Science.gov

Sample records for federal health initiative

  1. Integrating Oral Health and Primary Care: Federal Initiatives to Drive Systems Change.

    PubMed

    Joskow, Capt Renée W

    2016-10-01

    This article describes federal programs, initiatives, and partnerships that have the demonstrated potential to initiate and institutionalize interprofessional practice that includes oral health providers as integral to the provider team. A discussion of landmark documents and reports, the role of legislation and statutory authority, and the influence of federal program priorities towards a national movement to increase access to care to bridge the chasms between the medical health care system, dental delivery system, and oral health is presented.

  2. Integrating Oral Health and Primary Care: Federal Initiatives to Drive Systems Change.

    PubMed

    Joskow, Capt Renée W

    2016-10-01

    This article describes federal programs, initiatives, and partnerships that have the demonstrated potential to initiate and institutionalize interprofessional practice that includes oral health providers as integral to the provider team. A discussion of landmark documents and reports, the role of legislation and statutory authority, and the influence of federal program priorities towards a national movement to increase access to care to bridge the chasms between the medical health care system, dental delivery system, and oral health is presented. PMID:27671964

  3. 69 FR 56773 - Maternal and Child Health Federal Set-Aside Program; Healthy Start Initiative, Closing the Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2004-09-22

    ... HUMAN SERVICES Health Resources and Services Administration Maternal and Child Health Federal Set-Aside Program; Healthy Start Initiative, Closing the Health Gap Initiative on Infant Mortality: African American... award. SUMMARY: The Maternal and Child Health Bureau (MCHB), Health Resources and...

  4. Health Promotion and Aging: Educational and Clinical Initiatives by the Federal Government.

    ERIC Educational Resources Information Center

    Haber, David

    2002-01-01

    Discusses positive and negative effects of five federal health promotion initiatives: Medicare Prevention Benefits, Surgeon General's Reports, Healthy People 2000 and 2001, Guide to Clinical Preventive Services, and Put Prevention into Practice Campaign. Recommends additional research and coordination with state and private sector agencies.…

  5. Federal government expands compliance initiatives.

    PubMed

    Dugan, J K

    1997-09-01

    In 1995, the Federal government initiated Operation Restore Trust to increase enforcement of fraud and abuse regulations in Medicare and Medicaid programs. With the success of the original initiative, the government is expanding the project to additional states and program areas. The initial scrutiny of home health agencies, nursing homes, hospice care, and durable medical equipment is being expanded to managed care plans and acute care hospitals with an eye toward DRG creep. To manage this increased enforcement activity, healthcare organizations should institute comprehensive corporate compliance programs. Such programs should provide a framework that delineates responsibilities and provides a systematic means to resolve issues in a timely manner. PMID:10170318

  6. Federal government expands compliance initiatives.

    PubMed

    Dugan, J K

    1997-09-01

    In 1995, the Federal government initiated Operation Restore Trust to increase enforcement of fraud and abuse regulations in Medicare and Medicaid programs. With the success of the original initiative, the government is expanding the project to additional states and program areas. The initial scrutiny of home health agencies, nursing homes, hospice care, and durable medical equipment is being expanded to managed care plans and acute care hospitals with an eye toward DRG creep. To manage this increased enforcement activity, healthcare organizations should institute comprehensive corporate compliance programs. Such programs should provide a framework that delineates responsibilities and provides a systematic means to resolve issues in a timely manner.

  7. Federalism and health policy.

    PubMed

    Nathan, Richard P

    2005-01-01

    This paper presents a cyclical theory of U.S. federalism and social policy: Many social policy initiatives are tested and refined at the state level, especially during conservative periods, and later morph into national policies. The paper describes such federalism cycles and offers an interpretation of why and how they occur, focusing on Medicaid. State activism has preserved and expanded Medicaid through policy innovation and resistance to retrenchment, especially in conservative periods, by taking advantage of the flexibility the program provides. I conclude that Medicaid's incremental/partnership approach is appropriate and feasible to build on for a future expansion of health care coverage.

  8. [The federal politics of basic sanitation and the initiatives of participation, mobilization, social control, health and environmental education].

    PubMed

    Moisés, Márcia; Kligerman, Débora Cynamon; Cohen, Simone Cynamon; Monteiro, Sandra Conceição Ferreira

    2010-08-01

    The purpose of this article is to accomplish a critical analysis of two governmental important programs in health and environmental education - Health Education and Social Mobilization Program (PESMS) and Environmental Education and Sanitation Social Mobilization Program (PEAMSS), aiming at stimulate participative educational actions and social mobilization in sanitation projects. The methodology was based on reading and analysis of documents and observation in Workshops, Meetings, Seminars, Conventions, Congresses and Interviews. The authors describe the process of Program creation - PESMS and PEAMSS. They promoted a reflection and thought about Participation, Mobilization, Social Control, Health Education and Environmental Education. They also made considerations about the difficulties, facilities, advances and challenges in the implantation and implementation of PESMS and PEAMSS in the fundament for the realization of the public services of basic sanitation. They conclude that the creation of conditions by means of initiatives of Participation, Mobilization, Social Control, Health Education and Environmental Education become necessary for the development of Federal Policies of Basic Sanitation.

  9. [The federal politics of basic sanitation and the initiatives of participation, mobilization, social control, health and environmental education].

    PubMed

    Moisés, Márcia; Kligerman, Débora Cynamon; Cohen, Simone Cynamon; Monteiro, Sandra Conceição Ferreira

    2010-08-01

    The purpose of this article is to accomplish a critical analysis of two governmental important programs in health and environmental education - Health Education and Social Mobilization Program (PESMS) and Environmental Education and Sanitation Social Mobilization Program (PEAMSS), aiming at stimulate participative educational actions and social mobilization in sanitation projects. The methodology was based on reading and analysis of documents and observation in Workshops, Meetings, Seminars, Conventions, Congresses and Interviews. The authors describe the process of Program creation - PESMS and PEAMSS. They promoted a reflection and thought about Participation, Mobilization, Social Control, Health Education and Environmental Education. They also made considerations about the difficulties, facilities, advances and challenges in the implantation and implementation of PESMS and PEAMSS in the fundament for the realization of the public services of basic sanitation. They conclude that the creation of conditions by means of initiatives of Participation, Mobilization, Social Control, Health Education and Environmental Education become necessary for the development of Federal Policies of Basic Sanitation. PMID:20802890

  10. Towards Meeting the Needs of Adolescents: An Assessment of Federally Funded Adolescent Health Programs and Initiatives within the Department of Health and Human Services

    ERIC Educational Resources Information Center

    Brindis, Claire; Hair, Elizabeth; Valderrama, L. Teresa; Cleveland, Kevin; Park, Jane; Cochran, Stephanie

    2005-01-01

    The overall goal of this project is to better understand the types of youth programs available that may influence the health measures presented in the U.S. Chartbook where American adolescents fare differently--sometimes better, sometimes worse--than their counterparts in other countries. In an effort to do so, the authors reviewed the existing…

  11. Internet 2 Health Sciences Initiative.

    ERIC Educational Resources Information Center

    Simco, Greg

    2003-01-01

    The Internet 2 (I2) health sciences initiative (I2HSI) involves the formulation of applications and supporting technologies, and guidelines for their use in the health sciences. Key elements of I2HSI include use of visualization, collaboration, medical informatics, telemedicine, and educational tools that support the health sciences. Specific…

  12. Federal Mine Safety and Health Act - identifying opportunities for partnership

    SciTech Connect

    Beverage, L.

    1996-12-31

    Opportunities for partnership provided by the Federal Mine Safety and Health Act (FMSHA) are identified. These opportunities include: putting the FMSHA into perspective; criticisms of the Mine Act: legislative reform initiatives; understanding FMSHA`s inspections and investigation system; understanding FMSHA`s enforcement tools; developing a partnership built on mutual respect; and post-enforcement challenges.

  13. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  14. Federal Funding Sources for Public Job Creation Initiatives.

    ERIC Educational Resources Information Center

    Johnson, Clifford M.; Savner, Steve

    This overview on potential funding sources describes three major federal programs that can provide a financing base for public job creation initiatives serving hard-to-employ welfare recipients and non-custodial parents. Section I is an introduction. Section II focuses on the Temporary Assistance to Needy Families (TANF) block grant. Section III…

  15. State and federal regulatory initiatives: Pending or underway

    SciTech Connect

    Nosenchuck, N.H.

    1994-12-31

    The author discusses some of the present and future hazardous waste management regulatory initiatives and also presents some of his personal views on hazardous waste management. The primary federal statute governing the regulation of solid and hazardous wastes is the Resource Conservation and Recovery Act (RCRA). Subtitle C of RCRA, relating to hazardous waste management, has evolved into a command and control approach for hazardous waste generators and waste management facilities. The EPA, under RCRA, may authorize a state to administer and enforce a state hazardous waste program in lieu of the federal Subtitle C program.

  16. Public health assessment--Russian Federation, 1992.

    PubMed

    1992-02-14

    On December 25, 1991, the Russian Federation became an independent republic, and on January 2, 1992, restrictions on retail prices of most commodities were removed. From January 16 through February 6, a multidisciplinary team from the U.S. Food and Humanitarian Assistance Bureau (FHA) conducted an assessment of the needs for humanitarian and technical assistance, focusing on three regions in the southern Ural Mountains-Yekaterinburg, Perm, and Cheliabinsk-and three regions in south-central Siberia-Kusbas, Tomsk, and Novosibirsk. The FHA assessment included observations of health facilities, vaccine- and drug-storage centers, and disease-control programs; review of health data at central, regional, and district epidemiology stations; and collection of food-price and income data through interviews with administrative authorities and surveys of markets and private homes. This report summarizes findings from the assessment.

  17. Public health assessment--Russian Federation, 1992.

    PubMed

    1992-02-14

    On December 25, 1991, the Russian Federation became an independent republic, and on January 2, 1992, restrictions on retail prices of most commodities were removed. From January 16 through February 6, a multidisciplinary team from the U.S. Food and Humanitarian Assistance Bureau (FHA) conducted an assessment of the needs for humanitarian and technical assistance, focusing on three regions in the southern Ural Mountains-Yekaterinburg, Perm, and Cheliabinsk-and three regions in south-central Siberia-Kusbas, Tomsk, and Novosibirsk. The FHA assessment included observations of health facilities, vaccine- and drug-storage centers, and disease-control programs; review of health data at central, regional, and district epidemiology stations; and collection of food-price and income data through interviews with administrative authorities and surveys of markets and private homes. This report summarizes findings from the assessment. PMID:1734228

  18. Overview of the federal interagency ecosystem management initiative

    SciTech Connect

    Huke, S.

    1995-12-01

    In early 1994, the White House established a Federal Interagency Ecosystem Management Task Force and Working Group to implement the ecosystem management recommendation in the Vice President`s National Performance Review. The Task Force identified seven ecosystems where mature interagency ecosystem-based activities are mature and ongoing and may provide valuable lessons for broader application. Case studies of each of the seven ecosystems were prepared by interagency teams conducting interviews with representatives of federal, state, and local governments and private interests. The seven ecosystems are: the Southern Appalachian Highlands, Anacostia River Watershed, Prince William Sound, Pacific Northwest Forests, Coastal Louisiana, South Florida, and Great Lakes ecosystems. A final synthesis report, scheduled for completion in the Spring of 1995, will provide an overview of constraints, opportunities, and recommendations in five issue areas: legal, budgetary, science, institutional, policy, and public involvement. A second phase of this initiative will entail the development of ecosystem management strategies for three {open_quotes}new initiatives{close_quotes} laboratories.

  19. World Urologic Oncology Federation Bladder Cancer Prevention Program: a global initiative.

    PubMed

    Klotz, Laurence; Brausi, Maurizio A

    2015-01-01

    Bladder cancer is an international public health problem, and the incidence and mortality are closely tied to cigarette smoking. Urologists are, mostly, not involved in smoking cessation with their patients. The World Urologic Oncology Federation has launched a global initiative to incorporate smoking cessation into urological practice. We believe that urologists can readily be influenced to engage their patients, primary care physicians, and communities in bladder cancer prevention. The World Urologic Oncology Federation, a federation of 17 regional/national societies of urologic oncology around the world, is well positioned to lead this global effort. The results would be an extremely cost-effective program, which has the potential to substantially improve the health of the world's population.

  20. Federal funding of health policy in Brazil: trends and challenges.

    PubMed

    Machado, Cristiani Vieira; Lima, Luciana Dias de; Andrade, Carla Lourenço Tavares de

    2014-01-01

    The article analyzes Federal funding of health policy in Brazil in the 2000s, focusing on the Ministry of Health's budget implementation. Federal spending on health was less unstable between 2000 and 2002 and has expanded since 2006. However, it fluctuated as a share of both the Gross Domestic Product and Gross National Revenue. Federal intergovernmental transfers increased, exceeding 70% in 2007. Meanwhile, the proportion of Federal investments remained low, varying from 3.4% to 6.3%. The highest absolute amount of spending was on specialized outpatient and hospital care. The decade showed a proportionally greater increase in spending on pharmaceutical care. The growing allocation of Federal funds to States in the North and Northeast, especially for primary care and epidemiological surveillance, failed to offset the sharp regional inequalities in per capita Federal spending. The main characteristics of health funding limit Federal health policy governance and pose several challenges for the Brazilian Unified National Health System.

  1. How federalism shapes public health financing, policy, and program options.

    PubMed

    Ogden, Lydia L

    2012-01-01

    In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs. PMID:22635185

  2. Nurse-midwives in federally funded health centers: understanding federal program requirements and benefits.

    PubMed

    Carter, Martha

    2012-01-01

    Midwives are working in federally funded health centers in increasing numbers. Health centers provide primary and preventive health care to almost 20 million people and are located in every US state and territory. While health centers serve the entire community, they also serve as a safety net for low-income and uninsured individuals. In 2010, 93% of health center patients had incomes below 200% of the Federal Poverty Guidelines, and 38% were uninsured. Health centers, including community health centers, migrant health centers, health care for the homeless programs, and public housing primary care programs, receive grant funding and enjoy other benefits due to status as federal grantees and designation as federally qualified health centers. Clinicians working in health centers are also eligible for financial and professional benefits because of their willingness to serve vulnerable populations and work in underserved areas. Midwives, midwifery students, and faculty working in, or interacting with, health centers need to be aware of the regulations that health centers must comply with in order to qualify for and maintain federal funding. This article provides an overview of health center regulations and policies affecting midwives, including health center program requirements, scope of project policy, provider credentialing and privileging, Federal Tort Claims Act malpractice coverage, the 340B Drug Pricing Program, and National Health Service Corps scholarship and loan repayment programs.

  3. Review Of Internet Health Information Quality Initiatives

    PubMed Central

    Dzenowagis, Joan

    2001-01-01

    Background The massive growth of health information on the Internet; the global nature of the Internet; the seismic shift taking place in the relationships of various actors in this arena, and the absence of real protection from harm for citizens who use the Internet for health purposes are seen to be real problems. One response to many of these problems has been the burgeoning output of codes of conduct by numerous organizations trying to address quality of health information. Objectives Review the major self-regulatory initiatives in the English-speaking world to develop quality and ethical standards for health information on the Internet. Compare and analyze the approaches taken by the different initiatives. Clarify the issues around the development and enforcement of standards. Methods Quality initiatives selected meet one or more of the following criteria: Self-regulatory. A reasonable constituency. Diversity (eg, of philosophy, approach and process)-to achieve balance and wide representation, and to illustrate and compare different approaches. Historic value. A wider reach than a national audience, except when its reach is a significant sector of the Internet health information industry. The initiatives were compared in 3 ways: (1) Analysis and comparison of: key concepts, mechanism, or approach. Analysis of: the obligations that a provider has to meet to comply with the given initiative, the intended beneficiaries of that initiative, and the burdens imposed on different actors. These burdens are described in terms of their effect on the long-term sustainability and maintenance of the initiative by its developers. Analysis of the enforcement mechanisms. (2) Analysis and comparison by type of sponsoring organization, the reach of the initiative, and the sources of funding of the initiative or the sponsoring organization. (3) How the various initiatives fall under 1 of 3 key mechanisms and comparison of the advantages and disadvantages of these key mechanisms

  4. Federating Clinical Data from Six Pediatric Hospitals: Process and Initial Results from the PHIS+ Consortium

    PubMed Central

    Narus, Scott P.; Srivastava, Rajendu; Gouripeddi, Ramkiran; Livne, Oren E.; Mo, Peter; Bickel, Jonathan P.; de Regt, David; Hales, Joseph W.; Kirkendall, Eric; Stepanek, Richard L.; Toth, Jamie; Keren, Ron

    2011-01-01

    Integrating clinical data with administrative data across disparate electronic medical record systems will help improve the internal and external validity of comparative effectiveness research. The Pediatric Health Information System (PHIS) currently collects administrative information from 43 pediatric hospital members of the Child Health Corporation of America (CHCA). Members of the Pediatric Research in Inpatient Settings (PRIS) network have partnered with CHCA and the University of Utah Biomedical Informatics Core to create an enhanced version of PHIS that includes clinical data. A specialized version of a data federation architecture from the University of Utah (“FURTHeR”) is being developed to integrate the clinical data from the member hospitals into a common repository (“PHIS+”) that is joined with the existing administrative data. We report here on our process for the first phase of federating lab data, and present initial results. PMID:22195159

  5. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally qualified health center services. 405.2462 Section 405.2462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic...

  6. Hurricane Katrina and the need for changes in the federal funding of disaster mental health.

    PubMed

    Weems, Carl F

    2010-01-01

    Recent findings showing chronic post-traumatic stress disorder and other mental health symptoms in individuals exposed to Hurricane Katrina cogently argues for changes in the federal funding of mental health following disasters. This commentary discusses the evidence for protracted high rates of mental health problems in both adults and children following Katrina. The limitations to current mental health funding legislation post-disaster are noted, and initial suggestions for additional disaster-related mental health funding programs are made.

  7. Health Policy Formulation on a Federal Level, Process and Substance.

    ERIC Educational Resources Information Center

    Stambler, Moses

    Factors which influence the federal government's policy toward health care include cost, technology, social values, federalism, interest group politics, increased federal involvement, and the current utilitarian attitude toward research. The interaction of these factors results in a complex process of policy formation. For example, when the…

  8. 77 FR 18266 - Meeting of the Department of Justice Global Justice Information Sharing Initiative Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Office of Justice Programs Meeting of the Department of Justice Global Justice Information Sharing Initiative Federal Advisory Committee AGENCY: Office of Justice Programs (OJP), Justice. ACTION: Notice...

  9. 76 FR 54498 - Meeting of the Department of Justice Global Justice Information Sharing Initiative Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-01

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF JUSTICE Office of Justice Programs Meeting of the Department of Justice Global Justice Information Sharing Initiative Federal Advisory Committee AGENCY: Office of Justice Programs (OJP), Justice. ACTION: Notice...

  10. 76 FR 13226 - Meeting of the Department of Justice Global Justice Information Sharing Initiative Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-10

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Office of Justice Programs Meeting of the Department of Justice Global Justice Information Sharing Initiative Federal Advisory Committee AGENCY: Office of Justice Programs (OJP), Justice. ACTION: Notice...

  11. Federal Data Bases for Health Education Research.

    ERIC Educational Resources Information Center

    Wilson, Ronald; Iverson, Donald

    1982-01-01

    Described are some of the national health related databases which are useful in conducting health education research. Among areas covered by the projects are hypertension, myocardial infarction, neighborhood health centers, alcoholism, and over the counter drugs. (CJ)

  12. 78 FR 17232 - Meeting of the Global Justice Information Sharing Initiative Federal Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-20

    ... of Justice Programs Meeting of the Global Justice Information Sharing Initiative Federal Advisory... announcement of a meeting of the Global Justice Information Sharing Initiative (Global) Federal Advisory Committee (GAC) to discuss the Global Initiative, as described at www.it.ojp.gov/global . DATES: The...

  13. The historical development of federal involvement in health care.

    PubMed

    Cimini, T A; Wong, A

    1979-01-01

    In this historical summary of the federal role in health care, three time periods are described: 1) the late 1700's to 1940; 2) 1941 to 1964; and, 3) 1965 to the present. Significant legislation and federal programs are reviewed. The purpose of this overview is to provide health professionals with an historical perspective and to increase their knowledge of current and future events in the rapidly changing health care delivery system in the United States.

  14. Group Health Cooperative's community services initiative.

    PubMed

    Hildebrandt, K M; Beery, W L; Pearson, D C

    1993-12-01

    Service to the broader community is an important component of Group Health Cooperative's (GHC's) tradition, values, and mission. The role and potential of community services in a staff model HMO requires consensus, careful planning and communication, and attention to results. This paper describes GHC's efforts to define, implement, and sustain its community services initiative.

  15. Civil Wrongs: Federal Equity Initiative Promotes Paperwork, Not Equality

    ERIC Educational Resources Information Center

    Melnick, R. Shep

    2016-01-01

    In October 2014, U.S. secretary of education Arne Duncan announced the Obama administration's new "education equity initiative," explaining that the president could not "continue to wait" for Congress to act "on behalf of vulnerable children." The centerpiece of this initiative was a 37-page "Dear Colleague"…

  16. Comparative federal health care policy: evidence of collaborative federalism in Pakistan and Venezuela.

    PubMed

    Baracskay, Daniel

    2013-01-01

    Collaborative federalism has provided an effective analytical foundation for understanding how complex public policies are implemented in federal systems through intergovernmental and intersectoral alignments. This has particularly been the case in issue areas like public health policy where diseases are detected and treated at the local level. While past studies on collaborative federalism and health care policy have focused on federal systems that are largely democratic, little research has been conducted to examine the extent of collaboration in authoritarian structures. This article applies the collaborative federalism approach to the Islamic Republic of Pakistan and the Bolivarian Republic of Venezuela. Evidence suggests that while both nations have exhibited authoritarian governing structures, there have been discernible policy areas where collaborative federalism is embraced to facilitate the implementation process. Further, while not an innate aspect of their federal structures, Pakistan and Venezuela can potentially expand their use of the collaborative approach to successfully implement health care policy and the epidemiological surveillance and intervention functions. Yet, as argued, this would necessitate further development of their structures on a sustained basis to create an environment conducive for collaborative federalism to flourish, and possibly expand to other policy areas as well.

  17. Comparative federal health care policy: evidence of collaborative federalism in Pakistan and Venezuela.

    PubMed

    Baracskay, Daniel

    2013-01-01

    Collaborative federalism has provided an effective analytical foundation for understanding how complex public policies are implemented in federal systems through intergovernmental and intersectoral alignments. This has particularly been the case in issue areas like public health policy where diseases are detected and treated at the local level. While past studies on collaborative federalism and health care policy have focused on federal systems that are largely democratic, little research has been conducted to examine the extent of collaboration in authoritarian structures. This article applies the collaborative federalism approach to the Islamic Republic of Pakistan and the Bolivarian Republic of Venezuela. Evidence suggests that while both nations have exhibited authoritarian governing structures, there have been discernible policy areas where collaborative federalism is embraced to facilitate the implementation process. Further, while not an innate aspect of their federal structures, Pakistan and Venezuela can potentially expand their use of the collaborative approach to successfully implement health care policy and the epidemiological surveillance and intervention functions. Yet, as argued, this would necessitate further development of their structures on a sustained basis to create an environment conducive for collaborative federalism to flourish, and possibly expand to other policy areas as well. PMID:24350551

  18. 77 FR 46425 - Federal Advisory Committee; Defense Health Board Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-03

    ... of the Secretary Federal Advisory Committee; Defense Health Board Meeting AGENCY: Department of Defense (DoD). ACTION: Notice of meeting. SUMMARY: Pursuant to the Federal Advisory Committee Act of 1972... amended), and 41 CFR 102-3.150, and in accordance with section 10(a)(2) of Public Law, a meeting of...

  19. The National Federation of Families for Children's Mental Health

    ERIC Educational Resources Information Center

    Brown, Corey

    2011-01-01

    This article outlines the mission and vision of the National Federation of Families for Children's Mental Health and its history and accomplishments in the family movement. It gives examples of how the National Federation is leading the way for positive, collaborative, and engaging training; as well as research and advocacy. Five core principles…

  20. The effects of inflation on federal health spending.

    PubMed

    Russell, L B

    1975-09-01

    This paper examines the effects of inflation on the expenditures made by federal health programs, in total and by functional category. Over the period 1969-74, a total increase of more than 90 per cent in federal dollars was required to support real growth of 44 per cent. Federally financed service programs, like Medicare and Medicaid, and health manpower training programs made particularly large gains, while construction support for health care facilities lost substantially in real terms. Health research and prevention and control programs made more moderate real gains-25 and 29 per cent, respectively, over the period. Comparison of inflation rates in the health sector and in the economy generally suggest that there are important inflationary forces specific to that sector; policies to stem general inflation cannot be expected to solve the problem of health sector inflation.

  1. Finding Funding: A Guide to Federal Sources for Workforce Development Initiatives. Finding Funding Series

    ERIC Educational Resources Information Center

    Relave, Nannette

    2005-01-01

    This guide provides an overview of strategies for gaining access to and using federal funds, as well as a catalog of 87 funding sources that can potentially support workforce development initiatives for adults and youth. It is intended to help program developers, policy makers, and initiative leaders identify federal funding sources to support…

  2. The federal environmental health workforce in the United States.

    PubMed Central

    Sexton, K; Perlin, S A

    1990-01-01

    This paper summarizes existing data on the size and composition of the federal environmental health workforce, delineates the major categories of activities carried out by its members, identifies current and emerging issues that are likely to affect workforce activities, and makes qualitative inferences about future trends and directions. Findings suggest that there is a current and future need for more and better qualified professionals in the federal environmental health workforce. PMID:2368849

  3. Federal civil rights policy and mental health treatment access for persons with limited English proficiency.

    PubMed

    Snowden, Lonnie R; Masland, Mary; Guerrero, Rachel

    2007-01-01

    As noted in the supplement to the U.S. Surgeon General's report on mental health (U.S. Department of Health and Human Services, 2001), overcoming language access barriers associated with limited English proficiency (LEP) should help to eliminate racial and ethnic disparities in mental health care access and quality. Federal policy requires remedial action to overcome language barriers: Under Title VI of the Civil Rights Act of 1964, Medicaid and other federally funded programs must provide assistance to LEP persons. Some state-level public and mental health authorities have responded by instituting "threshold language" policies. The history and terms of federal civil rights policy, and of threshold-language-policy-inspired initiatives, should be understood by everyone concerned with overcoming ethnic disparities in mental health services use. Concerned parties should promote implementation of required measures for language assistance and help to evaluate their implementation and effectiveness.

  4. Quality Enhancement Research Initiative in Mental Health.

    PubMed

    Fischer, E P; Marder, S R; Smith, G R; Owen, R R; Rubenstein, L; Hedrick, S C; Curran, G M

    2000-06-01

    The Veterans Administration (VA) recently introduced its Quality Enhancement Research Initiative (QUERI) to facilitate the translation of best practices into usual clinical care. The Mental Health QUERI (MHQ) was charged with developing strategic plans for major depressive disorder (MDD) and schizophrenia. Twenty percent or more of VA service users are affected by 1 of these 2 disorders, disorders that often have a devastating impact on affected individuals. Despite the increasing availability of efficacious treatments for each disorder, substantial gaps remain between best practices and routine care. In this context, the MHQ identified steps critical to the success of a sustained process of rapid-cycle health care improvement for MDD and schizophrenia, including research initiatives to close gaps in knowledge of best treatment practices, demonstration projects to close gaps in practice and to expand understanding of effective strategies for implementing clinical guidelines, targeted enhancements of the VA information system, and research and dissemination initiatives to increase the availability of resources to support the accelerated incorporation of best practices into routine care. This article presents an overview of the elements in the initial MHQ strategic plans and the rationale behind them.

  5. 78 FR 54923 - Federal Advisory Council on Occupational Safety and Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... occupational safety and health, particularly as it pertains to the federal workforce; and 6. A statement that... responsibility for occupational safety and health matters involving the federal workforce; experience and... Occupational Safety and Health Administration Federal Advisory Council on Occupational......

  6. Federal Funding for Health Security in FY2017.

    PubMed

    Boddie, Crystal; Watson, Matthew; Sell, Tara Kirk

    2016-01-01

    This latest article in the Federal Funding for Health Security series assesses FY2017 US government funding in 5 domains critical to strengthening health security: biosecurity, radiological and nuclear security, chemical security, pandemic influenza and emerging infectious disease, and multiple-hazard and general preparedness. PMID:27575382

  7. Managing Evaluation in a Federal Public Health Setting

    ERIC Educational Resources Information Center

    Schooley, Michael W.

    2009-01-01

    The author, a federal manager who leads development and maintenance of evaluation for specific public health programs at the Centers for Disease Control and Prevention, tells the story of developing an evaluation unit in the Office on Smoking and Health. Lessons about managing evaluation, including his practices and related principles, are…

  8. Standards for Teaching about the Federal Reserve System: An Initiative by Two Federal Reserve Banks

    ERIC Educational Resources Information Center

    Bosshardt, William D.; Grimes, Paul W.; Suiter, Mary C.

    2011-01-01

    In the fall of 2008, the Federal Reserve Banks of Atlanta and St. Louis began a systematic evaluation of their economic and personal finance educational outreach programs. Both banks were interested in developing tools to assess the success of their existing economic and financial education programs. However, before any assessment could begin, a…

  9. Designing Work, Family & Health Organizational Change Initiatives

    PubMed Central

    Hammer, Leslie B.; Kelly, Erin L.; Moen, Phyllis

    2014-01-01

    Executive Summary For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win–win for productivity and employees’ well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today’s U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor. PMID:24683279

  10. Health System Leadership and the Federal Role in Canada.

    PubMed

    Marchildon, Gregory P

    2014-01-01

    While provincial governments constitute the primary locus for healthcare system decision-making and provision, the federal government retains an important funding and "steering" role in directing health system performance. This commentary explores three possible redeployments of the federal spending power to elevate health system performance; improve access; increase individual, provincial and regional equity; and achieve better health outcomes for present and future Canadians. The proposals include amending the Canada Health Transfer to better support its original policy purpose, improving and expanding an informational and analytical infrastructure and the eventual implementation of single pharmacare program by the Government of Canada. These changes are aimed at accelerating evidence-based health reforms to improve access, quality and responsiveness of healthcare and, ultimately, health outcomes.

  11. Research, policy, and the federal role in prevention initiatives for children.

    PubMed

    Ripple, Carol H; Zigler, Edward

    2003-01-01

    With the ability and the funds to implement programs on a national level, federal policy is a potentially potent tool in primary prevention. Despite the U.S. government's history of ambivalence toward intervening in child rearing and limited national support for primary prevention, several initiatives have been implemented for children and families with some measure of success. The successes, however, are mitigated by limitations of the initiatives themselves and by the inconclusive nature of much of the evaluation data. This review of 5 federal policy-based initiatives for children and families provides the backdrop for discussing aspects of federal prevention program design, implementation, policy, and research.

  12. Research, Policy, and the Federal Role in Prevention Initiatives for Children.

    ERIC Educational Resources Information Center

    Ripple, Carol H.; Zigler, Edward

    2003-01-01

    Reviews five federal policy-based initiatives for children and families (Project Head Start; lead poisoning prevention; Medicaid; Special Supplemental Program for Women, Infants, and Children; and Earned Income Tax Credit), discussing aspects of federal prevention program design, implementation, policy, and research. (Contains references.) (SM)

  13. 77 FR 58412 - Meeting of the Global Justice Information Sharing Initiative Federal Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Office of Justice Programs Meeting of the Global Justice Information Sharing Initiative Federal Advisory Committee AGENCY: Office of Justice Programs (OJP), Justice. ACTION: Notice of meeting. SUMMARY: This is...

  14. Reproductive health research in China: the Ford Foundation initiatives.

    PubMed

    Chu, C

    1994-08-01

    Increasing demographic and epidemiological evidence shows that maternal health problems are widespread and are linked to social, cultural, and economic factors, in particular, to women's status in society. Thus, there is an urgent need to expand existing knowledge about these influences on reproductive health and to empower women to gain control over them. To this end, there is a need for a comprehensive, interdisciplinary approach with an emphasis on social science research and training. The Ford Foundation, after an extensive review of its work in population and development, embarked on a new, ten-year, comprehensive reproductive health program for the 1990s. This paper describes one component of that program, a partnership with the All China Women's Federation to sponsor a series of reproductive health research activities. It examines the development and evaluates the positive and negative outcomes of the project, which commenced in 1991, from the perspective of a consultant involved in the process. So far, the project has generated interest in reproductive health in at least twenty-one Chinese provinces and has fostered a real partnership between the sponsoring and the collaborating agency. Based on the immediate outcomes of a research competition designed to identify research projects and investigators, of participant evaluation of the methodology training course, and of the strategies aimed at building capabilities and strengthening institutions in order to ensure future success, I conclude that the Ford Foundation's reproductive health initiative in China is a worthwhile and sustainable project.

  15. Rural health network development: public policy issues and state initiatives.

    PubMed

    Casey, M M; Wellever, A; Moscovice, I

    1997-02-01

    Rural health networks are a potential way for rural health care systems to improve access to care, reduce costs, and enhance quality of care. Networks provide a means for rural providers to contract with managed care organizations, develop their own managed care entities, share resources, and structure practice opportunities to support recruitment and retention of rural physicians and other health care professionals. The results of early network development initiatives indicate a need for state officials and others interested in encouraging network development to agree on common rural health network definitions, to identify clearly the goals of network development programs, and to document and analyze program outcomes. Future network development efforts need to be much more comprehensive if they are to have a significant impact on rural health care. This article analyzes public policy issues related to integrated rural health network development, discusses current efforts to encourage network development in rural areas, and suggests actions that states may take if they desire to support rural health network development. These actions include adopting a formal rural health network definition, providing networks with alternatives to certain regulatory requirements, and providing incentives such as matching grants, loans, or technical assistance. Without public sector support for networks, managed care options may continue to be unavailable in many less densely populated rural areas of the country, and locally controlled rural health networks are unlikely to develop as an alternative to the dominant pattern of managed care expansion by large urban entities. Implementation of Medicare reform legislation could provide significant incentives for the development of rural health networks, depending on the reimbursement provisions, financial solvency standards, and antitrust exemptions for provider-sponsored networks in the final legislation and federal regulations. PMID

  16. Federal Health Care Planning: Impact on the Student Health Center.

    ERIC Educational Resources Information Center

    Bogen, Gerald K.

    1978-01-01

    Major proposals for national health insurance are surveyed with regard to the alternative impacts on the student health center enterprise, and suggestions are made for preparing for and directing the impact. (Author/DS)

  17. 77 FR 58174 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of FACOSH meeting. SUMMARY: The Federal Advisory Council on Occupational Safety and Health (FACOSH)...

  18. 78 FR 68865 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of FACOSH meeting. SUMMARY: The Federal Advisory Council on Occupational Safety and Health (FACOSH)...

  19. Federal Funding for Health Security in FY2015

    PubMed Central

    Sell, Tara Kirk; Watson, Matthew

    2014-01-01

    Previous articles in this series have provided funding information for federal civilian biodefense programs and programs focused on radiological and nuclear preparedness and consequence management. This year the authors have expanded the focus of the analysis to US federal funding for health security. This article provides proposed funding amounts for FY2015, estimated amounts for FY2014, and actual amounts for FY2010 through FY2013 in 5 domains critical to health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. PMID:24988432

  20. Early experience with 'new federalism' in health insurance regulation.

    PubMed

    Pollitz, K; Tapay, N; Hadley, E; Specht, J

    2000-01-01

    The authors monitored the implementation of the Health Insurance Portability and Accountability Act (HIPAA) from 1997 to 1999. Regulators in all states and relevant federal agencies were interviewed and applicable laws and regulations studied. The authors found that HIPAA changed legal protections for consumers' health coverage in several ways. They examine how the process of regulating such coverage was affected at the state and federal levels and under an emerging partnership of the two. Despite some early implementation challenges, HIPAA's successes have been significant, although limited by the law's incremental nature.

  1. Implementing insurance market reforms under the federal health reform law.

    PubMed

    Nichols, Len M

    2010-06-01

    Lost in the rhetoric about the supposed government takeover of health care is an appreciation of the inherently federalist approach of the Patient Protection and Affordable Care Act. This federalist tradition, particularly with regard to health insurance, has a history that dates back at least to the 1940s. The new legislation broadens federal power and oversight considerably, but it also vests considerable new powers and responsibilities in the states. The precedents and examples it follows will guide federal and state policy makers, stakeholders, and ordinary citizens as they breathe life into the new law. The challenges ahead are formidable, and the greatest ones are likely to be political.

  2. Federal funding for health security in FY2015.

    PubMed

    Boddie, Crystal; Sell, Tara Kirk; Watson, Matthew

    2014-01-01

    Previous articles in this series have provided funding information for federal civilian biodefense programs and programs focused on radiological and nuclear preparedness and consequence management. This year the authors have expanded the focus of the analysis to US federal funding for health security. This article provides proposed funding amounts for FY2015, estimated amounts for FY2014, and actual amounts for FY2010 through FY2013 in 5 domains critical to health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. PMID:24988432

  3. Federal disaster mental health response and compliance with best practices.

    PubMed

    McIntyre, Jody; Nelson Goff, Briana S

    2012-12-01

    This study investigated the comprehensiveness of disaster mental health state plans and their adherence to published best practices in three states that experienced post-9/11 federally-declared disasters. There were 59 disaster mental health best practices used in this study to assess each state disaster mental plan's compliance with best practices; the states demonstrated a range of adherence to the best practices. This research may serve as a guide for those developing disaster mental health plans and encourage further considerations in disaster mental health response.

  4. [Congressional amendments to the Brazilian Federal health budget].

    PubMed

    Baptista, Tatiana Wargas de Faria; Machado, Cristiani Vieira; Lima, Luciana Dias de; Garcia, Marcia; Andrade, Carla Lourenço Tavares de; Gerassi, Camila Duarte

    2012-12-01

    The public budget in Brazil has undergone significant changes since enactment of the 1988 Federal Constitution. Mechanisms for integration of planning activities and budget execution have been created, and Legislative participation in budgeting has increased. Congressional amendments appeared in this context. The article discusses the participation of Congressional amendments in the Federal health budget from 1997 to 2006, combining elements for discussion of funding mechanisms and health planning. Such amendments played a significant role in the budget process, accounting for over half of health funds in some years. The North was the region of Brazil that received most resources resulting from Congressional amendments, suggesting the need for further studies on the relationship between the amendments' enforcement and political party coalitions. The article concludes that the amendments cannot be understood solely as a funding mechanism, but mainly as a political instrument, and that they are not necessarily subject to health planning logic. PMID:23288060

  5. [Congressional amendments to the Brazilian Federal health budget].

    PubMed

    Baptista, Tatiana Wargas de Faria; Machado, Cristiani Vieira; Lima, Luciana Dias de; Garcia, Marcia; Andrade, Carla Lourenço Tavares de; Gerassi, Camila Duarte

    2012-12-01

    The public budget in Brazil has undergone significant changes since enactment of the 1988 Federal Constitution. Mechanisms for integration of planning activities and budget execution have been created, and Legislative participation in budgeting has increased. Congressional amendments appeared in this context. The article discusses the participation of Congressional amendments in the Federal health budget from 1997 to 2006, combining elements for discussion of funding mechanisms and health planning. Such amendments played a significant role in the budget process, accounting for over half of health funds in some years. The North was the region of Brazil that received most resources resulting from Congressional amendments, suggesting the need for further studies on the relationship between the amendments' enforcement and political party coalitions. The article concludes that the amendments cannot be understood solely as a funding mechanism, but mainly as a political instrument, and that they are not necessarily subject to health planning logic.

  6. 75 FR 20314 - Federal Employees Health Benefits Program; Miscellaneous Changes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-19

    ... Health Benefits (FEHB) coverage for certain former Senate Restaurant employees who transferred to... INFORMATION: Background Senate Restaurants Employees Public Law 110-279, enacted July 17, 2008, provides for certain Federal employee benefits to be continued for certain employees of the Senate Restaurants...

  7. 20 CFR 636.8 - Initial and final determination; request for hearing at the Federal level.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Initial and final determination; request for hearing at the Federal level. 636.8 Section 636.8 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR COMPLAINTS, INVESTIGATIONS AND HEARINGS § 636.8 Initial and...

  8. 42 CFR 137.302 - Are Federal funds available to cover start-up costs associated with initial Tribal assumption of...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... associated with initial Tribal assumption of environmental responsibilities? 137.302 Section 137.302 Public... OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Nepa Process § 137.302 Are Federal funds available to cover start-up costs associated with initial Tribal assumption of...

  9. Federal mandatory spending caps vital for health care reform.

    PubMed

    Domenici, P V

    1992-01-01

    Rising health spending creates an increasing burden on families, businesses, and government. Federal health spending--chiefly on Medicare and Medicaid--is a major contributor to a budget deficit that threatens to exceed $400 billion. In order to control that deficit, the President and the Congress must cap mandatory spending, excluding Social Security. In turn, policymakers should adopt health reforms to fit spending within the cap including enrolling more consumers in managed care plans, resolving medical liability disputes in arbitration instead of courts, and increasing assessment of research into cost-effective new technology.

  10. Evaluating the federal role in financing health-related research.

    PubMed

    Garber, A M; Romer, P M

    1996-11-12

    This paper considers the appropriate role for government in the support of scientific and technological progress in health care; the information the federal government needs to make well-informed decisions about its role; and the ways that federal policy toward research and development should respond to scientific advances, technology trends, and changes in the political and social environment. The principal justification for government support of research rests upon economic characteristics that lead private markets to provide inappropriate levels of research support or to supply inappropriate quantities of the products that result from research. The federal government has two basic tools for dealing with these problems: direct subsidies for research and strengthened property rights that can increase the revenues that companies receive for the products that result from research. In the coming years, the delivery system for health care will continue to undergo dramatic changes, new research opportunities will emerge at a rapid pace, and the pressure to limit discretionary federal spending will intensify. These forces make it increasingly important to improve the measurement of the costs and benefits of research and to recognize the tradeoffs among alternative policies for promoting innovation in health care.

  11. Adoption and use of electronic health records among federally qualified health centers grew substantially during 2010-12.

    PubMed

    Jones, Emily B; Furukawa, Michael F

    2014-07-01

    Federally qualified health centers play an important role in providing health care to underserved populations. Recent substantial federal investments in health information technology have enabled health centers to expand their use of electronic health record (EHR) systems, but factors associated with adoption are not clear. We examined 2010-12 administrative data from the Health Resources and Services Administration's Uniform Data System for more than 1,100 health centers. We found that in 2012 nine out of ten health centers had adopted a EHR system, and half had adopted EHRs with basic capabilities. Seven in ten health centers reported that their providers were receiving meaningful-use incentive payments from the Centers for Medicare and Medicaid Services (CMS). Only one-third of health centers had EHR systems that could meet CMS's stage 1 meaningful-use core requirements. Health centers that met the stage 1 requirements had more than twice the odds of receiving quality recognition, compared with centers with less than basic EHRs. Policy initiatives should focus assistance on EHR capabilities with slower uptake; connect providers with technical assistance to support implementation; and leverage the connection between meaningful use and quality recognition programs.

  12. Adoption and use of electronic health records among federally qualified health centers grew substantially during 2010-12.

    PubMed

    Jones, Emily B; Furukawa, Michael F

    2014-07-01

    Federally qualified health centers play an important role in providing health care to underserved populations. Recent substantial federal investments in health information technology have enabled health centers to expand their use of electronic health record (EHR) systems, but factors associated with adoption are not clear. We examined 2010-12 administrative data from the Health Resources and Services Administration's Uniform Data System for more than 1,100 health centers. We found that in 2012 nine out of ten health centers had adopted a EHR system, and half had adopted EHRs with basic capabilities. Seven in ten health centers reported that their providers were receiving meaningful-use incentive payments from the Centers for Medicare and Medicaid Services (CMS). Only one-third of health centers had EHR systems that could meet CMS's stage 1 meaningful-use core requirements. Health centers that met the stage 1 requirements had more than twice the odds of receiving quality recognition, compared with centers with less than basic EHRs. Policy initiatives should focus assistance on EHR capabilities with slower uptake; connect providers with technical assistance to support implementation; and leverage the connection between meaningful use and quality recognition programs. PMID:25006154

  13. The New Knowledge Environment: Quality Initiatives in Health Sciences Libraries.

    ERIC Educational Resources Information Center

    Nagle, Ellen

    1996-01-01

    Reviews changes in health sciences libraries, including the evolving role of health sciences librarians, education and training of health sciences librarians, rethinking reference services, impact on quality health care, improving the value of information, virtual libraries, National Library of Medicine initiatives, and quality initiatives. (LRW)

  14. 75 FR 62147 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of meeting and member appointments. SUMMARY: The Federal Advisory Council on Occupational Safety and......

  15. Stroke findings in the Women's Health Initiative.

    PubMed

    Wassertheil-Smoller, Sylvia; Kaplan, Robert C; Salazar, Christian R

    2014-11-01

    The Women's Health Initiative (WHI) clinical trials of estrogen with or without progestin versus placebo in 27,341 postmenopausal women are the largest randomized, placebo-controlled, double-blind clinical trials to look at the effect of hormone therapy on the outcomes of stroke, dementia, and cognition. Data from a parallel prospective observational study of 93,676 women examine biomarkers and risk factors associated with stroke. We summarize the results of 29 published articles in the WHI with stroke or cognition as outcomes of interest. Estrogen alone or in combination with progestin resulted in approximately 50% excess risk of ischemic stroke and in a 76% excess risk of dementia in women 65 years or older. Other risk factors for stroke identified in the WHI were panic attacks, depression, use of antidepressants (particularly selective serotonin reuptake inhibitors for hemorrhagic but not ischemic stroke), high triglycerides, low walking speed, long sleep duration, certain inflammatory factors, and systolic blood pressure variability. Hormone therapy has adverse effects on the brain as manifested by higher risks of stroke and dementia. Additional risk factors for stroke identified in WHI should be followed up to determine if reversing them would result in lower stroke rates.

  16. Stroke findings in the Women's Health Initiative.

    PubMed

    Wassertheil-Smoller, Sylvia; Kaplan, Robert C; Salazar, Christian R

    2014-11-01

    The Women's Health Initiative (WHI) clinical trials of estrogen with or without progestin versus placebo in 27,341 postmenopausal women are the largest randomized, placebo-controlled, double-blind clinical trials to look at the effect of hormone therapy on the outcomes of stroke, dementia, and cognition. Data from a parallel prospective observational study of 93,676 women examine biomarkers and risk factors associated with stroke. We summarize the results of 29 published articles in the WHI with stroke or cognition as outcomes of interest. Estrogen alone or in combination with progestin resulted in approximately 50% excess risk of ischemic stroke and in a 76% excess risk of dementia in women 65 years or older. Other risk factors for stroke identified in the WHI were panic attacks, depression, use of antidepressants (particularly selective serotonin reuptake inhibitors for hemorrhagic but not ischemic stroke), high triglycerides, low walking speed, long sleep duration, certain inflammatory factors, and systolic blood pressure variability. Hormone therapy has adverse effects on the brain as manifested by higher risks of stroke and dementia. Additional risk factors for stroke identified in WHI should be followed up to determine if reversing them would result in lower stroke rates. PMID:25321421

  17. Federal Public Health Service: In Retrospect and Prospects.

    PubMed

    Kolbe, Lloyd J

    2016-10-01

    In this article, I offer a retrospective case study about my early, short-term work within the U.S. Office of the Assistant Secretary for Health and then my later, longer-term work within the U.S. Centers for Disease Control and Prevention, where I endeavored for two decades largely to help our nation's schools improve health and associated education outcomes. First, for context, I briefly portray the nature of our related political and public health systems. I then frame this retrospective by illustrating how my serial employment within other public health system organizations led to, and then resulted from, my work within these two federal public health agencies. To represent the many talented individuals in each organization with whom I had the good fortune to work, I name only one in each organization. I then characterize how these individuals and organizations progressively shaped my work and career. I conclude by speculating about prospects for academic institutions to more purposefully prepare students and faculty to work within federal government public health agencies.

