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Sample records for health concepts conflicts

  1. Italian occupational health: concepts, conflicts, implications.

    PubMed Central

    Reich, M R; Goldman, R H

    1984-01-01

    This paper examines Italy's worker-based model for occupational health, especially its key concepts and its relation to social conflict. It briefly reviews the history of three approaches to occupational health in Italy: university-based, industry-based, and government-based. It then analyzes the worker-based approach, which emerged in the late 1960s and early 1970s as worker groups and trade unions mobilized around new concepts of occupational health. Five key concepts are discussed: the workers' homogeneous group; workers' subjectivity; the use of contract language; the development of local occupational health institutions; and the use of occupational hazard risk maps. The analysis illustrates how the social processes of mobilization and institutionalization affected the ideas and structures of Italian occupational health. Worker mobilization in Italy produced ideological changes in the nation's occupational health system, institutional changes in universities and governments, and legislative changes at national and local levels. The institutionalization of reforms, however, created new conflicts and problems and tended to restrict worker participation and promote expert intervention. The paper concludes with a brief outline of the history of occupational health approaches in the United States and then discusses the implications of the five Italian concepts for US occupational health policy. PMID:6380322

  2. Armed conflict and child health

    PubMed Central

    Rieder, Michael; Choonara, Imti

    2012-01-01

    Summary Armed conflict has a major impact on child health throughout the world. One in six children worldwide lives in an area of armed conflict and civilians are more likely to die than soldiers as a result of the conflict. In stark contrast to the effect on children, the international arms trade results in huge profits for the large corporations involved in producing arms, weapons and munitions. Armed conflict is not inevitable but is an important health issue that should be prevented. PMID:21393303

  3. Climate change, conflict and health.

    PubMed

    Bowles, Devin C; Butler, Colin D; Morisetti, Neil

    2015-10-01

    Future climate change is predicted to diminish essential natural resource availability in many regions and perhaps globally. The resulting scarcity of water, food and livelihoods could lead to increasingly desperate populations that challenge governments, enhancing the risk of intra- and interstate conflict. Defence establishments and some political scientists view climate change as a potential threat to peace. While the medical literature increasingly recognises climate change as a fundamental health risk, the dimension of climate change-associated conflict has so far received little attention, despite its profound health implications. Many analysts link climate change with a heightened risk of conflict via causal pathways which involve diminishing or changing resource availability. Plausible consequences include: increased frequency of civil conflict in developing countries; terrorism, asymmetric warfare, state failure; and major regional conflicts. The medical understanding of these threats is inadequate, given the scale of health implications. The medical and public health communities have often been reluctant to interpret conflict as a health issue. However, at times, medical workers have proven powerful and effective peace advocates, most notably with regard to nuclear disarmament. The public is more motivated to mitigate climate change when it is framed as a health issue. Improved medical understanding of the association between climate change and conflict could strengthen mitigation efforts and increase cooperation to cope with the climate change that is now inevitable.

  4. Forces and Particles: Concepts Again in Conflict

    ERIC Educational Resources Information Center

    Gale, George

    1973-01-01

    Traces the historical developments in physics leading to the present conflict of fundamental beliefs about the nature of the physical world. It has been recently proposed that the concept of fundamental particles (corpuscularianism) be replaced with a full-blown field dynamical theory. (JR)

  5. [Conceptions and typology of conflicts between workers and managers in the context of primary healthcare in the Brazilian Unified National Health System (SUS)].

    PubMed

    Carvalho, Brígida Gimenez; Peduzzi, Marina; Ayres, José Ricardo de Carvalho Mesquita

    2014-07-01

    This study aimed to analyze perceptions of conflict between workers and managers in primary healthcare units and to present a typology of conflicts on the job. This was a comprehensive interpretive case study with a critical hermeneutic approach. Data collection techniques included: focus group with managers, workplace observation, and worker interviews, conducted from April to November 2011. The results were triangulated and indicated the coexistence of distinct concepts of conflict, typified in six modalities: lack of collaboration at work; disrespect resulting from asymmetrical relations between workers; problematic employee behavior; personal problems; asymmetry with other management levels; and inadequate work infrastructure. The relevance of (non)mutual recognition, as proposed by Axel Honneth, stood out in the interpretation of the causes and practical implications of these conflicts.

  6. Reexamining the Role of Cognitive Conflict in Science Concept Learning

    ERIC Educational Resources Information Center

    Kang, Sukjin; Scharmann, Lawrence C.; Noh, Taehee

    2004-01-01

    In this study, we defined and quantified the degree of cognitive conflict induced by a discrepant event from a cognitive perspective. Based on the scheme developed, we investigated the relationship between cognitive conflict and conceptual change, and the influences of students' cognitive characteristics on conflict in learning the concept of…

  7. Dysfunctional health service conflict: causes and accelerants.

    PubMed

    Nelson, H Wayne

    2012-01-01

    This article examines the causes and accelerants of dysfunctional health service conflict and how it emerges from the health system's core hierarchical structures, specialized roles, participant psychodynamics, culture, and values. This article sets out to answer whether health care conflict is more widespread and intense than in other settings and if it is, why? To this end, health care power, gender, and educational status gaps are examined with an eye to how they undermine open communication, teamwork, and collaborative forms of conflict and spark a range of dysfunctions, including a pervasive culture of fear; the deny-and-defend lawsuit response; widespread patterns of hierarchical, generational, and lateral bullying; overly avoidant conflict styles among non-elite groups; and a range of other behaviors that lead to numerous human resource problems, including burnout, higher staff turnover, increased errors, poor employee citizenship behavior, patient dissatisfaction, increased patient complaints, and lawsuits. Bad patient outcomes include decreased compliance and increased morbidity and mortality. Health care managers must understand the root causes of these problems to treat them at the source and implement solutions that avoid negative conflict spirals that undermine organizational morale and efficiency.

  8. Conflict management styles in the health professions.

    PubMed

    Sportsman, Susan; Hamilton, Patti

    2007-01-01

    The purpose of the study was to determine prevalent conflict management styles chosen by students in nursing and to contrast these styles with those chosen by students in allied health professions. The associations among the level of professional health care education and the style chosen were also determined. A convenience sample of 126 students in a comprehensive university completed the Thomas-Kilmann Conflict Mode Instrument (TKI), which requires respondents to choose behaviors most characteristic of their response to conflict and classifies these behaviors as one of five styles. There was no significant difference between the prevalent conflict management styles chosen by graduate and undergraduate nursing students and those in allied health. Some of the students were already licensed in their discipline; others had not yet taken a licensing exam. Licensure and educational level were not associated with choice of styles. Women and men had similar preferences. The prevalent style for nursing students was compromise, followed by avoidance. In contrast, avoidance, followed by compromise and accommodation, was the prevalent style for allied health students. When compared to the TKI norms, slightly more than one half of all participants chose two or more conflict management styles, commonly avoidance and accommodation at the 75th percentile or above. Only 9.8% of the participants chose collaboration at that level. Implications for nurse educators, researchers, and administrators are discussed.

  9. Reexamining the Role of Cognitive Conflict in Science Concept Learning

    NASA Astrophysics Data System (ADS)

    Kang, Sukjin; Scharmann, Lawrence C.; Noh, Taehee

    2004-02-01

    In this study, we defined and quantified the degree of cognitive conflict induced by a discrepant event from a cognitive perspective. Based on the scheme developed, we investigated the relationship between cognitive conflict and conceptual change, and the influences of students'' cognitive characteristics on conflict in learning the concept of density. Subjects were 171 seventh-grade girls from two city middle schools in Korea. Tests regarding logical thinking ability, field dependence/independence, and meaningful learning approach were administered. A preconception test and a test of responses to a discrepant event were also administered. Computer-assisted instruction was then provided to students as a conceptual change intervention. A conception test was administered as a posttest. In analysing students'' responses to the discrepant event, seven types of responses were identified: Rejection, reinterpretation, exclusion, uncertainty, peripheral belief change, belief decrease, and belief change. These types were then ordered into four levels. The results indicated that there existed a significant correlation between cognitive conflict and conceptual change. t-test results revealed that there were statistically significant differences in the degree of cognitive conflict by the levels of students'' logical thinking ability and field dependence/independence. Meaningful learning approach, however, was found to have no statistically significant effect on cognitive conflict. Educational implications are discussed.

  10. Conflict Probe Concepts Analysis in Support of Free Flight

    NASA Technical Reports Server (NTRS)

    Warren, Anthony W.; Schwab, Robert W.; Geels, Timothy J.; Shakarian, Arek

    1997-01-01

    This study develops an operational concept and requirements for en route Free Flight using a simulation of the Cleveland Air Route Traffic Control Center, and develops requirements for an automated conflict probe for use in the Air Traffic Control (ATC) Centers. In this paper, we present the results of simulation studies and summarize implementation concepts and infrastructure requirements to transition from the current air traffic control system to mature Free Right. The transition path to Free Flight envisioned in this paper assumes an orderly development of communications, navigation, and surveillance (CNS) technologies based on results from our simulation studies. The main purpose of this study is to provide an overall context and methodology for evaluating airborne and ground-based requirements for cooperative development of the future ATC system.

  11. Spiritual Health: A Concept Analysis.

    PubMed

    Jaberi, Azita; Momennasab, Marzieh; Yektatalab, Shahrzad; Ebadi, Abbas; Cheraghi, Mohammad Ali

    2017-03-10

    Spiritual health has attracted a lot of attention in health-related and nursing sciences and numerous researches. Yet, this concept has remained complex and ambiguous, and there is no consensus in this regard. This ambiguity can be challenging for holistic nursing; therefore, clarification of the concept is required for development of nursing knowledge. The present study aimed to explore the concept of spiritual health in health-related and nursing literature. Walker and Avant (Strategies for theory construction in nursing, Appleton & Lange, Norwalk, 1995) concept analysis method was used in this study. The results were categorized as antecedents, attributes, and outcomes of spiritual health. The critical attributes extracted for spiritual health included transcendence, purposefulness and meaningfulness, faithfulness, harmonious interconnectedness, integrative power, multidimensionality, and holistic being. Besides, the antecedents of spiritual health included capability and potentiality for transcendence, and spiritual awareness. Finally, well-being and moral development were the outcomes of spiritual health. Spiritual health is one of the basic aspects of health and providing a clear theoretical definition can result in a common understanding of this concept for nurses. Clarifying this concept would also be useful for provision of spiritual care interventions and development of nursing theories.

  12. The Impact of Marital Conflict and Disruption on Children's Health

    ERIC Educational Resources Information Center

    Houseknecht, Sharon K.; Hango, Darcy W.

    2006-01-01

    This article investigates the effect of inconsistency between parental marital conflict and disruption on children's health. Inconsistent situations arise when minimal marital conflict precedes disruption or when marital conflict is high but there is no disruption. Using data from the National Longitudinal Survey of Youth, two alternative…

  13. Fast-time Simulation of an Automated Conflict Detection and Resolution Concept

    NASA Technical Reports Server (NTRS)

    Windhorst, Robert; Erzberger, Heinz

    2006-01-01

    This paper investigates the effect on the National Airspace System of reducing air traffc controller workload by automating conflict detection and resolution. The Airspace Concept Evaluation System is used to perform simulations of the Cleveland Center with conventional and with automated conflict detection and resolution concepts. Results show that the automated conflict detection and resolution concept significantly decreases growth of delay as traffic demand is increased in en-route airspace.

  14. Health as an analogical concept.

    PubMed

    Mordacci, R

    1995-10-01

    This article examines the normative structure of the concept of health and tries to suggest an account of it in a phenomenological-hermeneutic framework. It is argued that the concept of health has a logical priority to illness, though the latter has an experiential priority. The fundamental feature of the concept of health as discussed in the literature is initially recognized in the notion of 'norm', in both the bio-statistical and normative-ideal sense. An analysis of this body of literature reveals some weaknesses in bio-statistical definitions of health as well as in those normative ones which endorse a value-relativity thesis. An approach based on the analogical structure of language is then advanced. In this framework, the notion of biological normativeness proposed by G. Canguilhem is connected with an analysis of the language of health through etymologies. It is argued that health can be characterized as an analogy of 'plenitude', which is the common ideal reference of the various health-concepts. The analogical structuring of language allows the recognition of different levels of meaning, and therefore of different kinds of normativeness (biological, mental, social, moral). Some hints of a theory of health deriving from this framework are then given.

  15. Moral conflict and collaborative mode as moral conflict resolution in health care.

    PubMed

    Jormsri, Pantip

    2004-09-01

    Moral conflict as a complex moral issue in health care has emerged from several causes that are related to different values, beliefs and opinions. Moral conflict can occur when duties and obligations of health care providers or general guiding ethical principles are unclear. Health care providers and institutions or agencies need to resolve or initiate appropriate methods for professional staff so they can recognize, discuss and resolve moral conflicts in the health care delivery system. Collaborative mode is a useful method for moral conflict resolution, because patient care is a complex phenomenon that results from the integrated knowledge and work of individuals with different professional training. In the process of collaborative practice, all members need to respect each other's opinions, values and responsibilities regarding patient care.

  16. Dissemination and implementation of evidence based, mental health interventions in post conflict, low resource settings

    PubMed Central

    Tol, Wietse; Jordans, Mark; Zangana, Goran Sabir; Amin, Ahmed Mohammed; Bolton, Paul; Bass, Judith; Bonilla-Escobar, Fransisco Javier; Thornicroft, Graham

    2014-01-01

    The burden of mental health problems in (post)conflict low- and middle-income countries (LMIC) is substantial. Despite growing evidence for the effectiveness of selected mental health programs in conflict-affected LMIC and growing policy support, actual uptake and implementation have been slow. A key direction for future research, and a new frontier within science and practice, is Dissemination and Implementation (DI) which directly addresses the movement of evidence-based, effective health care approaches from experimental settings into routine use. This paper outlines some key implementation challenges, and strategies to address these, while implementing evidence-based treatments in conflict-affected LMIC based on the authors’ collective experiences. Dissemination and implementation evaluation and research in conflict settings is an essential new research direction. Future DI work in LMIC should include: 1) defining concepts and developing measurement tools, 2) the measurement of DI outcomes for all programming, and 3) the systematic evaluation of specific implementation strategies. PMID:28316559

  17. [The concepts of health access].

    PubMed

    Sanchez, Raquel Maia; Ciconelli, Rozana Mesquita

    2012-03-01

    This article describes four dimensions of health access-availability, acceptability, ability to pay and information-correlating these dimensions to indicators and discussing the complexity of the concept of access. For a study of these four dimensions, searches were conducted using the PubMed/MEDLINE, LILACS, SciELO, and World Health Organization Library & Information Networks for Knowledge (WHOLIS) databases. Large-circulation media vehicles, such as The Economist, The Washington Post, and the BBC network were also searched. The concept of health access has become more complex with time. The first analyses, carried out in the 1970s, suggested a strong emphasis on geographical (availability) and financial (ability to pay) aspects. More recently, the literature has focused on less tangible aspects, such as cultural, educational, and socioeconomic issues, incorporating the element of acceptability into the notion of health access. The literature also shows that information provides the starting point for access to health, in association with health empowerment and literacy for health care decision-making. The study concludes that improvements in access to health and the guarantee of equity will not be achieved by initiatives focusing on health care systems alone, but rather will depend on intersectoral actions and social and economic policies aimed at eliminating income and education differences.

  18. Marital Conflict in Older Couples: Positivity, Personality, and Health

    PubMed Central

    Iveniuk, James; Waite, Linda J.; McClintock, Martha K.; Teidt, Andrew D.

    2016-01-01

    We examine the implications of health and personality characteristics for late-life marital conflict, using data from the 2010–11 wave of the National Social Life Health and Aging Project (NSHAP), a nationally representative study with data on both partners in 955 marital and cohabitational dyads. Using these data, we relate characteristics of husbands to characteristics of their wives, and vice versa. Wives with husbands in fair or poor physical health are more likely to report high levels of marital conflict, but the reverse is not true. Similarly, wives report more conflict when their husbands are high on Neuroticism, high on Extraversion, and low on a new measure we call Positivity. Our findings point to noteworthy gender differences between men and women in the associations between individual characteristics and levels of marital conflict. We point to differences between husbands’ and wives’ marital roles as a contributor to these differences. PMID:27274569

  19. Marital Conflict in Older Couples: Positivity, Personality, and Health.

    PubMed

    Iveniuk, James; Waite, Linda J; McClintock, Martha K; Teidt, Andrew D

    2014-02-01

    We examine the implications of health and personality characteristics for late-life marital conflict, using data from the 2010-11 wave of the National Social Life Health and Aging Project (NSHAP), a nationally representative study with data on both partners in 955 marital and cohabitational dyads. Using these data, we relate characteristics of husbands to characteristics of their wives, and vice versa. Wives with husbands in fair or poor physical health are more likely to report high levels of marital conflict, but the reverse is not true. Similarly, wives report more conflict when their husbands are high on Neuroticism, high on Extraversion, and low on a new measure we call Positivity. Our findings point to noteworthy gender differences between men and women in the associations between individual characteristics and levels of marital conflict. We point to differences between husbands' and wives' marital roles as a contributor to these differences.

  20. Teaching the Concept of Limit by Using Conceptual Conflict Strategy and Desmos Graphing Calculator

    ERIC Educational Resources Information Center

    Liang, Senfeng

    2016-01-01

    Although the mathematics community has long accepted the concept of limit as the foundation of modern Calculus, the concept of limit itself has been marginalized in undergraduate Calculus education. In this paper, I analyze the strategy of conceptual conflict to teach the concept of limit with the aid of an online tool--Desmos graphing calculator.…

  1. Conflicts of Interest: Manipulating Public Health

    ERIC Educational Resources Information Center

    Stein, Richard; Davis, Devra Lee

    2014-01-01

    Evaluating the potential health impacts of chemical, physical, and biological environmental factors represents a challenging task with profound medical, public health, and historical implications. The history of public health is replete with instances, ranging from tobacco to lead and asbestos, where the ability to obtain evidence on potential…

  2. Post-conflict health reconstruction: search for a policy.

    PubMed

    Rubenstein, Leonard S

    2011-10-01

    Despite increasing experience in health reconstruction in societies emerging from conflict, the policy basis for investing in the development of equitable and effective health systems in the wake of war remains unsettled. Consideration of post-conflict health reconstruction is almost entirely absent in donor policies on global health. Practically by default, health programmes are seen increasingly as an element of stabilisation and security interventions in the aftermath of armed conflict. That perspective, however, lacks an evidence base and can skew health programmes towards short-term security and stabilisation goals that have a marginal impact and violate the principles of equity, non-discrimination, and quality, which are central to sound health systems and public acceptance of them. A better approach is to ground policy in legitimacy, viewing health both as a core social institution and one that, if developed according to human rights principles, including equity, non-discrimination, participation and accountability, can advance the effectiveness and the quality of governance in the emerging state.

  3. Resource conflict and cooperation between human host and gut microbiota: implications for nutrition and health.

    PubMed

    Wasielewski, Helen; Alcock, Joe; Aktipis, Athena

    2016-05-01

    Diet has been known to play an important role in human health since at least the time period of the ancient Greek physician Hippocrates. In the last decade, research has revealed that microorganisms inhabiting the digestive tract, known as the gut microbiota, are critical factors in human health. This paper draws on concepts of cooperation and conflict from ecology and evolutionary biology to make predictions about host-microbiota interactions involving nutrients. To optimally extract energy from some resources (e.g., fiber), hosts require cooperation from microbes. Other nutrients can be utilized by both hosts and microbes (e.g., simple sugars, iron) in their ingested form, which may lead to greater conflict over these resources. This framework predicts that some negative health effects of foods are driven by the direct effects of these foods on human physiology and by indirect effects resulting from microbiome-host competition and conflict (e.g., increased invasiveness and inflammation). Similarly, beneficial effects of some foods on host health may be enhanced by resource sharing and other cooperative behaviors between host and microbes that may downregulate inflammation and virulence. Given that some foods cultivate cooperation between hosts and microbes while others agitate conflict, host-microbe interactions may be novel targets for interventions aimed at improving nutrition and human health.

  4. Verification of Legal Knowledge-base with Conflictive Concept

    NASA Astrophysics Data System (ADS)

    Hagiwara, Shingo; Tojo, Satoshi

    In this paper, we propose a verification methodology of large-scale legal knowledge. With a revision of legal code, we are forced to revise also other affected code to keep the consistency of law. Thus, our task is to revise the affected area properly and to investigate its adequacy. In this study, we extend the notion of inconsistency besides of the ordinary logical inconsistency, to include the conceptual conflicts. We obtain these conflictions from taxonomy data, and thus, we can avoid tedious manual declarations of opponent words. In the verification process, we adopt extended disjunctive logic programming (EDLP) to tolerate multiple consequences for a given set of antecedents. In addition, we employ abductive logic programming (ALP) regarding the situations to which the rules are applied as premises. Also, we restrict a legal knowledge-base to acyclic program to avoid the circulation of definitions, to justify the relevance of verdicts. Therefore, detecting cyclic parts of legal knowledge would be one of our objectives. The system is composed of two subsystems; we implement the preprocessor in Ruby to facilitate string manipulation, and the verifier in Prolog to exert the logical inference. Also, we employ XML format in the system to retain readability. In this study, we verify actual code of ordinances of Toyama prefecture, and show the experimental results.

  5. Health economics--concepts and conceptual problems.

    PubMed

    Satpathy, S K; Bansal, R D

    1982-01-01

    Awareness of the economic manifestation of health and diseases and the limited resources allocated to health care services has brought to the focus a new discipline - health economics. Cost accounting, cost benefit, cost effectiveness methods etc. are increasingly becoming an integral part of the health management and evaluation of health programmes. Various concepts and problems relating to health economics are discussed in the present paper. More efforts should be made to conduct health economic studies in hospitals and health centres by which the process of standardisation of the concepts, would be easier. Health economics should also find its due place in the medical curriculum.

  6. Human Health and the Environment: In Harmony or in Conflict?

    PubMed Central

    Resnik, David B

    2009-01-01

    Health policy frameworks usually construe environmental protection and human health as harmonious values. Policies that protect the environment, such as pollution control and pesticide regulation, also benefit human health. In recent years, however, it has become apparent that promoting human health sometimes undermines environmental protection. Some actions, policies, or technologies that reduce human morbidity, mortality, and disease can have detrimental effects on the environment. Since human health and environmental protection are sometimes at odds, political leaders, citizens, and government officials need a way to mediate and resolve conflicts between these values. Unfortunately, few approaches to applied bioethics have the conceptual tools to do accomplish this task. Theories of health care ethics have little to say about the environment, and theories of environmental ethics don't say much about human health. In this essay, I defend an approach to ethical decision-making that gives policy-makers some tools for balancing promotion of human health and protection of the environment. PMID:19130245

  7. Human health and the environment: in harmony or in conflict?

    PubMed

    Resnik, David B

    2009-09-01

    Health policy frameworks usually construe environmental protection and human health as harmonious values. Policies that protect the environment, such as pollution control and pesticide regulation, also benefit human health. In recent years, however, it has become apparent that promoting human health sometimes undermines environmental protection. Some actions, policies, or technologies that reduce human morbidity, mortality, and disease can have detrimental effects on the environment. Since human health and environmental protection are sometimes at odds, political leaders, citizens, and government officials need a way to mediate and resolve conflicts between these values. Unfortunately, few approaches to applied bioethics have the conceptual tools to do accomplish this task. Theories of health care ethics have little to say about the environment, and theories of environmental ethics don't say much about human health. In this essay, I defend an approach to ethical decision-making that gives policy-makers some tools for balancing promotion of human health and protection of the environment.

  8. Blunder Lecture to Reeducate Physiology Concepts by Cognitive Conflict Strategy

    ERIC Educational Resources Information Center

    Singh, Satendra

    2014-01-01

    Our students are not a tabula rasa in classes. These varied learners imbibe new information in relevance to others and reaffirm their own concepts. Quite often, in this journey of forming new connections, inadvertently, misconceptions are retained and may be reinforced if not corrected early. Students come to learning situations with preconceived…

  9. Viewing Cognitive Conflicts as Dilemmas: Implications for Mental Health

    PubMed Central

    Feixas, Guillem; Saúl, Luis Angel; Ávila-Espada, Alejandro

    2009-01-01

    The idea that internal conflicts play a significant role in mental health has been extensively addressed in various psychological traditions, including personal construct theory. In the context of the latter, several measures of conflict have been operationalized using the Repertory Grid Technique (RGT). All of them capture the notion that change, although desirable from the viewpoint of a given set of constructs, becomes undesirable from the perspective of other constructs. The goal of this study is to explore the presence of cognitive conflicts in a clinical sample (n = 284) and compare it to a control sample (n = 322). It is also meant to clarify which among the different types of conflict studied provides a greater clinical value and to investigate its relationship to symptom severity (SCL-90-R). Of the types of cognitive conflict studied, implicative dilemmas were the only ones to discriminate between clinical and nonclinical samples. These dilemmas were found in 34% of the nonclinical sample and in 53% of the clinical sample. Participants with implicative dilemmas showed higher symptom severity, and those from the clinical sample displayed a higher frequency of dilemmas than those from the nonclinical sample. PMID:22629109

  10. The life course model as a framework for post-conflict health analysis: reflections on the Gulf War critical period.

    PubMed

    Cange, Charles W

    2016-01-01

    In the Kuwait context, from January 1991 to December 1991, there were a series of chemical and psychological Gulf War-era exposures that left persistent, long-term damage. Extreme stress from a critical event speeds up the usual disease latency period, and may be part of a synergistic effect that leads to higher disease rates over a shorter period of time. I am interested in the impact of armed conflict on health outcomes over the life course in Kuwait, and particularly the pathways through which armed conflict causes changes in health on a population level. In this paper, I propose a culturally sensitive, post-conflict socio-ecological model that informs a three-pronged health study. I propose a macro-micro mix that includes an ecological study, a case-control study and a qualitative study to investigate Kuwait's post-conflict health concerns. Thus, I revise the concept of 'post-conflict health' as a trajectory that is mediated through different, complex social levels and develops over time during the latency period. The main advantage of a macro-micro mix approach for post-conflict health is that it contextualizes the Gulf War as an environmental health issue.

  11. Giant viruses: conflicts in revisiting the virus concept.

    PubMed

    Forterre, Patrick

    2010-01-01

    The current paradigm on the nature of viruses is based on early work of the 'phage group' (the pro-phage concept) and molecular biologists working on tumour viruses (the proto-oncogene concept). It posits that viruses evolved from either prokaryotic or eukaryotic cellular genes that became infectious via their association with capsid genes. In this view, after their emergence viruses continued to evolve by stealing cellular genes (the escape model). This paradigm has been challenged recently by scientists who propose that viruses pre-dated modern cells. In particular, the discovery of Mimivirus has stimulated a lot of discussions on the nature of viruses. There are two major schools of thought, those who defend the escape model, suggesting that giant viruses are giant pickpockets (chimera), and those who emphasize their uniqueness and ancient origin. Comparative genomics of Mimivirus and related viruses (nucleo-cytoplasmic large DNA viruses) have produced a lot of data that have been interpreted according to the prejudices of the authors and thus failed until now to generate a consensus. I briefly review here the history of these debates and how they lead to new proposals, such as the definition of viruses as capsid-encoding organisms or else the recognition of their fundamentally cellular nature, the virocell concept.

  12. Physicians' and consumers' conflicting attitudes toward health care advertising.

    PubMed

    Krohn, F B; Flynn, C

    2001-01-01

    The purpose of this paper is to explore the conflicting attitudes held by physicians and health care consumers toward health care advertising in an attempt to resolve the question. The paper introduces the differing positions held by the two groups. The rationale behind physicians' attitudes is then presented that advertising can be unethical, misleading, deceptive, and lead to unnecessary price increases. They believe that word-of-mouth does and should play the major role in attracting new patients. The opposite view of consumers is then presented which contends that health care advertising leads to higher consumer awareness of services, better services, promotes competitive pricing, and lowers rather than raises health care costs. The final section of the paper compares the arguments presented and concludes that health care advertising clearly has a place in the health care industry.

  13. Madness or sadness? Local concepts of mental illness in four conflict-affected African communities

    PubMed Central

    2013-01-01

    Background Concepts of ‘what constitutes mental illness’, the presumed aetiology and preferred treatment options, vary considerably from one cultural context to another. Knowledge and understanding of these local conceptualisations is essential to inform public mental health programming and policy. Methods Participants from four locations in Burundi, South Sudan and the Democratic Republic of the Congo, were invited to describe ‘problems they knew of that related to thinking, feeling and behaviour?’ Data were collected over 31 focus groups discussions (251 participants) and key informant interviews with traditional healers and health workers. Results While remarkable similarities occurred across all settings, there were also striking differences. In all areas, participants were able to describe localized syndromes characterized by severe behavioural and cognitive disturbances with considerable resemblance to psychotic disorders. Additionally, respondents throughout all settings described local syndromes that included sadness and social withdrawal as core features. These syndromes had some similarities with nonpsychotic mental disorders, such as major depression or anxiety disorders, but also differed significantly. Aetiological concepts varied a great deal within each setting, and attributed causes varied from supernatural to psychosocial and natural. Local syndromes resembling psychotic disorders were seen as an abnormality in need of treatment, although people did not really know where to go. Local syndromes resembling nonpsychotic mental disorders were not regarded as a ‘medical’ disorder, and were therefore also not seen as a condition for which help should be sought within the biomedical health-care system. Rather, such conditions were expected to improve through social and emotional support from relatives, traditional healers and community members. Conclusions Local conceptualizations have significant implications for the planning of mental-health

  14. Conflict, displacement and health in the Middle East.

    PubMed

    Mowafi, Hani

    2011-01-01

    Displacement is a hallmark of modern humanitarian emergencies. Displacement itself is a traumatic event that can result in illness or death. Survivors face challenges including lack of adequate shelter, decreased access to health services, food insecurity, loss of livelihoods, social marginalisation as well as economic and sexual exploitation. Displacement takes many forms in the Middle East and the Arab World. Historical conflicts have resulted in long-term displacement of Palestinians. Internal conflicts have driven millions of Somalis and Sudanese from their homes. Iraqis have been displaced throughout the region by invasion and civil strife. In addition, large numbers of migrants transit Middle Eastern countries or live there illegally and suffer similar conditions as forcibly displaced people. Displacement in the Middle East is an urban phenomenon. Many displaced people live hidden among host country populations in poor urban neighbourhoods - often without legal status. This represents a challenge for groups attempting to access displaced populations. Furthermore, health information systems in host countries often do not collect data on displaced people, making it difficult to gather data needed to target interventions towards these vulnerable populations. The following is a discussion of the health impacts of conflict and displacement in the Middle East. A review was conducted of published literature on migration and displacement in the region. Different cases are discussed with an emphasis on the recent, large-scale and urban displacement of Iraqis to illustrate aspects of displacement in this region.

  15. Syria: effects of conflict and sanctions on public health.

    PubMed

    Sen, Kasturi; Al-Faisal, Waleed; AlSaleh, Yaser

    2013-06-01

    The past 18 months have witnessed considerable turmoil in countries of the MENA region. The Syrian Arab Republic (SAR) is one such country, currently in the midst of a civil war. This report draws attention to some of the recent achievements of its health services, where, despite a dearth of published materials, the country achieved remarkable declines in maternal mortality and infant mortality rates. Its health sector now faces destruction from on-going violence compounded by economic sanctions that has affected access to health care, to medicines and to basic essentials as well as the destruction of infrastructure. This paper draws attention to the achievements of the country's health services and explores some of the consequences of conflict and of sanctions on population health. Readers need to be mindful that the situation on the ground in a civil war can alter on a daily basis. This is the case for Syria with much destruction of health facilities and increasing numbers of people killed and injured. We retain however our focus on the core theme of this paper which is on conflict and on sanctions.

  16. [Health Technology Dependency: A Concept Analysis].

    PubMed

    Chen, Miao-Yi; Chen, Ting-Yu; Kao, Chi-Wen

    2016-02-01

    Health technology dependence is a widely recognized concept that refers to the utilization of technology, including drugs, equipment, instruments, and related devices, to compensate for a physical disability or to prevent the progression of a disability. Although technology may significantly prolong the life of a patient, technology may also increase the psychological pressure of these patients and the burdens of their caregivers. There is a current dearth of related research and discussions related to the concept of "health technology dependency". Therefore, the present paper uses the strategies of concept analysis described by Walker & Avant (2010) to analyze this concept. The characteristic definition of health technology dependence addresses individuals who: (1) currently live with health technology, (2) may perceive physical or psychological burdens due to health technology, and (3) feel physical and psychological well-being when coping positively with their health technology dependency and, further, regard health technology as a part of their body. Further, the present paper uses case examples to help analyze the general concept. It is hoped that nurses may better understand the concept of "health technology dependency", consider the concerns of health-technology-dependent patients and their families, and develop relevant interventions to promote the well-being of these patients and their families.

