 The British Dietetic Association Ltd.

  18. Comparative health system performance in six middle-income countries: cross-sectional analysis using World Health Organization study of global ageing and health.

    PubMed

    Alshamsan, Riyadh; Lee, John Tayu; Rana, Sangeeta; Areabi, Hasan; Millett, Christopher

    2017-09-01

    Objective To assess and compare health system performance across six middle-income countries that are strengthening their health systems in pursuit of universal health coverage. Design Cross-sectional analysis from the World Health Organization Study on global AGEing and adult health, collected between 2007 and 2010. Setting Six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Participants Nationally representative sample of adults aged 50 years and older. Main outcome measures We present achievement against key indicators of health system performance across effectiveness, cost, access, patient-centredness and equity domains. Results We found areas of poor performance in prevention and management of chronic conditions, such as hypertension control and cancer screening coverage. We also found that cost remains a barrier to healthcare access in spite of insurance schemes. Finally, we found evidence of disparities across many indicators, particularly in the effectiveness and patient centredness domains. Conclusions These findings identify important focus areas for action and shared learning as these countries move towards achieving universal health coverage.

  19. Comparative health system performance in six middle-income countries: cross-sectional analysis using World Health Organization study of global ageing and health

    PubMed Central

    Alshamsan, Riyadh; Lee, John Tayu; Rana, Sangeeta; Areabi, Hasan; Millett, Christopher

    2017-01-01

    Objective To assess and compare health system performance across six middle-income countries that are strengthening their health systems in pursuit of universal health coverage. Design Cross-sectional analysis from the World Health Organization Study on global AGEing and adult health, collected between 2007 and 2010. Setting Six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Participants Nationally representative sample of adults aged 50 years and older. Main outcome measures We present achievement against key indicators of health system performance across effectiveness, cost, access, patient-centredness and equity domains. Results We found areas of poor performance in prevention and management of chronic conditions, such as hypertension control and cancer screening coverage. We also found that cost remains a barrier to healthcare access in spite of insurance schemes. Finally, we found evidence of disparities across many indicators, particularly in the effectiveness and patient centredness domains. Conclusions These findings identify important focus areas for action and shared learning as these countries move towards achieving universal health coverage. PMID:28895493

  20. Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study.

    PubMed

    Compton, Michael T; Frank, Erica

    2011-01-01

    In light of prior reports on the prevalence of stress, depression, and other mental health problems among physicians in training and practice, we examined the mental health concerns of Canadian physicians using data from the 2007-2008 Canadian Physician Health Study. Among 3213 respondents, 5 variables (depressive symptoms during the past year, anhedonia in the past year, mental health concerns making it difficult to handle one's workload in the past month, problems with work-life balance, and poor awareness of resources for mental health problems) were examined in relation to sex, specialty, practice type (solo practice vs group or other practice settings), and practice setting (inner city, urban/suburban, or rural/small town/remote). Nearly one quarter of physicians reported a 2-week period of depressed mood, and depression was more common among female physicians and general practitioners/family physicians. Anhedonia was reported by one fifth; anesthesiologists were most likely to report anhedonia, followed by general practitioners/family physicians. More than one quarter reported mental health concerns making it difficult to handle their workload, which was more common among female physicians and general practitioners/family physicians and psychiatrists. Nearly one quarter reported poor work-life balance. Lack of familiarity with mental health resources was problematic, which was more prominent among female physicians and specialists outside of general practice/family medicine or psychiatry. Mental health concerns are relatively common among Canadian physicians. Training programs and programmatic/policy enhancements should redouble efforts to address depression and other mental health concerns among physicians for the benefit of the workforce and patients served by Canadian physicians. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. HealthLit4Kids study protocol; crossing boundaries for positive health literacy outcomes.

    PubMed

    Nash, Rose; Elmer, Shandell; Thomas, Katy; Osborne, Richard; MacIntyre, Kate; Shelley, Becky; Murray, Linda; Harpur, Siobhan; Webb, Diane

    2018-06-05

    Health attitudes and behaviours formed during childhood greatly influence adult health patterns. This paper describes the research and development protocol for a school-based health literacy program. The program, entitled HealthLit4Kids, provides teachers with the resources and supports them to explore the concept of health literacy within their school community, through classroom activities and family and community engagement. HealthLit4Kids is a sequential mixed methods design involving convenience sampling and pre and post intervention measures from multiple sources. Data sources include individual teacher health literacy knowledge, skills and experience; health literacy responsiveness of the school environment (HeLLO Tas); focus groups (parents and teachers); teacher reflections; workshop data and evaluations; and children's health literacy artefacts and descriptions. The HealthLit4Kids protocol draws explicitly on the eight Ophelia principles: outcomes focused, equity driven, co-designed, needs-diagnostic, driven by local wisdom, sustainable, responsive, systematically applied. By influencing on two levels: (1) whole school community; and (2) individual classroom, the HealthLit4Kids program ensures a holistic approach to health literacy, raised awareness of its importance and provides a deeper exploration of health literacy in the school environment. The school-wide health literacy assessment and resultant action plan generates the annual health literacy targets for each participating school. Health promotion cannot be meaningfully achieved in isolation from health literacy. Whilst health promotion activities are common in the school environment, health literacy is not a familiar concept. HealthLit4Kids recognizes that a one-size fits all approach seldom works to address health literacy. Long-term health outcomes are reliant on embedded, locally owned and co-designed programs which respond to local health and health literacy needs.

  2. A Review of Epidemiologic Studies of the Health of Gulf War Women Veterans.

    PubMed

    Coughlin, Steven S; Krengel, Maxine; Sullivan, Kimberly; Pierce, Penny F; Heboyan, Vahé; Wilson, Lt Col Candy

    2017-01-01

    In the 25 years since the 1990-1991 Gulf War (GW), studies have evaluated Gulf War Illness (GWI), sometimes referred to as medically unexplained multi symptom illness, and other medical and neurological conditions in women GW veterans. In this article, we review epidemiologic studies of the health of women who served in the 1990-1991 GW based upon bibliographic searches in PubMed and CINAHL with relevant search terms through September 2015. A total of 56 articles were identified in the bibliographic searches. By screening abstracts or full-text articles, a total of 21 relevant studies were identified. Results from some studies, but not all, suggest that GWI is more common in women GW veterans than their male counterparts. Few studies of GW veterans focused on women's health. A small number of studies suggested excess rates of woman's health problems, e.g., breast cysts, abnormal Papanicolaou (Pap) smears, yeast infections, and bladder infections. Several studies have identified significantly elevated rates of birth defects and adverse reproductive outcomes among GW veterans. However, findings have varied with different study designs and sample sizes, with some studies showing elevated risks of stillbirths, miscarriages, and/or birth defects and others have not. In some studies, participants reported increased risks of ectopic pregnancies and spontaneous abortions. Further research is needed to provide a comprehensive picture of the health of women GW veterans and to examine a broad range of women's health issues including adverse reproductive outcomes. Some deployment-related health problems only become apparent decades later and other conditions may worsen or improve over time. Assessments are needed of current health status, changes in health symptoms and conditions over time, and possible differences in health outcomes associated with specific experiences and exposures during the war. Future studies would be strengthened by assessing GWI symptom patterns that

  3. Cultural activity participation and associations with self-perceived health, life-satisfaction and mental health: the Young HUNT Study, Norway.

    PubMed

    Hansen, Elisabeth; Sund, Erik; Skjei Knudtsen, Margunn; Krokstad, Steinar; Holmen, Turid Lingaas

    2015-06-10

    Leisure time activities and culture participation may have health effects and be important in pulic health promotion. More knowledge on how cultural activity participation may influence self-perceived health, life-satisfaction, self-esteem and mental health is needed. This article use data from the general population-based Norwegian HUNT Study, using the cross-sectional Young-HUNT3 (2006-08) Survey including 8200 adolescents. Data on cultural activity participation, self-perceived health, life-satisfaction, self-esteem, anxiety and depression were collected by self-reported questionnaires. Both attending meetings or training in an organisation or club, and attending sports events were positively associated with each of the health parameters good self-percieved health, good life-satisfaction, good self-esteem, and low anxiety and depression symptoms. We found differences according to gender and age (13-15 years versus 16-19 years old) for several culture activities, where girls aged 16-19 years seemed to benefit most from being culturally active. The extent of participation seemed to matter. Those who had frequent participation in cultural activities reported better health outcomes compared to inactive adolecents. The results from this study indicate that participation in cultural activities may be positively associated with health, life-satisfaction and self-esteem in adolescents and thus important in public health promotion. Possible sex and age differences should be taken into account.

  4. Connecting Primary Health Care: A Comprehensive Pilot Study.

    PubMed

    Maghsoudloo, Mehran; Abolhassani, Farid; Lotfibakhshaiesh, Nasrin

    2016-07-01

    The collection of data within the primary health care facilities in Iran is essentially paper-based. It is focused on family's health, monitoring of non-infectious and infectious diseases. Clearly due to the paper-based nature of the tasks, timely decision making at most can be difficult if not impossible. As part of an on-going electronic health record implementation project at Tehran University of Medical Sciences, for the first time in the region, based on a comprehensive pilot project, four urban healthcare facilities are connected to their headquarters and beyond, covering all aspects of primary health care, for the last four years. Without delving into the technical aspects of its software engineering processes, the progress of the implementation is reported, selection of summarized data is presented, and experience gained thus far are discussed. Four years passed and if time is any important reason to go by, then it is safe to accept that the software architecture and electronic health record structural model implemented are robust and yet extensible. Aims and duration of a pilot study should be clearly defined prior to start and managed till its completion. Resistance to change and particularly to information technology, apart from its technical aspects, is also based on human factors.

  5. Health service use, out-of-pocket payments and catastrophic health expenditure among older people in India: the WHO Study on global AGEing and adult health (SAGE).

    PubMed

    Brinda, Ethel Mary; Kowal, Paul; Attermann, Jørn; Enemark, Ulrika

    2015-05-01

    Healthcare financing through out-of-pocket payments and inequities in healthcare utilisation are common in low and middle income countries (LMICs). Given the dearth of pertinent studies on these issues among older people in LMICs, we investigated the determinants of health service use, out-of-pocket and catastrophic health expenditures among older people in one LMIC, India. We accessed data from a nationally representative, multistage sample of 2414 people aged 65 years and older from the WHO's Study on global AGEing and adult health in India. Sociodemographic characteristics, health profiles, health service utilisation and out-of-pocket health expenditure were assessed using standard instruments. Multivariate zero-inflated negative binomial regression models were used to evaluate the determinants of health service visits. Multivariate Heckman sample selection regression models were used to assess the determinants of out-of-pocket and catastrophic health expenditures. Out-of-pocket health expenditures were higher among participants with disability and lower income. Diabetes, hypertension, chronic pulmonary disease, heart disease and tuberculosis increased the number of health visits and out-of-pocket health expenditures. The prevalence of catastrophic health expenditure among older people in India was 7% (95% CI 6% to 8%). Older men and individuals with chronic diseases were at higher risk of catastrophic health expenditure, while access to health insurance lowered the risk. Reducing out-of-pocket health expenditure among older people is an important public health issue, in which social as well as medical determinants should be prioritised. Enhanced public health sector performance and provision of publicly funded insurance may protect against catastrophic health expenses and healthcare inequities in India. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Exploring causes and consequences of sex workers' psychological health: Implications for health care policy. A study conducted in Spain.

    PubMed

    Picos, Andrés Palacios; González, Ruth Pinedo; de la Iglesia Gutiérrez, Myriam

    2018-03-22

    The aim of the researchers is to explore the causes and consequences of the psychological health of sex workers as well as provide an intervention model for the prevention of mental disorders in accordance with World Health Organization (WHO) levels. The study sample consisted of 146 sex workers from Spain. Loneliness and maltreatment have a negative influence on psychological health, while self-esteem has a protector role over psychological health. Psychological health has a positive impact on perceived quality of life and other health domains. On the contrary, psychological health has a negative impact on drug use and symptoms of anxiety. Data are discussed.

  7. Swimming against the tide: A Canadian qualitative study examining the implementation of a province-wide public health initiative to address health equity.

    PubMed

    McPherson, Charmaine; Ndumbe-Eyoh, Sume; Betker, Claire; Oickle, Dianne; Peroff-Johnston, Nancy

    2016-08-19

    Effectively addressing the social determinants of health and health equity are critical yet still-emerging areas of public health practice. This is significant for contemporary practice as the egregious impacts of health inequities on health outcomes continue to be revealed. More public health organizations seek to augment internal organizational capacity to address health equity while the evidence base to inform such leadership is in its infancy. The purpose of this paper is to report on findings of a study examining key factors influencing the development and implementation of the social determinants of health public health nurse (SDH-PHN) role in Ontario, Canada. A descriptive qualitative case study approach examined the first Canadian province-wide initiative to add SDH-PHNs to each public health unit. Data sources were documents and staff from public health units (i.e., SDH-PHNs, Managers, Directors, Chief Nursing Officers, Medical Officers of Health) as well as external stakeholders. Data were collected through 42 individual interviews and 226 documents. Interview data were analyzed using framework analysis methods; Prior's approach guided document analysis. Three themes related to the SDH-PHN role implementation were identified: (1) 'Swimming against the tide' to lead change as staff navigated ideological tensions, competency development, and novel collaborations; (2) Shifting organizational practice environments impacted by initial role placement and action to structurally embed health equity priorities; and (3) Bridging policy implementation gaps related to local-provincial implementation and reporting expectations. This study extends our understanding of the dynamic interplay among leadership, change management, ideological tensions, and local-provincial public health policy impacting health equity agendas. Given that the social determinants of health lie outside public health, collaboration with communities, health partners and non-health partners is

  8. Global governance and the broader determinants of health: A comparative case study of UNDP's and WTO's engagement with global health.

    PubMed

    Gopinathan, Unni; Watts, Nick; Lefebvre, Alexandre; Cheung, Arthur; Hoffman, Steven J; Røttingen, John-Arne

    2018-05-31

    This comparative case study investigated how two intergovernmental organisations without formal health mandates - the United Nations Development Programme (UNDP) and the World Trade Organization (WTO) - have engaged with global health issues. Triangulating insights from key institutional documents, ten semi-structured interviews with senior officials, and scholarly books tracing the history of both organisations, the study identified an evolving and broadened engagement with global health issues in UNDP and WTO. Within WTO, the dominant view was that enhancing international trade is instrumental to improving global health, although the need to resolve tensions between public health objectives and WTO agreements was recognised. For UNDP, interviewees reported that the agency gained prominence in global health for its response to HIV/AIDS in the 1990s and early 2000s. Learning from that experience, the agency has evolved and expanded its role in two respects: it has increasingly facilitated processes to provide global normative direction for global health issues such as HIV/AIDS and access to medicines, and it has expanded its focus beyond HIV/AIDS. Overall, the study findings suggest the need for seeking greater integration among international institutions, closing key global institutional gaps, and establishing a shared global institutional space for promoting action on the broader determinants of health.

  9. Effect of Oral Health Care Program on Oral Health Status of Elderly People Living in Nursing Homes: a Quasi-experimental Study.

    PubMed

    Ildarabadi, Es-Hagh; Armat, Mohammad Reza; Motamedosanaye, Vahideh; Ghanei, Farzaneh

    2017-12-01

    Oral health of elderly people plays a major role in their overall health and quality of life, and is an integral part of personal care. The aim of this study was to evaluate the effect of implementing the oral health care program (OHCP) on oral health status of elderly people resident in nursing homes. This quasi-experimental study was carried out using a pretest-posttest design on 101 elderly people (46 in the intervention group and 55 in the control group) resident in two randomly selected nursing homes in Mashhad, Iran. In the intervention group, the OHCP was carried out by caregivers for 8 weeks. The control group received routine care. Using the oral health assessment tool, the oral health status of elderly people was assessed in both groups at three times; onset of the study, 4th, and 8th week after the start of the study. The oral health status of the elderly people in both groups was not statistically significantly different at baseline, but it changed significantly at the 4 th , and 8 th weeks (p<.001). The implementation of the OHCP for elderly people resident in nursing homes may improve their oral health status after 4 weeks. It is recommended that OHCP be included in care plans of all nursing homes to improve the elderly people's oral health status.