  18. Federal Public Health Service: In Retrospect and Prospects.

    PubMed

    Kolbe, Lloyd J

    2016-10-01

    In this article, I offer a retrospective case study about my early, short-term work within the U.S. Office of the Assistant Secretary for Health and then my later, longer-term work within the U.S. Centers for Disease Control and Prevention, where I endeavored for two decades largely to help our nation's schools improve health and associated education outcomes. First, for context, I briefly portray the nature of our related political and public health systems. I then frame this retrospective by illustrating how my serial employment within other public health system organizations led to, and then resulted from, my work within these two federal public health agencies. To represent the many talented individuals in each organization with whom I had the good fortune to work, I name only one in each organization. I then characterize how these individuals and organizations progressively shaped my work and career. I conclude by speculating about prospects for academic institutions to more purposefully prepare students and faculty to work within federal government public health agencies. PMID:27585459

  19. Health expectancy in the Russian Federation: a new perspective on the health divide in Europe.

    PubMed Central

    Andreev, Evgueni M.; McKee, Martin; Shkolnikov, Vladimir M.

    2003-01-01

    OBJECTIVES: To compare life expectancy and healthy life expectancy in the Russian Federation and in countries of Eastern and Western Europe. METHODS: WHO mortality data and data on self-reported health from the World Values Survey and the Russian Longitudinal Monitoring Survey were used to compare the above three regions. Life expectancy was calculated using Sullivan's method, with years of life lived divided into healthy and unhealthy. The gap in healthy life expectancy between the Russian Federation and Western Europe was examined by decomposing the difference by gender and age. FINDINGS: The probability of remaining alive and healthy declines faster in the Russian Federation than in Western Europe, with the gap between Eastern Europe and the Russian Federation widening at older ages. In the Russian Federation, this rapid decline is due mainly to the high probability of death or of poor health for men and women, respectively. CONCLUSIONS: There is a large toll of premature male mortality in the Russian Federation but there also appears to be a substantial burden of ill-health among women. As in other countries, the responses of men and women to adversity differ, leading to premature death in men but survival in a poor state of health in women. Epidemiological studies including objective measures of health would help policy-makers to estimate more precisely the scale and nature of this problem. Policy-makers must recognize that health expectancy in the Russian Federation is reduced in both men and women. PMID:14758403

  20. Expanding Federal Funding to Community Health Centers Slows Decline in Access for Low-Income Adults

    PubMed Central

    McMorrow, Stacey; Zuckerman, Stephen

    2014-01-01

    Objective To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. Data Sources Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000–2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001–2008). Study Design We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. Data Collection We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. Principal Findings Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults. Conclusions Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. PMID:24344818

  1. 42 CFR 405.2469 - Federally Qualified Health Centers supplemental payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural... they would receive under the cost-based Federally Qualified Health Center payment system. (a... per visit basis; and (ii) The Federally Qualified Health Center's all-inclusive cost-based per...

  2. 42 CFR 405.2469 - Federally Qualified Health Centers supplemental payments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural... they would receive under the cost-based Federally Qualified Health Center payment system. (a... per visit basis; and (ii) The Federally Qualified Health Center's all-inclusive cost-based per...

  3. 77 FR 10695 - Federal Housing Administration (FHA) Risk Management Initiatives: Revised Seller Concessions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... URBAN DEVELOPMENT 24 CFR Chapter II Federal Housing Administration (FHA) Risk Management Initiatives...) the capital ratio of the MMIF; and (5) FHA risk management. Each one of these five statutory grounds... allowable amount of seller concessions is part of FHA's ongoing risk management practices. FHA is a...

  4. 78 FR 8551 - Federal Housing Administration (FHA) Risk Management Initiatives: Changes to Maximum Loan-to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ... URBAN DEVELOPMENT Federal Housing Administration (FHA) Risk Management Initiatives: Changes to Maximum... effectively manage financial risk. As a result, FHA has been continually evaluating its portfolio to identify and respond to risks in ways that benefit the Fund and, ultimately, consumers and taxpayers....

  5. 78 FR 73518 - Notice Inviting Suggestions for New Experiments for the Experimental Sites Initiative; Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... and academic success, result in shorter time to degree, and reduce student loan indebtedness. Based on... reduce reliance on student loans. Subject to the statutory restrictions and limitations of the Secretary... Notice Inviting Suggestions for New Experiments for the Experimental Sites Initiative; Federal...

  6. Finding Funding: A Guide to Federal Sources for Asset-Building Initiatives. Finding Funding Series

    ERIC Educational Resources Information Center

    Lind, Christianne; Relave, Nanette; Schmid, William; Terzaghi, Damon

    2009-01-01

    This guide outlines strategies for financing asset-building initiatives and provides information on 71 federal funding sources that can be used to support a range of activities and services. It includes well-known sources of funding for asset building, for example, the Assets for Independence Demonstration Program and the Family Self-Sufficiency…

  7. Education Reform: Federal Initiatives and National Mandates, 1963-1993. Occasional Paper 1993-3.

    ERIC Educational Resources Information Center

    Levitan, Sar A.; Gallo, Frank

    The federal government initiated educational reform measures in the United States long before the subject became a matter of national concern. In recent decades, reform has focused on helping children whose special needs were neglected by the school system. Evidence shows that these efforts have improved services to neglected groups, but without…

  8. 77 FR 11798 - Federal Housing Administration (FHA) Risk Management Initiatives: Revised Seller Concessions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-28

    ... methods for submitting public comments. All submissions must refer to the docket number (FR-5572-N-01) and... URBAN DEVELOPMENT 24 CFR Chapter II Federal Housing Administration (FHA) Risk Management Initiatives: Revised Seller Concessions; Addresses for the Submission of Public Comments AGENCY: Office of...

  9. Intergovernmental relations in physician education and health planning: state adoption decisions and the impact of federal programs.

    PubMed

    Durand, R; Nelson, S L; Patel, K

    1982-10-01

    This study seeks to explain states' adoptions of programs in health planning and in physician education. It also seeks to further understanding of the impact of federal health planning and education programs on the states. Several theories and models are employed in analyzing the actions of state decision-makers. These include incremental theory, models of the diffusion of innovations, economic resources theory, and a theory of competitive partisanship. The data utilized in this research were principally derived from intensive interviews with "key" state actors and from historical, documentary materials. Only minimal federal impact appears on states' goals in physician education and health planning. Rather, there is evidence of considerable innovativeness among the states prior to Federal program initiatives. A problem-generated search for solutions seems to be a major source of this innovation. Finally, federal program implementation requirements appear to be a major source of federal--state conflict and opposition.

  10. Registration requirements within the German Federal Health Office.

    PubMed

    Lingk, W

    1985-02-01

    Public health authorities responsible for consumer protection in connection with the use of chemical products are faced with several conflicting requirements. In addition to the primary requirements of protecting human health and assessing the balance between benefits and risks, the authorities are faced with the need to identify appropriate tests, to avoid unnecessary testing in experimental animals, to adapt existing test guidelines in the light of new technological and scientific developments and to make optimal use of the facilities and expertise available. Among the measures being taken by the German Federal Health Office to resolve these difficulties, particularly in connection with the testing of chemicals for skin and eye irritancy, are the evaluation of alternatives to animal tests, the encouragement of more effective screening and use of existing test results, promotion of the international exchange of test data, and support for proposed changes in the use of the Draize test.

  11. [Use of routine data from statutory health insurances for federal health monitoring purposes].

    PubMed

    Ohlmeier, C; Frick, J; Prütz, F; Lampert, T; Ziese, T; Mikolajczyk, R; Garbe, E

    2014-04-01

    Federal health monitoring deals with the state of health and the health-related behavior of populations and is used to inform politics. To date, the routine data from statutory health insurances (SHI) have rarely been used for federal health monitoring purposes. SHI routine data enable analyses of disease frequency, risk factors, the course of the disease, the utilization of medical services, and mortality rates. The advantages offered by SHI routine data regarding federal health monitoring are the intersectoral perspective and the nearly complete absence of recall and selection bias in the respective population. Further, the large sample sizes and the continuous collection of the data allow reliable descriptions of the state of health of the insurants, even in cases of multiple stratification. These advantages have to be weighed against disadvantages linked to the claims nature of the data and the high administrative hurdles when requesting the use of SHI routine data. Particularly in view of the improved availability of data from all SHI insurants for research institutions in the context of the "health-care structure law", SHI routine data are an interesting data source for federal health monitoring purposes.

  12. Federalism and health policy: the intergovernmental committees in Brazil

    PubMed Central

    Machado, Cristiani Vieira; de Lima, Luciana Dias; Viana, Ana Luiza d'Ávila; de Oliveira, Roberta Gondim; Iozzi, Fabíola Lana; de Albuquerque, Mariana Vercesi; Scatena, João Henrique Gurtler; Mello, Guilherme Arantes; Pereira, Adelyne Maria Mendes; Coelho, Ana Paula Santana

    2014-01-01

    OBJECTIVE To analyze the dynamics of operation of the Bipartite Committees in health care in the Brazilian states. METHODS The research included visits to 24 states, direct observation, document analysis, and performance of semi-structured interviews with state and local leaders. The characterization of each committee was performed between 2007 and 2010, and four dimensions were considered: (i) level of institutionality, classified as advanced, intermediate, or incipient; (ii) agenda of intergovernmental negotiations, classified as diversified/restricted, adapted/not adapted to the reality of each state, and shared/unshared between the state and municipalities; (iii) political processes, considering the character and scope of intergovernmental relations; and (iv) capacity of operation, assessed as high, moderate, or low. RESULTS Ten committees had advanced level of institutionality. The agenda of the negotiations was diversified in all states, and most of them were adapted to the state reality. However, one-third of the committees showed power inequalities between the government levels. Cooperative and interactive intergovernmental relations predominated in 54.0% of the states. The level of institutionality, scope of negotiations, and political processes influenced Bipartite Committees’ ability to formulate policies and coordinate health care at the federal level. Bipartite Committees with a high capacity of operation predominated in the South and Southeast regions, while those with a low capacity of operations predominated in the North and Northeast. CONCLUSIONS The regional differences in operation among Bipartite Interagency Committees suggest the influence of historical-structural variables (socioeconomic development, geographic barriers, characteristics of the health care system) in their capacity of intergovernmental health care management. However, structural problems can be overcome in some states through institutional and political changes. The creation

  13. 76 FR 38281 - Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    .... Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated Plans... 3206-AM39 Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated... appeared in the Federal Register of June 23, 2011 (76 FR 36857). The document amends the Federal...

  14. Health Promoting Schools: Initiatives in Africa

    ERIC Educational Resources Information Center

    Macnab, Andrew J.; Stewart, Donald; Gagnon, Faith A.

    2014-01-01

    Purpose: The purpose of this paper is to describe the rationale for and potential of World Health Organization (WHO) health promoting schools (HPS) in Africa. Design/Methodology/Approach: Overview of the related literature and presentations at the 2011 Stellenbosch international colloquium on HPS relating to sub-Saharan Africa. Findings: Schools…

  15. Integrated Mission Simulation (IMSim): Multiphase Initialization Design with Late Joiners, Rejoiners and Federation Save & Restore

    NASA Technical Reports Server (NTRS)

    Dexter, Daniel E.; Varesic, Tony E.

    2015-01-01

    This document describes the design of the Integrated Mission Simulation (IMSim) federate multiphase initialization process. The main goal of multiphase initialization is to allow for data interdependencies during the federate initialization process. IMSim uses the High Level Architecture (HLA) IEEE 1516 [1] to provide the communication and coordination between the distributed parts of the simulation. They are implemented using the Runtime Infrastructure (RTI) from Pitch Technologies AB. This document assumes a basic understanding of IEEE 1516 HLA, and C++ programming. In addition, there are several subtle points in working with IEEE 1516 and the Pitch RTI that need to be understood, which are covered in Appendix A. Please note the C++ code samples shown in this document are for the IEEE 1516-2000 standard.

  16. ["Podmoskovie"--health resort institution of the Federal Drug Control Service of the Russian Federation celebrates the 20th anniversary].

    PubMed

    Bondar', I V; Minaev, D Iu; Nasretdinov, I N; Petukhov, A E

    2014-12-01

    The article is dedicated to the 20th anniversary of the Federal government health resort institution of the Federal Drug Control Service of the Russian Federation (FGI "Health resort "Podmoskovie" of the Federal Drug Control Service of the Russian Federation). In this health resort were developed treatment programs for patients with abnormalities of the cardiovascular, respiratory and digestive systems; methods of ultrasonic, laser and magnetic therapy, atmospheric hypoxic, herbal medicine, speleotherapy are employed. Widely used natural healing factors of Ruza district of the Moscow region such as climate therapy, treatment with mineral water group of X type of Smolensk from own wells and balneo-mudtherapy. Over the past 20 years 70 000 patients received an appropriate treatment in this health resort.

  17. [Art, health and prevention: initial collaborations].

    PubMed

    Avila, Noemí; Orellana, Ana; Cano, Marta G; Antúnez, Noelia; Claver, Dolores

    2014-01-01

    This article presents a summary of the first 2 years of the collaboration between the Faculty of Fine Arts of the Universidad Complutense in Madrid and Madrid Health, an autonomous organism of Madrid Council. This collaboration has allowed the development of joint experiences and projects among distinct professionals with highly diverse profiles: health professionals (sexologists, psychiatrists, nurses, etc.), and teachers, researchers, artists and students in the Faculty of Fine Arts. As a result, these experiences could be the beginning of future collaborations between the arts, health and prevention.

  18. Recent health policy initiatives in Nordic countries

    PubMed Central

    Saltman, Richard B.

    1992-01-01

    Health care systems in Sweden, Finland, and Denmark are in the midst of substantial organizational reconfiguration. Although retaining their tax-based single source financing arrangements, they have begun experiments that introduce a limited measure of competitive behavior in the delivery of health services. The emphasis has been on restructuring public operated hospitals and health centers into various forms of public firms, rather than on the privatization of ownership of institutions. If successful, the reforms will enable these Nordic countries to combine their existing macroeconomic controls with enhanced microeconomic efficiency, effectiveness, and responsiveness to patients. PMID:10122003

  19. [Art, health and prevention: initial collaborations].

    PubMed

    Avila, Noemí; Orellana, Ana; Cano, Marta G; Antúnez, Noelia; Claver, Dolores

    2014-01-01

    This article presents a summary of the first 2 years of the collaboration between the Faculty of Fine Arts of the Universidad Complutense in Madrid and Madrid Health, an autonomous organism of Madrid Council. This collaboration has allowed the development of joint experiences and projects among distinct professionals with highly diverse profiles: health professionals (sexologists, psychiatrists, nurses, etc.), and teachers, researchers, artists and students in the Faculty of Fine Arts. As a result, these experiences could be the beginning of future collaborations between the arts, health and prevention. PMID:25156001

  20. Women's Health Initiative (WHI) Background and Overview

    MedlinePlus

    ... disease, cancer and osteoporosis. A Community Prevention Study (CPS), a 5-year cooperative venture with CDC, was ... a multi-disciplinary approach. The purpose of the CPS was to develop community-based public health interventions ...

  1. 76 FR 17419 - Federal Health IT Strategic Plan: 2011-2015 Open Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... HUMAN SERVICES Federal Health IT Strategic Plan: 2011-2015 Open Comment Period AGENCY: Office of the... the Federal Health IT Strategic Plan (developed June 3, 2008) in consultation with other appropriate... the Federal Health IT Strategic Plan is open through Friday, April 22 at 11:59 p.m. (Eastern)....

  2. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Federal Coal Mine Health and Safety Act... OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Insurance Contracts § 726.203 Federal Coal Mine Health...

  3. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Federal Coal Mine Health and Safety Act... LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Insurance Contracts § 726.203 Federal Coal Mine Health and Safety...

  4. Enabling Quality: Electronic Health Record Adoption and Meaningful Use Readiness in Federally Funded Health Centers.

    PubMed

    Wittie, Michael; Ngo-Metzger, Quyen; Lebrun-Harris, Lydie; Shi, Leiyu; Nair, Suma

    2016-01-01

    The Health Resources and Services Administration has supported the adoption of electronic health records (EHRs) by federally funded health centers for over a decade; however, little is known about health centers' current EHR adoption rates, progress toward Meaningful Use, and factors related to adoption. We analyzed cross-sectional data from all 1,128 health centers in 2011, which served over 20 million patients during that year. As of 2011, 80% of health centers reported using an EHR, and high proportions reported using many advanced EHR functionalities. There were no indications of disparities in EHR adoption by census region, urban/rural location, patient sociodemographic composition, physician staffing, or health center funding; however, there were small variations in adoption by total patient cost and percent of revenue from grants. Findings revealed no evidence of a digital divide among health centers, indicating that health centers are implementing EHRs, in keeping with their mission to reduce health disparities.

  5. 42 CFR 405.2469 - Federally Qualified Health Centers supplemental payments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Federally Qualified Health Centers supplemental payments. 405.2469 Section 405.2469 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED...

  6. 42 CFR 137.302 - Are Federal funds available to cover start-up costs associated with initial Tribal assumption of...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Are Federal funds available to cover start-up costs... funds available to cover start-up costs associated with initial Tribal assumption of environmental responsibilities? (a) Yes, start-up costs are available as provided in section 508(c) of the Act . During...

  7. Health Impact Assessment, Physical Activity and Federal Lands Trail Policy

    PubMed Central

    Davis, Sally M.; Cruz, Theresa H.; Kozoll, Richard L.

    2016-01-01

    Objectives The objectives of this paper are to describe the application of Health Impact Assessment (HIA) to inform trail decisions affecting a rural, under-resourced community and propose the routine integration of HIAs to enhance NEPA environmental assessments and environmental impact statements for trail decisions on federal lands. Methods Screening, scoping, assessment, recommendations, reporting, monitoring and evaluation are being used to examine the health impact of trail location and design. Results HIA recommendations are being integrated into the public lands National Environmental Protection Act process for planning access to a new segment of the Continental Divide National Scenic Trail. Potential users from a nearby rural New Mexico community and a region of almost one million may benefit from this HIA-informed planning. Conclusions HIA can be integrated into the policy and decision-making process for trails on public lands. PMID:27213163

  8. Disaster prepared: How federal funding in the USA supports health system and public health readiness.

    PubMed

    Schlegelmilch, Jeff; Petkova, Elisaveta; Redlener, Irwin

    Federal funding for health and medical preparedness in the USA has created an important foundation for preparing the health and medical systems to respond to a wide range of hazards. A declining trend in funding for these preparedness activities threatens to undo the progress that has been made over the last decade and reduce the state of readiness to respond to the health and medical impacts of disasters. PMID:26642168

  9. Physical Restraint Initiation in Nursing Homes and Subsequent Resident Health

    ERIC Educational Resources Information Center

    Engberg, John; Castle, Nicholas G.; McCaffrey, Daniel

    2008-01-01

    Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental…

  10. DOE-HUD Initiative on Energy Efficiency in Housing: A federal partnership. Program summary report

    SciTech Connect

    Brinch, J.

    1996-06-01

    One of the primary goals of the US Department of Housing and urban Development (HUD) is the expansion of home ownership and affordable housing opportunities. Recognizing that energy efficiency is a key component in an affordable housing strategy, HUD and the US Department of Energy (DOE) created the DOE-HUD Initiative on Energy Efficiency in Housing. The DOE-HUD Initiative was designed to share the results of DOE research with housing providers throughout the nation, to reduce energy costs in federally-subsidized dwelling units and improve their affordability and comfort. This Program Summary Report provides an overview of the DOE-HUD Initiative and detailed project descriptions of the twenty-seven projects carried out with Initiative funding.

  11. Mental health and substance abuse insurance parity for federal employees: how did health plans respond?

    PubMed

    Barry, Colleen L; Ridgely, M Susan

    2008-01-01

    A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than coverage for general medical services. While mental health advocates view insurance limits as evidence of discrimination, adverse selection and moral hazard can also explain these differences in coverage. The intent of parity regulation is to equalize private insurance coverage for mental and physical illness (an equity concern) and to eliminate wasteful forms of competition due to adverse selection (an efficiency concern). In 2001, a presidential directive requiring comprehensive parity was implemented in the Federal Employees Health Benefits (FEHB) Program. In this study, we examine how health plans responded to the parity directive. Results show that in comparison with a set of unaffected health plans, federal employee plans were significantly more likely to augment managed care through contracts with managed behavioral health "carve-out" firms after parity. This finding helps to explain the absence of an effect of the FEHB Program directive on total spending, and is relevant to the policy debate in Congress over federal parity.

  12. 45 CFR 60.15 - Reporting exclusions from participation in Federal or state health care programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... or state health care programs. 60.15 Section 60.15 Public Welfare Department of Health and Human... exclusions from participation in Federal or state health care programs. (a) Who must report. Federal Government agencies and state law and fraud enforcement agencies must report health care...

  13. 45 CFR 61.10 - Reporting exclusions from participation in Federal or State health care programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... or State health care programs. 61.10 Section 61.10 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Reporting of Information § 61.10 Reporting exclusions from participation in Federal or State health care programs. (a) Who must report. Federal...

  14. 45 CFR 61.10 - Reporting exclusions from participation in Federal or State health care programs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... or State health care programs. 61.10 Section 61.10 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Reporting of Information § 61.10 Reporting exclusions from participation in Federal or State health care programs. (a) Who must report. Federal...

  15. 45 CFR 60.15 - Reporting exclusions from participation in Federal or state health care programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... or state health care programs. 60.15 Section 60.15 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... exclusions from participation in Federal or state health care programs. (a) Who must report. Federal Government agencies and state law and fraud enforcement agencies must report health care...

  16. DOE-HUD initiative on energy efficiency in housing: A federal partnership

    SciTech Connect

    Brinch, J.; Ternes, M.; Myers, M.

    1996-07-01

    A five-year initiative between the US Department of Energy (DOE) and the US Department of Housing and Urban Development (HUD) demonstrated the feasibility of improving the energy efficiency of publicly-assisted housing. Twenty-seven projects and activities undertaken during 1990--95 involved research and field demonstrations, institutional and administrative changes to HUD policies and procedures, innovative financing and leveraging of federal dollars with non-federal money, and education, training, and technical assistance. With most of the 27 projects and activities completed, the two departments have initiated a five-year deployment effort, the DOE-Energy Partnerships for Affordable Homes, to achieve energy and water savings in public and assisted housing on a large scale throughout the country. A Clearinghouse for Energy Efficiency in Public and Assisted Housing managed by the National Center for Appropriate Technology (NCAT), will offer hands-on energy assistance to housing providers to complement DOE`s assistance. This paper presents the findings of the DOE-HUD Initiative, with primary attention paid to those projects which successfully integrated energy efficiency into private and public single and multifamily housing. The paper includes examples of the publications, case-study reports, exhibits and videotapes developed during the course of the Initiative. Information on the new DOE Energy Partnerships and on the NCAT Clearinghouse is also presented. New Partnership projects with the Atlanta and Chicago Housing Authorities describe the technical assistance envisioned under the Partnership.

  17. Environmental safety & health requirements for a federal facility

    SciTech Connect

    Campbell, G.; Wong, J.

    1995-09-01

    I would like to take this opportunity to discuss the challenges that face an environmental, safety, and health (ES&H) manager at a federal facility situated in California. The challenges are, in many aspects, similar to those facing ES&H professionals all over this country: dwindling resources and increasing regulatory demands. The Laboratory (LLNL) is under closer scrutiny than other R&D facilities located in California because some of its research activities involve nuclear weapon design. Today I would like to talk about two actions we, the ES&H management at LLNL, have taken to decrease the impact of dwindling resources and increasing regulatory demands: (1) Institution of a performance-based contract, which the University of California negotiated with the Department of Energy (DOE) to reduce the impact of special mandates required of federal facilities. Under this contract, ES&H performance is measured by results rather than by process; (2) Redesign of the LLNL Hazards Control Department to a flat organization that incorporates employee empowerment and Self-Managed Work Teams (SMWTs).

  18. 77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-23

    ... From the Federal Register Online via the Government Publishing Office OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved Areas for 2013 AGENCY: U.S... Medically Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar...

  19. 76 FR 31998 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... From the Federal Register Online via the Government Publishing Office OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved Areas for 2012 AGENCY: U.S... the Federal Employees Health Benefits (FEHB) Program for calendar year 2012. This is necessary...

  20. Use of health information systems in the Russian federation in the assessment of environmental health effects.

    PubMed Central

    Jaakkola, J J; Cherniack, M; Spengler, J D; Ozkaynak, H; Wojtyniak, B; Egorov, A; Rakitin, P; Katsnelson, B; Kuzmin, S; Privalova, L; Lebedeva, N V

    2000-01-01

    The Russian Federation has made an intensive effort to compile and use information on the environment and human health. In 1996-1997, we evaluated the information that was collected and analyzed on the local (raion), regional (oblast), and federal levels with reference to its usefulness in the assessment of environmental health effects. The Russian Federation maintains standardized nationwide institutions that routinely collect health data in polyclinics and hospitals and then report to the national offices. The allocations of the workforce and the broad range of surveyed health outcomes are extensive, but a lack of systematic control of information quality limits the ability to take full advantage of these efforts. On the other hand, the hierarchical system of data collection has advantages over more decentralized or commercial health systems. A major weakness in the current reporting is the aggregation and transformation of data. Although this may not disturb the generation of health statistics, it seriously limits the use of regional and federal level data in the assessment of health effects of environmental exposures. In spite of limitations, some revised approaches to the analysis of existing data may be both feasible and fruitful. Combining information from routine data and newly collected data is likely to be the most effective way to assess the relationship between environmental exposures and diseases. Although there is a strong and justifiable desire to rapidly translate information of environmental health effects into policy alternatives, at present, it seems more useful to emphasize data quality, completeness, and plans for the use of data. PMID:10903609

  1. 76 FR 71077 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of... advise the Secretary of Labor (Secretary) on all matters relating to the occupational safety and......

  2. Decategorizing health services: interim findings from the Robert Wood Johnson Foundation's Child Health Initiative.

    PubMed

    Newacheck, P W; Hughes, D C; Brindis, C; Halfon, N

    1995-01-01

    Although results from the evaluation are preliminary thus far, certain tentative conclusions can be reached. First, both care coordination on a small scale and the production of community health report cards are achievable within the relatively short life of a foundation grant. Moreover, both efforts can result in tangible improvements for children and their families. Report cards associated with the initiative have made children's issues more prominent and appear to have led many community leaders to focus greater attention on children's needs. Likewise, many of the care coordination systems developed under the initiative have produced real change for children and their families by guiding them to needed health care and other services. It is important, however, to keep these accomplishments in perspective. While of significant benefit to demonstration communities, the monitoring and care coordination components of this initiative are not unique. A large number of communities have adopted monitoring and reporting programs in recent years. Similarly, care coordination efforts are well established in many communities. What is unique about the RWJF initiative is its attempt at decategorization, and much less progress has been demonstrated for this component. The less-than-hoped-for progress in implementing decategorization at the original sites appears to be the product of a number of interrelated factors. These include an absence of existing models and appropriate technical assistance; political difficulties in gaining cooperation from multiple local agencies involved in service provision; limited progress in establishing needed connections with the state and federal agencies that have authority over categorical programs; and difficulties in implementing major programatic changes when the health care system itself is undergoing rapid change. In combination, these barriers have proven to be largely insurmountable for the originally funded sites, although it is too

  3. Promoting Arab and Israeli cooperation: peacebuilding through health initiatives.

    PubMed

    Skinner, Harvey; Abdeen, Ziad; Abdeen, Hani; Aber, Phil; Al-Masri, Mohammad; Attias, Joseph; Avraham, Karen B; Carmi, Rivka; Chalin, Catherine; El Nasser, Ziad; Hijazi, Manaf; Jebara, Rema Othman; Kanaan, Moien; Pratt, Hillel; Raad, Firas; Roth, Yehudah; Williams, A Paul; Noyek, Arnold

    This article describes a positive experience in building Arab and Israeli cooperation through health initiatives. Over the past 10 years Israeli, Jordanian, and Palestinian health professionals have worked together through the Canada International Scientific Exchange Program (CISEPO). In the initial project, nearly 17,000 Arab and Israeli newborn babies were tested for early detection of hearing loss, an important health issue for the region. The network has grown to address additional needs, including mother-child health, nutrition, infectious diseases, and youth health. Our guiding model emphasises two goals: project-specific outcomes in health improvement, and broader effects on cross-border cooperation. Lessons learned from this experience and the model provide direction for ways that health professionals can contribute to peacebuilding. PMID:15811462

  4. Measuring the impact and outcomes of maternal child health federal programs.

    PubMed

    Taylor, Yhenneko J; Nies, Mary A

    2013-07-01

    Improving maternal and child health is a key objective of the United Nations' Millennium Development Goals and the Healthy People goals for improving the health of Americans. Government initiatives are important particularly for reducing disparities that affect disadvantaged populations. Head Start, Healthy Start, WIC and Medicaid are four federal programs that target disparities in maternal and child health outcomes. This paper reviews recent evaluations of these programs to identify outcomes assessed and opportunities for further evaluation of these programs. We conducted a review of recent evaluation studies assessing the impact of four maternal and child health programs on a health or healthcare outcome. Sources for published literature included the PubMed, Academic Search Complete, CINAHL and PsycInfo databases. Titles and abstracts of studies were examined to determine if they met inclusion criteria. Included studies were categorized by type of outcome examined. Twenty peer-reviewed studies published between January 2006 and June 2011 met inclusion criteria. The majority of studies examined infant outcomes (11), followed by breastfeeding/nutrition (4), maternal health (3), and unintended pregnancy (2). Measures used were consistent across studies; however, findings on the impact of programs were mixed reflecting differences in selection of comparison group, data source and statistical methods. The impact of maternal and child health programs may vary by setting and population served, but inconclusive findings remain. Health service researchers can build upon current evaluations to increase our understanding of what works, help target resources, and improve evaluation of programs in the future. PMID:22729661

  5. Federal Government Health, Education, and Welfare Programs of Assistance to American Indians Residing on Federal Reservations (Including Table of Contents and Index).

    ERIC Educational Resources Information Center

    Langone, Stephen A.

    Federal health, education, and welfare programs for 1970 benefiting American Indians residing on Federal reservations are listed. The report is divided into 3 sections: (1) Federal Indian programs aimed at improving or providing Indian health services, tribal management services, housing, higher education, and conservation; (2) Federal programs…

  6. Higher Education Initiatives for Disaster and Emergency Health in Iran

    PubMed Central

    ARDALAN, Ali; MESDAGHINIA, Alireza; MASOUMI, Gholamreza; HOLAKOUIE NAIENI, Kourosh; AHMADNEZHAD, Elham

    2013-01-01

    Iran’s health system is expanding the disaster and emergency higher education programs over the country to enhance the capacity of human resources for effective and efficient disaster mitigation, preparedness, response and recovery. In this article we present an overview about the initiatives and progress of disaster and emergency health higher education in Iran. Following the Bam earthquake, in collaboration with the Ministry of Health & Medical Education and National Institute of Health Research, School of Public Health at the Tehran University of Medical Sciences, Iran took the initiative to develop a Master of Public Health (MPH) with disaster concentration in 2006, a PhD in disaster and emergency health in 2011, and a well constructed certificate course in 2008 entitled Disaster Health Management and Risk Reduction (DHMR). Iran, Kerman and Shahid Beheshti Universities of Medical Sciences and University of Social Welfare and Rehabilitation are other academia that joined this initiative. Regarding the importance of programs evaluation, we have planned for a comprehensive evaluation of MPH and DHMR programs in 2013–4 and the Accreditation and Evaluation Board of Disaster & Emergency Health, based in MOH&ME, is responsible for evaluation of the PhD program in 3–5 years from initiation. PMID:23967432

  7. Higher education initiatives for disaster and emergency health in iran.

    PubMed

    Ardalan, Ali; Mesdaghinia, Alireza; Masoumi, Gholamreza; Holakouie Naieni, Kourosh; Ahmadnezhad, Elham

    2013-01-01

    Iran's health system is expanding the disaster and emergency higher education programs over the country to enhance the capacity of human resources for effective and efficient disaster mitigation, preparedness, response and recovery. In this article we present an overview about the initiatives and progress of disaster and emergency health higher education in Iran. Following the Bam earthquake, in collaboration with the Ministry of Health & Medical Education and National Institute of Health Research, School of Public Health at the Tehran University of Medical Sciences, Iran took the initiative to develop a Master of Public Health (MPH) with disaster concentration in 2006, a PhD in disaster and emergency health in 2011, and a well constructed certificate course in 2008 entitled Disaster Health Management and Risk Reduction (DHMR). Iran, Kerman and Shahid Beheshti Universities of Medical Sciences and University of Social Welfare and Rehabilitation are other academia that joined this initiative. Regarding the importance of programs evaluation, we have planned for a comprehensive evaluation of MPH and DHMR programs in 2013-4 and the Accreditation and Evaluation Board of Disaster & Emergency Health, based in MOH&ME, is responsible for evaluation of the PhD program in 3-5 years from initiation.

  8. Children and U.S. federal policy on health and health care: seen but not heard.

    PubMed

    Flores, Glenn; Lesley, Bruce

    2014-12-01

    Children account for 73.5 million Americans (24%), but 8% of federal expenditures. Data on health and health care indicate that child well-being in the United States has been in decline since the most recent recession. Childhood poverty has reached its highest level in 20 years, 1 in 4 children lives in a food-insecure household, 7 million children lack health insurance, a child is abused or neglected every 47 seconds, and 1 in 3 children is overweight or obese. Five children are killed daily by firearms, 1 in 5 experiences a mental disorder, racial/ethnic disparities continue to be extensive and pervasive, and major sequester cuts and underfunding of pediatric research have damaged our global leadership in biomedical research and hobbled economic growth. In this analysis, we identify 10 urgent priorities for the health and health care of US children, including poverty, food insufficiency, lack of health insurance, child abuse and neglect, overweight and obesity, firearm deaths and injuries, mental health, racial/ethnic disparities, immigration, and research. Overwhelming, bipartisan support by voters exists for enhancing our nation's investments in children's health and well-being. Federal policy action steps are proposed to successfully address these priorities and ensure a healthy, productive future for US children and the nation.

  9. [Health-Promoting Schools Regional Initiative of the Americas].

    PubMed

    Ippolito-Shepherd, Josefa; Cerqueira, Maria Teresa; Ortega, Diana Patricia

    2005-01-01

    In Latin America, comprehensive health promotion programmes and activities are being implemented in the school setting, which take into account the conceptual framework of the Health-Promoting Schools Regional Initiative of the Pan American Health Organization, Regional office of the World Health Organization (PAHO/WHO). These programmes help to strengthen the working relationships between the health and education sectors. The Health-Promoting Schools Regional Initiative, officially launched by PAHO/WHO in 1995, aims to form future generations to have the knowledge, abilities, and skills necessary for promoting and caring for their health and that of their family and community, as well as to create and maintain healthy environments and communities. The Initiative focuses on three main components: comprehensive health education, the creation and maintenance of healthy physical and psychosocial environments, and the access to health and nutrition services, mental health, and active life. In 2001, PAHO conducted a survey in 19 Latin American countries to assess the status and trends of Health-Promoting Schools in the Region, for the appropriate regional, subregional, and national planning of pertinent health promotion and health education programmes and activities. The results of this survey provided information about policies and national plans, multisectoral coordination mechanisms for the support of health promotion in the school settings, the formation and participation in national and international networks of Health-Promoting Schools and about the level of dissemination of the strategy. For the successful development of Health-Promoting Schools is essential to involve the society as a whole, in order to mobilise human resources and materials necessary for implementing health promotion in the school settings. Thus, the constitution and consolidation of networks has been a facilitating mechanism for the exchange of ideas, resources and experiences to strengthen

  10. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... health care program. 1001.601 Section 1001.601 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  11. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... health care program. 1001.601 Section 1001.601 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  12. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... health care program. 1001.601 Section 1001.601 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  13. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... health care program. 1001.601 Section 1001.601 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  14. 42 CFR 1001.601 - Exclusion or suspension under a Federal or State health care program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... health care program. 1001.601 Section 1001.601 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.601 Exclusion or suspension under a Federal or State health...

  15. 75 FR 10629 - Federal Advisory Council on Occupational Safety and Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-08

    ... Occupational Safety and Health Programs), 41 CFR part 102-3, and Secretary of Labor's Order 5-2007 (72 FR 31160... Labor Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and...; ] DEPARTMENT OF LABOR Occupational Safety and Health Administration Federal Advisory......

  16. 76 FR 60535 - Federal Advisory Council on Occupational Safety and Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Reopening of the record and extension of... submitting nominations for membership on the Federal Advisory Council on Occupational Safety......

  17. Third annual report of health activities under the Federal Mine Safety and Health Act of 1977

    SciTech Connect

    Not Available

    1981-02-01

    The federal mine health program in 1980 is discussed. Health hazard evaluations were completed for exposure to crystalline silica (7631869), oil shale, perchloroethylene (127184), and heat stress. A report from the coal workers health surveillance program is presented. Mine health research projects are reported on diesel exhausts, vibration, manual materials handling, coal workers pneumoconiosis, new miner studies, stomach cancer, metal toxicity on lung cells, lipid peroxidation, and diesel and metal particulates effects on interferon synthesis. Criteria documentation, standards development, and related research on radon daughters, heat stress, asbestos, silica, welding fumes, mine sanitation, and emergency medical services are reported. Respirators, personal dust samplers, and other safety equipment testing and certification are reported and mine health education programs are presented. This report represents an effort by NIOSH to identify, evaluate, and control work related disease among miners.

  18. Health-systems efficiency in the Russian Federation: tuberculosis control.

    PubMed Central

    Floyd, Katherine; Hutubessy, Raymond; Samyshkin, Yevgeniy; Korobitsyn, Alexei; Fedorin, Ivan; Volchenkov, Gregory; Kazeonny, Boris; Coker, Richard; Drobniewski, Francis; Jakubowiak, Wieslaw; Shilova, Margarita; Atun, Rifat A.

    2006-01-01

    OBJECTIVE: To conduct a comprehensive assessment of the case-mix of patients admitted to tuberculosis hospitals and the reasons for their admission in four Russian regions: Ivanovo, Orel, Samara and Vladimir. We also sought to quantify the extent to which efficiency could be improved by reducing hospitalization rates and re-profiling hospital beds available in the tuberculosis-control system. METHODS: We used a standard questionnaire to determine how beds were being used and who was using the beds in tuberculosis facilities in four Russian regions. Data were collected to determine how 4306 tuberculosis beds were utilized as well as on the socioeconomic and demographic indicators, clinical parameters and reasons for hospitalization for 3352 patients. FINDINGS: Of the 3352 patients surveyed about 70% were male; the average age was 40; and rates of unemployment, disability and alcohol misuse were high. About one-third of beds were occupied by smear-positive or culture-positive tuberculosis patients; 20% were occupied by tuberculosis patients who were smear-negative and/or culture-negative; 20% were occupied by patients who no longer had tuberculosis; and 20% were unoccupied. If clinical and public health admission criteria were applied then < 50% of admissions would be justified and < 50% of the current number of beds would be required. Up to 85% of admissions and beds were deemed to be necessary when social problems and poor access to outpatient care were considered along with clinical and public health admission criteria. CONCLUSION: Much of the Russian Federation's large tuberculosis hospital infrastructure is unnecessary when clinical and public health criteria are used, but the large hospital infrastructure within the tuberculosis-control system has an important social support function. Improving the efficiency of the system will require the reform of health-system norms and regulations as they relate to resource allocation and clinical care and implementation of

  19. The federal government commissioner for patient issues in Germany: initial analysis of the user inquiries

    PubMed Central

    Schneider, Nils; Dierks, Marie-Luise; Seidel, Gabriele; Schwartz, Friedrich W

    2007-01-01

    Background The political objective in many countries worldwide is to give better consideration to the interests of patients within the health system. The establishment of a federal government commissioner for the issues of patients in the health system in Germany in 2004 is part of these endeavours. The structure and field of activities of this institution has been unique so far. This study investigates for the first time the inquiries the commissioner receives from the public. Methods A 33% sampling (n = 850) of the written inquiries (correspondence and e-mails) addressed to the commissioner in the first six months of the year 2005 (n = 2580) was investigated. In a procedure comprising combined qualitative and quantitative levels, the material was thematically encoded and the inquiries allocated to the resulting categories (multiple nominations). The results are presented in descriptive form and investigated especially with respect to sex and age-specific differences. The interdependences between the categorized criteria are analysed. Results The inquirers are equally spread out amongst the sexes (49% women, 51% men). Older persons outweigh the younger (69% over 60 years). In most cases the issues take the form of claims (72%, n = 609). In every fifth inquiry (n = 168) the personal financial burden for health services is considered as being too high; about equally high (n = 159) is the proportion of persons who criticize the communication with health professionals, especially hospitals and doctors' surgeries. Every third who mentions a medical practice uses terms such as "uncertainty" and "anxiety". It is conspicuous that men more often than women write that they feel unfairly treated in the health system (62% vs. 38%, p < 0.05). Conclusion Predominantly older persons seek the assistance of the federal government commissioner for patient issues. Considerable uncertainty and anxiety with respect to services and charges within the system of the German health

  20. Hospital federations and human resources for health: trends and proposals for improvement.

    PubMed

    Vincent, Gérard; De Roodenbeke, Eric

    2007-01-01

    Health system performance depends on a performing health workforce. In many health care systems, hospital federations are key players as they represent actors, which are important in terms number of qualified health workers employed, and of the volume of services provided. In addressing the "crisis of human resources for health" (HRH) they are part of the problem as well as the solution.

  1. 42 CFR 440.365 - Coverage of rural health clinic and federally qualified health center (FQHC) services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.365 Coverage of rural health clinic and federally qualified health center (FQHC) services. If a State provides benchmark or...

  2. 42 CFR 440.365 - Coverage of rural health clinic and federally qualified health center (FQHC) services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.365 Coverage of rural health clinic and federally qualified health center (FQHC) services. If a State provides benchmark or...

  3. 42 CFR 440.365 - Coverage of rural health clinic and federally qualified health center (FQHC) services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.365 Coverage of rural health clinic and federally qualified health center (FQHC) services. If a State provides benchmark or...

  4. 42 CFR 440.365 - Coverage of rural health clinic and federally qualified health center (FQHC) services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.365 Coverage of rural health clinic and federally qualified health center (FQHC) services. If a State provides benchmark or...

  5. 42 CFR 440.365 - Coverage of rural health clinic and federally qualified health center (FQHC) services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.365 Coverage of rural health clinic and federally qualified health center (FQHC) services. If a State provides benchmark or...

  6. A Student-Led Health Education Initiative Addressing Health Disparities in a Chinatown Community

    PubMed Central

    Lee, Benjamin J.; So, Chunkit; Chiu, Brandon G.; Polisetty, Radhika; Quiñones-Boex, Ana; Liu, Hong

    2015-01-01

    Together with community advocates, professional student organizations can help improve access to health care and sustain services to address the health disparities of a community in need. This paper examines the health concerns of an underserved Chinese community and introduces a student-led health education initiative that fosters service learning and student leadership. The initiative was recognized by the American Association of Colleges of Pharmacy (AACP) and received the 2012-2013 Student Community Engaged Service Award. PMID:26839422

  7. A strategic approach of E-health initiatives.

    PubMed

    Asoh, Derek A; Rivers, Patrick A; Shih, Stephen C; Tsai, Kai-Li

    2008-01-01

    The Internet is transforming the US economy. Though it continues to lag behind other industries, healthcare has begun to incorporate this technology on a wider scale to reduce costs and more effectively address quality and patient-choice issues. This article presents the background of the US healthcare system, examines the application of e-health, advocates for the integration of e-health components and discusses the roles of major stakeholders in e-health as the basis for the strategic planning, initiation and implementation of integrated e-health systems. Strategic planning provides the opportunity for an insightful view and consideration of the impacts, expectations and responses of e-health stakeholders while implementing integrated e-health solutions for access to more cost-effective and better patient care delivery.

  8. Competencies for public health finance: an initial assessment and recommendations.

    PubMed

    Gillespie, Kathleen N; Kurz, Richard S; McBride, Timothy; Schmitz, Homer H

    2004-01-01

    The purpose of the study in this article was to identify The needs of public health managers with regard to public health finance. A survey of public health practitioners regarding competencies was conducted and a review of course offerings in finance among schools of public health was performed. Most public health practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a public health facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing public health care finance, with a few offering at most only one public health finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations for education and competency development, suggesting several next steps that can advance the field of public health's understanding of what managers need to master in public health finance to effectively function as public health managers.

  9. Competencies for public health finance: an initial assessment and recommendations.

    PubMed

    Gillespie, Kathleen N; Kurz, Richard S; McBride, Timothy; Schmitz, Homer H

    2004-01-01

    The purpose of the study in this article was to identify The needs of public health managers with regard to public health finance. A survey of public health practitioners regarding competencies was conducted and a review of course offerings in finance among schools of public health was performed. Most public health practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a public health facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing public health care finance, with a few offering at most only one public health finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations for education and competency development, suggesting several next steps that can advance the field of public health's understanding of what managers need to master in public health finance to effectively function as public health managers. PMID:15552772

  10. The Global Threat Reduction Initiative's Orphan Source Recovery Project in the Russian Federation

    SciTech Connect

    Russell, J. W.; Ahumada, A. D.; Blanchard, T. A.

    2012-06-04

    After 9/11, officials at the United States Department of Energy (DOE), National Nuclear Security Administration (NNSA) grew more concerned about radiological materials that were vulnerable to theft and illicit use around the world. The concern was that terrorists could combine stolen radiological materials with explosives to build and detonate a radiological dispersal device (RDD), more commonly known as a “dirty bomb.” In response to this and other terrorist threats, the DOE/NNSA formed what is now known as the Global Threat Reduction Initiative (GTRI) to consolidate and accelerate efforts to reduce and protect vulnerable nuclear and radiological materials located at civilian sites worldwide. Although a cooperative program was already underway in the Russian Federation to secure nuclear materials at a range of different facilities, thousands of sealed radioactive sources remained vulnerable at medical, research, and industrial sites. In response, GTRI began to focus efforts on addressing these materials. GTRI’s Russia Orphan Source Recovery Project, managed at the Nevada National Security Site’s North Las Vegas facility, was initiated in 2002. Throughout the life of the project, Joint Stock Company “Isotope” has served as the primary Russian subcontractor, and the organization has proven to be a successful partner. Since the first orphan source recovery of an industrial cobalt-60 irradiator with 647 curies (Ci) at an abandoned facility in Moscow in 2003, the GTRI Orphan Source Recovery Project in the Russian Federation has accomplished substantial levels of threat reduction. To date, GTRI has recovered and securely disposed of more than 5,100 sources totaling more that 628,000 Ci. This project serves as an extraordinary example of how international cooperation can be implemented by partners with mutual interests to achieve significant goals.

  11. Meeting the needs of people with AIDS: local initiatives and Federal support.

    PubMed Central

    Sundwall, D N; Bailey, D

    1988-01-01

    The Health Resources and Services Administration (HRSA), one of the seven agencies of the Public Health Service, is working to meet some of the resource and patient service needs engendered by the epidemic of acquired immune deficiency syndrome (AIDS). Those actions derived from, and support the continuation, expansion, and replication of, initiatives at the community and State levels. HRSA is carrying out many of the recommendations of the Intragovernmental Task Force on AIDS Health Care Delivery by enhancing the AIDS training of health care personnel in prevention, diagnosis, and care and by counseling and encouraging the expansion of facilities outside hospitals to care for AIDS patients. The agency, through its pediatric AIDS demonstration projects, is working on models for the care of children with HIV infections. The needs of AIDS patients are being addressed through a drug therapy reimbursement program; demonstration grants to 13 projects to promote coordinated, integrated systems of care in the community; and grants for the development of intermediate and long-term care facilities for patients. Ten regional education and training centers, funded in 1987 and 1988, will increase the supply of health care providers prepared to diagnose and treat persons with HIV infections. Programs will be conducted for several thousand providers over the next 3 years, using such modalities as televised programs and train-the-trainer courses. The centers will also offer support and referral services for providers. PMID:3131821

  12. Perspectives on the Federal Government and Health Information: Patterns, Impact, Expectations.

    ERIC Educational Resources Information Center

    Lunin, Lois F.; And Others

    1987-01-01

    Nine articles examine patterns of federal health information services including: the current Administration's policy; the history of the National Library of Medicine; Federal Health Information Clearinghouses and other unique projects; the Center for the Utilization of Technology; marketing trends at the Government Printing Office; and…

  13. 78 FR 50119 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved Areas for 2014 AGENCY: U.S... Medically Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year..., Louisiana, Mississippi, Missouri, New Mexico, North Dakota, Oklahoma, South Carolina and Wyoming. The...