  17. [Health literacy - a concept for professional nursing?].

    PubMed

    Thilo, F; Sommerhalder, K; Hahn, S

    2012-12-01

    Research results show that health literacy is an important concept in nursing. It has a positive effect on the health of individuals as well as on the costs of the healthcare system. The results of a comprehensive literature search (1980 - March 2009) revealed that the concept of health literacy is being increasingly discussed; however, the concept is barely addressed in literature specific to nursing. The existing definitions of health literacy are formulated predominantly within the medical context. Only one study from the United States analyzed the concept within the context of nursing care. The concept of health literacy is highly relevant because its' aim is to empower the patients, along with their relatives, in dealing with health and disease. In order to thoroughly examine health literacy, it must first be reviewed conceptually within the context of the profession of nursing. This has occurred in this article. The specific terms relevant to health literacy were identified. Moreover, an operational definition for health literacy was developed for the professional nursing setting. Possibilities for nursing practice, due to the conceptualization of health literacy, are discussed.

  18. Characteristics of the Colombian armed conflict and the mental health of civilians living in active conflict zones

    PubMed Central

    2012-01-01

    Background Despite the fact that the Colombian armed conflict has continued for almost five decades there is still very little information on how it affects the mental health of civilians. Although it is well established in post-conflict populations that experience of organised violence has a negative impact on mental health, little research has been done on those living in active conflict zones. Médecins Sans Frontières provides mental health services in areas of active conflict in Colombia and using data from these services we aimed to establish which characteristics of the conflict are most associated with specific symptoms of mental ill health. Methods An analysis of clinical data from patients (N = 6,353), 16 years and over, from 2010–2011, who consulted in the Colombian departments (equivalent to states) of Nariño, Cauca, Putumayo and Caquetá. Risk factors were grouped using a hierarchical cluster analysis and the clusters were included with demographic information as predictors in logistic regressions to discern which risk factor clusters best predicted specific symptoms. Results Three clear risk factor clusters emerged which were interpreted as ‘direct conflict related violence’, ‘personal violence not directly conflict-related’ and ‘general hardship’. The regression analyses indicated that conflict related violence was more highly related to anxiety-related psychopathology than other risk factor groupings while non-conflict violence was more related to aggression and substance abuse, which was more common in males. Depression and suicide risk were represented equally across risk factor clusters. Conclusions As the largest study of its kind in Colombia it demonstrates a clear impact of the conflict on mental health. Among those who consulted with mental health professionals, specific conflict characteristics could predict symptom profiles. However, some of the highest risk outcomes, like depression, suicide risk and aggression, were more

  19. The concept of health. Rural perspectives.

    PubMed

    Long, K A

    1993-03-01

    An understanding of the client's concept of health is necessary to conduct relevant and effective health assessment, planning, intervention, and evaluation. Client health concepts are affected by place of residence and further colored by specific community and individual level variations including occupation, education, subculture, age, gender, and health status. Rural nursing practice can be improved through knowledge of the health perceptions and definitions held by the rural clients to be served. Nursing, as a discipline, has traditionally emphasized the need to understand the client's perspective and to develop mutually agreed on health goals in collaboration with the client. Rural nursing practice offers unique opportunities to consider meanings of health within the environmental context. Further, it challenges nurses to work hand-in-hand with clients to develop strategies that fit the context, and thus effectively address rural health care needs.

  20. Reforms and Challenges of Post-conflict Kosovo Health System.

    PubMed

    Mustafa, Mybera; Berisha, Merita; Lenjani, Basri

    2014-04-01

    Before its collapse, Kosovo's healthcare system was an integrated part of the Former Yugoslav Republics System (known as relatively well advanced for its time). Standstill had begun in the last decade of the twentieth century as the result of political disintegration of the former state. The enthusiasm of the healthcare professionals and the people of Kosovo that at the end of the conflict healthcare services will consolidate did not prove just right. Although we can claim that reorganization of Kosovo healthcare was a serious push (especially in the first years after the conflict), the intensity of development begun to fall at the latter stages. Although the basic legislation for the operation of the Healthcare System today in Kosovo does exist, the largest cause for the reform stagnation is where the law is not implemented properly and measures are not set as to a meaningful system of accountability. Twelve years have passed by since the 1999 war-conflict and, although, Kosovo has made progress in many other spheres, it has not yet reached to consolidate a health system comparable to those of other European countries. Intending to get out of difficult situation, several healthcare strategic plans have been developed in the past decade in Kosovo, but attempts in this direction have not been particularly fruitful. This script describes the actual Healthcare complexity of a situation in Kosovo 12 years after the end of the 1999 war-conflict. Interconnection and historical background is also looked upon and is described in the flow of events. Finally, the description of transfer competencies from international administrators to the local authorities as well as the flow of strategic planning that took place since 1999 has also been analyzed.

  1. Community health nursing advocacy: a concept analysis.

    PubMed

    Ezeonwu, Mabel C

    2015-01-01

    The purpose of this article is to present an in-depth analysis of the concept of community health nursing (CHN) advocacy. Walker and Avant's (2010) 8-step concept analysis methodology was used. A broad inquiry into the literature between 1994 and 2014 resulted in the identification of the uses, defining attributes, empirical referents, antecedents, and consequences, as well as the articulation of an operational definition of CHN advocacy. Model and contrary cases were identified to demonstrate the concept's application and to clarify its meaning. This analysis contributes to the advancement of knowledge of CHN advocacy and provides nurse clinicians, educators, and researchers with some conceptual clarity to help improve community health outcomes.

  2. Health concept and health promotion process among Korean migrant women.

    PubMed

    Cha, Chiyoung

    2013-01-01

    My purpose in this study was to explore the concepts of health and the health promotion process among Korean women who migrated to North America for their children's education. Interviews and surveys were analyzed using a grounded theory analysis and descriptive statistics. Women in this study established their health concept and health promotion process in accordance to their socially constructed mother role. The women established unique meanings of health and developed an altruistic motivation to be healthy that allowed them to actively pursue health promotion despite their traditional care provider roles.

  3. Health Hybrid Concept Analysis in Old People

    PubMed Central

    Noghabi, Ahamadali Asadi; Alhani, Fatemeh; Peyrovi, Hamid

    2013-01-01

    Background: It seems necessary to study the health status of this age group to promote their health and prevent disease as well as care planning. In order to achieve this goal, a clear definition of the concept of elderly health is essential. Method: Hybrid concept analysis, our research design, utilizes both theoretical analysis of literature and empirical observation to define a concept. We chose the hybrid concept analysis method because its inclusion of old people perspectives enriches the limited health research literature. The method consists of three phases theory, fieldwork, and analysis. Results: In comparison, we can conclude that health in the elderly people is something more than the absence of illness and 4 physical, mental, social and spiritual domains which are referred to in the definition of a theoretical stage are supported by the findings. The relative health was also proposed against the complete welfare and comfort for the elderly and it showed that their expectations are less than their ages. In addition, the elderly have expressed the family as a preference and the researcher believes that this theme is context based because it has emerged following the interview. Since the family has a special place according to the Iranian culture and religion and the family health is a priority in their health. In addition, the daily activities have been raised as a major theme that can be considered as the physical health but the elderly have expressed it apart from the physical health. Conclusion: Health among the old is a concept that is affected by genetic, environmental, healthcare services and lifestyle-related factors and involves proportional physical, mental, social, familial, spiritual, and economical welfare along with the ability to handle daily life activities which is measurable through medical and functional approaches. PMID:24171892

  4. Constructing a conflict resolution program for health care.

    PubMed

    Porter-O'Grady, Tim

    2004-01-01

    Resolving conflict throughout organizations requires a programmatic infrastructure and a committed management team. Leaders must recognize the need to approach conflict by building a format for learning, creating and managing an effective conflict management program. Careful attention to the elements of design and the stages of development can make all the difference in building a sustainable and useful conflict management approach.

  5. Health as a clinic-epidemiological concept.

    PubMed

    Azevedo, Marco Antonio

    2015-06-01

    I propose a clinic-epidemiological concept of health as the best description of what physicians actually think about health within medical practice. Its aim is to be an alternative to the best approach in the philosophy of medicine about health, Christopher Boorse's biostatistical theory. Contrary to Boorse's 'theoretical' approach, I propose to take health as a practical clinical concept. In the first two parts of the paper, I will present my complaints against Boorse's view that health is a theoretical concept, a 'species normal functional ability'. I will claim that Boorse's view is actually a view on normal physiology. My claim is that health is best described as the state of absence of chronic diseases or disabilities (clinic-epidemiologically associated with a morbimortality index higher than the risk of death, disease and disabilities for individuals of the same population group or reference class free of that chronic clinical conditions). Health, therefore, is not the mere absence of disease. Diseases that do not increase patients' morbimortality and disability indexes are not incompatible with health; after all, clinical health is compatible with appropriate health care and medical treatments.

  6. Primary care mental health workers: role expectations, conflict and ambiguity.

    PubMed

    Bower, Peter; Jerrim, Sophie; Gask, Linda

    2004-07-01

    A number of professionals are involved in mental health in primary care. The NHS Plan proposed the introduction of a new professional, the primary care mental health worker (PCMHW), to improve care in this setting. The present study was conducted to examine pilot PCMHW-type roles currently in existence, to explore staff expectations concerning the new PCMHW role and to consider the issues relating to roles in primary care mental health that are raised by this new worker. The study used a case study design, and involved qualitative interviews with 46 managers and clinicians from primary care and specialist mental health services, including pilot PCMHW-type roles. The key findings were as follows: The pilot PCMHW-type roles were almost exclusively related to client work, whereas respondents had far wider role expectations of the new PCMHWs, relating to perceived gaps in current service provision. This highlights the potential for role conflict. Secondly, there was disagreement and ambiguity among some respondents as to the nature of the new PCMHW's role in client work, and its relationship with the work undertaken by other mental health professionals such as counsellors, psychologists and nurses. Given that multiple professionals are involved in mental health care in primary care, issues relating to roles are likely to be crucial in the effective implementation of the new PCMHWs.

  7. Conflict on interprofessional primary health care teams--can it be resolved?

    PubMed

    Brown, Judith; Lewis, Laura; Ellis, Kathy; Stewart, Moira; Freeman, Thomas R; Kasperski, M Janet

    2011-01-01

    Increasingly, primary health care teams (PHCTs) depend on the contributions of multiple professionals. However, conflict is inevitable on teams. This article examines PHCTs members' experiences with conflict and responses to conflict. This phenomenological study was conducted using in-depth interviews with 121 participants from 16 PHCTs (10 urban and 6 rural) including a wide range of health care professionals. An iterative analysis process was used to examine the verbatim transcripts. The analysis revealed three main themes: sources of team conflict; barriers to conflict resolution; and strategies for conflict resolution. Sources of team conflict included: role boundary issues; scope of practice; and accountability. Barriers to conflict resolution were: lack of time and workload; people in less powerful positions; lack of recognition or motivation to address conflict; and avoiding confrontation for fear of causing emotional discomfort. Team strategies for conflict resolution included interventions by team leaders and the development of conflict management protocols. Individual strategies included: open and direct communication; a willingness to find solutions; showing respect; and humility. Conflict is inherent in teamwork. However, understanding the potential barriers to conflict resolution can assist PHCTs in developing strategies to resolve conflict in a timely fashion.

  8. Development of Concepts of Political Conflict and Power by 5th and 8th Graders. Final Report.

    ERIC Educational Resources Information Center

    Sears, David O.

    This research investigated pre-adolescent children's concepts of political conflict and power, and the processes by which these are acquired. It focused particularly upon the acquisition of such attitudes by Black and Mexican-American children, minority groups currently involved in deep social and political conflicts. The data were obtained with a…

  9. Interpersonal conflict and health perceptions in long-distance caregiving relationships.

    PubMed

    Bevan, Jennifer L; Vreeburg, Sean K; Verdugo, Sherri; Sparks, Lisa

    2012-08-01

    With job markets expanding globally and life expectancy continually increasing, more demands are being placed on distant relatives to provide care for their aging family members, creating a health care situation known as long-distance caregiving. An online survey explored the relations between negative health perceptions by long-distance caregivers and conflict frequency and conflict strategy usage. The authors observed positive significant relations between distant caregiver negative health perceptions and conflict frequency and usage of the distributive and avoidance conflict strategies. However, they observed no significant associations between distant caregiver negative health perceptions and usage of the two integrative strategies. Implications for long-distance caregiving communication are discussed.

  10. Public health, conflict and human rights: toward a collaborative research agenda

    PubMed Central

    Thoms, Oskar NT; Ron, James

    2007-01-01

    Although epidemiology is increasingly contributing to policy debates on issues of conflict and human rights, its potential is still underutilized. As a result, this article calls for greater collaboration between public health researchers, conflict analysts and human rights monitors, with special emphasis on retrospective, population-based surveys. The article surveys relevant recent public health research, explains why collaboration is useful, and outlines possible future research scenarios, including those pertaining to the indirect and long-term consequences of conflict; human rights and security in conflict prone areas; and the link between human rights, conflict, and International Humanitarian Law. PMID:18005430

  11. The role of health professionals in preventing and mediating conflict.

    PubMed

    Buhmann, Caecilie Böck

    2005-01-01

    Since the early 1980s academics, governmental and non-governmental organisations have undertaken field projects inspired by the Peace through Health and similar concepts formulated by the World Health Organisation and the Department of Peace Studies at McMaster University, Canada. These have been criticised for lack of proper evaluation, the appropriateness of the skills of health workers involved, and the overall usefulness of the approach. This article, based on a literature review, compares existing evidence with the theoretical framework. There is still a lack of systematic evaluation, but no direct disproof of Peace through Health theory. It is concluded that the Peace through Health approach can have a positive impact on healing and reconciliation on a community scale, but there is no evidence of a peace impact on a larger scale.

  12. Associations Between Marital Conflict and Adolescent Conflict Appraisals, Stress Physiology, and Mental Health

    PubMed Central

    Lucas-Thompson, Rachel G.; Lunkenheimer, Erika S.; Dumitrache, Adina

    2015-01-01

    The goal of the current study was to examine conflict appraisals and diurnal cortisol production as mediators of the robust association between marital conflict and adolescent adjustment problems. Parents reported their marital conflict and were observed engaging in a marital conflict discussion; they also reported adolescent internalizing and externalizing behaviors. Adolescents (n = 105, 52% female, 10–17 years of age) appraised their parents’ marital conflict and reported their internalizing and externalizing behaviors. After the laboratory visit, adolescents provided four saliva samples on each of 2 consecutive days to assess diurnal cortisol production. More-negative marital conflict predicted more self-blame for parental conflict, which in turn predicted less robust decreases in cortisol across the day. Further, this flattened cortisol production pattern mediated the relationship between greater self-blame for parental conflict and adolescents’ elevated internalizing behaviors. Feeling responsible for parental conflict appears to be particularly damaging in terms of physiological regulation and adjustment, and may therefore be a particularly useful intervention target. PMID:26136117

  13. Investigating the work-family conflict and health link: Repetitive thought as a mechanism.

    PubMed

    Davis, Kelly D; Gere, Judith; Sliwinski, Martin J

    2016-10-06

    Research is needed to investigate mechanisms linking work-family conflict to poor health in working adults. We took a novel approach to build on extant studies by testing a potential mechanism in these associations - repetitive thought. Data came from a sample of 203 partnered working adults. There were significant direct effects of work-family conflict with lower life satisfaction, positive affect, and perceived health as well as greater fatigue. As for total effects, work-family conflict was significantly associated with all health outcomes - life satisfaction, positive affect, negative affect, fatigue, perceived health, and chronic health conditions - in the expected directions through repetitive thought. This study provides support that repetitive thought is one potential mechanism of how work-family conflict can take a toll on psychological and physical health. Findings are discussed in relation to improving workplace policies to improve the health of working adults managing work-family conflict.

  14. Inequalities in health: definitions, concepts, and theories.

    PubMed

    Arcaya, Mariana C; Arcaya, Alyssa L; Subramanian, S V

    2015-01-01

    Individuals from different backgrounds, social groups, and countries enjoy different levels of health. This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. We describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behavior, environmental, and selection explanations. Concepts of relative versus absolute; dose-response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. We close by reflecting on what conditions make health inequalities unjust, and to consider the merits of policies that prioritize the elimination of health disparities versus those that focus on raising the overall standard of health in a population.

  15. Inequalities in health: definitions, concepts, and theories

    PubMed Central

    Arcaya, Mariana C.; Arcaya, Alyssa L.; Subramanian, S. V.

    2015-01-01

    Individuals from different backgrounds, social groups, and countries enjoy different levels of health. This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. We describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behavior, environmental, and selection explanations. Concepts of relative versus absolute; dose–response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. We close by reflecting on what conditions make health inequalities unjust, and to consider the merits of policies that prioritize the elimination of health disparities versus those that focus on raising the overall standard of health in a population. PMID:26112142

  16. The case for addressing explosive weapons: conflict, violence and health.

    PubMed

    Rappert, Brian; Moyes, Richard; Lang, Iain

    2012-12-01

    In recent years, states and non-governmental organizations have expressed concern about the humanitarian consequences of the category of technologies labelled 'explosive weapons', particularly in relation to their use in populated areas. This article seeks to outline the magnitude of these consequences as well as what can be done to reduce harms. In particular, it makes a case for how health approaches could help prevent the harms associated with this category of weapons. Attention is given to the types of evidence and argument that might be required to characterize explosive weapons. An overarching aim is to consider how alternative ways of understanding weapons and violence can create new opportunities for addressing harms from conflict.

  17. Work-Family Conflict, Sleep, and Mental Health of Nursing Assistants Working in Nursing Homes.

    PubMed

    Zhang, Yuan; Punnett, Laura; Nannini, Angela

    2016-10-28

    Work-family conflict is challenging for workers and may lead to depression, anxiety, and overall poor health. Sleep plays an important role in the maintenance of mental health; however, the role of sleep in the association between work-family conflict and mental health is not well-studied. Questionnaires were collected from 650 nursing assistants in 15 nursing homes. Multivariate linear regression modeling demonstrated that increased work-family conflict was associated with lower mental health scores (β = -2.56, p < .01). More work-family conflict was correlated with more job demands, less job control, less social support, and longer work hours. Poor sleep quality, but not short sleep duration, mediated the association between work-family conflict and mental health. Workplace interventions to improve nursing assistants' mental health should increase their control over work schedules and responsibilities, provide support to meet their work and family needs, and address healthy sleep practices.

  18. The Hospice Concept: Health Occupation 305.

    ERIC Educational Resources Information Center

    Schobel, Deborah A.

    A description is provided of "The Hospice Concept," an elective course offered as part of a two-year college health occupations curriculum. The course is designed to further the students understanding of the multiple facets of death and dying and to prepare them to be hospice volunteers. Following a course description and a glossary of…

  19. Concept Development for Software Health Management

    NASA Technical Reports Server (NTRS)

    Riecks, Jung; Storm, Walter; Hollingsworth, Mark

    2011-01-01

    This report documents the work performed by Lockheed Martin Aeronautics (LM Aero) under NASA contract NNL06AA08B, delivery order NNL07AB06T. The Concept Development for Software Health Management (CDSHM) program was a NASA funded effort sponsored by the Integrated Vehicle Health Management Project, one of the four pillars of the NASA Aviation Safety Program. The CD-SHM program focused on defining a structured approach to software health management (SHM) through the development of a comprehensive failure taxonomy that is used to characterize the fundamental failure modes of safety-critical software.

  20. [The concept of health and disease].

    PubMed

    Ruíz, R H

    1976-12-01

    1. The author reviews some current concepts concerning the definitions and uses of the concepts of health and illness. Starting from the definitions in Psychiatry, "normality" is considered from the statistic, the normative and the clinical standpoints, and as a part of a continuum stretching from health to illness. Several approaches are analyzed, among which Wittaker's, who sets forth the following indicators of normality: a) self-knowledge; b) self-esteem; c) self-security; d) capacity for giving and receiving affection; e) satisfaction of corporal needs; f) productivity and capacity for happiness; g) lack of tensions and of hipersensitivity. 2. The concept of illness as an operative concept is also analyzed, leading to the following statements: a) it is inexistent in non-biological sciences; b) it appears in social sciences only through extrapolation; c) in medicine it means the breacking of homeosthasis; d) in psychology and dynamic psychiatry it means the abnormal stressing of normal mechanisms, common to all persons. 3. The concept of health as equilibrium is also analyzed, with the following precisions: a) equilibrium is defined within a system as affecting the whole of it, and implying transformation and self-regulation; b) homeosthasis is a case of equilibrium for steady complex systems; c) adaptation is the maintenance of equilibrium when there are exchanges with the evironment. 4. Finally, those concepts are applied to mental illness and its limits, and the following criteria are set forth: a) amount of anguish; b) depression related to its motives, intensity, persistence and frequency; c) regression to previous development stages; d) use of defense mechanisms in an inadequate or stereotyped way.

  1. Conflicts at work--the relationship with workplace factors, work characteristics and self-rated health.

    PubMed

    Oxenstierna, Gabriel; Magnusson Hanson, Linda L; Widmark, Maria; Finnholm, Kristina; Stenfors, Cecilia; Elofsson, Stig; Theorell, Töres

    2011-01-01

    Few studies have considered the work environment in relation to workplace conflicts and those who have been published have included relatively few psychosocial work environment factors. Little research has been published on the consequences of workplace conflicts in terms of employee health. In this study, the statistical relationships between work and workplace characteristics on one hand and conflicts on the other hand are examined. In addition, the relationship between conflicts at work and self-rated health are described. The study population was derived from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2006; n=5,141. Among employees at workplaces with more than 20 employees (n=3,341), 1,126 (33.7%) responded that they had been involved in some type of conflict during the two years preceding the survey. Among the work and workplace characteristics studied, the following factors were independently associated with increased likelihood of ongoing conflicts: Conflicting demands, emotional demands, risk of transfer or dismissal, poor promotion prospects, high level of employee influence and good freedom of expression. Factors that decreased the likelihood of ongoing conflicts were: Good resources, good relations with management, good confidence in management, good procedural justice (fairness of decisions) and good social support. After adjustment for socioeconomic conditions the odds ratio for low self-rated health associated with ongoing conflict at work was 2.09 (1.60-2.74). The results provide a good starting point for intervention and prevention work.

  2. The flight of white-collars: Civil conflict, availability of medical service providers and public health.

    PubMed

    Kıbrıs, Arzu; Metternich, Nils

    2016-01-01

    Civil conflicts devastate public health both in the short run and in the long run. Analyzing novel data sets that include yearly information on public health and the availability of health professionals across provinces in Turkey in the 1964-2010 period, we provide empirical evidence for our theoretical argument that a major mechanism through which civil conflicts exert their long term negative influences on public health is by discouraging medical personnel to practice in conflict regions. We also assess the effectiveness of certain policy measures that Turkish governments have tried out over the years to counteract this mechanism. Our results reveal that the long running civil conflict in Turkey has been driving away doctors and other highly trained medical personnel from conflict areas and that mandatory service requirements do help counteract this flight.

  3. [Conception of health: space-earth].

    PubMed

    Ushakov, I B; Orlov, O I; Baevskiĭ, R M; Bersen'ev, E Iu; Chernikova, A G

    2013-01-01

    In article the new approach to an estimation of a health state of cosmonauts, sportsmen, pilots, drivers, operators, persons of dangerous trades is considered. It has been created and developed in Institute of biomedical problems of the Russian Academy of Sciences under the direction of academician A.I. Grigoriev. Results of works of last decade, by the Program of Presidium of the Russian Academy of Sciences carried out at support of "Fundamental sciences--are submited to medicine". The new system for an estimation of a functional states of an organism at stressful influences in submitted. The methodology of remote studying of influence of ecological factors on health which has begun a new scientific--practical direction--to telemedical ecology is created. In conclusion of the article it is discussed questions of the further introduction of new concept of health and technologies prenosological diagnostics in practice of public health services.

  4. Tracking Official Development Assistance for Reproductive Health in Conflict-Affected Countries

    PubMed Central

    Patel, Preeti; Roberts, Bayard; Guy, Samantha; Lee-Jones, Louise; Conteh, Lesong

    2009-01-01

    Background Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA) for reproductive health activities in conflict-affected countries from 2003 to 2006. Methods and Findings The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US$20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US$509.3 million (2.4%) was allocated to reproductive health. This represents an annual average of US$1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. Conclusions This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict. PMID:19513098

  5. The concept of stewardship in health policy.

    PubMed Central

    Saltman, R. B.; Ferroussier-Davis, O.

    2000-01-01

    There is widespread agreement that both the configuration and the application of state authority in the health sector should be realigned in the interest of achieving agreed policy objectives. The desired outcome is frequently characterized as a search for good governance serving the public interest. The present paper examines the proposal in The World Health Report 2000 that the concept of stewardship offers the appropriate basis for reconfiguration. We trace the development of stewardship from its initial religious formulation to more recent ecological and sociological permutations. Consideration is given to the potential of stewardship for encouraging state decision-making that is both normatively based and economically efficient. Various dilemmas that could impede or preclude such a shift in state behaviour are examined. We conclude that the concept of stewardship holds substantial promise if adequately developed and effectively implemented. PMID:10916910

  6. The concept of territory in Mental Health.

    PubMed

    Furtado, Juarez Pereira; Oda, Wagner Yoshizaki; Borysow, Igor da Costa; Kapp, Silke

    2016-10-10

    The term "territory" and its correlates have become commonplace in the field of Mental Health since the psychiatric reform, a potentially emancipatory milestone in non-hospital-centered ideals. However, in a previous empirical study, we found a lack of consistent concepts and practices (corresponding to the use of this term) in the territorial reinsertion of persons with mental illness. To clarify the term's various uses and its possible correlations in practice, we have conducted a systematic survey of scientific articles and official documents, comparing them to each other and with the concept of territory from Critical Geography. We conclude that in the Mental Health field in Brazil, despite numerous and repeated critical efforts, a functional notion of territory has prevailed, overlooking power relations and symbolic appropriations, increasing the tendency of subjecting the reinsertion of persons with mental illness to a given territory rather than favoring socio-spatial transformations for the coexistence of differences.

  7. [Conflicts of interests in clinical research in primary health care].

    PubMed

    González-de Paz, L; Navarro-Rubio, M D; Sisó-Almirall, A

    2014-03-01

    Conflicts of interests between professionals and patients in biomedical research, is an ethical problem. None of the laws in Spain mention whether the clinical researcher has to clarify to participants the reasons why it proposes them to participate in a clinical trial. In this article, conflicts of interests in research are discussed in the context of primary healthcare. In this area conflicts of interests might alter the confidence between patients and healthcare professionals. Finally, we suggest some practical strategies that can help participants make the decision to participate in a clinical trial more willingly and freely.

  8. Early Adolescent Health Risk Behaviors, Conflict Resolution Strategies, and School Climate

    ERIC Educational Resources Information Center

    LaRusso, Maria; Selman, Robert

    2011-01-01

    Drawing upon an ethnically and socio-economically diverse sample of 323 7th grade students from twelve urban schools within one school district, this mixed method study examined early adolescents' self-reported health risk behaviors as related to their conflict resolution strategies and their school's conflict resolution climate. Survey data…

  9. A theoretical model to address organizational human conflict and disruptive behavior in health care organizations.

    PubMed

    Piper, Llewellyn E

    2006-01-01

    This article proposes a theoretical model for leaders to use to address organizational human conflict and disruptive behavior in health care organizations. Leadership is needed to improve interpersonal relationships within the workforce. A workforce with a culture of internal conflict will be unable to achieve its full potential to delivery quality patient care.

  10. The role of academic research and teaching in addressing health in situations of conflict and instability.

    PubMed

    Collinson, Lucie

    2014-01-01

    The key roles of academic research and teaching in addressing health in situations of conflict and instability are to better inform and better equip actors with the knowledge and skills to address health problems. The four key contributions of research are: quantifying the health problem, examining the contextual circumstances, investigating the epidemiology of health problems and evaluation of health care and humanitarian interventions. The role of teaching can complement research by distributing its' findings in addition to teaching skill sets to apply this knowledge and conduct further research. Academic research and teaching both play imperative roles in enabling more successful approaches in addressing health in situations of conflict and instability.

  11. Work-school conflict and health outcomes: beneficial resources for working college students.

    PubMed

    Park, Youngah; Sprung, Justin M

    2013-10-01

    This study extends prior college student employment research by examining health as an outcome variable. Using 2-wave data from a sample of 216 student workers, this study examined work-school conflict as a predictor of psychological and physical health among working college students. Additionally, 3 resource-providing variables--work-school facilitation, supervisor work-school support, and personal fulfillment at work--were tested for buffering effects in the relation between work-school conflict and health. Results demonstrated that work-school conflict was a significant predictor of psychological health but not physical health. All 3 resource-providing variables ameliorated the negative relation between work-school conflict and psychological health, whereas only personal fulfillment weakened the positive relation between work-school conflict and physical symptoms. These findings suggest the benefits of work-school facilitation, supervisor work-school support, and personal fulfillment in minimizing the detrimental effects of work-school conflict on health outcomes. Theoretical and practical implications for researchers, educational institutions, and organizations are discussed.

  12. Concepts for NASA longitudinal health studies

    NASA Technical Reports Server (NTRS)

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

    1983-01-01

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

  13. Living through conflict and post-conflict: experiences of health workers in northern Uganda and lessons for people-centred health systems

    PubMed Central

    Namakula, Justine; Witter, Sophie

    2014-01-01

    Providing people-centred health systems—or any systems at all—requires specific measures to protect and retain healthcare workers during and after the conflict. This is particularly important when health staff are themselves the target of violence and abduction, as is often the case. This article presents the perspective of health workers who lived through conflict in four districts of northern Uganda—Pader, Gulu, Amuru, and Kitgum. These contained more than 90% of the people displaced by the decades of conflict, which ended in 2006. The article is based on 26 in-depth interviews, using a life history approach. This participatory tool encouraged participants to record key events and decisions in their lives, and to explore areas such as their decision to become a health worker, their employment history, and their experiences of conflict and coping strategies. These were analyzed thematically to develop an understanding of how to protect and retain staff in these challenging contexts. During the conflict, many health workers lost their lives or witnessed the death of their friends and colleagues. They also experienced abduction, ambush and injury. Other challenges included disconnection from social and professional support systems, displacement, limited supplies and equipment, increased workload and long working days and lack of pay. Health workers were not passive in the face of these challenges, however. They adopted a range of safety measures, such as mingling with community members, sleeping in the bush, and frequent change of sleeping place, in addition to psychological and practical coping strategies. Understanding their motivation and their views provides an important insight how to maintain staffing and so to continue to offer essential health care during difficult times and in marginalized areas. PMID:25274642

  14. What Are the Costs of Marital Conflict and Dissolution to Children's Physical Health?

    ERIC Educational Resources Information Center

    Troxel, Wendy M.; Matthews, Karen A.

    2004-01-01

    Do parental marital conflict and dissolution influence the risk trajectory of children's physical health risk? This paper reviews evidence addressing this question in the context of understanding how early environmental adversities may trigger a succession of risks that lead to poor health in childhood and greater risk for chronic health problems…

  15. Conflict of interest in public health: should there be a law to prevent it?

    PubMed

    Gupta, Arun; Holla, Radha; Suri, Shoba

    2015-01-01

    "Conflict of interest", now being commonly cited, is a set of circumstances that creates a risk that professional judgement or actions regarding a primary interest will be unduly influenced by a secondary interest. Conflict of interest situations can be institutional or personal, and can stem from financial or other interests including post-employment opportunities or during public -private partnerships. Conflicts of interest in the creation of public policy, especially health or nutrition related policies such as the vaccine policy, tobacco control, and research related to health, can have negative impact on the lives of millions of people. While the UN Convention Against Corruption, to which India is a signatory, identifies conflict of interest as often being a precursor to corruption, there is no serious action being taken in this direction by the Indian government, in spite of the fact there are instances of serious nature coming to light that affect our peoples lives. If conflict of interest situations are allowed to continue especially in health policy it could be detrimental to millions of people; therefore, it would be in public interest that India enacts a law to prevent conflict of interest in the making of public policies, comprehensive enough to include financial and institutional conflicts of interest.