  10. Sexual orientation health inequality: Evidence from Understanding Society, the UK Longitudinal Household Study.

    PubMed

    Booker, Cara L; Rieger, Gerulf; Unger, Jennifer B

    2017-08-01

    Few studies from the United Kingdom have fully investigated inequalities between members of different sexual minority groups and heterosexuals over range of health outcomes. Using data from over 40,000 individuals, this study explores the health inequalities of sexual minority UK adults. We include respondents who identify as other and those who prefer not to say (PNS). Data come from wave three (2011-2012) of the nationally-representative Understanding Society, the UK Household Longitudinal Study. Sexual orientation was asked in the self-completion portion of the study. Markers of health include physical and mental functioning, minor psychological distress, self-rated health, substance use and disability. Multiple linear and logistic regression analyses tested for differences in markers of health between sexual orientation groups. Overall, heterosexual respondents had the best health while bisexual respondents had the worst. Gay and lesbian respondents reported poorer health than heterosexuals, specifically with regards to mental functioning, distress and illness status. The other and PNS respondents were most similar to each other and generally experienced fewer health inequalities than gay and lesbian respondents; they were less likely to use tobacco or alcohol. In sum, sexual minorities experience health inequality. The inclusion of other and PNS respondents has not been done in other studies and shows that while they may be healthier than gay/lesbian and bisexual respondents they still experiences poorer health than heterosexuals. Health promotion interventions are needed for these other and PNS individuals, who might not participate in interventions targeted toward known sexual minority groups. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Longitudinal Study-Based Dementia Prediction for Public Health

    PubMed Central

    Kim, HeeChel; Chun, Hong-Woo; Kim, Seonho; Coh, Byoung-Youl; Kwon, Oh-Jin; Moon, Yeong-Ho

    2017-01-01

    The issue of public health in Korea has attracted significant attention given the aging of the country’s population, which has created many types of social problems. The approach proposed in this article aims to address dementia, one of the most significant symptoms of aging and a public health care issue in Korea. The Korean National Health Insurance Service Senior Cohort Database contains personal medical data of every citizen in Korea. There are many different medical history patterns between individuals with dementia and normal controls. The approach used in this study involved examination of personal medical history features from personal disease history, sociodemographic data, and personal health examinations to develop a prediction model. The prediction model used a support-vector machine learning technique to perform a 10-fold cross-validation analysis. The experimental results demonstrated promising performance (80.9% F-measure). The proposed approach supported the significant influence of personal medical history features during an optimal observation period. It is anticipated that a biomedical “big data”-based disease prediction model may assist the diagnosis of any disease more correctly. PMID:28867810

  12. Maternal Health Situation in India: A Case Study

    PubMed Central

    Mavalankar, Dileep V.; Ramani, K.V.; Upadhyaya, Mudita; Sharma, Bharati; Iyengar, Sharad; Gupta, Vikram; Iyengar, Kirti

    2009-01-01

    Since the beginning of the Safe Motherhood Initiative, India has accounted for at least a quarter of maternal deaths reported globally. India's goal is to lower maternal mortality to less than 100 per 100,000 livebirths but that is still far away despite its programmatic efforts and rapid economic progress over the past two decades. Geographical vastness and sociocultural diversity mean that maternal mortality varies across the states, and uniform implementation of health-sector reforms is not possible. The case study analyzes the trends in maternal mortality nationally, the maternal healthcare-delivery system at different levels, and the implementation of national maternal health programmes, including recent innovative strategies. It identifies the causes for limited success in improving maternal health and suggests measures to rectify them. It recommends better reporting of maternal deaths and implementation of evidence-based, focused strategies along with effective monitoring for rapid progress. It also stresses the need for regulation of the private sector and encourages further public-private partnerships and policies, along with a strong political will and improved management capacity for improving maternal health. PMID:19489415

  13. Disaster mental health preparedness in the community: A systematic review study

    PubMed Central

    Roudini, Juliet; Khankeh, Hamid Reza; Witruk, Evelin

    2017-01-01

    The objective of this study was to perform a systematic review of articles that cover aspects of disaster mental health preparedness. This assessment was done by a thorough review and summary of the available studies which provided a considerable background and amplified the gaps in knowledge about community mental health preparedness. By this systematic review, we tried to identify available concept of community mental health preparedness and related tools that communities and individuals will need to prepare for natural disasters. We found there is a lack of mental health preparedness in the majority of countries; valid and reliable tools and context-bound programs should be developed based on the experiences and perceptions of the community. PMID:28680695

  14. Methodological issues in studies of air pollution and reproductive health.

    PubMed

    Woodruff, Tracey J; Parker, Jennifer D; Darrow, Lyndsey A; Slama, Rémy; Bell, Michelle L; Choi, Hyunok; Glinianaia, Svetlana; Hoggatt, Katherine J; Karr, Catherine J; Lobdell, Danelle T; Wilhelm, Michelle

    2009-04-01

    In the past decade there have been an increasing number of scientific studies describing possible effects of air pollution on perinatal health. These papers have mostly focused on commonly monitored air pollutants, primarily ozone (O(3)), particulate matter (PM), sulfur dioxide (SO(2)), carbon monoxide (CO), and nitrogen dioxide (NO(2)), and various indices of perinatal health, including fetal growth, pregnancy duration, and infant mortality. While most published studies have found some marker of air pollution related to some types of perinatal outcomes, variability exists in the nature of the pollutants and outcomes associated. Synthesis of the findings has been difficult for various reasons, including differences in study design and analysis. A workshop was held in September 2007 to discuss methodological differences in the published studies as a basis for understanding differences in study findings and to identify priorities for future research, including novel approaches for existing data. Four broad topic areas were considered: confounding and effect modification, spatial and temporal exposure variations, vulnerable windows of exposure, and multiple pollutants. Here we present a synopsis of the methodological issues and challenges in each area and make recommendations for future study. Two key recommendations include: (1) parallel analyses of existing data sets using a standardized methodological approach to disentangle true differences in associations from methodological differences among studies; and (2) identification of animal studies to inform important mechanistic research gaps. This work is of critical public health importance because of widespread exposure and because perinatal outcomes are important markers of future child and adult health.

  15. Correlates of ideal cardiovascular health in European adolescents: The HELENA study.

    PubMed

    Henriksson, P; Henriksson, H; Labayen, I; Huybrechts, I; Gracia-Marco, L; Ortega, F B; España-Romero, V; Manios, Y; González-Gross, M; Marcos, A; Moreno, L A; Gutiérrez, Á; Ruiz, J R

    2018-02-01

    The ideal cardiovascular health (iCVH) construct consists of 4 health behaviors (smoking status, body mass index, physical activity and diet) and 3 health factors (total cholesterol, blood pressure and fasting glucose). A greater number of iCVH components in adolescence are related to better cardiovascular health, but little is known about the correlates of iCVH in adolescents. Thus, the aim of the study was to examine correlates of iCVH in European adolescents. The study comprised 637 European adolescents with complete iCVH data. Participants were part of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional, multicenter study conducted in 9 different European countries. Correlates investigated were sex and age, family affluence scale, maternal education, geographic location, sleep time, television viewing, duration of pregnancy, birth weight and breastfeeding. Younger adolescents, those whose mothers had medium/high education or those who watched television less than 2 h per day had a greater number of iCVH components compared to those who were older, had a mother with low education or watched television 2 h or more daily (P ≤ 0.01). Since in our study older adolescents had worse iCVH than younger adolescents, early promotion of cardiovascular health may be important. Future studies may also investigate the usefulness of limiting television viewing to promote iCVH. Finally, since adolescents of mothers with low education had poorer iCVH, it may be of special interest to tailor public health promotion to adolescents from families with low socioeconomic status. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  16. Advancing LGBT Health Care Policies and Clinical Care Within a Large Academic Health Care System: A Case Study.

    PubMed

    Ruben, Mollie A; Shipherd, Jillian C; Topor, David; AhnAllen, Christopher G; Sloan, Colleen A; Walton, Heather M; Matza, Alexis R; Trezza, Glenn R

    2017-01-01

    Culturally competent health care is especially important among sexual and gender minority patients because poor cultural competence contributes to health disparities. There is a need to understand how to improve health care quality and delivery for lesbian, gay, bisexual, and transgender (LGBT) veterans in particular, because they have unique physical and mental health needs as both LGBT individuals and veterans. The following article is a case study that focuses on the policy and clinical care practices related to LGBT clinical competency, professional training, and ethical provision of care for veteran patients in the VA Boston Healthcare System. We apply Betancourt et al.'s (2003) cultural competence framework to outline the steps that VA Boston Healthcare System took to increase cultural competency at the organizational, structural, and clinical level. By sharing our experiences, we aim to provide a model and steps for other health care systems and programs, including other VA health care systems, large academic health care systems, community health care systems, and mental health care systems, interested in developing LGBT health initiatives.

  17. Hispanics' use of Internet health information: an exploratory study.

    PubMed

    Peña-Purcell, Ninfa

    2008-04-01

    The research examined use of the Internet to seek health information among Hispanics in the United States. A secondary analysis used the Impact of the Internet and Advertising on Patients and Physicians, 2000-2001, survey data. Pearson's chi(2) test, multivariate analysis of variance (MANOVA), analysis of variance (ANOVA), and independent samples t tests were conducted to test for relationships and differences between facets of Hispanic and non-Hispanic white online health information seeking. Findings indicated lower Internet health information seeking among Hispanics (28.9%, n=72) than non-Hispanic whites (35.6%, n=883). On a scale of 1 (strongly agree) to 4 (strongly disagree), Hispanics were likely to agree that Internet health information improves understanding of medical conditions and treatments (M=1.65), gives patients confidence to talk to doctors about health concerns (M=1.67), and helps patients get treatment they would not otherwise receive (M=2.23). Hispanics viewed their skills in assessing Internet health information as good. Overall ratings were also positive for items related to sharing Internet health information with a doctor. Conflicting with these findings, Hispanics (M=3.33) and non-Hispanic whites (M=3.46) reported that physician-patient relationships worsened as a result of bringing online health information to a visit (scale 1=a lot better to 5=a lot worse). This study provides further evidence of differences in Internet health information seeking among Hispanics and non-Hispanic whites. Cultural discordance may be a possible explanation for Hispanics' view that the Internet negatively impacts physician-patient relationships. Strategies to increase Hispanics' access to Internet health information will likely help them become empowered and educated consumers, potentially having a favorable impact on health outcomes.

  18. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    PubMed Central

    2011-01-01

    Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a) Structural domains (health service performance; sustainability; and quality of care); (b) Process domains (health service utilisation and satisfaction); and (c) Outcome domains (health behaviours, health outcomes and community viability). Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how; what benefits have been

  19. Self-knowledge of health teachers: A qualitative exploratory study.

    PubMed

    Canever, Bruna Pedroso; do Prado, Marta Lenise; Gomes, Diana Coelho; Backes, Vânia Marli Schubert; de Jesus, Bruna Helena

    2018-06-01

    Specific pedagogical training for teaching in the area of health emerges with the goal of creating critical and reflective professionals and as a necessary challenge to university teaching, where there is reflection on self-awareness, consciousness, and the incompleteness of being. This study aims to understand how Freire's critical consciousness is expressed in the pedagogical practice of health teachers. This study is a qualitative study that is descriptive, exploratory, and analytical. Twenty-one teachers from a public university in southern Brazil participated. Data were collected using open-ended, in-person interviews held from May to December 2013. Data systematization was based on Minayo's operative proposal. The analysis yielded 2 main categories, including the naïve critical consciousness of health teachers, i.e., education as a practice of oppression, and the epistemological critical consciousness of health teachers, i.e., education as a practice of freedom. The results revealed the teachers' self-knowledge, including the reasoning and motivations that made them become teachers, the characteristics considered necessary to be a teacher, the teachers' feelings in their teaching practice, and the teaching preparation required for being in the classroom from the perspective of naïve and epistemological critical consciousness. The study shows that the self-knowledge that emerged from the teachers' reports encourages new perspectives in the construction of the teacher, raising the challenge of development and transformation from naïve consciousness to epistemological consciousness, and thus contributing to a breakthrough with respect to critical and creative teacher training. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Exploring Ways to Implement the Health Services Mobility Study: A Feasibility Study.

    ERIC Educational Resources Information Center

    Lavine, Eileen M.; Moore, Audrey

    A feasibility study was aimed at developing a strategy for implementing and utilizing the job analysis methodology which resulted from the Health Services Mobility Study (HSMS), particularly as it can be applied to the field of diagnostic radiology. (The HSMS method of job analysis starts with task descriptions analyzing the tasks that make up a…

  1. Health Professionals' Perceptions of Sexual Assault Management: A Delphi Study

    ERIC Educational Resources Information Center

    Jancey, Jonine; Meuleners, Lynn; Phillips, Maureen

    2011-01-01

    Objective: To explore health professionals' perceptions of sexual assault management practices and identify issues related to these practices across Western Australia (WA). Design: A two-round electronic Delphi study was undertaken with health professionals (medical doctors, registered nurses, social workers and managers). Setting: Healthcare…

  2. A study of health beliefs and practices of the Yoruba.

    PubMed

    Adepoju, Joseph A

    2012-01-01

    The issue of how immigrant populations combine traditional and Western health beliefs and practices has not been given due attention. Hence, this qualitative research study of Yoruba immigrants, an ethnic group from south-western Nigeria, living in the mid-Atlantic region of the United States, sheds some light on the question of how best to provide culturally appropriate health care to Yoruba immigrant groups with differences in health beliefs and practices. The study found that there are three types of Yoruba immigrant groups: (1) those who use only Western medicine (though mostly for pragmatic reason); (2) those who combine traditional Yoruba and Western beliefs; and (3) those who combine Western medicine and Christian beliefs.

  3. [Mental health in physicians doing the rural and suburban health service in Peru: a baseline study].

    PubMed

    Galán-Rodas, Edén; Gálvez-Buccollini, Juan Antonio; Vega-Galdós, Favio; Osada, Jorge; Guerrero-Padilla, Daisy; Vega-Dienstmaier, Johann; Talledo, Lety; Catacora, Manuel; Fiestas, Fabián

    2011-06-01

    The disadvantageous conditions in which young physicians have to do their rural and sub-urban health service (SERUMS) may put them in a high risk for mental disorders. This study aims to establish the baseline levels of depression and alcohol use problems among those physicians scheduled to complete their SERUMS during the period 2011-2012. The Center for Epidemiologic Studies Depression Scale (CES-D) and the Alcohol Use Disorders Identification Test (AUDIT) were administered as screening tests to 493 physicians. Depression scores were met by 26% females and 14.5% males, and alcohol use problem scores were met by 22% females and 26% males. Overall, 39% persons scored for either of both mental health entities. Mental health problems seem to be common among young physicians scheduled to migrate to their SERUMS. These problems must be addressed to avoid greater risks.

  4. Diversity Considerations for Promoting Early Childhood Oral Health: A Pilot Study

    PubMed Central

    Prowse, Sarah; Schroth, Robert J.; Wilson, Alexandria; Edwards, Jeanette M.; Sarson, Janet; Levi, Jeremy A.; Moffatt, Michael E.

    2014-01-01

    Objectives. Several groups in Manitoba, Canada, experience early childhood caries (ECC), including Aboriginal, immigrant, and refugee children and those from select rural regions. The purpose of this pilot study was to explore the views of parents and caregivers from four cultural groups on early childhood oral health and ECC. Methods. A qualitative descriptive study design using focus groups recruited parents and caregivers from four cultural groups. Discussions were documented, audio-recorded, transcribed, and then analyzed for content based on themes. Results. Parents and caregivers identified several potential barriers to good oral health practice, including child's temperament, finances, and inability to control sugar intake. Both religion and genetics were found to influence perceptions of oral health. Misconceptions regarding breastfeeding and bottle use were present. One-on-one discussions, parental networks, and using laypeople from similar backgrounds were suggested methods to promote oral health. The immigrant and refugee participants placed emphasis on the use of visuals for those with language barriers while Hutterite participants suggested a health-education approach. Conclusions. These pilot study findings provide initial insight into the oral health-related knowledge and beliefs of these groups. This will help to inform planning of ECC prevention and research strategies, which can be tailored to specific populations. PMID:24624141

  5. [The health situation and health care needs of unaccompanied minor refugees - an approximation based on qualitative and quantitative studies from Bielefeld, Germany].