  14. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Federal Coal Mine Health and Safety Act endorsement. 726.203 Section 726.203 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG...

  15. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Federal Coal Mine Health and Safety Act endorsement. 726.203 Section 726.203 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG...

  16. 20 CFR 726.203 - Federal Coal Mine Health and Safety Act endorsement.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Federal Coal Mine Health and Safety Act endorsement. 726.203 Section 726.203 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG...

  17. 78 FR 62602 - Board of Regents, Uniformed Services University of the Health Sciences; Notice of Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... of the Secretary Board of Regents, Uniformed Services University of the Health Sciences; Notice of Federal Advisory Committee Meeting; Correction AGENCY: Uniformed Services University of the Health... (78 FR 61344), the Department of Defense published in the Federal Register, a notice to announce...

  18. 75 FR 32972 - Federal Employees Health Benefits Program; Medically Underserved Areas for 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-10

    ... From the Federal Register Online via the Government Publishing Office OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program; Medically Underserved Areas for 2011 AGENCY: Office of... Employees Health Benefits (FEHB) Program for calendar year 2011. This is necessary to comply with...

  19. Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

    PubMed

    Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

    2016-05-01

    Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.

  20. Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

    PubMed

    Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

    2016-05-01

    Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities. PMID:27168895

  1. Research activities of the Solid State Sciences Committee in the development of a Federal initiative on advanced materials and processing

    NASA Astrophysics Data System (ADS)

    Taylor, Ronald

    The Solid State Sciences Committee (SSSC) of the National Research Council (NRC) is charged with monitoring the health of the field of materials science in the United States. Accordingly, the committee identifies and examines both broad and specific issues affecting the field. Regular meetings, teleconferences, briefings from agencies and the scientific community, the formation of study panels to prepare reports, and special forums are among the mechanisms used by the SSSC to meet its charge. This progress report presents a review of SSSC activities from May 1, 1992 through April 30, 1993. The details of prior activities are discussed in earlier reports. During the above period, the SSSC has continued to track and participate, when requested, in the development of a federal initiative on advanced materials and processing. Specifically, the SSSC is presently planning the 1993 SSSC Forum (to be cosponsored with the National Materials Advisory Board (NMAB) and the Washington Materials Forum (WMF)). The thrust will be to highlight the Federal Advanced Materials and Processing Program (AMPP). In keeping with its charge to identify and highlight specific areas for scientific and technological opportunities, the SSSC continued to oversee the conduct of a study on biomolecular materials. Preliminary plans also were developed for a study on neutron science; however, further activity is pending. A proposed study on ultrasmall devices has been expanded and absorbed into a broader context; the Board on Physics and Astronomy (BPA), with SSSC participation, is preparing to hold a program initiation meeting to evaluate the need for a study on information technology and hardware.

  2. 77 FR 22355 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-13

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of... approved. FACOSH is authorized by 5 U.S.C. 7902, section 19 of the Occupational Safety and Health Act......

  3. 78 FR 30337 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement of.... 7902; section 19 of the Occupational Safety and Health Act of 1970 (OSH Act) (29 U.S.C. 668);...

  4. 42 CFR 422.316 - Special rules for payments to Federally qualified health centers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... health centers. 422.316 Section 422.316 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Payments to Medicare Advantage Organizations § 422.316 Special rules for payments to Federally qualified health...

  5. Sierra Health Foundation's Positive Youth Justice Initiative. Briefing Paper

    ERIC Educational Resources Information Center

    Sierra Health Foundation, 2012

    2012-01-01

    In December 2011, the Sierra Health Foundation board of directors approved a framework for a new youth development initiative. The framework built upon the foundation's recently concluded REACH Youth Development Program and incorporated findings and recommendations from the highly regarded "Healthy Youth/Healthy Regions" and "Renewing Juvenile…

  6. Increasing the practice of health promotion initiatives by licensed premises.

    PubMed

    Wiggers, J; Considine, R; Hazell, T; Haile, M; Rees, M; Daly, J

    2001-06-01

    Licensees of all licensed premises in the Hunter Region of New South Wales, Australia, were offered free services to encourage adoption of health promotion initiatives relating to responsible service of alcohol, environmental tobacco smoke, healthy food choices, breast and cervical cancer prevention, and the prevention of HIV/AIDS. A total of 239 premises participated in the follow-up survey. Increases in prevalence ranged between 11% and 59% for alcohol-related initiatives. The prevalence of smoke-free areas and healthy food choices increased from 32% to 65% and 42% to 96%, respectively, and the provision of cancer prevention information increased from 3% to 59%. Licensed premises represent a particularly challenging sector for health promotion practitioners to work in. The results of this study suggest that the adoption of health promotion initiatives by licensed premises can be increased. A considerable opportunity therefore exists for health promotion practitioners to become more actively involved in facilitating the adoption of such initiatives in this setting. PMID:11380053

  7. Mobile phone health risk policy in Germany: the role of the federal government and the Federal Office for Radiation Protection.

    PubMed

    Schweikardt, Christoph; Gross, Dominik

    2012-01-01

    In order to establish a regulatory framework for a given technology important to society, the government must make decisions in the face of existing unknowingness. In the last decade, health risks originating from electromagnetic fields of mobile telecommunication transmitting stations and devices have become a regulation policy issue in Germany. This article investigates the role of the government and the Federal Office for Radiation Protection in regard to policy-making by analysing publications and Federal Parliament reports, hearings and debates. The government and Federal Parliament perceived the research situation in 2001 as insufficient in the absence of hard evidence for health impairment. Against this background, the government struck a compromise with mobile telecommunication network operators, who did not want to integrate stricter limit values for transmission stations as precautionary measures. The network operators' voluntary self-commitment included financing half the budget of the German Mobile Telecommunication Research Programme (2002-2008) under the lead management of the Federal Office for Radiation Protection, which concluded that it was not required to change the position taken in 2001. The results of this programme provided the basis to continue the agreement of that year. With regard to health issues and all the other interests involved, this agreement was an acceptable and remarkably stable compromise.

  8. [Connections between fiscal federalism and the funding of the Brazilian health care policy].

    PubMed

    de Lima, Luciana Dias

    2007-01-01

    In the Brazilian society's context of meager financial resources for health care, associated with structural features of fiscal federalism and with the current model of funding transfers for the Unified Health System's (SUS), important inequities directly impact political negotiations and the deployment of federal financing alternatives which are not directly linked to the supply and production of health care activities and services by states and municipalities. We observed that health policies, since the second half of the nineties, have developed their own mechanisms that, in the above mentioned context, tend to accommodate different interests and federative conflicts generated by structural factors and by institutional rules. However, the absence of an integrated planning program between the criteria to establish resource redistribution for financing the Unified Health System and the Brazilian Federation's fiscal sharing system, end up reinforcing certain asymmetric patterns and generating new imbalances, making the compensation of inequities difficult in public health spending at the sub-national domain. PMID:17680105

  9. 78 FR 64873 - Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... the Federal Register (77 FR 42914-42918) to expand coverage of children under the FEHB Program and... children up to age 26. The regulations also allow children of same-sex domestic partners living in states that do not allow same-sex couples to marry to be covered family members under the FEHB and the...

  10. Effectiveness of health and wellness initiatives for seniors.

    PubMed

    Coberley, Carter; Rula, Elizabeth Y; Pope, James E

    2011-02-01

    Given the increasing prevalence of obesity and lifestyle-related chronic diseases in the United States and abroad, senior wellness initiatives have emerged as a means to stem the troubling trends that threaten the well-being and the economy of many nations. Seniors are an important demographic for such programs because this age group is growing, both as a proportion of the overall population and as a contributor to health care cost escalation. The goal of senior wellness programs is to improve the overall health of seniors through a variety of approaches, including increased physical activity, better nutrition, smoking cessation, and support of other healthy behaviors. Outcome metrics of particular interest are the effects of participation in these programs on health care utilization and expenditures. This review describes several studies that demonstrate reduced inpatient admissions and health care costs, as well as improved health-related quality of life as a direct result of participation in large-scale senior wellness programs. Programs that effectively engage seniors in, and change behavior as a direct result of, participation provide strong evidence that health improvements and decreased health care expenditures can be achieved. However, solutions to the challenges of broader enrollment and sustained participation in these programs would increase the impact of their outcomes and health-related benefits.

  11. Exploring Australian health promotion and environmental sustainability initiatives.

    PubMed

    Patrick, Rebecca; Kingsley, Jonathan

    2016-04-01

    Issue addressed Health promotion practitioners have important roles in applying ecosystem approaches to health and actively promoting environmental sustainability within community-level practice. The present study identified the nature and scope of health promotion activities across Australia that tackle environmental sustainability. Methods A mixed-method approach was used, with 82 participants undertaking a quantitative survey and 11 undertaking a qualitative interview. Purposeful sampling strategies were used to recruit practitioners who were delivering community-level health promotion and sustainability programs in Australia. The data were analysed thematically and interpretation was guided by the principles of triangulation. Results Study participants were at various stages of linking health promotion and environmental sustainability. Initiatives focused on healthy and sustainable food, active transport, energy efficiency, contact with nature and capacity building. Conclusion Capacity building approaches were perceived as essential to strengthening this field of practice. Healthy and sustainable food and active transport were suitable platforms for simultaneously promoting community health and sustainability. There was potential for expansion of programs that emphasise contact with nature and energy issues, as well as interventions that emphasise systems thinking and interdisciplinary approaches. So what? It was promising that Australian health promotion programs have started to address complexity rather than single issues, as evidenced by explicit engagement with environmental sustainability. However, more effort is required to enable a shift towards ecosystem approaches to health. PMID:26650394

  12. Exploring Australian health promotion and environmental sustainability initiatives.

    PubMed

    Patrick, Rebecca; Kingsley, Jonathan

    2016-04-01

    Issue addressed Health promotion practitioners have important roles in applying ecosystem approaches to health and actively promoting environmental sustainability within community-level practice. The present study identified the nature and scope of health promotion activities across Australia that tackle environmental sustainability. Methods A mixed-method approach was used, with 82 participants undertaking a quantitative survey and 11 undertaking a qualitative interview. Purposeful sampling strategies were used to recruit practitioners who were delivering community-level health promotion and sustainability programs in Australia. The data were analysed thematically and interpretation was guided by the principles of triangulation. Results Study participants were at various stages of linking health promotion and environmental sustainability. Initiatives focused on healthy and sustainable food, active transport, energy efficiency, contact with nature and capacity building. Conclusion Capacity building approaches were perceived as essential to strengthening this field of practice. Healthy and sustainable food and active transport were suitable platforms for simultaneously promoting community health and sustainability. There was potential for expansion of programs that emphasise contact with nature and energy issues, as well as interventions that emphasise systems thinking and interdisciplinary approaches. So what? It was promising that Australian health promotion programs have started to address complexity rather than single issues, as evidenced by explicit engagement with environmental sustainability. However, more effort is required to enable a shift towards ecosystem approaches to health.

  13. Federal guide for a radiological response: Supporting the Nuclear Regulatory Commission during the initial hours of a serious accident

    SciTech Connect

    Hogan, R.T.

    1993-11-01

    This document is a planning guide for those Federal agencies that work with the Nuclear Regulatory commission (NRC) during the initial hours of response to a serious radiological emergency in which the NRC is the Lead Federal Agency (LFA). These Federal agencies are: DOE, EPA, USDA, HHS, NOAA, and FEMA. This guide is intended to help these agencies prepare for a prompt response. Instructions are provided on receiving the initial notification, the type of person to send to the scene, the facility at which people are needed, how to get them to that facility, and what they should do when they arrive. Federal agencies not specifically mentioned in this guide may also be asked to support the NRC.

  14. Errors in Federal Report on Dental Health Personnel Present Problems.

    ERIC Educational Resources Information Center

    Solomon, Eric S.

    1990-01-01

    The "Seventh Report to the President and Congress on the Status of Health Personnel in the United States" by the Health Resources and Services Administration and the American Association of Dental Schools'"Manpower Project Report No. 2" are compared, and their findings and implications for dental health personnel are discussed. (MSE)

  15. Federal Program Encourages Health Service Innovations on Developmental Disabilities

    ERIC Educational Resources Information Center

    Nix, Mary P.

    2009-01-01

    There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…

  16. Federating clinical data from six pediatric hospitals: process and initial results for microbiology from the PHIS+ consortium.

    PubMed

    Gouripeddi, Ramkiran; Warner, Phillip B; Mo, Peter; Levin, James E; Srivastava, Rajendu; Shah, Samir S; de Regt, David; Kirkendall, Eric; Bickel, Jonathan; Korgenski, E Kent; Precourt, Michelle; Stepanek, Richard L; Mitchell, Joyce A; Narus, Scott P; Keren, Ron

    2012-01-01

    Microbiology study results are necessary for conducting many comparative effectiveness research studies. Unlike core laboratory test results, microbiology results have a complex structure. Federating and integrating microbiology data from six disparate electronic medical record systems is challenging and requires a team of varied skills. The PHIS+ consortium which is partnership between members of the Pediatric Research in Inpatient Settings (PRIS) network, the Children's Hospital Association and the University of Utah, have used "FURTHeR' for federating laboratory data. We present our process and initial results for federating microbiology data from six pediatric hospitals.

  17. Bioterrorism and biological threats dominate federal health security research; other priorities get scant attention.

    PubMed

    Shelton, Shoshana R; Connor, Kathryn; Uscher-Pines, Lori; Pillemer, Francesca Matthews; Mullikin, James M; Kellermann, Arthur L

    2012-12-01

    The federal government plays a critical role in achieving national health security by providing strategic guidance and funding research to help prevent, respond to, mitigate, and recover from disasters, epidemics, and acts of terrorism. In this article we describe the first-ever inventory of nonclassified national health security-related research funded by civilian agencies of the federal government. Our analysis revealed that the US government's portfolio of health security research is currently weighted toward bioterrorism and emerging biological threats, laboratory methods, and development of biological countermeasures. Eight of ten other priorities identified in the Department of Health and Human Services' National Health Security Strategy-such as developing and maintaining a national health security workforce or incorporating recovery into planning and response-receive scant attention. We offer recommendations to better align federal spending with health security research priorities, including the creation of an interagency working group charged with minimizing research redundancy and filling persistent gaps in knowledge.

  18. Bioterrorism and biological threats dominate federal health security research; other priorities get scant attention.

    PubMed

    Shelton, Shoshana R; Connor, Kathryn; Uscher-Pines, Lori; Pillemer, Francesca Matthews; Mullikin, James M; Kellermann, Arthur L

    2012-12-01

    The federal government plays a critical role in achieving national health security by providing strategic guidance and funding research to help prevent, respond to, mitigate, and recover from disasters, epidemics, and acts of terrorism. In this article we describe the first-ever inventory of nonclassified national health security-related research funded by civilian agencies of the federal government. Our analysis revealed that the US government's portfolio of health security research is currently weighted toward bioterrorism and emerging biological threats, laboratory methods, and development of biological countermeasures. Eight of ten other priorities identified in the Department of Health and Human Services' National Health Security Strategy-such as developing and maintaining a national health security workforce or incorporating recovery into planning and response-receive scant attention. We offer recommendations to better align federal spending with health security research priorities, including the creation of an interagency working group charged with minimizing research redundancy and filling persistent gaps in knowledge. PMID:23213160

  19. Federal Civil Rights Policy and Mental Health Treatment Access for Persons with Limited English Proficiency

    ERIC Educational Resources Information Center

    Snowden, Lonnie R.; Masland, Mary; Guerrero, Rachel

    2007-01-01

    As noted in the supplement to the U.S. Surgeon General's report on mental health (U.S. Department of Health and Human Services, 2001), overcoming language access barriers associated with limited English proficiency (LEP) should help to eliminate racial and ethnic disparities in mental health care access and quality. Federal policy requires…

  20. 77 FR 39743 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    .... App, 2), Executive Order 12196 and 13511, Secretary of Labor's Order 1-2012 (77 FR 3912, 1/25/2012... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Request...

  1. 76 FR 28816 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-18

    ...-2010 (75 FR 55335 (9/10/2010)). Signed at Washington, DC, on May 13, 2011. David Michaels, Assistant... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Announcement...

  2. 76 FR 39902 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-07

    ... 12196 and 13511, Secretary of Labor's Order 4-2010 (75 FR 55355, 9/10/2010), 29 CFR Part 1960 (Basic... Occupational Safety and Health Administration Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Request...

  3. Starting Early: A Guide to Federal Resources in Maternal and Child Health.

    ERIC Educational Resources Information Center

    Mockenhaupt, Robin

    Designed to simplify the search for federal government resources on maternal and child health, this guide was prepared for use by health professionals, educators, administrators, and the general public. It describes over 250 print and nonprint (posters, audiovisuals) resources in prenatal, infant, child, and adolescent health. The guide is divided…

  4. 42 CFR 422.527 - Agreements with Federally qualified health centers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... 422.527 Section 422.527 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Application Procedures and Contracts for Medicare Advantage Organizations § 422.527 Agreements with Federally qualified health...

  5. The Kuwait Oil Fire Health Risk Assessment Biological Surveillance Initiative.

    PubMed

    Deeter, David P

    2011-07-01

    An important environmental concern during the first Gulf War (Operation Desert Storm) was assessing exposures and potential health effects in U.S. forces exposed to the Kuwait oil fires. With only 3 weeks for planning, a Biological Surveillance Initiative (BSI) was developed and implemented for a U.S. Army unit. The BSI included blood and urine collections, questionnaire administration, and other elements during the predeployment, deployment, and post-deployment phases. Many BSI objectives were accomplished. Difficulties encountered included planning failures, loss of data and information, and difficulty in interpreting laboratory results. In order for biological surveillance initiatives to provide useful information for future deployments where environmental exposures may be a concern, meaningful, detailed, and realistic planning and preparation must occur long before the deployment is initiated. PMID:21916331

  6. The federal and Ontario budgets of 2012: what's in it for health equity?

    PubMed

    Ruckert, Arne

    2012-01-01

    Health equity has started to receive significant attention among Canadian policy-makers, with acknowledgement at both the federal and provincial levels of the importance of reducing health inequities. However, a challenging budget environment has led to a number of budget cutbacks in areas that are likely to negatively influence social determinants of health, such as housing, education, and social assistance. This article analyzes both the federal and Ontario budgets of 2012 and their potential impacts on and implications for health equity. Even though health care services have largely remained untouched in both budgets, the article argues that existing health inequities will be further amplified through the implementation of cutbacks in sectors other than health, given the importance of social determinants of health (SDH) for health equity outcomes. PMID:23617991

  7. Feminist initiatives on women's health in the Netherlands.

    PubMed

    Schmitz, L

    1984-04-01

    In the 1960s the Dutch Women's Liberation organization "Dolle Mina" carried out a campaign in Holland to promote the use of oral contraceptives and tried to generate political support in the home and through street demonstrations. What was needed was an adequate abortion service with a corresponding abortion law, a free and adequate supply of contraceptives, and a non-sexist approach to and treatment of women in the field of sexuality, birth control, and medical servicces in general. About 15 years later, the Netherlands now has a flourishing women's health movement, including efforts in information provision, guidance, research, reference, schooling, and contact-building. The basic principles of the women's movement are; 1) the woman herself is the stardard; 2) problems women have with regard to their health are not to be observed in isolation from their social l ife and position; 3) women's acquaintance with feelings about the functioning of their own bodies form the basis of all therapies to improve women's health; 4) women must be offered the choice of existing methods of treatment and help procedures; 5) women should help each other with their common ailments, and heirarchical divisions such as helper-patient, and expert-nonexpert, should be removed; and 6) as often as possible help should be given to women in their own surroundings. Women's health centers have begun to take on a number of women's physical and psychosomatic complaints; 5 centers now operate in 5 different cities, and others are being developed. The Women's Health Center in Amsterdam was initiated in 1976 and caters to gynecological questions, breast examination problems, eating disorders, and drug addiction. Contracts between feminist health groups and the traditional health system are varied, and individuals involved in family planning groups are often also active in the feminist health acctiities. There is resistance to feminist initiatives, mainly from those working in traditional health

  8. 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

  9. Federal Public Health Service: In Retrospect and Prospects

    ERIC Educational Resources Information Center

    Kolbe, Lloyd J.

    2016-01-01

    In this article, I offer a retrospective case study about my early, short-term work within the U.S. Office of the Assistant Secretary for Health and then my later, longer-term work within the U.S. Centers for Disease Control and Prevention, where I endeavored for two decades largely to help our nation's schools improve health and associated…

  10. FEDERAL MEAT INSPECTION AS A SAFEGUARD TO PUBLIC HEALTH

    PubMed Central

    Mohler, John R.

    1920-01-01

    There is no Federal inspection for one-third of the meat consumed in this country. Further than this, there is much needed in constructive work on the part of states and municipalities, in which this one-third is produced and slaughtered. Cities plead lack of funds, and there is also lack of knowledge and lack of interest. Meat is too important a feature in our lives to be thus neglected. PMID:18010309

  11. 75 FR 17700 - Energy Efficient Building Systems Regional Innovation Cluster Initiative-Joint Federal Funding...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-07

    ... organizations, and other interested parties to learn more about the Joint Federal Funding Opportunity...: To answer questions from potential applicants and other interested parties about the joint FOA...

  12. The role of the Thalassaemia International Federation in health professionals' education.

    PubMed

    Eleftheriou, Androulla

    2004-12-01

    The Thalassaemia International Federation (TIF) was established in 1986. The Federation has two important objectives: 1. To promote the continued control of thalassaemia major in countries with existing policies aimed at control, and 2. To support the establishment of policies of control in every affected country of the world. Over the years TIF has: - Held workshops and seminars attended by over 7,000 from 35 countries - Organized 11 International Conferences attended by 5,150 from 62 countries - Organized field trips/delegation visits in 42 countries - Prepared, published and distributed 70,000 books to 96 countries - Trained physicians and scientists from medical centres in the UK, US, Italy, Greece and Cyprus - Initiated and co-ordinated projects and clinical studies overseen by international experts in over 50 countries. - Established a vast network of scientific collaborators from every corner of the world, and - Has promoted close and productive collaborations with major health organizations. One of the most important projects that TIF has conducted was a multi-centre study on endocrine complications in the different affected regions of the world. It is hopeful that through the analysis of data already obtained and expected, other projects related to blood transfusion therapy, iron chelation and chronic hepatitis could be organized.

  13. 75 FR 59237 - TRICARE Co-Pay Waiver at Captain James A. Lovell Federal Health Care Center Demonstration Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... of the Secretary TRICARE Co-Pay Waiver at Captain James A. Lovell Federal Health Care Center... waiver at Captain James A. Lovell Federal Health Care Center demonstration project. SUMMARY: This notice... Captain James A. Lovell Federal Health Care (FHCC) Demonstration Project.'' Under this...

  14. 78 FR 27242 - Updated Special Advisory Bulletin on the Effect of Exclusion From Participation in Federal Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... From Participation in Federal Health Care Programs AGENCY: Office of Inspector General (OIG), HHS... effect of exclusion from participation in Federal health care programs by OIG. The updated Special Advisory Bulletin describes the scope and effect of the legal prohibition on payment by Federal health...

  15. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  16. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  17. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  18. 76 FR 38282 - Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ... MANAGEMENT 5 CFR Part 890 48 CFR Parts 1602, 1615, 1632, and 1652 RIN 3206-AM39 Federal Employees Health... Management (OPM) is issuing an interim final regulation amending the Federal Employees Health Benefits (FEHB) regulations and also the Federal Employees Health Benefits Acquisition Regulation (FEHBAR). This interim...

  19. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  20. Identification of managerial behavior dimensions in a federal health-care agency.

    PubMed

    Scherer, R F; Canty, A L; Peterson, F L; Cooper, R F

    1995-04-01

    Understanding the behavior of managers provides an opportunity to assess congruencies between organizational needs and managerial skills. This assessment is critical in federal health-care wherein the environment is rapidly changing. In the current investigation, dimensions of managerial behavior for 267 managers in a federal health-care agency were identified. Recommendations are provided with respect to the relevance of using these dimensions for organizational training and development activities.

  1. Federal expenditures on maternal and child health in the United States.

    PubMed

    Kenney, Mary Kay; Kogan, Michael D; Toomer, Stephanie; van Dyck, Peter C

    2012-02-01

    The goals of this study are to estimate federal maternal and child health (MCH) expenditures and identify their sources. This analysis is intended to provide a broad view of MCH funding appropriations and a basis for discussion of whether funds could be better utilized for the benefit of the population served. Data on federal maternal and child health expenditures for fiscal year (FY) 2006 were derived from examining federal legislation, department/agency budgets, and various web-based program documents posted by federal agencies. Based on selected criteria, we identified programs targeting children under 21 or pregnant/parenting women within the United States. The funding levels of agency programs for maternal and child health activities were determined and the programs briefly summarized. The identifiable funding for maternal and child health programs in FY 2006 approached $57.5 billion dollars. Funding sources for maternal and child health were concentrated within the U.S. Department of Health and Human Services, but spread across several different agencies within the department and in the Departments of Defense, Education, Agriculture, Housing and Urban Development, and the Environmental Protection Agency. Multiple agencies and offices often funded related activities, without evidence of a common underlying strategy. Federal maternal and child health funding mechanisms may lead to a fragmentation in maternal and child health activities. The funding and service delivery apparatus would benefit from an integrative MCH infrastructure approach to pediatric research, service delivery, and data collection/access that incorporates life-course and social/environmental determinants perspectives.

  2. Coordinated Public Health Initiatives to Address Violence Against Women and Adolescents

    PubMed Central

    James, Lisa; Langhorne, Aleisha; Kelley, Marylouise

    2015-01-01

    Abstract Intimate partner violence (IPV) is a well-recognized public health problem. IPV affects women's physical and mental health through direct pathways, such as injury, and indirect pathways, such as a prolonged stress response that leads to chronic health problems. The influence of abuse can persist long after the violence has stopped and women of color are disproportionately impacted. Successfully addressing the complex issue of IPV requires multiple prevention efforts that target specific risk and protective factors across individual, interpersonal, institutional, community, and societal levels. This paper includes examples of community-based, state led and federally funded public health programs focused on IPV along this continuum. Two community-based efforts to increase access to mental health care for low income, women of color who had experienced IPV, Mindfulness-Based Stress Reduction, and a telehealth intervention are discussed. Core tenets of a patient-centered comprehensive approach to assessment and responses and strategies for supporting a statewide comprehensive response are described in Project Connect: A Coordinated Public Health Initiative to Prevent Violence Against Women. Project Connect provides technical assistance to grantees funded through the Violence Against Women Act's health title and involves developing, implementing, and evaluating new ways to identify, respond to, and prevent domestic and sexual violence and promote an improved public health response to abuse in states and Native health programs. Health care partnerships with domestic violence experts are critical in order to provide training, develop referral protocols, and to link IPV victims to advocacy services. Survivors need a comprehensive response that addresses their safety concerns and may require advocacy around housing or shelter, legal assistance, and safety planning. Gaps in research knowledge identified are health system readiness to respond to IPV victims in health

  3. Coordinated public health initiatives to address violence against women and adolescents.

    PubMed

    Dutton, Mary Ann; James, Lisa; Langhorne, Aleisha; Kelley, Marylouise

    2015-01-01

    Intimate partner violence (IPV) is a well-recognized public health problem. IPV affects women's physical and mental health through direct pathways, such as injury, and indirect pathways, such as a prolonged stress response that leads to chronic health problems. The influence of abuse can persist long after the violence has stopped and women of color are disproportionately impacted. Successfully addressing the complex issue of IPV requires multiple prevention efforts that target specific risk and protective factors across individual, interpersonal, institutional, community, and societal levels. This paper includes examples of community-based, state led and federally funded public health programs focused on IPV along this continuum. Two community-based efforts to increase access to mental health care for low income, women of color who had experienced IPV, Mindfulness-Based Stress Reduction, and a telehealth intervention are discussed. Core tenets of a patient-centered comprehensive approach to assessment and responses and strategies for supporting a statewide comprehensive response are described in Project Connect: A Coordinated Public Health Initiative to Prevent Violence Against Women. Project Connect provides technical assistance to grantees funded through the Violence Against Women Act's health title and involves developing, implementing, and evaluating new ways to identify, respond to, and prevent domestic and sexual violence and promote an improved public health response to abuse in states and Native health programs. Health care partnerships with domestic violence experts are critical in order to provide training, develop referral protocols, and to link IPV victims to advocacy services. Survivors need a comprehensive response that addresses their safety concerns and may require advocacy around housing or shelter, legal assistance, and safety planning. Gaps in research knowledge identified are health system readiness to respond to IPV victims in health care

  4. An evaluation of selected federal categorical health programs for the poor.

    PubMed Central

    Komaroff, A L; Duffell, P J

    1976-01-01

    We examine evidence regarding the impact of several categorical federal health service programs--neighborhood health centers, maternal and infant care projects, and children and youth projects--on access to and quality of health care for the poor. We conclude that, although conclusive evidence of improved access and quality are lacking, suggestive evidence of improved quality exists. It is difficult to utilize legislative objectives as guidelines for evaluating the success of a federal program; it is also difficult to obtain solid data supporting the effectiveness or ineffectiveness of health care in general, and of other government programs. These difficulties are discussed. PMID:1259061

  5. Recommendations for evaluation of health care improvement initiatives.

    PubMed

    Parry, Gareth J; Carson-Stevens, Andrew; Luff, Donna F; McPherson, Marianne E; Goldmann, Donald A

    2013-01-01

    Intensive efforts are underway across the world to improve the quality of health care. It is important to use evaluation methods to identify improvement efforts that work well before they are replicated across a broad range of contexts. Evaluation methods need to provide an understanding of why an improvement initiative has or has not worked and how it can be improved in the future. However, improvement initiatives are complex, and evaluation is not always well aligned with the intent and maturity of the intervention, thus limiting the applicability of the results. We describe how initiatives can be grouped into 1 of 3 improvement phases-innovation, testing, and scale-up and spread-depending on the degree of belief in the associated interventions. We describe how many evaluation approaches often lead to a finding of no effect, consistent with what has been termed Rossi's Iron Law of Evaluation. Alternatively, we recommend that the guiding question of evaluation in health care improvement be, "How and in what contexts does a new model work or can be amended to work?" To answer this, we argue for the adoption of formative, theory-driven evaluation. Specifically, evaluations start by identifying a program theory that comprises execution and content theories. These theories should be revised as the initiative develops by applying a rapid-cycle evaluation approach, in which evaluation findings are fed back to the initiative leaders on a regular basis. We describe such evaluation strategies, accounting for the phase of improvement as well as the context and setting in which the improvement concept is being deployed. Finally, we challenge the improvement and evaluation communities to come together to refine the specific methods required so as to avoid the trap of Rossi's Iron Law. PMID:24268081

  6. 75 FR 54020 - Federal Housing Administration Risk Management Initiatives: New Loan-to-Value and Credit Score...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-03

    ... URBAN DEVELOPMENT 24 CFR Ch. II Federal Housing Administration Risk Management Initiatives: New Loan-to...: I. Background--HUD's July 15, 2010 Notice On July 15, 2010, at 75 FR 41217, HUD issued a proposed... reduce the maximum loan-to-value (LTV) for borrowers with lower credit scores who represent a higher...

  7. The Obesity Epidemic: Challenges, Health Initiatives, and Implications for Gastroenterologists

    PubMed Central

    Hurt, Ryan T.; Kulisek, Christopher; Buchanan, Laura A.

    2010-01-01

    Obesity is the next major epidemiologic challenge facing today's doctors, with the annual allocation of healthcare resources for the disease and related comorbidities projected to exceed $150 billion in the United States. The incidence of obesity has risen in the United States over the past 30 years; 60% of adults are currently either obese or overweight. Obesity is associated with a higher incidence of a number of diseases, including diabetes, cardiovascular disease, and cancer. Consumption of fast food, trans fatty acids (TFAs), and fructose—combined with increasing portion sizes and decreased physical activity—has been implicated as a potential contributing factor in the obesity crisis. The use of body mass index (BMI) alone is of limited utility for predicting adverse cardiovascular outcomes, but the utility of this measure may be strengthened when combined with waist circumference and other anthropomorphic measurements. Certain public health initiatives have helped to identify and reduce some of the factors contributing to obesity. In New York City and Denmark, for example, such initiatives have succeeded in passing legislation to reduce or remove TFAs from residents' diets. The obesity epidemic will likely change practice for gastroenterologists, as shifts will be seen in the incidence of obesity-related gastrointestinal disorders, disease severity, and the nature of comorbidities. The experience gained with previous epidemiologic problems such as smoking should help involved parties to expand needed health initiatives and increase the likelihood of preventing future generations from suffering the consequences of obesity. PMID:21301632

  8. The Arctic Human Health Initiative: a legacy of the International Polar Year 2007–2009

    PubMed Central

    Parkinson, Alan J.

    2013-01-01

    promotion; and promoting synergy and strategic direction of Arctic human health research and health promotion. Results As of 31 March, 2009, the official end of the IPY, AHHI represented a total of 38 proposals, including 21 individual Expressions of Intent (EoI), and 9 full proposals (FP), submitted to the IPY Joint Committee for review and approval from lead investigators from the US, Canada, Greenland, Norway, Finland, Sweden and the Russian Federation. In addition, there were 10 National Initiatives (NI-projects undertaken during IPY beyond the IPY Joint Committee review process). Individual project details can be viewed at www.arctichealth.org. The AHHI currently monitors the progress of 28 individual active human health projects in the following thematic areas: health network expansion (5 projects), infectious disease research (7 projects), environmental health research (7 projects), behavioral and mental health research (4 projects), and outreach education and communication (5 projects). Conclusions While some projects have been completed, others will continue well beyond the IPY. The IPY 2007–2008 represented a unique opportunity to further stimulate cooperation and coordination on Arctic health research and increase the awareness and visibility of Arctic regions. PMID:23971017

  9. What public health strategies are needed to reduce smoking initiation?

    PubMed

    Pierce, John P; White, Victoria M; Emery, Sherry L

    2012-03-01

    Smoking initiation is a key behaviour that determines the future health consequences of smoking in a society. There is a marked difference in smoking patterns around the world, driven by initiation rates. While a number of high-income countries have seen smoking prevalence decline markedly from peak, many low-income and middle-income countries appear to still be on an upward trend. Unlike cessation where changes are limited by nicotine dependence, rates of smoking initiation can change rapidly over a short time span. Interventions that can be effective in achieving this include increases in the price of tobacco products, mass media anti-smoking advertising, smoke-free policies, smoking curricula in schools, restrictions on marketing opportunities for the tobacco industry as well as social norms that lead to restrictions on adolescents' ability to purchase cigarettes. Comprehensive tobacco control programmes that aim to denormalise smoking behaviour in the community contain all of these interventions. Rapid reductions in smoking initiation in adolescents have been documented in two case studies of comprehensive tobacco control programmes in California and Australia. Consistent and inescapable messages from multiple sources appear to be key to success. However, the California experience indicates that the rapid decline in adolescent smoking will not continue if tobacco control expenditures and the relative price of cigarettes are reduced. These case studies provide strong additional evidence of the importance of countries implementing the provisions of the Framework Treaty on Tobacco Control.

  10. Federal investment in health information technology: how to motivate it?

    PubMed

    Bower, Anthony G

    2005-01-01

    Health care market failures include inefficient standard making, problems with coordination among local providers to optimize care, and inability to measure quality accurately, inexpensively, or reliably. Study of other industries suggests policy directions for health information technology and the magnitude of gains from improving market functioning, which are very large. A perspective drawn from U.S. industrial history--in particular railroads and the interstate highway system--suggests an investment level roughly consistent with recent estimates drawn from the medical literature. The benefits of quick action probably outweigh the benefits of delaying and choosing the perfect funding mechanism. PMID:16162570

  11. Federal Funding for Health Security in FY2016

    PubMed Central

    Sell, Tara Kirk; Watson, Matthew

    2015-01-01

    This article assesses US government funding in 5 domains critical to strengthening health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. This year's article also highlights the emergency funding appropriated in FY2015 to enable the international and domestic response to the Ebola outbreak in West Africa. PMID:26042863

  12. Federal Funding for Health Security in FY2016.

    PubMed

    Boddie, Crystal; Sell, Tara Kirk; Watson, Matthew

    2015-01-01

    This article assesses US government funding in 5 domains critical to strengthening health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. This year's article also highlights the emergency funding appropriated in FY2015 to enable the international and domestic response to the Ebola outbreak in West Africa.

  13. Reaching for the Stars: A New NASA-National Federation of the Blind Initiative

    NASA Astrophysics Data System (ADS)

    Maynard, N. G.; Riccobono, M. A.

    2004-12-01

    The National Aeronautics and Space Administration (NASA) and the National Federation of the Blind (NFB) recently launched a unique new partnership which will inspire and empower blind youth to consider opportunities in science, technologies, engineering, and math related careers from which they have typically been excluded. This partnership presents a framework for successful cultivation of the next generation of scientists. By partnering with the NFB Jernigan Institute, a one of a kind research and training facility developed and directed by blind people, NASA has engaged the most powerful tool for tapping the potential of blind youth. By teaming NASA scientists and engineers with successful blind adults within a national organization, the NFB, this partnership has established an unparalleled pipeline of talent and imagination. The NASA/NFB partnership seeks to facilitate the means that will lead to increased science and technology employment opportunities for the blind, and particularly within NASA. The initiative is facilitating the development of education programs and products which will stimulate better educational opportunities and supports for blind youth in the STEM areas and better preparing them to enter the NASA employment path. In addition, the partnership brings the unique perspective of the blind to the continuing effort to develop improved space technologies, which may be applied for navigation and wayfinding, technologies for education and outreach, and technologies for improving access to information using nonvisual techniques. This presentation describes some of the activities accomplished in the first year of the partnership. Examples include the establishment of the first NFB Science Academy for Blind Youth which included two summer science camps supported by NASA. During the first camp session, twelve middle school age blind youth explored earth science concepts such as identification and characterization of soils, weather parameters, plants

  14. Motherhood Preconceived: The Emergence of the Preconception Health and Health Care Initiative

    PubMed Central

    Waggoner, Miranda R.

    2013-01-01

    Since the 1980s, maternal and child health experts have sought to redefine maternity care to include the period prior to pregnancy, essentially by expanding the concept of prenatal care to encompass the time before conception. In 2004, the Centers for Disease Control and Prevention endorsed and promoted this new definition when it launched the Preconception Health and Health Care Initiative. In arguing that prenatal care was often too little too late, a group of maternal and child health experts in the United States attempted to spur improvements in population health and address systemic problems in health care access and health disparities. By changing the terms of pregnancy risk and by using maternalism as a social policy strategy, the preconception health and health care paradigm promoted an ethic of anticipatory motherhood and conflated women’s health with maternal health, sparking public debate about the potential social and clinical consequences of preconception care. This article tracks the construction of this policy idea and its ultimate potential utility in health and health policy discussions. PMID:23262764

  15. Developing targets for public health initiatives to improve palliative care

    PubMed Central

    2010-01-01

    Background Palliative Care is an approach that improves quality of life for patients and their families facing the problems associated with incurable life-threatening illness. In many countries, due to the rapidly ageing population, increasingly more people are suffering from serious chronic disease towards the end of life, making further development in palliative care a major public health challenge. The aim of this study was to develop the first targets for public health initiatives to improve palliative care in Germany. Methods Based on the findings from pilot studies (qualitative interviews and surveys with different stakeholders in the health care system), we conducted a modified Delphi study with two rounds of questionnaires with experts in public health and palliative care. In the first round, the experts commented on the findings from the pilot studies. The answers were evaluated descriptively and with qualitative content analysis, resulting in the formulation of 25 targets. These were presented to the experts in the second Delphi round to assess each of them separately with regard to its importance and current implementation (7-point answer scales) and in relation to the other targets (defining the five most important of the 25 targets). Results Six most relevant targets for public health initiatives to improve palliative care in Germany were worked out: Supporting palliative care as a basic attitude for the care of people in the last phase of life; coordinating healthcare for people in the last phase of life; establishing cooperation among health professions and disciplines; establishing education in palliative care for all professional groups with contact to people in the last phase of life; reviewing the evidence of palliative care measures; offering support to family members who are caring for someone in the last phase of life. Conclusions To systematically develop palliative care, it makes sense to define fields of action with individual targets. For

  16. Federal Manpower Legislation and the Academic Health Centers: An Interim Report.

    ERIC Educational Resources Information Center

    Carter, Grace M.; And Others

    Health Manpower Legislation and related research aspects are the topics of this report. The program of the Comprehensive Health Manpower Training Act of 1971 played a major role in the medical school enrollment expansion that occurred between 1971 and 1973. Medical school admissions decisions have been responsible to federal policy objectives and…

  17. 29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Other Federal agency standards affecting occupational safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other...

  18. 29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Other Federal agency standards affecting occupational safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other...

  19. 29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Other Federal agency standards affecting occupational safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other...

  20. 29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Other Federal agency standards affecting occupational safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other...

  1. 29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Other Federal agency standards affecting occupational safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other...

  2. Federal spending on behavioral health accelerated during recession as individuals lost employer insurance.

    PubMed

    Levit, Katharine R; Mark, Tami L; Coffey, Rosanna M; Frankel, Sasha; Santora, Patricia; Vandivort-Warren, Rita; Malone, Kevin

    2013-05-01

    The 2007-09 recession had a dramatic effect on behavioral health spending, with the effect most prominent for private, state, and local payers. During the recession behavioral health spending increased at a 4.6 percent average annual rate, down from 6.1 percent in 2004-07. Average annual growth in private behavioral health spending during the recession slowed to 2.7 percent from 7.2 percent in 2004-07. State and local behavioral health spending showed negative average annual growth, -1.2 percent, during the recession, compared with 3.7 percent increases in 2004-07. In contrast, federal behavioral health spending growth accelerated to 11.1 percent during the recession, up from 7.2 percent in 2004-07. These behavioral health spending trends were driven largely by increased federal spending in Medicaid, declining private insurance enrollment, and severe state budget constraints. An increased federal Medicaid match reduced the state share of Medicaid spending, which prevented more drastic cuts in state-funded behavioral health programs during the recession. Federal Medicaid served as a critical safety net for people with behavioral health treatment needs during the recession.

  3. 78 FR 63969 - Defense Health Board; Notice of Federal Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... of the Secretary Defense Health Board; Notice of Federal Advisory Committee Meeting AGENCY... Accessibility to the Meeting.'') FOR FURTHER INFORMATION CONTACT: The Director of the Defense Health Board is Ms... Meeting: The purpose of the meeting is to address and deliberate pending and new issues before the...

  4. 29 CFR 500.133 - Substantive Federal and State safety and health standards defined.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., DEPARTMENT OF LABOR REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Motor Vehicle Safety and Insurance for Transportation of Migrant and Seasonal Agricultural Workers, Housing Safety and Health for Migrant Workers Housing Safety and Health § 500.133 Substantive Federal and State safety and...

  5. 29 CFR 500.133 - Substantive Federal and State safety and health standards defined.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., DEPARTMENT OF LABOR REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Motor Vehicle Safety and Insurance for Transportation of Migrant and Seasonal Agricultural Workers, Housing Safety and Health for Migrant Workers Housing Safety and Health § 500.133 Substantive Federal and State safety and...

  6. 29 CFR 500.133 - Substantive Federal and State safety and health standards defined.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., DEPARTMENT OF LABOR REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Motor Vehicle Safety and Insurance for Transportation of Migrant and Seasonal Agricultural Workers, Housing Safety and Health for Migrant Workers Housing Safety and Health § 500.133 Substantive Federal and State safety and...

  7. 29 CFR 500.133 - Substantive Federal and State safety and health standards defined.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., DEPARTMENT OF LABOR REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Motor Vehicle Safety and Insurance for Transportation of Migrant and Seasonal Agricultural Workers, Housing Safety and Health for Migrant Workers Housing Safety and Health § 500.133 Substantive Federal and State safety and...

  8. Florida public health nurse workforce initiative: opportunity through crisis.

    PubMed

    2005-06-01

    The National Public Health Leadership Institute (NPHLI), a partnership between the Centers for Disease Control and Prevention and the University of North Carolina at Chapel Hill invites public health professionals to participate in a 2 year leadership program. Three Florida nurses participated in the NPHLI along with a cadre of 40 to 50 participants from the United States and foreign countries. Part of the commitment involved implementing a leadership project. This team chose to address the nursing shortage by developing and piloting mentorship program. Baseline research included a basic review of the literature and involvement in several work groups addressing various aspects of employing and retaining qualified public health nurses in Florida. During their NPHLI scholar year, team members sought input from a variety of professional sources on the reasons for the shortage of public health nurses in Florida. Based on responses from nurses, professional association members, and employees in the Florida Department of Health, team members developed a nursing mentorship project designed to address public health nursing retention and education. The goal was to develop a two-pronged mentorship program, which supported the attainment of clinical competence and workplace confidence while also improving the public health theoretical knowledge base of more experienced nurses. Nursing leadership at both the state and local levels agreed and embraced the concept. The Florida Team developed a Mentorship Handbook, which contains recruitment criteria, baseline, midterm and end of project assessment tools, and numerous other documents. The Team gained endorsement for the project and a commitment to see it through from the Department of Health's Nursing Office. The Florida Nurses Association partnered with the team to initiate the kickoff and involve team members in important discussion groups. In effecting change it is vital to have engaged and included the targeted "community" in

  9. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  10. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  11. Establishing public health security in a postwar Iraq: constitutional obstacles and lessons for other federalizing states.

    PubMed

    Wilson, Kumanan; Fidler, David P; McDougall, Christopher W; Lazar, Harvey

    2009-06-01

    The public health consequences of the conflict in Iraq will likely continue after the violence has subsided. Reestablishing public health security will require large investments in infrastructure and the creation of effective systems of governance. On the question of governance, the allocation of powers in the new constitution of Iraq is critical. Given the ease with which public health threats cross borders, the constitution needs to grant to the federal government the legal authority to manage such threats and simultaneously meet international requirements. Unfortunately, the draft constitution does not accomplish this objective. If politically possible, the constitution should be amended to provide the federal government with this authority. If not possible, the Iraqi federal government would have two options. It could attempt to use alternative constitutional powers, such as national security powers. This option would be contentious and the results uncertain. Alternatively, the federal government could attempt to establish collaborative relationships with regional governments. Residual sectarian tensions create potential problems for this option, however. Reflecting on the Iraqi situation, we conclude that other federalizing countries emerging from conflict should ensure that their constitutions provide the federal government with the necessary authority to manage threats to public health security effectively.

  12. ONE Nano: NIEHS’s Strategic Initiative on the Health and Safety Effects of Engineered Nanomaterials

    PubMed Central

    Johnson, Anne F.; Balshaw, David M.; Garantziotis, Stavros; Walker, Nigel J.; Weis, Christopher; Nadadur, Srikanth S.; Birnbaum, Linda S.

    2013-01-01

    Background: The past decade has seen tremendous expansion in the production and application of engineered nanomaterials (ENMs). The unique properties that make ENMs useful in the marketplace also make their interactions with biological systems difficult to anticipate and critically important to explore. Currently, little is known about the health effects of human exposure to these materials. Objectives: As part of its role in supporting the National Nanotechnology Initiative, the National Institute of Environmental Health Sciences (NIEHS) has developed an integrated, strategic research program—“ONE Nano”—to increase our fundamental understanding of how ENMs interact with living systems, to develop predictive models for quantifying ENM exposure and assessing ENM health impacts, and to guide the design of second-generation ENMs to minimize adverse health effects. Discussion: The NIEHS’s research investments in ENM health and safety include extramural grants and grantee consortia, intramural research activities, and toxicological studies being conducted by the National Toxicology Program (NTP). These efforts have enhanced collaboration within the nanotechnology research community and produced toxicological profiles for selected ENMs, as well as improved methods and protocols for conducting in vitro and in vivo studies to assess ENM health effects. Conclusion: By drawing upon the strengths of the NIEHS’s intramural, extramural, and NTP programs and establishing productive partnerships with other institutes and agencies across the federal government, the NIEHS’s strategic ONE Nano program is working toward new advances to improve our understanding of the health impacts of engineered nanomaterials and support the goals of the National Nanotechnology Initiative. PMID:23407114

  13. 76 FR 36857 - Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-23

    ... CFR Parts 1602, 1615, 1632, and 1652 RIN 3206-AM39 Federal Employees Health Benefits Program: New... Federal Regulations is sold by the Superintendent of Documents. #0;Prices of new books are listed in the... issuing an interim final regulation amending the Federal Employees Health Benefits (FEHB) regulations...