  16. Reconstruction of health service systems in the post-conflict Northern Province in Sri Lanka.

    PubMed

    Nagai, Mari; Abraham, Sandirasegaram; Okamoto, Miyoko; Kita, Etsuko; Aoyama, Atsuko

    2007-09-01

    Public health problems in armed conflicts have been well documented, however, effective national health policies and international assistance strategies in transition periods from conflict to peace have not been well established. After the long lasted conflicts in Sri Lanka, the Government and the rebel LTTE signed a cease-fire agreement in February 2002. As the peace negotiation has been disrupted since April 2003, a long-term prospect for peace is yet uncertain at present. The objective of this research is to detect unmet needs in health services in Northern Province in Sri Lanka, and to recommend fair and effective health strategies for post-conflict reconstruction. First, we compared a 20-year trend of health services and health status between the post-conflict Northern Province and other areas not directly affected by conflict in Sri Lanka by analyzing data published by Sri Lankan government and other agencies. Then, we conducted open-ended self-administered questionnaires to health care providers and inhabitants in Northern Province, and key informant interviews in Northern Province and other areas. The major health problems in Northern Province were high maternal mortality, significant shortage of human resources for health (HRH), and inadequate water and sanitation systems. Poor access to health facilities, lack of basic health knowledge, insufficient health awareness programs for inhabitants, and mental health problems among communities were pointed by the questionnaire respondents. Shortage of HRH and people's negligence for health were perceived as the major obstacles to improving the current health situation in Northern Province. The key informant interviews revealed that Sri Lankan HRH outside Northern Province had only limited information about the health issues in Northern Province. It is required to develop and allocate HRH strategically for the effective reconstruction of health service systems in Northern Province. The empowerment of inhabitants

  17. Tracing health system challenges in post-conflict Côte d'Ivoire from 1893 to 2013.

    PubMed

    Gaber, Sabrina; Patel, Preeti

    2013-07-01

    While scholarship on health in conflict-affected countries is growing, there has been relatively little analysis of how armed conflict affects health systems in specific African countries, especially former French colonies. There is even less literature on the role of history in shaping health systems and how historical factors such as inequity may influence health impacts of armed conflict. Based on Côte d'Ivoire, this article argues that historical multidisciplinary analysis can provide valuable insight into the macro-level political, economic and social determinants of the health system over time. It explores how armed conflict has affected health services and exacerbates historically inherited challenges to the health system including unequal distribution of health services, bias towards curative care in urban areas, inadequate human resources and weak health governance. In the post-conflict period, this understanding may assist governments and other stakeholders to develop more appropriate health policies that address both urgent and long-term health needs.

  18. Lay Worker Health Literacy: A Concept Analysis and Operational Definition.

    PubMed

    Cadman, Kathleen Paco

    2017-04-13

    The concept of lay worker health literacy is created by concurrently analyzing and synthesizing two intersecting concepts, lay workers and health literacy. Articulation of this unique intersection is the result of implementing a simplified Wilson's Concept Analysis Procedure. This process incorporates the following components: a) selecting a concept, b) determining the aims/purposes of analysis, c) identifying all uses of the concept, d) determining defining attributes, e) identifying a model case, f) identifying borderline, related, contrary, and illegitimate cases, g) identifying antecedents and consequences, and h) defining empirical referents. Furthermore, as current literature provides no operational definition for lay worker health literacy, one is created to contribute cohesion to the concept.

  19. Work-family conflict: experiences and health implications among immigrant Latinos.

    PubMed

    Grzywacz, Joseph G; Arcury, Thomas A; Márin, Antonio; Carrillo, Lourdes; Burke, Bless; Coates, Michael L; Quandt, Sara A

    2007-07-01

    Work-family conflict research has focused almost exclusively on professional, White adults. The goal of this article was to expand the understanding of culture and industry in shaping experiences and consequences of work-family conflict. Using in-depth interview data (n = 26) and structured survey data (n = 200) from immigrant Latinos employed in the poultry processing industry, the authors evaluated predictions drawn from emerging models emphasizing the influence of cultural characteristics such as collectivism and gender ideology on work-family conflict. Results indicated that immigrant Latinos in poultry processing experienced infrequent work-to-family conflict; both the level and the antecedents of work-to-family conflict differed by gender, with physical demands contributing to greater conflict for women but not men. In addition, there was little evidence that work-family conflict was associated with health in this population. These results demonstrate how traditional models of work-family conflict need to be modified to reflect the needs and circumstances of diverse workers in the new global economy.

  20. Statistical concepts in biology and health sciences.

    PubMed

    Zahir, Huma; Javaid, Aisha; Rehman, Rehana; Hussain, Zahir

    2014-01-01

    In view of its applied aspects, Statistics serves as a separate mathematical science. In that respect, biostatistics is the application of statistical concepts and methods in biology, public health and medicine. One major task of medical biostatistics is to understand why a disease occurs in certain area and why that disease does not occur in other areas. In general, the advantages for properly applying statistics for a country are to keep the detailed information of people in a country. However, there must in mind be the other face of the task remembering not to adapt these surveys and limited data with entirety for quick applications that might be less advantageous. Some of the programs are much expensive and time consuming and people may feel not comfortable conveying their personal information just for the sake of applying a so called organized procedure. In such conditions, one must consider the moral values as well. Another quite unfortunate fact is that a statistical data can be misused for personal needs of a presenter. There must be ways to eradicate such customs at the governmental level. Basic and higher courses, certificate courses, diploma programs, degree programs, and other opportunities for students can be well organized and can be utilized in various employment areas in industry, government, life sciences, computer science, medicine, public health, education, teaching, research, and survey research. Statisticians, hence, are very important people for establishing various schemes, programs, institutions and organizations in medical and biological sectors.

  1. Organizational influences on the work life conflict and health of shiftworkers.

    PubMed

    Pisarski, Anne; Lawrence, Sandra A; Bohle, Philip; Brook, Christine

    2008-09-01

    This study examined organizational factors affecting the impact of shiftwork on work life conflict and subjective health. A model was proposed in which support from supervisors, support from colleagues, and team identity influence time-based work life conflict through two mediating variables: team climate and control over the working environment. Reduced conflict, in turn, produces enhanced psychological well-being and diminished physical symptoms. A structural equation model based on survey data from 530 nurses supported the proposed model. It also identified unpredicted direct links between team identity and physical symptoms, and between supervisor support and both control over the work environment and psychological well-being. The results indicate that organizational interventions focused on social support, team identity, team climate, and control can diminish the negative effects of shiftwork on work life conflict and health in shiftworkers.

  2. Applying marketing concepts to promote health in vulnerable groups.

    PubMed

    Fontana, S A

    1991-06-01

    Public health nurses must have a valid marketing orientation. Two marketing concepts, exchange relationships and channels of distribution and their application for public health nursing practice, have relevance in this context. In spite of the complexities inherent in applying them, they can be used to promote health in at-risk populations. By incorporating these concepts in planning and delivering public health nursing services, it is hoped that the health goals of a larger number of vulnerable individuals can be achieved.

  3. Postdivorce living arrangements, parent conflict, and long-term physical health correlates for children of divorce.

    PubMed

    Fabricius, William V; Luecken, Linda J

    2007-06-01

    The authors tested a biopsychosocial model in which young adults' long-term relationships with fathers and ongoing distress surrounding their parents' divorces mediated the relationship between disrupted parenting (i.e., exposure to parent conflict before the divorce and up to 5 years after, and amount of time with father postdivorce) and indicators of their physical health. University students whose parents divorced before they were 16 (n = 266) participated. Findings supported the model. The more time children lived with their fathers after divorce, the better their current relationships were with their fathers, independent of parent conflict. The more parent conflict they experienced, the worse their relationships were with their fathers and the more distress they currently felt about their parents' divorce, independent of time with father. Poor father-child relationships and more distress in turn predicted poorer health status. There was no interaction between exposure to parent conflict and time with father; thus, more time with father was beneficial in both high- and low-conflict families, and more exposure to parent conflict was detrimental at both high and low levels of time with father.

  4. A diagnosis of conflict: theoretical barriers to integration in mental health services & their philosophical undercurrents.

    PubMed

    Gerard, Nathan M

    2010-02-04

    This paper examines the philosophical substructure to the theoretical conflicts that permeate contemporary mental health care in the UK. Theoretical conflicts are treated here as those that arise among practitioners holding divergent theoretical orientations towards the phenomena being treated. Such conflicts, although steeped in history, have become revitalized by recent attempts at integrating mental health services that have forced diversely trained practitioners to work collaboratively together, often under one roof. Part I of this paper examines how the history of these conflicts can be understood as a tension between, on the one hand, the medical model and its use by the dominant profession of psychiatry, and on the other, those alternative models and practitioners in some way differentiated from the medical model camp. Examples will be given from recent policy and research to highlight the prevalence of this tension in contemporary practice. Part II of this paper explores the deeper commonalities that lay beneath the theoretical conflict outlined in Part I. These commonalities will be shown to be apart of a captivating framework that has continued to grip the conflict since its inception. By exposing this underlying framework--and the motivations inherent therein--the topic of integration appears in wholly different light, allowing a renewed philosophical basis for integration to emerge.

  5. Transcending intractable conflict in health care: an exploratory study of communication and conflict management among anesthesia providers.

    PubMed

    Jameson, Jessica Katz

    2003-01-01

    This paper explores the contrast between the longstanding, intractable conflict between two anesthesia providers and the cooperation of many individual nurse anesthetists and anesthesiologists working side-by-side to provide safe, effective anesthesia. Analysis of interview transcripts reveals that communication among anesthesia nurses and anesthesiologists may enact or transcend the conflict. This article proposes recommendations for improving communication between anesthesiologists and certified registered nurse anesthetists in particular and de-escalating intractable conflict in general. It also contributes to communication theory in intractable conflict by examining how individual, interpersonal conflict management interactions lead to either transcendence or enactment of the larger group conflict.

  6. Trade policy and health: from conflicting interests to policy coherence.

    PubMed

    Blouin, Chantal

    2007-03-01

    Policy incoherence at the interface between trade policy and health can take many forms, such as international trade commitments that strengthen protection of pharmaceutical patents, or promotion of health tourism that exacerbates the shortage of physicians in rural areas. Focusing on the national policy-making process, we make recommendations regarding five conditions that are necessary, but not sufficient, to ensure that international trade policies are coherent with national health objectives. These conditions are: space for dialogue and joint fact-finding; leadership by ministries of health; institutional mechanisms for coordination; meaningful engagement with stakeholders; and a strong evidence base.

  7. Human resource management in post-conflict health systems: review of research and knowledge gaps

    PubMed Central

    2014-01-01

    In post-conflict settings, severe disruption to health systems invariably leaves populations at high risk of disease and in greater need of health provision than more stable resource-poor countries. The health workforce is often a direct victim of conflict. Effective human resource management (HRM) strategies and policies are critical to addressing the systemic effects of conflict on the health workforce such as flight of human capital, mismatches between skills and service needs, breakdown of pre-service training, and lack of human resource data. This paper reviews published literatures across three functional areas of HRM in post-conflict settings: workforce supply, workforce distribution, and workforce performance. We searched published literatures for articles published in English between 2003 and 2013. The search used context-specific keywords (e.g. post-conflict, reconstruction) in combination with topic-related keywords based on an analytical framework containing the three functional areas of HRM (supply, distribution, and performance) and several corresponding HRM topic areas under these. In addition, the framework includes a number of cross-cutting topics such as leadership and governance, finance, and gender. The literature is growing but still limited. Many publications have focused on health workforce supply issues, including pre-service education and training, pay, and recruitment. Less is known about workforce distribution, especially governance and administrative systems for deployment and incentive policies to redress geographical workforce imbalances. Apart from in-service training, workforce performance is particularly under-researched in the areas of performance-based incentives, management and supervision, work organisation and job design, and performance appraisal. Research is largely on HRM in the early post-conflict period and has relied on secondary data. More primary research is needed across the areas of workforce supply, workforce

  8. Human resource management in post-conflict health systems: review of research and knowledge gaps.

    PubMed

    Roome, Edward; Raven, Joanna; Martineau, Tim

    2014-01-01

    In post-conflict settings, severe disruption to health systems invariably leaves populations at high risk of disease and in greater need of health provision than more stable resource-poor countries. The health workforce is often a direct victim of conflict. Effective human resource management (HRM) strategies and policies are critical to addressing the systemic effects of conflict on the health workforce such as flight of human capital, mismatches between skills and service needs, breakdown of pre-service training, and lack of human resource data. This paper reviews published literatures across three functional areas of HRM in post-conflict settings: workforce supply, workforce distribution, and workforce performance. We searched published literatures for articles published in English between 2003 and 2013. The search used context-specific keywords (e.g. post-conflict, reconstruction) in combination with topic-related keywords based on an analytical framework containing the three functional areas of HRM (supply, distribution, and performance) and several corresponding HRM topic areas under these. In addition, the framework includes a number of cross-cutting topics such as leadership and governance, finance, and gender. The literature is growing but still limited. Many publications have focused on health workforce supply issues, including pre-service education and training, pay, and recruitment. Less is known about workforce distribution, especially governance and administrative systems for deployment and incentive policies to redress geographical workforce imbalances. Apart from in-service training, workforce performance is particularly under-researched in the areas of performance-based incentives, management and supervision, work organisation and job design, and performance appraisal. Research is largely on HRM in the early post-conflict period and has relied on secondary data. More primary research is needed across the areas of workforce supply, workforce

  9. An Australian Land Force for Conflict in a World Without Precedent (Future Warfare Concept Paper)

    DTIC Science & Technology

    2009-01-01

    chaos of future conflict. Discussion: In order to gain the best effect from the greater lethality of its weapon systems , and ensure its own...have and will continue to greatly enhance the lethality of weapon systems ; this will also change tactics and organizations as it has in the past... chaos of future conflict. Intended to 5 replace Industrial Age infantry brigades, the smaller ETF possesses greater combat weight. While possessing

  10. Soil health: The concept, its role, and strategies for monitoring

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil health is not a new concept as evidenced by writings by both Greek and Roman philosophers who were aware of the importance of soil health to agricultural prosperity. Most recently, the concept has been recognized as a tool to help evaluate the effects of various agricultural and land management...

  11. Considerations of the Concept of Infant Health: A Literature Review

    ERIC Educational Resources Information Center

    Almqvist-Tangen, Gerd; Axelsson, Asa

    2006-01-01

    This study examined a wide range of literature in order to describe factors associated with the concept of infant health. The design of the study is a literature review examining 21 research studies, written in the English language. The study explored which factors were found to exert an influence on the concept of infant health. The result showed…

  12. Compensation and wellness: a conflict for veterans' health.

    PubMed

    Ellis, Niki; Mackenzie, Alison; Mobbs, Robyn

    2008-05-01

    In Australia greater attention is being given to health determinants, and the dominance of treatment in health policy and budgets is giving away some ground to prevention, health promotion, rehabilitation and disability management. This creates a dilemma for compensation systems: should the inclusion criteria be broadened to match the new thinking or should a narrower definition of "disease, injury or death" be retained? This issue is explored in the context of war syndromes among veterans. While veterans experience symptoms more frequently and more severely than military and community controls, their patterns of symptoms are not unique. Current compensation and benefit programs can create iatrogenic effects. It is concluded that compensation systems should be kept as safety nets while resources are provided to improve the capacity of primary health care caregivers, community organisations and veterans with war syndromes and their families to better deal with these problems. Adapting compensation systems to promote wellness through self-management health partnerships is one way of directing resources to individuals and their families. Action research at the community level with veterans, their families, their organisations, primary health care organisations, policy makers and researchers would allow this sector to work out the best way to apply existing efficacious tools to these modern health problems.

  13. Health fairs bring wellness concepts to life.

    PubMed

    Serina, M; Giove, S

    1991-01-01

    Incorporated into the nursing curriculum, the health fair is a stimulating, unique, nontraditional educational project that examines effective health education tools, leadership skills, and interaction with the community. Students test theories and collaborate with other school disciplines while planning, implementing, and evaluating health education and health fair promotion. Health fairs help students to identify positive lifestyles and create opportunities to test the skills needed to improve the population's wellness level.

  14. Conflict in fiduciary duty involving health care error reporting.

    PubMed

    Stewart, Della Wyatt

    2002-08-01

    Fiduciary duty is the responsibility to act in the best interest of a person or organization. Health care professionals, as well as managers in other industries, struggle continuously with the dilemma of whether or not to admit potentially harmful mistakes to unsuspecting customers and patients. Limited public disclosure of medical errors will benefit health care staff, organizational executives, and patients if specific policies are enacted to improve error prevention.

  15. Mental Health Professionals in Children's Advocacy Centers: Is There Role Conflict?

    ERIC Educational Resources Information Center

    Cross, Theodore P.; Fine, Janet E.; Jones, Lisa M.; Walsh, Wendy A.

    2012-01-01

    Two recent chapters in professional books have criticized children's advocacy centers for creating role conflict for mental health professionals because of their work with criminal justice and child protection professionals in children's advocacy centers as part of a coordinated response to child abuse. This article argues that these critiques…

  16. Consequences of ongoing civil conflict in Somalia: evidence for public health responses.

    PubMed

    Guha-Sapir, Debarati; Ratnayake, Ruwan

    2009-08-01

    Debarati Guha-Sapir and Ruwan Ratnayake use field data to demonstrate the severe vulnerability faced by much of the Somalian population due to ongoing conflict, and call for concerted public health interventions and access to food aid especially in southern Somalia.

  17. Developmental Trajectories of African American Adolescents' Family Conflict: Differences in Mental Health Problems in Young Adulthood

    ERIC Educational Resources Information Center

    Choe, Daniel Ewon; Stoddard, Sarah A.; Zimmerman, Marc A.

    2014-01-01

    Family conflict is a salient risk factor for African American adolescents' mental health problems. No study we are aware of has estimated trajectories of their family conflict and whether groups differ in internalizing and externalizing problems during the transition to young adulthood, a critical antecedent in adult mental health and…

  18. Anglo-American nursing theory, individualism and mental health care: a social conflict perspective.

    PubMed

    Leighton, Kevin

    2004-01-01

    This paper uses social conflict theory to reconsider the relationship of American nursing theory and individualised mental health care in the UK. It is argued that nursing theory has developed within a context of 'American dream' individualism, and that this ideology may be problematic for some UK mental health nurses and service users whose values and beliefs are those of different socio-political traditions. The paper explores the historical background of Anglo-American nursing theory, and then uses conflict theory to generate challenging propositions about the culture bias and political instrumentality of individualised care in mental health settings. In so doing, it critiques the 'scientific' and 'liberal' preconceptions of individualised care which have dominated mental health care policy for over a decade.

  19. Human resources for health through conflict and recovery: lessons from African countries.

    PubMed

    Pavignani, Enrico

    2011-10-01

    A protracted conflict affects human resources for health (HRH) in multiple ways. In most cases, the inflicted damage constitutes the main obstacle to health sector recovery. Interventions aimed at healing derelict human resources are however fraught with difficulties of a political, technical, financial and administrative order. The experience accumulated in past recovery processes has made some important players aware of the cost incurred by neglecting human resource development. Several transitions from conflict to peace have been documented, even if largely in unpublished reports. This paper presents condensed descriptions of some African HRH-related recovery processes, which provide useful lessons. The technical work demanded to resuscitate a derelict health workforce is fairly well understood. In most situations, the highest hurdles lie outside of the health domain, and are of a political and administrative nature. Success stories are rare. But useful lessons are taught by failure as well as by success.

  20. Do current sports nutrition guidelines conflict with good oral health?

    PubMed

    Broad, Elizabeth M; Rye, Leslie A

    2015-01-01

    For optimal athletic performance, an athlete requires good oral health to reduce the risk of oral pain, inflammation, and infection and thereby minimize the use of analgesics and antimicrobial agents. Increased intake, frequency, and dental contact time of carbohydrate-rich foods, sports nutrition products, and acidic carbohydrate-containing sports and energy drinks may contribute to risks of dental erosion, caries, and inflammatory periodontal conditions in the athlete, especially when he or she also exhibits dehydration and poor oral hygiene habits. Examining the athlete before he or she begins participating in a sport allows the dental care provider to determine the patient's existing oral health, hygiene, and susceptibility to risk factors for erosion, caries, and inflammatory periodontal disease. This oral profile, in conjunction with the individual athlete's dietary needs, can be used to establish a treatment and preventive program, including oral health education. Good oral hygiene practices and application of topical fluoride, especially via fluoridated toothpastes and topical fluoride varnishes, must be available to the athlete. Rinsing with water or a neutral beverage after exposure to carbohydrates or acidic sports nutrition products may reduce carbohydrate contact time and bring oral pH levels back to neutral more quickly, reducing the risk of caries and erosion. Finally, the dentist should encourage the athlete to consult with an experienced sports dietitian to ensure that principles of sports nutrition are being appropriately applied for the type, frequency, and duration of exercise in consideration of the individual's oral health needs.

  1. Dance in mental health nursing: a hybrid concept analysis.

    PubMed

    Ravelin, Teija; Kylmä, Jari; Korhonen, Teija

    2006-04-01

    The aim of this concept analysis is to describe the defining attributes and consequences of the concept of dance and to define it in a mental health nursing context using hybrid concept analysis. Dance is a human resource learned from culture. Dance implies body movements, steps, expression, and interaction. The outcomes of dance are mostly functional, including a client's physical and emotional health, well-being, ability to cooperate with other people in activities of daily life, and meeting role expectations within family and community. Based on the findings of this concept analysis, dance can be used as a nursing intervention.

  2. Building an evidence base on mental health interventions for children affected by armed conflict

    PubMed Central

    Betancourt, Theresa S.; Williams, Timothy

    2009-01-01

    This paper reviews what is currently known from research about the effectiveness of interventions to address mental health problems in children and adolescents affected by armed conflict. The focus will be on interventions delivered in conflict affected countries either during active humanitarian emergencies or during the post conflict period. The paper will discuss two main paradigms of intervention dominating the field: psychosocial approaches and clinical/psychiatric approaches. The paper reviews some of the basic literature, theories and issues involved in assessment, programme planning, monitoring and evaluation of both approaches. In order to explore these issues in depth, the paper will draw from the author’s field experiences with research in the Russian Federation and in northern Uganda. The paper also presents a brief review of a handful of other published evaluations of mental health interventions for war affected children. We will close with a discussion of what future research is needed to build an evidence base regarding mental health interventions for children affected by armed conflict as well as the ethical and feasibility issues associated with carrying out this work. PMID:19997531

  3. Precarious employment, working hours, work-life conflict and health in hotel work.

    PubMed

    McNamara, Maria; Bohle, Philip; Quinlan, Michael

    2011-01-01

    Precarious or temporary work is associated with adverse outcomes including low control over working hours, work-life conflict and stress. The rise in precarious employment is most marked in the service sector but little research has been done on its health effects in this sector. This study compares permanent and temporary workers in the hotel industry, where working hours are highly variable. Survey data from 150 workers from eight 3-Star hotels in urban and regional areas around Sydney were analyzed. Forty-five per cent were male and 52 per cent were female. Fifty four per cent were permanent full-time and 46 per cent were temporary workers. The effects of employment status on perceived job security, control over working hours, and work-life conflict are investigated using PLS-Graph 3.0. The effects of control over working hours, on work-life conflict and subsequent health outcomes are also explored. Temporary workers perceived themselves as less in control of their working hours, than permanent workers (β = .27). However, they also reported lower levels of work intensity (β = .25) and working hours (β = .38). The effects of low hours control (β = .20), work intensity (β = .29), and excessive hours (β = .39) on work-life conflict (r² = .50), and subsequent health effects (r² = .30), are illustrated in the final structural equation model.

  4. Initial Concept for Terminal Area Conflict Detection, Alerting, and Resolution Capability on or Near the Airport Surface

    NASA Technical Reports Server (NTRS)

    Green, David F.; Otero, Sharon D.; Barker, Glover D.; Jones, Denise R.

    2009-01-01

    The Next Generation Air Transportation System (NextGen) concept for 2025 envisions the movement of large numbers of people and goods in a safe, efficient, and reliable manner. The NextGen will remove many of the constraints in the current air transportation system, support a wider range of operations, and deliver an overall system capacity up to 3 times that of current operating levels. In order to achieve the NextGen vision, research is necessary in the areas of surface traffic optimization, maximum runway capacity, reduced runway occupancy time, simultaneous single runway operations, and terminal area conflict prevention, among others. The National Aeronautics and Space Administration (NASA) is conducting Collision Avoidance for Airport Traffic (CAAT) research to develop technologies, data, and guidelines to enable Conflict Detection and Resolution (CD&R) in the Airport Terminal Maneuvering Area (ATMA) under current and emerging NextGen operating concepts. In this report, an initial concept for an aircraft-based method for CD&R in the ATMA is presented. This method is based upon previous NASA work in CD&R for runway incursion prevention, the Runway Incursion Prevention System (RIPS). CAAT research is conducted jointly under NASA's Airspace Systems Program, Airportal Project and the Aviation Safety Program, Integrated Intelligent Flight Deck Project.

  5. A Strategy to Develop a Concept of Peace as Conflict Resolution.

    ERIC Educational Resources Information Center

    Belden, George B.

    A teaching strategy designed to help elementary students conceptualize about peace as a process of conflict resolution is described. The Baboon Troop and Netsilik Eskimo materials of "Man: A Course of Study" provide the course content in which the students learn that cooperation is the most important ingredient in group survival.…

  6. Environmental Education in Sparsely Populated Areas: Conflicting Attitudes in Student's Conception of Environmental Issues.

    ERIC Educational Resources Information Center

    Chaib, Mohamed

    1988-01-01

    Two studies in southeastern Sweden examined rural children's conflicting attitudes toward environmental change in the local community. Following a yearlong curriculum in environmental studies, 14 fifth and sixth graders in Ramkvilla were presented with an imaginary scenario involving the construction of a new factory. Their small, somewhat idyllic…

  7. Fostering Conceptual Change by Cognitive Conflict Based Instruction on Students' Understanding of Heat and Temperature Concepts

    ERIC Educational Resources Information Center

    Baser, Mustafa

    2006-01-01

    The purpose of this study was to investigate the effectiveness of cognitive conflict based physics instruction over traditionally designed physics instruction on preservice primary school teachers at grade 2. The subjects were 82 (27 boys, 55 girls) second grade pre-service teachers in two classes. One of the classes (42 students) was randomly…

  8. Trauma in conflict and postconflict settings: contributions to health systems strengthening.

    PubMed

    Lunze, F I; Offergeld, C; Eichhorn, T; Tsorieva, Z; Esenov, C; Lunze, K

    2013-06-01

    Violent trauma does not only affect conflict and post conflict regions, but increasingly industrialized nations afflicted by violence from terror attacks. We conducted a comparative health systems analysis, assuming that that health systems with various backgrounds might learn from each other's health systems challenges caused by violent trauma. During the tragedy of Beslan in the Russian North Caucasus in September of 2004, more than 1000 children with their families were taken hostage in a school. Over three days, 334 people were killed and many more injured. While immediate trauma care was offered to all victims, many suffered from more complex injuries or from blast injuries to the ear caused by indoor bomb explosions, which were left untreated due to the lack of regional capacity for the required specialized microsurgery. Most if not all victims suffered from mental trauma as a consequence of violence, which also impacted surgical care-seeking. In April of 2013, two improvised explosive devices detonated at the Boston Marathon, killed three victims and injured 264, more than 20 of them critically. As a consequence of previous terror acts with mass casualties, local hospitals were prepared with drilling and coordination among health facilities, responders and government agencies. Some injury patterns similar to those in the North Caucasus emerged in the aftermath of the event and need to be addressed by the health system. Trauma from violent conflict and terrorism creates similar challenges to health systems. Preparedness for mass casualties requires revision and coordination of available services, and may prompt the strengthening of existing health systems. Health professionals should encourage victims' representatives and citizen groups to assist with assessing the prevalence and burden of injuries, including mental trauma, and to facilitate connecting affected patients to health care. Awareness for late trauma sequelae, including mental health trauma, is

  9. The post-war public health effects of civil conflict.

    PubMed

    Ghobarah, Hazem Adam; Huth, Paul; Russett, Bruce

    2004-08-01

    Civilian suffering from civil war extends well beyond the period of active warfare. We examine longer-term effects in a cross-national analysis of World Health Organization data on death and disability broken down by age, gender, and type of disease or condition. We find substantial long-term effects, even after controlling for several other factors. We estimate that the additional burden of death and disability incurred in 1999 alone, from the indirect and lingering effects of civil wars in the years 1991-1997, was nearly double the number incurred directly and immediately from all wars in 1999. This impact works its way through specific diseases and conditions, and disproportionately affects women and children.

  10. Neglected diseases, civil conflicts, and the right to health.

    PubMed

    Beyrer, Chris; Villar, Juan Carlos; Suwanvanichkij, Voravit; Singh, Sonal; Baral, Stefan D; Mills, Edward J

    2007-08-18

    Neglected diseases remain one of the largest causes of disease and mortality. In addition to the difficulties in provision of appropriate drugs for specific diseases, many other factors contribute to the prevalence of such diseases and the difficulties in reducing their burden. We address the role that poor governance and politically motivated oppression have on the epidemiology of neglected diseases. We give case examples including filariasis in eastern Burma and vector-borne diseases (Chagas' disease, leishmaniasis, and yellow fever) in Colombia, we show the links between systematic human rights violations and the effects of infectious disease on health. We also discuss the role of researchers in advocating for and researching within oppressed populations.

  11. Active Ways to Teach Health Concepts in the Elementary Setting

    ERIC Educational Resources Information Center

    Gregory, Julie

    2015-01-01

    This article provides three movement-based activities for teaching health concepts to elementary school students. Two activities focus on nutrition concepts and the other focuses on teaching body systems. Diagrams are provided to show the setup of activities, as well as links for accessing materials to help implement the activities.

  12. Flexible work in call centres: Working hours, work-life conflict & health.

    PubMed

    Bohle, Philip; Willaby, Harold; Quinlan, Michael; McNamara, Maria

    2011-01-01

    Call-centre workers encounter major psychosocial pressures, including high work intensity and undesirable working hours. Little is known, however, about whether these pressures vary with employment status and how they affect work-life conflict and health. Questionnaire data were collected from 179 telephone operators in Sydney, Australia, of whom 124 (69.3%) were female and 54 (30.2%) were male. Ninety-three (52%) were permanent full-time workers, 37 (20.7%) were permanent part-time, and 49 (27.4%) were casual employees. Hypothesised structural relationships between employment status, working hours and work organisation, work-life conflict and health were tested using partial least squares modelling in PLS (Chin, 1998). The final model demonstrated satisfactory fit. It supported important elements of the hypothesised structure, although four of the proposed paths failed to reach significance and the fit was enhanced by adding a path. The final model indicated that casual workers reported more variable working hours which were relatively weakly associated with greater dissatisfaction with hours. The interaction of schedule control and variability of hours also predicted dissatisfaction with hours. Conversely, permanent workers reported greater work intensity, which was associated with both lower work schedule control and greater work-life conflict. Greater work-life conflict was associated with more fatigue and psychological symptoms. Labour market factors and the undesirability of longer hours in a stressful, high-intensity work environment appear to have contributed to the results.

  13. A concept analysis of optimality in perinatal health.

    PubMed

    Kennedy, Holly Powell

    2006-01-01

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

  14. Demilitarization of the Siachen conflict zone : concepts for implementation and monitoring.

    SciTech Connect

    Kanwal, Gurmeet; Hakeem, Asad; Vannoni, Michael Geoffrey; Rajen, Gaurav

    2007-09-01

    Pakistani and Indian militaries have been occupying the Siachen Glacier and surrounding regions for decades. Although a cease-fire is in place, continued occupation carries the risk of an inadvertent conflict, which could escalate into a full-fledged nuclear-backed confrontation. Political and military analysts in Pakistan and India now question the strategic significance of the Siachen Glacier and agree that under the right circumstances, military withdrawal from the Siachen Glacier region would not adversely affect either state. The difficulty lies in conducting the withdrawal in such a way that neither side feels vulnerable, and in maintaining the demilitarization in a way that can be verified. In this paper, the authors who have both held command responsibilities in the Siachen Glacier region present a process for conducting and verifying the demilitarization of the Siachen Glacier region. The authors discuss the role of monitoring and verification tools and their relevance to this border zone of conflict.