    PubMed

    Spallek, Jacob; Tempes, Jana; Ricksgers, Hannah; Marquardt, Louisa; Prüfer-Krämer, Luise; Krämer, Alexander

    2016-05-01

    Unaccompanied minor refugees are children or adolescents below the age of 18 years who are not accompanied by their parents. International studies show that unaccompanied minor refugees represent a special risk group. Currently, empirical study results about the health status of unaccompanied minor refugees barely exist for Germany. Therefore, the goal of this article is an assessment of the health status and health care of unaccompanied minor refugees in Bielefeld, Germany. For this purpose, two qualitative studies and one quantitative study from Bielefeld are used.Results demonstrate that the health care of unaccompanied minor refugees underlies certain peculiarities that indicate major medical needs: Firstly, the need for psychological/psychiatric care and secondly the need for health care regarding infectious diseases. Further challenges in the health care needs of this population group result from its specific situation, and comprise legal conditions, as well as language and cultural competencies on behalf of the health care providers and the unaccompanied minor refugees themselves.

  6. Health promotion in Australian multi-disciplinary primary health care services: case studies from South Australia and the Northern Territory.

    PubMed

    Baum, Fran; Freeman, Toby; Jolley, Gwyn; Lawless, Angela; Bentley, Michael; Värttö, Kaisu; Boffa, John; Labonte, Ronald; Sanders, David

    2014-12-01

    This paper reports on the health promotion and disease prevention conducted at Australian multi-disciplinary primary health care (PHC) services and considers the ways in which the organizational environment affects the extent and type of health promotion and disease prevention activity. The study involves five PHC services in Adelaide and one in Alice Springs. Four are managed by a state health department and two by boards of governance. The study is based on an audit of activities and on 68 interviews conducted with staff. All the sites undertake health promotion and recognize its importance but all report that this activity is under constant pressure resulting from the need to provide services to people who have health problems. We also found an increased focus on chronic disease management and prevention which prioritized individuals and behavioural change strategies rather than addressing social determinants affecting whole communities. There was little health promotion work that reflected a salutogenic approach to the creation of health. Most activity falls under three types: parenting and child development, chronic disease prevention and mental health. Only the non-government organizations reported advocacy on broader policy issues. Health reform and consequent reorganizations were seen to reduce the ability of some services to undertake health promotion. The paper concludes that PHC in Australia plays an important role in disease prevention, but that there is considerable scope to increase the amount of community-based health promotion which focuses on a salutogenic view of health and which engages in community partnerships. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Webinar Presentation: Air Pollution, Social and Psychosocial Stress, and Respitory Health in the Southern California Children's Health Study

    EPA Pesticide Factsheets

    This presentation, Air Pollution, Social and Psychosocial Stress, and Respitory Health in the Southern California Children's Health Study, was given at the NIEHS/EPA Children's Centers 2016 Webinar Series: Exposome held on May 11, 2016.

  8. Do we develop public health leaders?- association between public health competencies and emotional intelligence: a cross-sectional study.

    PubMed

    Czabanowska, Katarzyna; Malho, André; Schröder-Bäck, Peter; Popa, Daniela; Burazeri, Genc

    2014-04-17

    Professional development of public health leaders requires a form of instruction which is competency-based to help them develop the abilities to address complex and evolving demands of health care systems. Concurrently, emotional intelligence (EI) is a key to organisational success. Our aim was twofold: i) to assess the relationship between the level of self-assessed public health and EI competencies among Master of European Public Health (MEPH) students and graduates at Maastricht University, and; ii) to determine the relationship between different groups of public health competencies and specific EI skills. A cross-sectional study was conducted including all recent MEPH graduates and students from 2009-2012, out of 67 eligible candidates N = 51 were contacted and N = 33 responded (11 males and 22 females; overall response: 64.7%).Two validated tools were employed: i) public health competencies self-assessment questionnaire, and; ii) Assessing Emotions Scale. Females scored higher than males in all seven domains of the self-assessed key public health competencies (NS) and emotional intelligence competences (P = 0.022). Overall, the mean value of public health competencies was the lowest in students with "staff" preferences and the highest among students with mixed job preferences (P < 0.001). There was evidence of a correlation between the overall public health competencies and the overall emotional intelligence competencies (r = 0.61, P < 0.001). The study shows a positive correlation between public health specific competencies and EI attributes. It can contribute to the improvement of the educational content of PH curricula by rising awareness through self-assessment and supporting the identification of further educational needs related to leadership.

  9. Policy development and challenges of global mental health: a systematic review of published studies of national-level mental health policies.

    PubMed

    Zhou, Wei; Yu, Yu; Yang, Mei; Chen, Lizhang; Xiao, Shuiyuan

    2018-05-18

    Mental health policy can be an essential and powerful tool to improve a population's mental health. However, around one third of countries do not possess a mental health policy, and there are large disparities in population coverage rates between high- and low-income countries. The goal of this study is to identify the transition and implementation challenges of mental health policies in both high-income countries (HICs) as well as middle- and low-income countries (MLICs). PubMed, Cochrane Library and Campbell Library were searched from inception to 31 December 2017, for studies on implemented mental health policies at the national level. Abstracts and the main texts of papers were double screened, and extracted data were analysed through thematic synthesis. A total of 93 papers were included in this study, covering 24 HICs, 28 MLICs and 5 regions. Studies on mental health policies, especially those of MLICs, kept increasing, but MLICs were still underrepresented in terms of publication quantity and study frequency. Based on the included studies, nine policy domains were summarized: service organizing, service provision, service quality, human resources, legislation and human rights, advocacy, administration, surveillance and research, and financing and budgeting. HICs incrementally enriched their policy content in all domains over centuries of development; following HICs' experience, mental health policies in MLICs have boomed since the 1990s and quickly extended to all domains. Implementation problems in HICs were mainly related to service organizing and service provision; for MLICs, more severe implementation problems converged on financing and budgeting, administration and human resources. Mental health policy developments in both HICs and MLICs present a process of diversification and enrichment. In terms of implementation, MLICs are faced with more and greater challenges than HICs, especially in funding, human resources and administration. Therefore, future

  10. A comparative study of interprofessional education in global health care

    PubMed Central

    Herath, Chulani; Zhou, Yangfeng; Gan, Yong; Nakandawire, Naomie; Gong, Yanghong; Lu, Zuxun

    2017-01-01

    Abstract Background: The World Health Organization (WHO) and its partners identify interprofessional (IP) collaboration in education and practice as an innovative strategy that plays an important role in mitigating the global health workforce crisis. Evidence on the practice of global health level in interprofessional education (IPE) is scarce and hampered due to the absence of aggregate information. Therefore, this systematic review was conducted to examine the incidences of IPE and summarize the main features about the IPE programs in undergraduate and postgraduate education in developed and developing countries. Methods: The PubMed, Embase, Web of Science, and Google Scholar were searched from their inception to January 31, 2016 for relevant studies regarding the development of IPE worldwide, IPE undergraduate and postgraduate programs, IP interaction in health education, IPE content, clinical placements, and teaching methods. Countries in which a study was conducted were classified as developed and developing countries according to the definition by the United Nations (UN) in 2014. Results: A total of 65 studies from 41 countries met our inclusion criteria, including 45 studies from 25 developed countries and 20 studies from 16 developing countries. Compared with developing countries, developed countries had more IPE initiatives. IPE programs were mostly at the undergraduate level. Overall, the university was the most common academic institution that provided IPE programs. The contents of the curricula were mainly designed to provide IP knowledge, skills, and values that aimed at developing IP competencies. IPE clinical placements were typically based in hospitals, community settings, or both. The didactic and interactive teaching methods varied significantly within and across universities where they conducted IPE programs. Among all health care disciplines, nursing was the discipline that conducted most of the IPE programs. Conclusion: This systematic review

  11. Integrating health education and physical activity programming for cardiovascular health promotion among female inmates: A proof of concept study.

    PubMed

    Nair, Uma S; Jordan, Jeremy S; Funk, Daniel; Gavin, Kristin; Tibbetts, Erica; Collins, Bradley N

    2016-05-01

    Female inmate populations in the United States tend to be overweight, physically inactive, experience high stress, and have a history of nicotine and other drug dependence. Thus, they bear an elevated risk of cardiovascular (CV) disease than the general population. However, few evidence-based health interventions exist for this population. This study will test proof of concept, feasibility, and potential efficacy of a multiple health behavior change intervention that integrates CV-health promotion education delivered during a physical activity (PA) program (indoor cycling) tailored to this population. This study uses a quasi-experimental 2-group design with two measurement time-points: baseline and 8-week end of treatment. N=120 incarcerated women (18-59years of age) who are medically cleared for participation in PA will be enrolled. Indoor cycling instructors will be trained to deliver five health education topics over an 8-week period during twice-weekly cycling classes. Topics match the American Heart Association recommendations for CV health: (a) nutrition, (b) PA promotion, (c) weight management, (d) stress management, and (e) smoking cessation and relapse prevention. Modes of intervention include instructor advice, written materials and audio/video clips reviewed during class. CV-related and mental health measures will be assessed at both time-points. Results will guide a full scale efficacy study. Future research in this area has potential to impact the health of female inmates, a high-risk population. Moreover, this multiple health behavior change intervention model represents a community approach to health promotion that could generalize to other underserved populations who may benefit most from similar intervention efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Educating Future Health Care Professionals About Cybercivility: Needs Assessment Study.

    PubMed

    De Gagne, Jennie C; Conklin, Jamie L; Yamane, Sandra S; Kang, Hee Sun; Hyun, Myung-Sun

    2017-12-04

    As misbehaviors online in higher education have been widely addressed in recent research, the discourse on cyberincivility has become a contemporary issue in health professions education. However, studies regarding cybercivility, particularly from an interprofessional education standpoint, are few. This study assessed the knowledge, experience, and perceptions about cyberincivility among students in 4 health care disciplines. Their preferred means of learning about cybercivility and the perceived benefits of such education are also discussed.

  13. HABIT-an early phase study to explore an oral health intervention delivered by health visitors to parents with young children aged 9-12 months: study protocol.

    PubMed

    Eskyte, Ieva; Gray-Burrows, Kara; Owen, Jenny; Sykes-Muskett, Bianca; Zoltie, Tim; Gill, Susanne; Smith, Victoria; McEachan, Rosemary; Marshman, Zoe; West, Robert; Pavitt, Sue; Day, Peter

    2018-01-01

    Parental supervised brushing (PSB) when initiated in infancy can lead to long-term protective home-based oral health habits thereby reducing the risk of dental caries. However, PSB is a complex behaviour with many barriers reported by parents hindering its effective implementation. Within the UK, oral health advice is delivered universally to parents by health visitors and their wider teams when children are aged between 9 and 12 months. Nevertheless, there is no standardised intervention or training upon which health visitors can base this advice, and they often lack the specialised knowledge needed to help parents overcome barriers to performing PSB and limiting sugary foods and drinks.Working with health visitors and parents of children aged 9-24 months, we have co-designed oral health training and resources (Health Visitors delivering Advice in Britain on Infant Toothbrushing (HABIT) intervention) to be used by health visitors and their wider teams when providing parents of children aged 9-12 months with oral health advice.The aim of the study is to explore the acceptability of the HABIT intervention to parents and health visitors, to examine the mechanism of action and develop suitable objective measures of PSB. Six health visitors working in a deprived city in the UK will be provided with training on how to use the HABIT intervention. Health visitors will then each deliver the intervention to five parents of children aged 9-12 months. The research team will collect measures of PSB and dietary behaviours before and at 2 weeks and 3 months after the HABIT intervention. Acceptability of the HABIT intervention to health visitors will be explored through semi-structured diaries completed after each visit and a focus group discussion after delivery to all parents. Acceptability of the HABIT intervention and mechanism of action will be explored briefly during each home visit with parents and in greater details in 20-25 qualitative interviews after the

  14. Health Systems Integration of Sexual and Reproductive Health and HIV Services in Sub-Saharan Africa: A Scoping Study

    PubMed Central

    Kendall, Tamil; Langer, Ana; Bärnighausen, Till

    2014-01-01

    Objective: Both sexual and reproductive health (SRH) services and HIV programs in sub-Saharan Africa are typically delivered vertically, operating parallel to national health systems. The objective of this study was to map the evidence on national and international strategies for integration of SRH and HIV services in sub-Saharan Africa and to develop a research agenda for future health systems integration. Methods: We examined the literature on national and international strategies to integrate SRH and HIV services using a scoping study methodology. Current policy frameworks, national HIV strategies and research, and gray literature on integration were mapped. Five countries in sub-Saharan Africa with experience of integrating SRH and HIV services were purposively sampled for detailed thematic analysis, according to the health systems functions of governance, policy and planning, financing, health workforce organization, service organization, and monitoring and evaluation. Results: The major international health policies and donor guidance now support integration. Most integration research has focused on linkages of SRH and HIV front-line services. Yet, the common problems with implementation are related to delayed or incomplete integration of higher level health systems functions: lack of coordinated leadership and unified national integration policies; separate financing streams for SRH and HIV services and inadequate health worker training, supervision and retention. Conclusions: Rigorous health systems research on the integration of SRH and HIV services is urgently needed. Priority research areas include integration impact, performance, and economic evaluation to inform the planning, financing, and coordination of integrated service delivery. PMID:25436826

  15. Update of the Dutch manual for costing studies in health care.

    PubMed

    Kanters, Tim A; Bouwmans, Clazien A M; van der Linden, Naomi; Tan, Siok Swan; Hakkaart-van Roijen, Leona

    2017-01-01

    Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version. An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute. The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1) costs within the health care sector; 2) patient and family costs; and 3) costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added. The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines.

  16. Social and Health Correlates of Sleep Duration in a US Hispanic Population: Results from the Hispanic Community Health Study/Study of Latinos

    PubMed Central

    Patel, Sanjay R.; Sotres-Alvarez, Daniela; Castañeda, Sheila F.; Dudley, Katherine A.; Gallo, Linda C.; Hernandez, Rosalba; Medeiros, Elizabeth A.; Penedo, Frank J.; Mossavar-Rahmani, Yasmin; Ramos, Alberto R.; Redline, Susan; Reid, Kathryn J.; Zee, Phyllis C.