  14. 77 FR 19522 - Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-02

    ... MANAGEMENT 5 CFR Part 890 48 CFR Parts 1602, 1615, 1632, and 1652 RIN 3206-AM39 Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated Plans AGENCY: U.S. Office of Personnel... regulation amending the Federal Employees Health Benefits (FEHB) regulations and also the Federal...

  15. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... eligible under 38 U.S.C. 1710 or 38 CFR 17.44. Care in a Federal facility not operated by the Department of... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  16. Coordinating Canada's research response to global health challenges: the Global Health Research Initiative.

    PubMed

    Di Ruggiero, Erica; Zarowsky, Christina; Frank, John; Mhatre, Sharmila; Aslanyan, Garry; Perry, Alita; Previsich, Nick

    2006-01-01

    The Global Health Research Initiative (GHRI) involving the Canadian International Development Agency, the Canadian Institutes of Health Research, Health Canada and the International Development Research Centre seeks to coordinate Canada's research response to global health challenges. In light of numerous calls to action both nationally and internationally, an orientation to applied health policy and systems research, and to public health research and its application is required to redress global inequalities in wealth and health and to tackle well-documented constraints to achieving the United Nations Millennium Development Goals. Over the last four years, the GHRI has funded close to 70 research program development and pilot projects. However, longer-term investment is needed. The proposed dollars 100 million Teasdale-Corti Global Health Research Partnership Program is such a response, and is intended to support teams of researchers and research users to develop, test and implement innovative approaches to strengthening institutional capacity, especially in low- and middle-income countries; to generating knowledge and its effective application to improve the health of populations, especially those most vulnerable; and to strengthen health systems in those countries. While Canada stands poised to act, concerted leadership and resources are still required to support "research that matters" for health and development in low- and middle-income countries.

  17. Coordinating Canada's research response to global health challenges: the Global Health Research Initiative.

    PubMed

    Di Ruggiero, Erica; Zarowsky, Christina; Frank, John; Mhatre, Sharmila; Aslanyan, Garry; Perry, Alita; Previsich, Nick

    2006-01-01

    The Global Health Research Initiative (GHRI) involving the Canadian International Development Agency, the Canadian Institutes of Health Research, Health Canada and the International Development Research Centre seeks to coordinate Canada's research response to global health challenges. In light of numerous calls to action both nationally and internationally, an orientation to applied health policy and systems research, and to public health research and its application is required to redress global inequalities in wealth and health and to tackle well-documented constraints to achieving the United Nations Millennium Development Goals. Over the last four years, the GHRI has funded close to 70 research program development and pilot projects. However, longer-term investment is needed. The proposed dollars 100 million Teasdale-Corti Global Health Research Partnership Program is such a response, and is intended to support teams of researchers and research users to develop, test and implement innovative approaches to strengthening institutional capacity, especially in low- and middle-income countries; to generating knowledge and its effective application to improve the health of populations, especially those most vulnerable; and to strengthen health systems in those countries. While Canada stands poised to act, concerted leadership and resources are still required to support "research that matters" for health and development in low- and middle-income countries. PMID:16512323

  18. [The periodic health examination: from law to the directive of the German Federal Joint Committee (G-BA)].

    PubMed

    Perleth, Matthias; Matthias, Katja

    2014-01-01

    Since 1989 a periodic health examination beginning at the age of 35 for the early detection of "common diseases" (especially cardiovascular and kidney diseases as well as diabetes) by means of history-taking, physical examination, blood and urine tests and counselling has been available in Germany. Altogether, the respective directive of the Federal Joint Committee (G-BA) was revised six times, but a substantive change took place only once (i. e., the cancellation of uric acid, creatinine, and resting ECG in 1999). However, additional examinations (e.g., glaucoma screening) were not added to the health check after systematic assessments of the evidence were completed. In the mid-1990s, several evaluations were performed which showed that new diagnoses were established in a significant proportion of patients, and measures were initiated such as nutrition counselling. A patient-relevant benefit in terms of avoided adverse events (such as heart attacks) could, however, not be demonstrated due to methodological reasons. Criticism of the health examination is not new, in particular concerning the lack of evidence of benefit for the diagnostic procedures of the health examination. A draft law issued by the former Federal Government proposing an amendment to the health examination has recently been rejected in the Bundesrat (upper house of the German parliament).

  19. Social Health Maintenance Organizations: assessing their initial experience.

    PubMed

    Newcomer, R; Harrington, C; Friedlob, A

    1990-08-01

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

  20. Policy succession: the case for federal health planning in the 1990's.

    PubMed

    Mueller, K J

    1993-01-01

    Direct federal involvement in local health planning ended in 1986 with the repeal of the Health Planning and Resources Development Act of 1974. This article argues that planning has remained an important element in state and local public health activities, and that it will re-emerge as a national effort. Theories of policy succession are used to derive conditions for policy renewal that are satisfied by the current policy environment for health planning. The need for planning is obvious when issues related to health care delivery in rural areas are considered, and there are strong advocates of the need for planning.

  1. 76 FR 61384 - Notice of Initial Determination Revising the List of Products Requiring Federal Contractor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-04

    ... Security. DATES: Information should be submitted to the Office of Child Labor, Forced Labor and Human... countries of origin, might have been mined, produced, or manufactured by forced or indentured child labor... Federal Register on June 16, 1999 (64 FR 32383). EO 13126 declared that it was ``the policy of the...

  2. Assessing regression to the mean effects in health care initiatives

    PubMed Central

    2013-01-01

    Background Interventions targeting individuals classified as “high-risk” have become common-place in health care. High-risk may represent outlier values on utilization, cost, or clinical measures. Typically, such individuals are invited to participate in an intervention intended to reduce their level of risk, and after a period of time, a follow-up measurement is taken. However, individuals initially identified by their outlier values will likely have lower values on re-measurement in the absence of an intervention. This statistical phenomenon is known as “regression to the mean” (RTM) and often leads to an inaccurate conclusion that the intervention caused the effect. Concerns about RTM are rarely raised in connection with most health care interventions, and it is uncommon to find evaluators who estimate its effect. This may be due to lack of awareness, cognitive biases that may cause people to systematically misinterpret RTM effects by creating (erroneous) explanations to account for it, or by design. Methods In this paper, the author fully describes the RTM phenomenon, and tests the accuracy of the traditional approach in calculating RTM assuming normality, using normally distributed data from a Monte Carlo simulation and skewed data from a control group in a pre-post evaluation of a health intervention. Confidence intervals are generated around the traditional RTM calculation to provide more insight into the potential magnitude of the bias introduced by RTM. Finally, suggestions are offered for designing interventions and evaluations to mitigate the effects of RTM. Results On multivariate normal data, the calculated RTM estimates are identical to true estimates. As expected, when using skewed data the calculated method underestimated the true RTM effect. Confidence intervals provide helpful guidance on the magnitude of the RTM effect. Conclusion Decision-makers should always consider RTM to be a viable explanation of the observed change in an outcome in

  3. The free health care initiative: how has it affected health workers in Sierra Leone?

    PubMed

    Witter, Sophie; Wurie, Haja; Bertone, Maria Paola

    2016-02-01

    There is an acknowledged gap in the literature on the impact of fee exemption policies on health staff, and, conversely, the implications of staffing for fee exemption. This article draws from five research tools used to analyse changing health worker policies and incentives in post-war Sierra Leone to document the effects of the Free Health Care Initiative (FHCI) of 2010 on health workers.Data were collected through document review (57 documents fully reviewed, published and grey); key informant interviews (23 with government, donors, NGO staff and consultants); analysis of human resource data held by the MoHS; in-depth interviews with health workers (23 doctors, nurses, mid-wives and community health officers); and a health worker survey (312 participants, including all main cadres). The article traces the HR reforms which were triggered by the FHCI and evidence of their effects, which include substantial increases in number and pay (particularly for higher cadres), as well as a reported reduction in absenteeism and attrition, and an increase (at least for some areas, where data is available) in outputs per health worker. The findings highlight how a flagship policy, combined with high profile support and financial and technical resources, can galvanize systemic changes. In this regard, the story of Sierra Leone differs from many countries introducing fee exemptions, where fee exemption has been a stand-alone programme, unconnected to wider health system reforms. The challenge will be sustaining the momentum and the attention to delivering results as the FHCI ceases to be an initiative and becomes just 'business as normal'. The health system in Sierra Leone was fragile and conflict-affected prior to the FHCI and still faces significant challenges, both in human resources for health and more widely, as vividly evidenced by the current Ebola crisis.

  4. A plan for a more effective federal and state health administration. 1919.

    PubMed

    Hoffman, Frederick L

    2009-10-01

    This Classic article is a reprint of the original work by Frederick L. Hoffman, LLD, A Plan for a More Effective Federal and State Health Administration. An accompanying biographical sketch on Frederick L. Hoffman, LLD, is available at DOI 10.1007/s11999-009-1001-9. The Classic Article is (c)1919 by the American Public Health Association and is reprinted with permission from Hoffman FL. A plan for a more effective federal and state health administration. Am J Public Health. 1919;9:161-169. The article can also be accessed on the American Journal of Public Health web site at (http://www.ajph.org/cgi/reprint/9/3/161-a).

  5. Federal expenditures on maternal and child health in the United States.

    PubMed

    Kenney, Mary Kay; Kogan, Michael D; Toomer, Stephanie; van Dyck, Peter C

    2012-02-01

    The goals of this study are to estimate federal maternal and child health (MCH) expenditures and identify their sources. This analysis is intended to provide a broad view of MCH funding appropriations and a basis for discussion of whether funds could be better utilized for the benefit of the population served. Data on federal maternal and child health expenditures for fiscal year (FY) 2006 were derived from examining federal legislation, department/agency budgets, and various web-based program documents posted by federal agencies. Based on selected criteria, we identified programs targeting children under 21 or pregnant/parenting women within the United States. The funding levels of agency programs for maternal and child health activities were determined and the programs briefly summarized. The identifiable funding for maternal and child health programs in FY 2006 approached $57.5 billion dollars. Funding sources for maternal and child health were concentrated within the U.S. Department of Health and Human Services, but spread across several different agencies within the department and in the Departments of Defense, Education, Agriculture, Housing and Urban Development, and the Environmental Protection Agency. Multiple agencies and offices often funded related activities, without evidence of a common underlying strategy. Federal maternal and child health funding mechanisms may lead to a fragmentation in maternal and child health activities. The funding and service delivery apparatus would benefit from an integrative MCH infrastructure approach to pediatric research, service delivery, and data collection/access that incorporates life-course and social/environmental determinants perspectives. PMID:21318294

  6. Surgical Safety Training of World Health Organization Initiatives.

    PubMed

    Davis, Christopher R; Bates, Anthony S; Toll, Edward C; Cole, Matthew; Smith, Frank C T; Stark, Michael

    2014-01-01

    Undergraduate training in surgical safety is essential to maximize patient safety. This national review quantified undergraduate surgical safety training. Training of 2 international safety initiatives was quantified: (1) World Health Organization (WHO) "Guidelines for Safe Surgery" and (2) Department of Health (DoH) "Principles of the Productive Operating Theatre." Also, 13 additional safety skills were quantified. Data were analyzed using Mann-Whitney U tests. In all, 23 universities entered the study (71.9% response). Safety skills from WHO and DoH documents were formally taught in 4 UK medical schools (17.4%). Individual components of the documents were taught more frequently (47.6%). Half (50.9%) of the additional safety skills identified were taught. Surgical societies supplemented safety training, although the total amount of training provided was less than that in university curricula (P < .0001). Surgical safety training is inadequate in UK medical schools. To protect patients and maximize safety, a national undergraduate safety curriculum is recommended.

  7. Initial external validation of REGRESS in public health graduate students.

    PubMed

    Kidwell, Kelley M; Enders, Felicity B

    2014-12-01

    Linear regression is typically taught as a second and potentially last required (bio)statistics course for Public Health and Clinical and Translational Science students. There has been much research on the attitudes of students toward basic biostatistics, but there has not been much assessing students' understanding of critical regression topics. The REGRESS (REsearch on Global Regression Expectations in StatisticS) quiz developed at Mayo Clinic utilizes 27 questions to assess understanding for simple and multiple linear regression. We performed an initial external validation of this tool with 117 University of Michigan public health students. We compare the results of pre- and postcourse quiz scores from the Michigan cohort to scores of Mayo medical students and professional statisticians. University of Michigan students performed higher than Mayo students on the precourse quiz due to previous related coursework, but did not perform as high postcourse indicating the need for course modification. In the Michigan cohort, REGRESS scores improved by a mean (standard deviation) of 4.6 (3.4), p < 0.0001. Our results support the use of the REGRESS quiz as a learning tool for students and an evaluation tool to identify topics for curricular improvement for teachers, while we highlight future directions of research. PMID:25041650

  8. Initial external validation of REGRESS in public health graduate students.

    PubMed

    Kidwell, Kelley M; Enders, Felicity B

    2014-12-01

    Linear regression is typically taught as a second and potentially last required (bio)statistics course for Public Health and Clinical and Translational Science students. There has been much research on the attitudes of students toward basic biostatistics, but there has not been much assessing students' understanding of critical regression topics. The REGRESS (REsearch on Global Regression Expectations in StatisticS) quiz developed at Mayo Clinic utilizes 27 questions to assess understanding for simple and multiple linear regression. We performed an initial external validation of this tool with 117 University of Michigan public health students. We compare the results of pre- and postcourse quiz scores from the Michigan cohort to scores of Mayo medical students and professional statisticians. University of Michigan students performed higher than Mayo students on the precourse quiz due to previous related coursework, but did not perform as high postcourse indicating the need for course modification. In the Michigan cohort, REGRESS scores improved by a mean (standard deviation) of 4.6 (3.4), p < 0.0001. Our results support the use of the REGRESS quiz as a learning tool for students and an evaluation tool to identify topics for curricular improvement for teachers, while we highlight future directions of research.

  9. The evolution of the federal funding policies for the public health surveillance component of Brazil's Unified Health System (SUS).

    PubMed

    Pinto, Vitor Laerte; Cerbino Neto, José; Penna, Gerson Oliveira

    2014-12-01

    Health surveillance (HS) is one of the key components of the Brazilian Unified Health System (SUS). This article describes recent changes in health surveillance funding models and the role these changes have had in the reorganization and decentralization of health actions. Federal law no. 8.080 of 1990 defined health surveillance as a fundamental pillar of the SUS, and an exclusive fund with equitable distribution criteria was created in the Basic Operational Norm of 1996 to pay for health surveillance actions. This step facilitated the decentralization of health care at the municipal level, giving local authorities autonomy to plan and provide services. The Health Pact of 2006 and its regulation under federal decree No. 3252 in 2009 bolstered the processes of decentralization, regionalization and integration of health care. Further changes in the basic concepts of health surveillance around the world and in the funding policies negotiated by different spheres of government in Brazil have been catalysts for the process of HS institutionalization in recent years. PMID:25388192

  10. Cooperative Russian Federation -United States Near-Earth Object (NEO) Observation Initiative

    NASA Astrophysics Data System (ADS)

    Schnelzer, Garry; Marshall, James; Bottke, William; Andrews, John

    On February 15, 2013, an asteroid exploded in the atmosphere near Chelyabinsk, Russia, causing significant damage and concern. Following the Chelyabinsk event, scientists and government leaders in the Russian Federation and United States have highlighted the need for collaborative efforts to quantify and characterize the potential threat from a Near Earth Objects (NEO). This paper will explore the possibility of a collaborative Russian Federation - United States program to perform a survey mission and create mechanisms and protocols for sharing of data relating to NEO threats to our planet. The joint collaboration would focus on identifying capability improvements for NEO observations using current or future space-based and/or ground-based assets of the two countries. Another part of the effort would include improvements in Bolide reporting, to include the “real-time” characterization of a NEO entry.

  11. Using global health initiatives to strengthen health systems: a civil society perspective.

    PubMed

    Cohn, Jennifer; Russell, Asia; Baker, Brook; Kayongo, Alice; Wanjiku, Esther; Davis, Paul

    2011-01-01

    Research into the effects of global health initiatives (GHIs) on health systems has largely left out the viewpoints and contributions of civil society. This study details civil society's perspective regarding the effects of two GHIs, the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), on country health systems and the added value of civil society interacting with GHIs to strengthen health systems. The study employed qualitative data collection methods using semi-structured interviews administered during focus groups and key informant interviews. A range of health system stakeholders were interviewed in Kenya, Malawi, Uganda and Zambia. Data were coded and analysed for themes and sub-themes. In total, 2910 civil society participants provided information individually or in focus groups. Respondents reported that GHIs have contributed to dramatic health benefits within and outside of a disease-specific focus, including health systems strengthening efforts. However, opportunities for synergy between GHIs and health systems have been missed, and GHIs have not worked sufficiently to close capacity gaps of grassroots civil society organisations. Despite some governance innovations, civil society's opportunities to participate meaningfully in GHI priority setting efforts are limited. Recommendations are included on how to best use GHIs to strengthen health systems by partnering with civil society.

  12. Emergency medicine public health research funded by federal agencies: progress and priorities.

    PubMed

    D'Onofrio, Gail; Goldstein, Amy B; Denisco, Richard A; Hingson, Ralph; Heffelfinger, James D; Post, Lori A

    2009-11-01

    The emergency department (ED) visit provides an opportunity to impact the health of the public throughout the entire spectrum of care, from prevention to treatment. As the federal government has a vested interest in funding research and providing programmatic opportunities that promote the health of the public, emergency medicine (EM) is prime to develop a research agenda to advance the field. EM researchers need to be aware of federal funding opportunities, which entails an understanding of the organizational structure of the federal agencies that fund medical research, and the rules and regulations governing applications for grants. Additionally, there are numerous funding streams outside of the National Institutes of Health (NIH; the primary federal health research agency). EM researchers should seek funding from agencies according to each agency's mission and aims. Finally, while funds from the Department of Health and Human Services (HHS) are an important source of support for EM research, we need to look beyond traditional sources and appeal to other agencies with a vested interest in promoting public health in EDs. EM requires a broad skill set from a multitude of medical disciplines, and conducting research in the field will require looking for funding opportunities in a variety of traditional and not so traditional places within and without the federal government. The following is the discussion of a moderated session at the 2009 Academic Emergency Medicine consensus conference that included panel discussants from the National Institutes of Mental Health, Drug Abuse, and Alcoholism and Alcohol Abuse and the Centers for Disease Control and Prevention (CDC). Further information is also provided to discuss those agencies and centers not represented.

  13. 78 FR 9890 - DoD Medicare-Eligible Retiree Health Care Board of Actuaries; Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ... of the Secretary DoD Medicare-Eligible Retiree Health Care Board of Actuaries; Notice of Federal... that the following Federal Advisory Committee meeting of the DoD Medicare-Eligible Retiree Health Care... in the valuation of benefits under DoD retiree health care programs for...

  14. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Emergency use of Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51...

  15. Job Satisfaction and Expected Turnover Among Federal, State, and Local Public Health Practitioners

    PubMed Central

    Harper, Elizabeth; Shon, Ji Won; Sellers, Katie; Castrucci, Brian C.

    2016-01-01

    Objectives. To use data on the governmental public health workforce to examine demographics and elucidate drivers of job satisfaction and intent to leave one’s organization. Methods. Using microdata from the 2014 Federal Employee Viewpoint Survey and 2014 Public Health Workforce Interests and Needs Survey, we drew comparisons between federal, state, and local public health staff. We fitted logistic regressions to examine correlates of both job satisfaction and intent to leave one’s organization within the coming year. Results. Correlates of job satisfaction included pay satisfaction, organizational support, and employee involvement. Approximately 40% of federal, state, and local staff said they were either considering leaving their organization in the next year or were planning to retire by 2020. Conclusions. Public health practitioners largely like their jobs, but many are dissatisfied with their pay and are considering working elsewhere. More should be done to understand the determinants of job satisfaction and how to successfully retain high-quality staff. Public Health Implications. Public health is at a crossroads. Significant turnover is expected in the coming years. Retention efforts should engage staff across all levels of public health. PMID:27552269

  16. 78 FR 57178 - Meeting of the Global Justice Information Sharing Initiative Federal Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-17

    ... Committee (GAC) to discuss the Global Initiative, as described at www.it.ojp.gov/global . DATES: The meeting... Global information sharing concept. It will advise the Assistant Attorney General, OJP; the...

  17. The roles of federal legislation and evolving health care systems in promoting medical-dental collaboration.

    PubMed

    Edelstein, Burton L

    2014-01-01

    Recent federal health care legislation contains explicit and implicit drivers for medical-dental collaboration. These laws implicitly promote health care evolution through value-based financing, "big data" and health information technology, increased number of care providers and a more holistic approach. Additional changes--practice aggregation, consumerism and population health perspectives--may also influence dental care. While dentistry will likely lag behind medicine toward value-based and accountable care organizations, dentists will be affected by changing consumer expectations. PMID:25080685

  18. Current initiatives in One Health: consolidating the One Health Global Network.

    PubMed

    Vandersmissen, A; Welburn, S C

    2014-08-01

    The Global Response to Avian Influenza has led to a longer-term One Health movement, which addresses risks, including zoonoses, at the human-animal- environment interface, and requires the development of innovative partnerships at the political, institutional and technical levels. One Health is a sustainable and rational option when the cumulative effects of health hazards on food and economic security are considered, but demands long-term financial investment. Projections of growth in the demand for livestock production and consumption in Asia and Africa also call for effective One Health responses. However, an effective response also requires validated evidence of the socio-economic value that the One Health approach can provide. Implementing the One Health approach depends on forging strong links between human and animal health services, the environment and public policy. The authors present a list of some of the national and transnational partnerships established since 2006. Political support, good governance and effective policies and networks are crucial building blocks for One Health sustainability. The Global Response to Avian Influenza was initially established under the joint leadership of the European Union, the United States and the United Nations System Influenza Coordination Office. Since then it has supported numerous initiatives, including the World Health Organization (WHO)/Food and Agriculture Organization of the United Nations (FAO)/World Organisation for Animal Health (OIE) Global Early Warning System (GLEWS). Indeed, the Global Response to Avian Influenza paved the way for an unprecedented WHO/FAO/OIE tripartite partnership, which promoted the integration of foodborne, neglected zoonotic and tropical diseases within the One Health movement and led to the tripartite High-Level Technical Meeting of 2011 in Mexico. The One Health Global Network, which began as a proposition at an Expert Consultation in Winnipeg, Canada, in 2009, is now a reality

  19. Current initiatives in One Health: consolidating the One Health Global Network.

    PubMed

    Vandersmissen, A; Welburn, S C

    2014-08-01

    The Global Response to Avian Influenza has led to a longer-term One Health movement, which addresses risks, including zoonoses, at the human-animal- environment interface, and requires the development of innovative partnerships at the political, institutional and technical levels. One Health is a sustainable and rational option when the cumulative effects of health hazards on food and economic security are considered, but demands long-term financial investment. Projections of growth in the demand for livestock production and consumption in Asia and Africa also call for effective One Health responses. However, an effective response also requires validated evidence of the socio-economic value that the One Health approach can provide. Implementing the One Health approach depends on forging strong links between human and animal health services, the environment and public policy. The authors present a list of some of the national and transnational partnerships established since 2006. Political support, good governance and effective policies and networks are crucial building blocks for One Health sustainability. The Global Response to Avian Influenza was initially established under the joint leadership of the European Union, the United States and the United Nations System Influenza Coordination Office. Since then it has supported numerous initiatives, including the World Health Organization (WHO)/Food and Agriculture Organization of the United Nations (FAO)/World Organisation for Animal Health (OIE) Global Early Warning System (GLEWS). Indeed, the Global Response to Avian Influenza paved the way for an unprecedented WHO/FAO/OIE tripartite partnership, which promoted the integration of foodborne, neglected zoonotic and tropical diseases within the One Health movement and led to the tripartite High-Level Technical Meeting of 2011 in Mexico. The One Health Global Network, which began as a proposition at an Expert Consultation in Winnipeg, Canada, in 2009, is now a reality

  20. Crisis, leadership, consensus: the past and future federal role in health.

    PubMed

    Boufford, J I

    1999-06-01

    This paper touches on patterns of federal government involvement in the health sector since the late 18th century to the present and speculates on its role in the early decades of the 21st century. Throughout the history of the US, government involvement in the health sector came only in the face of crisis, only when there was widespread consensus, and only through sustained leadership. One of the first health-related acts of Congress came about as a matter of interstate commerce regarding the dilemma as to what to do about treating merchant seamen who had no affiliation with any state. Further federal actions were implemented to address epidemics, such as from yellow fever, that traveled from state to state through commercial ships. Each federal action was met with concern and resistance from states' rights advocates, who asserted that the health of the public was best left to the states and localities. It was not until the early part of the 20th century that a concern for social well-being, not merely commerce, drove the agenda for public health action. Two separate campaigns for national health insurance, as well as a rapid expansion of programs to serve the specific health needs of specific populations, led finally to the introduction of Medicaid and Medicare in the 1960s, the most dramatic example of government intervention in shaping the personal health care delivery system in the latter half of the 20th century. As health costs continued to rise and more and more Americans lacked adequate health insurance, a perceived crisis led President Clinton to launch his 1993 campaign to insure every American--the third attempt in this century to provide universal coverage. While the crisis was perceived by many, there was no consensus on action, and leadership outside government was missing. Today, the health care crisis still looms. Despite an economic boom, 1 million Americans lose their health insurance each year, with 41 million Americans, or 15% of the population

  1. Involving local health departments in community health partnerships: evaluation results from the partnership for the public's health initiative.

    PubMed

    Cheadle, Allen; Hsu, Clarissa; Schwartz, Pamela M; Pearson, David; Greenwald, Howard P; Beery, William L; Flores, George; Casey, Maria Campbell

    2008-03-01

    Improving community health "from the ground up" entails a comprehensive ecological approach, deep involvement of community-based entities, and addressing social determinants of population health status. Although the Centers for Disease Control and Prevention, the Office of the Surgeon General, and other authorities have called for public health to be an "inter-sector" enterprise, few models have surfaced that feature local health departments as a key part of the collaborative model for effecting community-level change. This paper presents evaluation findings and lessons learned from the Partnership for the Public's Health (PPH), a comprehensive community initiative that featured a central role for local health departments with their community partners. Funded by The California Endowment, PPH provided technical and financial resources to 39 community partnerships in 14 local health department jurisdictions in California to promote community and health department capacity building and community-level policy and systems change designed to produce long-term improvements in population health. The evaluation used multiple data sources to create progress ratings for each partnership in five goal areas related to capacity building, community health improvement programs, and policy and systems change. Overall results were generally positive; in particular, of the 37 partnerships funded continuously throughout the 5 years of the initiative, between 25% and 40% were able to make a high level of progress in each of the Initiative's five goal areas. Factors associated with partnership success were also identified by local evaluators. These results showed that health departments able to work effectively with community groups had strong, committed leaders who used creative financing mechanisms, inclusive planning processes, organizational changes, and open communication to promote collaboration with the communities they served. PMID:18259870

  2. Involving local health departments in community health partnerships: evaluation results from the partnership for the public's health initiative.

    PubMed

    Cheadle, Allen; Hsu, Clarissa; Schwartz, Pamela M; Pearson, David; Greenwald, Howard P; Beery, William L; Flores, George; Casey, Maria Campbell

    2008-03-01

    Improving community health "from the ground up" entails a comprehensive ecological approach, deep involvement of community-based entities, and addressing social determinants of population health status. Although the Centers for Disease Control and Prevention, the Office of the Surgeon General, and other authorities have called for public health to be an "inter-sector" enterprise, few models have surfaced that feature local health departments as a key part of the collaborative model for effecting community-level change. This paper presents evaluation findings and lessons learned from the Partnership for the Public's Health (PPH), a comprehensive community initiative that featured a central role for local health departments with their community partners. Funded by The California Endowment, PPH provided technical and financial resources to 39 community partnerships in 14 local health department jurisdictions in California to promote community and health department capacity building and community-level policy and systems change designed to produce long-term improvements in population health. The evaluation used multiple data sources to create progress ratings for each partnership in five goal areas related to capacity building, community health improvement programs, and policy and systems change. Overall results were generally positive; in particular, of the 37 partnerships funded continuously throughout the 5 years of the initiative, between 25% and 40% were able to make a high level of progress in each of the Initiative's five goal areas. Factors associated with partnership success were also identified by local evaluators. These results showed that health departments able to work effectively with community groups had strong, committed leaders who used creative financing mechanisms, inclusive planning processes, organizational changes, and open communication to promote collaboration with the communities they served.

  3. Federal regulation comes to private health care financing: the group health insurance provisions of the Health Insurance Portability and Accountability Act of 1996.

    PubMed

    Rovner, J A

    1998-01-01

    Attorney Rovner presents a very detailed accounting of the impacts of the Health Insurance Portability and Accountability Act as it relates to group health insurance including provisions that concern pre-existing conditions, special enrollment rights, premium discrimination, maternity lengths of stay, parity for mental health benefits and small groups coverage. The article concludes with a discussion of the federalism question as it relates to regulation of private market health financing.

  4. The Role of the Federal Government in Financing Health and Medical Services

    ERIC Educational Resources Information Center

    Bloom, Bernard S.; Martin, Samuel

    1976-01-01

    This analysis of public and private sector spending for health services shows they have paralleled each other for four decades although total expenditures have grown dramatically. Since 1966 the federal government's major participation has been through the Medicare trust fund. Need for larger government role is predicted. (Editor/JT)

  5. Vocational Instructional Materials for Allied Health Education Available from Federal Agencies.

    ERIC Educational Resources Information Center

    Hill, Carol L., Comp.

    This listing of federally produced curriculum and instructional materials for allied health education is one of eight annotated bibliographies that provide information for vocational educators at the secondary, postsecondary, and adult levels. Introductory information given includes a description of how to use the listing and sources and ordering…

  6. Uncertainties of Federal Child Health Policies: Impact in Two States; NCHSR Research Digest Series.

    ERIC Educational Resources Information Center

    Foltz, Anne-Marie

    This report assesses the impact of federal child health policy under Titles V and XIX of the Social Security Act upon the states of Connecticut and Vermont for the years 1935 to 1975, and analyzes the reasons for the discrepancy between policy intent and state execution. Two simultaneous approaches are used for data analysis: a cross sectional…

  7. 76 FR 53156 - Submission for Review: Request To Change Federal Employees Health Benefits (FEHB) Enrollment for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-25

    ... Spouse Equity/Temporary Continuation of Coverage (TCC) Enrollees/Direct Pay Annuitants (DPRS 2809) AGENCY... Change Federal Employees Health Benefits (FEHB) Enrollment for Spouse Equity/Temporary Continuation of... Register on April 11, 2011 at Volume 76 FR 18810 allowing for a 60-day public comment period. We...

  8. Clinical Perspectives on Colorectal Cancer Screening at Latino-Serving Federally Qualified Health Centers

    ERIC Educational Resources Information Center

    Coronado, Gloria D.; Petrik, Amanda F.; Spofford, Mark; Talbot, Jocelyn; Do, Huyen Hoai; Taylor, Victoria M.

    2015-01-01

    Purpose: Colorectal cancer is the second most common cause of cancer death in the United States, and rates of screening for colorectal cancer are low. We sought to gather the perceptions of clinic personnel at Latino-serving Federally Qualified Health Centers (operating 17 clinics) about barriers to utilization of screening services for colorectal…

  9. Global health initiative investments and health systems strengthening: a content analysis of global fund investments

    PubMed Central

    2013-01-01

    Background Millions of dollars are invested annually under the umbrella of national health systems strengthening. Global health initiatives provide funding for low- and middle-income countries through disease-oriented programmes while maintaining that the interventions simultaneously strengthen systems. However, it is as yet unclear which, and to what extent, system-level interventions are being funded by these initiatives, nor is it clear how much funding they allocate to disease-specific activities – through conventional ‘vertical-programming’ approach. Such funding can be channelled to one or more of the health system building blocks while targeting disease(s) or explicitly to system-wide activities. Methods We operationalized the World Health Organization health system framework of the six building blocks to conduct a detailed assessment of Global Fund health system investments. Our application of this framework framework provides a comprehensive quantification of system-level interventions. We applied this systematically to a random subset of 52 of the 139 grants funded in Round 8 of the Global Fund to Fight AIDS, Tuberculosis and Malaria (totalling approximately US$1 billion). Results According to the analysis, 37% (US$ 362 million) of the Global Fund Round 8 funding was allocated to health systems strengthening. Of that, 38% (US$ 139 million) was for generic system-level interventions, rather than disease-specific system support. Around 82% of health systems strengthening funding (US$ 296 million) was allocated to service delivery, human resources, and medicines & technology, and within each of these to two to three interventions. Governance, financing, and information building blocks received relatively low funding. Conclusions This study shows that a substantial portion of Global Fund’s Round 8 funds was devoted to health systems strengthening. Dramatic skewing among the health system building blocks suggests opportunities for more balanced

  10. 75 FR 17903 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-08

    ... Management Initiative. The Board may also vote on issues presented by the Psychological Health External Advisory Subcommittee and the Trauma and Injury Subcommittee. Pursuant to 5 U.S.C. 552b, as amended, and...

  11. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... and all Federal health care programs. 1003.105 Section 1003.105 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES CIVIL MONEY PENALTIES... health care programs. (a)(1) Except as set forth in paragraph (b) of this section, the following...

  12. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and all Federal health care programs. 1003.105 Section 1003.105 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES CIVIL MONEY PENALTIES... health care programs. (a)(1) Except as set forth in paragraph (b) of this section, the following...

  13. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... and all Federal health care programs. 1003.105 Section 1003.105 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES CIVIL MONEY PENALTIES... health care programs. (a)(1) Except as set forth in paragraph (b) of this section, the following...

  14. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and all Federal health care programs. 1003.105 Section 1003.105 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES CIVIL MONEY PENALTIES... health care programs. (a)(1) Except as set forth in paragraph (b) of this section, the following...

  15. 42 CFR 1003.105 - Exclusion from participation in Medicare, Medicaid and all Federal health care programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... and all Federal health care programs. 1003.105 Section 1003.105 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES CIVIL MONEY PENALTIES... health care programs. (a)(1) Except as set forth in paragraph (b) of this section, the following...

  16. [Will health promotion remain a utopia in a fragmented political system? The case of the Wallonia-Brussels Federation].

    PubMed

    Bantuelle, Martine

    2013-01-01

    In the French Community of Belgium (the Wallonia-Brussels Federation), the changing political landscape and the various laws relating to the roles of the federal state, communities and regions introduced since 1980 have had a significant impact on health policy. Since then, there have been significant developments in health education services and activities. In 1997, a government decree was issued to promote the concept of health promotion, to reform the existing system and to define policy priorities as part of a new five-year plan (1998-2003). Significant progress was made during this period as a result of the development of a global approach extending beyond the mere analysis of risk factors. The second five-year plan (2004-2008), aimed at combining preventive medicine and health promotion, resulted in the involvement of a wider range of actors and greater cross-sector collaboration. However, the sheer number of decision-making levels has been a major obstacle to popular participation and consultation. If the question of social and cultural accessibility is not seriously addressed, the focus on preventive medicine programs may prove to be detrimental to the development of an effective health promotion framework. The disconnect between the political vision and the reality of practice has had an adverse impact on health promotion. Health promotion professionals have repeatedly called for a third five-year plan involving all ministers and aimed at developing a cross-sector approach, at addressing the determinants of health, at promoting the active participation of local communities and at reducing social health inequalities. The concerns of health promotion practitioners were further exacerbated by the introduction of an external assessment process initiated by the Ministry of Health in 2010. The current concerns over the future of the Belgian state, the economic crisis and the impact of spending cuts have increased the sense of uncertainty. The upcoming elections

  17. [Will health promotion remain a utopia in a fragmented political system? The case of the Wallonia-Brussels Federation].

    PubMed

    Bantuelle, Martine

    2013-01-01

    In the French Community of Belgium (the Wallonia-Brussels Federation), the changing political landscape and the various laws relating to the roles of the federal state, communities and regions introduced since 1980 have had a significant impact on health policy. Since then, there have been significant developments in health education services and activities. In 1997, a government decree was issued to promote the concept of health promotion, to reform the existing system and to define policy priorities as part of a new five-year plan (1998-2003). Significant progress was made during this period as a result of the development of a global approach extending beyond the mere analysis of risk factors. The second five-year plan (2004-2008), aimed at combining preventive medicine and health promotion, resulted in the involvement of a wider range of actors and greater cross-sector collaboration. However, the sheer number of decision-making levels has been a major obstacle to popular participation and consultation. If the question of social and cultural accessibility is not seriously addressed, the focus on preventive medicine programs may prove to be detrimental to the development of an effective health promotion framework. The disconnect between the political vision and the reality of practice has had an adverse impact on health promotion. Health promotion professionals have repeatedly called for a third five-year plan involving all ministers and aimed at developing a cross-sector approach, at addressing the determinants of health, at promoting the active participation of local communities and at reducing social health inequalities. The concerns of health promotion practitioners were further exacerbated by the introduction of an external assessment process initiated by the Ministry of Health in 2010. The current concerns over the future of the Belgian state, the economic crisis and the impact of spending cuts have increased the sense of uncertainty. The upcoming elections

  18. [Memorandum on sustainable reinforcement of prevention and health promotion: challenges at the federal, state and local level].

    PubMed

    Walter, U; Nöcker, G; Pawils, S; Robra, B-P; Trojan, A; Franz, M; Grossmann, B; Schmidt, T-A; Lehmann, H; Bauer, U; Göpel, E; Janz, A; Kuhn, J; Naegele, G; Müller-Kohlenberg, H; Plaumann, M; Stender, K-P; Stolzenberg, R; Süß, W; Trenker, M; Wanek, V; Wildner, M

    2015-05-01

    Research-based evidence and practice-based experience are core requirements for the effective implementation of preventive interventions. The knowledge gained in the Prevention Research Funding Initiative of the German Federal Ministry of Education and Research (2004-2013) was therefore amalgamated, reflected and consolidated in the Cooperation for Sustainable Prevention Research (KNP) meta-project. In annual strategy meetings, researchers and practitioners from the field and other experts developed 3 memoranda providing recommendations for the further development of research and practice in the field of prevention and health promotion. Memorandum III is primarily aimed at decision-makers in politics and administration at the federal, state and local level, in civil society and in the workplace. Its recommendations show that structuring efforts are urgently needed to achieve sustainable policy, particularly in the fields of health, education, employment and social affairs. Memorandum III brings together the knowledge extracted and problems identified in research projects. More so than its 2 predecessors, Memorandum III abstracts knowledge from the individual projects and attempts to derive guidance for action and decision-making, as shown by the 7 recommendations that appear to useful for consensus-building in practice and research. Value judgments are inevitable. Prevention and health promotion are an investment in the future: of social health, social capital and social peace. Improvement of the framework conditions is needed to achieve the harmonized awareness and the sustained effectiveness of these structure-building efforts in different policy areas, spheres of life, fields of action, and groups of actors. This includes the implementation of an overall national strategy as well as the expansion of sources of funding, extension of the legal framework, overarching coordination, and the establishment of a National Center of Excellence to develop and safeguard

  19. Federal state differentials in the efficiency of health production in Germany: an artifact of spatial dependence?

    PubMed

    Felder, Stefan; Tauchmann, Harald

    2013-02-01

    Due to regional competition and patient migration, the efficiency of healthcare provision at the regional level is subject to spatial dependence. We address this issue by applying a spatial autoregressive model to longitudinal data from Germany at the district ('Kreis') level. The empirical model is specified to explain efficiency scores, which we derive through non-parametric order-m efficiency analysis of regional health production. The focus is on the role of health policy of federal states ('Bundesländer') for district efficiency. Regression results reveal significant spatial spillover effects. Notably, accounting for spatial dependence does not decrease but increases the estimated effect of federal states on district efficiency. It appears that genuinely more efficient states are less affected by positive efficiency spillovers, so that taking into account spatial dependence clarifies the importance of health policy at the state level. PMID:21901473

  20. Politics and the Erosion of Federal Scientific Capacity: Restoring Scientific Integrity to Public Health Science

    PubMed Central

    Rest, Kathleen M.; Halpern, Michael H.

    2007-01-01

    Our nation’s health and prosperity are based on a foundation of independent scientific discovery. Yet in recent years, political interference in federal government science has become widespread, threatening this legacy. We explore the ways science has been misused, the attempts to measure the pervasiveness of this problem, and the effects on our long-term capacity to meet today’s most complex public health challenges. Good government and a functioning democracy require public policy decisions to be informed by independent science. The scientific and public health communities must speak out to defend taxpayer-funded science from political interference. Encouragingly, both the scientific community and Congress are exploring ways to restore scientific integrity to federal policymaking. PMID:17901422

  1. Politics and the erosion of federal scientific capacity: restoring scientific integrity to public health science.

    PubMed

    Rest, Kathleen M; Halpern, Michael H

    2007-11-01

    Our nation's health and prosperity are based on a foundation of independent scientific discovery. Yet in recent years, political interference in federal government science has become widespread, threatening this legacy. We explore the ways science has been misused, the attempts to measure the pervasiveness of this problem, and the effects on our long-term capacity to meet today's most complex public health challenges. Good government and a functioning democracy require public policy decisions to be informed by independent science. The scientific and public health communities must speak out to defend taxpayer-funded science from political interference. Encouragingly, both the scientific community and Congress are exploring ways to restore scientific integrity to federal policymaking.

  2. A Technical Assistance Framework to Facilitate the Delivery of Integrated Behavioral Health Services in Federally Qualified Health Centers (FQHCs).

    PubMed

    Chaple, Michael; Sacks, Stanley; Randell, Joan; Kang, Barbara

    2016-01-01

    An implementation approach, featuring direct, onsite technical assistance is described, and findings from a pilot study assessing the capability of Federally Qualified Health Centers to provide integrated behavioral health services are presented. Investigators used the Behavioral Health Integration in Medical Care (BHIMC) index to measure integration at baseline and follow-up at four FQHCs in New Jersey. Results indicate that the average baseline capability score of 1.95 increased to 2.44 at follow-up, almost one-half point on the five-point BHIMC index. This pilot project demonstrates that co-occurring capability can be assessed, and system-wide technical assistance can be delivered to assist FQHCs in integrating behavioral health services. Future research should test technical assistance as an implementation strategy to promote the integration of medical care and behavioral health treatment on a wider scale.

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

    PubMed

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

    2014-07-01

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

  4. NAVIGATING the Future Through the Past The Enduring Historical Legacy of Federal Children's Health Programs in the United States

    PubMed Central

    2012-01-01

    The United States excels at treating the most complex medical conditions, but our low-ranking health statistics (relative to other countries) do not match our high-end health care spending. One way to understand this paradox is to examine the history of federal children's health programs. In the 1800s, children's health advocates confronted social determinants of health to reduce infant mortality. Over the past 100 years, however, physicians have increasingly focused on individual doctor–patient encounters; public health professionals, meanwhile, have maintained a population health perspective but struggled with the politics of addressing root causes of disease. Political history and historical demography help explain some salient differences with European nations that date to the founding of federal children's health programs in the early 20th century. More recently, federal programs for children with intellectual disability illustrate technical advances in medicine, shifting children's health epidemiology, and the politics of public health policy. PMID:22897550

  5. Strategic initiatives for HMOs under mental health carve-outs.

    PubMed

    Lazarus, A

    2001-02-01

    Many MCOs provide consumers with mental health care benefits--whether internally or through an outside vendor. Just having a plan in place is not enough, however. The author outlines seven ways that health plans can maximize the benefits of mental health coverage while at the same time satisfying members and purchasers.

  6. Teaching Medical Students about Health Literacy: 2 Chicago Initiatives

    ERIC Educational Resources Information Center

    Harper, William; Cook, Sandy; Makoul, Gregory

    2007-01-01

    Objective: To develop medical students' skills in interacting with individuals who have limited health literacy. Methods: Described are 2 novel approaches to health literacy curriculum design. Efforts at both schools have been implemented to improve medical student awareness of health literacy, as well as specific skills in clear communication and…

  7. Impact of global health governance on country health systems: the case of HIV initiatives in Nigeria

    PubMed Central

    Chima, Charles Chikodili; Homedes, Nuria

    2015-01-01

    Background Three global health initiatives (GHIs) – the US President’s Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank Multi–Country HIV/AIDS Program – finance most HIV services in Nigeria. Critics assert that GHIs burden fragile health systems in resource–poor countries and that health system limitations in these countries constrain the achievement of the objectives of GHIs. This study analyzed interactions between HIV GHIs and the Nigerian Health System and explored how the impact of the GHIs could be optimized. Methods A country case study was conducted using qualitative methods, including: semi–structured interviews, direct observation, and archival review. Semi–structured interviews were held with key informants selected to reach a broad range of stakeholders including policymakers, program managers, service providers, representatives of donor agencies and their implementing partners; the WHO country office in Nigeria; independent consultants; and civil society organizations involved in HIV work. The fieldwork was conducted between June and August 2013. Findings HIV GHIs have had a mixed impact on the health system. They have enhanced availability of and access to HIV services, improved quality of services, and strengthened health information systems and the role of non–state actors in health care. On the negative end, HIV donor funding has increased dependency on foreign aid, widened disparities in access to HIV services, done little to address the sustainability of the services, crowded out non–HIV health services, and led to the development of a parallel supply management system. They have also not invested significantly in the production of new health workers and have not addressed maldistribution problems, but have rather contributed to internal brain drain by luring health workers from the public sector to non–governmental organizations and have increased workload for

  8. Initiating continuing improvement within Greenfield sites: A federal remanufacturing facility case study

    SciTech Connect

    Montgomery, J.C.; Paul, B.K.

    1992-09-01

    The setting for this study was a federal government remanufacturing depot, responsible for the replacement and overhaul of large wheeled vehicles. These vehicles include 2.5 and 5 ton trucks and their major subordinate component items such as engines, axles, and transmissions. At the time of the case study the depot was involved in the design and construction of a 400,000 square foot hard metal subordinate items remanufacturing facility. The purpose of the facility was to consolidate all existing subordinate item remanufacturing under one roof. Commodity items to be remanufactured within the facility included engines, transmissions, transfer cases, axles, differentials, power generators, and other components. From the onset, the concept of consolidating existing processes under one roof had posed a significant material handling problem. Digital simulation was used to analyze material flow patterns within the new facility. As a result it was determined that, without changing the existing flow of material between processes, significant choke points would form in the areas of shared-capacity resources such as cleaning and painting. It was estimated that these choke points, representing piles of work-in-process (WIP) inventory, would clog aisles and prevent forklifts from making essential deliveries. Thus, a strategy was needed for controlling the buildup of WIP inventory within the new facility. To accomplish this objective, a program was begun to certify the WIP inventory levels of each subordinate item commodity line within existing facilities prior to the move into the new facility. This program focused on training workers in new methods of inventory control, production control, and quality control needed to minimize the WIP levels required within the new facility.

  9. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... hospital care under 38 U.S.C. 1710 or 38 CFR 17.46. Use of Public or Private Hospitals ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public...

  10. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... hospital care under 38 U.S.C. 1710 or 38 CFR 17.46. Use of Public or Private Hospitals ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public...

  11. 76 FR 22899 - Federal Health IT Strategic Plan: 2011-2015 Open Comment Period Extended Until Friday, May 6

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-25

    ... HUMAN SERVICES Federal Health IT Strategic Plan: 2011-2015 Open Comment Period Extended Until Friday...: Notice. SUMMARY: The Federal Health IT Strategic Plan: 2011-2015 (``the Plan'') ] was posted on the ONC....m. (Eastern). This notice serves to announce that the public comment period for the Plan has...

  12. 75 FR 42085 - Workshop To Review Initial Health Effects Draft Materials for the Ozone (O3

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-20

    ... AGENCY Workshop To Review Initial Health Effects Draft Materials for the Ozone (O 3 ) Integrated Science... (O 3 ), EPA is announcing that a workshop to evaluate initial draft materials for the health effects... sections on the health effects evidence from in vivo and in vitro animal toxicology, human clinical,...