  15. Coal mining, social injustice and health: a universal conflict of power and priorities.

    PubMed

    Morrice, Emily; Colagiuri, Ruth

    2013-01-01

    Given the current insatiable demand for coal to build and fuel the world's burgeoning cities the debate about mining-related social, environmental and health injustices remains eminently salient. Furthermore, the core issues appear universally consistent. This paper combines the theoretical base for defining these injustices with reports in the international health literature about the impact of coal mining on local communities. It explores and analyses mechanisms of coal mining related injustice, conflicting priorities and power asymmetries between political and industry interests versus inhabitants of mining communities, and asks what would be required for considerations of health to take precedence over wealth.

  16. The mental health of civilians displaced by armed conflict: an ecological model of refugee distress.

    PubMed

    Miller, K E; Rasmussen, A

    2016-04-04

    Early research on the mental health of civilians displaced by armed conflict focused primarily on the direct effects of exposure to war-related violence and loss. Largely overlooked in this war exposure model were the powerful effects of ongoing stressors related to the experience of displacement itself. An ecological model of refugee distress is proposed, drawing on research demonstrating that mental health among refugees and asylum seekers stems not only from prior war exposure, but also from a host of ongoing stressors in their social ecology, or displacement-related stressors. Implications of this model for addressing the mental health and psychosocial needs of refugees and other displaced populations are considered.

  17. Species concepts should not conflict with evolutionary history, but often do.

    PubMed

    Velasco, Joel D

    2008-12-01

    Many phylogenetic systematists have criticized the Biological Species Concept (BSC) because it distorts evolutionary history. While defences against this particular criticism have been attempted, I argue that these responses are unsuccessful. In addition, I argue that the source of this problem leads to previously unappreciated, and deeper, fatal objections. These objections to the BSC also straightforwardly apply to other species concepts that are not defined by genealogical history. What is missing from many previous discussions is the fact that the Tree of Life, which represents phylogenetic history, is independent of our choice of species concept. Some species concepts are consistent with species having unique positions on the Tree while others, including the BSC, are not. Since representing history is of primary importance in evolutionary biology, these problems lead to the conclusion that the BSC, along with many other species concepts, are unacceptable. If species are to be taxa used in phylogenetic inferences, we need a history-based species concept.

  18. Understanding resilience in armed conflict: Social resources and mental health of children in Burundi

    PubMed Central

    Hall, Brian J.; Tol, Wietse A.; Jordans, Mark J.D.; Bass, Judith; de Jong, Joop T.V.M.

    2014-01-01

    Little is known about the role of cognitive social capital among war-affected youth in low- and middle-income countries. We examined the longitudinal association between cognitive social capital and mental health (depression and posttraumatic stress disorder (PTSD) symptoms), functioning, and received social support of children in Burundi. Data were obtained from face-to-face interviews with 176 children over three measurement occasions over the span of 4-months. Cognitive social capital measured the degree to which children believed their community was trustworthy and cohesive. Mental health measures included the Depression Self-Rating Scale (DSRS) (Birleson, 1981), the Child Posttraumatic Symptom Scale (Foa, Johnson, & Feeny, 2001), and a locally constructed scale of functional impairment. Children reported received social support by listing whether they received different types of social support from self-selected key individuals. Cross-lagged path analytic modeling evaluated relationships between cognitive social capital, symptoms and received support separately over baseline (T1), 6-week follow-up (T2), and 4-month follow-up (T3). Each concept was treated and analyzed as a continuous score using manifest indicators. Significant associations between study variables were unidirectional. Cognitive social capital was associated with decreased depression between T1 and T2 (B=−0.22, p<.001) and T2 and T3 (β=−0.25, p<.001), and with functional impairment between T1 and T2 (β=−0.15, p=.005) and T2 and T3 (β=−0.14, p=.005); no association was found for PTSD symptoms at either time point. Cognitive social capital was associated with increased social support between T1 and T2 (β=0.16, p=.002) and T2 and T3 (β=0.16, p=.002). In this longitudinal study, cognitive social capital was related to a declining trajectory of children’s mental health problems and increases in social support. Interventions that improve community relations in war-affected communities

  19. Work–family conflict and self-rated health among Japanese workers: How household income modifies associations

    PubMed Central

    Kobayashi, Tomoko; Honjo, Kaori; Eshak, Ehab Salah; Iso, Hiroyasu; Sawada, Norie; Tsugane, Shoichiro

    2017-01-01

    To examine associations between work–family conflict and self-rated health among Japanese workers and to determine whether the associations differed by household income. Data was derived from the Japan Public Health Center-based Prospective Study for the Next Generation in Saku area in 2011–2012 (7,663 men and 7,070 women). Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health by work–family conflict consisting of two dimensions (work-to-family and family-to-work conflicts) were calculated by gender and household income. Multivariate ORs of high work-to-family and family-to-work conflicts for poor self-rated health were 2.46 (95% CI; 2.04–2.97) for men and 3.54 (95% CI; 2.92–4.30) for women, with reference to the low work-to-family and family-to-work conflicts (p-value for gender interaction = 0.02). Subgroup analysis indicated that health effects of work–family conflict were likely to be more evident in the low income group only among women. Work–family conflict was associated with poor self-rated health among middle-aged Japanese men and women; its health impact was relatively stronger among women, and particularly economically disadvantaged women. PMID:28207757

  20. Corporate philanthropy and conflicts of interest in public health: ExxonMobil, Equatorial Guinea, and malaria.

    PubMed

    Shah, Naman K

    2013-01-01

    Equatorial Guinea, the most prosperous country in Africa, still bears a large malaria burden. With massive wealth from oil reserves, and nearly half its population living in island ecotypes favourable for malaria control, only poor governance can explain continued parasite burden. By financially backing the country's dictator and other officials through illicit payments, the oil company ExxonMobil contributed to the state's failure. Now ExxonMobil, having helped perpetuate malaria in Equatorial Guinea, gives money to non-governmental organizations, charitable foundations, and universities to advocate for and undertake malaria work. How, and on what terms, can public health engage with such an actor? We discuss challenges in the identification and management of conflicts of interest in public health activities. We reviewed the business and foundation activities of ExxonMobil and surveyed organizations that received ExxonMobil money about their conflict of interest policies. Reforms in ExxonMobil's business practices, as well as its charitable structure, and reforms in the way public health groups screen and manage conflicts of interest are needed to ensure that any relationship ultimately improves the health of citizens.

  1. [Analysis of dental students' knowledge and concepts in oral health: evaluation by concept maps].

    PubMed

    Struchiner, M; Vieira, A R; Ricciardi, R M

    1999-11-01

    This study sought to analyze senior dental students' cognitive structure concerning the topic of "enamel", which is fundamentally important for understanding oral health, since it offers basic scientific concepts for clinical and preventive practices and is the main subject of several courses during dentistry training. The strategy used to analyze students' cognitive structures was Novak's Concept Maps, based on Ausubel's Meaningful Learning theory. Analysis of students' maps allowed for a study of students' cognitive structure and concepts concerning oral health. It also fostered a diagnosis of students' knowledge in several important aspects of scientific and professional training. The results highlighted the need for rethinking the teaching/learning process in dentistry training.

  2. Maternal health care amid political unrest: the effect of armed conflict on antenatal care utilization in Nepal.

    PubMed

    Price, James I; Bohara, Alok K

    2013-05-01

    Armed conflicts, which primarily occur in low- and middle-income countries, have profound consequences for the health of affected populations, among them a decrease in the utilization of maternal health care services. The quantitative relationship between armed conflict and maternal health care utilization has received limited attention in the public health literature. We evaluate this relationship for a particular type of health care service, antenatal care, in Nepal. Using count regression techniques, household survey data and sub-national conflict data, we find a negative correlation between the number of antenatal care visits and incidents of conflict-related violence within a respondent's village development committee. Specifically, we find that under high-intensity conflict conditions women receive between 0.3 and 1.5 fewer antenatal care check-ups. These findings imply that maternal health care utilization is partially determined by characteristics of the social environment (e.g. political instability) and suggest health care providers need to revise maternal health strategies in conflict-affected areas. Strategies may include decentralization of services, maintaining neutrality among factions, strengthening community-based health services and developing mobile clinics.

  3. Global health in conflict. Understanding opposition to vitamin A supplementation in India.

    PubMed

    Wallace, Sarah K

    2012-07-01

    Vitamin A supplementation is a public health intervention that clinical trials have suggested can significantly improve child survival in the developing world. Yet, prominent scientists in India have questioned its scientific validity, opposed its implementation, and accused its advocates of corruption and greed. It is ironic that these opponents were among the pioneers of populationwide vitamin A supplementation for ocular health. Historically, complex interests have shaped vitamin A supplementation resistance in India. Local social and nutritional revolutions and shifting international paradigms of global health have played a role. Other resistance movements in Indian history, such as those in response to campaigns for bacillus Calmette-Guérin and novel vaccines, have been structured around similar themes. Public health resistance is shaped by the cultural and political context in which it develops. Armed with knowledge of the history of a region and patterns of past resistance, public health practitioners can better understand how to negotiate global health conflicts.

  4. Food and beverage industries' participation in health scientific events: considerations on conflicts of interest.

    PubMed

    Canella, Daniela S; Martins, Ana Paula B; Silva, Hugo F R; Passanha, Adriana; Lourenço, Bárbara H

    2015-10-01

    Several sectors of the industry (pharmaceutical, food, and other) often occupy a prominent position in scientific meetings on health. The aim of this article is to discuss the participation of food and beverage industries (Big Food and Big Soda) in events organized by scientific institutions in health and nutrition, highlighting potential conflicts of interest in such partnerships. As an example, the authors report the case of a Brazilian national event organized by a nutrition scientific association in 2011. Focused on the theme "Evidence-based Nutrition," the event's scientific program was largely influenced by corporate sponsors. For example, a symposium at this congress was organized by a beverage company known worldwide for its sugar-sweetened products and classified as the "diamond sponsor" of the event. While debating the adoption of healthy lifestyles in the current scenario of rising occurrence of obesity, the rationale for health promotion was reduced to providing information that would motivate rational individual choices, thus ignoring any political, economic, cultural, marketing, and social factors involved in the global process of nutrition transition. The authors conclude that conflicts of interest are present in the participation of food and beverage industries in health scientific events. The industries' strategy attempts to grant legitimacy to the production and marketing of their products through an association with adequate health practices. Health professionals and policy-makers should reflect on such partnerships because their main purpose is to generate profit, not the promotion of public health.

  5. Work–family conflict as a mediator between occupational stress and psychological health among mental health nurses in Japan

    PubMed Central

    Sugawara, Norio; Danjo, Kazuma; Furukori, Hanako; Sato, Yasushi; Tomita, Tetsu; Fujii, Akira; Nakagami, Taku; Kitaoka, Kazuyo; Yasui-Furukori, Norio

    2017-01-01

    Background Occupational stress among mental health nurses may affect their psychological health, resulting in reduced performance. To provide high-quality, sustainable nursing care, it is necessary to identify and control the factors associated with psychological health among mental health nurses. The purpose of this study was to examine the role of work–family conflict (WFC) in the well-known relationship between occupational stress and psychological health among mental health nurses in Japan. Methods In this cross-sectional study, data were gathered from 180 mental health nurses who had a coresident child or were married. Data from the Work–Family Conflict Scale, the Generic Job Stress Questionnaire, the Maslach Burnout Inventory-General Survey, and the Center for Epidemiologic Studies for Depression Scale were obtained via self-report questionnaires. The effects of occupational stress and WFC on psychological health were explored by hierarchical linear regression analysis. Results The relationship between emotional exhaustion and occupational factors, including quantitative workload and the variance in workload, disappeared with the addition of WFC (each work interference with family [WIF] or family interference with work [FIW]). The relationship between emotional exhaustion and mental demands disappeared only with the addition of WIF. The relationship between depressive symptoms and variance in workload disappeared with the addition of WFC (each WIF or FIW). Conclusion Our findings may encourage hospital administrators to consider the risks of medical staff WFC. Furthermore, longitudinal investigations into the factors associated with WFC are required for administrative and psychological interventions. PMID:28331330

  6. Psychometrics of the Laffrey Health Conception Scale for adolescents.

    PubMed

    Yarcheski, Adela; Mahon, Noreen E; Yarcheski, Thomas J

    2005-01-01

    The purposes of this methodological study were to factor analyze the Laffrey Health Conception Scale (LHCS) and to assess construct validity of the instrument with early adolescents. The final sample consisted of 230 early adolescents, aged 12 to 14, who responded to instrument packets in classrooms in an urban middle school. Data obtained on the LHCS were subjected to principal components factor analysis with oblique rotation. A two-factor solution was accepted, which is consistent with early adolescents' conceptions of health. Factor I was labeled Wellness and Factor II was labeled Clinical Health. A higher order factor analysis yielded one factor with 26 items, labeled the LHCS for Early Adolescents. The 26-item LHCS had a coefficient alpha of .95. Construct validity was assessed by testing three theoretical propositions, which significantly linked health conception to social support, self-esteem, and positive health practices. The findings indicate that the LHCS is a reliable and valid measure of health conceptions in early adolescents. Results also offer flexibility to researchers interested in testing theory involving the constructs of the definition of health, wellness, and clinical health in early adolescents.

  7. Health Maintenance Organization: Concept and Functions. Conference Proceedings.

    ERIC Educational Resources Information Center

    Hornback, May, Ed.

    The proceedings published in the document are the outcomes from a conference to consider the role of professional nursing in relation to health maintenance organizations (HMOs) as one possible way to improve health care delivery. Emphasis is placed on strategies underlying the HMO concept and reviewing and extending understanding of factors which…

  8. Empirical application of empathy enhancing program based on movement concept for married couples in conflict

    PubMed Central

    Kim, Soo-Yeon; Kang, Hye-Won; Chung, Yong-Chul; Park, Seungha

    2013-01-01

    In the field of marital therapy, it is known that couple movement program helps married couples faced with conflict situation to rebuild the relationship and to maintain a family homeostasis. The purpose of this study was to configure and apply the kinesthetic empathy program and to assess the effectiveness for married couples in conflict. To achieve the research aims, qualitative research method has been conducted, subjecting three couples, 6 people, who are participating in expressive movement program for this study. The study used focus group interview method for collecting date and employed for the interview method by mixing the semi-structured and unstructured questionnaire. The results were followings. First, through kinesthetic empathy enhancing program, one could develop self-awareness and emotional attunement. Second, the result showed the relationship between intention and empathy. It shows that “knowing spouse’s hidden intention” is significant factors to understand others. Third, kinesthetic empathy program could complement general marriage counseling program. The results of this study provide empirical evidence that movement program functions as an empathy enhancer through the process of perceiving, feeling, thinking, and interacting with others. PMID:24278896

  9. Cognitive Factors in Fibromyalgia: The Role of Self-Concept and Identity Related Conflicts

    PubMed Central

    Compañ, Victoria; Feixas, Guillem; Varlotta-Domínguez, Nicolás; Torres-Viñals, Mercedes; Aguilar-Alonso, Ángel; Dada, Gloria; Ángel Saúl, Luís

    2010-01-01

    Fibromyalgia is a syndrome characterized by the presence of diffuse and chronic musculoskeletal pain of unknown etiology. Clinical diagnosis and the merely palliative treatments considerably affect the patient's experience and the chronic course of the disease. Therefore, several authors have emphasized the need to explore issues related to self in these patients. The repertory grid technique (RGT), derived from personal construct theory, is a method designed to assess the patient's construction of self and others. A group of women with fibromyalgia (n = 30) and a control group (n = 30) were assessed using RGT. Women with fibromyalgia also completed the Fibromyalgia Impact Questionnaire and a visualanalogue scale for pain, and painful tender points were explored. Results suggest that these women had a higher present self–ideal self discrepancy and a lower perceived adequacy of others, and it was more likely to find implicative dilemmas among them compared to controls. These dilemmas are a type of cognitive conflict in which the symptom is construed as “enmeshed” with positive characteristics of the self. Finally, implications of these results for the psychological treatment of fibromyalgia are suggested to give a more central role to self-identity issues and to the related cognitive conflicts. PMID:22629110

  10. Support of public–private partnerships in health promotion and conflicts of interest

    PubMed Central

    Hernandez-Aguado, Ildefonso; Zaragoza, G A

    2016-01-01

    Objectives Public–private partnerships (PPPs) are considered key elements in the development of effective health promotion. However, there is little research to back the enthusiasm for these partnerships. Our objective was to describe the diversity of visions on PPPs and to assess the links between the authors and corporations engaged in such ventures. Methods We reviewed the scientific literature through PubMed in order to select all articles that expressed a position or recommendation on governments and industries engaging in PPPs for health promotion. We included any opinion paper that considered agreements between governments and corporations to develop health promotion. Papers that dealt with healthcare provision or clinical preventive services and those related to tobacco industries were excluded. We classified the articles according to the authors' position regarding PPPs: strongly agree, agree, neutral, disagree and strongly disagree. We related the type of recommendation to authors' features such as institution and conflicts of interest. We also recorded whether the recommendations were based on previous assessments. Results Of 46 papers analysed, 21 articles (45.6%) stated that PPPs are helpful in promoting health, 1 was neutral and 24 (52.1%) were against such collaborations. 26 papers (57%) set out conditions to assure positive outcomes of the partnerships. Evidence for or against PPPs was mentioned in 11 papers that were critical or neutral (44%) but not in any of those that advocated collaboration. Where conflicts were declared (26 papers), absence of conflicts was more frequent in critics than in supporters (86% vs 17%). Conclusions Although there is a lack of evidence to support PPPs for health promotion, many authors endorse this approach. The prevalence of ideas encouraging PPPs can affect the intellectual environment and influence policy decisions. Public health researchers and professionals must make a contribution in properly framing the PPP

  11. Public health week: marketing the concept of public health.

    PubMed

    Evans, C A; Margolis, L A

    1992-01-01

    The Public Health Programs and Services (PHP&S) Branch of the Los Angeles County Department of Health Services began a strategic planning effort in January 1986 to meet new disease trends, curb rising health care costs, consolidate limited resources, and handle shifting demographics. A strategic plan was designed to assess the opportunities and challenges facing the agency over a 5-year horizon. Priority areas were recognized, and seven strategic directives were formulated to guide PHP&S in expanding public health services to a changing community. Health promotion was acknowledged as a critical target of the strategic planning process. Among the most significant results of the health promotion directive was the establishment of an annual Public Health Week in Los Angeles County. Beginning in 1988, 1 week per year was selected to enhance the community's awareness of public health programs and the leadership role PHP&S plays in providing these programs to nearly 9 million residents of Los Angeles County. Events in Public Health Week include a professional lecture series and the honoring of an outstanding public health activist and a media personality who has fostered health promotion. Other free community activities such as mobile clinics, screenings, and health fairs are held throughout the county. With intensive media coverage of Public Health Week, PHP&S has been aggressive in promoting its own services and accomplishments while also educating the community on vital wellness issues. The strategic methodology employed by PHP&S, with its emphasis on long-range proactive planning, is receiving national recognition and could be adopted by similar agencies wishing to enhance their image and develop unique health promotion projects in their communities.

  12. Values in Health Policy – A Concept Analysis

    PubMed Central

    Shams, Lida; Akbari Sari, Ali; Yazdani, Shahram

    2016-01-01

    Background: Despite the significant role "values" play in decision-making no definition or attributes regarding the concept have been provided in health policy-making. This study aimed to clarify the defining attributes of a concept of value and its irrelevant structures in health policy-making. We anticipate our findings will help reduce the semantic ambiguities associated with the use of "values" and other concepts such as principles, criteria, attitudes, and beliefs. Methods: An extensive search of literature was carried out using electronic data base and library. The overall search strategy yielded about 1540 articles and 450 additional records. Based on traditional qualitative research, studies were purposefully selected and the coding of articles continued until data saturation was reached. Accordingly, 31 articles, 2 books, and 5 other documents were selected for the review. We applied Walker and Avant’s method of concept analysis in studying the phenomenon. Definitions, applications, attributes, antecedents, and consequences of the concept of "value in health policy-making" were extracted. We also identified similarities and differences that exist between and within them. Results: We identified eight major attributes of "value in health policy-making": ideological origin, affect one’s choices, more resistant to change over time, source of motivation, ability to sacrifice one’s interest, goal-oriented nature for community, trans-situational and subjectivity. Other features pinpointed include alternatives, antecedents, and consequences. Alternative, antecedents and consequences case may have more or fewer attributes or may lack one of these attributes and at the same time have other distinctive ones. Conclusion: Despite the use of the value framework, ambiguities still persist in providing definition of the concept value in health policy-making. Understanding the concept of value in health policy-making may provide extra theoretical support to decision

  13. Current concepts on airborne particles and health

    SciTech Connect

    Mauderly, J.L.

    1994-11-01

    Epidemiological evidence of associations between environmental particulate concentrations and both acute and chronic health effects has grown with numerous recent studies conducted in the US and other countries. An association between short-term changes in particulate levels and acute mortality now seems certain. The association is consistent among studies and coherent among indicators of mortality and morbidity. Effects observed at surprisingly low pollution levels have raised concern for current exposures even in modestly polluted cities. Toxicology did not predict the acute mortality effect, and causal mechanisms are difficult to rationalize. Present data suggest that the fine fraction of particulate pollution is more toxic than larger particles, but the contribution of specific particulate species is poorly understood.

  14. Politics and technology in health information systems development: a discourse analysis of conflicts addressed in a systems design group.

    PubMed

    Irestig, Magnus; Timpka, Toomas

    2008-02-01

    Different types of disagreements must be managed during the development of health information systems. This study examines the antagonisms discussed during the design of an information system for 175,000 users in a public health context. Discourse analysis methods were used for data collection and analysis. Three hundred and twenty-six conflict events were identified from four design meetings and divided into 16 categories. There were no differences regarding the types of conflicts that the different participants brought into the design discussions. Instead, conflict occurrence was primarily affected by the agendas that set the stage for examinations and debates. The results indicate that the selection of design method and the structure used for the meetings are important factors for the manner in which conflicts are brought into consideration during health information system design. Further studies comparing participatory and non-participatory information system design practices in health service settings are warranted.

  15. Expanding the psychosocial work environment: workplace norms and work-family conflict as correlates of stress and health.

    PubMed

    Hammer, Tove Helland; Saksvik, Per Øystein; Nytrø, Kjell; Torvatn, Hans; Bayazit, Mahmut

    2004-01-01

    This study examined the contributions of organizational level norms about work requirements and social relations, and work-family conflict, to job stress and subjective health symptoms, controlling for Karasek's job demand-control-support model of the psychosocial work environment, in a sample of 1,346 employees from 56 firms in the Norwegian food and beverage industry. Hierarchical linear modeling analyses showed that organizational norms governing work performance and social relations, and work-to-family and family-to-work conflict, explained significant amounts of variance for job stress. The cross-level interaction between work performance norms and work-to-family conflict was also significantly related to job stress. Work-to-family conflict was significantly related to health symptoms, but family-to-work conflict and organizational norms were not.

  16. Politics and Power in Global Health: The Constituting Role of Conflicts

    PubMed Central

    Askheim, Clemet; Heggen, Kristin; Engebretsen, Eivind

    2016-01-01

    In a recent article, Gorik Ooms has drawn attention to the normative underpinnings of the politics of global health. We claim that Ooms is indirectly submitting to a liberal conception of politics by framing the politics of global health as a question of individual morality. Drawing on the theoretical works of Chantal Mouffe, we introduce a conflictual concept of the political as an alternative to Ooms’ conception. Using controversies surrounding medical treatment of AIDS patients in developing countries as a case we underline the opportunity for political changes, through political articulation of an issue, and collective mobilization based on such an articulation. PMID:26927399

  17. Genomic conflicts and sexual antagonism in human health: insights from oxytocin and testosterone.

    PubMed

    Mokkonen, Mikael; Crespi, Bernard J

    2015-04-01

    We review the hypothesized and observed effects of two of the major forms of genomic conflicts, genomic imprinting and sexual antagonism, on human health. We focus on phenotypes mediated by peptide and steroid hormones (especially oxytocin and testosterone) because such hormones centrally mediate patterns of physical and behavioral resource allocation that underlie both forms of conflict. In early development, a suite of imprinted genes modulates the human oxytocinergic system as predicted from theory, with paternally inherited gene expression associated with higher oxytocin production, and increased solicitation to mothers by infants. This system is predicted to impact health through the incompatibility of paternal-gene and maternal-gene optima and increased vulnerability of imprinted gene systems to genetic and epigenetic changes. Early alterations to oxytocinergic systems have long-term negative impacts on human psychological health, especially through their effects on attachment and social behavior. In contrast to genomic imprinting, which generates maladaptation along an axis of mother-infant attachment, sexual antagonism is predicted from theory to generate maladaptation along an axis of sexual dimorphism, modulated by steroid and peptide hormones. We describe evidence of sexual antagonism from studies of humans and other animals, demonstrating that sexually antagonistic effects on sex-dimorphic phenotypes, including aspects of immunity, life history, psychology, and behavior, are commonly observed and lead to forms of maladaptation that are demonstrated, or expected, to impact human health. Recent epidemiological and psychiatric studies of schizophrenia in particular indicate that it is mediated, in part, by sexually antagonistic alleles. The primary implication of this review is that data collection focused on (i) effects of imprinted genes that modulate the oxytocin system, and (ii) effects of sexually antagonistic alleles on sex-dimorphic, disease

  18. Genomic conflicts and sexual antagonism in human health: insights from oxytocin and testosterone

    PubMed Central

    Mokkonen, Mikael; Crespi, Bernard J

    2015-01-01

    We review the hypothesized and observed effects of two of the major forms of genomic conflicts, genomic imprinting and sexual antagonism, on human health. We focus on phenotypes mediated by peptide and steroid hormones (especially oxytocin and testosterone) because such hormones centrally mediate patterns of physical and behavioral resource allocation that underlie both forms of conflict. In early development, a suite of imprinted genes modulates the human oxytocinergic system as predicted from theory, with paternally inherited gene expression associated with higher oxytocin production, and increased solicitation to mothers by infants. This system is predicted to impact health through the incompatibility of paternal-gene and maternal-gene optima and increased vulnerability of imprinted gene systems to genetic and epigenetic changes. Early alterations to oxytocinergic systems have long-term negative impacts on human psychological health, especially through their effects on attachment and social behavior. In contrast to genomic imprinting, which generates maladaptation along an axis of mother–infant attachment, sexual antagonism is predicted from theory to generate maladaptation along an axis of sexual dimorphism, modulated by steroid and peptide hormones. We describe evidence of sexual antagonism from studies of humans and other animals, demonstrating that sexually antagonistic effects on sex-dimorphic phenotypes, including aspects of immunity, life history, psychology, and behavior, are commonly observed and lead to forms of maladaptation that are demonstrated, or expected, to impact human health. Recent epidemiological and psychiatric studies of schizophrenia in particular indicate that it is mediated, in part, by sexually antagonistic alleles. The primary implication of this review is that data collection focused on (i) effects of imprinted genes that modulate the oxytocin system, and (ii) effects of sexually antagonistic alleles on sex-dimorphic, disease

  19. Reproductive health concerns in six conflict-affected areas of Sri Lanka.

    PubMed

    Kottegoda, Sepali; Samuel, Kumudini; Emmanuel, Sarala

    2008-05-01

    This article draws on a study conducted by the Women and Media Collective between 2004 and 2005 to highlight some of the reproductive health concerns of women from Sinhalese, Tamil and Muslim ethnic groups, living in situations of conflict in Sri Lanka. The study focussed on women from six conflict-affected areas in the north and east of the country: Jaffna (Northern Province), Mannar and Puttalam (North-Western Province), Polonnaruwa (North-Central Province), Batticaloa and Ampara (Eastern Province). Higher levels of poverty, higher rates of school drop-out, low pay and precarious access to work, mainly in the informal sector, higher rates of early marriage, pregnancy and home births, higher levels of maternal mortality and lower levels of contraceptive use were found. Economic, social and physical insecurity were key to these phenomena. Physically and psychologically, women were at high risk of sexual and physical violence, mainly from their partners/spouses but also from family members, often related to dowry. The article brings out the voices of women whose lives have been overshadowed by conflict and displacement, and the nature of structural barriers that impede their right to health care services, to make informed decisions about their lives and to live free of familial violence.

  20. Wars and Child Health: Evidence from the Eritrean-Ethiopian Conflict *

    PubMed Central

    Akresh, Richard; Lucchetti, Leonardo; Thirumurthy, Harsha

    2012-01-01

    Conflict between and within countries can have lasting health and economic consequences, but identifying such effects can be empirically challenging. This paper uses household survey data from Eritrea to estimate the effect of exposure to the 1998–2000 Eritrea-Ethiopia war on children’s health. The identification strategy exploits exogenous variation in the conflict’s geographic extent and timing and the exposure of different birth cohorts to the fighting. The unique survey data include details on each household’s migration history, which allows us to measure a child’s geographic location during the war and without which war exposure would be incorrectly classified. War-exposed children have lower height-for-age Z-scores, with similar effects for children born before or during the war. Both boys and girls who are born during the war experience negative impacts due to conflict. Effects are robust to including region-specific time trends, alternative conflict exposure measures, and mother fixed effects. PMID:22962514

  1. Towards responsible system development in health services: a discourse analysis study of design conflict resolution tactics.

    PubMed

    Irestig, Magnus; Timpka, Toomas

    2010-02-01

    We set out to examine design conflict resolution tactics used in development of large information systems for health services and to outline the design consequences for these tactics. Discourse analysis methods were applied to data collected from meetings conducted during the development of a web-based system in a public health context. We found that low risk tactics were characterized by design issues being managed within the formal mandate and competences of the design group. In comparison, high risk tactics were associated with irresponsible compromises, i.e. decisions being passed on to others or to later phases of the design process. The consequence of this collective disregard of issues such as responsibility and legitimacy is that the system design will be impossible to implement in factual health service contexts. The results imply that downstream responsibility issues have to be continuously dealt with in system development in health services.

  2. An overview of concept mapping in Dutch mental health care.

    PubMed

    Nabitz, Udo; van Randeraad-van der Zee, Carlijn; Kok, Ineke; van Bon-Martens, Marja; Serverens, Peter

    2017-02-01

    About 25 years ago, concept mapping was introduced in the Netherlands and applied in different fields. A collection of concept mapping projects conducted in the Netherlands was identified, in part in the archive of the Netherlands Institute of Mental Health and Addiction (Trimbos Institute). Some of the 90 identified projects are internationally published. The 90 concept mapping projects reflect the changes in mental health care and can be grouped into 5-year periods and into five typologies. The studies range from conceptualizing the problems of the homeless to the specification of quality indicators for treatment programs for patients with cystic fibrosis. The number of concept mapping projects has varied over time. Growth has been considerable in the last 5 years compared to the previous 5 years. Three case studies are described in detail with 12 characteristics and graphical representations. Concept mapping aligns well with the typical Dutch approach of the "Poldermodel." A broad introduction of concept mapping in European countries in cooperation with other countries, such as the United States and Canada, would strengthen the empirical basis for applying this approach in health care policy, quality, and clinical work.

  3. Equality and Human Capital: Conflicting Concepts within State-Funded Adult Education in Ireland

    ERIC Educational Resources Information Center

    Hurley, Kevin

    2015-01-01

    This article offers a critique of the concept of equality as it informs the White Paper on Adult Education: Learning for Life (2000). It also outlines the extent to which human capital theory can be seen to have effectively colonised lifelong learning from the outset of its adoption by the European Union with highly constraining implications for…

  4. Implementing a Basic Package of Health Services in post-conflict Liberia: perceptions of key stakeholders.

    PubMed

    Petit, Dörte; Sondorp, Egbert; Mayhew, Susannah; Roura, Maria; Roberts, Bayard

    2013-02-01

    Recovery of the health sector in post-conflict countries is increasingly initiated through a Basic Package of Health Services (BPHS) approach. The country government and partners, including international donors, typically contract international and local NGOs to deliver the BPHS. Evidence from routine data suggests that a BPHS approach results in rapid increases in service coverage, coordination, equity, and efficiency. However, studies also show progress may then slow down, the cause of which is not immediately obvious from routine data. Qualitative research can provide insight into possible barriers in the implementation process, particularly the role of health workers delivering the BPHS services. The aim of this study was to explore perceptions of health service providers and policy makers on the implementation of the BPHS in post-conflict Liberia, using SRH services as a tracer and Lipsky's work on "street-level bureaucrats" as a theoretical framework. In July-October 2010, 63 interviews were conducted with midwives, officers-in-charge, and supervisors in two counties of Liberia, and with policy makers in Monrovia. The findings suggest health workers had a limited understanding of the BPHS and associated it with low salaries, difficult working conditions, and limited support from policy makers. Health workers responded by sub-optimal delivery of certain services (such as facility-based deliveries), parallel private services, and leaving their posts. These responses risk distorting and undermining the BPHS implementation. There were also clear differences in the perspectives of health workers and policy makers on the BPHS implementation. The findings suggest the need for greater dialogue between policy makers and health workers to improve understanding of the BPHS and recognition of the working conditions in order to help achieve the potential benefits of the BPHS in Liberia.