    2015-01-01

    Study Objectives: To define the prevalence of poor sleep patterns in the US Hispanic/Latino population, identify sociodemographic and psychosocial predictors of short and long sleep duration, and the association between sleep and cardiometabolic outcomes. Design: Cross-sectional analysis. Setting: Community-based study. Participants: Adults age 18–74 y free of sleep disorders (n = 11,860) from the Hispanic Community Health Study/Study of Latinos baseline examination (2008–2011). Interventions: N/A. Measurements and Results: The mean self-reported sleep duration was 8.0 h per night with 18.6% sleeping less than 7 h and 20.1% sleeping more than 9 h in age- and sex-adjusted analyses. Short sleep was most common in individuals of Puerto Rican heritage (25.6%) and the Other Hispanic group (27.4%). Full-time employment, low level of education, and depressive symptoms were independent predictors of short sleep, whereas unemployment, low household income, low level of education, and being born in the mainland US were independent predictors of long sleep. After accounting for sociodemographic differences, short sleep remained significantly associated with obesity with an odds ratio of 1.29 [95% confidence interval 1.12–1.49] but not with diabetes, hypertension, or heart disease. In contrast, long sleep was not associated with any of these conditions. Conclusions: Sleep duration is highly variable among US Hispanic/Latinos, varying by Hispanic/Latino heritage as well as socioeconomic status. These differences may have health consequences given associations between sleep duration and cardiometabolic disease, particularly obesity. Citation: Patel SR, Sotres-Alvarez D, Castañeda SF, Dudley KA, Gallo LC, Hernandez R, Medeiros EA, Penedo FJ, Mossavar-Rahmani Y, Ramos AR, Redline S, Reid KJ, Zee PC. Social and health correlates of sleep duration in a US Hispanic population: results from the Hispanic Community Health Study/Study of Latinos. SLEEP 2015;38(10):1515–1522

  17. Danish Health Professionals' Experiences of Being Coached: A Pilot Study

    ERIC Educational Resources Information Center

    Ammentorp, Jette; Jensen, Hanne Irene; Uhrenfeldt, Lisbeth

    2013-01-01

    Introduction: In recent years, coaching, as a supplement to professional development, has received increased attention, especially in nursing. Still, only little is known about how health professionals experience participating in coaching sessions. The purpose of this pilot study was to describe and analyze health professionals' experiences from…

  18. Measurement of health system performance at district level: A study protocol.

    PubMed

    Sharma, Atul; Prinja, Shankar; Aggarwal, Arun Kumar

    2017-12-13

    Limited efforts have been observed in low and middle income countries to undertake health system performance assessment at district level. Absence of a comprehensive data collection tool and lack of a standardised single summary measure defining overall performance are some of the main problems. Present study has been undertaken to develop a summary composite health system performance index at district level. A broad range of indicators covering all six domains as per building block framework were finalized by an expert panel. The domains were classified into twenty sub-domains, with 70 input and process indicators to measure performance. Seven sub-domains for assessing health system outputs and outcomes were identified, with a total of 28 indicators. Districts in Haryana state from north India were selected for the study. Primary and secondary data will be collected from 378 health facilities, district and state health directorate headquarters. Indicators will be normalized, aggregated to generate composite performance index at district level. Domain specific scores will present the quality of individual building block domains in the public health system. Robustness of the results will be checked using sensitivity analysis. The study presents a methodology for comprehensive assessment of all health system domains on basis of input, process, output and outcome indicators which has never been reported from India. Generation of this index will help identify policy and implementation areas of concern and point towards potential solutions. Results may also help understand relationships between individual building blocks and their sub-components.

  19. Determinants of health promotion action in primary health care: comparative study of health and home care personnel in four municipalities in Finland.

    PubMed

    Simonsen-Rehn, Nina; Laamanen, Ritva; Sundell, Jari; Brommels, Mats; Suominen, Sakari

    2009-01-01

    The purpose of this paper is to contribute to understanding which factors influence health promotion action in primary health care (PHC) on the municipal, i.e. local, level. A cross-sectional mail survey of all PHC personnel in four municipalities in Finland in 2002. The data were analysed by descriptive statistics, and univariate and multivariate logistic regression analyses. A total of 417 (response rate 57%) healthcare professionals participated in the study; 65% of the personnel working in ambulatory care, 52% working in home care and 44% working in inpatient care were engaged in health promotion action (=higher than median engagement). Factors independently associated with engagement in health promotion were organizational values, reflected in perceived skill discretion and social support from coworkers, and the personnel's competence, reflected in knowledge about the health and living conditions of the population served. Further, the opportunities, reflected in cooperation with partners outside the organization were strongly associated with engagement in health promotion action. The results suggest that working conditions such as possibilities for skill usage, reflection and development as well as collegial support enable higher engagement in health promotion action in PHC. However, access to data on the local population's health and living conditions, in addition to opportunities to cooperate with decision makers and partners in the community turned out to be as important. This should be taken into consideration when striving to reorient health services to health promotion.

  20. Experiences of health care providers with integrated HIV and reproductive health services in Kenya: a qualitative study.

    PubMed

    Mutemwa, Richard; Mayhew, Susannah; Colombini, Manuela; Busza, Joanna; Kivunaga, Jackline; Ndwiga, Charity

    2013-01-11

    There is broad consensus on the value of integration of HIV services and reproductive health services in regions of the world with generalised HIV/AIDS epidemics and high reproductive morbidity. Integration is thought to increase access to and uptake of health services; and improves their efficiency and cost-effectiveness through better use of available resources. However, there is still very limited empirical literature on health service providers and how they experience and operationalize integration. This qualitative study was conducted among frontline health workers to explore provider experiences with integration in order to ascertain their significance to the performance of integrated health facilities. Semi-structured in-depth interviews were conducted with 32 frontline clinical officers, registered nurses, and enrolled nurses in Kitui district (Eastern province) and Thika and Nyeri districts (Central province) in Kenya. The study was conducted in health facilities providing integrated HIV and reproductive health services (post-natal care and family planning). All interviews were conducted in English, transcribed and analysed using Nvivo 8 qualitative data analysis software. Providers reported delivering services in provider-level and unit-level integration, as well as a combination of both. Provider experiences of actual integration were mixed. At personal level, providers valued skills enhancement, more variety and challenge in their work, better job satisfaction through increased client-satisfaction. However, they also felt that their salaries were poor, they faced increased occupational stress from: increased workload, treating very sick/poor clients, and less quality time with clients. At operational level, providers reported increased service uptake, increased willingness among clients to take an HIV test, and reduced loss of clients. But the majority also reported infrastructural and logistic deficiencies (insufficient physical room space, equipment

  1. [Constraints and opportunities for inter-sector health promotion initiatives: a case study].

    PubMed

    Magalhães, Rosana

    2015-07-01

    This article analyzes the implementation of inter-sector initiatives linked to the Family Grant, Family Health, and School Health Programs in the Manguinhos neighborhood in the North Zone of Rio de Janeiro, Brazil. The study was conducted in 2010 and 2011 and included document review, local observation, and 25 interviews with program managers, professionals, and staff. This was an exploratory case study using a qualitative approach that identified constraints and opportunities for inter-sector health experiences, contributing to the debate on the effectiveness of health promotion and poverty relief programs.

  2. Accountability Studies on Air Pollution and Health: the HEI Experience.

    PubMed

    Boogaard, Hanna; van Erp, Annemoon M; Walker, Katherine D; Shaikh, Rashid

    2017-12-01

    Assessing health effects of air quality interventions is of ever-increasing interest. Given the prominent role Health Effects Institute (HEI) has played in accountability research, this review focuses on HEI's recent experiences, the challenges it has encountered, and provides possible directions for future research. Most accountability studies to date have focused on effects of relatively short-term, local-scale, and sometimes temporary interventions. Only a few recent accountability studies have sought to investigate large-scale, multiyear regulatory programs. Common challenges encountered include lack of statistical power, how to account appropriately for background trends in air quality and health, and difficulties in direct attribution of changes in air pollution and health to a single intervention among many regulatory actions. New methods have been developed for accountability research that has shown promise addressing some of those challenges, including use of causal inference methods. These and other approaches that would enhance the attribution of changes in air quality and health directly to an intervention should continue to be further explored. In addition, integration of social and behavioral sciences in accountability research is warranted, and climate related co-benefits and dis-benefits may be considered.

  3. Study on a model for future occupational health: proposal for an occupational health service model in Japan.

    PubMed

    Higashi, Toshiaki

    2006-10-01

    The Study Model for Future Occupational Health (funded by a research grant from the Ministry of Health, Welfare and Labor) is a joint research project involving various organizations and agencies undertaken from 2002 to 2004. Society has undergone a dramatic transformation due to technological developments and internationalization. At the same time a low birth rate and an aging population have resulted in an increase in both the percentage of workers experiencing strong anxiety and stress in relation to their jobs and the working environment and the number of suicides. As a natural consequence, occupational health services are now expected to provide EAP, consulting and other functions that were formerly considered outside the realm of occupational health. In consideration of this background, the present study propose the following issues to provide a model for future occupational health services that meet the conditions presently confronted by each worker. 1. How to provide occupational health services and occupational physicians' services: 1) a basic time of 20 minutes of occupational health services per year should be allotted to each worker and to all workers; 2) the obligatory regulations should be revised to expand the obligation from businesses each with 50 or more employees under the present laws to businesses each with 30 or more employees. 2. Providers of occupational health services and occupational physicians' services: (1) reinforcement of outside occupational health agencies; (2) fostering occupational health consultant firms; (3) development of an institute of occupational safety and health; (4) support of activities by authorized occupational physicians in the field; (5) expanding of joint selection of occupational physicians including subsidy increase and the extension of a period of subsidy to five hears; (6) licensing of new entry into occupational health undertaking. 3. Introduction of new report system: (1) establishment of the obligation to

  4. Leadership for Primary Health Care. Levels, Functions, and Requirements Based on Twelve Case Studies. Public Health Papers No. 82.

    ERIC Educational Resources Information Center

    Flahault, Daniel; Roemer, Milton I.

    This book considers the role of and the need for primary health care leadership, drawing upon case studies and research from the World Health Organization (WHO) communities. The differing levels and functions of leadership in primary health care are delineated, with particular emphasis given to regarding the leadership concept as "effective…

  5. Dissemination of a Web-Based Tool for Supporting Health Insurance Plan Decisions (Show Me Health Plans): Cross-Sectional Observational Study.

    PubMed

    Zhao, Jingsong; Mir, Nageen; Ackermann, Nicole; Kaphingst, Kimberly A; Politi, Mary C

    2018-06-20

    The rate of uninsured people has decreased dramatically since the Affordable Care Act was passed. To make an informed decision, consumers need assistance to understand the advantages and disadvantages of health insurance plans. The Show Me Health Plans Web-based decision support tool was developed to improve the quality of health insurance selection. In response to the promising effectiveness of Show Me Health Plans in a randomized controlled trial (RCT) and the growing need for Web-based health insurance decision support, the study team used expert recommendations for dissemination and implementation, engaged external stakeholders, and made the Show Me Health Plans tool available to the public. The purpose of this study was to implement the public dissemination of the Show Me Health Plans tool in the state of Missouri and to evaluate its impact compared to the RCT. This study used a cross-sectional observational design. Dissemination phase users were compared with users in the RCT study across the same outcome measures. Time spent using the Show Me Health Plans tool, knowledge, importance rating of 9 health insurance features, and intended plan choice match with algorithm predictions were examined. During the dissemination phase (November 2016 to January 2017), 10,180 individuals visited the SMHP website, and the 1069 users who stayed on the tool for more than one second were included in our analyses. Dissemination phase users were more likely to live outside St. Louis City or County (P<.001), were less likely to be below the federal poverty level (P<.001), and had a higher income (P=.03). Overall, Show Me Health Plans users from St. Louis City or County spent more time on the Show Me Health Plans tool than those from other Missouri counties (P=.04); this association was not observed in the RCT. Total time spent on the tool was not correlated with knowledge scores, which were associated with lower poverty levels (P=.009). The users from the RCT phase were more

  6. The social gradient in work and health: a cross-sectional study exploring the relationship between working conditions and health inequalities

    PubMed Central

    2013-01-01

    Background Social inequalities in health are widely examined. But the reasons behind this phenomenon still remain unclear in parts. It is undisputed that the work environment plays a crucial role in this regard. However, the contribution of psychosocial factors at work is unclear and inconsistent, and most studies are limited with regard to work factors and health outcomes. This study, therefore, aimed to explore the role and contribution of various physical and psychosocial working conditions to explaining social inequalities in different self-reported health outcomes. Methods Data from a postal survey among the workforces of four medium-sized and large companies from diverse industries of the secondary sector in Switzerland were used and analysed. The study sample covered 1,846 employees aged 20 and 64 and included significant proportions of unskilled manual workers and highly qualified non-manual workers. Cross tabulations and logistic regression analyses were performed to study multiple associations between social status, work factors and health outcomes. Combinations of educational level and occupational position wee used as a measure of social status or class. Results Clear social gradients were observed for almost all adverse working conditions and poor health outcomes studied, but in different directions. While physical workloads and other typical blue-collar job characteristics not suprisingly, were found to be much more common among the lower classes, most psychosocial work demands and job resources were more prevalent in the higher classes. Furthermore, workers in lower classes, i.e. with lower educational and occupational status, were more likely to report poor self-rated health, limited physical functioning and long sickness absence, but at the same time were less likely to experience increased stress feelings and burnout symptoms showing a reversed health gradient. Finally, blue-collar job characteristics contributed substantially to the social

  7. Why Do Students Withdraw from Online Graduate Nursing and Health Studies Education?

    ERIC Educational Resources Information Center

    Perry, Beth; Boman, Jeanette; Care, W. Dean; Edwards, Margaret; Park, Caroline

    2008-01-01

    Why do nursing and health studies graduate students who are enrolled in online programs decide to withdraw? The qualitative study reported in this paper investigated students' self-identified reasons for withdrawing from an online graduate program in nursing and health studies. The focus of the study was Athabasca Universities' Centre for Nursing…

  8. The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching

    PubMed Central

    Kim, Jae-Hyun; Lee, Kwang-Soo; Yoo, Ki-Bong; Park, Eun-Cheol

    2015-01-01

    Study Objectives Health care utilization has progressively increased, especially among Medical Aid beneficiaries in South Korea. The Medical Aid classifies beneficiaries into two categories, type 1 and 2, on the basis of being incapable (those under 18 or over 65 years of age, or disabled) or capable of working, respectively. Medical Aid has a high possibility for health care utilization due to high coverage level. In South Korea, the national health insurance (NHI) achieved very short time to establish coverage for the entire Korean population. However there there remaine a number of problems to be solved. Therefore, the objective of this study was to investigate the differences in health care utilization between Medical Aid beneficiaries and Health Insurance beneficiaries. Methods & Design Data were collected from the Korean Welfare Panel Study from 2008 to 2012 using propensity score matching. Of the 2,316 research subjects, 579 had Medical Aid and 1,737 had health insurance. We also analyzed three dependent variables: days spent in the hospital, number of outpatient visits, and hospitalizations per year. Analysis of variance and longitudinal data analysis were used. Results The number of outpatient visits was 1.431 times higher (p<0.0001) in Medical Aid beneficiaries, the number of hospitalizations per year was 1.604 times higher (p<0.0001) in Medical Aid beneficiaries, and the number of days spent in the hospital per year was 1.282 times higher (p<0.268) for Medical Aid beneficiaries than in individuals with Health Insurance. Medical Aid patients had a 0.874 times lower frequency of having an unmet needs due to economic barrier (95% confidence interval: 0.662-1.156). Conclusions Health insurance coverage has an impact on health care utilization. More health care utilization among Medical Aid beneficiaries appears to have a high possibility of a moral hazard risk under the Health Insurance program. Therefore, the moral hazard for Medical Aid beneficiaries

  9. Health behavior change in pregnant women: a two-phase study.

    PubMed

    Davis, Ann M; Wambach, Karen A; Nelson, Eve Lynn; Odar, Cathleen; Lillis, Teresa; McKinley, Amanda; Gallagher, Mia

    2014-12-01

    Maternal health behaviors during pregnancy/infancy can have a significant impact on maternal and child health. Many women engage in health risk behaviors during pregnancy. Multiple health behavior change (MHBC) interventions provide support to change health behaviors, but further information is needed on potential targets for such an intervention, as well as on the feasibility of technology use and e-health with this population. Two studies were completed as part of this project. First, a survey to examine views regarding health behaviors, desires to change health behaviors, and use of technology was completed by 68 pregnant women presenting for routine care. Based on survey findings, a brief MHBC e-health educational intervention related to breastfeeding, healthy nutrition/lifestyle, and stress management, using iPad(®) (Apple, Cupertino, CA) and text-messaging media, was then developed and piloted in the home with five pregnant women. In the survey, the majority of participants reported interest in receiving help to improve health behaviors, including losing weight or eating a healthier diet, breastfeeding, smoking cessation, and help with depression. The majority of women reported access to a computer with Internet, a phone, and frequent use of text messaging. In the second phase, results suggest that the home-based intervention was feasible and that the technology was convenient and user-friendly. Pregnant women are interested in improving health behaviors and found a brief technology-based e-health intervention feasible, convenient, and user-friendly. In-home technology appears to be a feasible and convenient approach to addressing the multiple health behavior change needs of pregnant women.