  13. Federal Parity In The Evolving Mental Health And Addiction Care Landscape.

    PubMed

    Barry, Colleen L; Goldman, Howard H; Huskamp, Haiden A

    2016-06-01

    The intent of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 is to eliminate differences between health insurance coverage of mental health and substance use disorder benefits and coverage of medical or surgical benefits. The Affordable Care Act significantly extended the reach of the Wellstone-Domenici law by applying it to new insurance markets. We summarize the evolution of legislative and regulatory actions to bring about federal insurance parity. We also summarize available evidence on how the Wellstone-Domenici law has contributed to addressing insurance discrimination; rectifying market inefficiencies due to adverse selection; and altering utilization, spending, and health outcomes for people with mental health and substance use disorders. In addition, we highlight important gaps in knowledge about how parity has been implemented, describe the groups still lacking parity-level coverage, and make recommendations on steps to improve the likelihood that the Wellstone-Domenici law will fulfill the aims of its architects.

  14. Who gets how much: funding formulas in federal public health programs.

    PubMed

    Buehler, James W; Holtgrave, David R

    2007-01-01

    Federal public health programs use a mix of formula-based and competitive methods to allocate funds among states and other constituent jurisdictions. Characteristics of formula-based allocations used by a convenience sample of four programs, three from the Centers for Disease Control and Prevention and one from the Health Resources and Services Administration, are described to illustrate formula-based allocation methods in public health. Data sources in these public health formulas include population counts and funding proportions based on historical precedent. None include factors that adjust allocations based on variations in the availability of local resources or the cost of delivering services. Formula-funded activities are supplemented by programs that target specific prevention needs or encourage development of innovative methods to address emerging problems, using set-aside funds. A public health finance research agenda should address ways to improve the fit between funding allocation formulas and program objectives.

  15. Mental Health and Substance Abuse Insurance Parity for Federal Employees: How Did Health Plans Respond?

    ERIC Educational Resources Information Center

    Barry, Colleen L.; Ridgely, M. Susan

    2008-01-01

    A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than…

  16. SU-E-T-544: A Radiation Oncology-Specific Multi-Institutional Federated Database: Initial Implementation

    SciTech Connect

    Hendrickson, K; Phillips, M; Fishburn, M; Evans, K; Banerian, S; Mayr, N; Wong, J; McNutt, T; Moore, J; Robertson, S

    2014-06-01

    Purpose: To implement a common database structure and user-friendly web-browser based data collection tools across several medical institutions to better support evidence-based clinical decision making and comparative effectiveness research through shared outcomes data. Methods: A consortium of four academic medical centers agreed to implement a federated database, known as Oncospace. Initial implementation has addressed issues of differences between institutions in workflow and types and breadth of structured information captured. This requires coordination of data collection from departmental oncology information systems (OIS), treatment planning systems, and hospital electronic medical records in order to include as much as possible the multi-disciplinary clinical data associated with a patients care. Results: The original database schema was well-designed and required only minor changes to meet institution-specific data requirements. Mobile browser interfaces for data entry and review for both the OIS and the Oncospace database were tailored for the workflow of individual institutions. Federation of database queries--the ultimate goal of the project--was tested using artificial patient data. The tests serve as proof-of-principle that the system as a whole--from data collection and entry to providing responses to research queries of the federated database--was viable. The resolution of inter-institutional use of patient data for research is still not completed. Conclusions: The migration from unstructured data mainly in the form of notes and documents to searchable, structured data is difficult. Making the transition requires cooperation of many groups within the department and can be greatly facilitated by using the structured data to improve clinical processes and workflow. The original database schema design is critical to providing enough flexibility for multi-institutional use to improve each institution s ability to study outcomes, determine best practices

  17. Courts and health care rationing: the case of the Brazilian Federal Supreme Court.

    PubMed

    Wang, Daniel W L

    2013-01-01

    The recognition that access to health care is a constitutional right in Brazil has resulted in a situation in which citizens denied treatments by the public health care system have brought lawsuits against health authorities, claiming that their right to health was violated. This litigation forces the courts to decide between a patient-centred and a population-centred approach to public health - a choice that forces the courts to assess health care rationing decisions. This article analyses the judgments of the Brazilian Federal Supreme Court in right to health cases, arguing that the Court's recent decisions have been contrary to their long-standing stance against rationing. In 2009, the Court organized a public hearing to discuss this topic with civil society and established criteria to determine when rationing would be legal. However, I argue that these criteria for health care rationing do not adequately address the most difficult health care distribution dilemmas. They force the health care system to keep their rationing criteria implicit and make population-centred concerns secondary to individual-centred ones.

  18. Collaborative practice in health systems change: the Nova Scotia experience with the Strengthening Primary Care Initiative.

    PubMed

    Martin-Misener, Ruth; McNab, John; Sketris, Ingrid S; Edwards, Lynn

    2004-05-01

    Recently attention has been focussed on the significance of primary care to the Canadian healthcare system. Nova Scotia. Like other provinces, is seeking ways to improve the healthcare that it provides within a financially constrained publicly funded system. The Strengthening Primary Care Initiative in Nova Scotia (SPCI) was a primary care demonstration project to evaluate specific goals related to primary care. Although the provincial government conceived the SPCI, the approach to its planning and implementation was participatory and consultative. Funded through the federal Health Transition Fund (HTF) (Health Canada 2002) and the government of Nova Scotia, the SPCI involved changes in four communities over a three-year period (2000-2002). These changes included the introduction of a primary healthcare nurse practitioner in collaborative practice with one or more family physicians; remuneration of the family physician(s) with methods other than a solely fee-for-service (FFS) arrangement; and the introduction and utilization of a computerized patient medical record. The SPCI was committed to a consultative process with stakeholders, and this gave rise to several challenges. Initially there was disagreement on the requirement for nurse practitioners at each of the demonstration sites. The Minister of Health confirmed that a nurse practitioner was a required component at each demonstration site. Differences in perspectives on the role of allied health professionals in the SPCI were encountered, and the significance of the role pharmacists have in primary care was not fully appreciated until after the SPCI had started. At the time the SPCI began there was no legislation for nurse practitioners in Nova Scotia; therefore, an approval mechanism for nurse practitioner practice was authorized through the provincial regulatory bodies for nursing and medicine. Malpractice and liability issues, particularly on the part of providers who had never worked with nurse

  19. Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance Program: eligibility for Pathway Programs participants. Interim final rule with request for comments.

    PubMed

    2014-01-01

    The U.S. Office of Personnel Management (OPM) is issuing an interim final regulation to update the Federal Employees Health Benefits Program (FEHBP) and the Federal Employees Dental and Vision Insurance Program (FEDVIP) regulations to reflect updated election opportunities for participants in the Pathways Programs. The Pathways Programs were created by Executive Order (E.O.) 13562, signed by the President on December 27, 2010, and are designed to enable the Federal Government to compete effectively for students and recent graduates by improving its recruitment efforts through internships and similar programs with Federal agencies. This interim final rule furthers these recruitment and retention efforts by providing health insurance, as well as dental and vision benefits, to eligible program participants and their families.

  20. What does it take? How federal initiatives can support the implementation of evidence-based programs to improve outcomes for adolescents.

    PubMed

    Metz, Allison; Albers, Bianca

    2014-03-01

    Over the last 20 years, there has been a growing emphasis on developing and identifying evidence-based programs and practices for children and families and within the last decade an increasing number of federally funded initiatives have been dedicated to replicating and scaling evidence-based programs with the hope of achieving socially meaningful impact. However, only recently have efforts to promote high-fidelity implementation been given the attention needed to ensure evidence-based practices are used as intended and generate the outcomes they were designed to produce. In this article, we propose that the wide-scale implementation of evidence-based practices requires: (1) careful assessment and selection of the "what"; (2) a stage-based approach that provides adequate time and resources for planning and installation activities; (3) the co-creation of a visible infrastructure by a triad of key stakeholders including funders and policymakers, program developers, and implementing sites; and (4) the use of data to guide decision-making and foster curiosity into continuous improvement among grantees. Each of these strategies is explored in greater detail through the lens of the Teen Pregnancy Prevention (TPP) Program, a $100 million initiative overseen by the Office of Adolescent Health (OAH) in the U.S. Department of Health and Human Services.

  1. Recent federal initiatives to promote unconventional gas: High octane delivery of just hot air?

    SciTech Connect

    Griff, M.T.

    1995-10-01

    This paper provides an overview of recent initiatives of the United States which promote greater use of natural gas and unconventional gas as one part of this nations`s larger response to the global warming threat. Measurable increases in greenhouse gas concentrations since the beginning of the industrial revolution have led to the belief in the existence of a global warming problem. The international community has responded to the global warming threat with the United Nations Framework Convention on Climate Change which is directed toward the stabilization of greenhouse gases in the atmosphere. The Climate Change Action Plan is the Clinton Administration`s detailed response to the global warming threat. It is designed to return United States emissions of greenhouse gases to their 1990 levels by the year 2000. The Action Plan targets all greenhouse gases and emphasizes energy efficiency. Significant regulatory reformation designed to increase the efficiency of the natural gas industry has already occurred and will be continued. Recovery of methane emissions from landfills will be encouraged through indentification of suitable sites and use of existing technology and development of new technology. Recovery of methane from coal mining operations will be promoted by targeting 50 of the gassiest mines in the United States. Even if the Action Plan is fully implemented. legitimate questions arise as to whether its goals will be achieved as a result of funding shortfalls.

  2. Rainbows: a primary health care initiative for primary schools.

    PubMed

    Munns, Ailsa; Forde, Karen A; Krouzecky, Miriam; Shields, Linda

    2015-01-01

    Within the current Australian health system is the understanding of a need to change from the predominate biomedical model to incorporate a comprehensive primary health care centred approach, embracing the social contexts of health and wellbeing. Recent research investigated the benefits of the primary health care philosophy and strategies in relation to the Rainbows programme which addresses grief and loss in primary school aged students in Western Australia. A multidisciplinary collaboration between the Western Australian Departments of Health and Education enabled community school health nurse coordinators to train teacher facilitators in the implementation of Rainbows, enabling support for students and their parents. The results of this qualitative study indicate that all participants regard Rainbows as effective, with many perceived benefits to students and their families. PMID:26281402

  3. Federalism, the economic-industrial health care complex and high-cost pharmaceutical assistance in Brazil.

    PubMed

    da Fonseca, Elize Massard; Costa, Nilson do Rosario

    2015-04-01

    Brazil has a relevant, although relatively unknown, special medicines programme that distributes high-cost products, such as drugs needed for cancer treatments. In 2009, the purchase of these medicines became the responsibility of the Brazilian Federal Government. Until then, there were no clear norms regarding the responsibilities, in terms of the management/financing of these medicines, of the Brazilian Federal Government and of the states themselves. This qualitative study analyses the policy process needed to transfer this programme to the central government. The study examines the reports of the Tripartite Commission between 2000 and 2012, and in-depth interviews with eleven key informants were conducted. The study demonstrates that throughout the last decade, institutional changes have been made in regard to the federal management of these programmes (such as recentralisation of the purchasing of medicines). It concludes that these changes can be explained because of the efficiency of the coordinating mechanisms of the Federal Government. These findings reinforce the idea that the Ministry of Health is the main driver of public health policies, and it has opted for the recentralisation of activities as a result of the development project implicit in the agenda of the Industrial and Economic Heal.

  4. Financing of dental health care in the Federation of Bosnia and Herzegovina.

    PubMed

    Ivanković, A; Rebac, Z

    1999-06-01

    Financing dental health care in the Federation of Bosnia and Herzegovina (FBH) over the last 10 years was analyzed with respect to time before the war, during the 1992-1995 war, and after the war. In the first period (until 1991) the system was centralized, well structured, financed through the communities of interest, and burdened with a lack of financial discipline and high inflation. By the end of 1991, all citizens in the territory of BH Federation had the right to dental health insurance and participated in the price of dental service with 10-50%. During the 1992-1995 war, insurance and financial institutions ceased their work until the establishment of civilian governing authorities. The system of dental services was legalized within the health system as its integral part, yet, because of insufficient financial support, the rights of the insured were not fulfilled. Following the Dayton Peace Agreement in 1995, two systems (Croat and Muslim) were in function in FBH, each based on different legal grounds, and dental care stagnated considerably. The 1997 FBH Law on Health Care and Health Insurance and the Law on the Privatization of companies introduced a unique health system, widening the sources of financing and categories of health insurance. The process of health care privatization has been legalized, but not yet implemented. Lack of definitions of ownership diminish foreign investments, and without foreign financial support the improvements will be slower than needs. The process of health care restructuring will thus directly depend on the solving the political crisis in the country. PMID:10234058

  5. STOPPING DECEPTIVE HEALTH CLAIMS: THE NEED FOR A PRIVATE RIGHT OF ACTION UNDER FEDERAL LAW.

    PubMed

    Hoffmann, Diane; Schwartz, Jack

    2016-01-01

    This Article offers a thorough analysis of an important public health issue, namely how to confront the growing problem of deceptive claims regarding foods and dietary supplements, including increasingly prevalent but unverifiable claims. The authors call for the creation of a limited private right of action under the Federal Trade Commission (FTC) Act for deceptive health-related claims for these products. The proposal responds to the growing market for these products and the inadequacy of current laws and enforcement actions to prevent such claims. In crafting the limited private right of action, the authors attempt to enhance consumer protection without undermining federal agency primacy in enforcement. The Article ends with an appendix setting forth proposed language for a statutory amendment to the FTC Act incorporating the authors' proposal. PMID:27263263

  6. STOPPING DECEPTIVE HEALTH CLAIMS: THE NEED FOR A PRIVATE RIGHT OF ACTION UNDER FEDERAL LAW.

    PubMed

    Hoffmann, Diane; Schwartz, Jack

    2016-01-01

    This Article offers a thorough analysis of an important public health issue, namely how to confront the growing problem of deceptive claims regarding foods and dietary supplements, including increasingly prevalent but unverifiable claims. The authors call for the creation of a limited private right of action under the Federal Trade Commission (FTC) Act for deceptive health-related claims for these products. The proposal responds to the growing market for these products and the inadequacy of current laws and enforcement actions to prevent such claims. In crafting the limited private right of action, the authors attempt to enhance consumer protection without undermining federal agency primacy in enforcement. The Article ends with an appendix setting forth proposed language for a statutory amendment to the FTC Act incorporating the authors' proposal.

  7. Federal air travel restrictions for public health purposes--United States, June 2007-May 2008.

    PubMed

    2008-09-19

    Persons with communicable diseases who travel on commercial aircraft can pose a risk for infection to the traveling public. In June 2007, federal agencies developed a public health Do Not Board (DNB) list, enabling domestic and international public health officials to request that persons with communicable diseases who meet specific criteria and pose a serious threat to the public be restricted from boarding commercial aircraft departing from or arriving in the United States. The public health DNB list is managed by CDC and the U.S. Department of Homeland Security (DHS). To describe the experience with the public health DNB list since its inception, CDC analyzed data from June 2007 to May 2008. This report summarizes the results of that analysis, which indicated that CDC received requests for inclusion of 42 persons on the public health DNB list, all with suspected or confirmed pulmonary tuberculosis (TB). From the requests, 33 (79%) persons were included on the list. The public health DNB list enables public health officials to prevent travel on commercial aircraft by persons who pose a risk for infection to other travelers. State and local health departments in the United States and other countries should be aware of this new public health tool.

  8. Professional and educational initiatives, supports, and opportunities for advanced training in public health.

    PubMed

    Truong, Hoai-An; Patterson, Brooke Y

    2010-09-10

    The United States is facing a public health workforce shortage and pharmacists have the opportunity and obligation to address this challenge in health care. There have been initiatives and supports from within and beyond the profession for the pharmacist's role in public health. This article identifies existing professional and educational initiatives for the pharmacist's expanded role in public health, as well as postgraduate and other advanced educational opportunities in public health. Recommendations also are provided on how to further engage pharmacists in public health activities to alleviate the public health workforce challenge. PMID:21088727

  9. Capital cost reimbursement to community hospitals under Federal health insurance programs.

    PubMed

    Kinney, E D; Lefkowitz, B

    1982-01-01

    Issues in current capital cost reimbursement to community hospitals by Medicare and Medicaid are described, and options for change analyzed. Major reforms in the way the federal government pays for capital costs--in particular substitution of other methods of payment for existing depreciation reimbursement--could have significant impact on the structure of the health care system and on government expenditures. While such reforms are likely to engender substantial political opposition, they may be facilitated by broader changes in the reimbursement system.

  10. Licensed Practical Nurses in Occupational Health. An Initial Survey.

    ERIC Educational Resources Information Center

    Lee, Jane A.; And Others

    The study, conducted in 1971, assessed characteristics of licensed practical nurses (LPN's) who worked in occupational health nursing. The survey instrument, a questionnaire, was returned by 591 LPN's in occupational health and provided data related to: personal characteristics, work and setting, administrative and professional functioning,…

  11. Health Care of Incarcerated Youth: State Programs & Initiatives.

    ERIC Educational Resources Information Center

    Thompson, Linda S.; Sheahan, Paula M.

    This report presents the analysis and results of a survey of states' progress in meeting the goals and objectives of their state action plans on the health care of incarcerated youth. The survey questioned 48 juvenile justice professionals, health care professionals, and university faculty from across the nation concerning state progress toward…

  12. The impact of federal bioterrorism funding programs on local health department preparedness activities.

    PubMed

    Avery, George H; Zabriskie-Timmerman, Jennifer

    2009-06-01

    Using the 2005 National Association of County and City Health Officers Profile of Local Health Departments data set, bivariate probit and Heckman selection models were used to test the hypothesis that the level of federal funding received for bioterrorism preparedness is related to the preparedness activities undertaken by local health departments. Overall budget, leadership, and crisis experience are found to be the most important determinants of local preparedness activity, but Centers for Disease Control and Prevention preparedness funding plays a mediating role by building capacity through the hiring of one key leadership position, the emergency preparedness coordinator. Additional research is needed to determine the potential impact of these funds on other aspects of the local public health system, such as the scope of services delivered, to determine secondary effects of the program.

  13. Veterans Affairs Health System Enrollment and Health Care Utilization After the Affordable Care Act: Initial Insights.

    PubMed

    Silva, Abigail; Tarlov, Elizabeth; French, Dustin D; Huo, Zhiping; Martinez, Rachael N; Stroupe, Kevin T

    2016-05-01

    The Affordable Care Act (ACA) was signed into law in 2010 and its individual mandate and expanded health care coverage options were implemented in 2014. These provisions may affect Veterans Affairs (VA) enrollment and health care utilization. Using data from two VA regional networks, we examined recent patterns in the number of new VA enrollees and their primary care use. Trends were assessed by enrollment priority group (based on the veteran's severity of service-connected disabilities, exposures, and income level) and a state's Medicaid expansion status. Compared to the same time period in the previous year, the number of new enrollees from low-income priority groups was higher during the open enrollment period and the increase was sharper in Medicaid non-expansion states (25-42%) than in expansion states (20-32%). In addition, low-income patients with a copay requirement who enrolled in the VA during the ACA open enrollment had a lower average number of primary care visits than counterparts who had enrolled in prior time periods (1.73 versus 1.87, p < 0.0001). Although this study is an initial step, more research is required to better understand veterans' decision making and behavior in regard to health care coverage through the ACA and related impacts on VA and non-VA health care utilization and care coordination. PMID:27136655

  14. The Long Way From Government Open Data to Mobile Health Apps: Overcoming Institutional Barriers in the US Federal Government

    PubMed Central

    2014-01-01

    Background Government agencies in the United States are creating mobile health (mHealth) apps as part of recent policy changes initiated by the White House’s Digital Government Strategy. Objective The objective of the study was to understand the institutional and managerial barriers for the implementation of mHealth, as well as the resulting adoption pathways of mHealth. Methods This article is based on insights derived from qualitative interview data with 35 public managers in charge of promoting the reuse of open data through Challenge.gov, the platform created to run prizes, challenges, and the vetting and implementation of the winning and vendor-created apps. Results The process of designing apps follows three different pathways: (1) entrepreneurs start to see opportunities for mobile apps, and develop either in-house or contract out to already vetted Web design vendors; (2) a top-down policy mandates agencies to adopt at least two customer-facing mobile apps; and (3) the federal government uses a policy instrument called “Prizes and Challenges”, encouraging civic hackers to design health-related mobile apps using open government data from HealthData.gov, in combination with citizen needs. All pathways of the development process incur a set of major obstacles that have to be actively managed before agencies can promote mobile apps on their websites and app stores. Conclusions Beyond the cultural paradigm shift to design interactive apps and to open health-related data to the public, the managerial challenges include accessibility, interoperability, security, privacy, and legal concerns using interactive apps tracking citizen. PMID:25537314

  15. Barriers to sustainable tuberculosis control in the Russian Federation health system.

    PubMed Central

    Atun, R. A.; Samyshkin, Y. A.; Drobniewski, F.; Skuratova, N. M.; Gusarova, G.; Kuznetsov, S. I.; Fedorin, I. M.; Coker, R. J.

    2005-01-01

    The Russian Federation has the eleventh highest tuberculosis burden in the world in terms of the total estimated number of new cases that occur each year. In 2003, 26% of the population was covered by the internationally recommended control strategy known as directly observed treatment (DOT) compared to an overall average of 61% among the 22 countries with the highest burden of tuberculosis. The Director-General of WHO has identified two necessary starting points for the scaling-up of interventions to control emerging infectious diseases. These are a comprehensive engagement with the health system and a strengthening of the health system. The success of programmes aimed at controlling infectious diseases is often determined by constraints posed by the health system. We analyse and evaluate the impact of the arrangements for delivering tuberculosis services in the Russian Federation, drawing on detailed analyses of barriers and incentives created by the organizational structures, and financing and provider-payment systems. We demonstrate that the systems offer few incentives to improve the efficiency of services or the effectiveness of tuberculosis control. Instead, the system encourages prolonged supervision through specialized outpatient departments in hospitals (known as dispensaries), multiple admissions to hospital and lengthy hospitalization. The implementation, and expansion and sustainability of WHO-approved methods of tuberculosis control in the Russian Federation are unlikely to be realized under the prevailing system of service delivery. This is because implementation does not take into account the wider context of the health system. In order for the control programme to be sustainable, the health system will need to be changed to enable services to be reconfigured so that incentives are created to reward improvements in efficiency and outcomes. PMID:15798846

  16. Health Insurance and Health Policy In The Federal Republic of Germany

    PubMed Central

    Reinhardt, Uwe E.

    1981-01-01

    This paper presents a structured survey of the West German health care and health insurance system. The West German health insurance system is very comprehensive and generous. The scheme provides full coverage for all medically necessary services, including ambulatory and inpatient care, prescription drugs, dental care, medical appliances and even prolonged rehabilitation in the so called Kurorten (localities with health spas). Typically, patients do not bear any copayment at the point of service, or only very modest ones. Physicians are paid on a fee-for-service basis (according to negotiated fee schedules), hospitals are reimbursed on the basis of prospectively negotiated per diems, and the suppliers of drugs and appliances are reimbursed at what is referred to as “market prices” (that is, at prices set by suppliers with only mild indirect control from the public sector or third-party payors). This extraordinarily liberal insurance system causes West Germany to devote no greater a proportion of their Gross National Product (GNP) to health care than does the United States. Using the American definition of “national health care expenditures,” both nations currently devote about 9.4 percent of their GNP to health care. PMID:10309554

  17. Student-Initiated Sexual Health Selective as a Curricular Tool

    PubMed Central

    Johnson, Katie; Rullo, Jordan; Faubion, Stephanie

    2015-01-01

    Introduction Patients’ sexual health functioning is important for physicians in all fields of medicine to consider; however, this topic is lacking from almost half of U.S. medical school curricula. Aims This study aims to develop, implement, and assess the feasibility of a preliminary sexual health curriculum for medical students. Methods This Sexual Health Selective (SHS) was developed and implemented by a student and faculty champion for first year medical students. Its design incorporated a number of the guiding principles and recommendations from the 2012 Summit on Medical School Education in Sexual Health. Main Outcome Measures Feasibility was measured by limited-efficacy testing and participant acceptability of the SHS. Limited-efficacy testing was accomplished by conducting descriptive comparisons of responses to a sexual health attitudes and knowledge survey. These responses were compared between (i) participants vs. nonparticipants prior to the SHS, (ii) participants immediately after vs. participants prior to the SHS, (iii) participants 3 months after vs. participants prior to the SHS, and (iv) participants 3 months after vs. participants immediately after the SHS. Participant acceptability was assessed by asking qualitatively and quantitatively whether students enjoyed the SHS, found it beneficial to their learning, and would recommend it to their classmates. Results Immediately after the SHS and 3 months later, participants reported increased comfort and open-mindedness in their attitudes toward sexual health and demonstrated an increase in accurate knowledge about sexual health issues compared with baseline. Objective follow-up also revealed that most participants enjoyed the SHS, found it beneficial to their learning, and would recommend it to their classmates. Conclusions The 1-week SHS was successfully implemented through the teamwork of a medical student and faculty champion. It resulted in more accurate knowledge and more open attitudes toward

  18. Unregulated drinking water initiative for environmental surveillance and public health.

    PubMed

    Backer, Lorraine C; Tosta, Nancy

    2011-03-01

    The critical public health need to assess and protect the drinking water used by 37 million Americans requires attention and resources. NCEH, in partnership with states, has begun the process to identify information available on unregulated drinking water sources to improve the availability of data to support decisive public health actions and resource allocation. Far more attention and resources are needed to complete this process.

  19. eHealth in Belgium, a new "secure" federal network: role of patients, health professions and social security services.

    PubMed

    France, Francis Roger

    2011-02-01

    eHealth platform is the official federal network in Belgium (created by law on 21 August 2008) devoted to a secure exchange of health data in many types of applications, such as health care purposes, simplification of administrative procedures and contribution to health policy. It implies a controlled access to decentralized databases and uses encrypted personal data. The national identification number has been chosen in order to authenticate the requester, the patient, and the receiver of information exchange. Authorizations have to be respected in order to obtain personal health data. Several questions are raised about its security: the lack of mandatory request for systematic journaling on accesses to the electronic patient record as well as the absence of explicit procedures for sanctions in case of unauthorized access, the new role of social security administration in managing security where a eHealth manager can be both judge and party (in the function of trusted third party for health data encryption and of a required lawyer for texts proposed by physicians to the Commission for the protection of private life). Another critic concerns the number of physicians in minority and the absence of patients' delegates in the eHealth Board. At a time when the patient is becoming a partner in the care team, should not he be the gate-keeper for the access to his own health record? How could networks help him to get the appropriate knowledge to contribute to care and to write his testament of life? Recent laws (on private life, patient rights and euthanasia) have contributed to a behavioural change in citizens and physician attitudes. Recommendations are made in order to improve the acceptability of eHealth platform.

  20. Federal legal preparedness tools for facilitating medical countermeasure use during public health emergencies.

    PubMed

    Courtney, Brooke; Sherman, Susan; Penn, Matthew

    2013-03-01

    Preparing for and responding to public health emergencies involving medical countermeasures (MCMs) raise often complex legal challenges and questions among response stakeholders at the local, state, and federal levels. This includes concerns about emergency legal authorities, liability, emergency use of regulated medical products, and regulations that might enhance or hinder public health response goals. In this article, lawyers from the U.S. Department of Health and Human Services' (HHS) Office of the General Counsel (OGC), Centers for Disease Control and Prevention (CDC), and Food and Drug Administration (FDA) discuss federal legal tools that are critical to enhancing MCM legal preparedness for public health emergencies, with an emphasis on the legal mechanisms that can be used to facilitate the emergency use of countermeasures. Specifically, the authors describe the Public Readiness and Emergency Preparedness (PREP) Act and Emergency Use Authorization (EUA) authority, outlining the conditions under which these tools can be utilized and providing examples of how they have supported both pre-event (e.g., doxycycline mass dispensing preparedness for anthrax) and intra-event (e.g., 2009 H1N1 influenza pandemic response) activities.

  1. 75 FR 1384 - Indian Health Professions Preparatory, Indian Health Professions Pregraduate and Indian Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Indian Health Professions Preparatory, Indian Health Professions Pregraduate and Indian Health Professions Scholarship Programs Announcement Type: Initial. CFDA Numbers:...

  2. [The need of prenatal public health initiatives in Poland].

    PubMed

    Jarosz, Mirosław J

    2012-11-01

    The author emphasizes the achievements of the Polish Gynecological Society in the field of improving the health indicators concerning perinatal mortality among infants during the last two decades in Poland. Attention is paid to the contribution of the members of the Society to organizational change in Polish health care after 1990, which resulted in the improvement of the care of mother and child. It is also underlined that the members of the Society contributed to the creation of early detection system of breast and cervical cancer in Poland. However it is noteworthy that in 'Polish Gynecology' - the publication of the Polish Gynecological Society - the number of reports devoted to risky health behaviors of women during periconceptional period and pregnancy is scarce. The author draws attention to the percentage of women who smoke cigarettes and consume alcohol before and during pregnancy Emphasis is also placed on the problem of nutritional disorders (mainly pathological methods of dieting) among Polish women during the reproductive period and in the first weeks of pregnancy (before the pregnancy is confirmed). These aspects may result in epigenetic changes shaping the phenotype of the offspring. The author refers to the Barker's theory of Developmental Origins of Adult Diseases and warns that the above-mentioned health behaviors of women may bring about negative effects for the offspring and future generations, namely susceptibility to chronic diseases: arterial hypertension, obesity type 2 diabetes and metabolic syndrome. Negative effects for the health of offspring may also result from low level of physical activity of women before and during pregnancy The author concludes that it is necessary to intensify the efforts of the Polish Gynecological Society in the area of prenatal public health.

  3. Analysis of participation in the federally mandated coal workers' health-surveillance program

    SciTech Connect

    Nickolaus, M.E.

    1987-01-01

    The Federal Coal Mine Health and Safety Act of 1969 required that periodic chest radiographs be offered to underground coal miners to protect the miners from the development of Coal Workers' Pneumoconiosis (CWP) and progression of the disease to progressive massive fibrosis (PMF). These examinations are administered by the National Institute for Occupational Safety and Health (NIOSH) through the Coal Workers' Health Surveillance Program (CWHSP). This study developed rates of participation for each of 558 West Virginia underground coal mines who submitted or had NIOSH assigned plans for making chest radiographs available during the third round, July 1978 through December 1980. These rates were analyzed in relation to desired levels of participation and to reinforcing, predisposing and enabling factors presumed to affect rates of participation in disease prevention and surveillance programs.

  4. UNICEF and New Initiatives in Child Health and Development.

    ERIC Educational Resources Information Center

    Nyi, Nyi

    The four sections of this paper outline changes in UNICEF programs from their inception in 1946 to recent initiatives circa 1983. The first section delineates shifts in program emphasis, showing how the organization's focus has moved from meeting the emergency needs of post-World War II European children toward addressing the long-term needs of…

  5. Buprenorphine maintenance treatment retention improves nationally recommended preventive primary care screenings when integrated into urban federally qualified health centers.

    PubMed

    Haddad, Marwan S; Zelenev, Alexei; Altice, Frederick L

    2015-02-01

    Buprenorphine maintenance therapy (BMT) expands treatment access for opioid dependence and can be integrated into primary health-care settings. Treating opioid dependence, however, should ideally improve other aspects of overall health, including preventive services. Therefore, we examined how BMT affects preventive health-care outcomes, specifically nine nationally recommended primary care quality health-care indicators (QHIs), within federally qualified health centers (FQHCs) from an observational cohort study of 266 opioid-dependent patients initiating BMT between 07/01/07 and 11/30/08 within Connecticut's largest FQHC network. Nine nationally recommended preventive QHIs were collected longitudinally from electronic health records, including screening for chronic infections, metabolic conditions, and cancer. A composite QHI score (QHI-S), based on the percentage of eligible QHIs achieved, was categorized as QHI-S ≥80% (recommended) and ≥90% (optimal). The proportion of subjects achieving a composite QHI-S ≥80 and ≥90 % was 57.1 and 28.6%, respectively. Screening was highest for hypertension (91.0%), hepatitis C (80.1%), hepatitis B (76.3%), human immunodeficiency virus (71.4%), and hyperlipidemia (72.9%) and lower for syphilis (49.3%) and cervical (58.5%), breast (44.4%), and colorectal (48.7%) cancer. Achieving QHI-S ≥80% was positively and independently associated with ≥3-month BMT retention (adjusted odds ratio (AOR) = 2.19; 95% confidence interval (CI) = 1.18-4.04) and BMT prescription by primary care providers (PCPs) rather than addiction psychiatric specialists (AOR = 3.38; 95% CI = 1.78-6.37), and negatively with being female (AOR = 0.30; 95% CI = 0.16-0.55). Within primary health-care settings, achieving greater nationally recommended health-care screenings or QHIs was associated with being able to successfully retain patients on buprenorphine longer (3 months or more) and when buprenorphine was prescribed

  6. Breckinridge Project, initial effort. Report VII, Volume 4. Safety and health plan

    SciTech Connect

    1982-01-01

    The Safety and Health Plan recognizes the potential hazards associated with the Project and has been developed specifically to respond to these risks in a positive manner. Prevention, the primary objective of the Plan, starts with building safety controls into the process design and continues through engineering, construction, start-up, and operation of the Project facilities and equipment. Compliance with applicable federal, state, and local health and safety laws, regulations, and codes throughout all Project phases is required and assured. The Plan requires that each major Project phase be thoroughly reviewed and analyzed to determine that those provisions required to assure the safety and health of all employees and the public, and to prevent property and equipment losses, have been provided. The Plan requires followup on those items or situations where corrective action needs were identified to assure that the action was taken and is effective. Emphasis is placed on loss prevention. Exhibit 1 provides a breakdown of Ashland Synthetic Fuels, Inc.'s (ASFI's) Loss Prevention Program. The Plan recognizes that the varied nature of the work is such as to require the services of skilled, trained, and responsible personnel who are aware of the hazards and know that the work can be done safely, if done correctly. Good operating practice is likewise safe operating practice. Training is provided to familiarize personnel with good operational practice, the general sequence of activities, reporting requirements, and above all, the concept that each step in the operating procedures must be successfully concluded before the following step can be safely initiated. The Plan provides for periodic review and evaluation of all safety and loss prevention activities at the plant and departmental levels.

  7. The inequity of the Swiss health care system financing from a federal state perspective

    PubMed Central

    2014-01-01

    Introduction Previous studies have shown that Swiss health-care financing is particularly regressive. However, as it has been emphasized in the 2011 OECD Review of the Swiss Health System, the inter cantonal variations of income-related inequities are still broadly unexplored. The present paper aims to fill this gap by analyzing the differences in the level of equity of health-care system financing across cantons and its evolution over time using household data. Methods Following the methodology proposed by Wagstaff et al. (JHE 11:361–387, 1992) we use the Kakwani index as a summary measure of regressivity and we compute it for each canton and for each of the sources that have a role in financing the health care system. We graphed concentration curves and performed relative dominance tests, which utilize the full distribution of expenditures. The microdata come from the Swiss Household Income and Expenditure Survey (SHIES) based on a sample of the Swiss population (about 3500 households per year), for the years 1998 - 2005. Results The empirical evidence confirms that the health-care financing in Switzerland has remained regressive since the major reform of 1996 and shows that the variations in equity across cantons are quite significant: the difference between the most and the least regressive canton is about the same as between two extremely different financing systems like the US and Sweden. There is no evidence, instead, of a clear evolution over time of regressivity. Conclusions The significant variation in equity across cantons can be explained by fiscal federalism and the related autonomy in the design of tax and social policies. In particular, the results highlight that earmarked subsidies, the policy adopted to smooth the regressivity of the premiums, appear to be not enough; in the practice of federal states the combination of allowances with mandatory community-rated health insurance premiums might lead to a modest outcome in terms of equity. PMID

  8. 77 FR 12577 - Department of Defense (DoD) Medicare-Eligible Retiree Health Care Board of Actuaries; Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... of the Secretary Department of Defense (DoD) Medicare-Eligible Retiree Health Care Board of Actuaries... that the following Federal advisory committee meeting of the DoD Medicare-Eligible Retiree Health Care... Medicare- Eligible Retiree Health Care Board of Actuaries meeting or make an oral presentation or submit...

  9. 75 FR 6360 - Federal Advisory Committee; DoD Medicare-Eligible Retiree Health Care Board of Actuaries

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-09

    ... of the Secretary Federal Advisory Committee; DoD Medicare-Eligible Retiree Health Care Board of... that the DoD Medicare-Eligible Retiree Health Care Board of Actuaries will meet on August 18, 2010... used in the valuation of benefits under DoD retiree health care programs for...

  10. Private and Public Initiatives: Working Together for Health and Education.

    ERIC Educational Resources Information Center

    Gaag, Jacques van der

    The World Bank helps countries to arrive at whatever combination of public and private control is best for their particular economic circumstances. This booklet describes that work and summarizes examples of private-sector involvement in health and education provision in the developing world today. The examples also illustrate what the World Bank…

  11. Federal Enactment of Healthy Homes Legislation in the United States to Improve Public Health

    PubMed Central

    Ferguson, Alesia Coralie; Yates, Christopher

    2016-01-01

    Not all homes across America are “healthy” homes. This contributes to the poor health of Americans and exacerbates existing health conditions costing millions each year in health-care cost. Newer research is being conducted into strategies to alleviate biological, chemical, and physical hazards in the home, and various programs exist to assist the homeowner in making improvements in the quality of their home. Not every homeowner or renter nationwide or within community localities has access to these strategies or programs that could potentially improve their home environment and therefore the health of their family. The objective of this article is to propose elements of a policy to address this inconsistency and variation. This proposal centers around the federal enactment of a national policy demanding that each state implements a healthy homes program tailored to fit their specific state housing and health needs. Members of Congress from States that have successfully implemented healthy home programs should champion this policy. Organizations that recognize the impact of housing on health should support the development of a national healthy homes strategy. This article will discuss the need, outcomes, stakeholders, and minimum requirements of such a policy. PMID:27047913

  12. Identifying emergent social networks at a federally qualified health center-based farmers' market.

    PubMed

    Alia, Kassandra A; Freedman, Darcy A; Brandt, Heather M; Browne, Teri

    2014-06-01

    Identifying potential mechanisms connecting farmers' market interventions with health, economic, and community outcomes could inform strategies for addressing health disparities. The present study used social network theory to guide the in-depth examination of naturally occurring social interactions at a farmers' market located at a federally qualified health center located in a rural, low-income community. Trained observers recorded 61 observation logs at the market over 18 weeks. Thematic analysis revealed a range of actors and nonhuman facilitators instrumental to the farmers' market context. These actors connected with one another for communication and relationship development, economic and financial exchange, education, resource sharing, community ownership of the farmers' market, and conflict resolution. These interactions provided opportunities for social networks to develop among attendees, which may have facilitated the acquisition of social supports related to improved health, economic and community outcomes. Results provide insight into the role social networks may play in mediating the relationship between a farmers' market intervention and individual benefits. Findings also contribute to defining the typology of social networks, which may further disentangle the complex relationships between social networks and health outcomes. Future research should identify strategies for purposefully targeting social networks as a way to reduce diet-related health disparities.

  13. Policy initiation and political levers in health policy: lessons from Ghana’s health insurance

    PubMed Central

    2012-01-01

    Background Understanding the health policy formulation process over the years has focused on the content of policy to the neglect of context. This had led to several policy initiatives having a still birth or ineffective policy choices with sub-optimal outcomes when implemented. Sometimes, the difficulty has been finding congruence between different values and interests of the various stakeholders. How can policy initiators leverage the various subtle mechanisms that various players draw on to leverage their interests during policy formulation. This paper attempts to conceptualise these levers of policy formulation to enhance an understanding of this field of work based on lived experience. Methodology This is a qualitative participant observation case study based on retrospective recollection of the policy process and political levers involved in developing the Ghana National Health Insurance Scheme. The study uses a four-concept framework which is agenda setting, symbols manipulation, constituency preservation and coalition building to capture the various issues, negotiations and nuanced approaches used in arriving at desired outcomes. Results Technical experts, civil society, academicians and politicians all had significant influence on setting the health insurance agenda. Each of these various stakeholders carefully engaged in ways that preserved their constituency interests through explicit manoeuvres and subtle engagements. Where proposals lend themselves to various interpretations, stakeholders were quick to latch on the contentious issues to preserve their constituency and will manipulate the symbols that arise from the proposals to their advantage. Where interests are contested and the price of losing out will leave government worse off which will favour its political opponent, it will push for divergent interests outside parliamentary politics through intense negotiations to build coalitions so a particular policy may pass. Conclusions This paper has

  14. [Families of incarcerated women, health promotion and access to social policies in the Federal District, Brazil].

    PubMed

    Pereira, Éverton Luís

    2016-06-01

    This paper assesses the options for accessing public policies available to families of women incarcerated in the female penitentiary of Brazil's Federal District. It seeks to contribute to the construction of health promotion strategies for the female population living in the prison system. Some of the claims were revealed in the national comprehensive healthcare policy for individuals in the prison system, especially those that acknowledge the importance of intersectoral actions and relationship networks to promote health. Data are presented from research conducted at the penitentiary in 2014 that used qualitative methodology by means of participant observation and semi-structured interviews with family members of women incarcerated in the Federal District. It was detected that attention must be paid to the different types of relationship that exist between incarcerated women and their families, and especially to the allegations of exhaustion and difficulty of access to public policies. A more in-depth survey into how this population organizes itself could assist in the development of public policies to promote health and overcome social vulnerability. PMID:27383346

  15. Financing medical care for the underserved in an era of Federal retrenchment: the health service district.

    PubMed

    Nichols, A W; Silverstein, G

    1987-01-01

    Federal funding programs have, since the 1960s, been available in a variety of forms to deal with problems of access to medical care for the medically underserved. Certain programs, such as the National Health Service Corps, have recently pulled back from their points of maximal impact in terms of numbers of obligated physicians in the field. This change leaves a need for greater contributions by State and local entities in the face of Federal retrenchment. The health service district (HSD) is one such mechanism for filling the gap. It has been available under this name in Arizona law since 1977, but the first such district in the State in only now under development in a small copper mining community. Similar to school districts in concept, the HSDs allow residents in their catchment areas to tax themselves for the purpose of delivering primary health care. Two successful HSDs--or similar entities--in other States are described. One program is in Stickney, IL, and other in Condon, OR. The political success and financial viability of the Condon program are documented.

  16. Federal Employees Health Benefits Program: Enrollment Options Following the Termination of a Plan or Plan Option. Final rule.

    PubMed

    2015-10-28

    The U.S. Office of Personnel Management (OPM) is issuing a final rule to amend the Federal Employees Health Benefits (FEHB) Program regulations regarding enrollment options following the termination of a plan or plan option. PMID:26524768

  17. Patients’ Perceptions of Colorectal Cancer Screening Tests and Preparatory Education in Federally Qualified Health Centers1

    PubMed Central

    Gwede, Clement K.; Koskan, Alexis M.; Quinn, Gwendolyn P.; Davis, Stacy N.; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T.; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G.; Meade, Cathy D.

    2014-01-01

    Background This study explored federally qualified health center (FQHC) patients’ perceptions about colorectal cancer screening (CRCS) tests, including immunochemical fecal occult blood tests (iFOBT), as well as preferences for receiving in-clinic education about CRCS. Methods Eight mixed-gender focus groups were conducted with 53 patients. Results Findings centered on three thematic factors: 1) motivators and impediments to CRCS, 2) test-specific preferences and receptivity to iFOBTs, and 3) preferences for entertaining and engaging plain language materials. Conclusion Results informed the development of educational priming materials to increase CRCS using iFOBT in FQHCs. PMID:25249181

  18. Patients' perceptions of colorectal cancer screening tests and preparatory education in federally qualified health centers.

    PubMed

    Gwede, Clement K; Koskan, Alexis M; Quinn, Gwendolyn P; Davis, Stacy N; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G; Meade, Cathy D

    2015-06-01

    This study explored federally qualified health center (FQHC) patients' perceptions about colorectal cancer screening (CRCS) tests, including immunochemical fecal occult blood tests (iFOBT), as well as preferences for receiving in-clinic education about CRCS. Eight mixed gender focus groups were conducted with 53 patients. Findings centered on three thematic factors: (1) motivators and impediments to CRCS, (2) test-specific preferences and receptivity to iFOBTs, and (3) preferences for entertaining and engaging plain language materials. Results informed the development of educational priming materials to increase CRCS using iFOBT in FQHCs.

  19. The role of the Federal Trade Commission in advertising health products and services.

    PubMed

    Daynard, Matthew

    2006-01-01

    The Federal Trade Commission plays a unique role in enforcing well-established standards ensuring that consumers can make informed purchase and use decisions about health-related products and services based on truthful, nonmisleading advertising claims. Deceptive and unfair practices are defined. The importance of the "net impression" that ads convey to consumers and the need for substantiation of objective, factual claims is explained. The FTC uses its enforcement powers and consumer and industry outreach to create a climate for preventing misleading advertising. PMID:16696500

  20. The role of the Federal Trade Commission in advertising health products and services.

    PubMed

    Daynard, Matthew

    2004-01-01

    The Federal Trade Commission plays a unique role in enforcing well-established standards ensuring that consumers can make informed purchase and use decisions about health-related products and services based on truthful, non-misleading advertising claims while encouraging competition. Deceptive and unfair practices are defined. The importance of the "net impression" that ads convey to consumers and the need for substantiation of objective, factual claims is explained. The FTC uses its enforcement powers and consumer and industry outreach to create a climate for preventing misleading advertising. PMID:15347100

  1. Patients' perceptions of colorectal cancer screening tests and preparatory education in federally qualified health centers.

    PubMed

    Gwede, Clement K; Koskan, Alexis M; Quinn, Gwendolyn P; Davis, Stacy N; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G; Meade, Cathy D

    2015-06-01

    This study explored federally qualified health center (FQHC) patients' perceptions about colorectal cancer screening (CRCS) tests, including immunochemical fecal occult blood tests (iFOBT), as well as preferences for receiving in-clinic education about CRCS. Eight mixed gender focus groups were conducted with 53 patients. Findings centered on three thematic factors: (1) motivators and impediments to CRCS, (2) test-specific preferences and receptivity to iFOBTs, and (3) preferences for entertaining and engaging plain language materials. Results informed the development of educational priming materials to increase CRCS using iFOBT in FQHCs. PMID:25249181

  2. The role of the Federal Trade Commission in advertising health products and services.

    PubMed

    Daynard, Matthew

    2006-01-01

    The Federal Trade Commission plays a unique role in enforcing well-established standards ensuring that consumers can make informed purchase and use decisions about health-related products and services based on truthful, nonmisleading advertising claims. Deceptive and unfair practices are defined. The importance of the "net impression" that ads convey to consumers and the need for substantiation of objective, factual claims is explained. The FTC uses its enforcement powers and consumer and industry outreach to create a climate for preventing misleading advertising.

  3. The role of the Federal Trade Commission in advertising health products and services.

    PubMed

    Daynard, Matthew

    2004-01-01

    The Federal Trade Commission plays a unique role in enforcing well-established standards ensuring that consumers can make informed purchase and use decisions about health-related products and services based on truthful, non-misleading advertising claims while encouraging competition. Deceptive and unfair practices are defined. The importance of the "net impression" that ads convey to consumers and the need for substantiation of objective, factual claims is explained. The FTC uses its enforcement powers and consumer and industry outreach to create a climate for preventing misleading advertising.

  4. The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

    PubMed Central

    Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

    2014-01-01

    Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

  5. 2 CFR 376.147 - Does an exclusion from participation in Federal health care programs under Title XI of the Social...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Federal health care programs under Title XI of the Social Security Act affect a person's eligibility to..., Medicaid, and other Federal health care programs under Title XI of the Social Security Act, 42 U.S.C. 1320a... General from participation in Medicare, Medicaid, and/or other Federal health care programs, in...

  6. 2 CFR 376.147 - Does an exclusion from participation in Federal health care programs under Title XI of the Social...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Federal health care programs under Title XI of the Social Security Act affect a person's eligibility to..., Medicaid, and other Federal health care programs under Title XI of the Social Security Act, 42 U.S.C. 1320a... General from participation in Medicare, Medicaid, and/or other Federal health care programs, in...