  5. Mental health promotion: concepts and strategies for reaching the population.

    PubMed

    Jané-Llopis, Eva

    2007-12-01

    There have been many attempts to define mental health promotion. To date, there is no consensus in the field as to what it entails. While some understand it as a holistic concept including intervening at structural, societal and political levels to positively influence mental health, others conceptualise it basically as strategies with an individual focus to improve personal competencies. Many of these differences are related to the distinct understanding of the concepts of mental well-being and positive mental health. The lack of clarity on the boundaries of mental health promotion has divided professionals and is a missed opportunity, as momentum is moving mental health promotion on to political agendas. In Europe, two important milestones for mental health, the WHO Ministerial Conference and the EC Green Paper on Mental Health, have moved mental health promotion into the political landscape, recognising positive mental health and mental well-being as fundamental to the quality of life and productivity of Europeans and a contributor to sustainable development. Although proven efficacious, ad hoc implementation of mental health promotion programs alone is not sufficient to ensure improvement of the population's mental health. Co-ordinated action that includes efficient ways to deliver such interventions in a sustainable way is essential. Two such delivery mechanisms in the search for efficiency are discussed in this paper: a) identifying co-occurrence of mental and physical health problems in order to include mental health promotion components into existing health promotion interventions; and, b) supporting the inclusion of mental health indicators into sound public policy options in order to prove that efficacious policies in labour, education, environment, etc, also bring about positive mental health outcomes. To support the current interest to bring about positive mental health it is essential that evaluation of existing initiatives is put in place, as well as

  6. Relationships among nurses' professional self-concept, health, and lifestyles.

    PubMed

    Hensel, Desiree

    2011-02-01

    According to the American Nurses Association, the entire profession of nursing exists to serve and improve society's health. Thus, to become a nurse, individuals must master a body of knowledge surrounding numerous health aspects. While acquiring the unique knowledge, skills, and values of their profession, nurses form perceptions of personal adequacy in their role, known as professional or nurse self-concept. Given the centrality of health to the profession, it would seem logical that nurses would personally value health and integrate core health behaviors into their professional self-concept and everyday lives. Yet the prevailing evidence leaves in question whether nurses associate their personal health and lifestyles with their professional roles. This article explores the relationships among nurse self-concept, health status, and healthy lifestyle practices in a sample of Midwestern nurses in an attempt to better understand if nurses who integrate healthy behaviors into their everyday lives feel a stronger sense of professional adequacy relative to nurses who do not.

  7. Concept of Educational Assistance to Health Protection of the Individual

    PubMed Central

    Levanova, Elena Aleksandrovna; Kokorina, Olga Rafailovna; Nikitin, Yuriy Vladimirovich; Perepelkina, Tatiyna Vladislavovna; Segodina, Polina Anatolievna

    2016-01-01

    The article describes the theoretical and practical need for the development of the concept of assistance to health protection of the individual in order to address the problem of health protection of students and teachers in the conditions of a higher pedagogical education. The problem of studying human health, its entirety, systemacity and connection with the environment attracts particular attention in recent years. This was one of the reasons to study the problem of “healthy lifestyle” as the qualitative characteristic of a human life aimed at health, due to the fact that a healthy lifestyle is one of the determinants of health. This is made possible with the use of specific health-protecting technologies aimed at searching for ways and means of protection and conservation of health of students and teachers in the conditions of the educational process and using educational tools, which is currently included into the priorities of education. PMID:26493439

  8. [The concept of health in the General Health Law (1986)].

    PubMed

    Peral, D

    1993-01-01

    The 1986 "Le General de Sanidad" (Sanitary General Regulations) has been studied using the method of the "Topología del Discurso" in order to elucidate what are the thoughts of the lawmakers. The law protects not only the population of catastrophes as it happened with the choleric epidemic of the XIX century, but considers a new concept a sanitary wealth should be provided to the individuals. Together with this new concept there are new ones such as equality and universalization of the sanitary assistence that would be keys of the aim of the lawmakers: to coordinate all the State resources in the reform of the spanish sanity. This includes the integration of the Universities. This can help in the understanding of the dificulties in the development and aplication of the Law present reality.

  9. Relations of parenting quality, interparental conflict, and overnights with mental health problems of children in divorcing families with high legal conflict.

    PubMed

    Sandler, Irwin N; Wheeler, Lorey A; Braver, Sanford L

    2013-12-01

    The current study examined the associations between child mental health problems and the quality of maternal and paternal parenting, and how these associations were moderated by three contextual factors: quality of parenting by the other parent, interparental conflict, and the number of overnights parents had with the child. Data for the current study came from a sample of divorcing families who are in high legal conflict over developing or maintaining a parenting plan following divorce. Analyses revealed that the associations between child mental health problems and positive maternal and paternal parenting were moderated by the quality of parenting provided by the other parent and by the number of overnights children spent with parents, but not by the level of interparental conflict. When parenting by the other parent and number of overnights were considered together in the same model, only number of overnights moderated the relations between parenting and child-behavior problems. The results support the proposition that the well-being of children in high-conflict divorcing families is better when they spend adequate time with at least one parent who provides high-quality parenting.

  10. The human environment interface: applying ecosystem concepts to health.

    PubMed

    Preston, Nicholas D; Daszak, Peter; Colwell, Rita R

    2013-01-01

    One Health approaches have tended to focus on closer collaboration among veterinarians and medical professionals, but remain unclear about how ecological approaches could be applied or how they might benefit public health and disease control. In this chapter, we review ecological concepts, and discuss their relevance to health, with an emphasis on emerging infectious diseases (EIDs). Despite the fact that most EIDs originate in wildlife, few studies account for the population, community, or ecosystem ecology of the host, reservoir, or vector. The dimensions of ecological approaches to public health that we propose in this chapter are, in essence, networks of population dynamics, community structure, and ecosystem matrices incorporating concepts of complexity, resilience, and biogeochemical processes.

  11. Mental health services in Cambodia, challenges and opportunities in a post-conflict setting.

    PubMed

    Jegannathan, Bhoomikumar; Kullgren, Gunnar; Deva, Parameshvara

    2015-02-01

    Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will.

  12. The Colombian conflict: a description of a mental health program in the Department of Tolima.

    PubMed

    Sanchez-Padilla, Elisabeth; Casas, German; Grais, Rebecca F; Hustache, Sarah; Moro, Marie-Rose

    2009-12-23

    Colombia has been seriously affected by an internal armed conflict for more than 40 years affecting mainly the civilian population, who is forced to displace, suffers kidnapping, extortion, threats and assassinations. Between 2005 and 2008, Médecins Sans Frontières-France provided psychological care and treatment in the region of Tolima, a strategic place in the armed conflict. The mental health program was based on a short-term multi-faceted treatment developed according to the psychological and psychosomatic needs of the population. Here we describe the population attending during 2005-2008, in both urban and rural settings, as well as the psychological treatment provided during this period and its outcomes.We observed differences between the urban and rural settings in the traumatic events reported, the clinical expression of the disorders, the disorders diagnosed, and their severity. Although the duration of the treatment was limited due to security reasons and access difficulties, patient condition at last visit improved in most of the patients. These descriptive results suggest that further studies should be conducted to examine the role of short-term psychotherapy, adapted specifically to the context, can be a useful tool to provide psychological care to population affected by an armed conflict.

  13. The Colombian conflict: a description of a mental health program in the Department of Tolima

    PubMed Central

    2009-01-01

    Colombia has been seriously affected by an internal armed conflict for more than 40 years affecting mainly the civilian population, who is forced to displace, suffers kidnapping, extortion, threats and assassinations. Between 2005 and 2008, Médecins Sans Frontières-France provided psychological care and treatment in the region of Tolima, a strategic place in the armed conflict. The mental health program was based on a short-term multi-faceted treatment developed according to the psychological and psychosomatic needs of the population. Here we describe the population attending during 2005-2008, in both urban and rural settings, as well as the psychological treatment provided during this period and its outcomes. We observed differences between the urban and rural settings in the traumatic events reported, the clinical expression of the disorders, the disorders diagnosed, and their severity. Although the duration of the treatment was limited due to security reasons and access difficulties, patient condition at last visit improved in most of the patients. These descriptive results suggest that further studies should be conducted to examine the role of short-term psychotherapy, adapted specifically to the context, can be a useful tool to provide psychological care to population affected by an armed conflict. PMID:20030811

  14. Mental Health and Self-Esteem of Institutionalized Adolescents Affected by Armed Conflict.

    PubMed

    War, Firdous Ahmad; Ved, Rifat Saroosh; Paul, Mohammad Altaf

    2016-04-01

    The primary purpose of this paper was to compare the epidemiology of mental health problems and self-esteem of conflict hit adolescents living in charitable seminaries with their counterparts brought up in natural homes. Substantive body of the literature illustrates the emotional and behavioral issues experienced by these adolescents. In this study, 27 adolescents from a charitable Muslim seminary and 30 adolescents from a regular school were recruited. Self-report measures and clinical interview were used to measure mental health and self-esteem. The findings indicate that adolescents in institution setting may not be having mental health and self-esteem-related issues when compared to adolescents living in intact by parent homes. While the authors acknowledge the limitations of the study, these findings need further research to examine the causes for these differences.

  15. Etiologic theories of idiopathic scoliosis: enantiomorph disorder concept of bilateral symmetry, physeally-created growth conflicts and possible prevention.

    PubMed

    Burwell, R G; Freeman, B J C; Dangerfield, P H; Aujla, R K; Cole, A A; Kirby, A S; Pratt, R K; Webb, J K; Moulton, A

    2006-01-01

    The detection of anomalous extra-spinal left-right skeletal length asymmetries in the upper limbs, periapical ribs, ilia and lower limbs of subjects with adolescent idiopathic scoliosis (AIS) raises questions about skeletal bilateral symmetry of vertebrates in health and disorder, its origin and control. The vertebrate body plan externally has mirror-image bilateral symmetries that are highly conserved culminating in the adult form. The normal human body can be viewed as containing paired skeletal structures in the axial and appendicular skeleton as 1) separate left and right paired forms (eg long limb bones, ribs, ilia), and 2) united in paired forms (eg vertebrae, sternum, skull, mandible). Each of these separate and united pairs are mirror-image forms--enantiomorphs. Left-right asymmetries of growth plates (physes) may cause (1) in long bones length asymmetries, (2) within one or more vertebral physes putative growth conflict with distortion as deformity, and (3) between ribs and vertebrae putative growth conflict that triggers thoracic AIS suggesting preventive surgery on spine and ribs. There is evidence of a possible role for environmental factors in AIS development. Genes and the environment (nature/nurture) may interact pre- and/or post-natally to explain both the deformity of AIS and its association with widespread anomalous skeletal length asymmetries. If substantiated there may ultimately be a place for the prevention of AIS in some subjects.

  16. Human Trafficking in Areas of Conflict: Health Care Professionals' Duty to Act.

    PubMed

    Bloem, Christina; Morris, Rikki E; Chisolm-Straker, Makini

    2017-01-01

    Given the significant global burden of human trafficking, the ability of clinicians to identify and provide treatment for trafficked persons is critical. Particularly in conflict settings, health care facilities often serve as the first and sometimes only point of contact for trafficked persons. As such, medical practitioners have a unique opportunity and an ethical imperative to intervene, even in nonclinical roles. With proper training, medical practitioners can assist trafficked persons by documenting human trafficking cases, thereby placing pressure on key stakeholders to enforce legal protections, and by providing adequate services to those trafficked.

  17. The mental health of populations directly and indirectly exposed to violent conflict in Indonesia

    PubMed Central

    2010-01-01

    Background Large disasters affect people who live both near and far from the areas in which they occur. The mental health impact is expected to be similar to a ripple effect, where the risk of mental health consequences generally decreases with increasing distance from the disaster center. However, we have not been able to identify studies of the ripple effect of man-made disaster on mental health in low-income countries. Objectives The objective was to examine the hypothesis of a ripple effect on the mental health consequences in populations exposed to man-made disasters in a developing country context, through a comparison of two different populations living in different proximities from the center of disaster in Mollucas. Methods Cross-sectional longitudinal data were collected from 510 Internally Displaced Persons (IDPs) living in Ambon, who were directly exposed to the violence, and non-IDPs living in remote villages in Mollucas, Indonesia, who had never been directly exposed to violence in Mollucas. Data were collected during home visits and statistical comparisons were conducted by using chi square tests, t-test and logistic regression. Results There was significantly more psychological distress "caseness" in IDPs than non-IDPs. The mental health consequences of the violent conflict in Ambon supported the ripple effect hypothesis as displacement status appears to be a strong risk factor for distress, both as a main effect and interaction effect. Significantly higher percentages of IDPs experienced traumatic events than non-IDPs in all six event types reported. Conclusions This study indicates that the conflict had an impact on mental health and economic conditions far beyond the area where the actual violent events took place, in a diminishing pattern in line with the hypothesis of a ripple effect. PMID:20673322

  18. Transdisciplinary research for complex One Health issues: a scoping review of key concepts.

    PubMed

    Min, B; Allen-Scott, L K; Buntain, B

    2013-11-01

    In order to address the complexity inherent in researching One Health (OH) issues, we support the concept that researchers must transcend individual disciplinary and non-disciplinary boundaries, and move into the realm of transdisciplinary (TD) research approaches. For the purposes of this paper we use the term OH and the concept that OH research is conducted to solve complex health challenges at the animal-human--human-ecosystem interface. TD goes beyond interdisciplinary research to engages disciplines and communities through a unified conceptual framework. In this scoping review we investigated key concepts, definitions and themes in OH and TD based on the peer reviewed literature. We identified nine emerging themes in TD research: (1) education, (2) conflict amongst disciplines, (3) effective communication, (4) shared conceptual framework, (5) leadership, (6) perceived power differentials, (7) community-based methodologies, (8) support for TD research and (9) time and effort. This review provides a synthesized knowledge base that describes the nature, extent of evidence and challenges of engaging in TD initiatives. This knowledge base further provides a foundation for those interested in developing improved strategies for TD collaborative and cross-sectoral research in OH.

  19. IS WORK-FAMILY CONFLICT A MULTILEVEL STRESSOR LINKING JOB CONDITIONS TO MENTAL HEALTH? EVIDENCE FROM THE WORK, FAMILY AND HEALTH NETWORK

    PubMed Central

    Moen, Phyllis; Kaduk, Anne; Kossek, Ellen Ernst; Hammer, Leslie; Buxton, Orfeu M.; O’Donnell, Emily; Almeida, David; Fox, Kimberly; Tranby, Eric; Oakes, J. Michael; Casper, Lynne

    2015-01-01

    Purpose Most research on the work conditions and family responsibilities associated with work-family conflict and other measures of mental health uses the individual employee as the unit of analysis. We argue that work conditions are both individual psychosocial assessments and objective characteristics of the proximal work environment, necessitating multilevel analyses of both individual- and team-level work conditions on mental health. Methodology/approach This study uses multilevel data on 748 high-tech professionals in 120 teams to investigate relationships between team- and individual-level job conditions, work-family conflict, and four mental health outcomes (job satisfaction, emotional exhaustion, perceived stress, and psychological distress). Findings We find that work-to-family conflict is socially patterned across teams, as are job satisfaction and emotional exhaustion. Team-level job conditions predict team-level outcomes, while individuals’ perceptions of their job conditions are better predictors of individuals’ work-to-family conflict and mental health. Work-to-family conflict operates as a partial mediator between job demands and mental health outcomes. Practical implications Our findings suggest that organizational leaders concerned about presenteeism, sickness absences, and productivity would do well to focus on changing job conditions in ways that reduce job demands and work-to-family conflict in order to promote employees’ mental health. Originality/value of the chapter We show that both work-to-family conflict and job conditions can be fruitfully framed as team characteristics, shared appraisals held in common by team members. This challenges the framing of work-to-family conflict as a “private trouble” and provides support for work-to-family conflict as a structural mismatch grounded in the social and temporal organization of work. PMID:25866431

  20. An exploration of violence, mental health and substance abuse in post-conflict Guatemala.

    PubMed

    Branas, Charles C; Dinardo, Andrew R; Puac Polanco, Victor D; Harvey, Michael J; Vassy, Jason L; Bream, Kent

    2013-05-01

    Guatemala's 36-year civil war officially ended in December 1996 after some 200,000 deaths and one million refugees. Despite the ceasefire, Guatemala continues to be a violent country with one of the highest homicide rates in the world. We investigated potential associations between violence, mental health, and substance abuse in post-conflict Guatemala using a community-based survey of 86 respondents living in urban and rural Guatemala. Overall, 17.4% of our respondents had at least one, direct violent experience during the civil war. In the post-conflict period, 90.7% of respondents reported being afraid that they might be hurt by violence, 40.7% screened positive for depression, 50.0% screened positive for PTSD, and 23.3% screened positive for alcohol dependence. Potential associations between prior violent experiences during the war and indicators of PTSD and aspects of alcohol dependence were found in regression-adjusted models (p < 0.05). Certain associations between prior civil war experiences, aspects of PTSD and alcohol dependence in this cohort are remarkable, raising concerns for the health and safety of the largely indigenous populations we studied. Higher than expected rates of depression, PTSD, and substance abuse in our cohort may be related to the ongoing violence, injury and fear that have persisted since the end of the civil war. These, in turn, have implications for the growing medical and surgical resources needed to address the continuing traumatic and post-traumatic complications in the post-conflict era. Limitations of the current study are discussed. These findings are useful in beginning to understand the downstream effects of the Guatemalan civil war, although a much larger, randomly sampled survey is now needed.

  1. An exploration of violence, mental health and substance abuse in post-conflict Guatemala

    PubMed Central

    Branas, Charles C.; Dinardo, Andrew R.; Puac Polanco, Victor D.; Harvey, Michael J.; Vassy, Jason L.; Bream, Kent

    2016-01-01

    Guatemala’s 36-year civil war officially ended in December 1996 after some 200,000 deaths and one million refugees. Despite the ceasefire, Guatemala continues to be a violent country with one of the highest homicide rates in the world. We investigated potential associations between violence, mental health, and substance abuse in post-conflict Guatemala using a community-based survey of 86 respondents living in urban and rural Guatemala. Overall, 17.4% of our respondents had at least one, direct violent experience during the civil war. In the post-conflict period, 90.7% of respondents reported being afraid that they might be hurt by violence, 40.7% screened positive for depression, 50.0% screened positive for PTSD, and 23.3% screened positive for alcohol dependence. Potential associations between prior violent experiences during the war and indicators of PTSD and aspects of alcohol dependence were found in regression-adjusted models (p < 0.05). Certain associations between prior civil war experiences, aspects of PTSD and alcohol dependence in this cohort are remarkable, raising concerns for the health and safety of the largely indigenous populations we studied. Higher than expected rates of depression, PTSD, and substance abuse in our cohort may be related to the ongoing violence, injury and fear that have persisted since the end of the civil war. These, in turn, have implications for the growing medical and surgical resources needed to address the continuing traumatic and post-traumatic complications in the post-conflict era. Limitations of the current study are discussed. These findings are useful in beginning to understand the downstream effects of the Guatemalan civil war, although a much larger, randomly sampled survey is now needed. PMID:27818726

  2. Public health challenges in the political economy of conflict: the case of Syria.

    PubMed

    Sen, Kasturi; Faisal, Waleed Al

    2015-01-01

    Recent uprisings in the Arab world and a full-scale war in Syria are widely viewed as popular demand for political voice against repressive regimes. However, growing economic inequalities and serious economic dysfunction played a role as trigger for conflict than is commonly accepted. Tunisia, Egypt and Syria all implemented policies of liberalization over the past two decades, leading to the worsening of living standards for the majority. The various forms of liberalization played a significant role in embedding social division and discontent whose outcomes affected other countries of the region with the onset of market reforms in nascent welfare states. Egypt, for example, was viewed by the World Bank as an economic 'best performer', despite regular riots over food prices, job losses and land expropriation for tourism. Tunisia was praised by donors just prior to the uprising (in 2010), for 'weathering well' the global economic downturn through 'sound macroeconomic management'. In Syria, the market economy made its mark over the 90s, but macroeconomic adjustment policies were implemented in a bilateral agreement with the European Union and approved by the International Monetary Fund in 2003. The economic stabilization programme that followed had limited concern for social impacts such as jobs losses, price rises and national debt, which ultimately caused immense hardship for the population at large, acting as a trigger for the initial uprising in 2011, prior to its transformation into a fully blown conflict. This article focuses on reforms implemented in the health sector and sets these in the context of the current political economy of Syria. It suggests that a protective approach to public health services during and in the aftermath of conflict may increase the possibilities of reconstruction and reconciliation between warring sides.

  3. Knowledge translation in health care: a concept analysis

    PubMed Central

    khoddam, Homeira; Mehrdad, Neda; Peyrovi, Hamid; Kitson, Alison L; Schultz, Timothy J; Athlin, Asa Muntlin

    2014-01-01

    Background: Although knowledge translation is one of the most widely used concepts in health and medical literature, there is a sense of ambiguity and confusion over its definition. The aim of this paper is to clarify the characteristics of KT. This will assist the theoretical development of it and shape its implementation into the health care system Methods: Walker and Avant’s framework was used to analyze the concept and the related literature published between 2000 and 2010 was reviewed. A total of 112 papers were analyzed. Results: Review of the literature showed that "KT is a process" and "implementing refined knowledge into a participatory context through a set of challenging activities" are the characteristics of KT. Moreover, to occur successfully, KT needs some necessary antecedents like an integrated source of knowledge, a receptive context, and preparedness. The main consequence of successful process is a change in four fields of healthcare, i.e. quality of patient care, professional practice, health system, and community. In addition, this study revealed some empirical referents which are helpful to evaluate the process. Conclusion: By aiming to portray a clear picture of KT, we highlighted its attributes, antecedents, consequences and empirical referents. Identifying the characteristics of this concept may resolve the existing ambiguities in its definition and boundaries thereby facilitate distinction from similar concepts. In addition, these findings can be used as a knowledge infrastructure for developing the KT-related models, theories, or tools. PMID:25664299

  4. Experience and expectation: conflict and change in traditional family health care among the Quichua of Saraguro.

    PubMed

    Finerman, R D

    1983-01-01

    Quichua Indian mothers have traditionally served as primary health caretakers for the families of Saraguro in highland Ecuador. A hospital has recently opened, providing biomedical health care and programs in preventive medicine for local indigenous commmunities. Opposition to the new facility has arisen, however, as families express dissatisfaction with hospital policies. Surveys and in-depth interviews, conducted with Saraguro families ad hospital staff between 1977 and 1982 have outlined problems encountered i the introduction and administration of biomedical care. The hospital is seen by some residents as a threat to Quichua women's authority as herbalists and family curers. More importantly, however, Saraguro families view the facility as a disappointment, as it provided services inconsistent with traditional health values, practices and felt needs, and it fails to fulfill residents' expectations of hospital care. Conflicts between traditional and hospital health care experiences and between expectations and reality, have bred hostility between the health facility and the community it serves. Inability to negotiate with hospital staff for greater flexibility in policies has intensified community frustration. The impact of cultural health values, expectations, and program flexibility are discussed with potential implications for planning and administration of biomedical delivery services.

  5. A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants

    PubMed Central

    2014-01-01

    Background The rising global burden of forced migration due to armed conflict is increasingly recognised as an important issue in global health. Forced migrants are at a greater risk of developing mental disorders. However, resilience, defined as the ability of a person to successfully adapt to or recover from stressful and traumatic experiences, has been highlighted as a key potential protective factor. This study aimed to review systematically the global literature on the impact of resilience on the mental health of adult conflict-driven forced migrants. Methodology Both quantitative and qualitative studies that reported resilience and mental health outcomes among forcibly displaced persons (aged 18+) by way of exploring associations, links, pathways and causative mechanisms were included. Fourteen bibliographic databases and seven humanitarian study databases/websites were searched and a four stage screening process was followed. Results Twenty three studies were included in the final review. Ten qualitative studies identified highlighted family and community cohesion, family and community support, individual personal qualities, collective identity, supportive primary relationships and religion. Thirteen quantitative studies were identified, but only two attempted to link resilience with mental disorders, and three used a specific resilience measure. Over-reliance on cross-sectional designs was noted. Resilience was generally shown to be associated with better mental health in displaced populations, but the evidence on this and underlying mechanisms was limited. Discussion The review highlights the need for more epidemiological and qualitative evidence on resilience in forcibly displaced persons as a potential avenue for intervention development, particularly in resource-poor settings. PMID:25177360

  6. Rehabilitating public health infrastructure in the post-conflict setting: epidemic prevention and preparedness in Kosovo.

    PubMed

    Brennan, R J; Valderrama, C; MacKenzie, W R; Raj, K; Nandy, R

    2001-01-01

    The war in Kosovo in 1999 resulted in the displacement of up to 1.5 million persons from their homes. On the subsequent return of the refugees and internally displaced persons, one of the major challenges facing the local population and the international community, was the rehabilitation of Kosovo's public health infrastructure, which had sustained enormous damage as a result of the fighting. Of particular importance was the need to develop a system of epidemic prevention and preparedness. But no single agency had the resources or capacity to implement such a program. Therefore, a unique six-point model was developed as a collaboration between the Kosovo Institute of Public Health, the World Health Organization, and an international, non-governmental organization. Important components of the program included a major Kosovo-wide baseline health survey, the development of a province-wide public health surveillance system, rehabilitation of microbiology laboratories, and the development of a local capacity for epidemic response. While all program objectives were met, important lessons were learned concerning the planning, design, and implementation of such a project. This program represents a model that potentially could be replicated in other post-conflict or development settings.

  7. Health risk assessment of electromagnetic fields: a conflict between the precautionary principle and environmental medicine methodology.

    PubMed

    Dämvik, Mats; Johansson, Olle

    2010-01-01

    The purpose of the precautionary principle is that legal requirements are to be made to safeguard against the possible health risks that have not yet been scientifically established. That a risk is not established cannot, therefore, be used as an excuse for not applying the principle. Yet, that rationale is exactly what is happening in the case of the possible health risks from exposure to electromagnetic fields (EMF). The scientists, representing both the World Health Organization and the European Commission, do not have at all the precautionary principle in mind when they report on health risks. Their starting point is instead to determine whether new research findings have been scientifically established and thus cannot be the basis for an amendment to the existing exposure limits. Uncertain indications of risk are ignored or played down. This approach is in conflict with European Union (EU) law, which requires that the degree of scientific uncertainty should be presented correctly. A thorough examination of the state of research shows many serious indications of possible health risks from exposure very far below existing limits for EMF. Case law, for other types of exposure, also shows that the precautionary principle can be applied on the basis of weaker evidence than that. Our investigation shows that the precautionary principle is not being used for its intended purpose in relation to exposure to EMF. The reason for this position is that decision-makers are being misled by inaccurate risk assessments.

  8. SSFF Health Management Analysis Report. Part 2: Proof of Concept

    NASA Technical Reports Server (NTRS)

    Wilson, L.; Spruill, J.; Hong, Y.

    1995-01-01

    In this Proof of Concept analysis on SSFF Health Management the following area was described: the Gas Distribution Subsystem (GDS) was studied and evaluated utilizing the PDR Configuration and with respect to the design features encompassing Health Management (HM) aspects outlined in the Generic Handbook. From the results of this study, it was found that there is a definite need for coordinating measurements within and between the subsystems that will ensure that Functional Failures are properly revealed and substantiated as valid by other measurements, even those from other interfacing subsystems.

  9. Spirituality Concept by Health Professionals in Iran: A Qualitative Study.

    PubMed

    Memaryan, Nadereh; Rassouli, Maryam; Mehrabi, Maryam

    2016-01-01

    Background. For years, researchers have sought to provide a clear definition of spirituality and its features and consequences, but the definitions provided of this concept still lack transparency. The present qualitative research was conducted to clarify this concept within the religious-cultural context of Iran. Materials and Methods. The present conventional qualitative content analysis was conducted with an inductive approach. Data were collected through semistructured interviews with 17 spiritual health experts and activists selected through purposive sampling. Results. Three themes emerged from the analysis of the data, including (1) the structure of spirituality, (2) defects in the conceptualization of spirituality, and (3) spirituality in practice, which are explained in this paper with their relevant subthemes and codes. The definition which this study proposes for this concept is that "spirituality is the sublime aspect of human existence bestowed on all humans in order for them to traverse the path of transcendence that is closeness to God (Allah)." Conclusion. The definition provided by this study is similar to the previous definitions of this concept in its main part (transcendence) and in incorporating a God-centered view of spirituality within the context of an Islamic society. This definition has implications for health services' education, research, and practice in similar societies.

  10. Spirituality Concept by Health Professionals in Iran: A Qualitative Study

    PubMed Central

    2016-01-01

    Background. For years, researchers have sought to provide a clear definition of spirituality and its features and consequences, but the definitions provided of this concept still lack transparency. The present qualitative research was conducted to clarify this concept within the religious-cultural context of Iran. Materials and Methods. The present conventional qualitative content analysis was conducted with an inductive approach. Data were collected through semistructured interviews with 17 spiritual health experts and activists selected through purposive sampling. Results. Three themes emerged from the analysis of the data, including (1) the structure of spirituality, (2) defects in the conceptualization of spirituality, and (3) spirituality in practice, which are explained in this paper with their relevant subthemes and codes. The definition which this study proposes for this concept is that “spirituality is the sublime aspect of human existence bestowed on all humans in order for them to traverse the path of transcendence that is closeness to God (Allah).” Conclusion. The definition provided by this study is similar to the previous definitions of this concept in its main part (transcendence) and in incorporating a God-centered view of spirituality within the context of an Islamic society. This definition has implications for health services' education, research, and practice in similar societies. PMID:27493675

  11. The Cost of War on Public Health: An Exploratory Method for Understanding the Impact of Conflict on Public Health in Sri Lanka

    PubMed Central

    2017-01-01

    Purpose The direct impact of protracted conflict on population health and development is well understood. However, the extent of a war's impact on long-term health, and the opportunity costs, are less well understood. This research sought to overcome this gap by asking whether or not health outcomes in Sri Lanka would have been better in the absence of a 26-year war than they were in the presence of war. Methods A counterfactual model of national and district-level health outcomes was created for Sri Lanka for the period 1982 to 2002. At the national level, the model examined life expectancy, infant mortality rate (IMR), and maternal mortality ratios (MMR). At the district level, it looked at IMR and MMR. The model compared outcomes generated by the counterfactual model to actual obtained health outcomes. It looked at the rate of change and absolute values. Results The analysis demonstrated that war altered both rate of change and absolute health outcomes for the worse. The impact was most clearly evident at the district level. IMR was poorer than predicted in 10 districts; of these 8 were outside of the conflict zone. The MMR was worse than expected in 11 districts of which 9 were not in the conflict zone. Additionally, the rate of improvement in IMR slowed as a result of war in 16 districts whereas the rate of improvement in MMR slowed in 9. Conclusion This project showed that protracted conflict degraded the trajectory of public health in Sri Lanka and hurt population health outside of the conflict zone. It further provided a novel methodology with which to better understand the indirect impact of conflict on population health by comparing what is to what could have been achieved in the absence of war. In so doing, this research responded to two public health challenges by providing a tool through which to better understand the human and opportunity costs of war and by answering a call for new methodologies. PMID:28081118

  12. Ensuring accountability through health professional regulatory bodies: the case of conflict of interest.

    PubMed

    Zelisko, Debra; Baumann, Andrea; Gamble, Brenda; Laporte, Audrey; Deber, Raisa B

    2014-09-01

    How do self-regulated health professions' regulatory bodies address financial conflict of interest (coi) and ensure accountability to the public? using document analysis, we examined how four ontario regulatory colleges (physicians, nurses, physiotherapists, audiologists/speech-language pathologists) defined coi and the education, guidance and enforcement they provided for coi-related issues. These colleges are upholding the mandates to define, identify and address financial coi by providing regulations or standards and guidelines to their membership; they differed in the amount of educational materials provided to their registrants and in the possible coi scenarios they presented. Although there were few disciplinary hearings pertaining to financial coi, findings for the hearings that did occur were documented and posted on the college public registers (the listing of all registered college members along with all relevant practice information), informing the public of any limitations or restrictions placed on a member as a result of the hearing.