  10. [The study of social inequalities in child and adolescent health in Spain].

    PubMed

    Font-Ribera, Laia; García-Continente, Xavier; Davó-Blanes, M Carmen; Ariza, Carles; Díez, Elia; García Calvente, M del Mar; Maroto, Gracia; Suárez, Mónica; Rajmil, Luis

    2014-01-01

    To identify and describe studies on social inequalities in child and adolescent health conducted in Spain with special emphasis on social determinants. In July 2012, we conducted a systematic review in the PubMed, MEDES, SCOPUS and COCHRANE databases. We included studies on social inequalities in child and adolescent health in Spain published between 2000 and 2012. A total of 2147 abstracts were reviewed by two researchers and 80 manuscripts were fully reviewed by three researchers. Risk of bias was assessed. Seventy-two articles were finally included. A total of 83% of the studies were cross-sectional and the most frequently studied age group consisted of 13-15-year-olds. More than 20 individual or group determinants were identified. The most frequently analyzed determinants were the most advantaged educational level and occupation of the mother or the father. In 38% of the studies analyzing education and occupation, there was no definition of the determinant. Social inequalities were detected in dental health with all determinants and in all age groups (9% of studies with a high risk of bias). Social inequalities were also detected in obesity, physical activity and mental health with some determinants. Specific data were missing for younger children. No social inequalities were found in the use of health services, excluding dental care. Few studies analyzed immigration and 42% of them had a high risk of bias. Wide diversity was found in the measurement of social determinants, with a lack of studies in preschoolers and of studies with longitudinal designs. The results of this study confirm social inequalities in some aspects of health. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. Health resources and health strategies among older Swedish-speaking Finns--a hermeneutic study.

    PubMed

    Kulla, Gunilla; Sarvimäki, Anneli; Fagerström, Lisbeth

    2006-03-01

    Research has shown that the Swedish-speaking Finns have better health than the Finnish-speaking majority. The aim of this paper was to explore the health resources and health strategies among home-dwelling Swedish-speaking Finns aged 75 or older. The objective was to develop health-promotive nursing care for this group. Data was collected through recorded semistructured conversations with 22 older persons. The conversations were transcribed and interpreted through a hermeneutic approach. The material was read through several times and compiled into 22 narratives with relevant quotations. The narratives were subsequently summarised into one core narrative under each major category, to present the health resources and health strategies. Six categories were found: the Positive, the Social, the Active, the Adaptable, the Stubborn and the Passive. Within the Positive category, morale played an important role as a health resource and health strategy. Within the Social category, social activities were regarded as both health resources and health strategies, whereas their absence was a health obstacle. Within the Active category, a wide range of physical activities played an important role. Within the Adaptable category, contentment was a health resource. Within the Stubborn category, stubbornness itself was a health resource, whereas strong belief was a health strategy. Within the Passive category, although health obstacles permeated the life context, contentment and caution were seen as health resources. The vision of the future varied from the confidence found in the Positive category to the uncertainty prevalent in the Passive category. The main health resources and strategies used by the elderly Swedish-speaking Finns were related to social and other activities as well as to personality. Transforming health obstacles into resources could be an important health-promotive nursing strategy.

  12. Forgiveness, Stress, and Health: a 5-Week Dynamic Parallel Process Study

    PubMed Central

    Toussaint, Loren L.; Shields, Grant S.; Slavich, George M.

    2016-01-01

    Background Psychological stress is a well-known risk factor for poor health, and recent research has suggested that the emotion-focused coping process of forgiveness may help mitigate these effects. To date, however, no studies have examined how levels of forgiveness, stress, and health fluctuate and interrelate over time. Purpose We addressed this issue by examining how forgiveness, stress, and mental and physical health symptoms change and relate to one another over 5 weeks. We hypothesized that increases in state levels of forgiveness would be associated with decreases in perceptions of stress, which would in turn be related to decreases in mental and physical health symptoms. A reverse effects model was also tested. Methods We recruited a large, community-based sample of 332 young, middle-aged, and older adults (16–79 years old; Mage = 27.9). Each week for 5 weeks, participants reported on their levels of state forgiveness, perceived stress, and mental and physical health symptoms. Results Levels of forgiveness, stress, and mental and physical health symptoms each showed significant change and individual variability in change over time. As hypothesized, increases in forgiveness were associated with decreases in stress, which were in turn related to decreases in mental (but not physical) health symptoms (i.e., forgiveness→ stress→ health). The reverse effects model (i.e., health → stress → forgiveness) provided a relatively poorer fit. Conclusions This study is the first to provide prospective, longitudinal evidence showing that greater forgiveness is associated with less stress and, in turn, better mental health. Strategies for cultivating forgiveness may thus have beneficial effects on stress and health. PMID:27068160

  13. Worksite health promotion program participation: a study to examine the determinants of participation.

    PubMed

    Hall, Michael Edward; Bergman, Randall J; Nivens, Samantha

    2014-09-01

    This study explores the relationship between organizational health climate and worksite health promotion program participation, specifically engaging individuals who are unlikely to make positive health behavior choices on their own. Participants consisted of employees at three separate furniture-manufacturing facilities completing a voluntary survey. Using responses (n = 349) from the health climate instrument, which is a measure of the collective attitudes, beliefs, and readiness to change a health behavior, this study identified two factors that were significant contributors to worksite health promotion program participation. Health norms, the collective attitudes regarding healthy lifestyle, as measured by the subscales-health scale and intention to make a behavior change-and "optimistic bias," the overassessment of one's personal health, were found to be predictors of participation. Additionally, significant (p < .05) predictors of self-assessed health, included perceived control to initiate, competence to carry out, and the organizational support of the health behavior change. The findings suggest that the organization's health norms and self-assessed health are associated with the worker's motivation to become involved with health promotion interventions. Offering worksite health screenings and advanced programming and creating a culture of health at work can help address program participation. © 2013 Society for Public Health Education.

  14. Pathways into mental health care for UK veterans: a qualitative study.

    PubMed

    Mellotte, Harriet; Murphy, Dominic; Rafferty, Laura; Greenberg, Neil

    2017-01-01

    Background : It is well established that veterans suffering from mental health difficulties under use mental health services. Objective : This study aimed to understand more about the barriers that prevent veterans from seeking professional help and the enablers that assist veterans in seeking professional help. It also aimed to explore potential mechanisms to improve veterans' help-seeking and pathways to care. Method : The study employed a qualitative design whereby 17 veterans who had recently attended specialist veteran mental health services took part in semi-structured interviews. The resultant data were analysed using grounded theory. Results : Participants described two distinct stages to their help-seeking: initial help-seeking and pathways through treatment. Specific barriers and enablers to help-seeking were identified at each stage. Initial barriers included recognizing that there is a problem, self-stigma and anticipated public stigma. Initial enablers included being in crisis, social support, motivation and the media. Treatment pathway barriers included practical factors and negative beliefs about health services and professionals. Treatment pathway enablers included having a diagnosis, being seen in a veteran-specific service and establishing a good therapeutic relationship. Participants provided some suggestions for interventions to improve veterans' help-seeking in future; these focussed on enhancing both veterans and health professionals' knowledge regarding mental health difficulties. Conclusions : This study identified a number of barriers and enablers that may impact a veteran's journey in seeking help from professional services for mental health difficulties. Enablers such as reaching a crisis point, social support, the media, having a diagnosis of PTSD and veteran-specific mental health services appeared to be important in opposing stigma-related beliefs and in supporting veterans to engage in help-seeking behaviours.

  15. The past, present, and future of soils and human health studies

    NASA Astrophysics Data System (ADS)

    Brevik, E. C.; Sauer, T. J.

    2015-01-01

    The idea that human health is tied to the soil is not a new one. As far back as circa 1400 BC the Bible depicts Moses as understanding that fertile soil was essential to the well-being of his people. In 400 BC the Greek philosopher Hippocrates provided a list of things that should be considered in a proper medical evaluation, including the properties of the local ground. By the late 1700s and early 1800s, American farmers had recognized that soil properties had some connection to human health. In the modern world, we recognize that soils have a distinct influence on human health. We recognize that soils influence (1) food availability and quality (food security), (2) human contact with various chemicals, and (3) human contact with various pathogens. Soils and human health studies include investigations into nutrient supply through the food chain and routes of exposure to chemicals and pathogens. However, making strong, scientific connections between soils and human health can be difficult. There are multiple variables to consider in the soil environment, meaning traditional scientific studies that seek to isolate and manipulate a single variable often do not provide meaningful data. The complete study of soils and human health also involves many different specialties such as soil scientists, toxicologists, medical professionals, anthropologists, etc. These groups do not traditionally work together on research projects, and do not always effectively communicate with one another. Climate change and how it will affect the soil environment/ecosystem going into the future is another variable affecting the relationship between soils and health. Future successes in soils and human health research will require effectively addressing difficult issues such as these.

  16. Collaboration between general practitioners and mental health care professionals: a qualitative study.

    PubMed

    Fredheim, Terje; Danbolt, Lars J; Haavet, Ole R; Kjønsberg, Kari; Lien, Lars

    2011-05-23

    Collaboration between general practice and mental health care has been recognised as necessary to provide good quality healthcare services to people with mental health problems. Several studies indicate that collaboration often is poor, with the result that patient' needs for coordinated services are not sufficiently met, and that resources are inefficiently used. An increasing number of mental health care workers should improve mental health services, but may complicate collaboration and coordination between mental health workers and other professionals in the treatment chain. The aim of this qualitative study is to investigate strengths and weaknesses in today's collaboration, and to suggest improvements in the interaction between General Practitioners (GPs) and specialised mental health service. This paper presents a qualitative focus group study with data drawn from six groups and eight group sessions with 28 health professionals (10 GPs, 12 nurses, and 6 physicians doing post-doctoral training in psychiatry), all working in the same region and assumed to make professional contact with each other. GPs and mental health professionals shared each others expressions of strengths, weaknesses and suggestions for improvement in today's collaboration. Strengths in today's collaboration were related to common consultations between GPs and mental health professionals, and when GPs were able to receive advice about diagnostic treatment dilemmas. Weaknesses were related to the GPs' possibility to meet mental health professionals, and lack of mutual knowledge in mental health services. The results describe experiences and importance of interpersonal knowledge, mutual accessibility and familiarity with existing systems and resources. There is an agreement between GPs and mental health professionals that services will improve with shared knowledge about patients through systematic collaborative services, direct cell-phone lines to mental health professionals and allocated

  17. Accounting for health in climate change policies: a case study of Fiji

    PubMed Central

    Morrow, Georgina; Bowen, Kathryn

    2014-01-01

    Background Climate change is expected to affect the health of most populations in the coming decades, having the greatest impact on the poorest and most disadvantaged people in the world. The Pacific islands, including Fiji, are particularly vulnerable to the effects of climate change. Objective The three major health impacts of climate change in Fiji explored in this study were dengue fever, diarrhoeal disease, and malnutrition, as they each pose a significant threat to human health. The aim of this study was to investigate to what extent the Fiji National Climate Change Policy, and a selection of relevant sectoral policies, account for these human health effects of climate change. Design The study employed a three-pronged policy analysis to evaluate: 1) the content of the Fijian National Climate Change Policy and to what extent health was incorporated within this; 2) the context within which the policy was developed; 3) the relevant processes; and 4) the actors involved. A selection of relevant sectoral policies were also analysed to assess the extent to which these included climate change and health considerations. Results The policy analysis showed that these three health impacts of climate change were only considered to a minor extent, and often indirectly, in both the Fiji National Climate Change Policy and the corresponding National Climate Change Adaptation Strategy, as well as the Public Health Act. Furthermore, supporting documents in relevant sectors including water and agriculture made no mention of climate change and health impacts. Conclusions The projected health impacts of climate change should be considered as part of reviewing the Fiji National Climate Change Policy and National Climate Change Adaptation Strategy, and the Public Health Act. In the interest of public health, this should include strategies for combating dengue fever, malnutrition, and water-borne disease. Related sectoral policies in water and agriculture should also be revised to

  18. Accounting for health in climate change policies: a case study of Fiji.

    PubMed

    Morrow, Georgina; Bowen, Kathryn

    2014-01-01

    Climate change is expected to affect the health of most populations in the coming decades, having the greatest impact on the poorest and most disadvantaged people in the world. The Pacific islands, including Fiji, are particularly vulnerable to the effects of climate change. The three major health impacts of climate change in Fiji explored in this study were dengue fever, diarrhoeal disease, and malnutrition, as they each pose a significant threat to human health. The aim of this study was to investigate to what extent the Fiji National Climate Change Policy, and a selection of relevant sectoral policies, account for these human health effects of climate change. The study employed a three-pronged policy analysis to evaluate: 1) the content of the Fijian National Climate Change Policy and to what extent health was incorporated within this; 2) the context within which the policy was developed; 3) the relevant processes; and 4) the actors involved. A selection of relevant sectoral policies were also analysed to assess the extent to which these included climate change and health considerations. The policy analysis showed that these three health impacts of climate change were only considered to a minor extent, and often indirectly, in both the Fiji National Climate Change Policy and the corresponding National Climate Change Adaptation Strategy, as well as the Public Health Act. Furthermore, supporting documents in relevant sectors including water and agriculture made no mention of climate change and health impacts. The projected health impacts of climate change should be considered as part of reviewing the Fiji National Climate Change Policy and National Climate Change Adaptation Strategy, and the Public Health Act. In the interest of public health, this should include strategies for combating dengue fever, malnutrition, and water-borne disease. Related sectoral policies in water and agriculture should also be revised to consider climate change and its impact on human

  19. Cohort Profile: The Malawi Longitudinal Study of Families and Health (MLSFH).

    PubMed

    Kohler, Hans-Peter; Watkins, Susan C; Behrman, Jere R; Anglewicz, Philip; Kohler, Iliana V; Thornton, Rebecca L; Mkandawire, James; Honde, Hastings; Hawara, Augustine; Chilima, Ben; Bandawe, Chiwoza; Mwapasa, Victor; Fleming, Peter; Kalilani-Phiri, Linda

    2015-04-01

    The Malawi Longitudinal Study of Families and Health (MLSFH) is one of very few long-standing, publicly available longitudinal cohort studies in a sub-Saharan African (SSA) context. It provides a rare record of more than a decade of demographic, socioeconomic and health conditions in one of the world's poorest countries. The MLSFH was initially established in 1998 to study social network influences on fertility behaviours and HIV risk perceptions, and over time the focus of the study expanded to include health, sexual behaviours, intergenerational relations and family/household dynamics. The currently available data include MLSFH rounds collected in 1998, 2001, 2004, 2006, 2008, 2010 and 2012 for up to 4000 individuals, providing information about socioeconomic and demographic characteristics, sexual behaviours, marriage, household/family structure, risk perceptions, social networks and social capital, intergenerational relations, HIV/AIDS and other dimensions of health. The MLSFH public use data can be requested on the project website: http://www.malawi.pop.upenn.edu/. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  20. [Work in mental health: a job satisfaction and work impact study].

    PubMed

    Rebouças, Denise; Abelha, Lúcia; Legay, Letícia Fortes; Lovisi, Giovanni Marcos

    2008-03-01

    Knowledge of job satisfaction and work impact among psychiatric staff is highly useful for policymakers and mental health professionals. Since there are few studies on this issue in Brazil, a cross-sectional study was carried out among mental health professionals. Data were collected for 133 professionals from 4 mental health services in Rio de Janeiro, using SATIS-BR and IMPACTO-BR scales and a socio-demographic questionnaire. Statistical associations were analyzed using the Mann-Whitney, Kruskal-Wallis, and chi-square tests and multiple linear regression. SPSS 10.1 for Windows was used for statistical analyses. Mean satisfaction was 3.30 and mean work impact was 2.08 (on a scale from 1 to 5). 62.4% of subjects reported moderate satisfaction. Mental health workers with less schooling showed higher satisfaction. Work impact was not associated with any explanatory variable. The results for job satisfaction were similar to those of other studies. Work impact was very low. Unlike studies from the United States and Europe, there were no differences between the community-based and in-hospital staff.