  7. 2 CFR 376.147 - Does an exclusion from participation in Federal health care programs under Title XI of the Social...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Federal health care programs under Title XI of the Social Security Act affect a person's eligibility to..., Medicaid, and other Federal health care programs under Title XI of the Social Security Act, 42 U.S.C. 1320a... General from participation in Medicare, Medicaid, and/or other Federal health care programs, in...

  8. Local Food Policies Can Help Promote Local Foods and Improve Health: A Case Study from the Federated States of Micronesia

    PubMed Central

    Lorens, Adelino; Pretrick, Moses; Tara, Mona J; Johnson, Emihner

    2011-01-01

    The Federated States of Micronesia (FSM) and other countries throughout the Pacific are facing an epidemic of non-communicable disease health problems. These are directly related to the increased consumption of unhealthy imported processed foods, the neglect of traditional food systems, and lifestyle changes, including decreased physical activity. The FSM faces the double burden of malnutrition with both non-communicable diseases and micronutrient deficiencies, including vitamin A deficiency and anemia. To help increase the use of traditional island foods and improve health, the Island Food Community of Pohnpei has initiated a program in the FSM to support and promote local food policies, along with its Go Local awareness campaign. Such local food policies are defined broadly and include individual and family commitments, community group local food policies and policies established by government, including presidential proclamations and increased taxation on soft drinks. The aim of this paper is to describe this work. An inter-agency, community- and research-based, participatory and media approach was used. Partners are both non-governmental and governmental. The use of continuing awareness work along with local food policy establishment and the acknowledgement of the individuals and groups involved are essential. The work is still in the preliminary stage but ad hoc examples show that this approach has had success in increased awareness on health issues and improving dietary intake on both an individual and group basis. This indicates that further use of local food policies could have an instrumental impact in FSM as well as other Pacific Island countries in promoting local foods and improving dietary intake and health, including the control of non-communicable diseases and other dietary-related health problems. PMID:22235156

  9. Local food policies can help promote local foods and improve health: a case study from the Federated States of Micronesia.

    PubMed

    Englberger, Lois; Lorens, Adelino; Pretrick, Moses; Tara, Mona J; Johnson, Emihner

    2011-11-01

    The Federated States of Micronesia (FSM) and other countries throughout the Pacific are facing an epidemic of non-communicable disease health problems. These are directly related to the increased consumption of unhealthy imported processed foods, the neglect of traditional food systems, and lifestyle changes, including decreased physical activity. The FSM faces the double burden of malnutrition with both non-communicable diseases and micronutrient deficiencies, including vitamin A deficiency and anemia. To help increase the use of traditional island foods and improve health, the Island Food Community of Pohnpei has initiated a program in the FSM to support and promote local food policies, along with its Go Local awareness campaign. Such local food policies are defined broadly and include individual and family commitments, community group local food policies and policies established by government, including presidential proclamations and increased taxation on soft drinks. The aim of this paper is to describe this work. An inter-agency, community- and research-based, participatory and media approach was used. Partners are both non-governmental and governmental. The use of continuing awareness work along with local food policy establishment and the acknowledgement of the individuals and groups involved are essential. The work is still in the preliminary stage but ad hoc examples show that this approach has had success in increased awareness on health issues and improving dietary intake on both an individual and group basis. This indicates that further use of local food policies could have an instrumental impact in FSM as well as other Pacific Island countries in promoting local foods and improving dietary intake and health, including the control of non-communicable diseases and other dietary-related health problems.

  10. Federally-Assisted Healthcare Coverage among Male State Prisoners with Chronic Health Problems

    PubMed Central

    Rosen, David L.; Grodensky, Catherine A.; Holley, Tara K.

    2016-01-01

    Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA). We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative sample of prisoners to estimate the number eligible for healthcare coverage at release. There were 643,290 US male prisoners aged 18–64 with a chronic health condition. At release, 73% in Medicaid-expansion states would qualify for Medicaid or tax credits. In non-expansion states, 54% would qualify for tax credits, but 22% (n = 69,827) had incomes of ≤ 100% the federal poverty limit and thus would be ineligible for ACA-mediated healthcare coverage. These prisoners comprise 11% of all male prisoners with a chronic condition. The ACA was projected to provide coverage to most male state prisoners with a chronic health condition; however, roughly 70,000 fall in the “coverage gap” and may require non-routine care at emergency departments. Mechanisms are needed to secure coverage for this at risk group and address barriers to routine utilization of health services. PMID:27479089

  11. Federally-Assisted Healthcare Coverage among Male State Prisoners with Chronic Health Problems.

    PubMed

    Rosen, David L; Grodensky, Catherine A; Holley, Tara K

    2016-01-01

    Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA). We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative sample of prisoners to estimate the number eligible for healthcare coverage at release. There were 643,290 US male prisoners aged 18-64 with a chronic health condition. At release, 73% in Medicaid-expansion states would qualify for Medicaid or tax credits. In non-expansion states, 54% would qualify for tax credits, but 22% (n = 69,827) had incomes of ≤ 100% the federal poverty limit and thus would be ineligible for ACA-mediated healthcare coverage. These prisoners comprise 11% of all male prisoners with a chronic condition. The ACA was projected to provide coverage to most male state prisoners with a chronic health condition; however, roughly 70,000 fall in the "coverage gap" and may require non-routine care at emergency departments. Mechanisms are needed to secure coverage for this at risk group and address barriers to routine utilization of health services. PMID:27479089

  12. Update on MSHA`s health and safety initiatives

    SciTech Connect

    Langton, J.F.

    1995-12-31

    Historically, society in general and the mining community in particular have very often used the results of major catastrophes such as mine fires, explosions, and inundations to characterize the mining industry`s health and safety record. One doesn`t have to travel too far back in time to recall the ore pass failure which occurred at the Magma Copper Mining Company in 1993, killing four miners and the South Mountain Coal Company`s No. 3 Mine explosion in 1992, which took the lives of eight miners. Both are still fresh in the public`s collective mind. These events, due to the amount of local and national media coverage that they generated, help to define in the minds of many individuals what are perceived to be the prevalent health and safety hazards in the mining industry. Fortunately, these traumatic events are becoming more the exception than the norm. The mining industry has made tremendous strides in minimizing the potential for mine disasters and they are to be commended for this accomplishment.

  13. "Peer" educator initiatives for adolescent reproductive health projects in Indonesia.

    PubMed

    Hull, Terence H; Hasmi, Eddy; Widyantoro, Ninuk

    2004-05-01

    Since the ICPD in 1994, the Government of Indonesia has struggled with the challenge of providing sexual and reproductive health education to adolescents. Following an attempt at a family-centred approach, a pilot project was carried out in Central and East Java to train peer educators, coordinated by the National Family Planning Coordinating Board (BKKBN). A total of 80 peer educators (male/female teams) carried out small-group information sessions in ten different districts. Over 1,300 adolescents attended in all. Forty peer counsellors in 20 teams then carried out five outreach sessions each in their communities, attended by nearly 4,000 adults and adolescents. Educators chosen were older in age, knowledge level, authority and communication skills than adolescents, but were well accepted as mentors. Adolescents wanted to know how to deal with sexual relationships and feelings, unwanted pregnancy and STDs. With 42 million Indonesian adolescents needing information, the government cannot produce enough manuals to satisfy demand. New strategies are required to put information in the public domain, e.g. via the media. The approach described in this paper would probably be beyond the staffing and resource capacity of most districts in Indonesia. Nonetheless, it shows that there was great enthusiasm across a variety of communities for efforts to educate young people on protecting their reproductive health.

  14. [A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

    PubMed

    Petrini, Carlo

    2015-01-01

    The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values.

  15. Public health and climate change adaptation at the federal level: one agency's response to Executive Order 13514.

    PubMed

    Hess, Jeremy J; Schramm, Paul J; Luber, George

    2014-03-01

    Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change.

  16. Public Health and Climate Change Adaptation at the Federal Level: One Agency’s Response to Executive Order 13514

    PubMed Central

    Schramm, Paul J.; Luber, George

    2014-01-01

    Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change. PMID:24432931

  17. Informing the gestalt: an ethical framework for allocating scarce federal public health and medical resources to states during disasters.

    PubMed

    Knebel, Ann R; Sharpe, Virginia A; Danis, Marion; Toomey, Lauren M; Knickerbocker, Deborah K

    2014-02-01

    During catastrophic disasters, government leaders must decide how to efficiently and effectively allocate scarce public health and medical resources. The literature about triage decision making at the individual patient level is substantial, and the National Response Framework provides guidance about the distribution of responsibilities between federal and state governments. However, little has been written about the decision-making process of federal leaders in disaster situations when resources are not sufficient to meet the needs of several states simultaneously. We offer an ethical framework and logic model for decision making in such circumstances. We adapted medical triage and the federalism principle to the decision-making process for allocating scarce federal public health and medical resources. We believe that the logic model provides a values-based framework that can inform the gestalt during the iterative decision process used by federal leaders as they allocate scarce resources to states during catastrophic disasters.

  18. 75 FR 62686 - Health Information Technology: Revisions to Initial Set of Standards, Implementation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ..., implementation specifications, and certification criteria (75 FR 2014). The certification criteria adopted in... Federal Register a final rule (75 FR 44590) to complete the Secretary's adoption of the initial set of... Register (75 FR 11328) a rule proposing the establishment of two certification programs for purposes...

  19. The Cost and Impact of the Interim Federal Health Program Cuts on Child Refugees in Canada

    PubMed Central

    Evans, Andrea; Caudarella, Alexander; Ratnapalan, Savithiri; Chan, Kevin

    2014-01-01

    Introduction On June 30, 2012, Interim Federal Health Program (IFHP) funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. Methods We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. Results There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (p<0.001). Interpretation After the cuts to the IFHP, The Hospital for Sick Children was unable to obtain federal health coverage for the vast majority of refugee claimant children registered under the IFHP. This preliminary analysis showed that post-IFHP cuts healthcare costs at the largest tertiary pediatric institution in the country increased. PMID:24809676

  20. [Health initiatives in Latin America: a historical assessment from the inception of the Pan American Sanitary Bureau to the Mesoamerican Health Initiative].

    PubMed

    Santos Preciado, José Ignacio; Franco Paredes, Carlos

    2011-01-01

    Latin America has undergone gradual transformations in public health influenced by historical events locally or at a global level. These epidemiologic transitions have also occurred through the implementation of interventions by public institutions such as the Pan-American Health Organization, by philanthropic foundations, non-governmental organizations, and bilateral or multilateral international donor organizations. These public health initiatives have produced substantial improvements in the heath status of many populations in Latin America. Overall, human development and health have advanced over the past century. However, these public health benefits have not been shared equally among all areas of Latin America. The Mesoamerican Region -the area encompassing from Southern Mexico to Panama- continues to experience profound social inequities focalized to indigenous communities and groups of African-descent living in urban, periurban, or rural areas. The Mesoamerican Health Initiative is a private-public partnership that attempts to close the gap of health inequalities affecting the most vulnerable populations in this region of Latin America.

  1. Future health disparity initiatives at the Warren Alpert Medical School of Brown University.

    PubMed

    Rappaport, Leah; Coleman, Natasha; Dumenco, Luba; Tobin-Tyler, Elizabeth; Dollase, Richard H; George, Paul

    2014-09-02

    As the United States embarks on health care reform through the Affordable Care Act (ACA), the knowledge, skills and attitudes necessary to practice medicine will change. Education centered on health disparities and social determinants of health will become increasingly more important as 32 million Americans receive coverage through the ACA. In this paper, we describe future initiatives at the Warren Alpert Medical School of Brown University in training medical students on health disparities and social determinants of health through mechanisms such as the Primary Care-Population Medicine Program, the Rhode Island Area Health Education Center, the Scholarly Concentration program and other mechanisms.

  2. The ethical review of health care quality improvement initiatives: findings from the field.

    PubMed

    Taylor, Holly A; Pronovost, Peter J; Faden, Ruth R; Kass, Nancy E; Sugarman, Jeremy

    2010-08-01

    Questions have been raised about whether and how health care quality improvement (QI) initiatives ought to be reviewed to address possible ethical issues associated with them. These questions have focused primarily on whether some QI initiatives meet the regulatory criteria for human subject research and should therefore be regulated and reviewed as such. Based on surveys of health care system professionals conducting QI initiatives and hospital CEOs, this issue brief finds that QI initiatives are routinely reviewed by a variety of internal mechanisms prior to implementation, although rarely through an institutional review board or another independent body charged specifically with ethical oversight of QI initiatives. Further research, the authors say, is needed to achieve a better understanding of how review mechanisms for QI initiatives are structured, including information on who reviews these activities, how they are reviewed, and whether such processes include an ethical assessment of the proposed QI initiative.

  3. [Public Health initiative for improved vaccination for asylum seekers].

    PubMed

    Brockmann, Stefan O; Wjst, Stephanie; Zelmer, Ursula; Carollo, Stefanie; Schmid, Mirjam; Roller, Gottfried; Eichner, Martin

    2016-05-01

    The number of asylum seekers in Germany has increased dramatically in 2015. Their medical care includes the officially recommended vaccinations; yet, no detailed information on this is yet available in Germany. In light of the rising number of asylum seekers, we have developed a concept to facilitate their vaccination. This concept includes the coordination of different partners, the supply of vaccines and other materials through the local health office, and the cooperation with the local physicians' association. To evaluate and accelerate progress, we compared the number of vaccinations conducted by physicians independently of the vaccination concept with those conducted within the new concept. For the period of investigation, 2,256 new asylum seekers were temporarily accommodated in the facilities. The vaccination concept was applied in only some of the facilities. Twenty-eight percent of all asylum seekers (642) were vaccinated at least once; 89 % of the vaccinees (571) were vaccinated within the newly developed concept. In the facilities that were not included in this concept, only 6 % of the refugees were vaccinated, whereas in the facilities that were included up to 58 % were vaccinated. Even though the new concept has started successfully, further innovations are required to reach sufficient vaccination coverage among asylum seekers. In view of the large number of new asylum seekers expected, the adjustment and expansion of the new concept requires professional planning and coordination. Furthermore, additional resources are required. PMID:27072499

  4. Multiple Healthful Dietary Patterns and Type 2 Diabetes in the Women's Health Initiative.

    PubMed

    Cespedes, Elizabeth M; Hu, Frank B; Tinker, Lesley; Rosner, Bernard; Redline, Susan; Garcia, Lorena; Hingle, Melanie; Van Horn, Linda; Howard, Barbara V; Levitan, Emily B; Li, Wenjun; Manson, JoAnn E; Phillips, Lawrence S; Rhee, Jinnie J; Waring, Molly E; Neuhouser, Marian L

    2016-04-01

    The relationship between various diet quality indices and risk of type 2 diabetes (T2D) remains unsettled. We compared associations of 4 diet quality indices--the Alternate Mediterranean Diet Index, Healthy Eating Index 2010, Alternate Healthy Eating Index 2010, and the Dietary Approaches to Stop Hypertension (DASH) Index--with reported T2D in the Women's Health Initiative, overall, by race/ethnicity, and with/without adjustment for overweight/obesity at enrollment (a potential mediator). This cohort (n = 101,504) included postmenopausal women without T2D who completed a baseline food frequency questionnaire from which the 4 diet quality index scores were derived. Higher scores on the indices indicated a better diet. Cox regression was used to estimate multivariate hazard ratios for T2D. Pearson coefficients for correlation among the indices ranged from 0.55 to 0.74. Follow-up took place from 1993 to 2013. During a median 15 years of follow-up, 10,815 incident cases of T2D occurred. For each diet quality index, a 1-standard-deviation higher score was associated with 10%-14% lower T2D risk (P < 0.001). Adjusting for overweight/obesity at enrollment attenuated but did not eliminate associations to 5%-10% lower risk per 1-standard-deviation higher score (P < 0.001). For all 4 dietary indices examined, higher scores were inversely associated with T2D overall and across racial/ethnic groups. Multiple forms of a healthful diet were inversely associated with T2D in these postmenopausal women. PMID:26940115

  5. Rural health care delivery amidst federal retrenchment: lessons from the Robert Wood Johnson Foundation's Rural Practice Project.

    PubMed

    Moscovice, I S; Rosenblatt, R A

    1982-12-01

    This paper examines the experience of the Robert Wood Johnson Foundation's Rural Practice Project (RPP), a major non-governmental effort in the last decade concentrating on the direct delivery of rural health services. The nine RPP sites started prior to 1977 showed a slow but steady increase in their utilization levels and improvement in their financial status during their initial operational years. The tempo of their development was remarkably similar to that of federally sponsored practices in underserved rural areas. After four years of operation, all of the practices had completed their period of grant support; the practices survived in all cases, with almost all of the practices still retaining community sponsorship, salaried physicians, and a commitment to comprehensive care. Practices in sparsely populated rural areas and in areas with fewer hospital beds grew more slowly than those set in rural areas with higher population density and more ancillary resources. We conclude that the use of time-limited initial subsidies is an effective strategy in starting new rural practices in underserved areas and that those practices have a good chance of surviving their start-up phase.

  6. Rural health care delivery amidst federal retrenchment: lessons from the Robert Wood Johnson Foundation's Rural Practice Project.

    PubMed Central

    Moscovice, I S; Rosenblatt, R A

    1982-01-01

    This paper examines the experience of the Robert Wood Johnson Foundation's Rural Practice Project (RPP), a major non-governmental effort in the last decade concentrating on the direct delivery of rural health services. The nine RPP sites started prior to 1977 showed a slow but steady increase in their utilization levels and improvement in their financial status during their initial operational years. The tempo of their development was remarkably similar to that of federally sponsored practices in underserved rural areas. After four years of operation, all of the practices had completed their period of grant support; the practices survived in all cases, with almost all of the practices still retaining community sponsorship, salaried physicians, and a commitment to comprehensive care. Practices in sparsely populated rural areas and in areas with fewer hospital beds grew more slowly than those set in rural areas with higher population density and more ancillary resources. We conclude that the use of time-limited initial subsidies is an effective strategy in starting new rural practices in underserved areas and that those practices have a good chance of surviving their start-up phase. PMID:7137435

  7. The body donation program at the Federal University of Health Sciences of Porto Alegre: a successful experience in Brazil.

    PubMed

    da Rocha, Andrea Oxley; Tormes, Diane Alícia; Lehmann, Natassia; Schwab, Rafael Santos; Canto, Raphael Teixeira

    2013-01-01

    The use of dissection to study human anatomy is the foundation for educational excellence among future health professionals, as it offers an ideal opportunity to learn the body's morphology in three dimensions while also providing students with a more humanistic education. The shortage of bodies for dissection, combined with the Brazilian population's lack of knowledge concerning the possibility of voluntarily donating their own bodies, led to the creation of the Body Donation Programs for Education and Research in Anatomy at the Federal University of Health Sciences of Porto Alegre (UFCSPA). The program is based on three pillars: Informing the general public about the program, donor registration, and donation itself. Since the creation of the donor program in 2008, there has been an increase in both the number of donations made during donor's lifetime and the number of bodies received by the university. There has also been a shift in relation to the origin of these bodies, as before the creation of the program most bodies were unclaimed cadavers, while today most of the bodies are sourced from voluntary donations. The initial results regarding the public's acceptance of the possibility of making body donations have been encouraging, as shown by the annual growth in donor registrations. Consequently, the quality and quantity of the material available for educational purposes have greatly improved. PMID:23184541

  8. The body donation program at the Federal University of Health Sciences of Porto Alegre: a successful experience in Brazil.

    PubMed

    da Rocha, Andrea Oxley; Tormes, Diane Alícia; Lehmann, Natassia; Schwab, Rafael Santos; Canto, Raphael Teixeira

    2013-01-01

    The use of dissection to study human anatomy is the foundation for educational excellence among future health professionals, as it offers an ideal opportunity to learn the body's morphology in three dimensions while also providing students with a more humanistic education. The shortage of bodies for dissection, combined with the Brazilian population's lack of knowledge concerning the possibility of voluntarily donating their own bodies, led to the creation of the Body Donation Programs for Education and Research in Anatomy at the Federal University of Health Sciences of Porto Alegre (UFCSPA). The program is based on three pillars: Informing the general public about the program, donor registration, and donation itself. Since the creation of the donor program in 2008, there has been an increase in both the number of donations made during donor's lifetime and the number of bodies received by the university. There has also been a shift in relation to the origin of these bodies, as before the creation of the program most bodies were unclaimed cadavers, while today most of the bodies are sourced from voluntary donations. The initial results regarding the public's acceptance of the possibility of making body donations have been encouraging, as shown by the annual growth in donor registrations. Consequently, the quality and quantity of the material available for educational purposes have greatly improved.

  9. Human resource capacity building initiatives for public health laboratories in India.

    PubMed

    Pandey, Anuja; Zodpey, Sanjay; Shrikhande, Sunanda; Sharma, Anjali

    2014-01-01

    Public health laboratories play a critical role in disease surveillance and response. With changes in disease dynamics and transmission, their role has evolved over time, and they serve a range of important public health functions. For their effective functioning, it is important to have specialized manpower in these laboratories, which can contribute to their maximum utilization. The present manuscript is an attempt to explore the human resource capacity building initiatives for public health laboratories in India. Using three parallel methods we have attempted to gather information regarding various human resource capacity building initiatives for public health laboratories in India. Our study results show that there is a paucity of programs providing specialized training for human resources in public health laboratories in India. It highlights the urgent need to address this scarcity and introduce capacity building measures to generate human resources for public health laboratories to strengthen their role in public health action.

  10. Measuring quality of mental health care: a review of initiatives and programs in selected countries.

    PubMed

    Spaeth-Rublee, Brigitta; Pincus, Harold Alan; Huynh, Phuong Trang

    2010-09-01

    This review article presents a systematic review of grey literature describing current initiatives that assess the quality of mental health care in 12 countries, as collected by the International Initiative for Mental Health Leadership.There have been increased efforts in many countries to develop and implement mental health indicator schemes to measure and monitor the quality of mental health care at the national and subnational level. Most mental health indicator sets are part of larger health policy initiatives at the national and (or) provincial or state level, with indicators and domains regularly reviewed and revised. The indicator sets described in health care quality initiatives vary widely in their scope, intended use, and degree of development, and they often cut across a broad range of domains, reflecting not only a country's specific health system and how it is organized and structured but also the implementation of such schemes (that is, collection and analysis of data) and the sociopolitical realities that determine mental health priorities.

  11. What cell biologists should know about the National Institutes of Health BRAIN Initiative

    PubMed Central

    Insel, Thomas R.; Koroshetz, Walter

    2015-01-01

    The BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative is an ambitious project to develop innovative tools for a deeper understanding of how the brain functions in health and disease. Early programs in the National Institutes of Health BRAIN Initiative focus on tools for next-generation imaging and recording, studies of cell diversity and cell census, and integrative approaches to circuit function. In all of these efforts, cell biologists can play a leading role. PMID:26668172

  12. What cell biologists should know about the National Institutes of Health BRAIN Initiative.

    PubMed

    Insel, Thomas R; Koroshetz, Walter

    2015-12-15

    The BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative is an ambitious project to develop innovative tools for a deeper understanding of how the brain functions in health and disease. Early programs in the National Institutes of Health BRAIN Initiative focus on tools for next-generation imaging and recording, studies of cell diversity and cell census, and integrative approaches to circuit function. In all of these efforts, cell biologists can play a leading role.

  13. The men's health forum: an initiative to address health disparities in the community.

    PubMed

    Grant, Cathy G; Davis, Jenna L; Rivers, Brian M; Rivera-Colón, Venessa; Ramos, Roberto; Antolino, Prado; Harris, Erika; Green, B Lee

    2012-08-01

    Racial/ethnic, socioeconomic, and gender disparities in health and access to and use of health care services currently exist. Health professionals are continually striving to reduce and eliminate health disparities within their own community. One such effort in the area of Tampa Bay, Florida was the creation of the African American Men's Health Forum, currently referred to as the Men's Health Forum. The African American Men's Health Forum was the result of the community's desire to reduce the gap in health outcomes for African American men. Later, it was recognized that the gap in health outcomes impacts other communities; therefore, it was broadened to include all men considered medically underserved (those who are uninsured, underinsured, or without a regular health care provider). The Men's Health Forum empowers men with the resources, knowledge, and information to effectively manage their health by providing health education and screenings to the community. This article provides an explanation of the key components that have contributed to the success of the Men's Health Forum, including challenges and lessons learned. It is intended that this information be replicated in other communities in an effort to eliminate health disparities. PMID:22105601

  14. The first federal budget under Prime Minister Justin Trudeau: Addressing social determinants of health?

    PubMed

    Ruckert, Arne; Labonté, Ronald

    2016-01-01

    A challenging budget environment during the Harper years has meant that crucial investments in the social determinants of health (SDHs) have increasingly been neglected. The tabling of what is widely considered a more progressive budget with expansionary fiscal elements under the new Prime Minister, Justin Trudeau, raises the question as to what extent this budget invests in policy areas that are crucial for achieving a more equitable distribution in the social determinants of health, as promised in the Liberal party platform. In this commentary, we argue that the first Liberal budget represents a step in the right direction, but that this first step needs to be followed up with a sustained commitment to address the pervasive (and unfair) social inequalities that are the root cause of persistent health inequities in Canada. We conclude that the first Trudeau budget, while moving in the right direction, does not fully embody the sustained policy changes needed to effectively address SDHs, including a more expansive role for the federal government in the redistribution of income and wealth. PMID:27526222

  15. Despite obstacles, considerable potential exists for more robust federal policy on community development and health.

    PubMed

    Arcaya, Mariana; Briggs, Xavier de Souza

    2011-11-01

    The implementation of the Affordable Care Act of 2010 and the Obama administration's urban policy create an opportunity to link community development with health in new and powerful ways. The administration's policy emphasizes improved access to and quality of care through coordinated local and regional approaches, expansion of access to healthy food, and the support of environmental health-including clean air, water, and soil-and healthy homes. New federal programs, such as the Affordable Care Act's Community Transformation Grants, seek to prevent death and disability through policy, environmental, programmatic, and infrastructure changes. But fragmented congressional jurisdiction and budget "scoring" rules pose challenges to needed reform. We argue that government agencies need to adopt so-called systems of innovation, or organizational practices and support mechanisms that seek continuously to test new models, refine promising ones, bring to scale those that work best, and restructure or terminate what does not. We also argue that a strong and well-focused policy advocacy coalition is needed to help drive reform focused on the social determinants of health. PMID:22068397

  16. Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

    PubMed Central

    2012-01-01

    Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered), blueprints (or frameworks to tailor developed programs), and building blocks (resources to develop programs). Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the public health sector may face

  17. Finding Funding: A Guide to Federal Sources for Out-of-School Time and Community School Initiatives.

    ERIC Educational Resources Information Center

    Reder, Nancy D.

    Noting the increasing need for improved access to quality after-school services, this guide to federal funding sources for out-of-school time programs and community schools (OST/CS) is designed to assist program leaders, policymakers, and others in nonprofit, public, and private organizations in taking advantage of federal funding opportunities.…

  18. Incorporating Preliminary Mental Health Assessment in the Initial Healthcare for Refugees in New Jersey.

    PubMed

    Al-Obaidi, AbdulKareem; West, Bernadette; Fox, Anne; Savin, Daniel

    2015-07-01

    The study aims to assess the feasibility of introducing a mental health screening tool into the initial health care assessment for refugees in New Jersey, US. A semi-structured interview was conducted with a convenience sample of professionals providing refugee health care in New Jersey and in a number of other states. There is a widespread appreciation of the need to consider the mental and emotional issues of the refugees as a priority in healthcare services. A mental health screening tool is required for practice in NJ. Community resources should be coupled with early screening for better refugee mental health outcomes. PMID:25821926

  19. Incorporating Preliminary Mental Health Assessment in the Initial Healthcare for Refugees in New Jersey.

    PubMed

    Al-Obaidi, AbdulKareem; West, Bernadette; Fox, Anne; Savin, Daniel

    2015-07-01

    The study aims to assess the feasibility of introducing a mental health screening tool into the initial health care assessment for refugees in New Jersey, US. A semi-structured interview was conducted with a convenience sample of professionals providing refugee health care in New Jersey and in a number of other states. There is a widespread appreciation of the need to consider the mental and emotional issues of the refugees as a priority in healthcare services. A mental health screening tool is required for practice in NJ. Community resources should be coupled with early screening for better refugee mental health outcomes.

  20. A Healthy Communities Initiative in Rural Alberta: Building Rural Capacity for Health.

    ERIC Educational Resources Information Center

    GermAnn, Kathy; Smith, Neale; Littlejohns, Lori Baugh

    Efforts of health professionals are shifting away from programs that "deliver health" toward those that build the capacity of communities to work together to create healthy places. The Healthy Communities Initiative (HCI) is a community development model in central Alberta (Canada) that involves the creation of a widely shared vision of a…

  1. The Delaware Geography-Health Initiative: Lessons Learned in Designing a GIS-Based Curriculum

    ERIC Educational Resources Information Center

    Rees, Peter W.; Silberman, Jordan A.

    2010-01-01

    The Delaware Geography-Health Initiative is a Web- and GIS-based set of lesson units for teaching geographic concepts and research methods within the context of the state's high school geography standards. Each unit follows a research-based, inquiry-centered model addressing questions of health because of Delaware's high incidence of cancer,…

  2. The Federal Government's Deinstitutionalization Program Initiatives: A Status Report (A Litany of Reports, Studies, Recommendations, Policy Debates, and Even Some Progress).

    ERIC Educational Resources Information Center

    Ross, E. Clarke

    1979-01-01

    Analysis of six federal government studies on deinstitutionalization is followed by a discussion of initiatives enacted by the 95th Congress and proposals under consideration in the 96th. Among studies described are reports by the U.S. Government Accounting Office ("Returning the Mentally Disabled to the Community: Government Needs to Do More");…

  3. Impact of dental therapists on productivity and finances: II. Federally Qualified Health Centers.

    PubMed

    Beazoglou, Tryfon J; Bailit, Howard L; DeVitto, Judy; McGowan, Taegen; Myne-Joslin, Veronica

    2012-08-01

    This article estimates the impact of dental therapists treating children on Federally Qualified Health Center (FQHC) dental clinic finances and productivity. The analysis is based on twelve months of patient visit and financial data from large FQHC dental clinics (multiple delivery sites) in Connecticut and Wisconsin. Assuming dental therapists provide restorative, extraction, and pulpal services and dental hygienists continue to deliver all hygiene services, the maximum reduction in costs is about 6 percent. The limited impact of dental therapists on FQHC dental clinic finances is because 1) dental therapists only account for 17 percent of children services and 2) dentists are responsible for only 25 percent of clinic expenses and cost reductions are related to the difference between dental therapist and dentist wage rates.

  4. Reconciliation of the cloud computing model with US federal electronic health record regulations.

    PubMed

    Schweitzer, Eugene J

    2012-01-01

    Cloud computing refers to subscription-based, fee-for-service utilization of computer hardware and software over the Internet. The model is gaining acceptance for business information technology (IT) applications because it allows capacity and functionality to increase on the fly without major investment in infrastructure, personnel or licensing fees. Large IT investments can be converted to a series of smaller operating expenses. Cloud architectures could potentially be superior to traditional electronic health record (EHR) designs in terms of economy, efficiency and utility. A central issue for EHR developers in the US is that these systems are constrained by federal regulatory legislation and oversight. These laws focus on security and privacy, which are well-recognized challenges for cloud computing systems in general. EHRs built with the cloud computing model can achieve acceptable privacy and security through business associate contracts with cloud providers that specify compliance requirements, performance metrics and liability sharing. PMID:21727204

  5. [Psychiatric reform, federalism, and the decentralization of the public health in Brazil].

    PubMed

    Costa, Nilson do Rosário; Siqueira, Sandra Venâncio; Uhr, Deborah; Silva, Paulo Fagundes da; Molinaro, Alex Alexandre

    2011-12-01

    This study examines the relationships between Brazilian psychiatric reform, the adoption of the Centers for Psychosocial Care (CAPS) and the development of the Unified Health System (SUS). The adherence of municipal governments was a variable determinant for the spread of reform, especially due to the continental scale and fragmentation of the Brazilian federation. The article demonstrates the institutional stability of psychiatric reform in Brazil over two decades. The institutional nature of the decision-making process in the public arena has permitted the implementation of new organizational formats through imitation and financial incentives. The psychiatric reform was successful in defending the advantages of CAPS in relation to the asylum and hospital model dominant in past decades. The inductive policies, strengthened and upheld by Law 10.216/2001, transformed the agenda of psychiatric reform, limited to pioneering cities in a national public policy.

  6. Implications of the Federal Abortion Ban for Women's Health in the United States.

    PubMed

    Weitz, Tracy A; Yanow, Susan

    2008-05-01

    In 2007, the US Supreme Court upheld the Partial Birth Abortion Ban Act of 2003, also known as the Federal Abortion Ban or "the Ban." The decision undermines decades of established US abortion law that had recognised the preservation of the health of women as a paramount consideration. The Ban asserts that the state's interests in how an abortion is performed and in fetal life override women's rights. It thus further erodes access to safe and legal abortion care. The new law negatively affects evidence-based clinical practice, the training of new providers and clinical innovation. It may also lead to additional legal restrictions on abortion access in the US and has implications for abortion service delivery internationally. Advocates must develop strategies that focus on women's right to control their fertility throughout the trajectory of an unwanted pregnancy. PMID:18772090

  7. Reconciliation of the cloud computing model with US federal electronic health record regulations

    PubMed Central

    2011-01-01

    Cloud computing refers to subscription-based, fee-for-service utilization of computer hardware and software over the Internet. The model is gaining acceptance for business information technology (IT) applications because it allows capacity and functionality to increase on the fly without major investment in infrastructure, personnel or licensing fees. Large IT investments can be converted to a series of smaller operating expenses. Cloud architectures could potentially be superior to traditional electronic health record (EHR) designs in terms of economy, efficiency and utility. A central issue for EHR developers in the US is that these systems are constrained by federal regulatory legislation and oversight. These laws focus on security and privacy, which are well-recognized challenges for cloud computing systems in general. EHRs built with the cloud computing model can achieve acceptable privacy and security through business associate contracts with cloud providers that specify compliance requirements, performance metrics and liability sharing. PMID:21727204

  8. Reconciliation of the cloud computing model with US federal electronic health record regulations.

    PubMed

    Schweitzer, Eugene J

    2012-01-01

    Cloud computing refers to subscription-based, fee-for-service utilization of computer hardware and software over the Internet. The model is gaining acceptance for business information technology (IT) applications because it allows capacity and functionality to increase on the fly without major investment in infrastructure, personnel or licensing fees. Large IT investments can be converted to a series of smaller operating expenses. Cloud architectures could potentially be superior to traditional electronic health record (EHR) designs in terms of economy, efficiency and utility. A central issue for EHR developers in the US is that these systems are constrained by federal regulatory legislation and oversight. These laws focus on security and privacy, which are well-recognized challenges for cloud computing systems in general. EHRs built with the cloud computing model can achieve acceptable privacy and security through business associate contracts with cloud providers that specify compliance requirements, performance metrics and liability sharing.

  9. The Health Insurance Flexibility and Accountability (HIFA) Demonstration program. A new initiative to cover the uninsured.

    PubMed

    Benjamin, G C

    2001-01-01

    Seeking to keep his promise to give states more flexibility while expanding health insurance coverage to low-income people, President George W. Bush released a proposal to reform Medicaid and The Children's Health Insurance Program. This initiative, the Health Insurance Flexibility and Accountability Act (HIFA), represents a significant change in Medicaid policy. Whether states will find this proposal a useful tool to expand coverage remains to be seen.

  10. Research for Improved Health: Variability and Impact of Structural Characteristics in Federally Funded Community Engaged Research

    PubMed Central

    Pearson, Cythina R.; Duran, Bonnie; Oetzel, John; Margarati, Maya; Villegas, Malia; Lucero, Julie; Wallerstein, Nina

    2016-01-01

    Background Although there is strong scientific, policy, and community support for community-engaged research (CEnR)—including community-based participatory research (CBPR)—the science of CEnR is still developing. Objective To describe structural differences in federally funded CEnR projects by type of research (i.e., descriptive, intervention, or dissemination/policy change) and race/ethnicity of the population served. Methods We identified 333 federally funded projects in 2009 that potentially involved CEnR, 294 principal investigators/project directors (PI/PD) were eligible to participate in a key informant (KI) survey from late 2011 to early 2012 that asked about partnership structure (68% response rate). Results The National Institute on Minority Health & Health Disparities (19.1%), National Cancer Institute (NCI; 13.3%), and the Centers for Disease Control and Prevention (CDC; 12.6%) funded the most CEnR projects. Most were intervention projects (66.0%). Projects serving American Indian or Alaskan Native (AIAN) populations (compared with other community of color or multiple-race/unspecified) were likely to be descriptive projects (p < .01), receive less funding (p < .05), and have higher rates of written partnership agreements (p < .05), research integrity training (p < .05), approval of publications (p < .01), and data ownership (p < .01). AIAN-serving projects also reported similar rates of research productivity and greater levels of resource sharing compared with those serving multiple-race/unspecified groups. Conclusions There is clear variability in the structure of CEnR projects with future research needed to determine the impact of this variability on partnering processes and outcomes. In addition, projects in AIAN communities receive lower levels of funding yet still have comparable research productivity to those projects in other racial/ethnic communities. PMID:25981421

  11. A Student-Led Global Health Education Initiative: Reflections on the Kenyan Village Medical Education Program.

    PubMed

    John, Christopher; Asquith, Heidi; Wren, Tom; Mercuri, Stephanie; Brownlow, Sian

    2016-04-26

    The Kenyan Village Medical Education Program is a student-led global health initiative that seeks to improve health outcomes in rural Kenya through culturally appropriate health education. The month-long program, which is organised by the Melbourne University Health Initiative (Australia), is conducted each January in southern rural Kenya. Significance for public healthThe Kenyan Village Medical Education (KVME) Program is a student-led global health initiative that involves exploring well-established strategies for the prevention of disease through workshops that are conducted in southern rural Kenya. These workshops are tailored to the unique needs and circumstances of rural Kenyan communities, and are delivered to community leaders, as well as to adults and children within the wider community. Aside from the KVME Program's emphasis on reducing the burden of preventable disease through health education, the positive impact of the KVME Program on the Program's student volunteers also deserves consideration. Throughout the month-long KVME Program, student volunteers are presented with opportunities to develop their understanding of cultural competency, the social and economic determinants of health, as well as the unique challenges associated with working in resource-poor communities. Importantly, the KVME Program also represents an avenue through which global health leadership can be fostered amongst student volunteers. PMID:27190974

  12. A Student-Led Global Health Education Initiative: Reflections on the Kenyan Village Medical Education Program

    PubMed Central

    John, Christopher; Asquith, Heidi; Wren, Tom; Mercuri, Stephanie; Brownlow, Sian

    2016-01-01

    The Kenyan Village Medical Education Program is a student-led global health initiative that seeks to improve health outcomes in rural Kenya through culturally appropriate health education. The month-long program, which is organised by the Melbourne University Health Initiative (Australia), is conducted each January in southern rural Kenya. Significance for public health The Kenyan Village Medical Education (KVME) Program is a student-led global health initiative that involves exploring well-established strategies for the prevention of disease through workshops that are conducted in southern rural Kenya. These workshops are tailored to the unique needs and circumstances of rural Kenyan communities, and are delivered to community leaders, as well as to adults and children within the wider community. Aside from the KVME Program’s emphasis on reducing the burden of preventable disease through health education, the positive impact of the KVME Program on the Program’s student volunteers also deserves consideration. Throughout the month-long KVME Program, student volunteers are presented with opportunities to develop their understanding of cultural competency, the social and economic determinants of health, as well as the unique challenges associated with working in resource-poor communities. Importantly, the KVME Program also represents an avenue through which global health leadership can be fostered amongst student volunteers. PMID:27190974

  13. Interactions between Global Health Initiatives and Country Health Systems: The Case of a Neglected Tropical Diseases Control Program in Mali

    PubMed Central

    Cavalli, Anna; Bamba, Sory I.; Traore, Mamadou N.; Boelaert, Marleen; Coulibaly, Youssouf; Polman, Katja; Pirard, Marjan; Van Dormael, Monique

    2010-01-01

    Background Recently, a number of Global Health Initiatives (GHI) have been created to address single disease issues in low-income countries, such as poliomyelitis, trachoma, neonatal tetanus, etc.. Empirical evidence on the effects of such GHIs on local health systems remains scarce. This paper explores positive and negative effects of the Integrated Neglected Tropical Disease (NTD) Control Initiative, consisting in mass preventive chemotherapy for five targeted NTDs, on Mali's health system where it was first implemented in 2007. Methods and Findings Campaign processes and interactions with the health system were assessed through participant observation in two rural districts (8 health centres each). Information was complemented by interviews with key informants, website search and literature review. Preliminary results were validated during feedback sessions with Malian authorities from national, regional and district levels. We present positive and negative effects of the NTD campaign on the health system using the WHO framework of analysis based on six interrelated elements: health service delivery, health workforce, health information system, drug procurement system, financing and governance. At point of delivery, campaign-related workload severely interfered with routine care delivery which was cut down or totally interrupted during the campaign, as nurses were absent from their health centre for campaign-related activities. Only 2 of the 16 health centres, characterized by a qualified, stable and motivated workforce, were able to keep routine services running and to use the campaign as an opportunity for quality improvement. Increased workload was compensated by allowances, which significantly improved staff income, but also contributed to divert attention away from core routine activities. While the campaign increased the availability of NTD drugs at country level, parallel systems for drug supply and evaluation requested extra efforts burdening local

  14. International Society of Nephrology-Hydration and Kidney Health Initiative - Expanding Research and Knowledge.

    PubMed

    Moist, Louise M; Clark, William F; Segantini, Luca; Damster, Sandrine; Le Bellego, Laurent; Wong, Germaine; Tonelli, Marcello

    2016-01-01

    The purpose of this manuscript is to describe a collaborative research initiative to explore the role of hydration in kidney health. Our understanding of the effects of hydration in health and disease is surprisingly limited, particularly when we consider the vital role of hydration in basic human physiology. Recent initiatives and research outcomes have challenged the global medical community to expand our knowledge about hydration, including the differences between water, sugared beverages and other consumables. Identification of the potential mechanisms contributing to the benefits of hydration has stimulated the global nephrology community to advance research regarding hydration for kidney health. Hydration and kidney health has been a focus of research for several research centers with a rapidly expanding world literature and knowledge. The International Society of Nephrology has collaborated with Danone Nutricia Research to promote development of kidney research initiatives, which focus on the role of hydration in kidney health and the global translation of this new information. This initiative supports the use of existing data in different regions and countries to expand dialogue among experts in the field of hydration and health, and to increase scientific interaction and productivity with the ultimate goal of improving kidney health.

  15. A survey of local health promotion initiatives for older people in Wales

    PubMed Central

    Hendry, Maggie; Williams, Nefyn H; Wilkinson, Clare

    2008-01-01

    Background As the demographic profile of the UK changes, policy makers and practitioners have to respond to health challenges presented by a progressively ageing population. The health promotion plan for older people, aged over 50 years, in Wales included eight key areas: physical activity, healthy eating, home safety and warmth, emotional health, health protection, smoking, alcohol and sexual health. The aim of this study was to describe the extent, content and regional variation of existing health promotion initiatives for older people in Wales, provided by statutory, voluntary and private sector agencies. Method A questionnaire was sent to senior health promotion specialists employed in the 22 local authority areas in Wales to ascertain details of all projects promoting health and wellbeing in the eight key areas where the priority population was aged over 50, or the majority of users were older people. Additional information was sought from project leads and websites. Results Eighteen questionnaires were returned; not all were fully completed. Four areas did not return a questionnaire. Additional information was obtained from internet searches but this mainly concerned national initiatives rather than local projects. In all, 120 projects were included, 11 were throughout Wales. Best provision was for physical activity, with 3 national and 42 local initiatives, but local provision was patchy. Healthy eating, and home safety and warmth had far fewer initiatives, as did health protection, which comprised two national immunisation campaigns. Smoking and alcohol misuse were poorly provided for, and there was no provision for older people's sexual health. Evaluation arrangements were poorly described. Half of those who responded identified unmet training needs. Conclusion The reasons for patchy provision of services were not clear. Increased efforts to improve the coverage of interventions known to be effective should be made. Rigorous evaluation of projects is

  16. The Genesis, Implementation and Impact of the Better Access Mental Health Initiative Introducing Medicare-Funded Psychology Services

    ERIC Educational Resources Information Center

    Littlefield, Lyn; Giese, Jill

    2008-01-01

    The Australian Government's Better Access to Mental Health Care initiative introduced mental health reforms that included the availability of Medicare-funded psychology services. The mental health initiative has resulted in a huge uptake of these services, demonstrating the strong community demand for psychological treatment. The initiative has…

  17. Evaluation of population health short courses: implications for developing and evaluating population health professional development initiatives.

    PubMed

    Naccarella, Lucio; Greenstock, Louise; Butterworth, Iain

    2016-01-01

    Population health as an approach to planning is key to improving the health and well-being of whole populations and to reduce inequities within and between population groups. The Victorian Department of Health North and West Metropolitan Region, in collaboration with The University of Melbourne (School of Population Health), have delivered four annual population health short courses. The short courses were designed to equip participants with knowledge and skills to implement population health approaches upon their return to their workplaces. For three consecutive years, online surveys (n=41) and semi-structured interviews (n=35), underpinned by participatory and realist evaluation approaches, were conducted to obtain the perceptions and experiences of the population health short course participants. Evaluation findings indicate that participants' understanding of population health concepts increased; however, there were mixed outcomes in assisting participants' implementation of population health approaches upon their return to their workplaces. A core list of perceived requirements, enablers and barriers emerged at an individual, organisational and system level as influencing the capability of participants to implement population health approaches. Evaluation recommendations and actions taken to revise short course iterations are presented, providing evidence that the evaluation approaches were appropriate and increased the use of evaluation learnings. Implications of evaluation findings for professional development practice (i.e. shift from a 'Course' as a one-off event to a Population Health 'Program' of inter-dependent components) and evaluation (i.e. participatory realist evaluation approaches) are presented.