  13. Using a Conflict Map as an Instructional Tool To Change Student Conceptions in Simple Series Electric-Circuits.

    ERIC Educational Resources Information Center

    Tsai, Chin-Chung

    2003-01-01

    Examines the effects of using a conflict map on 8th grade students' conceptual change and ideational networks about simple series electric circuits. Analyzes student interview data through a flow map method. Shows that the use of conflict maps could help students construct greater, richer, and more integrated ideational networks about electric…

  14. [Migrant related health education: Concept and measures of the Federal Centre for Health Education, Germany].

    PubMed

    Blümel, Stephan

    2015-06-01

    The Federal Centre for Health Education (BZgA) regards migrants as an important target group in nationwide health education programmes because they make up a large part of the population in Germany. The elements of the health education strategy are described and illustrated by examples of sex education and family planning. This includes concept development, migrant related mass communication, addressing target groups with special needs by personal communication, and cooperation with partners from migration work.

  15. Mental Health Outcomes of Drug Conflict Among University Students at the U.S.-Mexico Border.

    PubMed

    O'Connor, Kathleen; Vizcaino, Maricarmen; Benavides, Nora A

    2015-06-01

    The purpose of this cross-sectional study was to investigate to what extent young adults with close ties to Mexico were at greater risk for self-reported negative mental health outcomes than comparison groups during drug-related armed conflict from 2008 through 2012, and the effect of type and number of traumatic events on mental health outcomes. Using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist, 202 university students living in the El Paso-Ciudad Juárez border region were surveyed for symptoms of depression, anxiety, and posttraumatic stress. Students with close ties to Mexico reported symptoms of anxiety and posttraumatic stress at significantly higher rates compared with those without connection to Mexico, but there was no significant difference in rates of depression. Although more than a third of participants reported experiencing 5 or more traumatic events connected with the drug war, being confined to home had the most significant effect. Frequency of traumatic events reported by students as well as rates of anxiety and posttraumatic stress symptoms were higher among students with greater connection to Mexico. Rates of clinically-significant depressive symptoms among all students were higher than expected for U.S. adults but comparable with all U.S. college students. This study presents important new data on the mental health effects of Mexico's drug war.

  16. Generating Conflict for Greater Good: Utilizing Contingency Theory to Assess Black and Mainstream Newspapers as Public Relations Vehicles to Promote Better Health among African Americans

    PubMed Central

    Lumpkins, Crystal Y.; Bae, Jiyang; Cameron, Glen T.

    2010-01-01

    The potential use of strategic conflict management ( Wilcox and Cameron, 2006; Cameron, Wilcox, Reber and Shin ( in press) as a health advocacy tool in US African-American and mainstream newspapers, arguing that escalation of conflict can increase effectiveness of health-related news releases. For health communicators focusing on at-risk populations with poor health outcomes, such goals would include increased awareness of health problems and solutions, along with increased motivation arising from indignation over health disparities. Content analysis of 1,197 stories in 24 Black and 12 mainstream newspapers showed that more conflict factors were present in Black vs. mainstream newspapers, suggesting a way to strategically place health messages in news releases disseminated to newspapers that motivate at-risk publics to better health. The findings suggest that conflict factors such as racial disparity data regarding health issues may enhance media advocacy. PMID:22822291

  17. Generating Conflict for Greater Good: Utilizing Contingency Theory to Assess Black and Mainstream Newspapers as Public Relations Vehicles to Promote Better Health among African Americans.

    PubMed

    Lumpkins, Crystal Y; Bae, Jiyang; Cameron, Glen T

    2010-03-01

    The potential use of strategic conflict management ( Wilcox and Cameron, 2006; Cameron, Wilcox, Reber and Shin ( in press) as a health advocacy tool in US African-American and mainstream newspapers, arguing that escalation of conflict can increase effectiveness of health-related news releases. For health communicators focusing on at-risk populations with poor health outcomes, such goals would include increased awareness of health problems and solutions, along with increased motivation arising from indignation over health disparities. Content analysis of 1,197 stories in 24 Black and 12 mainstream newspapers showed that more conflict factors were present in Black vs. mainstream newspapers, suggesting a way to strategically place health messages in news releases disseminated to newspapers that motivate at-risk publics to better health. The findings suggest that conflict factors such as racial disparity data regarding health issues may enhance media advocacy.

  18. On the frontline of eastern Burma's chronic conflict--listening to the voices of local health workers.

    PubMed

    Footer, Katherine H A; Meyer, Sarah; Sherman, Susan G; Rubenstein, Leonard

    2014-11-01

    Globally, attacks on and interferences with health workers and healthcare delivery, including targeted violence towards providers, attacks on hospitals and delays and denial of health care, represent a serious humanitarian and human rights issue. However, gaps in research about these events persist, limiting the evidence base from which to understand and address the problem. This paper focuses on experiences of local health workers in eastern Burma's chronic conflict, including their strategies for addressing security and ensuring access to vulnerable ethnic communities in the region. Face-to-face in-depth interviews were conducted in June and August 2012 with 27 health workers from three health organizations that operate throughout eastern Burma, with their operational head quarters located in Mae Sot, Tak Province, Thailand. Qualitative analysis found that health workers in this setting experience violent and non-violent interferences with their work, and that the Burmese government's military activities in the region have severely impacted access to care, which remains restricted. Data show that innovative security strategies have emerged, including the important role of the community in ensuring securer access to health care. This study underscores health workers' concern for improved data collection to support the rights of health workers to provide health care, and the rights of community members to receive health care in conflict-affected settings. Findings will inform the development of an incident reporting form to improve systematic data collection and documentation of attacks on health in this setting.

  19. Global agenda, local health: including concepts of health security in preparedness programs at the jurisdictional level.

    PubMed

    Eby, Chas

    2014-01-01

    The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives.

  20. Comment on Cross, Fine, Jones, and Walsh (2012): Do Mental Health Professionals Who Serve on/with Child Advocacy Centers Experience Role Conflict?

    ERIC Educational Resources Information Center

    Friend, Colleen

    2012-01-01

    Cross, Fine, Jones, and Walsh's (2012) article "Mental Health Professionals in Children's Advocacy Centers: Is There Role Conflict?" challenges two recent publications' criticisms that child advocacy centers create role conflict for mental health professionals and explains how child advocacy centers actually work, describing the different roles…

  1. Big pharma and health care: unsolvable conflict of interests between private enterprise and public health.

    PubMed

    Brezis, Mayer

    2008-01-01

    A landmark paper on Game Theory showed that individual maximization of profit necessarily endangers the public good, and since the problem has no technical solution, "it requires a fundamental extension in morality" (1). We propose here that public health, as a public good, now emerges as a grave example of this problem. Recent events and reports increasingly suggest misalignment between the interests of the pharmaceutical industry and those of public health. Johnson & Johnson illegally and effectively promoted Propulsid off-label for children despite internal company documents raising safety concerns. Death in drug trial has been described as a "trade secret." On Vioxx, Topol wrote: "Sadly, it is clear that Merck's commercial interest exceeded its concern about the drug's toxicity" (2). More and more concerns are raised by scholars and major journal editors about the type and the quality of published evidence, often biased towards efficacy of new products. The industry, funding over 80% of trials, sets up a research agenda guided more by marketing than by clinical considerations. Smart statistical and epidemiological tactics help obtain the desired results. Budget for marketing is by far greater than for research. Massive advertising to physicians and to the public gets increasingly sophisticated: ghost writing, professional guidelines, targeting of consumer groups and manipulating media for disease mongering. Pervasive lobbying and political ties limit the independence of regulatory bodies. Obligation to shareholders overriding public health considerations is not unique to the pharmaceutical industry. The chemical, tobacco and food industries share similar tactics: proclaiming doubts about safety issues, buying researchers, infiltrating universities, boards, media and legislative agencies. By contrast, powerful and cheap health promoting activities, poorly supported by industry because they are too cheap and not patented, are markedly underutilized: technologies

  2. The impact of social action funds on child health in a conflict affected country: evidence from Angola.

    PubMed

    Djimeu, Eric W

    2014-04-01

    Although recent evidence shows significant and long-lasting detrimental effects of armed conflict on child health, there is lack of studies rigorously assessing the effectiveness of different social and economic development interventions aiming to mitigate the impact of armed conflict on child health. In order to fill this knowledge gap, this study assesses the impact of health projects and water, sanitation, and waste management interventions financed by the Angola Social Action Fund (ASAF) from 1994 to 2001 on child health. I use data from Inquérito aos Agregados Familiares sobre Despesas e Receitas 2000/2001(IDR 2001), a household survey on expenditures and incomes conducted between February 2000 and February 2001 in Angola. IDR 2001 uses a stratified sampling design in which 12 households were surveyed in a random fashion in each aldeia (village) in rural areas and bairro (neighborhood) in urban areas. Using propensity score matching, a fixed effects model, and propensity-based weighted regression, I find that ASAF leads to a statistically significant increase of the height-for-age Z-scores (HAZ) by 0.335 standard deviations of children less than 5 years. This finding is robust to different implementations of the propensity score model specification and when conducting the sensitivity analysis of hidden bias. The main result that emerges from an analysis of heterogeneous effects shows that ASAF has no impact on children living in war displaced households. Despite many challenges faced by conflict affected countries, social funds which are one the key instruments of the World Bank used to promote development at the local level can be used to mitigate the impact of armed conflict on child health. For children living in war displaced households, specific interventions should be designed to mitigate the impact of armed conflict.

  3. Resolving conflicts in public health protection and ecosystem service provision at designated bathing waters.

    PubMed

    Quilliam, Richard S; Kinzelman, Julie; Brunner, Joel; Oliver, David M

    2015-09-15

    Understanding and quantifying the trade-off between the requirement for clean safe bathing water and beaches and their wider ecosystem services is central to the aims of the European Union (EU) Marine Strategy Framework Directive (MSFD), and vital for the sustainability and economic viability of designated bathing waters. Uncertainty surrounding the impacts of ensuing bathing water policy transitions, e.g. the EU revised Bathing Waters Directive (rBWD), puts new urgency on our need to understand the importance of natural beach assets for human recreation, wildlife habitat and for protection from flooding and erosion. However, managing coastal zones solely in terms of public health could have potentially negative consequences on a range of other social and cultural ecosystem services, e.g. recreation. Improving our knowledge of how bathing waters, surrounding beach environments and local economies might respond to shifts in management decisions is critical in order to inform reliable decision-making, and to evaluate future implications for human health. In this paper we explore the conflicts and trade-offs that emerge at public beach environments, and propose the development of an evaluative framework of viable alternatives in environmental management whereby bathing waters are managed for their greatest utility, driven by identifying the optimal ecosystem service provision at any particular site.

  4. Conflict of roles: a conflict of ideas? The unsettled relations between care team staff and independent mental health advocates.

    PubMed

    McKeown, Mick; Ridley, Julie; Newbigging, Karen; Machin, Karen; Poursanidou, Konstantina; Cruse, Kaaren

    2014-10-01

    Drawing on a national study of independent mental health advocacy, we explored the social relations of independent advocacy. The study was commissioned by the Department of Health (England), and involved a case study design covering eight different geographies and service configurations, and interviews or focus groups with a total of 289 stakeholders across two phases of inquiry. This paper focused on the analysis of qualitative data relevant to the relationship between mental health-care services and independent advocacy services, drawn from interviews with 214 participants in phase two of the study. Discussion of these particular findings affords insights into the working relations of independent advocacy within mental health services beset by reorganizational change and funding cuts, and increasing levels of legally-sanctioned compulsion and coercion. We offer a matrix, which accounts for the different types of working relationships that can arise, and how these are associated with various levels of understanding of independent advocacy and appreciation for the value of advocacy. The discussion is framed by the wider literature on advocacy and the claims by practitioners, such as nurses, for an advocacy role as part of their professional repertoire.

  5. Integrated System Health Management: Foundational Concepts, Approach, and Implementation

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2009-01-01

    A sound basis to guide the community in the conception and implementation of ISHM (Integrated System Health Management) capability in operational systems was provided. The concept of "ISHM Model of a System" and a related architecture defined as a unique Data, Information, and Knowledge (DIaK) architecture were described. The ISHM architecture is independent of the typical system architecture, which is based on grouping physical elements that are assembled to make up a subsystem, and subsystems combine to form systems, etc. It was emphasized that ISHM capability needs to be implemented first at a low functional capability level (FCL), or limited ability to detect anomalies, diagnose, determine consequences, etc. As algorithms and tools to augment or improve the FCL are identified, they should be incorporated into the system. This means that the architecture, DIaK management, and software, must be modular and standards-based, in order to enable systematic augmentation of FCL (no ad-hoc modifications). A set of technologies (and tools) needed to implement ISHM were described. One essential tool is a software environment to create the ISHM Model. The software environment encapsulates DIaK, and an infrastructure to focus DIaK on determining health (detect anomalies, determine causes, determine effects, and provide integrated awareness of the system to the operator). The environment includes gateways to communicate in accordance to standards, specially the IEEE 1451.1 Standard for Smart Sensors and Actuators.

  6. Health financing for universal coverage and health system performance: concepts and implications for policy.

    PubMed

    Kutzin, Joseph

    2013-08-01

    Unless the concept is clearly understood, "universal coverage" (or universal health coverage, UHC) can be used to justify practically any health financing reform or scheme. This paper unpacks the definition of health financing for universal coverage as used in the World Health Organization's World health report 2010 to show how UHC embodies specific health system goals and intermediate objectives and, broadly, how health financing reforms can influence these. All countries seek to improve equity in the use of health services, service quality and financial protection for their populations. Hence, the pursuit of UHC is relevant to every country. Health financing policy is an integral part of efforts to move towards UHC, but for health financing policy to be aligned with the pursuit of UHC, health system reforms need to be aimed explicitly at improving coverage and the intermediate objectives linked to it, namely, efficiency, equity in health resource distribution and transparency and accountability. The unit of analysis for goals and objectives must be the population and health system as a whole. What matters is not how a particular financing scheme affects its individual members, but rather, how it influences progress towards UHC at the population level. Concern only with specific schemes is incompatible with a universal coverage approach and may even undermine UHC, particularly in terms of equity. Conversely, if a scheme is fully oriented towards system-level goals and objectives, it can further progress towards UHC. Policy and policy analysis need to shift from the scheme to the system level.

  7. An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

    PubMed Central

    2011-01-01

    Background Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases. Methods We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia. Results Six key lessons emerge from this analysis: (i) the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii) the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii) a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv) effective strategies for HIV/AIDS care in other settings should be validated in Liberia and

  8. Offering Mental Health Services in a Conflict Affected Region of Pakistan: Who Comes, and Why?

    PubMed Central

    Shah, Safieh; Van den Bergh, Rafael; Van Bellinghen, Benedicte; Severy, Nathalie; Sadiq, Sana; Afridi, Sher Ali; Akhtar, Asma; Maïkére, Jacob; Van Overloop, Catherine; Saeed-ur-Rehman; Khilji, Tahir Bashir-ud-Din; Saleem-ur-Rehman; van Griensven, Johan; Schneider, Serge; Bosman, Philippe; Guillergan, Erwin Lloyd D.; Dazzi, Francesca; Zachariah, Rony

    2014-01-01

    Background North West Pakistan is an area ravaged by conflict and population displacement for over three decades. Recently, drone attacks and military operations have aggravated underlying mental disorders, while access to care is limited. Among patients attending a mental health clinic integrated in district hospital conducted by psychologists; we describe service utilization, patient characteristics, presenting complaints, morbidity patterns, and follow-up details. Methodology/Principal Findings A retrospective study using routinely collected programme data was conducted from February to December 2012. A total of 1545 consultations were conducted for 928 patients (86% females). There were 71(8%) children and adolescents. An increase was observed from February to July, followed by a decline. 163 new patients (18%) were on psychotropic medication at presentation. The most common morbidity in females (36%) were symptoms of adjustment disorders and acute reactions. Depression and anxiety were common in both genders while post traumatic disorder was frequent in males (21%). Out of the 928 new patients, 639(69%) had a follow up visit planned with their psychologist, but only 220(34%) new patients returned for a follow up visit. Conclusion In a district hospital, mental health services managed by psychologists were well attended. There is a need to consider widening the current package of care to cater to the diversity of mental health disorders, gender difference, children and adolescents. Standardized diagnostic and monitoring tools would also need to be adapted accordingly and to assess patient progress. Innovative approaches to tackle the problem of the low return rate are needed. PMID:24963793

  9. Fetal microchimerism and maternal health: A review and evolutionary analysis of cooperation and conflict beyond the womb

    PubMed Central

    Fortunato, Angelo; Wilson Sayres, Melissa; Aktipis, Athena

    2015-01-01

    The presence of fetal cells has been associated with both positive and negative effects on maternal health. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. We use cooperation and conflict theory to generate testable predictions about domains in which fetal microchimerism may enhance maternal health and those in which it may be detrimental. This framework suggests that fetal cells may function both to contribute to maternal somatic maintenance (e.g. wound healing) and to manipulate maternal physiology to enhance resource transmission to offspring (e.g. enhancing milk production). In this review, we use an evolutionary framework to make testable predictions about the role of fetal microchimerism in lactation, thyroid function, autoimmune disease, cancer and maternal emotional, and psychological health. Also watch the Video Abstract. PMID:26316378

  10. Initial Concept for Terminal Area Conflict Detection, Alerting, and Resolution Capability On or Near the Airport Surface, Version 2.0

    NASA Technical Reports Server (NTRS)

    Otero, Sharon D.; Barker, Glover D.; Jones, Denise R.

    2013-01-01

    The Next Generation Air Transportation System (NextGen) concept for 2025 envisions the movement of large numbers of people and goods in a safe, efficient, and reliable manner. The NextGen will remove many of the constraints in the current air transportation system, support a wider range of operations, and deliver an overall system capacity up to 3 times that of current operating levels. In order to achieve the NextGen vision, research is necessary in the areas of surface traffic optimization, maximum runway capacity, reduced runway occupancy time, simultaneous single runway operations, and terminal area conflict prevention, among others. The National Aeronautics and Space Administration (NASA) is conducting Collision Avoidance for Airport Traffic (CAAT) research to develop technologies, data, and guidelines to enable Conflict Detection and Resolution (CD&R) in the Airport Terminal Maneuvering Area (ATMA) under current and emerging NextGen operating concepts. The term ATMA was created to reflect the fact that the CD&R concept area of operation is focused near the airport within the terminal maneuvering area. In the following, an initial concept for an aircraft-based method for CD&R in the ATMA is presented. This method is based upon previous NASA work in CD&R for runway incursion prevention, the Runway Incursion Prevention System (RIPS).

  11. HEALTH GeoJunction: place-time-concept browsing of health publications

    PubMed Central

    2010-01-01

    Background The volume of health science publications is escalating rapidly. Thus, keeping up with developments is becoming harder as is the task of finding important cross-domain connections. When geographic location is a relevant component of research reported in publications, these tasks are more difficult because standard search and indexing facilities have limited or no ability to identify geographic foci in documents. This paper introduces HEALTH GeoJunction, a web application that supports researchers in the task of quickly finding scientific publications that are relevant geographically and temporally as well as thematically. Results HEALTH GeoJunction is a geovisual analytics-enabled web application providing: (a) web services using computational reasoning methods to extract place-time-concept information from bibliographic data for documents and (b) visually-enabled place-time-concept query, filtering, and contextualizing tools that apply to both the documents and their extracted content. This paper focuses specifically on strategies for visually-enabled, iterative, facet-like, place-time-concept filtering that allows analysts to quickly drill down to scientific findings of interest in PubMed abstracts and to explore relations among abstracts and extracted concepts in place and time. The approach enables analysts to: find publications without knowing all relevant query parameters, recognize unanticipated geographic relations within and among documents in multiple health domains, identify the thematic emphasis of research targeting particular places, notice changes in concepts over time, and notice changes in places where concepts are emphasized. Conclusions PubMed is a database of over 19 million biomedical abstracts and citations maintained by the National Center for Biotechnology Information; achieving quick filtering is an important contribution due to the database size. Including geography in filters is important due to rapidly escalating attention to

  12. [Concept and history of public health in Mexico (XVIII to XX century)].

    PubMed

    Fierros Hernández, Arturo

    2014-01-01

    This paper is a brief history of public health. I review the concept of public health and its origins in the West, and also analyze the input of politics in the Mexican health system through the government of Porfirio Diaz.

  13. Policies on Conflicts of Interest in Health Care Guideline Development: A Cross-Sectional Analysis

    PubMed Central

    Morciano, Cristina; Basevi, Vittorio; Faralli, Carla; Hilton Boon, Michele; Tonon, Sabina; Taruscio, Domenica

    2016-01-01

    Objective To assess whether organisations that develop health care guidelines have conflict of interest (COI) policies and to review the content of the available COI policies. Methods Survey and content analysis of COI policies available in English, French, Spanish, and Italian conducted between September 2014 and June 2015. A 24-item data abstraction instrument was created on the basis of guideline development standards. Results The survey identified 29 organisations from 19 countries that met the inclusion criteria. From these organisations, 19 policies were eligible for inclusion in the content analysis. Over one-third of the policies (7/19, 37%) did not report or did not clearly report whether disclosure was a prerequisite for membership of the guideline panel. Strategies for the prevention of COI such as divestment were mentioned by only two organisations. Only 21% of policies (4/19) used criteria to determine whether an interest constitutes a COI and to assess the severity of the risk imposed. Conclusions The finding that some organisations, in contradiction of widely available standards, still do not have COI policies publicly available is concerning. Also troubling were the findings that some policies did not clearly report critical steps in obtaining, managing and communicating disclosure of relationships of interest. This in addition to the variability encountered in content and accessibility of COI policies may cause confusion and distrust among guideline users. It is in the interest of guideline users and developers to design an agreed-upon, comprehensive, clear, and accessible COI policy. PMID:27846255

  14. Transforming Ottawa Charter health promotion concepts into Swedish public health policy.

    PubMed

    Pettersson, Bosse

    2007-01-01

    Swedish public health policy clearly illustrates how the concept of the Ottawa Charter for health promotion can be utilized at a national level. The impact has been more implicit than explicit. Public health has a long history in Sweden and much of the present and future is, and will be, linked to traditional values and structures. International input, however, has been essential to prompt new approaches and change. Health inequalities remain the major shortcoming. The Swedish system offers universal access to healthcare in a decentralized system. Still, primary healthcare, and the health services as a whole have not yet sufficiently embraced the idea of health promotion. Political attention to modern public health at the Prime Minister level was established in late 1980s. Since, continuous initiatives in terms of organization, infrastructure and funding have taken place. With regard to funding, a vast majority of the resources allocated to health promotion will be found outside the health sector. An interesting observation is that the Swedish public health policy with its 11 objective domains remains the same, also after a change of government. Future challenges include maintaining and developing an intersectoral mechanism for implementation, allocating more resources for intervention research to strengthen knowledge-based health promotion, and developing tools for coping better with the challenges of globalisation identified in the Bangkok Charter.

  15. Benchmarks for ethically credible partnerships between industry and academic health centers: beyond disclosure of financial conflicts of interest.

    PubMed

    Meslin, Eric M; Rager, Joshua B; Schwartz, Peter H; Quaid, Kimberly A; Gaffney, Margaret M; Duke, Jon; Tierney, William H

    2015-12-01

    Relationships between industry and university-based researchers have been commonplace for decades and have received notable attention concerning the conflicts of interest these relationships may harbor. While new efforts are being made to update conflict of interest policies and make industry relationships with academia more transparent, the development of broader institutional partnerships between industry and academic health centers challenges the efficacy of current policy to effectively manage these innovative partnerships. In this paper, we argue that existing strategies to reduce conflicts of interest are not sufficient to address the emerging models of industry-academic partnerships because they focus too narrowly on financial matters and are not comprehensive enough to mitigate all ethical risk. Moreover, conflict-of-interest strategies are not designed to promote best practices nor the scientific and social benefits of academic-industry collaboration. We propose a framework of principles and benchmarks for "ethically credible partnerships" between industry and academic health centers and describe how this framework may provide a practical and comprehensive approach for designing and evaluating such partnerships.

  16. Environmental pollutions associated to conflicts in Iraq and related health problems.

    PubMed

    Al-Shammari, Ahmed Majeed

    2016-06-01

    Several wars and a 13-year embargo as well as several years of civil war with the recent war on terrorism have cumulatively damaged Iraq's land, air, water, and health infrastructure. The sand particles in Iraq contain toxic substances, which dates back to the pollution caused by military actions that disassemble the desert sands and turn it into light dust. This dust reaches cities as dust storms that effect most Iraqi cities. The presence of depleted uranium (DU) in the Iraqi food chain is documented by measuring the uranium in animals organs in different Iraqi cities with the highest concentration in the south of Iraq. One of the major sites of pollution in Iraq is the Al-twaitha nuclear research site. The nuclear research reactors were destroyed in the 1991 Gulf War. Barrels containing radioactive materials and sources were stolen from the site in the 2003 war. This resulted in considerable radioactive pollution at the site and in its surrounding areas. Soil sample have been found to be contaminated by Cs-137and Co-60. Cancer and birth defects are most associated with the environmental pollution caused by the conflicts. All studies related to this by Iraqi researchers are discussed in this review. From studying the Iraqi scientific publications, we can conclude that Basrah, Baghdad, Faluja, Mosul and Thi-Qar are the most effected cities in Iraq. This review concludes that the presence of a heavily contaminated environment with war related pollutants in most of the Iraqi cities needs much attention and huge effort to reduce the related health problems.

  17. Predicting positive mental health in internally displaced persons in Indonesia: the roles of economic improvement and exposure to violent conflict.

    PubMed

    Saragih Turnip, Sherly; Sörbom, Dag; Hauff, Edvard

    2016-01-01

    Positive mental health, rather than just the absence of mental illness, is rarely investigated among the internally displaced persons (IDPs) affected by violent conflict in low-income countries. The purpose of this study was to investigate a model that could explain the interrelationship between factors contributing to positive mental health in displaced populations. In a longitudinal study we examine poverty, exposure to traumatic events and the change of material well-being after one year. We collected data in two consecutive years (2005 and 2006) from a community-based sample of IDPs in Ambon, Indonesia, through face-to-face structured interviews with consenting adults. Participants of this study were IDPs lived in Ambon during the violent conflict period. We interviewed 471 IDPs in the first year and reinterviewed 399 (85%) of the same subjects in the second year. The IDPs possessed good sense of coherence and subjective well-being. Our final model, which was generated by the use of structural equation modeling, fits the data well (χ(2) = 52.51, df = 45, p = .21, CFI = .99, RMSEA = .019). Exposure to violent conflict had a negative impact on IDPs' mental health initially and better economic conditions improved it (r = -.30 and .29 respectively). Mental health status one year previously was a strong predictor of future mental health, followed by individual economic growth in the past year (r = .43 and .29 respectively). On a group level the IDPs were resilient and adaptive to survive in adverse living conditions after devastating violent conflict, and the economic improvement contributed to it.

  18. Developing a model of source-specific interpersonal conflict in health care.

    PubMed

    Guidroz, Ashley M; Wang, Mo; Perez, Lisa M

    2012-02-01

    Nurses work in complex social environments, and conflict may arise with fellow coworkers, their supervisor, physicians or the patients and family they care for. Although much research has documented the negative effects of conflict on nurses, no research to date has examined the comparative effect that conflict from all four sources can have on nurses. The purpose of this study is to test a model of workplace conflict where the negative effect of conflict on nurses will be experienced via emotional exhaustion. We test the mediator model by analysing the cross-sectional data collected within one hospital (N1=182) and cross-validating those results in a second hospital (N2=161). The pattern of results was largely consistent across the two samples indicating support for a mediated model of workplace conflict for physician, supervisor and patient. Conflict with other nurses, however, did not have a relationship with either emotional exhaustion or other personal and organizational outcomes. The theoretical and practical implications of the current findings, as well as the limitations and future research directions, are discussed.

  19. Motivational Interference in School-Leisure Conflict and Learning Outcomes: The Differential Effects of Two Value Conceptions

    ERIC Educational Resources Information Center

    Hofer, Manfred; Kuhnle, Claudia; Kilian, Britta; Marta, Elena; Fries, Stefan

    2011-01-01

    It was hypothesized that students' value orientations are connected to their experience of motivational interference in a conflict between a school- and a leisure-related activity as well as to school marks as indicators of learning outcomes. In a self-report study with Italian adolescents (N = 433; M = 14.5 years) using a school-leisure conflict…

  20. Consumer Health Concepts That Do Not Map to the UMLS: Where Do They Fit?

    PubMed Central

    Keselman, Alla; Smith, Catherine Arnott; Divita, Guy; Kim, Hyeoneui; Browne, Allen C.; Leroy, Gondy; Zeng-Treitler, Qing

    2008-01-01

    Objective This study has two objectives: first, to identify and characterize consumer health terms not found in the Unified Medical Language System (UMLS) Metathesaurus (2007 AB); second, to describe the procedure for creating new concepts in the process of building a consumer health vocabulary. How do the unmapped consumer health concepts relate to the existing UMLS concepts? What is the place of these new concepts in professional medical discourse? Design The consumer health terms were extracted from two large corpora derived in the process of Open Access Collaboratory Consumer Health Vocabulary (OAC CHV) building. Terms that could not be mapped to existing UMLS concepts via machine and manual methods prompted creation of new concepts, which were then ascribed semantic types, related to existing UMLS concepts, and coded according to specified criteria. Results This approach identified 64 unmapped concepts, 17 of which were labeled as uniquely “lay” and not feasible for inclusion in professional health terminologies. The remaining terms constituted potential candidates for inclusion in professional vocabularies, or could be constructed by post-coordinating existing UMLS terms. The relationship between new and existing concepts differed depending on the corpora from which they were extracted. Conclusion Non-mapping concepts constitute a small proportion of consumer health terms, but a proportion that is likely to affect the process of consumer health vocabulary building. We have identified a novel approach for identifying such concepts. PMID:18436906

  1. Scoping literature review on the Learning Organisation concept as applied to the health system.

    PubMed

    Akhnif, E; Macq, J; Idrissi Fakhreddine, M O; Meessen, B

    2017-03-01

    ᅟ: There is growing interest in the use of the management concept of a 'learning organisation'. The objective of this review is to explore work undertaken towards the application of this concept to the health sector in general and to reach the goal of universal health coverage in particular. Of interest are the exploration of evaluation frameworks and their application in health.

  2. Out of the Shadows: The Health and Well-Being of Private Contractors Working in Conflict Environments.

    PubMed

    Dunigan, Molly; Farmer, Carrie M; Burns, Rachel M; Hawks, Alison; Setodji, Claude Messan

    2014-01-01

    Over the past decade, private contractors have been deployed extensively around the globe. In addition to supporting U.S. and allied forces in Iraq and Afghanistan, contractors have assisted foreign governments, nongovernmental organizations, and private businesses by providing a wide range of services, including base support and maintenance, logistical support, transportation, intelligence, communications, construction, and security. At the height of the conflicts in Iraq and Afghanistan, contractors outnumbered U.S. troops deployed to both theaters. Although these contractors are not supposed to engage in offensive combat, they may nonetheless be exposed to many of the stressors that are known to have physical and mental health implications for military personnel. RAND conducted an online survey of a sample of contractors who had deployed on contract to a theater of conflict at least once between early 2011 and early 2013. The survey collected demographic and employment information, along with details about respondents' deployment experience (including level of preparation for deployment, combat exposure, and living conditions), mental health (including probable posttraumatic stress disorder, depression, and alcohol misuse), physical health, and access to and use of health care. The goal was to describe the contractors' health and well-being and to explore differences across the sample by such factors as country of citizenship, job specialty, and length and frequency of contract deployment. The findings provide a foundation for future studies of contractor populations and serve to inform policy decisions affecting contractors, including efforts to reduce barriers to mental health treatment for this population.