  1. Predictors of health behaviors after the economic downturn: a longitudinal study.

    PubMed

    Macy, Jonathan T; Chassin, Laurie; Presson, Clark C

    2013-07-01

    Economic declines and their associated stress, shortage of financial resources, and changes in available time can impair health behaviors. This study tested the association between change in working hours, change in employment status, and financial strain and health behaviors measured after the 2008 recession after controlling for pre-recession levels of the health behaviors. The moderating influences of demographic factors and pre-recession levels of the health behaviors on the association between change in working hours and employment status and financial strain and the health behaviors were also tested. Participants (N = 3984) were from a longitudinal study of a U.S. Midwestern community-based sample. Regression analyses tested the unique relations between change in hours worked per week, change in employment status, and financial strain and five health behaviors over and above demographic factors and pre-recession levels of the same behavior. Models included predictor by covariate interactions. Participants who reported higher levels of financial strain engaged in lower levels of all but one of the five health behaviors, but there were no significant main effects of a change in the number of hours worked per week or change in employment status. Significant interactions revealed moderation of these relations by demographic characteristics, but findings differed across health behaviors. Financial strain negatively affected engagement in multiple healthy behaviors. Promoting the maintenance of healthy behaviors for disease prevention is an important public health goal during times of economic decline. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Postings and transfers in the Ghanaian health system: a study of health workforce governance.

    PubMed

    Kwamie, Aku; Asiamah, Miriam; Schaaf, Marta; Agyepong, Irene Akua

    2017-09-15

    Decision-making on postings and transfers - that is, the geographic deployment of the health workforce - is a key element of health workforce governance. When poorly managed, postings and transfers result in maldistribution, absenteeism, and low morale. At stake is managing the balance between organisational (i.e., health system) and individual (i.e., staff preference) needs. The negotiation of this potential convergence or divergence of interests provides a window on practices of postings and transfers, and on the micro-practices of governance in health systems more generally. This article explores the policies and processes, and the interplay between formal and informal rules and norms which underpin postings and transfers practice in two rural districts in the Greater Accra Region of Ghana. Semi-structured interviews were conducted with eight district managers and 87 frontline staff from the district health administration, district hospital, polyclinic, health centres and community outreach compounds across two districts. Interviews sought to understand how the postings and transfers process works in practice, factors in frontline staff and district manager decision-making, personal experiences in being posted, and study leave as a common strategy for obtaining transfers. Differential negotiation-spaces at regional and district level exist and inform postings and transfers in practice. This is in contrast to the formal cascaded rules set to govern decision-making authority for postings and transfers. Many frontline staff lack policy clarity of postings and transfers processes and thus 'test' the system through informal staff lobbying, compounding staff perception of the postings and transfers process as being unfair. District managers are also challenged with limited decision-space embedded in broader policy contexts of systemic hierarchy and resource dependence. This underscores the negotiation process as ongoing, rather than static. These findings point to

  3. Addressing refugee health through evidence-based policies: a case study

    PubMed Central

    de Bocanegra, Heike Thiel; Carter-Pokras, Olivia; Ingleby, J. David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I.; Smith-Gagen, Julie; Hidalgo, Bertha

    2017-01-01

    The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the US and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. PMID:28554498

  4. Do we develop public health leaders?- association between public health competencies and emotional intelligence: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Professional development of public health leaders requires a form of instruction which is competency-based to help them develop the abilities to address complex and evolving demands of health care systems. Concurrently, emotional intelligence (EI) is a key to organisational success. Our aim was twofold: i) to assess the relationship between the level of self-assessed public health and EI competencies among Master of European Public Health (MEPH) students and graduates at Maastricht University, and; ii) to determine the relationship between different groups of public health competencies and specific EI skills. Methods A cross-sectional study was conducted including all recent MEPH graduates and students from 2009–2012, out of 67 eligible candidates N = 51 were contacted and N = 33 responded (11 males and 22 females; overall response: 64.7%).Two validated tools were employed: i) public health competencies self-assessment questionnaire, and; ii) Assessing Emotions Scale. Results Females scored higher than males in all seven domains of the self-assessed key public health competencies (NS) and emotional intelligence competences (P = 0.022). Overall, the mean value of public health competencies was the lowest in students with “staff” preferences and the highest among students with mixed job preferences (P < 0.001). There was evidence of a correlation between the overall public health competencies and the overall emotional intelligence competencies (r = 0.61, P < 0.001). Conclusions The study shows a positive correlation between public health specific competencies and EI attributes. It can contribute to the improvement of the educational content of PH curricula by rising awareness through self-assessment and supporting the identification of further educational needs related to leadership. PMID:24742091

  5. Eating habits, health status, and concern about health: a study among 1641 employees in the German metal industry.

    PubMed

    Reime, B; Novak, P; Born, J; Hagel, E; Wanek, V

    2000-04-01

    Nutrition has been found to be associated with sociodemographic characteristics and concern about health. There is limited knowledge, however, of associations between blue-collar worker's diet, morbidity, and health care utilization. We conducted a survey on eating habits, physical symptoms, health care utilization, health status, and concern about health in two German metal companies. A self-administered questionnaire was mailed to employees of whom 1641 participated in the study (response rate 54. 7%). Most employees were characterized by a combination of healthy and unhealthy eating elements. Using linear regression analyses adjusted for age, gender, and occupational status, healthy eating was negatively associated with stomach aches and headaches, but not with cardiovascular disease. Restricted activity days and days in hospital were associated with healthy eating, but self-assessed health status and physician consultations were not. Using stepwise multiple regression analysis, age, gender, and concern about health were strongly and morbidity was weakly related to diet. Occupational status, marital status, and number of children were not associated with nutrition. Health promotion programs should motivate younger and male employees to participate in and aim toward increasing concern about health. Copyright 2000 American Health Foundation and Academic Press.

  6. A Brief History of Soils and Human Health Studies

    NASA Astrophysics Data System (ADS)

    Brevik, Eric C.; Sauer, Thomas J.

    2013-04-01

    scientist to date to be awarded a Nobel Prize. In the 1940s and 50s William Albrecht of the University of Missouri became interested in links between soils and human health, an interest that lead to the publication of several papers. Albrecht's works focused on links between soil fertility and dental health, with a particular focus on the relationships between soil fertility and dental cavities. However, Albrecht did extend the relationships between soil fertility and human health out to broader, more general health issues in some of his writings as well. Well-known figures such as Sir Albert Howard and J.I. Rodale also published works in the 1940s that included soils and human health components. Then André Voisin published "Soil, Grass, and Cancer" in 1959. Much of Voisin's work focused on nutrient content in soils, including both nutrient deficiencies and imbalances, and how that influences nutrient status in plants and animals that are in turn consumed by humans. Several health problems are discussed, including but not limited to birth defects, goiter, mental illness, diabetes, and cancer. Voisin concluded that the medical profession had largely ignored soils in their efforts to improve human health, but that soil science should be the foundation of preventative medicine. Soils and human health studies continued in the later part of the 20th Century. The health effects of exposures to radioactive elements in soils received considerable attention after the 1986 Chernobyl incident, however, even prior to Chernobyl radionuclides in the soil and how they may affect human health were receiving attention. Investigations into the effects of heavy metals in soils became a common theme as did organic chemicals in soils and the effects of trace elements on human health. Following up on the discovery of antibiotics, soil organisms received increased attention as they related to human health. By the end of the 1900s, M.A. Oliver (1997) noted that "… there is a dearth of

  7. Promoting Self-Regulation in Health Among Vulnerable Brazilian Children: Protocol Study

    PubMed Central

    Mattos, Luciana B.; Mattos, Marina B.; Barbosa, Ana P. O.; Bauer, Mariana da Silva; Strack, Maina H.; Rosário, Pedro; Reppold, Caroline T.; Magalhães, Cleidilene R.

    2018-01-01

    The Health and Education Ministries of Brazil launched the Health in School Program (Programa Saúde na Escola - PSE) in 2007. The purpose of the PSE is two-fold: articulate the actions of the education and health systems to identify risk factors and prevent them; and promote health education in the public elementary school system. In the health field, the self-regulation (SR) construct can contribute to the understanding of life habits which can affect the improvement of individuals' health. This research aims to present a program that promotes SR in health (SRH). This program (PSRH) includes topics on healthy eating and oral health from the PSE; it is grounded on the social cognitive framework and uses story tools to train 5th grade Brazilian students in SRH. The study consists of two phases. In Phase 1, teachers and health professionals participated in a training program on SRH, and in Phase 2, they will be expected to conduct an intervention in class to promote SRH. The participants were randomly assigned into three groups: the Condition I group followed the PSE program, the Condition II group followed the PSRH (i.e., PSE plus the SRH program), and the control group (CG) did not enroll in either of the health promotion programs. For the baseline of the study, the following measures and instruments were applied: Body Mass Index (BMI), Simplified Oral Hygiene Index (OHI-S), Previous Day Food Questionnaire (PFDQ), and Declarative Knowledge for Health Instrument. Data indicated that the majority are eutrophic children, but preliminary outcomes showed high percentages of children that are overweight, obese and severely obese. Moreover, participants in all groups reported high consumption of ultraprocessed foods (e.g., soft drinks, artificial juices, and candies). Oral health data from the CI and CII groups showed a prevalence of regular oral hygiene, while the CG presented good oral hygiene. The implementation of both PSE and PSRH are expected to help reduce health

  8. Assessment of a Pesticide Exposure Intensity Algorithm in the Agricultural Health Study

    EPA Science Inventory

    The accuracy of the exposure assessment is a critical factor in epidemiological investigations of pesticide exposures and health in agricultural populations. However, few studies have been conducted to evaluate questionnaire-based exposure metrics. The Agricultural Health Study...

  9. Using local authority data for action on health inequalities: the Caerphilly Health and Social Needs Study.

    PubMed Central

    Fone, David; Jones, Andrew; Watkins, John; Lester, Nathan; Cole, Jane; Thomas, Gary; Webber, Margaret; Coyle, Edward

    2002-01-01

    BACKGROUND: Primary care organisations in the United Kingdom have been given new and challenging population health responsibilities to improve health and address health inequality in local communities through partnership working with local authorities. This requires robust health and social needs assessment data for effective local planning. AIM: To assess the use and value of local authority data shared through partnership working between Caerphilly Local Health Group and Caerphilly County Borough Council. DESIGN OF STUDY: Cross-sectional analysis of aggregate electoral division data. SETTING: Caephilly County Borough, south-east Wales. METHOD: Local authority datasets identified were categorised into one of six domains: income, unemployment, housing, health, education, and social services. Data were presented at electoral division level as rates in thematic maps and correlations between the variables within and between each domain were explored using Spearman's rank correlation coefficient, with particular focus on children in families. Local planning documents were scrutinised to ascertain the use and value of the data. RESULTS: A broad range of data described a comprehensive picture of health and social inequalities within the borough. Multiple deprivation tended to cluster in electoral divisions, particularly for data relating to children, painting an overwhelming picture of inequality in life chances. The data were used in a wide range of local partnership planning initiatives, including the Health Improvement Programme, Children's Services Plan, and a successful Healthy Living Centre bid. CONCLUSION: Local authority data can help primary care organisations in a population approach to needs assessment for use in local partnership planning targeted at reducing health inequalities. PMID:12392118

  10. Organizational capacities for health promotion implementation: results from an international hospital study.

    PubMed

    Röthlin, Florian; Schmied, Hermann; Dietscher, Christina

    2015-06-01

    In this article, organizational structures in hospitals are discussed as possible capacities for hospital health promotion (HP) implementation, based on data from the PRICES-HPH study. PRICES-HPH is a cross-sectional evaluation study of the International Network of Health Promoting Hospitals & Health Services (HPH-Network) and was conducted in 2008-2012. Data from 159 acute care hospitals were used in the analysis. Twelve organizational structures, which were denoted as possible organizational health promotion capacities in previous literature, were tested for their association with certain strategic HP implementation approaches. Four organizational structures were significantly (p = 0.05) associated with one or more elaborate and comprehensive strategic HP implementation approaches: (1) a health promotion specific quality assessment routine; (2) an official hospital health promotion team; (3) a fulltime hospital health promotion coordinator; and (4) officially documented health promotion policies, strategies or standards. The results add further evidence to the importance of organizational capacity structures for hospital health promotion and identify four tangible structures as likely candidates for organizational HP capacities in hospitals. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Latin American Study of Nutrition and Health (ELANS): rationale and study design.

    PubMed

    Fisberg, M; Kovalskys, I; Gómez, G; Rigotti, A; Cortés, L Y; Herrera-Cuenca, M; Yépez, M C; Pareja, R G; Guajardo, V; Zimberg, I Z; Chiavegatto Filho, A D P; Pratt, M; Koletzko, B; Tucker, K L

    2016-01-30

    Obesity is growing at an alarming rate in Latin America. Lifestyle behaviours such as physical activity and dietary intake have been largely associated with obesity in many countries; however studies that combine nutrition and physical activity assessment in representative samples of Latin American countries are lacking. The aim of this study is to present the design rationale of the Latin American Study of Nutrition and Health/Estudio Latinoamericano de Nutrición y Salud (ELANS) with a particular focus on its quality control procedures and recruitment processes. The ELANS is a multicenter cross-sectional nutrition and health surveillance study of a nationally representative sample of urban populations from eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Perú and Venezuela). A standard study protocol was designed to evaluate the nutritional intakes, physical activity levels, and anthropometric measurements of 9000 enrolled participants. The study was based on a complex, multistage sample design and the sample was stratified by gender, age (15 to 65 years old) and socioeconomic level. A small-scale pilot study was performed in each country to test the procedures and tools. This study will provide valuable information and a unique dataset regarding Latin America that will enable cross-country comparisons of nutritional statuses that focus on energy and macro- and micronutrient intakes, food patterns, and energy expenditure. Clinical Trials NCT02226627.

  12. PRELIMINARY HEALTH BURDEN ANALYSIS FOR EPIDEMIOLOGIC RECREATIONAL WATER STUDY

    EPA Science Inventory

    Introduction: The National Epidemiological and Environmental Assessment of Recreational Water Study (NEEAR) offers a rare opportunity for researchers. The study's design involves the collection of health data before and after visiting the beach in conjunction with water quality...

  13. Ideal Cardiovascular Health and Arterial Stiffness in Spanish Adults-The EVIDENT Study.

    PubMed

    García-Hermoso, Antonio; Martínez-Vizcaíno, Vicente; Gomez-Marcos, Manuel Ángel; Cavero-Redondo, Iván; Recio-Rodriguez, José Ignacio; García-Ortiz, Luis

    2018-05-01

    Studies concerning ideal cardiovascular (CV) health and its relationship with arterial stiffness are lacking. This study examined the association between arterial stiffness with ideal CV health as defined by the American Heart Association, across age groups and gender. The cross-sectional study included 1365 adults. Ideal CV health was defined as meeting ideal levels of the following components: 4 behaviors (smoking, body mass index, physical activity, and Mediterranean diet adherence) and 3 factors (total cholesterol, blood pressure, and glycated hemoglobin). Patients were grouped into 3 categories according to their number of ideal CV health metrics: ideal (5-7 metrics), intermediate (3-4 metrics), and poor (0-2 metrics). We analyzed the pulse wave velocity (PWV), the central and radial augmentation indexes, and the ambulatory arterial stiffness index (AASI). The ideal CV health profile was inversely associated with lower arterial radial augmentation index and AASI in both genders, particularly in middle-aged (45-65 years) and in elderly subjects (>65 years). Also in elderly subjects, adjusted models showed that adults with at least 3 health metrics at ideal levels had significantly lower PWV than those with 2 or fewer ideal health metrics. An association was found between a favorable level of ideal CV health metrics and lower arterial stiffness across age groups. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Mental health problems among young doctors: an updated review of prospective studies.