  18. Analysis of Service-learning activities adopted in health courses of Federal University of Bahia.

    PubMed

    Baldoino, Aline Silva; Veras, Renata Meira

    2016-06-01

    is study aimed to raise and discuss the data about the integration of health courses teaching and service activities o ered at the Federal University of Bahia (UFBA), pre- senting scenarios practices and major di culties existing in the relationship between the university and the services of health. is was a qualitative study of descriptive explo- ratory character, using a questionnaire as a research tool applied to the coordinators of selected health courses. e selection was by reading the political pedagogical project, the following courses were selected: nursing, physical therapy, speech therapy, medicine, nu- trition, dentistry and public health. e results indicated eight types of teaching-service integration activities, 57 scenarios of practice and the main di culties. It was concluded that these courses are sticking to changes in academic training in health, in view of the large number of basic health units in the teaching service process. us, it emphasizes that the UFBA includes activities in health care that enable the integration-education in the higher education process, although there are some di culties in this relationship indicated by the coordinators. Esse estudo teve como objetivo levantar e discutir os dados acerca das atividades de integração ensino-serviço de cursos de saúde oferecidos na Universidade Federal da Bahia (UFBA), apresentando os cenários de práticas e as principais di culdades existentes na relação entre a uni- versidadeeosserviçosdesaúde.Tratou-sedeumapesquisaqualitativa,decaráterdescritivoexploratório,utilizando-seumquestionáriocomo instrumento de investigação aplicado aos coordenadores dos cursos de saúde selecionados. A seleção foi mediante a leitura do projeto político pedagógico, sendo selecionados os seguintes cursos: enfermagem, sioterapia, fonoaudiologia, medicina, nutrição, odontologia e saúde coletiva. Os resultados indicaram 8 tipos de atividades de integração ensino-serviço, 57 cenários de pr

  19. Analysis of Service-learning activities adopted in health courses of Federal University of Bahia.

    PubMed

    Baldoino, Aline Silva; Veras, Renata Meira

    2016-06-01

    is study aimed to raise and discuss the data about the integration of health courses teaching and service activities o ered at the Federal University of Bahia (UFBA), pre- senting scenarios practices and major di culties existing in the relationship between the university and the services of health. is was a qualitative study of descriptive explo- ratory character, using a questionnaire as a research tool applied to the coordinators of selected health courses. e selection was by reading the political pedagogical project, the following courses were selected: nursing, physical therapy, speech therapy, medicine, nu- trition, dentistry and public health. e results indicated eight types of teaching-service integration activities, 57 scenarios of practice and the main di culties. It was concluded that these courses are sticking to changes in academic training in health, in view of the large number of basic health units in the teaching service process. us, it emphasizes that the UFBA includes activities in health care that enable the integration-education in the higher education process, although there are some di culties in this relationship indicated by the coordinators. Esse estudo teve como objetivo levantar e discutir os dados acerca das atividades de integração ensino-serviço de cursos de saúde oferecidos na Universidade Federal da Bahia (UFBA), apresentando os cenários de práticas e as principais di culdades existentes na relação entre a uni- versidadeeosserviçosdesaúde.Tratou-sedeumapesquisaqualitativa,decaráterdescritivoexploratório,utilizando-seumquestionáriocomo instrumento de investigação aplicado aos coordenadores dos cursos de saúde selecionados. A seleção foi mediante a leitura do projeto político pedagógico, sendo selecionados os seguintes cursos: enfermagem, sioterapia, fonoaudiologia, medicina, nutrição, odontologia e saúde coletiva. Os resultados indicaram 8 tipos de atividades de integração ensino-serviço, 57 cenários de pr

  20. The Smart Health Initiative in China: The Case of Wuhan, Hubei Province.

    PubMed

    Fan, Meiyu; Sun, Jian; Zhou, Bin; Chen, Min

    2016-03-01

    To introduce smart health in Wuhan, and provide some references for other cities. As the largest mega-city in central China, Wuhan is investing large amounts of resources to push forward the development of Smart Wuhan and Health Wuhan, and it has unique features. It is one of the centerpieces of China's New Healthcare Reform, and great hope is put on it to help solve the conflict between limited healthcare resources and the large population of patients. How to plan and design smart health is important. The construction of Wuhan Smart Health includes some aspects as follows, like requirement analysis, the establishment of objectives and blueprint, the architecture design of regional health information platform, evaluation and implementation, problems and solutions, and so on. Wuhan Smart Health has obtained some achievements in health network, information systems, resident's health records, information standard, and the first phase of municipal health information platform. The focus of this article is the whole construction process of smart health in Wuhan. Although there are some difficulties during this period, some smart health services and management have been reflected. Compared with other cities or countries, Wuhan Smart Health has its own advantages and disadvantages. This study aims to provide a reference for other cities. Because smart health of Wuhan is characteristic in construction mode. Though still in the initial stage, it has great potentials in the future. PMID:26667820

  1. The Smart Health Initiative in China: The Case of Wuhan, Hubei Province.

    PubMed

    Fan, Meiyu; Sun, Jian; Zhou, Bin; Chen, Min

    2016-03-01

    To introduce smart health in Wuhan, and provide some references for other cities. As the largest mega-city in central China, Wuhan is investing large amounts of resources to push forward the development of Smart Wuhan and Health Wuhan, and it has unique features. It is one of the centerpieces of China's New Healthcare Reform, and great hope is put on it to help solve the conflict between limited healthcare resources and the large population of patients. How to plan and design smart health is important. The construction of Wuhan Smart Health includes some aspects as follows, like requirement analysis, the establishment of objectives and blueprint, the architecture design of regional health information platform, evaluation and implementation, problems and solutions, and so on. Wuhan Smart Health has obtained some achievements in health network, information systems, resident's health records, information standard, and the first phase of municipal health information platform. The focus of this article is the whole construction process of smart health in Wuhan. Although there are some difficulties during this period, some smart health services and management have been reflected. Compared with other cities or countries, Wuhan Smart Health has its own advantages and disadvantages. This study aims to provide a reference for other cities. Because smart health of Wuhan is characteristic in construction mode. Though still in the initial stage, it has great potentials in the future.

  2. The Shared Health Research Information Network (SHRINE): a prototype federated query tool for clinical data repositories.

    PubMed

    Weber, Griffin M; Murphy, Shawn N; McMurry, Andrew J; Macfadden, Douglas; Nigrin, Daniel J; Churchill, Susanne; Kohane, Isaac S

    2009-01-01

    The authors developed a prototype Shared Health Research Information Network (SHRINE) to identify the technical, regulatory, and political challenges of creating a federated query tool for clinical data repositories. Separate Institutional Review Boards (IRBs) at Harvard's three largest affiliated health centers approved use of their data, and the Harvard Medical School IRB approved building a Query Aggregator Interface that can simultaneously send queries to each hospital and display aggregate counts of the number of matching patients. Our experience creating three local repositories using the open source Informatics for Integrating Biology and the Bedside (i2b2) platform can be used as a road map for other institutions. The authors are actively working with the IRBs and regulatory groups to develop procedures that will ultimately allow investigators to obtain identified patient data and biomaterials through SHRINE. This will guide us in creating a future technical architecture that is scalable to a national level, compliant with ethical guidelines, and protective of the interests of the participating hospitals.

  3. Patient safety goals for the proposed Federal Health Information Technology Safety Center.

    PubMed

    Sittig, Dean F; Classen, David C; Singh, Hardeep

    2015-03-01

    The Office of the National Coordinator for Health Information Technology is expected to oversee creation of a Health Information Technology (HIT) Safety Center. While its functions are still being defined, the center is envisioned as a public-private entity focusing on promotion of HIT related patient safety. We propose that the HIT Safety Center leverages its unique position to work with key administrative and policy stakeholders, healthcare organizations (HCOs), and HIT vendors to achieve four goals: (1) facilitate creation of a nationwide 'post-marketing' surveillance system to monitor HIT related safety events; (2) develop methods and governance structures to support investigation of major HIT related safety events; (3) create the infrastructure and methods needed to carry out random assessments of HIT related safety in complex HCOs; and (4) advocate for HIT safety with government and private entities. The convening ability of a federally supported HIT Safety Center could be critically important to our transformation to a safe and effective HIT enabled healthcare system. PMID:25332353

  4. California Hospitals’ Response to State and Federal Policies Related to Health Care–Associated Infections

    PubMed Central

    Stone, Patricia W.; Pogorzelska, Monika; Graham, Denise; Jia, Haomiao; Uchida, Mayuko; Larson, Elaine L.

    2011-01-01

    In October 2008, the Centers for Medicare and Medicaid Services (CMS) denied payment for ten selected health care–associated infections (HAI). In January 2009, California enacted mandatory reporting of infection prevention processes and HAI rates. This longitudinal mixed-methods study examined the impact of federal and state policy changes on California hospitals. Data on structures, processes, and outcomes of care were collected pre- and post-policy changes. In-depth interviews with hospital personnel were performed after policy implementation. More than 200 hospitals participated with 25 personnel interviewed. We found significant increases in adoption of and adherence to evidence-based practices and decreased HAI rates (p < .05). Infection preventionists (IP) spent more time on surveillance and in their offices and less time on education and in other locations (p < .05). Qualitative data confirmed mandatory reporting had intended and unintended consequences and highlighted the importance of technology and organizational climate in preventing infections and the changing IPs’ role. This is especially relevant because the California Department of Public Health has since mandated hospitals to report data on 29 different for surgical site infections and a lawsuit has been filed to delay the implementation of these requirements. PMID:22042613

  5. Patient safety goals for the proposed Federal Health Information Technology Safety Center.

    PubMed

    Sittig, Dean F; Classen, David C; Singh, Hardeep

    2015-03-01

    The Office of the National Coordinator for Health Information Technology is expected to oversee creation of a Health Information Technology (HIT) Safety Center. While its functions are still being defined, the center is envisioned as a public-private entity focusing on promotion of HIT related patient safety. We propose that the HIT Safety Center leverages its unique position to work with key administrative and policy stakeholders, healthcare organizations (HCOs), and HIT vendors to achieve four goals: (1) facilitate creation of a nationwide 'post-marketing' surveillance system to monitor HIT related safety events; (2) develop methods and governance structures to support investigation of major HIT related safety events; (3) create the infrastructure and methods needed to carry out random assessments of HIT related safety in complex HCOs; and (4) advocate for HIT safety with government and private entities. The convening ability of a federally supported HIT Safety Center could be critically important to our transformation to a safe and effective HIT enabled healthcare system.

  6. Enacting sustainable school-based health initiatives: a communication-centered approach to policy and practice.

    PubMed

    LeGreco, Marianne; Canary, Heather E

    2011-03-01

    Communication plays an important role in all aspects of the development and use of policy. We present a communication-centered perspective on the processes of enacting public health policies. Our proposed conceptual framework comprises 4 communication frames: orientation, amplification, implementation, and integration. Empirical examples from 2 longitudinal studies of school-based health policies show how each frame includes different communication processes that enable sustainable public health policy practices in school-based health initiatives. These 4 frames provide unique insight into the capacity of school-based public health policy to engage youths, parents, and a broader community of stakeholders. Communication is often included as an element of health policy; however, our framework demonstrates the importance of communication as a pivotal resource in sustaining changes in public health practices.

  7. The Bamako Initiative: Primary Health Care Experience. Children in the Tropics: Review of the International Children's Centre.

    ERIC Educational Resources Information Center

    Knippenberg, Rudolph; And Others

    1990-01-01

    During the 1987 World Health Organization's Regional Assembly, the Ministers of Health of the African States launched the Bamako Initiative, an effort aimed at reorganizing the health system to ensure universal, permanent accessibility of maternal and child health services. Three conditions were initially seen as necessary for success: improvement…

  8. Under the (legal) radar screen: global health initiatives and international human rights obligations

    PubMed Central

    2012-01-01

    Background Given that many low income countries are heavily reliant on external assistance to fund their health sectors the acceptance of obligations of international assistance and cooperation with regard to the right to health (global health obligations) is insufficiently understood and studied by international health and human rights scholars. Over the past decade Global Health Initiatives, like the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) have adopted novel approaches to engaging with stakeholders in high and low income countries. This article explores how this experience impacted on acceptance of the international obligation to (help) fulfil the right to health beyond borders. Methods The authors conducted an extensive review of international human rights law literature, transnational legal process literature, global public health literature and grey literature pertaining to Global Health Initiatives. To complement this desk work and deepen their understanding of how and why different legal norms evolve the authors conducted 19 in-depth key informant interviews with actors engaged with three stakeholders; the European Union, the United States and Belgium. The authors then analysed the interviews through a transnational legal process lens. Results Through according value to the process of examining how and why different legal norms evolve transnational legal process offers us a tool for engaging with the dynamism of developments in global health suggesting that operationalising global health obligations could advance the right to health for all. Conclusions In many low-income countries the health sector is heavily dependent on external assistance to fulfil the right to health of people thus it is vital that policies and tools for delivering reliable, long-term assistance are developed so that the right to health for all becomes more than a dream. Our research suggests that the Global Fund experience offers lessons to build on. PMID

  9. Federal Policy & American Indian Health Needs: The Role of the Consumers in a National Health Program. Report of the National Conference on Indian Health (6th, New York, New York, October 29-30, 1973).

    ERIC Educational Resources Information Center

    Association on American Indian Affairs, Inc., New York, NY.

    American Indian professionals and community representatives, Indian Health Service (IHS) officials, professors of medicine and public health, and other advocates of improved Indian health services attended a 2-day roundtable conference to: explore the relationship of Federal Policy and Indian health needs, and relate these to issues affecting the…

  10. Can a regional government's social inclusion initiative contribute to the quest for health equity?

    PubMed

    Baum, Fran; Newman, Lareen; Biedrzycki, Katherine; Patterson, Jan

    2010-12-01

    Despite decades of concern about reducing health inequity, the Commission on the Social Determinants of Health (CSDH) painted a picture of persistent and, in some cases, increasing health inequity. It also made a call for increased evaluation of interventions that might reduce inequities. This paper describes such an intervention-the Social Inclusion Initiative (SII) of the South Australian Government-that was documented for the Social Exclusion Knowledge Network of the CSDH. This initiative is designed to increase social inclusion by addressing key determinants of health inequity-in the study period these were education, homelessness and drug use. Our paper examines evidence from a rapid appraisal to determine whether a social inclusion initiative is a useful aspect of government action to reduce health inequity. It describes achievements in each specific area and the ways they can be expected to affect health equity. Our study highlighted four factors central to the successes achieved by the SII. These were the independent authority and influence of the leadership of the SII, the whole of government approach supported by an overarching strategic plan which sets clear goals for government and the clear and unambiguous support from the highest level of government. We conclude that a social inclusion approach can be valuable in the quest to reduce inequities and that further research on innovative social policy approaches is required to examine their likely impact on health equity.

  11. Amendments to the Center for Devices and Radiological Health federal performance standard for laser products.

    PubMed

    Dennis, J E

    1997-12-01

    Federal law requires that all laser products that are imported into or introduced into commerce in the United States comply with the performance standard published in the Code of Federal Regulations (CRF), Title 21, Parts 1040.10 and 1040.11, administered by the Center for Devices and Radiological Health (CDRH), US Food and Drug Administration. Although it contains somewhat different requirements for hazard classification, engineering controls and labeling, the ANSI Z136.1 standard defers to the CDRH standard. The CDRH standard became effective in August, 1976 and was amended, in 1978 and also in 1985. In the early 1990s, US experts met to formulate an approach to bring the requirements of the CDRH standard and those of the International Electrotechnical Commission (IEC) standard, IEC 825, into closer agreement in order to lower barriers to international trade and to remove any excessive compliance burdens on manufacturers. In 1993, the CDRH published, formally in the Federal Register and informally, a Notice of Intent to amend the CDRH standard. Responses to those notices have now been analyzed and informal draft amendments were distributed in 1996. This draft is now being prepared for formal issuance as a Notice of Proposed Rulemaking. Meanwhile, the IEC standard was amended in 1993 and republished as IEC 825-1; these amendments created considerable controversy since they resulted in over classification of the hazard of many products, especially light emitting diodes (LEDs) that have a large divergence and increased source dimensions. Additional amendments are now being developed to correct this problem. The CDRH has carefully monitored developments in the IEC and actively participated in its proceedings as a guide in developing its own proposal. This paper describes the major changes that are being proposed for the CDRH standard and presents some rationale for the major changes. The more significant changes include expansion of applicability to include LEDs

  12. Mitigating HIV Health Disparities: The Promise of Mobile Health for a Patient-Initiated Solution

    PubMed Central

    Kumar, Disha; Patel, Sajani; Street, Richard L.; Giordano, Thomas Peter; Viswanath, Kasisomayajula

    2014-01-01

    The HIV epidemic is an ongoing public health problem fueled, in part, by undertesting for HIV. When HIV-infected people learn their status, many of them decrease risky behaviors and begin therapy to decrease viral load, both of which prevent ongoing spread of HIV in the community. Some physicians face barriers to testing their patients for HIV and would rather their patients ask them for the HIV test. A campaign prompting patients to ask their physicians about HIV testing could increase testing. A mobile health (mHealth) campaign would be a low-cost, accessible solution to activate patients to take greater control of their health, especially populations at risk for HIV. This campaign could achieve Healthy People 2020 objectives: improve patient–physician communication, improve HIV testing, and increase use of mHealth. PMID:25322292

  13. Addressing the social determinants of health through the Alameda County, California, place matters policy initiative.

    PubMed

    Schaff, Katherine; Desautels, Alexandra; Flournoy, Rebecca; Carson, Keith; Drenick, Teresa; Fujii, Darlene; Lee, Anna; Luginbuhl, Jessica; Mena, Mona; Shrago, Amy; Siegel, Anita; Stahl, Robert; Watkins-Tartt, Kimi; Willow, Pam; Witt, Sandra; Woloshin, Diane; Yamashita, Brenda

    2013-11-01

    In Alameda County, California, significant health inequities by race/ethnicity, income, and place persist. Many of the county's low-income residents and residents of color live in communities that have faced historical and current disinvestment through public policies. This disinvestment affects community conditions such as access to economic opportunities, well-maintained and affordable housing, high-quality schools, healthy food, safe parks, and clean water and air. These community conditions greatly affect health. At the invitation of the Joint Center for Political and Economic Studies' national Place Matters initiative, Alameda County Supervisor Keith Carson's Office and the Alameda County Public Health Department launched Alameda County Place Matters, an initiative that addresses community conditions through local policy change. We describe the initiative's creation, activities, policy successes, and best practices.

  14. Addressing the Social Determinants of Health through the Alameda County, California, Place Matters Policy Initiative

    PubMed Central

    Schaff, Katherine; Flournoy, Rebecca; Carson, Keith; Drenick, Teresa; Fujii, Darlene; Lee, Anna; Luginbuhl, Jessica; Mena, Mona; Shrago, Amy; Siegel, Anita; Stahl, Robert; Watkins-Tartt, Kimi; Willow, Pam; Witt, Sandra; Woloshin, Diane; Yamashita, Brenda

    2013-01-01

    In Alameda County, California, significant health inequities by race/ethnicity, income, and place persist. Many of the county's low-income residents and residents of color live in communities that have faced historical and current disinvestment through public policies. This disinvestment affects community conditions such as access to economic opportunities, well-maintained and affordable housing, high-quality schools, healthy food, safe parks, and clean water and air. These community conditions greatly affect health. At the invitation of the Joint Center for Political and Economic Studies' national Place Matters initiative, Alameda County Supervisor Keith Carson's Office and the Alameda County Public Health Department launched Alameda County Place Matters, an initiative that addresses community conditions through local policy change. We describe the initiative's creation, activities, policy successes, and best practices. PMID:24179279

  15. [The provision of population of the Russian Federation with basic personnel resource of public health care system].

    PubMed

    Schepin, V O

    2013-01-01

    The article presents the results of complex scientific analysis of number and structure of physicians and paramedical personnel of public and municipal health care system of the Russian Federation. The provision of country population, its federal okrugs and federation subjects with physicians and paramedical personnel of various specialties are analyzed too, including ratio of physicians and paramedical personnel and territorial differentiation of provision of population with basic medical personnel. The study results demonstrate that in 2012 provision of population (per 10 000 of population) with physicians increased from 43.9 to 44.7. At the same time provision with paramedical personnel decreased from 92.3 to 90.8. in the Russian Federation are preserved significant territorial disproportions of provision of population with medical personnel resource. The provision of population with physicians and paramedical personnel is 4.3 times and 1.9 times higher in cities than in rural area. The differences between extreme indicators of provision of population of the Russian Federation with physicians and paramedical personnel are 2.9 and 2.4 times correspondingly. The differences between indicators of provision with physicians of clinical specialties are 2.6 times. The average ratio between physician and paramedical personnel is 1:2.03. The structure of medical manpower corresponds to the need of population in medical care in incomplete measure. The materials substantiate necessity to continue modernization, optimization and development of manpower support of public health care system in the Russian Federation.

  16. [Health Education for Men by the Federal Centre of Health Education: A Contribution to the Presentation of Men as unaware of Health? (1970-1990)].

    PubMed

    Pfütsch, Pierre

    2015-01-01

    This article offers a close consideration about the gender-specific contents of health education campaigns in the Federal Republic of Germany from 1970 to 1990. By using educational publications issued by the Bundeszentrale für gesundheitliche Aufklärung (BZgA), it is shown which breaks and continuities emerged and which kinds of role models are thereby conveyed. Whereas the health education of the 1950s and 1960s was characterised by a didactical approach towards men and women, this changed as from the 1970s. By deconstructing exemplary education campaigns and including internal files of the BZgA, it can be shown, that the societal discourse on the feminism in the FRG contributed to the fact, that during the 1970s the switch has been made to an increased use of positive role models. However, within the men-specific health education there was no break; the health deficiency discourse was still applied in many and diverse ways in order to describe male health behaviour and knowledge. PMID:26219193

  17. [Perspectives on veterinary public health, food security, and the "One Health" joint initiative].

    PubMed

    Cartín-Rojas, Andrés

    2014-09-01

    Veterinarians play a key role in food security. The health of millions of people, stimulation of national economies, development of sustainable livestock production related to this food source, and the different agricultural production systems that compose value chains, and access to more profitable international markets all depend on their efficient and transparent work. Shifting nutritional patterns globally, along with expected population growth, and the increase in marketable food commodity routes and volumes, forecast that demand for animal source food will steadily intensify over the coming decades. To successfully address these challenges, the veterinary profession should establish more practical and up-to-date conceptual and methodological frameworks for academic and professional profiles, focusing the profession on the different public health subject areas, in undergraduate and graduate courses. Furthermore, interdisciplinary alliances should also be developed--such as the "One Health" approach proposed by the United Nations Food and Agriculture Organization (FAO), the World Organization for Animal Health (OIE), and the World Health Organization (WHO)--to establish frameworks for joint work and public policies more in line with the domestic conditions of Latin American countries, using a collaborative, sustainable, and comprehensive approach to animal health, food security, and public health policy.

  18. Advances in Public Health Accreditation Readiness and Quality Improvement: Evaluation Findings From the National Public Health Improvement Initiative

    PubMed Central

    McLees, Anita W.; Thomas, Craig W.; Nawaz, Saira; Young, Andrea C.; Rider, Nikki; Davis, Mary

    2015-01-01

    Introduction Continuous quality improvement is a central tenet of the Public Health Accreditation Board’s (PHAB) national voluntary public health accreditation program. Similarly, the Centers for Disease Control and Prevention launched the National Public Health Improvement Initiative (NPHII) in 2010 with the goal of advancing accreditation readiness, performance management, and quality improvement (QI). Objective Evaluate the extent to which NPHII awardees have achieved program goals. Design NPHII awardees responded to an annual assessment and program monitoring data requests. Analysis included simple descriptive statistics. Setting Seventy-four state, tribal, local, and territorial public health agencies receiving NPHII funds. Participants NPHII performance improvement managers or principal investigators. Main Outcome Measure(s) Development of accreditation prerequisites, completion of an organizational self-assessment against the PHAB Standards and Measures, Version 1.0, establishment of a performance management system, and implementation of QI initiatives to increase efficiency and effectiveness. Results Of the 73 responding NPHII awardees, 42.5% had a current health assessment, 26% had a current health improvement plan, and 48% had a current strategic plan in place at the end of the second program year. Approximately 26% of awardees had completed an organizational PHAB self-assessment, 72% had established at least 1 of the 4 components of a performance management system, and 90% had conducted QI activities focused on increasing efficiencies and/or effectiveness. Conclusions NPHII appears to be supporting awardees’ initial achievement of program outcomes. As NPHII enters its third year, there will be additional opportunities to advance the work of NPHII, compile and disseminate results, and inform a vision of high-quality public health necessary to improve the health of the population. PMID:24322683

  19. Considerations for community-based mHealth initiatives: insights from three Beacon Communities.

    PubMed

    Abebe, Nebeyou A; Capozza, Korey L; Des Jardins, Terrisca R; Kulick, David A; Rein, Alison L; Schachter, Abigail A; Turske, Scott A

    2013-10-15

    Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs.

  20. Considerations for Community-Based mHealth Initiatives: Insights From Three Beacon Communities

    PubMed Central

    2013-01-01

    Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs. PMID:24128406

  1. Leveraging finances for public health system improvement: results from the Turning Point initiative.

    PubMed

    Bekemeier, Betty; Riley, Catharine M; Berkowitz, Bobbie

    2007-01-01

    Reforming the public health infrastructure requires substantial system changes at the state level; state health agencies, however, often lack the resources and support for strategic planning and systemwide improvement. The Turning Point Initiative provided support for states to focus on large-scale system changes that resulted in increased funding for public health capacity and infrastructure development. Turning Point provides a test case for obtaining financial and institutional resources focused on systems change and infrastructure development-areas for which it has been historically difficult to obtain long-term support. The purpose of this exploratory, descriptive survey research was to enumerate the actual resources leveraged toward public health system improvement through the partnerships, planning, and implementation activities funded by the Robert Wood Johnson Foundation as a part of the Turning Point Initiative.

  2. Park rangers as public health educators: the Public Health in the Parks Grants Initiative.

    PubMed

    Wong, David; Higgins, Charles L

    2010-08-01

    Health education in nontraditional settings can supplement messages received in more traditional venues, such as schools and health care facilities, and can reach new populations. In 2007, the US National Park Service awarded one-time seed grants of $10 000 or less to 16 parks in 16 states to fund the development of public health-focused programs for visitors. These programs used a wide variety of formats and addressed topics such as air pollution, prevention of vector-borne diseases, and promotion of physical activity in the parks. Almost 12 000 visitors attended the programs in 2007. Most programs were supported by park management and were well received by visitors. National parks and similar settings may be underutilized resources for delivering health messages to the general population.

  3. Impact of electronic health record (EHR) reminder on human papillomavirus (HPV) vaccine initiation and timely completion

    PubMed Central

    Ruffin, Mack T.; Plegue, Melissa A.; Rockwell, Pamela G.; Young, Alisa P.; Patel, Divya A.; Yeazel, Mark W.

    2016-01-01

    Background Initiation and timely completion of the HPV vaccine in young women is critical. We compared initiation and completion of HPV vaccine among women in two community-based networks with electronic health records: one with a prompt and reminder system (prompted cohort) and one without (unprompted cohort). Methods Female patients aged 9–26 years seen between March 1, 2007 and January 25, 2010 were used as retrospective cohorts. Patient demographics and vaccination dates were extracted from the electronic health record. Results Patients eligible for the vaccine included 6019 from the prompted cohort and 9096 from the unprompted cohort. Mean age at initiation was 17.3 years in prompted cohort and 18.1 years at unprompted cohort with significantly more (p<0.001) patients initiating in the prompted cohort (34.9%) compared to the unprompted cohort (21.5%). African Americans age 9–18 years with three or more visits during the observation period were significantly more likely to initiate in the prompted cohort (p<0.001). Prompted cohort was significantly more (p<0.001) likely to complete the vaccine series timely compared to unprompted cohort. Conclusion More patients age 9–26 years initiated and timely completed the HPV vaccine series in clinics using an electronic health record system with prompts compared to clinics without prompts. PMID:25957365

  4. Overview of Federal, New York State, and New York City Law Regarding Environmental Health and Safety in Schools.

    ERIC Educational Resources Information Center

    Advocates for Children of New York, Inc., Long Island City.

    This document presents many of the federal, state, and New York City laws that apply to the health, safety, and environmental conditions of schools. The relevant portions of the law have been selected along with the mechanisms of legal enforcement that may exist and contact information where applicable. Legislative categories covered include air…

  5. 78 FR 71676 - Submission for Review: 3206-0201, Federal Employees Health Benefits (FEHB) Open Season Express...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ... MANAGEMENT Submission for Review: 3206-0201, Federal Employees Health Benefits (FEHB) Open Season Express Interactive Voice Response (IVR) System and Open Season Web site AGENCY: U.S. Office of Personnel Management. ACTION: 60-Day Notice and request for comments. SUMMARY: The Retirement Services, Office of...

  6. The Administration's American Competitiveness Initiative: Providing Federal Funding for Basic Research in the Physical Sciences. BHEF Issue Brief

    ERIC Educational Resources Information Center

    Business-Higher Education Forum (NJ1), 2006

    2006-01-01

    Investing in research, which drives industrial development and innovation, is essential to ensuring America's economic prosperity, national security, and leadership in a global economy. Although U.S. commitment to research and development (R&D) has traditionally been strong and sustained, federal funding of R&D as a share of U.S. gross domestic…

  7. Finding Funding: A Guide to Federal Sources for Out-of-School TIme and Community School Initiatives. Revised and Updated.

    ERIC Educational Resources Information Center

    Padgette, Heather Clapp

    Noting the growing nation-wide demand for affordable, high-quality, out-of-school time and community school programs, this guide is intended to assist program developers, policy makers, and community leaders identify federal funding sources to support out-of-school time or broader-based community school services. The guide provides an overview of…

  8. Mental health promotion in the health care setting: collaboration and engagement in the development of a mental health promotion capacity-building initiative.

    PubMed

    Horn, Michelle A; Rauscher, Alana B; Ardiles, Paola A; Griffin, Shannon L

    2014-01-01

    Health Compass is an innovative, multiphased project that aims to transform health care practice and shift organizational culture by building the capacity of Provincial Health Services Authority (PHSA) health care providers to further promote the mental health and well-being of patients and families accessing PHSA's health care services. Health Compass was developed within a health promotion framework, which involved collaboration and engagement with stakeholders across all partnering PHSA agencies. This approach led to the development of an educational and training resource that contributes to increased capacity for mental health promotion within the health care setting. Based on interviews with Health Compass' internal Project Team and findings from a Stakeholder Engagement Evaluation Report, this article outlines the participatory approach taken to develop the Health Compass Mental Health Promotion Resource and E-Learning Tool. A number of key facilitators for collaboration and engagement are discussed, which may be particularly applicable to the implementation of a mental health promotion program or initiative within a complex health care setting.

  9. Evaluation of a "traditional food for health" intervention in Pohnpei, Federated States of Micronesia.

    PubMed

    Kaufer, Laura; Englberger, Lois; Cue, Roger; Lorens, Adelino; Albert, Kiped; Pedrus, Podis; Kuhnlein, Harriet V

    2010-04-01

    Federated States of Micronesia (FSM) faces increasing rates of non-communicable diseases related to the neglect of the traditional food system and the shift to consumption of imported food and adoption of sedentary lifestyles. To reverse this trend, a two-year, food-based intervention in one Pohnpeian community in FSM promoted local food production and consumption using a variety of approaches including education, training, agriculture and social marketing following a "Go Local" message. Foods promoted were banana, giant swamp taro, breadfruit and pandanus varieties, green leafy vegetables and fruits for their provitamin A and total carotenoids, vitamins, minerals and fiber content. An evaluation was conducted in a random sample of households (n=47) to examine the extent of dietary changes following the intervention. Results indicated increased (110%) provitamin A carotenoid intake; increased frequency of consumption of local banana (53%), giant swamp taro (475%), and local vegetables (130%); and increased dietary diversity from local food. Exposure to intervention activities was high and there were positive changes in attitudes towards local food. The intervention approaches appear to have been successful in this short period. It is likely that similar approaches in additional communities in Pohnpei and other parts of the Pacific would also be successful in promoting local food. Evidence gathering should continue to document the long-term health outcomes of increased reliance on local food. PMID:20968237

  10. Food security and nutrition in the Russian Federation – a health policy analysis

    PubMed Central

    Lunze, Karsten; Yurasova, Elena; Idrisov, Bulat; Gnatienko, Natalia; Migliorini, Luigi

    2015-01-01

    Background In the Russian Federation (Russia), an elevated burden of premature mortality attributable to non-communicable diseases (NCDs) has been observed since the country's economic transition. NCDs are largely related to preventable risk factors such as unhealthy diets. Objective This health policy study's aim was to analyze past and current food production and nutritional trends in Russia and their policy implications for Russia's NCD burden. Design We examined food security and nutrition in Russia using an analytical framework of food availability, access to food, and consumption. Results Agricultural production declined during the period of economic transition, and nutritional habits changed from high-fat animal products to starches. However, per-capita energy consumption remained stable due to increased private expenditures on food and use of private land. Paradoxically, the prevalence of obesity still increased because of an excess consumption of unsaturated fat, sugar, and salt on one side, and insufficient intake of fruit and vegetables on the other. Conclusions Policy and economic reforms in Russia were not accompanied by a food security crisis or macronutrient deprivation of the population. Yet, unhealthy diets in contemporary Russia contribute to the burden of NCDs and related avoidable mortality. Food and nutrition policies in Russia need to specifically address nutritional shortcomings and food-insecure vulnerable populations. Appropriate, evidence-informed food and nutrition policies might help address Russia's burden of NCDs on a population level. PMID:26112143

  11. Evaluation of a "traditional food for health" intervention in Pohnpei, Federated States of Micronesia.

    PubMed

    Kaufer, Laura; Englberger, Lois; Cue, Roger; Lorens, Adelino; Albert, Kiped; Pedrus, Podis; Kuhnlein, Harriet V

    2010-04-01

    Federated States of Micronesia (FSM) faces increasing rates of non-communicable diseases related to the neglect of the traditional food system and the shift to consumption of imported food and adoption of sedentary lifestyles. To reverse this trend, a two-year, food-based intervention in one Pohnpeian community in FSM promoted local food production and consumption using a variety of approaches including education, training, agriculture and social marketing following a "Go Local" message. Foods promoted were banana, giant swamp taro, breadfruit and pandanus varieties, green leafy vegetables and fruits for their provitamin A and total carotenoids, vitamins, minerals and fiber content. An evaluation was conducted in a random sample of households (n=47) to examine the extent of dietary changes following the intervention. Results indicated increased (110%) provitamin A carotenoid intake; increased frequency of consumption of local banana (53%), giant swamp taro (475%), and local vegetables (130%); and increased dietary diversity from local food. Exposure to intervention activities was high and there were positive changes in attitudes towards local food. The intervention approaches appear to have been successful in this short period. It is likely that similar approaches in additional communities in Pohnpei and other parts of the Pacific would also be successful in promoting local food. Evidence gathering should continue to document the long-term health outcomes of increased reliance on local food.

  12. Decreased Cancer Mortality-to-Incidence Ratios with Increased Accessibility of Federally Qualified Health Centers

    PubMed Central

    Adams, Swann Arp; Choi, Seul Ki; Khang, Leepao; Campbell, Dayna A.; Friedman, Daniela B.; Eberth, Jan M.; Glasgow, Russell E.; Tucker-Seeley, Reginald; Xirasagar, Sudha; Yip, Mei Po; Young, Vicki M.; Hébert, James R.

    2015-01-01

    Federally qualified health centers (FQHCs) offer primary and preventive healthcare, including cancer screening, for the nation’s most vulnerable population. The purpose of this study was to explore the relationship between access to FQHCs and cancer mortality-to-incidence ratios (MIRs). One-way analysis of variance was conducted to compare the mean MIRs for breast, cervical, prostate, and colorectal cancers for each U.S. county for 2006–2010 by access to FQHCs (direct access, in-county FQHC; indirect access, adjacent-county FQHC; no access, no FQHC either in the county or in adjacent counties). ArcMap 10.1 software was used to map cancer MIRs and FQHC access levels. The mean MIRs for breast, cervical, and prostate cancer differed significantly across FQHC access levels (p < 0.05). In urban and healthcare professional shortage areas, mean MIRs decreased as FQHC access increased. A trend of lower breast and prostate cancer MIRs in direct access to FQHCs was found for all racial groups, but this trend was significant for whites only. States with a large proportion of rural and medically underserved areas had high mean MIRs, with correspondingly more direct FQHC access. Expanding FQHCs to more underserved areas and concentrations of disparity populations may have an important role in reducing cancer morbidity and mortality, as well as racial-ethnic disparities, in the United States. PMID:25634545

  13. The research agenda on oral health inequalities: the IADR-GOHIRA initiative.

    PubMed

    Williams, David M

    2014-01-01

    The World Health Organization asserts that oral health is a basic human right, yet this is a right enjoyed by few. Oral disease is a major problem in high-income countries, where the cost of treating oral diseases often exceeds that for major non-communicable diseases. In low-to-middle income countries, oral diseases are a severe and growing public health problem. Furthermore, major inequalities exist both within and between countries in terms of disease severity and prevalence, and major social gradients exist in the prevalence of oral disease. The International Association for Dental Research (IADR) has responded to the challenge of poor oral health and oral health inequalities through the Global Oral Health Inequalities: the Research Agenda (GOHIRA) initiative. In a Call to Action it has set out the priorities for research that can lead to a reduction in oral health inequalities. Three key challenges have been identified, namely gaps in knowledge and an insufficient focus on social policy, the separation of oral health from general health, and inadequate evidence-based data. Ten key research priorities have been identified with due regard to the differing needs of the variety of global health care systems, and a set of prioritized outcomes and a timeline for implementation have been defined. In the wider context of the proposals set out above, five immediate priorities for action have been proposed.

  14. Mapping of initiatives to increase membership in mutual health organizations in Benin

    PubMed Central

    2012-01-01

    Introduction Mutual health organizations (MHO) have been implemented across Africa to increase access to healthcare and improve financial protection. Despite efforts to develop MHOs, low levels of both initial enrolment and membership renewals continue to threaten their financial viability. The purpose of this study was to map initiatives implemented to increase the pool of MHO members in Benin. Methods A multiple case study was conducted to assess MHOs supported by five major promoters in Benin. Three months of fieldwork resulted in 23 semi-structured interviews and two focus groups with MHO promoters, technicians, elected members, and health professionals affiliated with the MHOs. Fifteen non-structured interviews provided additional information and a valuable source of triangulation. Results MHOs have adopted a wide range of initiatives targeting different entry points and involving a variety of stakeholders. Initiatives have included new types of collective health insurance packages and efforts to raise awareness by going door-to-door and organizing health education workshops. Different types of partnerships have been established to strengthen relationships with healthcare professionals and political leaders. However, the selection and implementation of these initiatives have been limited by insufficient financial and human resources. Conclusions The study highlights the importance of prioritizing sustainable strategies to increase MHO membership. No single MHO initiative has been able to resolve the issue of low membership on its own. If combined, existing initiatives could provide a comprehensive and inclusive approach that would target all entry points and include key stakeholders such as household decision-makers, MHO elected members, healthcare professionals, community leaders, governmental authorities, medical advisors, and promoters. There is a need to evaluate empirically the implementation of these interventions. Mechanisms to promote dialogue between

  15. 75 FR 82397 - Medicaid Program: Initial Core Set of Health Quality Measures for Medicaid-Eligible Adults

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-30

    ...: Chronic ........ obstructive pulmonary disease. 13......... 0276...... AHRQ PQI 07: ........ Hypertension... Federal Register (75 FR 44314). NQF EHR Number ID Measure owner Measure name Prevention & Health Promotion... Chronic Conditions 29......... 0071...... NCQA Persistence of Beta- ........ Blocker Treatment After...

  16. Park Rangers as Public Health Educators: The Public Health in the Parks Grants Initiative

    PubMed Central

    Higgins, Charles L.

    2010-01-01

    Health education in nontraditional settings can supplement messages received in more traditional venues, such as schools and health care facilities, and can reach new populations. In 2007, the US National Park Service awarded one-time seed grants of $10 000 or less to 16 parks in 16 states to fund the development of public health–focused programs for visitors. These programs used a wide variety of formats and addressed topics such as air pollution, prevention of vector-borne diseases, and promotion of physical activity in the parks. Almost 12 000 visitors attended the programs in 2007. Most programs were supported by park management and were well received by visitors. National parks and similar settings may be underutilized resources for delivering health messages to the general population. PMID:20558795

  17. Preparing the next generation of maternal and newborn health leaders: the maternal and newborn health champions initiatives.

    PubMed

    Dao, Blami; Otolorin, Emmanuel; Gomez, Patricia P; Carr, Catherine; Sanghvi, Harshad

    2015-06-01

    A champion in health care can be defined as any health professional who has the requisite knowledge and skills in a relevant health field, who is respected by his/her peers and supported by his/her supervisors, and who takes the lead to promote or introduce evidence-based interventions to improve the quality of care. Jhpiego used a common approach during two distinct initiatives to identify individuals in Africa, Asia, and Latin America and the Caribbean whose expertise in their clinical service area and whose leadership capacity could be strengthened to enable them to serve as champions for maternal and newborn health (MNH). These champions have gone on to contribute to the improvement of MNH in their respective countries and regions. The lessons learned from this approach are shared so they can be used by other organizations to design leadership development strategies for MNH in low-resource countries. PMID:26115857

  18. Eliminating inequities in health care: understanding perceptions and participation in an antiracism initiative.

    PubMed

    Havens, Betsy E; Yonas, Michael A; Mason, Mondi A; Eng, Eugenia; Farrar, Vanessa D

    2011-11-01

    Antiracism training for staff of health care institutions is a promising intervention strategy to address racial and ethnic disparities in health care. In 2001, Southern County Public Health Department (SCPHD) staff completed a mandatory Dismantling Racism (DR) training, and some continued with an optional DR process to challenge institutional racism within their agency. To explore factors influencing participation in optional DR activities (i.e., caucuses and Change Team), a process evaluation was conducted involving in-depth interviews with 28 SCPHD administrators and staff members, whose participation in the DR process varied. Findings demonstrate that familiarity with and receptiveness to the relationship between racism and health care inequities influenced participation in DR activities. Perceived relevance and impact of the DR process on the organization and staff were also major factors affecting participation. Improvements for implementing such efforts including the consideration of institutional power and other implications for addressing racial health care inequities through antiracism initiatives are discussed.

  19. Dietary patterns are associated with disease risk among participants in the women's health initiative observational study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women’s Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infar...

  20. U.S. Public School Enrollment-Based Health Insurance Initiatives and America's Uninsured.

    ERIC Educational Resources Information Center

    Romund, Camilla M.; Farmer, Frank L.; Tilford, John M.

    1997-01-01

    Reviews current literature on school enrollment-based health insurance programs underway or pending in the United States, focusing on initiatives in Florida, New Hampshire, Arkansas, and Texas and discussing programs in several other states. The paper discusses problems with uninsuredness in the United States and examines innovations in child…

  1. The Psychological Structure of African Americans Who Terminate Mental Health Treatment Services after Their Initial Sessions

    ERIC Educational Resources Information Center

    Dossman, Craig Arthur, Sr.

    2012-01-01

    The purpose of the qualitative phenomenological research study was to describe and explain the experiences of African Americans who terminated mental health treatment services after their initial sessions. The goal of the study was to expand the available knowledge by scientifically illuminating the lived experiences of African Americans who used…

  2. 3 CFR - Medicare Demonstration To Test Medical Homes in Federally Qualified Health Centers

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Memorandum for the Secretary of Health and Human Services My Administration is committed to building a high-quality, efficient health care system and improving access to health care for all Americans. Health centers are a vital part of the health care delivery system. For more than 40 years, health centers...

  3. Are state renewable feed-in tariff initiatives truly throttled by Federal statutes after the FERC California decision?

    SciTech Connect

    Yaffe, David P.

    2010-10-15

    For the last few years, several local and state governments have adopted ''feed-in tariffs'' to promote development of dispersed, small-scale renewable generation through incentive pricing. Most FITs are intended to stimulate development of small solar or renewable energy facilities. In July, FERC issued a decision restating that the Federal Power Act and PURPA 210, not state (or local) legislation, govern the price that local utilities may pay under FITs. (author)

  4. An examination of the Total Quality Management (TQM) concept given current Federal/DoD competition initiatives

    NASA Astrophysics Data System (ADS)

    Stabile, Michael E.

    1992-06-01

    Quality is vital to our defense and quality improvement is key to increasing productivity. The Department of Defense (DoD) Total Quality Management (TQM) effort has been given top priority by the Secretary of Defense. Many questions exist concerning the problems encountered when implementing TQM throughout DoD. This thesis looks at the compatibility of the TQM philosophy with current Federal Acquisition Regulation competition requirements. The writer concludes that the TQM philosophy implementation is compatible with existing competition policy.

  5. Integrating the environment, the economy, and community health: a Community Health Center's initiative to link health benefits to smart growth.

    PubMed

    McAvoy, Peter V; Driscoll, Mary Beth; Gramling, Benjamin J

    2004-04-01

    The Sixteenth Street Community Health Center (SSCHC) in Milwaukee, Wis, is making a difference in the livability of surrounding neighborhoods and the overall health of the families it serves. SSCHC is going beyond traditional health care provider models and working to link the environment, the economy, and community health through urban brownfield redevelopment and sustainable land-use planning. In 1997, SSCHC recognized that restoration of local air and water quality and other environmental conditions, coupled with restoring family-supporting jobs in the neighborhood, could have a substantial impact on the overall health of families. Recent events indicate that SSCHC's pursuit of smart growth strategies has begun to pay off. PMID:15053995

  6. Responses of Canada's health care management education programs to health care reform initiatives.

    PubMed

    Angus, D E; Lay, C M

    2000-01-01

    Canada's provincial health care systems have been experiencing significant changes, mostly through horizontal integration achieved by merging hospitals, and, in a few cases, through vertical integration of public health, long term care, home care and hospital services. The government motivation for forcing these changes seems to have been primarily financial. In a few cases, the integration seems to have resulted in a stable and successful outcome, but, in most others, there has been destabilization, and in some, there has been chaos. The question posed in this research was how the five accredited Canadian graduate programs in health care management were responding to these changes. Two of the programs have recently made major changes in structure and/or delivery processes, following careful examination of their perceived environments. One has rationalized by subdividing courses. Another is repatriating courses from the business school in order to achieve more health-related content. Four of the five programs have added a number of courses in the last few years, or plan to do so in the next year or two, either because of accreditation criteria or student or faculty interest. The program directors viewed the educational requirements for clinicians and non-clinicians as being identical. In spite of the major structural changes, and the resulting destabilization of the health care organizations (and even governments), none of the programs emphasized the changes as factors in their plans for program changes. They expressed some concern about the possibility of fads as opposed to significant changes. It may be that these changes are dealt with in the content of individual courses. This aspect was not examined by the survey nor by interviews with the directors. Each of the programs has emphasized its own niche, with no consensus about changes required.

  7. The Role of Prevention in Promoting Continuity of Health Care in Prisoner Reentry Initiatives

    PubMed Central

    Lanza, A. Stephen; Dyson, William; Gordon, Derrick M.

    2013-01-01

    Most incarcerated individuals will return to the community, and their successful reentry requires consideration of their health and how their health will affect their families and communities. We propose the use of a prevention science framework that integrates universal, selective, and indicated strategies to facilitate the successful reentry of men released from prison. Understanding how health risks and disparities affect the transition from prison to the community will enhance reentry intervention efforts. To explore the application of the prevention rubric, we evaluated a community-based prisoner reentry initiative. The findings challenge all involved in reentry initiatives to reconceptualize prisoner reentry from a program model to a prevention model that considers multilevel risks to and facilitators of successful reentry. PMID:23488516

  8. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services

    PubMed Central

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    Background A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. Methods This is a sub-analysis of a national population-based survey of postpartum women entitled “Birth in Brazil”, performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Results Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk–adjusted OR of 2.3 (CI 1.5–3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1–2.3) for women of high obstetric risk. Conclusion The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care. PMID:27196102

  9. [The federal government discourse during the political decentralization process and the obstacles to implement the Brazilian Public Health Care System].

    PubMed

    Pellegrini, Bárbara

    2007-01-01

    A discourse analysis carried out on basic operating standard Norma Operacional Básica do Sistema Unico de Saúde (NOB-SUS 01/96) of the Brazilian public health care system aiming at locating signs that could allow to identify lines of thought which have influenced health care policies prioritized by the federal administration. The author points out a peculiarity in the kind of discourse employed by the ministry directive: its structure is based on isolated aspects of legislation and on ideas advocated by other discourse communities, articulated with redefined legal principles - an effort towards authorizing the official reasoning in favor of the relevance in keeping the decentralization process under the control of the federal administration. The analysis concludes that an infra-legal standard can neither grant state and federal administrations a hierarchical superiority (mediation function) over municipal administrations, nor can it transfer the legal responsibilities pertaining to Health Councils over to inter-administration commissions (Comissões Intergestores) , thus making the former mere decision ratifiers. This study found that granting privileges not contemplated in the legislation to state and federal administrations surfaced again and more strongly so in 2001 in yet another operating standard.

  10. How federal health-care policies interface with urban and rural areas: a comparison of three systems.

    PubMed

    Baracskay, Daniel

    2012-01-01

    Global public health policies span national borders and affect multitudes of people. The spread of infectious disease has neither political nor economic boundaries, and when elevated to a status of pandemic proportions, immediate action is required. In federal systems of government, the national level leads the policy formation and implementation process, but also collaborates with supranational organisations as part of the global health network. Likewise, the national level of government cooperates with sub-national governments located in both urban and rural areas. Rural areas, particularly in less developed countries, tend to have higher poverty rates and lack the benefits of proper medical facilities, communication modes and technology to prevent the spread of disease. From the perspective of epidemiological surveillance and intervention, this article will examine federal health policies in three federal systems: Australia, Malaysia and the USA. Using the theoretical foundations of collaborative federalism, this article specifically examines how collaborative arrangements and interactions among governmental and non-governmental actors help to address the inherent discrepancies that exist between policy implementation and reactions to outbreaks in urban and rural areas. This is considered in the context of the recent H1N1 influenza pandemic, which spread significantly across the globe in 2009 and is now in what has been termed the 'post-pandemic era'.