  3. Mexico’s northern border conflict: collateral damage to health and human rights of vulnerable groups

    PubMed Central

    Beletsky, Leo; Martinez, Gustavo; Gaines, Tommi; Nguyen, Lucie; Lozada, Remedios; Rangel, Gudelia; Vera, Alicia; McCauley, Heather L.; Sorensen, Andrea; Strathdee, Steffanie A.

    2013-01-01

    Objective To compare distributions of human rights violations and disease risk; to juxtapose these patterns against demographic and structural environmental variables, and to formulate implications for structural interventions. Methods Female sex workers who inject drugs were surveyed in Tijuana and Ciudad Juarez, Mexico. Structured interviews and testing for sexually transmitted infections (STIs) were conducted (October 2008 to October 2009). Frequencies of individual and environmental factors, including police abuse, risk of HIV infection, and protective behaviors, were compared between sites using univariate logistic regression. Results Of 624 women, almost half reported police syringe confiscation despite syringes being legal; 55.6% reported extortion (past 6 months), with significantly higher proportions in Ciudad Juarez (P < 0.001). Reports of recent solicitation of sexual favors (28.5% in Tijuana, 36.5% in Ciudad Juarez, P = 0.04) and sexual abuse (15.7% in Tijuana, 18.3% in Ciudad Juarez) by police were commonplace. Prevalence of STIs was significantly lower in Tijuana than in Ciudad Juarez (64.2% and 83.4%, P < 0.001), paralleling the lower prevalence of sexual risk behaviors there. Ciudad Juarez respondents reported significantly higher median number of monthly clients (6.8 versus 1.5, P < 0.001) and lower median pay per sex act (US$ 10 versus US$ 20, P < 0.001) (in the past month). Relative to Tijuana, security deployment, especially the army’s presence, was perceived to have increased more in Ciudad Juarez in the past year (72.1% versus 59.2%, P = 0.001). Conclusions Collateral damage from police practices in the context of Mexico’s drug conflict may affect public health in the Northern Border Region. Itinerant officers may facilitate disease spread beyond the region. The urgency for mounting structural interventions is discussed. PMID:22767041

  4. Integrated System Health Management: Foundational Concepts, Approach, and Implementation.

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey

    2009-01-01

    Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following

  5. Changing concepts of health and health services: new opportunities for nutrition promotion.

    PubMed

    Horwitz, A

    1983-01-01

    Life expectancy slowly and steadily increased during the course of the 20th century resulting in a change in the concept of health for both individuals and society. This has been primarily the consequence of the reduction of infant and early childhood mortality and the control of major infectious diseases. Fear of dying has been replaced by the dedication to survival, health, and production, and science and technology have contributed much to creating this pattern of thinking. Lawrence Henderson recognized adaptability as a basic biological phenomenon. The relation between nutritional requirements and homeostatic mechanisms is significant. Beyond a certain threshold, the latter cannot prevent impairments resulting from undernutrition, but the establishment of this threshold involves a complex process. In addition to being an end for each person, health is also regarded as a means for society. These ideas seem embodied in the World Health Organization's (WHO's) definition of health: "a state of complete physical, mental and social well-being and not merely the absence of disease of infirmity." The main and perennial problem is how to translate the ideal into practical reality. Recognition of health as a right has strengthened the acceptance of its role as a determinant of development. An important cluster of determinants of health and disease stems from the health services, and these have changed in both concept and in practice, particularly following World War 2. Health care, being a basic need, was conceived as a service to be provided, even imposed by the central authorities, to those entrenched in their traditions. Currently, there is movement from paternalism to community participation. It has become essential to catalyze the community for it is a vast potential source of cooperation in carrying out activities for disease prevention and cure throughout the world. A series of circumstances have supported the renaissance of the primary health care movement in the

  6. [The notion of conflict of interest in the field of health and environment: philosophical and legal approaches].

    PubMed

    Hermitte, M-A; Le Coz, P

    2014-06-01

    This paper considers the conflict of interest in philosophical and legal perspective. The philosophical approach comes from two perspectives: political philosophy focuses on the role of the link of interest in the city considered in the light of a broader reflection on the conditions of living together. Antiquity philosophers have enhanced the interest link as privileged vector of humanization and socialization of individuals. In the eighteenth century, Adam Smith considers the pursuit of individual interests a stronger social base that love of neighbor advocated by Christians. Moral philosophy focuses specifically on the passage of interest linked to the conflict of interest. It wondered if we should be impartial in all circumstances or whether it's right to give priority to our friends and loved ones. Thus, it poses the question of whether introspection is sufficient to detect conflicts of interest or if the look of an external third party is still required. The legal process differs from the philosophical approach at two levels; on the one hand, its scope is more limited: the law doesn't envisage the benefits of links of interest on social life even though it may protect some of them (in the context of the family, for example) and is intended to prevent bias that may taint the decision public. On the other hand, the lawyer doesn't enter the interiority of individuals but stands by what appears on the outside: it tracks the suspicion of bias can have serious impacts, such as health and the environment. Somehow, it is more radical. It's noteworthy that despite its many developments, the law can't to stop conflicts of interest in research. Several reasons account for this impasse: scientists receive mission to partner with industry to develop products but they must remain independent in order to assess the risks; there is a tendency to always choose the same experts; there are conflicts of interest intellectuals which are not easy to detect.

  7. Mental Health Disorders Among Women Victims of Conflict-Related Sexual Violence in the Democratic Republic of Congo.

    PubMed

    Dossa, Nissou Ines; Zunzunegui, Maria Victoria; Hatem, Marie; Fraser, William Donald

    2015-08-01

    To assess the effects of sexual violence (SV) in armed conflicts on women's mental health, on its own and in conjunction with reproductive health issues such as fistula or chronic pelvic pain (CPP). A cross-sectional population-based study of 320 women living in Goma, the Democratic Republic of Congo, aged 15 to 45 years, was conducted. Women who experienced conflict-related sexual violence (CRSV) were compared with those who experienced non-conflict-related sexual violence (NCRSV) and those who never experienced such acts. Data were gathered through individual interviews by local staff using standardized questionnaires. The outcomes investigated were post-traumatic stress disorder (PTSD) symptoms severity and psychological distress symptoms (PDS) severity. Experience of SV in either context was associated with more severe PDS (p < .0001). Only CRSV was associated with more severe PTSD symptoms (p < .0001). Women who suffered from fistula or CPP also had a higher PDS score mean (p < .0001 and p = .007) and a higher PTSD symptoms score mean (p < .0001, for both reproductive health issues). Multivariate analyses showed that compared with women who never experienced SV and never suffered from fistula or CPP, those who experienced CRSV and suffered from fistula or CPP had the most severe PDS and PTSD symptoms after adjustment for potential confounders. The differences in PDS and PTSD symptoms severity were all significant (p < .0001). Psychological and physical health care are urgently needed for women who experienced CRSV, particularly those with additional issues of fistula or CPP. Current interventions should simultaneously seek to improve both reproductive and mental health.

  8. [A new concept of organization and scope of neurosurgical care in the US army during armed conflicts in the early 2000s].

    PubMed

    Khrapov, Yu V; Alekseev, D E; Svistov, D V

    2017-01-01

    Military operations in various parts of the world in the early 2000s are becoming more regionalized; new warfare tactics emerge, which makes it necessary to review and modify the neurosurgical care system. The article reviews the results of original studies on this issue and summarizes the experience of the US Army medical service in Afghanistan and Iraq. The article discusses the structure of sanitary losses, organization and scope of medical and evacuation neurosurgical measures, types and techniques of surgical interventions, and the rate of complications. We describe five levels of neurosurgical care echelons and an implemented "injury control - neurosurgery" concept; particular attention is paid to the peculiarities of research and specialist training. We demonstrate that implementation of the new concept for organization and scope of neurosurgical care has improved treatment outcomes and reduced the mortality rate in the mentioned military conflicts of recent years compared to those in the Vietnam War. We may conclude that the described experience of the US Army can be used to improve the efficacy of neurosurgical care to the wounded and victims of armed conflicts.

  9. Uneasy money: the Instituto Carlos Slim de la Salud, tobacco philanthropy and conflict of interest in global health

    PubMed Central

    Burch, Tiffany; Wander, Nathaniel; Collin, Jeff

    2015-01-01

    In May 2007, the Instituto Carso de la Salud—now Instituto Carlos Slim de la Salud (ICSS)—was endowed with US$500 million to focus on priority health issues in Latin America, notably issues of ‘globalisation and non-communicable diseases’. ICSS was soon criticised, however, on the grounds that its funding was derived from tobacco industry profits and that its founder Carlos Slim Hélu remained an active industry principal. Collaboration with ICSS was said to run counter to the WHO Framework Convention on Tobacco Control. The Institute's then Executive President Julio Frenk disputed these charges. This research employs an archive of tobacco industry documents triangulated with materials from commercial, media, regulatory and NGO sources to examine the financial relations between Slim and the tobacco industry. The paper analyses Slim's continuing service to the industry and role in ICSS. It demonstrates a prima facie conflict of interest between ICSS's health mission and its founder's involvement in cigarette manufacturing and marketing, reflected on ICSS's website as a resounding silence on issues of tobacco and health. It is concluded that the reliance of international health agencies upon the commercial sector requires more robust institutional policies to effectively regulate conflicts of interest. PMID:21088061

  10. Predicting the Impact of the 2011 Conflict in Libya on Population Mental Health: PTSD and Depression Prevalence and Mental Health Service Requirements

    PubMed Central

    Charlson, Fiona J.; Steel, Zachary; Degenhardt, Louisa; Chey, Tien; Silove, Derrick; Marnane, Claire; Whiteford, Harvey A.

    2012-01-01

    Background Mental disorders are likely to be elevated in the Libyan population during the post-conflict period. We estimated cases of severe PTSD and depression and related health service requirements using modelling from existing epidemiological data and current recommended mental health service targets in low and middle income countries (LMIC’s). Methods Post-conflict prevalence estimates were derived from models based on a previously conducted systematic review and meta-regression analysis of mental health among populations living in conflict. Political terror ratings and intensity of exposure to traumatic events were used in predictive models. Prevalence of severe cases was applied to chosen populations along with uncertainty ranges. Six populations deemed to be affected by the conflict were chosen for modelling: Misrata (population of 444,812), Benghazi (pop. 674,094), Zintan (pop. 40,000), displaced people within Tripoli/Zlitan (pop. 49,000), displaced people within Misrata (pop. 25,000) and Ras Jdir camps (pop. 3,700). Proposed targets for service coverage, resource utilisation and full-time equivalent staffing for management of severe cases of major depression and post-traumatic stress disorder (PTSD) are based on a published model for LMIC’s. Findings Severe PTSD prevalence in populations exposed to a high level of political terror and traumatic events was estimated at 12.4% (95%CI 8.5–16.7) and was 19.8% (95%CI 14.0–26.3) for severe depression. Across all six populations (total population 1,236,600), the conflict could be associated with 123,200 (71,600–182,400) cases of severe PTSD and 228,100 (134,000–344,200) cases of severe depression; 50% of PTSD cases were estimated to co-occur with severe depression. Based upon service coverage targets, approximately 154 full-time equivalent staff would be required to respond to these cases sufficiently which is substantially below the current level of resource estimates for these regions. Discussion

  11. PATCH: Its Origin, Basic Concepts, and Links to Contemporary Public Health Policy.

    ERIC Educational Resources Information Center

    Kreuter, Marshall W.

    1992-01-01

    PATCH (Planned Approach to Community Health), a cooperative program of technical assistance from the Centers for Disease Control, strengthens state and local health departments' capacities to plan, implement, and evaluate community-based health promotion activities for priority health problems. The article describes its origin, concepts, and…

  12. The concept of health in One Health and some practical implications for research and education: what is One Health?

    PubMed Central

    Lerner, Henrik; Berg, Charlotte

    2015-01-01

    From a strict biological point of view, humans are just one species among other species, albeit one with very special capacities, characteristics, and skills. Among scientists, it is generally acknowledged that we share many features with other animal species, which are certainly relevant when the concepts of health and disease are discussed. The term ‘One Health’ is used in many different contexts and by people with varying backgrounds. However, there appears to be some confusion as to what the term really means, and it is used in a wide range of contexts, often including or bordering concepts such as infection biology, contagious diseases, zoonotic infections, evolutionary medicine, comparative medicine, and translational medicine. Without claiming to present the one and only true interpretation, we will argue for a wide approach using the ‘umbrella’ depiction developed by One Health Sweden. We argue that this one should, compared to other demarcations, be more useful to science. We will also analyze the concept of health on different levels: individual, population, and ecosystem health, and describe how these levels inherently influence each other for both humans and animals. Both these choices are normative and have practical consequences for research and education, a way of reasoning which we develop further in this paper. Finally, we conclude that the choice of term for the approach might be normative in deciding which disciplines or parts of disciplines that may be included. PMID:25660757

  13. A New Concept of Health Can Improve the Definition of Frailty.

    PubMed

    Boers, Maarten; Cruz Jentoft, Alfonso J

    2015-11-01

    Following a newly developed concept of health, this viewpoint suggests that the concept of frailty can usefully be defined as: the weakening of health, i.e. the resilience or capacity to cope, and to maintain and restore one's integrity, equilibrium, and sense of wellbeing in three domains: physical, mental, and social.

  14. Swedish Nursing Students' Perceptions of the Concept of Health: A Phenomenographic Study

    ERIC Educational Resources Information Center

    Skär, Lisa; Söderberg, Siv

    2016-01-01

    Objectives: Health is a central and important concept in nursing and nursing education, and has been theorised about in both positive and negative terms. The purpose of this study was to explore Swedish nursing students' perceptions of the concept of health. Design: A phenomenographic research approach was used to understand how nursing students…

  15. 78 FR 24154 - Notice of Availability of a National Animal Health Laboratory Network Reorganization Concept Paper

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ... Network Reorganization Concept Paper AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... Plant Health Inspection Service is making available a concept paper that describes a revised structure... paper we are making available for comment presents a structure we believe will give the NAHLN...

  16. The ISTSS/Rand guidelines on mental health training of primary healthcare providers for trauma-exposed populations in conflict-affected countries.

    PubMed

    Eisenman, David; Weine, Stevan; Green, Bonnie; de Jong, Joop; Rayburn, Nadine; Ventevogel, Peter; Keller, Allen; Agani, Ferid

    2006-02-01

    Mental health care for trauma-exposed populations in conflict-affected developing countries often is provided by primary healthcare providers (PHPs), including doctors, nurses, and lay health workers. The Task Force on International Trauma Training, through an initiative sponsored by the International Society for Traumatic Stress Studies and the RAND Corporation, has developed evidence- and consensus-based guidelines for the mental health training of PHPs in conflict-affected developing countries. This article presents the Guidelines, which provide a conceptual framework and specific principles for improving the quality of mental health training for PHPs working with trauma-exposed populations.

  17. Applying the concept of culture to reduce health disparities through health behavior research.

    PubMed

    Kagawa Singer, Marjorie

    2012-11-01

    Culture is often cited as an underlying cause of the undue burden of disease borne by communities of color along the entire life cycle. However, culture is rarely defined or appropriately measured. Scientifically, culture is a complex, integrated, and dynamic conceptual framework that is incongruent with the way it is operationalized in health behavior theories: as a unidimensional, static, and immutable character element of a homogeneous population group. This paper lays out this contradiction and proposes a more scientifically grounded approach to the use of culture. The premise is that if the concept of culture were better operationalized, results from studies of diverse population groups would produce findings that are more scientifically valid and relevant to the community. Practitioners could then use these findings to develop more effective strategies to reduce health disparities and improve the health of all population groups. Six steps are proposed to increase our ability to achieve greater clarity on what culture is and to identify how it impacts health behavior and ultimately health outcomes, enabling researchers to build a stronger science of cultural diversity.

  18. Concepts and solutions for future-proof health information systems and health networks.

    PubMed

    Blobel, Bernd

    2003-01-01

    Based on shared care information systems' requirements for high level interoperability, a generic component architecture has been derived. For implementing, running and maintaining acceptable and useable health information systems components, all views of the ISO Reference Model--Open Distributed Processing have to be considered. Following the Model Driven Architecture (MDA) paradigm, a reference model as well as concept-representing domain models both independent of platforms must be specified, which are combined and harmonised as well as automatically transferred into the platform-specific models using appropriate tools.

  19. Assessing the responsiveness of chronic disease care - is the World Health Organization's concept of health system responsiveness applicable?

    PubMed

    Röttger, Julia; Blümel, Miriam; Fuchs, Sabine; Busse, Reinhard

    2014-07-01

    The concept of health system responsiveness is an important dimension of health system performance assessment. Further efforts have been made in recent years to improve the analysis of responsiveness measurements, yet few studies have applied the responsiveness concept to the evaluation of specific health care delivery structures. The objective of this study was to test the World Health Organization's (WHO's) responsiveness concept for an application in the evaluation of chronic disease care. In September and October 2012 we conducted four focus groups of chronically ill people (n = 38) in Germany, in which participants discussed their experiences and expectations regarding health care. The data was analyzed deductively (on the basis of the WHO responsiveness concept) and inductively using directed content analysis. Ten themes related to health system responsiveness and one theme (finances) not directly related to health system responsiveness, but of high importance to the focus group participants, could be identified. Eight of the ten responsiveness themes are consistent with the WHO concept. Additionally, two new themes were identified: trust (consultation and treatment are not led by any motive other than the patients' wellbeing) and coordination (treatment involving different providers is coordinated and different actors communicate with each other). These findings indicate the suitability of the WHO responsiveness concept for the evaluation of chronic disease care. However, some amendments, in particular an extension of the concept to include the two domains trust and coordination, are necessary for a thorough assessment of the responsiveness of chronic disease care.

  20. Workplace conflict resolution and the health of employees in the Swedish and Finnish units of an industrial company.

    PubMed

    Hyde, Martin; Jappinen, Paavo; Theorell, Tores; Oxenstierna, Gabriel

    2006-10-01

    New patterns of working, the globalisation of production and the introduction of information technologies are changing the way we work. This new working environment has eliminated some risks whilst introducing others. The importance of the psychosocial working environment for the health of employees is now well documented, but the effects of managerial style have received relatively little attention. Yet management is an increasingly important aspect of companies' policies. In this paper, we examine the relationship between conflict management in the workplace and self-reported measures of stress, poor general health, exhaustion and sickness absence due to overstrain or fatigue. Our sample consists of non-supervisory employees (N = 9309) working in the Swedish and Finnish plants of a multinational forestry company who were surveyed in 2000. Bivariate analyses show that those who report that differences are resolved through discussion are least likely to report stress, poor general health, exhaustion or sickness absence. Those who report that authority is used or that no attempts are made to resolve differences have quite similar rates across all measures. Binary logistic regression analyses were performed for all health outcomes controlling for age, sex, occupational group, job complexity, job autonomy and support from superiors. Results show significantly lower likelihoods of reporting stress, poor general health, exhaustion or sickness absence amongst employees who report that differences of opinion are resolved through discussion compared to those who report that no attempts are made. No significant differences were found between those who reported that differences were resolved through use of authority and subjects in the 'no attempt' category. These results suggest that the workplace conflict resolution is important in the health of employees in addition to traditional psychosocial work environment risk factors.

  1. Work-Family Conflict and Employee Sleep: Evidence from IT Workers in the Work, Family and Health Study

    PubMed Central

    Buxton, Orfeu M.; Lee, Soomi; Beverly, Chloe; Berkman, Lisa F.; Moen, Phyllis; Kelly, Erin L.; Hammer, Leslie B.; Almeida, David M.

    2016-01-01

    Study Objectives: Work-family conflict is a threat to healthy sleep behaviors among employees. This study aimed to examine how Work-to-Family Conflict (demands from work that interfere with one's family/personal life; WTFC) and Family-to-Work Conflict (demands from family/personal life that interfere with work; FTWC) are associated with several dimensions of sleep among information technology workers. Methods: Employees at a U.S. IT firm (n = 799) provided self-reports of sleep sufficiency (feeling rested upon waking), sleep quality, and sleep maintenance insomnia symptoms (waking up in the middle of the night or early morning) in the last month. They also provided a week of actigraphy for nighttime sleep duration, napping, sleep timing, and a novel sleep inconsistency measure. Analyses adjusted for work conditions (job demands, decision authority, schedule control, and family-supportive supervisor behavior), and household and sociodemographic characteristics. Results: Employees who experienced higher WTFC reported less sleep sufficiency, poorer sleep quality, and more insomnia symptoms. Higher WTFC also predicted shorter nighttime sleep duration, greater likelihood of napping, and longer nap duration. Furthermore, higher WTFC was linked to greater inconsistency of nighttime sleep duration and sleep clock times, whereas higher FTWC was associated with more rigidity of sleep timing mostly driven by wake time. Conclusions: Results highlight the unique associations of WTFC/FTWC with employee sleep independent of other work conditions and household and sociodemographic characteristics. Our novel methodological approach demonstrates differential associations of WTFC and FTWC with inconsistency of sleep timing. Given the strong associations between WTFC and poor sleep, future research should focus on reducing WTFC. Citation: Buxton OM, Lee S, Beverly C, Berkman LF, Moen P, Kelly EL, Hammer LB, Almeida DM. Work-family conflict and employee sleep: evidence from IT workers

  2. Egyptian contribution to the concept of mental health.

    PubMed

    Okasha, A

    2001-05-01

    This paper provides an historical look at the Egyptian contribution to mental health from Pharaonic times through to the Islamic era and up to today. The current situation as regards mental health in Egypt is described.

  3. Tufts academic health information network: concept and scenario.

    PubMed

    Stearns, N S

    1986-04-01

    Tufts University School of Medicine's new health sciences education building, the Arthur M. Sackler Center for Health Communications, will house a modern medical library and computer center, classrooms, auditoria, and media facilities. The building will also serve as the center for an information and communication network linking the medical school and adjacent New England Medical Center, Tufts' primary teaching hospital, with Tufts Associated Teaching Hospitals throughout New England. Ultimately, the Tufts network will join other gateway networks, information resource facilities, health care institutions, and medical schools throughout the world. The center and the network are intended to facilitate and improve the education of health professionals, the delivery of health care to patients, the conduct of research, and the implementation of administrative management approaches that should provide more efficient utilization of resources and save dollars. A model and scenario show how health care delivery and health care education are integrated through better use of information transfer technologies by health information specialists, practitioners, and educators.

  4. Understanding of Proportion as Embodied in the Concept of Fullness. An Investigation into Bruner's "Modes-of-Representation-Conflict Hypothesis"

    ERIC Educational Resources Information Center

    McWhirter, Elizabeth P.

    1978-01-01

    This replication study negates Bruner's finding that older subjects (age 15 and adult) understand the mathematical concept of ratio as exemplified by comparing judgments of fullness in pairs of glasses differing in height, diameter, and water volume. Weaknesses in Bruner's design and procedure that explain the discrepancy between the two studies…

  5. The Role of Games and Simulations to Teach Abstract Concepts of Anarchy, Cooperation, and Conflict in World Politics

    ERIC Educational Resources Information Center

    McCarthy, Mary M.

    2014-01-01

    Games and simulations are increasingly used in courses on international politics. This study explores the hypothesis that games are better than simulations (as well as only reading and lectures) in introducing students to abstract concepts integral to an understanding of world politics. The study compares a two-level Prisoner's Dilemma game…

  6. Integrating Healthy Communities concepts into health professions training.

    PubMed Central

    Kinder, G; Cashman, S B; Seifer, S D; Inouye, A; Hagopian, A

    2000-01-01

    To meet the demands of the evolving health care system, health professionals need skills that will allow them to anticipate and respond to the broader social determinants of health. To ensure that these skills are learned during their professional education and training, health professions institutions must look beyond the medical model of caring for communities. Models in Seattle and Roanoke demonstrate the curricular changes necessary to ensure that students in the health professions are adequately prepared to contribute to building Healthy Communities in the 21st century. In addition to these models, a number of resources are available to help promote the needed institutional changes. PMID:10968767

  7. International cooperation and health. Part I: Issues and concepts.

    PubMed

    McKee, Martin; Gilmore, Anna B; Schwalbe, Nina

    2005-08-01

    The world is increasingly shaped by powerful global forces, many of which have consequences for human health and the social, economic, and environmental factors that influence health are increasingly determined at a supranational level. As a result, local or national level efforts to influence health determinants can have only a limited impact and it is all too easy for the individual public health practitioner to feel powerless. Yet while public health practitioners, on their own, may indeed be comparatively powerless, together they can achieve a great deal. Part I of this glossary explores a range of issues that arise as they seek to make a difference.

  8. Spirituality in nursing and health-related literature: a concept analysis.

    PubMed

    Sessanna, Loralee; Finnell, Deborah; Jezewski, Mary Ann

    2007-12-01

    Spirituality has become an increasingly popular concept among the nursing and health-related literature. The purpose for conducting this concept analysis, guided by Walker and Avant's methodology, was to (a) examine how spirituality has been used within the current body of nursing and health-related literature, (b) clarify the meaning of spirituality by discovering what this concept's current critical attributes/characteristics are, and (c) propose a definition of spirituality based on the concept analysis findings. A total of 90 references were reviewed, including 73 nursing and health-related references. Concept analysis findings revealed that spirituality was defined within four main themes in the nursing and health-related literature: (a) spirituality as religious systems of beliefs and values (spirituality = religion); (b) spirituality as life meaning, purpose, and connection with others; (c) spirituality as nonreligious systems of beliefs and values; and (d) spirituality as metaphysical or transcendental phenomena.

  9. The Role of Conflict Identification and Management in Sustaining Community Collaboration: Report on a Four-Year Exploratory Study.

    PubMed

    Blanch, Andrea K; Boustead, Robyn; Boothroyd, Roger A; Evans, Mary E; Chen, Huey-Jen

    2015-07-01

    Community collaboration has become increasingly common in behavioral health services. Conflict is likely to occur in any community coalition bringing together organizations with differing mandates, missions, and histories. However, research on how coalitions identify and handle conflict, and on the impact of conflict on sustainability is scarce. An exploratory study examined conflict in two federally funded children's "systems of care" using site visits and concept mapping to describe differences in how sites conceptualize and respond to conflict. Results suggest that unacknowledged and unaddressed conflict can negatively affect the development and sustainability of sites, and that focusing on cooperation may, paradoxically, make it more difficult to acknowledge conflict and to implement conflict transformation processes. Implications for behavioral health administrators are discussed, including potential interventions that could address these issues.

  10. [Socioeconomic impact of armed conflict on the health of women and children in the Democratic Republic of the Congo].

    PubMed

    Omba Kalonda, J C

    2011-04-01

    Since 1996, the Democratic Republic of Congo (DRC) has been the theatre of armed conflict. More than 5.4 millions have died and 500,000 to 1,000,000 women have been raped. As a result of permanent insecurity including frequent massacres, burning of villages and plundering of personal property and crops, millions of Congolese people especially in eastern regions have been displaced with around 1.3 million in internal refugee camps. Rural populations have abandoned farming that was the main source of employment, food, and income. The purpose of this paper is to describe the socioeconomic impact of this armed conflict particularly on the health of women and children. Consequences include i) decreased food production, ii) worsening food insecurity and malnutrition, iii) reduced household income, and iv) inadequate health care leading to epidemic outbreaks of diseases such as cholera, measles, and meningitis. Food insecurity and poverty affect around 70% of the population. Chronic malnutrition and growth retardation affect 38% of children. The mortality rate for children under 5 has reached 205 per 1000 live births. Other than achieving lasting peace that is a prerequisite for development in the DRC, the main priority must be to provide victims with multiform assistance aimed at restarting the economy and ensuring food self-sufficiency, thereby reducing both malnutrition and child mortality. Better access to healthcare and to psychosocial, medical, and legal services is also needed for rape victims.

  11. Livestock/Animal Assets Buffer the Impact of Conflict-Related Traumatic Events on Mental Health Symptoms for Rural Women

    PubMed Central

    Glass, Nancy; Perrin, Nancy A.; Kohli, Anjalee; Remy, Mitima Mpanano

    2014-01-01

    Background In the context of multiple adversities, women are demonstrating resilience in rebuilding their futures, through participation in microfinance programs. In addition to the economic benefits of microfinance, there is evidence to suggest that it is an effective vehicle for improving health. Methods The parent study is a community-based trial to evaluate the effectiveness of a livestock microfinance intervention, Pigs for Peace (PFP), on health and economic outcomes with households in 10 villages in eastern Democratic Republic of Congo. The analysis for this manuscript includes only baseline data from female participants enrolled in the ongoing parent study. Multiple regression analysis was used to examine if livestock/animal asset value moderates the relationship between conflict-related traumatic events and current mental health symptoms. Findings The majority of women are 25 years or older, married, have on average 4 children in the home and have never attended school. Nearly 50% of women report having at least one livestock/animal asset at baseline. Over the past 10 years, women report on average more than 4 (M = 4.31, SD 3·64) traumatic events (range 0–18). Women reported symptoms consistent with PTSD with a mean score of ·2.30 (SD = 0·66range 0–4) and depression with a mean score of 1.86 (SD  = 0·49, range 0–3.47). The livestock/animal asset value by conflict-related traumatic events interaction was significant for both the PTSD (p = 0·021) and depression (p = 0·002) symptom models. Interpretation The study provides evidence of the moderating affect of livestock/animal assets on mental health symptoms for women who have experienced conflict. The findings supports evidence about the importance of livestock/animal assets to economics in rural households but expands on previous research by demonstrating the psychosocial effects of these assets on women's health. Trial Registration clinicaltrials.gov NCT02008708 PMID

  12. Identifying and Addressing Students' Alternative Conceptions of the Causes of Global Warming: The Need for Cognitive Conflict

    NASA Astrophysics Data System (ADS)

    Meadows, George; Wiesenmayer, Randall L.

    1999-09-01

    School-age children are frequently exposed to issues related to global warming/global climatic change. Yet, their conceptions regarding the scope and nature of this phenomenon are often incomplete or even inconstant with predominant scientific understandings. The complex conceptual knowledge required to understand issues related to global warming create learning situations that harbor the development of incomplete or inaccurate ideas related to global warming. This study presents some of those misconceptions and discusses strategies for mitigation.

  13. Health care mergers and acquisitions: implications of robbers cave realistic conflict theory and prisoner's dilemma game theory.

    PubMed

    Creasy, Todd; Kinard, Jerry

    2013-01-01

    Many health care mergers and acquisitions have proven highly successful because of the geographic proximity of the institutions, coalignment strategies, complementary services, and improved financial performance. Other health care mergers and acquisitions, however, have been dismal failures. This article seeks to explain a primary cause of less successful mergers or acquisitions through the prism of a multiscale, iterative prisoner's dilemma that occurs between department managers. Aspects of "Coping Theory," "Resource (Conservation) Theory," and "Social Comparison Theory" are used to analyze the experience of employees charged with making mergers or acquisitions successful. Lastly, this article suggests possible culture clash remedies drawn from the realistic conflict experiment conducted by Muzafer Sherif near Robbers Cave State Park in Oklahoma.

  14. Examining the Concept of Choice in Sexual Health Interventions for Young People

    ERIC Educational Resources Information Center

    Spencer, Grace; Doull, Marion; Shoveller, Jean A.

    2014-01-01

    Concepts of choice are often drawn upon within sexual health promotion discourses to encourage young people to take "responsibility" for and promote their own sexual health and reproductive control. A systematic literature search using predefined inclusion criteria identified peer-reviewed articles focusing on sexual health interventions…

  15. In search of a health education model: teachers' conceptions in four Mediterranean countries.

    PubMed

    Caussidier, Claude; El Hage, Fadi; Munoz, François; Remki, Latifa; Larribi, Rym; Khzami, Salah-Eddine; Berger, Dominique; de Carvalho, Graça S; Favre, Daniel

    2011-12-01

    School programs are defined to promote the health of the pupils and to develop their competencies so that they can adopt behaviors favorable to their health. With the European project FP6 Biohead-Citizen (2004-2007), we analyzed the conceptions of teachers as regards health education, in France, Lebanon, Morocco and Tunisia, in reference to the biomedical model and the social health model. These four countries were selected because their school curricula represented different models of health education. Lebanon and Tunisia addressed health education with the biomedical model. In Morocco, the curriculum was also primarily based on the biomedical model and enclosed a few instructions issued from the social health model. In France, the health education curriculum declared an approach based on the health promotion model. Our study was based on multivariate statistical analyses of questionnaires filled out by 2537 in-service and pre-service teachers. Our analysis showed that the conceptions of the teachers concerning health education were not structured and related to a specific model. We also found that the dominating factors of influence on the choices expressed with regards to health education were, among different sociocultural variables, the religion, the home country, and, to a lesser extent, the level of training. Thus, the conceptions of the teachers were not integrated into comprehensive approaches but related to individual characteristics. Consequently health education implementation would require thorough training for pre-service and in-service teachers and should also explicitly take into account their conceptions and values.