    PubMed

    Tyssen, Reidar; Vaglum, Per

    2002-01-01

    Previous studies have shown the medical community to exhibit a relatively high level of certain mental health problems, particularly depression, which may lead to drug abuse and suicide. We reviewed prospective studies published over the past 20 years to investigate the prevalence and predictors of mental health problems in doctors during their first postgraduate years. We selected clinically relevant mental health problems as the outcome measure. We found nine cohort studies that met our selection criteria. Each of them had limitations, notably low response rate at follow-up, small sample size, and/or short observation period. Most studies showed that symptoms of mental health problems, particularly of depression, were highest during the first postgraduate year. They found that individual factors, such as family background, personality traits (neuroticism and self-criticism), and coping by wishful thinking, as well as contextual factors including perceived medical-school stress, perceived overwork, emotional pressure, working in an intensive-care setting, and stress outside of work, were often predictive of mental health problems. The studies revealed somewhat discrepant findings with respect to gender. The implications of these findings are discussed.

  15. Maternal health in Gujarat, India: a case study.

    PubMed

    Mavalankar, Dileep V; Vora, Kranti S; Ramani, K V; Raman, Parvathy; Sharma, Bharati; Upadhyaya, Mudita

    2009-04-01

    Gujarat state of India has come a long way in improving the health indicators since independence, but progress in reducing maternal mortality has been slow and largely unmeasured or documented. This case study identified several challenges for reducing the maternal mortality ratio, including lack of the managerial capacity, shortage of skilled human resources, non-availability of blood in rural areas, and infrastructural and supply bottlenecks. The Gujarat Government has taken several initiatives to improve maternal health services, such as partnership with private obstetricians to provide delivery care to poor women, a relatively-short training of medical officers and nurses to provide emergency obstetric care (EmOC), and an improved emergency transport system. However, several challenges still remain. Recommendations are made for expanding the management capacity for maternal health, operationalization of health facilities, and ensuring EmOC on 24/7 (24 hours a day, seven days a week) basis by posting nurse-midwives and trained medical officers for skilled care, ensuring availability of blood, and improving the registration and auditing of all maternal deaths. However, all these interventions can only take place if there are substantially-increased political will and social awareness.

  16. Maternal Health in Gujarat, India: A Case Study

    PubMed Central

    Vora, Kranti S.; Ramani, K.V.; Raman, Parvathy; Sharma, Bharati; Upadhyaya, Mudita

    2009-01-01

    Gujarat state of India has come a long way in improving the health indicators since independence, but progress in reducing maternal mortality has been slow and largely unmeasured or documented. This case study identified several challenges for reducing the maternal mortality ratio, including lack of the managerial capacity, shortage of skilled human resources, non-availability of blood in rural areas, and infrastructural and supply bottlenecks. The Gujarat Government has taken several initiatives to improve maternal health services, such as partnership with private obstetricians to provide delivery care to poor women, a relatively-short training of medical officers and nurses to provide emergency obstetric care (EmOC), and an improved emergency transport system. However, several challenges still remain. Recommendations are made for expanding the management capacity for maternal health, operationalization of health facilities, and ensuring EmOC on 24/7 (24 hours a day, seven days a week) basis by posting nurse-midwives and trained medical officers for skilled care, ensuring availability of blood, and improving the registration and auditing of all maternal deaths. However, all these interventions can only take place if there are substantially-increased political will and social awareness. PMID:19489418

  17. Update of the Dutch manual for costing studies in health care

    PubMed Central

    Kanters, Tim A.; Bouwmans, Clazien A. M.; van der Linden, Naomi; Tan, Siok Swan; Hakkaart-van Roijen, Leona

    2017-01-01

    Objectives Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version. Methods An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute. Results The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1) costs within the health care sector; 2) patient and family costs; and 3) costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added. Conclusions The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines. PMID:29121647

  18. Text messaging in health care: a systematic review of impact studies.

    PubMed

    Yeager, Valerie A; Menachemi, Nir

    2011-01-01

    Studies suggest text messaging is beneficial to health care; however, no one has synthesized the overall evidence on texting interventions. In response to this need, we conducted a systematic review of the impacts of text messaging in health care. PubMed database searches and subsequent reference list reviews sought English-language, peer-reviewed studies involving text messaging in health care. Commentaries, conference proceedings, and feasibilities studies were excluded. Data was extracted using an article coding sheet and input into a database for analysis. Of the 61 papers reviewed, 50 articles (82%) found text messaging had a positive effect on the primary outcome. Average sample sizes in articles reporting positive findings (n=813) were significantly larger than those that did not find a positive impact (n=178) on outcomes (p = 0.032). Articles were categorized into focal groups as follows: 27 articles (44.3%) investigated the impact of texting on disease management, 24 articles (39.3%) focused texting's impact to public health related outcomes, and 10 articles (16.4%) examined texting and its influence on administrative processes. Articles in focal groups differed by the purpose of the study, direction of the communication, and where they were published, but not in likelihood of reporting a positive impact from texting. Current evidence indicates that text messaging health care interventions are largely beneficial clinically, in public health related uses, and in terms of administrative processes. However, despite the promise of these findings, literature gaps exist, especially in primary care settings, across geographic regions and with vulnerable populations.

  19. Capturing how age-friendly communities foster positive health, social participation and health equity: a study protocol of key components and processes that promote population health in aging Canadians.

    PubMed

    Levasseur, Mélanie; Dubois, Marie-France; Généreux, Mélissa; Menec, Verena; Raina, Parminder; Roy, Mathieu; Gabaude, Catherine; Couturier, Yves; St-Pierre, Catherine

    2017-05-25

    To address the challenges of the global aging population, the World Health Organization promoted age-friendly communities as a way to foster the development of active aging community initiatives. Accordingly, key components (i.e., policies, services and structures related to the communities' physical and social environments) should be designed to be age-friendly and help all aging adults to live safely, enjoy good health and stay involved in their communities. Although age-friendly communities are believed to be a promising way to help aging Canadians lead healthy and active lives, little is known about which key components best foster positive health, social participation and health equity, and their underlying mechanisms. This study aims to better understand which and how key components of age-friendly communities best foster positive health, social participation and health equity in aging Canadians. Specifically, the research objectives are to: 1) Describe and compare age-friendly key components of communities across Canada 2) Identify key components best associated with positive health, social participation and health equity of aging adults 3) Explore how these key components foster positive health, social participation and health equity METHODS: A mixed-method sequential explanatory design will be used. The quantitative part will involve a survey of Canadian communities and secondary analysis of cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA). The survey will include an age-friendly questionnaire targeting key components in seven domains: physical environment, housing options, social environment, opportunities for participation, community supports and healthcare services, transportation options, communication and information. The CLSA is a large, national prospective study representative of the Canadian aging population designed to examine health transitions and trajectories of adults as they age. In the qualitative part, a multiple

  20. Trade liberalization, social policies and health: an empirical case study.

    PubMed

    McNamara, Courtney

    2015-10-12

    This study investigates the health impacts of a major liberalization episode in the textile and clothing (T&C) sector. This episode triggered substantial shifts in employment across a wide range of countries. It is the first study to empirically link trade liberalization to health via changes in employment and offers some of the first empirical insights on how trade liberalization interacts with social policies to influence health. Data from 32 T&C reliant countries were analysed in reference to the pre- and post-liberalization periods of 2000-2004 and 2005-2009. Fuzzy-set qualitative comparative analysis (fsQCA) was used to examine the association between countries' a) level of development b) labour market and welfare state protections c) T&C employment changes and d) changes in adult female and infant mortality rates. Process tracing was used to further investigate these associations through twelve in-depth country studies. Results from the fsQCA relate changes in employment after the phase-out to both changing adult female and infant mortality rates. Findings from the in-depth country studies suggest that the worsening of adult female mortality rates is related to workers' lack of social protection, both in the context of T&C employment growth and loss. Overall, it is found that social protection is often inaccessible to the type of workers who may be the most vulnerable to processes of liberalization and that many workers are particularly vulnerable due to the structure of social protection policies. Social policies are therefore found to both moderate pathways to health and influence the type of health-related pathways resulting from trade liberalizing policies.

  1. The health benefits of yoga and exercise: a review of comparison studies.

    PubMed

    Ross, Alyson; Thomas, Sue

    2010-01-01

    Exercise is considered an acceptable method for improving and maintaining physical and emotional health. A growing body of evidence supports the belief that yoga benefits physical and mental health via down-regulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). The purpose of this article is to provide a scholarly review of the literature regarding research studies comparing the effects of yoga and exercise on a variety of health outcomes and health conditions. Using PubMed((R)) and the key word "yoga," a comprehensive search of the research literature from core scientific and nursing journals yielded 81 studies that met inclusion criteria. These studies subsequently were classified as uncontrolled (n = 30), wait list controlled (n = 16), or comparison (n = 35). The most common comparison intervention (n = 10) involved exercise. These studies were included in this review. In the studies reviewed, yoga interventions appeared to be equal or superior to exercise in nearly every outcome measured except those involving physical fitness. The studies comparing the effects of yoga and exercise seem to indicate that, in both healthy and diseased populations, yoga may be as effective as or better than exercise at improving a variety of health-related outcome measures. Future clinical trials are needed to examine the distinctions between exercise and yoga, particularly how the two modalities may differ in their effects on the SNS/HPA axis. Additional studies using rigorous methodologies are needed to examine the health benefits of the various types of yoga.

  2. Therapeutic Jurisprudence in Health Research: Enlisting Legal Theory as a Methodological Guide in an Interdisciplinary Case Study of Mental Health and Criminal Law.

    PubMed

    Ferrazzi, Priscilla; Krupa, Terry

    2015-09-01

    Studies that seek to understand and improve health care systems benefit from qualitative methods that employ theory to add depth, complexity, and context to analysis. Theories used in health research typically emerge from social science, but these can be inadequate for studying complex health systems. Mental health rehabilitation programs for criminal courts are complicated by their integration within the criminal justice system and by their dual health-and-justice objectives. In a qualitative multiple case study exploring the potential for these mental health court programs in Arctic communities, we assess whether a legal theory, known as therapeutic jurisprudence, functions as a useful methodological theory. Therapeutic jurisprudence, recruited across discipline boundaries, succeeds in guiding our qualitative inquiry at the complex intersection of mental health care and criminal law by providing a framework foundation for directing the study's research questions and the related propositions that focus our analysis. © The Author(s) 2014.

  3. What is eHealth (6)? Development of a Conceptual Model for eHealth: Qualitative Study with Key Informants

    PubMed Central

    Janssen, Anna; Barnet, Stewart

    2017-01-01

    Background Despite rapid growth in eHealth research, there remains a lack of consistency in defining and using terms related to eHealth. More widely cited definitions provide broad understanding of eHealth but lack sufficient conceptual clarity to operationalize eHealth and enable its implementation in health care practice, research, education, and policy. Definitions that are more detailed are often context or discipline specific, limiting ease of translation of these definitions across the breadth of eHealth perspectives and situations. A conceptual model of eHealth that adequately captures its complexity and potential overlaps is required. This model must also be sufficiently detailed to enable eHealth operationalization and hypothesis testing. Objective This study aimed to develop a conceptual practice-based model of eHealth to support health professionals in applying eHealth to their particular professional or discipline contexts. Methods We conducted semistructured interviews with key informants (N=25) from organizations involved in health care delivery, research, education, practice, governance, and policy to explore their perspectives on and experiences with eHealth. We used purposeful sampling for maximum diversity. Interviews were coded and thematically analyzed for emergent domains. Results Thematic analyses revealed 3 prominent but overlapping domains of eHealth: (1) health in our hands (using eHealth technologies to monitor, track, and inform health), (2) interacting for health (using digital technologies to enable health communication among practitioners and between health professionals and clients or patients), and (3) data enabling health (collecting, managing, and using health data). These domains formed a model of eHealth that addresses the need for clear definitions and a taxonomy of eHealth while acknowledging the fluidity of this area and the strengths of initiatives that span multiple eHealth domains. Conclusions This model extends current

  4. Measuring and understanding motivation among community health workers in rural health facilities in India-a mixed method study.

    PubMed

    Tripathy, Jaya Prasad; Goel, Sonu; Kumar, Ajay M V

    2016-08-09

    Motivated human resource is the key to improve health system performance and retention of health workers. There is scanty literature on measuring motivation of health workers in India. Thus, the objective of this study was to measure and identify important aspects of health workers' motivation in North India. A mixed method study design was adopted. Under the quantitative component, we interviewed randomly selected 62 community health workers (CHWs) in 18 sub-centres in two blocks of District Ambala, Haryana, India using a structured motivation scale. In-depth interviews were also carried out with 18 CHWs to explore the sources of motivation. The age of respondents and training in the past 12 months were found to be significantly associated with motivation. Job burnout, poor personal health, job insecurity and less career development opportunities were the individual level de-motivators, whereas not being able to fulfil family roles and poor supportive supervision were identified as environmental factors for poor motivation. Love for work, and financial incentives were individual level motivators, while community support and recognition, organizational commitment and pride, regular training were identified as environmental level motivators. Non-financial motivators such as interpersonal relations, family support, skill and career development opportunities require more attention. Regular need-based training is essential to maintain high levels of motivation.

  5. Structural Determinants and Children's Oral Health: A Cross-National Study.

    PubMed

    Baker, S R; Foster Page, L; Thomson, W M; Broomhead, T; Bekes, K; Benson, P E; Aguilar-Diaz, F; Do, L; Hirsch, C; Marshman, Z; McGrath, C; Mohamed, A; Robinson, P G; Traebert, J; Turton, B; Gibson, B J

    2018-03-01

    Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors-the so-called structural determinants of health-play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health-related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries ( N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda.

  6. Antenatal and obstetric care in Afghanistan--a qualitative study among health care receivers and health care providers.

    PubMed

    Rahmani, Zuhal; Brekke, Mette

    2013-05-06

    Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled "the worst country in which to be a mom" in Save the Children's World's Mothers' Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi's phenomenological analysis. Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and transportation problems led to underuse of available care

  7. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    PubMed Central

    2012-01-01

    Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form) for reporting violent incidents, the DCS (demand/control/support) model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors. PMID:22551645

  8. Association of Electronic Health Literacy With Health-Promoting Behaviors in Patients With Type 2 Diabetes: A Cross-sectional Study.

    PubMed

    Kim, Kyoung A; Kim, Yu Jin; Choi, Mona

    2018-05-04

    It is important to know how well patients with type 2 diabetes understand and use health information available online in relation to health-promoting behaviors. Thus, the purposes of this study were to examine the association among electronic health literacy, perceived benefits, self-efficacy, and health-promoting behaviors in patients with type 2 diabetes, and to identify factors that affect health-promoting behaviors. A cross-sectional survey was conducted in a diabetes center in Seoul, South Korea. It was found that health-promoting behaviors were significantly correlated with electronic health literacy (r = 0.15, P < .05), perceived benefits (r = 0.15, P < .05), and self-efficacy (r = 0.47, P < .01). In the multiple linear regression analysis to identify the factors influencing health-promoting behaviors, electronic health literacy (β = .13, P = .040) and self-efficacy (β = .38, P < .001) were found to be significant factors, even after adjusting for general and disease-related characteristics. Strategies to improve health-promoting behaviors in patients with type 2 diabetes should focus on analyzing levels of electronic health literacy and deepening their understanding of online information accordingly.