  11. Private initiatives and policy options: recent health system experience in India.

    PubMed

    Purohit, B C

    2001-03-01

    In the recent past the impact of structural adjustment in the Indian health care sector has been felt in the reduction in central grants to States for public health and disease control programmes. This falling share of central grants has had a more pronounced impact on the poorer states, which have found it more difficult to raise local resources to compensate for this loss of revenue. With the continued pace of reforms, the likelihood of increasing State expenditure on the health care sector is limited in the future. As a result, a number of notable trends are appearing in the Indian health care sector. These include an increasing investment by non-resident Indians (NRIs) in the hospital industry, leading to a spurt in corporatization in the States of their original domicile and an increasing participation by multinational companies in diagnostics aiming to capture the potential of the Indian health insurance market. The policy responses to these private initiatives are reflected in measures comprising strategies to attract private sector participation and management inputs into primary health care centres (PHCs), privatization or semi-privatization of public health facilities such as non-clinical services in public hospitals, innovating ways to finance public health facilities through non-budgetary measures, and tax incentives by the State governments to encourage private sector investment in the health sector. Bearing in mind the vital importance of such market forces and policy responses in shaping the future health care scenario in India, this paper examines in detail both of these aspects and their implications for the Indian health care sector. The analysis indicates that despite the promising newly emerging atmosphere, there are limits to market forces; appropriate refinement in the role of government should be attempted to avoid undesirable consequences of rising costs, increasing inequity and consumer exploitation. This may require opening the health

  12. Building analytic capacity, facilitating partnerships, and promoting data use in state health agencies: a distance-based workforce development initiative applied to maternal and child health epidemiology.

    PubMed

    Rankin, Kristin M; Kroelinger, Charlan D; Rosenberg, Deborah; Barfield, Wanda D

    2012-12-01

    The purpose of this article is to summarize the methodology, partnerships, and products developed as a result of a distance-based workforce development initiative to improve analytic capacity among maternal and child health (MCH) epidemiologists in state health agencies. This effort was initiated by the Centers for Disease Control's MCH Epidemiology Program and faculty at the University of Illinois at Chicago to encourage and support the use of surveillance data by MCH epidemiologists and program staff in state agencies. Beginning in 2005, distance-based training in advanced analytic skills was provided to MCH epidemiologists. To support participants, this model of workforce development included: lectures about the practical application of innovative epidemiologic methods, development of multidisciplinary teams within and across agencies, and systematic, tailored technical assistance The goal of this initiative evolved to emphasize the direct application of advanced methods to the development of state data products using complex sample surveys, resulting in the articles published in this supplement to MCHJ. Innovative methods were applied by participating MCH epidemiologists, including regional analyses across geographies and datasets, multilevel analyses of state policies, and new indicator development. Support was provided for developing cross-state and regional partnerships and for developing and publishing the results of analytic projects. This collaboration was successful in building analytic capacity, facilitating partnerships and promoting surveillance data use to address state MCH priorities, and may have broader application beyond MCH epidemiology. In an era of decreasing resources, such partnership efforts between state and federal agencies and academia are essential for promoting effective data use.

  13. Building Analytic Capacity, Facilitating Partnerships, and Promoting Data Use in State Health Agencies: A Distance-Based Workforce Development Initiative Applied to Maternal and Child Health Epidemiology

    PubMed Central

    Kroelinger, Charlan D.; Rosenberg, Deborah; Barfield, Wanda D.

    2015-01-01

    The purpose of this article is to summarize the methodology, partnerships, and products developed as a result of a distance-based workforce development initiative to improve analytic capacity among maternal and child health (MCH) epidemiologists in state health agencies. This effort was initiated by the Centers for Disease Control’s MCH Epidemiology Program and faculty at the University of Illinois at Chicago to encourage and support the use of surveillance data by MCH epidemiologists and program staff in state agencies. Beginning in 2005, distance-based training in advanced analytic skills was provided to MCH epidemiologists. To support participants, this model of workforce development included: lectures about the practical application of innovative epidemiologic methods, development of multidisciplinary teams within and across agencies, and systematic, tailored technical assistance The goal of this initiative evolved to emphasize the direct application of advanced methods to the development of state data products using complex sample surveys, resulting in the articles published in this supplement to MCHJ. Innovative methods were applied by participating MCH epidemiologists, including regional analyses across geographies and datasets, multilevel analyses of state policies, and new indicator development. Support was provided for developing cross-state and regional partnerships and for developing and publishing the results of analytic projects. This collaboration was successful in building analytic capacity, facilitating partnerships and promoting surveillance data use to address state MCH priorities, and may have broader application beyond MCH epidemiology. In an era of decreasing resources, such partnership efforts between state and federal agencies and academia are essential for promoting effective data use. PMID:23143158

  14. Local adaptations to a global health initiative: penalties for home births in Zambia.

    PubMed

    Greeson, Dana; Sacks, Emma; Masvawure, Tsitsi B; Austin-Evelyn, Katherine; Kruk, Margaret E; Macwan'gi, Mubiana; Grépin, Karen A

    2016-11-01

    Global health initiatives (GHIs) are implemented across a variety of geographies and cultures. Those targeting maternal health often prioritise increasing facility delivery rates. Pressure on local implementers to meet GHI goals may lead to unintended programme features that could negatively impact women. This study investigates penalties for home births imposed by traditional leaders on women during the implementation of Saving Mothers, Giving Life (SMGL) in Zambia. Forty focus group discussions (FGDs) were conducted across four rural districts to assess community experiences of SMGL at the conclusion of its first year. Participants included women who recently delivered at home (3 FGDs/district), women who recently delivered in a health facility (3 FGDs/district), community health workers (2 FGDs/district) and local leaders (2 FGDs/district). Findings indicate that community leaders in some districts-independently of formal programme directive-used fines to penalise women who delivered at home rather than in a facility. Participants in nearly all focus groups reported hearing about the imposition of penalties following programme implementation. Some women reported experiencing penalties firsthand, including cash and livestock fines, or fees for child health cards that are typically free. Many women who delivered at home reported their intention to deliver in a facility in the future to avoid penalties. While communities largely supported the use of penalties to promote facility delivery, the penalties effectively introduced a new tax on poor rural women and may have deterred their utilization of postnatal and child health care services. The imposition of penalties is thus a punitive adaptation that can impose new financial burdens on vulnerable women and contribute to widening health, economic and gender inequities in communities. Health initiatives that aim to increase demand for health services should monitor local efforts to achieve programme targets in order

  15. United States Federal Health Care Websites: A Multimethod Evaluation of Website Accessibility for Individuals with Disabilities

    ERIC Educational Resources Information Center

    Brobst, John L.

    2012-01-01

    The problem addressed by this study is the observed low levels of compliance with federal policy on website accessibility. The study examines the two key federal policies that promote website accessibility, using a side-by-side policy analysis technique. The analysis examines the Americans with Disabilities Act of 1990 and Section 508 of the…

  16. 76 FR 9968 - Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-23

    ... accrediting standard that, regardless of whether such standard provides exceptions or exemptions, requires an... of Federal Law'' (73 FR 50274). In the preamble to the 2008 Final Rule, the Department concluded that... Federal Law,'' 73 FR 78072, 78074, 45 CFR part 88 (Dec. 19, 2008)). The 2008 Final Rule was published...

  17. Medicare Part D and the Federal Employees Health Benefits Program: A Comparison of Prescription Drug Coverage

    PubMed Central

    Lovett, Annesha

    2013-01-01

    Background There is much debate currently about how to restructure the Medicare program to achieve better value for the money. Many have cited the Federal Employees Health Benefits Program (FEHBP) as a model for reform. Objective To compare drug coverage and cost-sharing between Medicare Part D and the FEHBP plans. Methods A cross-sectional comparison was conducted of January 2009 data obtained from the Centers for Medicare & Medicaid Services, the Office of Personnel Management, and 3 health plan websites. Regression analysis and t-tests were used to examine drug coverage, copayment, and coinsurance amounts among Medicare Part D and FEHBP plans. The final study sample of Medicare Part D plans consisted of 19 formularies, covering 63% of total Part D enrollment. These 19 formularies represented 232 stand-alone prescription drug plans. In addition, 5 prescription drug plans or formularies in the FEHBP plans were included, which represents 70% of total FEHBP enrollment. Results The results of this study reveal that formulary coverage of the top drugs dispensed and sold in the United States in 2009 ranged from 72% to 94% (average, 84%) in Medicare Part D plans and from 85% to 99% (average, 94%) in the FEHBP plans (P <.01). The mean copayment for generic drugs in Medicare Part D plans was $4.53 compared with a mean of $7.67 (P <.05) in the FEHBP plans. The difference between the 2 programs in mean copayment for brand-name drugs was nonsignificant. For generic drugs, the mean coinsurance rate was 17% for Medicare Part D plans and a mean of 20% for the FEHBP plans (P <.05). Conclusions This analysis shows that there are differences in prescription drug coverage and cost-sharing among plans within Medicare Part D and the FEHBP. To avoid extreme increases in payroll taxes and other revenues or major cutbacks in services, Medicare must explore ways to change the healthcare system to achieve better value for the money. The experience of the FEHBP suggests a possible means of

  18. Using GIS to profile health-care costs of VA Quality-Enhancement Research Initiative diseases.

    PubMed

    Yu, Wei; Cowper, Diane; Berger, Magdalena; Kuebeler, Mark; Kubal, Joe; Manheim, Larry

    2004-06-01

    The Health Services Research and Development (HSR&D) Service at the Department of Veterans Affairs (VA) Health Care System launched a Quality Enhancement Research Initiative (QUERI) in 1998. This study estimated health-care costs of nine diseases under the QUERI project and analyzed geographic differences in health-care costs and utilization across 22 VA Integrated Service Networks (VISNs), using a geographic information system (GIS). Patients with these diseases were identified from diagnoses recorded between October 1999 and September 2000. Annual health-care costs for each disease were estimated in four categories: inpatient medical or surgical, other inpatient, outpatient, and outpatient pharmacy. Geographic differences of costs and health-care utilization across the 22 VISNs for chronic heart failure, diabetes, and spinal-cord injury were mapped using a GIS package. Average costs and patterns of health-care utilization varied substantially across the 22 VISNs. The observed differences in health-care utilization across geographic regions raised questions for further investigation. PMID:15446617

  19. Real-world comparison of health care utilization between duloxetine and pregabalin initiators with fibromyalgia

    PubMed Central

    Peng, X; Sun, P; Novick, D; Andrews, J; Sun, S

    2014-01-01

    Objectives To compare health care utilization of duloxetine initiators and pregabalin initiators among fibromyalgia patients in a real-world setting. Methods A retrospective cohort study was conducted based on a US national commercial health claims database (2006–2009). Fibromyalgia patients who initiated duloxetine or pregabalin in 2008, aged 18–64 years, and who maintained continuous health insurance coverage 1 year before and 1 year after initiation were assigned to duloxetine or pregabalin cohorts on the basis of their initiated agent. Patients who had pill coverage of the agents over the course of 90 days preceding the initiation were excluded. The two comparative cohorts were constructed using propensity score greedy match methods. Descriptive analysis and paired t-test were performed to compare health care utilization rates in the postinitiation year and the changes of these rates from the preinitiation year to the postinitiation year. Results Both matched cohorts (n=1,265 pairs) had a similar mean initiation age (49–50 years), percentage of women (87%–88%), and prevalence of baseline comorbid conditions (neuropathic pain other than diabetic peripheral neuropathic pain, low back pain, cardiovascular disease, hypertension, headache or migraine, and osteoarthritis). In the preinitiation year, both cohorts had similar inpatient, outpatient, and medication utilization rates (inpatient, 15.7%–16.1%; outpatient, 100.0%; medication, 97.9%–98.7%). The utilization rates diverged in the postinitiation year, with the pregabalin cohort using more fibromyalgia-related inpatient care (3.2% versus 2.2%; P<0.05), any inpatient care (19.3% versus 16.8%; P<0.05), and fibromyalgia-related outpatient care (62.1% versus 51.8%; P<0.05). From the preinitiation period to the postinitiation period, the duloxetine cohort experienced decreases in certain utilization rates, whereas the pregabalin cohort had increases (percentage of patients with a fibromyalgia

  20. [The Unified National Health System and public policies: psychological care for menopausal women in the Federal District, Brazil].

    PubMed

    Mori, Maria Elizabeth; Coelho, Vera Lúcia Decnop; Estrella, Renata da Costa Netto

    2006-09-01

    This study focused on psychological care for middle-aged women in public health services in the Federal District (Brasilia), Brazil. The article discusses women's health and more specifically menopause and its place in Brazilian public health policies. The survey confirmed the lack of psychological support for menopausal women. In most cases only outpatient medical care was offered. No psychologist had been designated in any of the units surveyed to assist these women. The study concludes that this period of women's life has failed to receive psychological care in Brazil, thus neglecting the principles of the Unified National Health System. Menopausal women deserve comprehensive health care, including attention to conflicts related to biological, psychological, and socio-cultural dimensions of aging, thus contributing to the process of working through maturity.

  1. A Performance Management Initiative for Local Health Department Vector Control Programs

    PubMed Central

    Gerding, Justin; Kirshy, Micaela; Moran, John W.; Bialek, Ron; Lamers, Vanessa; Sarisky, John

    2016-01-01

    Local health department (LHD) vector control programs have experienced reductions in funding and capacity. Acknowledging this situation and its potential effect on the ability to respond to vector-borne diseases, the U.S. Centers for Disease Control and Prevention and the Public Health Foundation partnered on a performance management initiative for LHD vector control programs. The initiative involved 14 programs that conducted a performance assessment using the Environmental Public Health Performance Standards. The programs, assisted by quality improvement (QI) experts, used the assessment results to prioritize improvement areas that were addressed with QI projects intended to increase effectiveness and efficiency in the delivery of services such as responding to mosquito complaints and educating the public about vector-borne disease prevention. This article describes the initiative as a process LHD vector control programs may adapt to meet their performance management needs. This study also reviews aggregate performance assessment results and QI projects, which may reveal common aspects of LHD vector control program performance and priority improvement areas. LHD vector control programs interested in performance assessment and improvement may benefit from engaging in an approach similar to this performance management initiative. PMID:27429555

  2. Palliative Care in Rural Minnesota: Findings from Stratis Health's Minnesota Rural Palliative Care Initiative.

    PubMed

    McKinley, Deb; Shearer, Janelle; Weng, Karla

    2016-01-01

    Palliative care, which involves managing symptoms, controlling pain and addressing stress caused by a chronic or terminal illness, has been shown to keep patients out of the hospital and allow them to stay home and live more comfortably with their illness. Typically, it is provided by an interdisciplinary team led by a physician trained in palliative medicine. Rural areas have not always had access to such specialists. Yet, today, rural health care organizations are finding ways to create palliative care programs that meet the needs of their chronically ill and aging populations. This article describes a six-year initiative led by Stratis Health to advance palliative care in rural Minnesota. It highlights the work of FirstLight Health System in Mora and describes Stratis Health's Rural Palliative Care Measurement Pilot Project, an effort to develop and test measures for evaluating rural palliative care programs.

  3. 29 CFR 1952.272 - Level of Federal enforcement.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Level of Federal enforcement. 1952.272 Section 1952.272... Level of Federal enforcement. Pursuant to §§ 1902.20(b)(1)(iii) and 1954.3 of this chapter under which... initiated with regard to Federal occupational safety and health standards in issues covered under 29...

  4. THE AFFORDABLE CARE ACT AND INCENTIVIZED HEALTH WELLNESS PROGRAMS--A TALE OF FEDERALISM AND SHIFTING ADMINISTRATIVE BURDEN.

    PubMed

    Sirpal, Sanjeev

    2014-01-01

    The Patient Protection and Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs and encourage opportunities to support healthier workplaces. The proposed rules are promulgated by the Department of Health and Human Services (HHS), the Department of Labor, and the Treasury Department, and seek to encourage appropriately designed, consumer-protective wellness programs in group health coverage. This legislative landscape raises significant federalism concerns insofar as it largely shifts the responsibility for administration of health incentive programs to the states. Little attention has been paid to the shifting "administrative burden" that would thereby ensue. This paper will address the distribution of power in the American federal system vis-à-vis subnational counterparts in the wake of rampant, recent health care reform efforts. This paper will therefore explore the willingness of the national government to delegate policymaking responsibility to state governments in the context of an important aspect of healthcare reform. This, in turn, can be used to assess the distribution of powers between governmental levels--a subject that has received little systematic inquiry to date. Finally, this paper will explore the degree of administrative burden shifting that may likely occur as a result of these changes in health reform and what potential impacts it may have on individual health. PMID:27439262

  5. 75 FR 38493 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... Psychological Health External Advisory Subcommittee. Additionally, the Board will receive briefings regarding... Joint Theater Trauma System, as well as the review of the Deployment Health Research Center conducted...

  6. Health Sector Initiatives for Disaster Risk Management in Ethiopia: A Narrative Review

    PubMed Central

    Tadesse, Luche; Ardalan, Ali

    2014-01-01

    Background: Natural and man-made disasters are prevailing in Ethiopia mainly due to drought, floods, landslides, earthquake, volcanic eruptions, and disease epidemics. Few studies so far have critically reviewed about medical responses to disasters and little information exists pertaining to the initiatives being undertaken by health sector from the perspective of basic disaster management cycle. This article aimed to review emergency health responses to disasters and other related interventions which have been undertaken in the health sector. Methods: Relevant documents were identified by searches in the websites of different sectors in Ethiopian and international non-governmental organizations and United Nations agencies. Using selected keywords, articles were also searched in the data bases of Medline, CINAHL, Scopus, and Google Scholar. In addition, pertinent articles from non-indexed journals were referred to. Results: Disaster management system in Ethiopia focused on response, recovery, and rehabilitation from 1974 to 1988; while the period between 1988 and 1993 marked the transition phase towards a more comprehensive approach. Theoretically, from 1993 onwards, the disaster management system has fully integrated the mitigation, prevention, and preparedness phases into already existing response and recovery approach, particularly for drought. This policy has changed the emergency response practices and the health sector has taken some initiatives in the area of emergency health care. Hence, drought early warning system, therapeutic feeding program in hospitals, health centers and posts in drought prone areas to manage promptly acute malnutrition cases have all been put in place. In addition, public health disease emergencies have been responded to at all levels of health care system. Conclusions: Emergency health responses to drought and its ramifications such as acute malnutrition and epidemics have become more comprehensive in the context of basic disaster

  7. The PAR Framework Proof of Concept: Initial Findings from a Multi-Institutional Analysis of Federated Postsecondary Data

    ERIC Educational Resources Information Center

    Ice, Phil; Diaz, Sebastian; Swan, Karen; Burgess, Melissa; Sharkey, Mike; Sherrill, Jonathan; Huston, Dan; Okimoto, Hae

    2012-01-01

    Despite high enrollment numbers, postsecondary completion rates have generally remained unchanged for the past 30 years and half of these students do not attain a degree within six years of initial enrollment. Although online learning has provided students with a convenient alternative to face-to-face instruction, there remain significant…

  8. 45 CFR 60.13 - Reporting Federal or state criminal convictions related to the delivery of a health care item or...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... related to the delivery of a health care item or service. 60.13 Section 60.13 Public Welfare DEPARTMENT OF... § 60.13 Reporting Federal or state criminal convictions related to the delivery of a health care item... against health care practitioners, providers, and suppliers related to the delivery of a health care...

  9. 45 CFR 60.13 - Reporting Federal or state criminal convictions related to the delivery of a health care item or...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... related to the delivery of a health care item or service. 60.13 Section 60.13 Public Welfare Department of... § 60.13 Reporting Federal or state criminal convictions related to the delivery of a health care item... against health care practitioners, providers, and suppliers related to the delivery of a health care...

  10. Geographically varying effects of weather on tobacco consumption: implications for health marketing initiatives.

    PubMed

    Govind, Rahul; Garg, Nitika; Sun, Wenbin

    2014-01-01

    Weather and its fluctuations have been found to influence the consumption of negative hedonic goods. However, such findings are of limited use to health marketers who cannot control the weather, and hence, its effects. The current research utilizes data obtained at the zip-code level to study geographical variations in the effect of weather on tobacco consumption across the entire continental United States. The results allow health marketers to identify areas that will be most responsive to marketing efforts aimed at curtailing negative hedonic consumption and thus implement more effective, region-specific initiatives.

  11. The legacy of the Child Health and Nutrition Research Initiative (CHNRI).

    PubMed

    Black, Robert E

    2016-06-01

    Under the Global Forum for Health Research, the Child Health and Nutrition Research Initiative (CHNRI) began its operations in 1999 and became a Swiss foundation in 2006. The vision of CHNRI was to improve child health and nutrition of all children in low- and middle-income countries (LMIC) through research that informs health policy and practice. Specific objectives included expanding global knowledge on childhood disease burden and cost-effectiveness of interventions, promoting priority setting in research, ensuring inclusion of institutions and scientists in LMIC in setting priorities, promoting capacity development in LMIC and stimulating donors and countries to increase resources for research. CHNRI created a knowledge network, funded research through multiple rounds of a global competitive process and published research papers and policy briefs. A signature effort was to develop a systematic methodology for prioritizing health and nutrition research investments. The "CHNRI method" has been extensively applied to global health problems and is now the most commonly used method for prioritizing health research questions. PMID:26955468

  12. The legacy of the Child Health and Nutrition Research Initiative (CHNRI)

    PubMed Central

    Black, Robert E

    2016-01-01

    Under the Global Forum for Health Research, the Child Health and Nutrition Research Initiative (CHNRI) began its operations in 1999 and became a Swiss foundation in 2006. The vision of CHNRI was to improve child health and nutrition of all children in low– and middle–income countries (LMIC) through research that informs health policy and practice. Specific objectives included expanding global knowledge on childhood disease burden and cost–effectiveness of interventions, promoting priority setting in research, ensuring inclusion of institutions and scientists in LMIC in setting priorities, promoting capacity development in LMIC and stimulating donors and countries to increase resources for research. CHNRI created a knowledge network, funded research through multiple rounds of a global competitive process and published research papers and policy briefs. A signature effort was to develop a systematic methodology for prioritizing health and nutrition research investments. The “CHNRI method” has been extensively applied to global health problems and is now the most commonly used method for prioritizing health research questions. PMID:26955468

  13. The legacy of the Child Health and Nutrition Research Initiative (CHNRI).

    PubMed

    Black, Robert E

    2016-06-01

    Under the Global Forum for Health Research, the Child Health and Nutrition Research Initiative (CHNRI) began its operations in 1999 and became a Swiss foundation in 2006. The vision of CHNRI was to improve child health and nutrition of all children in low- and middle-income countries (LMIC) through research that informs health policy and practice. Specific objectives included expanding global knowledge on childhood disease burden and cost-effectiveness of interventions, promoting priority setting in research, ensuring inclusion of institutions and scientists in LMIC in setting priorities, promoting capacity development in LMIC and stimulating donors and countries to increase resources for research. CHNRI created a knowledge network, funded research through multiple rounds of a global competitive process and published research papers and policy briefs. A signature effort was to develop a systematic methodology for prioritizing health and nutrition research investments. The "CHNRI method" has been extensively applied to global health problems and is now the most commonly used method for prioritizing health research questions.

  14. The Maternal and Child Health Bureau's Initiative for Mental Health in Schools. Report from the Summit. (Washington, DC, March 7, 1998).

    ERIC Educational Resources Information Center

    Adelman, Howard; Taylor, Linda

    When the Maternal and Child Health Bureau implemented an initiative in 1995 to support mental health for school-age children and youth by strengthening the capacity of school-linked health programs to address psychosocial issues and mental health problems, two national centers and five state projects were developed. The work of projects in…

  15. International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals.

    PubMed

    Di Renzo, Gian Carlo; Conry, Jeanne A; Blake, Jennifer; DeFrancesco, Mark S; DeNicola, Nathaniel; Martin, James N; McCue, Kelly A; Richmond, David; Shah, Abid; Sutton, Patrice; Woodruff, Tracey J; van der Poel, Sheryl Ziemin; Giudice, Linda C

    2015-12-01

    Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice. PMID:26433469

  16. International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals.

    PubMed

    Di Renzo, Gian Carlo; Conry, Jeanne A; Blake, Jennifer; DeFrancesco, Mark S; DeNicola, Nathaniel; Martin, James N; McCue, Kelly A; Richmond, David; Shah, Abid; Sutton, Patrice; Woodruff, Tracey J; van der Poel, Sheryl Ziemin; Giudice, Linda C

    2015-12-01

    Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice.

  17. State Children's Health Insurance Program financing and the need for significant federal funding increases as part of reauthorization.

    PubMed

    Broaddus, Matt; Park, Edwin

    2006-01-01

    In order to better inform the debate as federal policymakers prepare to reauthorize the State Children's Health Insurance Program (SCHIP) in 2007, this brief analyzes the key components of the financing structure of SCHIP including capped federal block-grant funding, the methodology for determining state's allotments of federal funding, the period of availability of allotments, and the redistribution of unspent funds. In addition, estimates presented in this brief indicate that under Congressional Budget Office baseline assumptions, SCHIP is reauthorized but annual SCHIP funding will be permanently frozen at 5.04 billion US dollars without any increases for population growth or healthcare inflation. As a result, states will suffer an aggregate federal SCHIP funding shortfall of 10.4 billion US dollars to 12.1 billion US dollars over the 5-year period from 2008 through 2012, thus placing SCHIP coverage of many low-income children at significant risk. As part of SCHIP reauthorization, federal policymakers should include substantial increases to SCHIP funding above baseline levels to avert these shortfalls.

  18. Developing a statewide public health initiative to reduce infant mortality in Oklahoma.

    PubMed

    Dooley, Suzanna; Patrick, Paul; Lincoln, Alicia; Cline, Janette

    2014-01-01

    The Preparing for a Lifetime, It's Everyone's Responsibility initiative was developed to improve the health and well- being of Oklahoma's mothers and infants. The development phase included systematic data collection, extensive data analysis, and multi-disciplinary partnership development. In total, seven issues (preconception/interconception health, tobacco use, postpartum depression, breastfeeding, infant safe sleep, preterm birth, and infant injury prevention) were identified as crucial to addressing infant mortality in Oklahoma. Workgroups were created to focus on each issue. Data and media communications workgroups were added to further partner commitment and support for policy and programmatic changes across multiple agencies and programs. Leadership support, partnership, evaluation, and celebrating small successes were important factors that lead to large scale adoption and support for the state-wide initiative to reduce infant mortality. PMID:25790592

  19. Pan-Canadian REspiratory STandards INitiative for Electronic Health Records (PRESTINE): 2011 National Forum Proceedings

    PubMed Central

    Lougheed, M Diane; Minard, Janice; Dworkin, Shari; Juurlink, Mary-Ann; Temple, Walley J; To, Teresa; Koehn, Marc; Van Dam, Anne; Boulet, Louis-Philippe

    2012-01-01

    In a novel knowledge translation initiative, the Government of Ontario’s Asthma Plan of Action funded the development of an Asthma Care Map to enable adherence with the Canadian Asthma Consensus Guidelines developed under the auspices of the Canadian Thoracic Society (CTS). Following its successful evaluation within the Primary Care Asthma Pilot Project, respiratory clinicians from the Asthma Research Unit, Queen’s University (Kingston, Ontario) are leading an initiative to incorporate standardized Asthma Care Map data elements into electronic health records in primary care in Ontario. Acknowledging that the issue of data standards affects all respiratory conditions, and all provinces and territories, the Government of Ontario approached the CTS Respiratory Guidelines Committee. At its meeting in September 2010, the CTS Respiratory Guidelines Committee agreed that developing and standardizing respiratory data elements for electronic health records are strategically important. In follow-up to that commitment, representatives from the CTS, the Lung Association, the Government of Ontario, the National Lung Health Framework and Canada Health Infoway came together to form a planning committee. The planning committee proposed a phased approach to inform stakeholders about the issue, and engage them in the development, implementation and evaluation of a standardized dataset. An environmental scan was completed in July 2011, which identified data definitions and standards currently available for clinical variables that are likely to be included in electronic medical records in primary care for diagnosis, management and patient education related to asthma and COPD. The scan, sponsored by the Government of Ontario, includes compliance with clinical nomenclatures such as SNOMED-CT® and LOINC®. To help launch and create momentum for this initiative, a national forum was convened on October 2 and 3, 2011, in Toronto, Ontario. The forum was designed to bring together key

  20. Pan-Canadian REspiratory STandards INitiative for Electronic Health Records (PRESTINE): 2011 national forum proceedings.

    PubMed

    Lougheed, M Diane; Minard, Janice; Dworkin, Shari; Juurlink, Mary-Ann; Temple, Walley J; To, Teresa; Koehn, Marc; Van Dam, Anne; Boulet, Louis-Philippe

    2012-01-01

    In a novel knowledge translation initiative, the Government of Ontario's Asthma Plan of Action funded the development of an Asthma Care Map to enable adherence with the Canadian Asthma Consensus Guidelines developed under the auspices of the Canadian Thoracic Society (CTS). Following its successful evaluation within the Primary Care Asthma Pilot Project, respiratory clinicians from the Asthma Research Unit, Queen's University (Kingston, Ontario) are leading an initiative to incorporate standardized Asthma Care Map data elements into electronic health records in primary care in Ontario. Acknowledging that the issue of data standards affects all respiratory conditions, and all provinces and territories, the Government of Ontario approached the CTS Respiratory Guidelines Committee. At its meeting in September 2010, the CTS Respiratory Guidelines Committee agreed that developing and standardizing respiratory data elements for electronic health records are strategically important. In follow-up to that commitment, representatives from the CTS, the Lung Association, the Government of Ontario, the National Lung Health Framework and Canada Health Infoway came together to form a planning committee. The planning committee proposed a phased approach to inform stakeholders about the issue, and engage them in the development, implementation and evaluation of a standardized dataset. An environmental scan was completed in July 2011, which identified data definitions and standards currently available for clinical variables that are likely to be included in electronic medical records in primary care for diagnosis, management and patient education related to asthma and COPD. The scan, sponsored by the Government of Ontario, includes compliance with clinical nomenclatures such as SNOMED-CT® and LOINC®. To help launch and create momentum for this initiative, a national forum was convened on October 2 and 3, 2011, in Toronto, Ontario. The forum was designed to bring together key

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

    PubMed

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

    2014-08-01

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

  2. Are current debt relief initiatives an option for scaling up health financing in beneficiary countries?

    PubMed

    Kaddar, M; Furrer, E

    2008-11-01

    One central goal of the enhanced Heavily Indebted Poor Countries (HIPC) Initiative and the more recent Multilateral Debt Relief Initiative (MDRI) is to free up additional resources for public spending on poverty reduction. The health sector was expected to benefit from a considerable share of these funds. The volume of released resources is important enough in certain countries to make a difference for priority programmes that have been underfunded so far. However, the relevance of these initiatives in terms of boosting health expenditure depends essentially, at the global level, on the compliance of donors with their aid commitments and, at the domestic level, on the success of health officials in advocating for an adequate share of the additional fiscal space. Advocacy efforts are often limited by a state of asymmetric information whereby some ministries are not well aware of the economic consequences of debt relief on public finances and of the management systems in place to deal with savings from debt relief. A thorough comprehension of these issues seems essential for health advocates to increase their bargaining power and for a wider public to readjust expectations of what debt relief can realistically achieve and of what can be measured. This paper intends to narrow the information gap by classifying debt relief savings management systems observed in practice. We illustrate some of the major advantages and stated drawbacks and outline the policy implications for health officials operating in the countries concerned. There should be careful monitoring of fungibility (i.e. where untraceable funds risk substitution) and additionality (i.e. the extent to which new inputs add to existing inputs at national and international level).

  3. 29 CFR 1952.365 - Level of Federal enforcement.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... Mexico occupational health and safety plan, discretionary Federal enforcement authority under section 18(e) of the Act (29 U.S.C. 667(e)) will not be initiated with regard to Federal occupational...

  4. 29 CFR 1952.365 - Level of Federal enforcement.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... Mexico occupational health and safety plan, discretionary Federal enforcement authority under section 18(e) of the Act (29 U.S.C. 667(e)) will not be initiated with regard to Federal occupational...

  5. 29 CFR 1952.365 - Level of Federal enforcement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... Mexico occupational health and safety plan, discretionary Federal enforcement authority under section 18(e) of the Act (29 U.S.C. 667(e)) will not be initiated with regard to Federal occupational...

  6. Using photovoice as a participatory evaluation tool in Kaiser Permanente's Community Health Initiative.

    PubMed

    Kramer, Leila; Schwartz, Pamela; Cheadle, Allen; Rauzon, Suzanne

    2013-09-01

    Photovoice is a community-based participatory research method that provides participants who traditionally have little voice in community policy decisions, with training in photography, ethics, critical dialogue, photo captioning, and policy advocacy. Photovoice has been used primarily as a needs assessment and advocacy tool and only rarely as a pre-/postintervention evaluation method. This article describes the use of Photovoice as a participatory evaluation method in the Community Health Initiative, a 6-year, multisite community-based obesity prevention initiative, sponsored by Kaiser Permanente. Fifty community participants (including six youth) from six Community Health Initiative communities used photos and captions to identify, from their perspective, the most significant accomplishments from the initiative at both baseline and follow-up. Accomplishments identified included increased access to fresh/healthy food in local neighborhoods; policy changes supporting a "healthy eating, active living" community; increased access to physical activity; changes to the built environment creating increased neighborhood walkability/safety; and leadership development. PMID:23159999

  7. Applying a global justice lens to health systems research ethics: an initial exploration.

    PubMed

    Pratt, Bridget; Hyder, Adnan A

    2015-03-01

    Recent scholarship has considered what, if anything, rich people owe to poor people to achieve justice in global health and the implications of this for international research. Yet this work has primarily focused on international clinical research. Health systems research is increasingly being performed in low and middle income countries and is essential to reducing global health disparities. This paper provides an initial description of the ethical issues related to priority setting, capacity-building, and the provision of post-study benefits that arise during the conduct of such research. It presents a selection of issues discussed in the health systems research literature and argues that they constitute ethical concerns based on their being inconsistent with a particular theory of global justice (the health capability paradigm). Issues identified include the fact that priority setting for health systems research at the global level is often not driven by national priorities and that capacity-building efforts frequently utilize one-size-fits-all approaches.

  8. The Monterey County Health Initiative. A post-mortem analysis of a California Medicaid demonstration project.

    PubMed

    Aved, B M

    1987-01-01

    Twenty months after the California State Department of Health Services turned its Medicaid program in Monterey County over to a local health care authority, the Monterey County Health Initiative (MCHI), the state terminated the pilot project in favor of a return to fee-for-service reimbursement. The MCHI, plagued from its inception with shaky provider support and a flawed program design, failed to demonstrate its anticipated cost savings. The key features of this failure were overly generous fees for primary case managers, inadequate utilization control measures, a general hesitancy to assume the necessary gatekeeper function, and a management information system that was not fully operational until well into the implementation of the program. Policy implications and recommendations for future state-sponsored Medicaid demonstration projects are discussed. PMID:3543525

  9. The laboratory efficiencies initiative: partnership for building a sustainable national public health laboratory system.

    PubMed

    Ridderhof, John C; Moulton, Anthony D; Ned, Renée M; Nicholson, Janet K A; Chu, May C; Becker, Scott J; Blank, Eric C; Breckenridge, Karen J; Waddell, Victor; Brokopp, Charles

    2013-01-01

    Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners.

  10. The Laboratory Efficiencies Initiative: Partnership for Building a Sustainable National Public Health Laboratory System

    PubMed Central

    Moulton, Anthony D.; Ned, Renée M.; Nicholson, Janet K.A.; Chu, May C.; Becker, Scott J.; Blank, Eric C.; Breckenridge, Karen J.; Waddell, Victor; Brokopp, Charles

    2013-01-01

    Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners. PMID:23997300

  11. Using a Health Informatics System to Assess Effect of a Federal Cigarette Tax Increase on Readiness to Quit Among Low-Income Smokers, Louisiana, 2009

    PubMed Central

    Moody-Thomas, Sarah; Horswell, Ronald; Yi, Yong; Celestin, Michael D.; Jones, Krysten D.

    2014-01-01

    Introduction Health informatics systems are a proven tool for tobacco control interventions. To address the needs of low-income groups, the Tobacco Control Initiative was established in partnership with the Louisiana State University Health Care Services Division to provide cost-effective tobacco use cessation services through the health informatics system in the state public hospital system. Methods In this study we used a Web-based, result-reporting application to monitor and assess the effect of the 2009 federal cigarette tax increase. We assessed readiness to quit tobacco use before and after a cigarette tax increase among low-income tobacco users who were outpatients in a public hospital system. Results Overall, there was an increase in readiness to quit, from 22% during the first week of February to 33% during the first week of April, when the tax went into effect. Smokers who were female, 31 or older, African American, and assessed at a clinic visit in April were more likely to report readiness to quit than were men, those aged 30 or younger, those who were white, and those who were assessed at a clinic visit in February. Conclusion A health informatics system that efficiently tracks trends in readiness to quit can be used in combination with other strategies and thus optimize efforts to control tobacco use. Our data suggest that a cigarette tax increase affects smokers’ readiness to quit and provides an opportunity to intervene at the most beneficial time. PMID:24698530

  12. Wisconsin's Lifecourse Initiative for Healthy Families: application of the maternal and child health life course perspective through a regional funding initiative.

    PubMed

    Frey, Catherine A; Farrell, Philip M; Cotton, Quinton D; Lathen, Lorraine S; Marks, Katherine

    2014-02-01

    National experts are calling for more integrated approaches such as the life course perspective to reduce health disparities and achieve greater health equity. The translation and application of the life course perspective is therefore of great interest to public health planners, policy makers and funders to promote community-wide improvements in maternal and child health. However, few organizations have applied the life course perspective in designing strategic funding initiatives. For over three decades, Wisconsin has observed persistent racial disparities in birth outcomes. This complex public health issue led to the development of the Lifecourse Initiative for Health Families, a regional multi-million dollar funding initiative created and supported by the Wisconsin Partnership Program of the University of Wisconsin School of Medicine and Public Health (Created by the UW SMPH from an endowment following the conversion of Blue Cross Blue Shield United of Wisconsin, the Partnership Program makes investments in research, education, and public health and prevention initiatives that improve health and reduce health disparities in the state.). Over a 2-year period, the program funded four collaboratives to adopt a life course perspective and develop strategic plans for improving African American birth outcomes. The Twelve-point plan to close the black-white gap in birth outcomes provided the framework for the planning process. Despite the conceptual challenges, the life course perspective was embraced by the collaboratives, challenged community assumptions on the root causes of poor birth outcomes and provided a unifying funding construct for organizing and planning complementary individual-level interventions with social and physical environmental change strategies. These integrated and complimentary approaches provide a long-term opportunity to address the persistent racial birth outcome disparity in Wisconsin. PMID:23595565

  13. Wisconsin's Lifecourse Initiative for Healthy Families: application of the maternal and child health life course perspective through a regional funding initiative.

    PubMed

    Frey, Catherine A; Farrell, Philip M; Cotton, Quinton D; Lathen, Lorraine S; Marks, Katherine

    2014-02-01

    National experts are calling for more integrated approaches such as the life course perspective to reduce health disparities and achieve greater health equity. The translation and application of the life course perspective is therefore of great interest to public health planners, policy makers and funders to promote community-wide improvements in maternal and child health. However, few organizations have applied the life course perspective in designing strategic funding initiatives. For over three decades, Wisconsin has observed persistent racial disparities in birth outcomes. This complex public health issue led to the development of the Lifecourse Initiative for Health Families, a regional multi-million dollar funding initiative created and supported by the Wisconsin Partnership Program of the University of Wisconsin School of Medicine and Public Health (Created by the UW SMPH from an endowment following the conversion of Blue Cross Blue Shield United of Wisconsin, the Partnership Program makes investments in research, education, and public health and prevention initiatives that improve health and reduce health disparities in the state.). Over a 2-year period, the program funded four collaboratives to adopt a life course perspective and develop strategic plans for improving African American birth outcomes. The Twelve-point plan to close the black-white gap in birth outcomes provided the framework for the planning process. Despite the conceptual challenges, the life course perspective was embraced by the collaboratives, challenged community assumptions on the root causes of poor birth outcomes and provided a unifying funding construct for organizing and planning complementary individual-level interventions with social and physical environmental change strategies. These integrated and complimentary approaches provide a long-term opportunity to address the persistent racial birth outcome disparity in Wisconsin.

  14. Private initiatives and policy options: recent health system experience in India.

    PubMed

    Purohit, B C

    2001-03-01

    In the recent past the impact of structural adjustment in the Indian health care sector has been felt in the reduction in central grants to States for public health and disease control programmes. This falling share of central grants has had a more pronounced impact on the poorer states, which have found it more difficult to raise local resources to compensate for this loss of revenue. With the continued pace of reforms, the likelihood of increasing State expenditure on the health care sector is limited in the future. As a result, a number of notable trends are appearing in the Indian health care sector. These include an increasing investment by non-resident Indians (NRIs) in the hospital industry, leading to a spurt in corporatization in the States of their original domicile and an increasing participation by multinational companies in diagnostics aiming to capture the potential of the Indian health insurance market. The policy responses to these private initiatives are reflected in measures comprising strategies to attract private sector participation and management inputs into primary health care centres (PHCs), privatization or semi-privatization of public health facilities such as non-clinical services in public hospitals, innovating ways to finance public health facilities through non-budgetary measures, and tax incentives by the State governments to encourage private sector investment in the health sector. Bearing in mind the vital importance of such market forces and policy responses in shaping the future health care scenario in India, this paper examines in detail both of these aspects and their implications for the Indian health care sector. The analysis indicates that despite the promising newly emerging atmosphere, there are limits to market forces; appropriate refinement in the role of government should be attempted to avoid undesirable consequences of rising costs, increasing inequity and consumer exploitation. This may require opening the health

  15. [THE PERSPECTIVES OF DEVELOPMENT OF HEALTH CARE OF THE RUSSIAN FEDERATION].

    PubMed

    Schepin, O P; Korotkikh, R V

    2015-01-01

    The article considers actual conditions and characteristics of reformation of health care of Russia. The comparison is applied to such sectoral aspects as decentralization, medical care accessibility, public sector of health care, health of healthy population, resources distribution, medical insurance, paid medical services, etc. The comprehensive approach is proposed to resolving problems of national health care and alternatives of main direction of sectoral development. PMID:27116828

  16. 76 FR 41221 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... briefings regarding military health needs and priorities. The DHB Trauma and Injury Subcommittee will... tranexamic acid use in theater. The Board will vote on issues presented by the Psychological Health External..., and complementary and alternative medicine use in the DoD. The Psychological Health External...

  17. Sexual initiation among adolescents (10 to 14 years old) and health behaviors

    PubMed Central

    Gonçalves, Helen; Machado, Eduardo Coelho; Soares, Ana Luiza Gonçalves; Camargo-Figuera, Fabio Alberto; Seering, Lenise Menezes; Mesenburg, Marília Arndt; Guttier, Marília Cruz; Barcelos, Raquel Siqueira; Buffarini, Romina; Assunção, Maria Cecília Formoso; Hallal, Pedro Curi; Menezes, Ana Maria Baptista

    2015-01-01

    Objective To assess the prevalence of sexual initiation until the age of 14 years old, as well as sociodemographic and behavioral factors. Methods In 2008, 4,325 from the 5,249 adolescents of the 1993 birth cohort in Pelotas, Rio Grande do Sul, were interviewed. Sexual initiation was defined as the first intercourse up to the age of 14 years old. The information was obtained by interviewing adolescents in their houses, during the 2008 follow-up. The analyzed variables were: skin color, asset index, maternal and adolescents’ schooling, experimental use of tobacco and alcohol, drunkenness episode, use of any illicit drug, illegal drug use by friends and involvement in fights during the past year. Use of condoms and contraceptive methods, number of partners and the age of sexual initiation were also analyzed. Results The prevalence of sexual initiation by the age of 14 was of 18.6%. Lower schooling, asset index and maternal education were related to higher prevalence of sexual initiation until the age of 14, as well as being male or being born to adolescent mothers. Sexual intercourse was also related to the behavioral variables analyzed. Among adolescent girls who had intercourse up to the age of 14, 30% did not use contraception and 18% did not use condoms in the last sexual intercourse. Boys reported a higher number of sexual partners than girls. Conclusion The results suggest a relationship between sexual intercourse (≤ 14 years) and some health-risk behaviors. The non-use of condoms and contraceptives may make them vulnerable to experiencing unwanted situations. Education and sociocultural strategies for health should be implemented from the beginning of adolescence. PMID:25651009

  18. WIC mothers' social environment and postpartum health on breastfeeding initiation and duration.

    PubMed

    Darfour-Oduro, Sandra Asantewaa; Kim, Juhee

    2014-12-01

    A low breastfeeding rate has been a consistent maternal and child health problem in the United States, especially for low-income families. Understanding mothers' social environment and overall well-being is important in determining how mothers will take care of themselves and their infants during the postnatal period in relation to the breastfeeding rate among low-income mothers. In this study, we examined the effects of the social environment of mothers enrolled in a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in eastern Illinois and their postpartum health on breastfeeding initiation (n=103) and maintaining breastfeeding for at least 3 months (n=73). Using logistic regression models, a significant positive association (adjusted odds ratio [AOR]=3.47; 95% confidence interval [CI], 1.15-10.47; p=0.03) between marital status and breastfeeding initiation and a significant negative association (AOR=0.23; 95% CI, 0.06-0.88) between receiving food stamps and breastfeeding initiation were found. WIC mothers who were married were 4.1 times as likely to maintain any breastfeeding for at least 3 months than single mothers, and the association was significant (AOR=4.08; 95% CI, 1.36-12.27; p=0.01). The breastfeeding initiation rate was 77.7%, however, the mean±standard deviation age of the child when breastfeeding stopped was 2.2±1.4 months. There was a nonsignificant association between postpartum depression and breastfeeding initiation and maintaining any breastfeeding for 3 months. This study has shown that the familial environment of mothers plays a very important role in improving breastfeeding rates among WIC mothers. In addition, there is a negative relationship between using a food assistance program and breastfeeding among low-income women. PMID:25188784

  19. United States-Mexico cross-border health insurance initiatives: Salud Migrante and Medicare in Mexico.

    PubMed

    Vargas Bustamante, Arturo; Laugesen, Miriam; Caban, Mabel; Rosenau, Pauline

    2012-01-01

    While U.S. health care reform will most likely reduce the overall number of uninsured Mexican-Americans, it does not address challenges related to health care coverage for undocumented Mexican immigrants, who will remain uninsured under the measures of the reform; documented low-income Mexican immigrants who have not met the five-year waiting period required for Medicaid benefits; or the growing number of retired U.S. citizens living in Mexico, who lack easy access to Medicare-supported services. This article reviews two promising binational initiatives that could help address these challenges-Salud Migrante and Medicare in Mexico; discusses their prospective applications within the context of U.S. health care reform; and identifies potential challenges to their implementation (legal, political, and regulatory), as well as the possible benefits, including coverage of uninsured Mexican immigrants, and their integration into the U.S. health care system (through Salud Migrante), and access to lower-cost Medicare-supported health care for U.S. retirees in Mexico (Medicare in Mexico).

  20. United States-Mexico cross-border health insurance initiatives: Salud Migrante and Medicare in Mexico

    PubMed Central

    Bustamante, Arturo Vargas; Laugesen, Miriam; Caban, Mabel; Rosenau, Pauline

    2014-01-01

    While U.S. health care reform will most likely reduce the overall number of uninsured Mexican-Americans, it does not address challenges related to health care coverage for undocumented Mexican immigrants, who will remain uninsured under the measures of the reform; documented low-income Mexican immigrants who have not met the five-year waiting period required for Medicaid benefits; or the growing number of retired U.S. citizens living in Mexico, who lack easy access to Medicare-supported services. This article reviews two promising binational initiatives that could help address these challenges—Salud Migrante and Medicare in Mexico; discusses their prospective applications within the context of U.S. health care reform; and identifies potential challenges to their implementation (legal, political, and regulatory), as well as the possible benefits, including coverage of uninsured Mexican immigrants, and their integration into the U.S. health care system (through Salud Migrante), and access to lower-cost Medicare-supported health care for U.S. retirees in Mexico (Medicare in Mexico). PMID:22427168