  9. Stalking and health – an Austrian prevalence study.

    PubMed

    Freidl, W; Neuberger, I; Schönberger, S; Raml, R

    2011-04-01

    The aim of this study was to estimate the prevalence of stalking and related subjective health impairment, based on concrete definitions of stalking, for a representative random sample of the female population in the Austrian Federal State of Styria. A representative random sample (randomised last digits procedure) of 2000 women selected from the female population of Styria aged 18 years or older underwent a computer-aided phone interview survey (CATI). Questions centred on the occurrence of stalking, the exact period of stalking, the gender of the stalker, the subjective impairment through stalking, addressing the aspects of life-style and the subjectively perceived state of health, and socio-demographic variables. For data analyses descriptive statistics, and chi(2)-tests and t-tests were applied. Lifetime prevalence varies between ca. 6% and 18%, depending on definition levels. The annual prevalences reveal a range of 1-4%. 39-43% of the stalked women feel they are impaired in their life-style, and 32-40% feel impaired in their health. Higher age and living in a partnership reduce the likelihood of being stalked. 81% of the stalked women are stalked by a male person. The prevalences found in this study are in line with other international studies, although, in a direct comparison, they are in the lower range. However, these data document the relevance of the phenomenon of stalking for the female Austrian population. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Medical students' health behaviour and self-reported mental health status by their country of origin: a cross-sectional study.

    PubMed

    Terebessy, András; Czeglédi, Edit; Balla, Bettina Claudia; Horváth, Ferenc; Balázs, Péter

    2016-05-28

    Numerous previous studies have investigated the lifestyle and self-perceived health status of medical students. This study examined whether students' country of origin contributed to their mental health and health risk behaviour. We conducted our cross-sectional questionnaire survey over four consecutive years (2009-2012). The target population was fourth-year English- and Hungarian-language course medical students at Semmelweis University, Hungary. We gathered data on medical students' health behaviour (tobacco smoking, alcohol consumption, dietary habits and exercise) and mental health status and used analysis of variance (ANOVA) to examine the association between country of origin and mental health. The response rate was 76.1 % for the Hungarian and 63.4 % for the English course students. The mean age of our sample was 24.1 years (SD = 2.42). Only 15.3 % of students reported following dietary recommendations, but 75.0 % reported engaging in vigorous and regular physical exercise. The prevalence of tobacco smoking was 18.6 % and 13.8 % overconsumed alcoholic beverages. Hungarian and Iranian students reported lower mental well-being than Mediterranean, Israeli and Scandinavian students (F(4) = 18.943, p < 0.001, η(2) = 0.103). Results of the multiway ANOVA indicated that both country of origin and exercise showed a significant relationship with mental health: vigorous exercise was associated with better mental health status (F(1) = 5.505, p = 0.019). Medical students' mental health and health behaviour are associated with multiple factors. One of these is country of origin but exercise may also influence mental health. Health promotion programmes organised for medical students should take their country of origin into consideration and should include physical activity.

  11. Preparing tomorrow's health sciences librarians: feasibility and marketing studies.

    PubMed Central

    Moran, B B; Jenkins, C G; Friedman, C P; Lipscomb, C E; Gollop, C J; Moore, M E; Morrison, M L; Tibbo, H R; Wildemuth, B M

    1996-01-01

    The University of North Carolina at Chapel Hill is devising and evaluating five curricular models designed to improve education for health sciences librarianship. These models fit into a continual learning process from the initial professional preparation to lifelong learning opportunities. Three of them enhance existing degree and certificate programs in the School of Information and Library Science (SILS) with a health sciences specialization, and two are new programs for working information professionals. The approaches involve partnerships among SILS, the Health Sciences Library, and the program in Medical Informatics. The planning process will study the feasibility of the proposed programs, test the marketability of the models to potential students and employers, and make recommendations about implementation. PMID:8913557

  12. Health risk behaviours amongst school adolescents: protocol for a mixed methods study.

    PubMed

    El Achhab, Youness; El Ammari, Abdelghaffar; El Kazdouh, Hicham; Najdi, Adil; Berraho, Mohamed; Tachfouti, Nabil; Lamri, Driss; El Fakir, Samira; Nejjari, Chakib

    2016-11-29

    Determining risky behaviours of adolescents provides valuable information for designing appropriate intervention programmes for advancing adolescent's health. However, these behaviours are not fully addressed by researchers in a comprehensive approach. We report the protocol of a mixed methods study designed to investigate the health risk behaviours of Moroccan adolescents with the goal of identifying suitable strategies to address their health concerns. We used a sequential two-phase explanatory mixed method study design. The approach begins with the collection of quantitative data, followed by the collection of qualitative data to explain and enrich the quantitative findings. In the first phase, the global school-based student health survey (GSHS) was administered to 800 students who were between 14 and 19 years of age. The second phase engaged adolescents, parents and teachers in focus groups and assessed education documents to explore the level of coverage of health education in the programme learnt in the middle school. To obtain opinions about strategies to reduce Moroccan adolescents' health risk behaviours, a nominal group technique will be used. The findings of this mixed methods sequential explanatory study provide insights into the risk behaviours that need to be considered if intervention programmes and preventive strategies are to be designed to promote adolescent's health in the Moroccan school.

  13. 75 FR 29754 - Claims of Confidentiality of Certain Chemical Identities Contained in Health and Safety Studies...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-27

    ... Certain Chemical Identities Contained in Health and Safety Studies and Data from Health and Safety Studies... identities in health and safety studies, and in data from health and safety studies, submitted under the.... Section 14(b) of TSCA does not extend confidential treatment to health and safety studies, or data from...

  14. SHPPS 2006: School Health Policies and Programs Study--Sexually Transmitted Disease (STD) Prevention

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of sexually transmitted disease (STD) prevention, covering the following topics (1) Health Education; and…

  15. Travel health risk perceptions and prevention behaviors of US study abroad students.

    PubMed

    Hartjes, Laurie B; Baumann, Linda C; Henriques, Jeffrey B

    2009-01-01

    The number of American study abroad students increased more than 150% in the past decade, along with growth in destinations with increased health risks. This study investigated travel health risk perceptions and prevention behaviors to guide interventions that address the emerging health needs of US study abroad students. A cross-sectional design was used to collect data from 318 American study abroad students using a Web-based survey. The primary source of travel health information was youth-oriented travel guidebooks (85%). The grand mean risk perception score for 18 travel health threats was 1.7 on a 1 to 4 scale, with top-rated threats being contaminated food/water, psychological distress, personal assault, and excessive sun exposure. Predeparture advice was received from primary care providers (52%) and travel health specialists (18%). Additional prevention measures were vaccines (42%) and medication (24%). Of 114 students listing their travel vaccinations, 11% described receiving a malaria vaccine and 4% a hepatitis C vaccine, although no such vaccines exist. Most respondents were confident/very confident in their ability to engage in prevention behaviors (94%). Health problems were primarily infectious disease (70%), psychological distress (10%), and injuries (8%). When asked if prior travel destinations involved areas where malaria transmission occurs, 20% responded, "Don't know." Identified gaps in travel health knowledge and prevention behaviors may produce hazardous consequences when combined with low-perceived risk, reliance on travel guidebooks for health information, and high ratings for prevention self-efficacy. Future research is needed to test the effectiveness of educational interventions designed for student travelers who would benefit from guided practice with destination-specific risk appraisal and prevention planning. Web-based educational resources are a good fit for this population because they are easily updated, available in all phases of

  16. China's rural public health system performance: a cross-sectional study.

    PubMed

    Tian, Miaomiao; Feng, Da; Chen, Xi; Chen, Yingchun; Sun, Xi; Xiang, Yuanxi; Yuan, Fang; Feng, Zhanchun

    2013-01-01

    In the past three years, the Government of China initiated health reform with rural public health system construction to achieve equal access to public health services for rural residents. The study assessed trends of public health services accessibility in rural China from 2008 to 2010, as well as the current situation about the China's rural public health system performance. The data were collected from a cross-sectional survey conducted in 2011, which used a multistage stratified random sampling method to select 12 counties and 118 villages from China. Three sets of indicators were chosen to measure the trends in access to coverage, equality and effectiveness of rural public health services. Data were disaggregated by provinces and by participants: hypertension patients, children, elderly and women. We examined the changes in equality across and within region. China's rural public health system did well in safe drinking water, children vaccinations and women hospital delivery. But more hypertension patients with low income could not receive regular healthcare from primary health institutions than those with middle and high income. In 2010, hypertension treatment rate of Qinghai in Western China was just 53.22% which was much lower than that of Zhejiang in Eastern China (97.27%). Meanwhile, low performance was showed in effectiveness of rural public health services. The rate of effective treatment for controlling their blood pressure within normal range was just 39.7%. The implementation of health reform since 2009 has led the public health development towards the right direction. Physical access to public health services had increased from 2008 to 2010. But, inter- and intra-regional inequalities in public health system coverage still exist. Strategies to improve the quality and equality of public health services in rural China need to be considered.

  17. Development of a Health Empowerment Programme to improve the health of working poor families: protocol for a prospective cohort study in Hong Kong

    PubMed Central

    Fung, Colman Siu Cheung; Yu, Esther Yee Tak; Guo, Vivian Yawei; Kung, Kenny; Ho, Sin Yi; Lam, Lai Ying; Ip, Patrick; Fong, Daniel Yee Tak; Lam, David Chi Leung; Wong, William Chi Wai; Tsang, Sandra Kit Man; Tiwari, Agnes Fung Yee; Lam, Cindy Lo Kuen

    2016-01-01

    Introduction People from working poor families are at high risk of poor health partly due to limited healthcare access. Health empowerment, a process by which people can gain greater control over the decisions affecting their lives and health through education and motivation, can be an effective way to enhance health, health-related quality of life (HRQOL), health awareness and health-seeking behaviours of these people. A new cohort study will be launched to explore the potential for a Health Empowerment Programme to enable these families by enhancing their health status and modifying their attitudes towards health-related issues. If proven effective, similar empowerment programme models could be tested and further disseminated in collaborations with healthcare providers and policymakers. Method and analysis A prospective cohort study with 200 intervention families will be launched and followed up for 5 years. The following inclusion criteria will be used at the time of recruitment: (1) Having at least one working family member; (2) Having at least one child studying in grades 1–3; and (3) Having a monthly household income that is less than 75% of the median monthly household income of Hong Kong families. The Health Empowerment Programme that will be offered to intervention families will comprise four components: health assessment, health literacy, self-care enablement and health ambassador. Their health status, HRQOL, lifestyle and health service utilisation will be assessed and compared with 200 control families with matching characteristics but will not receive the health empowerment intervention. Ethics and dissemination This project was approved by the University of Hong Kong—the Hospital Authority Hong Kong West Cluster IRB, Reference number: UW 12-517. The study findings will be disseminated through a series of peer-reviewed publications and conference presentations, as well as a yearly report to the philanthropic funding body–Kerry Group Kuok

  18. Awareness and Use of mHealth Apps: A Study from England

    PubMed Central

    Kayyali, Reem; Peletidi, Aliki; Ismail, Muhammad; Hashim, Zahra; Bandeira, Pedro; Bonnah, Jennifer

    2017-01-01

    Purpose: Mobile health (mHealth) solutions have become an inevitable element of the healthcare landscape. The recommendation and use of mHealth is important, but it is often underutilised. This study was conducted in England. It aimed to determine the use and recommendation of mHealth apps by pharmacists, the public’s perceptions of mHealth apps in general, and the awareness and use of health apps by diabetic patients in particular. Methods: The study used a mixed research approach, utilising a sequence of survey-based questionnaires with pharmacists and the general public, followed by semi-structured interviews with diabetic patients. Results: Pharmacists’ questionnaires revealed that 56% of the respondents were aware of health apps, 60% of which recommended them to patients. Over 76% of the individuals owned a smartphone. The types of applications that saw the most use from the general public were health and lifestyle apps (24%), social apps (19%), followed by news (18%). Although eight out of nine diabetic patients owned a smartphone, only three used diabetes apps. Diabetic patients also suggested an interest in using diabetes apps to aid in optimising care via the utilisation of visual aids, reminders, recording patient data, social coaching, and remote collaboration with healthcare professionals (HCPs), but time was seen as the biggest obstacle to using a diabetes mHealth application. Conclusion: Despite the growing number of mHealth apps, the level of awareness and usability of such apps by patients and pharmacists was still relatively low. Nevertheless, the majority who used health apps found them to be beneficial, and the public agreed that it helped them to live a healthier lifestyle. Therefore, health apps have great potential in health promotion. Pharmacists are ideally placed to promote them and make patients more aware of them. To increase the use of these apps, it is necessary to first increase awareness and knowledge of these apps, both to the

  19. Assistive Walking Device Use and Knee Osteoarthritis: the Health, Aging, and Body Composition Study (Health ABC Study)

    PubMed Central

    Carbone, Laura D.; Satterfield, Suzanne; Liu, Caiqin; Kwoh, Kent C.; Neogi, Tuhina; Tolley, Elizabeth; Nevitt, Michael

    2012-01-01

    Objectives To identify factors that predicted incident use of assistive walking devices (AWDs) and to explore whether AWD use was associated with changes in osteoarthritis of the knee. Design Prospective cohort study. Setting 2,639 elderly men and women in the Health ABC (Health, Aging and Body Composition). Study followed for incident use of AWDs, including a subset of 874 with prevalent knee pain. Participants NA Interventions NA Main Outcome Measures Incident use of AWDs, mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores and frequency of joint space narrowing on knee radiographs over a three year time period. Results AWD use was initiated by 9% of the entire Health ABC cohort and 12% of the knee pain subset. Factors that predicted use in both groups were age ≥73 [entire cohort: OR 2.07 (95% CI 1.43, 3.01); knee pain subset: OR 1.87 (95% CI 1.16, 3.03)], black race [entire cohort: OR 2.95 (95% CI 2.09, 4.16); knee pain subset: OR 3.21 (95% CI 2.01, 5.11)] and lower balance ratios [entire cohort: OR 3.18 (95% CI 2.21, 4.59); knee pain subset: OR 3.77 (95% CI 2.34, 6.07)]. Mean WOMAC pain scores decreased slightly over time in both AWD and non-AWD users. 20% of non-AWD users and 28% of AWD users had radiographic progression in joint space narrowing of the tibiofemoral joint in at least one knee. 14% of non-AWD users and 12% of AWD users had radiographic progression in joint space narrowing in the patellofemoral joint in at least one knee. Conclusions Assistive walking devices are frequently used by elderly men and women. Knee pain and balance problems are significant reasons why elderly individuals initiate use of an assistive walking device. In an exploratory analysis, there was no consistent relationship between use or nonuse of an AWD and WOMAC pain scores or knee joint space narrowing progression. Further studies of the relationship of use of AWDs to changes in knee osteoarthritis are needed. PMID:23041146

  20. The Past, Present, and Future of Soils and Human Health Studies

    NASA Astrophysics Data System (ADS)

    Brevik, E. C.; Sauer, T. J.

    2012-04-01

    The idea that human health is tied to the soil is not a new one. As far back as approximately 1400 B.C. the Bible depicts Moses as understanding that fertile soil was essential to the well-being of his people. While exploring Canaan, Moses charged the men he sent to evaluate the fertility of the soil. In 400 B.C. the Greek philosopher Hippocrates provided a list of things that should be considered in a proper medical evaluation, including the ground. By the late 1700 and early 1800s, American farmers had recognized that soil properties had some connection to human health. In "Letters from an American Farmer", published in 1792, J. Hector St. John De Crèvecoeur stated "Men are like plants; the goodness and flavor of the fruit proceeds from the peculiar soil and exposition in which they grow". And in "Larding the Lean Earth", published in 2002, S. Stoll noted that North American farmers in the early 1800s recognized a link between an enduring agriculture and an enduring society, leading them to become concerned about the fertility of their soils and to seek ways of improving the soil in order to insure a healthy society. Continuing into the first half of the 20th Century, a 1940 publication by the International Harvester Company noted that poor soils lead to "stoop-shouldered, poverty-stricken people." Then, in 1947, Sir Albert Howard published his landmark work "The Soil and Health: A Study of Organic Agriculture", a work that took a critical look at modern production agriculture and at the link between soil fertility and health. Despite these various lines of evidence of some earlier level of understanding that healthy soils are required for healthy people, the scientific study of the relationship between soils and human health is a fairly new undertaking. In his 1997 work "Soil and Human Health: A Review", M.A. Oliver states "… there is a dearth of quantitative information on the relations between elements in the soil and human health;…there is much