  16. Changing Concepts of Health and Illness among Children of Primary School Age in Western Kenya

    ERIC Educational Resources Information Center

    Onyango-Ouma, W.; Aagaard-Hansen, J.; Jensen, B. B.

    2004-01-01

    This paper examines changes in children's concepts of health and illness following an action-oriented health education intervention in Bondo district of Western Kenya. The study is a feasibility study exploring a specific educational approach, and it combines elements of health education research and anthropological research. Forty primary…

  17. Children's Perceptions of Health and Illness: Images and Lay Concepts in Preadolescence

    ERIC Educational Resources Information Center

    Piko, Bettina F.; Bak, Judit

    2006-01-01

    Despite a growing body of research into children's concepts of illness, many basic questions still remain. This study aims to describe 8- to 11-year olds' lay beliefs of health, illness, health promotion and disease prevention. Children responded to open-ended questions about health and illness by drawing and writing their responses. Two primary…

  18. Is Acculturation in Hispanic Health Research a Flawed Concept? JSRI Working Paper.

    ERIC Educational Resources Information Center

    Ponce, Carlos; Comer, Brendon

    Some health researchers have used the concept of acculturation to explain health behaviors or illnesses prevalent among Hispanic people. This paper reviews studies in health, educational, and social science research among Hispanics and argues that acculturation studies are seriously limited by several basic conceptual and methodological problems.…

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

    PubMed Central

    2013-01-01

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

  20. Impact of Mahatma Gandhi's concepts on mental health: Reflections

    PubMed Central

    Tandon, Abhinav; Singh, V. K.

    2013-01-01

    Mahatma Gandhi can be looked upon as one of the greatest visionaries born. His life tells us about the varied emotions he went through as a boy and young adult during difficult times, and the experiments he did to cope up with these problems. It was his perseverance and dedication to an unrelenting pursuit of his goal that finally led to his transformation. His concepts like nonviolence, satyagraha, brahmcharya and the concepts related to ‘Truth’ and ‘God’ can give psychological strength and mental resilience to any individual trying to cope up with the demands of life. PMID:23858259

  1. Career and Vocational Education. Concepts of Health Management System.

    ERIC Educational Resources Information Center

    Larson, Curtis G.; Fiedler, Beatrice

    This curriculum guide is designed to assist students in developing the ability to understand the many aspects of personal/social/mental health. It emphasizes student performance objectives in physical well-being, disease, reproduction, heredity, mental health and aging. It is also designed to assist the local teacher with organization and…

  2. An agenda for future debate on concepts of health and disease.

    PubMed

    Khushf, George

    2007-03-01

    The traditional contrast between naturalist and normativist disease concepts fails to capture the most salient features of the health concepts debate. By using health concepts as a window on background notions of medical science and ethics, I show how Christopher Boorse (an influential naturalist) and Lennart Nordenfelt (an influential normativist) actually share deep assumptions about the character of medicine. Their disease concepts attempt, in different ways, to shore up the same medical model. For both, health concepts function like demarcation criteria in the philosophy of science: they mark off the jurisdiction of medical science, and protect it from an inappropriate intrusion of socioeconomic factors, which threaten the integrity of modern medicine. These views are challenged by new developments in healthcare such as managed care and total quality review. To frame the health concepts debate in a way that better captures the issues integral to these new developments, I advance a new way of reading the distinction between weak and strong normativists. Strong normativists are skeptical of the demarcation project, think facts and values cannot be disentangled, and hold that socioeconomic conditions unavoidably influence how pathology is understood. The new health concepts debate should be framed as one between weak and strong normativists, and it concerns how we should respond to the current developments in health care.

  3. Health concepts, issues, and experience in the Abakaliki area, Nigeria.

    PubMed Central

    Chukwuma, C

    1994-01-01

    Environmental health problems are increasingly receiving global attention. The health of entire nations may not only be affected by adverse environmental conditions, but by nutritional deficiencies that lead to morbidity and mortality. The type and extent of adverse health effects in a population depend on the potential for exposure to some environmental factors and pathogens as well as other environmental variables like industrialization, sanitation conditions, and urbanization. National and international comparisons between health status indicators can reveal the extent of any differences that exist, including dynamic changes in prevailing environmental conditions which may be helpful in characterizing the role of specific risk factors. Improvements in collection of environmental data related to health can help to identify, control, and eliminate many of the factors that are associated with environmental risk in the Abakaliki area of eastern Nigeria. PMID:9644193

  4. Rural health care in Vietnam and China: conflict between market reforms and social need.

    PubMed

    Huong, Dang Boi; Phuong, Nguyen Khanh; Bales, Sarah; Jiaying, Chen; Lucas, Henry; Segall, Malcolm

    2007-01-01

    China and Vietnam have adopted market reforms in the health sector in the context of market economic reforms. Vietnam has developed a large private health sector, while in China commercialization has occurred mainly in the formal public sector, where user fees are now the main source of facility finance. As a result, the integrity of China's planned health service has been disrupted, especially in poor rural areas. In Vietnam the government has been an important financer of public health facilities and the pre-reform health service is largely intact, although user fees finance an increasing share of facility expenditure. Over-servicing of patients to generate revenue occurs in both countries, but more seriously in China. In both countries government health expenditure has declined as a share of total health expenditure and total government expenditure, while out-of-pocket health spending has become the main form of health finance. This has particularly affected the rural poor, deterring them from accessing health care. Assistance for the poor to meet public-sector user fees is more beneficial and widespread in Vietnam than China. China is now criticizing the degree of commercialization of its health system and considers its health reforms "basically unsuccessful." Market reforms that stimulate growth in the economy are not appropriate to reform of social sectors such as health.

  5. Toward Proof of Concept of a One Health Approach to Disease Prediction and Control

    PubMed Central

    Kock, Richard; Kachani, Malika; Kunkel, Rebekah; Thomas, Jason; Gilbert, Jeffrey; Wallace, Robert; Blackmore, Carina; Wong, David; Karesh, William; Natterson, Barbara; Dugas, Raymond; Rubin, Carol

    2013-01-01

    A One Health approach considers the role of changing environments with regard to infectious and chronic disease risks affecting humans and nonhuman animals. Recent disease emergence events have lent support to a One Health approach. In 2010, the Stone Mountain Working Group on One Health Proof of Concept assembled and evaluated the evidence regarding proof of concept of the One Health approach to disease prediction and control. Aspects examined included the feasibility of integrating human, animal, and environmental health and whether such integration could improve disease prediction and control efforts. They found evidence to support each of these concepts but also identified the need for greater incorporation of environmental and ecosystem factors into disease assessments and interventions. The findings of the Working Group argue for larger controlled studies to evaluate the comparative effectiveness of the One Health approach. PMID:24295136

  6. Managing Ethical Challenges to Mental Health Research in Post‐Conflict Settings

    PubMed Central

    Khan, Muhammad Naseem; Rahman, Atif; Frith, Lucy

    2015-01-01

    Abstract Recently the World Health Organization (WHO) has highlighted the need to strengthen mental health systems following emergencies, including natural and manmade disasters. Mental health services need to be informed by culturally attuned evidence that is developed through research. Therefore, there is an urgent need to establish rigorous ethical research practice to underpin the evidence‐base for mental health services delivered during and following emergencies. PMID:25580875

  7. Changing Work and Work-Family Conflict: Evidence from the Work, Family, and Health Network*

    PubMed Central

    Kelly, Erin L.; Moen, Phyllis; Oakes, J. Michael; Fan, Wen; Okechukwu, Cassandra; Davis, Kelly D.; Hammer, Leslie; Kossek, Ellen; King, Rosalind Berkowitz; Hanson, Ginger; Mierzwa, Frank; Casper, Lynne

    2013-01-01

    Schedule control and supervisor support for family and personal life are work resources that may help employees manage the work-family interface. However, existing data and designs have made it difficult to conclusively identify the effects of these work resources. This analysis utilizes a group-randomized trial in which some units in an information technology workplace were randomly assigned to participate in an initiative, called STAR, that targeted work practices, interactions, and expectations by (a) training supervisors on the value of demonstrating support for employees’ personal lives and (b) prompting employees to reconsider when and where they work. We find statistically significant, though modest, improvements in employees’ work-family conflict and family time adequacy and larger changes in schedule control and supervisor support for family and personal life. We find no evidence that this intervention increased work hours or perceived job demands, as might have happened with increased permeability of work across time and space. Subgroup analyses suggest the intervention brings greater benefits to employees more vulnerable to work-family conflict. This study advances our understanding of the impact of social structures on individual lives by investigating deliberate organizational changes and their effects on work resources and the work-family interface with a rigorous design. PMID:25349460

  8. Using GoNoodle to Introduce Health Concepts in the K-5 Classroom

    ERIC Educational Resources Information Center

    Whitney, Elizabeth A.

    2016-01-01

    This article introduces readers to the GoNoodle platform for incorporating physical activity throughout the school day, and describes how one of the features, Ultimate Champ Training, can be used to teach health concepts in the elementary school classroom.

  9. The Health Utilities Index (HUI): concepts, measurement properties and applications.

    PubMed

    Horsman, John; Furlong, William; Feeny, David; Torrance, George

    2003-10-16

    This is a review of the Health Utilities Index (HUI) multi-attribute health-status classification systems, and single- and multi-attribute utility scoring systems. HUI refers to both HUI Mark 2 (HUI2) and HUI Mark 3 (HUI3) instruments. The classification systems provide compact but comprehensive frameworks within which to describe health status. The multi-attribute utility functions provide all the information required to calculate single-summary scores of health-related quality of life (HRQL) for each health state defined by the classification systems. The use of HUI in clinical studies for a wide variety of conditions in a large number of countries is illustrated. HUI provides comprehensive, reliable, responsive and valid measures of health status and HRQL for subjects in clinical studies. Utility scores of overall HRQL for patients are also used in cost-utility and cost-effectiveness analyses. Population norm data are available from numerous large general population surveys. The widespread use of HUI facilitates the interpretation of results and permits comparisons of disease and treatment outcomes, and comparisons of long-term sequelae at the local, national and international levels.

  10. Americans' conflicting views about the public health system, and how to shore up support.

    PubMed

    Blendon, Robert J; Benson, John M; SteelFisher, Gillian K; Connolly, John M

    2010-11-01

    This analysis of national opinion polls shows that a majority of Americans support increased spending on public health in general and that they see public health interventions as saving money in the long term. At the same time, many do not favor increased federal spending in a number of areas that public health officials deem important. In addition, polls show striking partisan differences, with Republicans much less supportive than Democrats of additional spending on public health. This split may have political implications for the public health component of the new health reform law if there is a change in party control of one or more houses of Congress after the November 2010 elections. As a result, in order to sustain public support for increased spending, it will be critically important to give examples of cost savings from public health programs and to highlight how they have reduced mortality from major chronic illnesses, such as cancer, heart disease, and HIV/AIDS.

  11. Survivors of the war in the Northern Kosovo: violence exposure, risk factors and public health effects of an ethnic conflict

    PubMed Central

    2010-01-01

    Background The aim of this population-based study was to assess the long-lasting effects of ethnic conflict on health and well-being (with a focus on injury and persistent pain) at family and community level. We have also investigated possible risk factors for victimisation during the conflict and factors contributing to healing. Methods We conducted a district-level cross-sectional cluster survey of 1,115 households with a population of 6,845. Interviews were carried out in Mitrovicë district in Northern Kosovo from September to October 2008, using standardised questionnaire to collect lifetime violence exposure, lifestyle factors and health information on individual and household. Results Ethnic Albanians made up 95% of the sample population. Crude mortality and under-five mortality rate was not high in 2008. Over 90% of families had been exposed to at least two categories of violence and human rights violations, and 493 individuals from 341 families reported torture experiences. During the two weeks before the survey, 20% of individuals had suffered physical or mental pain. There were differences in pain complaints according to gender and age, and whether people had been injured within 12 months, had lifetime exposure to violence-related injury, or had been tortured. Patterns of social and political participation in a family could affect the proportion of family members complaining of pain. The proportion of family members with pain complaints was related to a decline in the household income (coef = 9.31, 95% CI = 6.16-12.46, P < 0.001) and the fact of borrowing money (coef = 6.11, 95% CI = 2.91-9.30, P < 0.001) because of an injured person in the household. Families that were affiliated with the Kosovo Liberation Army, or had participated in a protest before or during the war, were likely to be targeted by Serbian paramilitary and law enforcement agencies. Conclusions Mitrovicë district is currently characterised by a low level of violence, but the effects of

  12. Conceptions of mental health among Ugandan youth orphaned by AIDS.

    PubMed

    Harms, Sheila; Kizza, Ruth; Sebunnya, Joshua; Jack, Susan

    2009-03-01

    The AIDS epidemic has disproportionately affected developing or low-income sub-Saharan African countries. Within the context of the epidemic, children and youth are at risk of losing their parents at an early age. The experience of orphanhood due to AIDS has the potential to negatively impact on a child's mental health. A qualitative study was conducted to comprehensively describe the experience of orphanhood and its impact on mental health from the culturally specific perspective of Ugandan youths. We conducted interviews with a purposeful sample of 13 youths (ages 12 to 18) who had lost one or both parents to AIDS illness and who were also affiliated with a non-governmental organisation providing support to orphans. The orphaned youths experienced significant ongoing emotional difficulties following the death of their parent(s). The youths in this study were unfamiliar with the term 'mental health,' however they easily identified factors associated with good or poor mental health. In general, good mental health was associated with social conduct that is culturally appropriate. Poor mental health was perceived as a form of madness or insanity and it was associated with a loss of basic life necessities, such as access to food, education or shelter. The youths also identified factors that promote more successful orphans. The findings of this study suggest that Western terminologies and symptom constellations in the Diagnostic and Statistical Manual IV may not be applicable in an African cultural context. There are several clinical implications, including the development of a mental health intervention paradigm that emphasises resilience.

  13. Conflicting paradigms in radiation protection: 20 Questions with answers from the regulator, the health physicist, the scientist, and the lawyers

    SciTech Connect

    Strom, D.J.; Stansbury, P.S.; Porter, S.W. Jr.

    1995-01-01

    George Orwell`s {open_quotes}doublethink{close_quotes} should be generalized to {open_quotes}polythink{close_quotes} to describe the multiplicity of views that radiation protection professionals must simultaneously accommodate. The paradigms, that is, organizing principles and beliefs, that (1) regulators, (2) operational health physicists, (3) scientists, (4) lawyers for the defendant, and (5) lawyers for the plaintiff use in their approaches to radiation protection are presented. What we believe as scientists often conflicts with what we do for purposes of radiation protection. What we need to do merely to protect humankind and the environment from harmful effects of radiation is far less than what we must do to satisfy the regulator, whose paradigm has checklists, score-keeping, and penalties. In the hands of lawyers, our work must overcome different challenges. Even if the paradigms of the operational health physicist, the scientist, and the regulator match, the odds against the lawyers paradigms also matching are astronomical. The differing paradigms are illustrated by example questions and answers. It is important for educators, trainers, and health physicists to recognize and separate the score-keeping, practice, science, and legal issues in health physics.

  14. Applying total quality management concepts to public health organizations.

    PubMed Central

    Kaluzny, A D; McLaughlin, C P; Simpson, K

    1992-01-01

    Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project. PMID:1594734

  15. Prioritizing Healthcare Delivery in a Conflict Zone Comment on "TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo".

    PubMed

    Wood, Robin; Richardson, Eugene T

    2013-09-01

    Nowhere are the barriers to a functional health infrastructure more clearly on display than in the Goma region of Democratic Republic of Congo. Kaboru et al. report poorly integrated services for HIV and TB in this war-torn region. Priorities in conflict zones include provision of security, shelter, food, clean water and prevention of sexual violence. In Goma, immediate health priorities include emergency treatment of cholera, malaria, respiratory illnesses, provision of maternal care, millions of measles vaccinations, and management of an ongoing rabies epidemic. It is a daunting task to determine an essential package of medical services in a setting where there are so many competing priorities, where opportunity costs are limited and epidemiologic information is scarce. Non-governmental agencies sometimes add to the challenge via an insidious reduction of state sovereignty and the creation of new levels of income inequality. Kaboru et al. have successfully highlighted many of the complexities of rebuilding and prioritizing healthcare in a conflict zone.

  16. A Lifetime of Trauma: Mental Health Challenges for Higher Education in a Conflict Environment in Afghanistan

    ERIC Educational Resources Information Center

    Babury, Mohammed Osman; Hayward, Fred Manwarren

    2013-01-01

    More than 30 years of war in Afghanistan have resulted in immense policy challenges to address the resulting mental health issues. The purpose of this policy analysis is to examine the potential role of higher education in addressing the pressing mental health problems in Afghanistan's public universities and higher education institutions as a…

  17. [The concept of endocrine disruption and human health].

    PubMed

    Cravedi, Jean-Pierre; Zalko, Daniel; Savouret, Jean-François; Menuet, Arnaud; Jégou, Bernard

    2007-02-01

    In Europe, endocrine disruptors (EDs) have been defined as substances foreign to the body that have deleterious effects on the individuals or their descendants, due to changes in endocrine function. In the United States, EDs have been described as exogenous agents that interfere with the production, release, transport, metabolism, binding, action or elimination of the natural ligands responsible for maintaining homeostasis and regulating body development. These two definitions are complementary, but both indicate that the effects induced by EDs probably involve mechanisms relating in some way to hormonal homeostasis and action. EDs are generally described as substances with anti-oestrogenic, oestrogenic, anti-androgenic or androgenic effects. More recently, other targets have been evidenced such as the thyroid and immune system. Many different EDs are present in the various compartments of the environment (air, water and land) and in foods (of plant and animal origin). They may originate from food packaging, combustion products, plant health treatments, detergents and the chemical industry in general. In addition to the potential effects of these compounds on adults, the sensitivity of embryos and fetuses to many of the xenobiotic compounds likely to cross the placenta has raised considerable concern and led to major research efforts. With the exception of the clearly established links between diethylstilbestrol, reproductive health abnormalities and cancers, very little is known for certain about the effects of EDs on human health. Given the lack of available data, current concerns about the possible involvement of EDs in the increase in the incidence of breast cancer, and possibly of endometriosis and early puberty in girls, remain hypothetical. Conversely, the deterioration in male reproductive health is at the heart of preoccupations and progress in analyses of the relationship between EDs and human health. This literature review aims to describe the current

  18. Change and stability in work-family conflict and mothers' and fathers' mental health: Longitudinal evidence from an Australian cohort.

    PubMed

    Cooklin, A R; Dinh, H; Strazdins, L; Westrupp, E; Leach, L S; Nicholson, J M

    2016-04-01

    Work-family conflict (WFC) occurs when work or family demands are 'mutually incompatible', with detrimental effects on mental health. This study contributes to the sparse longitudinal research, addressing the following questions: Is WFC a stable or transient feature of family life for mothers and fathers? What happens to mental health if WFC increases, reduces or persists? What work and family characteristics predict WFC transitions and to what extent are they gendered? Secondary analyses of 5 waves of data (child ages 4-5 to 12-13 years) from employed mothers (n = 2693) and fathers (n = 3460) participating in the Longitudinal Study of Australian Children were conducted. WFC transitions, across four two-year intervals (Waves 1-2, 2-3, 3-4, and 4-5) were classified as never, conscript, exit or chronic. Significant proportions of parents experienced change in WFC, between 12 and 16% of mothers and fathers for each transition 'type'. Parents who remained in chronic WFC reported the poorest mental health (adjusted multiple regression analyses), followed by those who conscripted into WFC. When WFC was relieved (exit), both mothers' and fathers' mental health improved significantly. Predictors of conscript and chronic WFC were somewhat distinct for mothers and fathers (adjusted logit regressions). Poor job quality, a skilled occupation and having more children differentiated chronic fathers' from those who exited WFC. For mothers, work factors only (skilled occupation; work hours; job insecurity) predicted chronic WFC. Findings reflect the persistent, gendered nature of work and care shaped by workplaces, but also offer tailored opportunities to redress WFC for mothers and fathers. We contribute novel evidence that mental health is directly influenced by the WFC interface, both positively and negatively, highlighting WFC as a key social determinant of health.

  19. Perspectives on the strategic uses of concept mapping to address public health challenges.

    PubMed

    Anderson, Lynda A; Slonim, Amy

    2017-02-01

    We examine the adaptation of approaches used to plan and implement the steps of concept mapping to meet specialized needs and requirements in several public health projects. Seven published concept mapping projects are detailed to document how each of the phases were modified to meet the specific aims of each project. Concept mapping was found to be a useful tool to complement public health roles such as assessment, program development, and priority setting. The phases of concept mapping allow for a blending of diverse perspectives, which is critical to public health efforts. The adaptability of concept mapping permits the use of multiple modalities such as the addition of face-to-face brainstorming; use of qualitative methods, including structured interviews; and review and use of published literature and guidelines. Another positive aspect of concept mapping for public health practice is its ability to identify program elements, provide a visual map of generated ideas and their relationships to one another, and assist in identifying priorities. Our reflections on the adaptability should help inform another generation in designing concept mapping projects and related products that may benefit from unique adaptations and the rapidly expanding social media technology and platforms.

  20. Peace-building and reconciliation dividends of integrated health services delivery in post-conflict Burundi: qualitative assessments of providers and community members.

    PubMed

    Christensen, Cathryn; Edward, Anbrasi

    2015-01-01

    While demonstrating causality remains challenging, several 'health-peace' mechanisms have been proposed to describe how health systems contribute to peace-building and stability in post-conflict settings. A qualitative study was undertaken in southern Burundi to identify drivers of social tension and reconciliation in the catchment area of Village Health Works, a health services organisation. Key informant interviews and focus group discussions were conducted in early 2014 with a total of one hundred and twenty community members and staff representing a range of conflict and recovery experience. Themes emerging from these interviews indicated mechanisms at the individual, household, community, and regional levels through which health provision mitigates tensions and promotes social cohesion. This peace dividend was amplified by the clinic's integrated model, which facilitates further community interaction through economic, agricultural and education programmes. Land pressure and the marginalisation of repatriated refugees were cited as drivers of local tension.

  1. What matters for working fathers? Job characteristics, work-family conflict and enrichment, and fathers' postpartum mental health in an Australian cohort.

    PubMed

    Cooklin, Amanda R; Giallo, Rebecca; Strazdins, Lyndall; Martin, Angela; Leach, Liana S; Nicholson, Jan M

    2015-12-01

    One in ten fathers experience mental health difficulties in the first year postpartum. Unsupportive job conditions that exacerbate work-family conflict are a potential risk to fathers' mental health given that most new fathers (95%) combine parenting with paid work. However, few studies have examined work-family conflict and mental health for postpartum fathers specifically. The aim of the present study was to identify the particular work characteristics (e.g., work hours per week, job quality) associated with work-family conflict and enrichment, and fathers' mental health in the postpartum period. Survey data from 3243 fathers of infants (aged 6-12 months) participating in the Longitudinal Study of Australian Children were analysed via path analysis, considering key confounders (age, education, income, maternal employment, maternal mental health and relationship quality). Long and inflexible work hours, night shift, job insecurity, a lack of autonomy and more children in the household were associated with increased work-family conflict, and this was in turn associated with increased distress. Job security, autonomy, and being in a more prestigious occupation were positively associated with work-family enrichment and better mental health. These findings from a nationally representative sample of Australian fathers contribute novel evidence that employment characteristics, via work-family conflict and work-family enrichment, are key determinants of fathers' postnatal mental health, independent from established risk factors. Findings will inform the provision of specific 'family-friendly' conditions protective for fathers during this critical stage in the family life-cycle, with implications for their wellbeing and that of their families.

  2. Concept Attainment Teaching Methodology (CATM)--An Effective Approach for Training Workers on Chemicals Health Hazards

    ERIC Educational Resources Information Center

    Suleiman, Abdulqadir Mohamad

    2016-01-01

    Workers handling chemicals need to understand the risk to health involved in their work, and this requires training. In this study effectivity of concept attainment teaching methodology (CATM) as training strategy for cleaning workers was assessed. CATM was used to train workers on chemicals information and health hazards. Pictures, illustrations,…

  3. Media Health Literacy (MHL): Development and Measurement of the Concept among Adolescents

    ERIC Educational Resources Information Center

    Levin-Zamir, Diane; Lemish, Dafna; Gofin, Rosa

    2011-01-01

    Increasing media use among adolescents and its significant influence on health behavior warrants in-depth understanding of their response to media content. This study developed the concept and tested a model of Media Health Literacy (MHL), examined its association with personal/socio-demographic determinants and reported sources of health…

  4. Concepts of Healthful Food among Low-Income African American Women

    ERIC Educational Resources Information Center

    Lynch, Elizabeth B.; Holmes, Shane; Keim, Kathryn; Koneman, Sylvia A.

    2012-01-01

    Objective: Describe beliefs about what makes foods healthful among low-income African American women. Methods: In one-on-one interviews, 28 low-income African American mothers viewed 30 pairs of familiar foods and explained which food in the pair was more healthful and why. Responses were grouped into codes describing concepts of food…

  5. Linking Health Concepts in the Assessment and Evaluation of Water Distribution Systems

    ERIC Educational Resources Information Center

    Karney, Bryan W.; Filion, Yves R.

    2005-01-01

    The concept of health is not only a specific criterion for evaluation of water quality delivered by a distribution system but also a suitable paradigm for overall functioning of the hydraulic and structural components of the system. This article views health, despite its complexities, as the only criterion with suitable depth and breadth to allow…

  6. Concept Paper on Health and Safety Issues in Day Care. Final Manuscript.

    ERIC Educational Resources Information Center

    Pizzo, Peggy; Aronson, Susan S.

    This report discusses the existence and prevention of major health and safety risks for children in day care and makes recommendations for the Federal Interagency Day Care requirements (FIDCR) concerning health and safety. Section I describes varying concepts of risk related to probability and to possibility of adverse events, and discusses…

  7. A mental health needs assessment of children and adolescents in post-conflict Liberia: results from a quantitative key-informant survey

    PubMed Central

    Borba, Christina P.C.; Ng, Lauren C.; Stevenson, Anne; Vesga-Lopez, Oriana; Harris, Benjamin L.; Parnarouskis, Lindsey; Gray, Deborah A.; Carney, Julia R.; Domínguez, Silvia; Wang, Edward K.S.; Boxill, Ryan; Song, Suzan J.; Henderson, David C.

    2016-01-01

    Between 1989 and 2004, Liberia experienced a devastating civil war that resulted in widespread trauma with almost no mental health infrastructure to help citizens cope. In 2009, the Liberian Ministry of Health and Social Welfare collaborated with researchers from Massachusetts General Hospital to conduct a rapid needs assessment survey in Liberia with local key informants (n = 171) to examine the impact of war and post-war events on emotional and behavioral problems of, functional limitations of, and appropriate treatment settings for Liberian youth aged 5–22. War exposure and post-conflict sexual violence, poverty, infectious disease and parental death negatively impacted youth mental health. Key informants perceived that youth displayed internalizing and externalizing symptoms and mental health-related functional impairment at home, school, work and in relationships. Medical clinics were identified as the most appropriate setting for mental health services. Youth in Liberia continue to endure the harsh social, economic and material conditions of everyday life in a protracted post-conflict state, and have significant mental health needs. Their observed functional impairment due to mental health issues further limited their access to protective factors such as education, employment and positive social relationships. Results from this study informed Liberia's first post-conflict mental health policy. PMID:26807147

  8. A mental health needs assessment of children and adolescents in post-conflict Liberia: results from a quantitative key-informant survey.

    PubMed

    Borba, Christina P C; Ng, Lauren C; Stevenson, Anne; Vesga-Lopez, Oriana; Harris, Benjamin L; Parnarouskis, Lindsey; Gray, Deborah A; Carney, Julia R; Domínguez, Silvia; Wang, Edward K S; Boxill, Ryan; Song, Suzan J; Henderson, David C

    2016-01-02

    Between 1989 and 2004, Liberia experienced a devastating civil war that resulted in widespread trauma with almost no mental health infrastructure to help citizens cope. In 2009, the Liberian Ministry of Health and Social Welfare collaborated with researchers from Massachusetts General Hospital to conduct a rapid needs assessment survey in Liberia with local key informants (n = 171) to examine the impact of war and post-war events on emotional and behavioral problems of, functional limitations of, and appropriate treatment settings for Liberian youth aged 5-22. War exposure and post-conflict sexual violence, poverty, infectious disease and parental death negatively impacted youth mental health. Key informants perceived that youth displayed internalizing and externalizing symptoms and mental health-related functional impairment at home, school, work and in relationships. Medical clinics were identified as the most appropriate setting for mental health services. Youth in Liberia continue to endure the harsh social, economic and material conditions of everyday life in a protracted post-conflict state, and have significant mental health needs. Their observed functional impairment due to mental health issues further limited their access to protective factors such as education, employment and positive social relationships. Results from this study informed Liberia's first post-conflict mental health policy.

  9. Analytical concepts for health management systems of liquid rocket engines

    NASA Technical Reports Server (NTRS)

    Williams, Richard; Tulpule, Sharayu; Hawman, Michael

    1990-01-01

    Substantial improvement in health management systems performance can be realized by implementing advanced analytical methods of processing existing liquid rocket engine sensor data. In this paper, such techniques ranging from time series analysis to multisensor pattern recognition to expert systems to fault isolation models are examined and contrasted. The performance of several of these methods is evaluated using data from test firings of the Space Shuttle main engines.

  10. Mental Health Outcomes of Drug Conflict Among University Students at the U.S.–Mexico Border

    PubMed Central

    O’Connor, Kathleen; Vizcaino, Maricarmen; Benavides, Nora A.

    2015-01-01

    The purpose of this cross-sectional study was to investigate to what extent young adults with close ties to Mexico were at greater risk for self-reported negative mental health outcomes than comparison groups during drug-related armed conflict from 2008 through 2012, and the effect of type and number of traumatic events on mental health outcomes. Using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist, 202 university students living in the El Paso–Ciudad Juárez border region were surveyed for symptoms of depression, anxiety, and posttraumatic stress. Students with close ties to Mexico reported symptoms of anxiety and posttraumatic stress at significantly higher rates compared with those without connection to Mexico, but there was no significant difference in rates of depression. Although more than a third of participants reported experiencing 5 or more traumatic events connected with the drug war, being confined to home had the most significant effect. Frequency of traumatic events reported by students as well as rates of anxiety and posttraumatic stress symptoms were higher among students with greater connection to Mexico. Rates of clinically-significant depressive symptoms among all students were higher than expected for U.S. adults but comparable with all U.S. college students. This study presents important new data on the mental health effects of Mexico’s drug war. PMID:26633944

  11. Health, supervisory support, and workplace culture in relation to work-family conflict and synergy.

    PubMed

    Beutell, Nicholas J

    2010-08-01

    This research examined health, supervisory support, and workplace culture as predictors of work interfering with family, family interfering with work, and work-family synergy. The analysis of data from 2,796 respondents from the 2002 National Study of the Changing Workforce yielded significant relations among measures of mental health, self-rated health, supervisory support, and work-family culture with a focus on career concerns. Support was found for a measure of work-family synergy. Implications and directions for research are discussed.

  12. Evaluation of Health in All Policies: concept, theory and application.

    PubMed

    Baum, Fran; Lawless, Angela; Delany, Toni; Macdougall, Colin; Williams, Carmel; Broderick, Danny; Wildgoose, Deborah; Harris, Elizabeth; Mcdermott, Dennis; Kickbusch, Ilona; Popay, Jennie; Marmot, Michael

    2014-06-01

    This article describes some of the crucial theoretical, methodological and practical issues that need to be considered when evaluating Health in All Policies (HiAP) initiatives. The approaches that have been applied to evaluate HiAP in South Australia are drawn upon as case studies, and early findings from this evaluative research are provided. The South Australian evaluation of HiAP is based on a close partnership between researchers and public servants. The article describes the South Australian HiAP research partnership and considers its benefits and drawbacks in terms of the impact on the scope of the research, the types of evidence that can be collected and the implications for knowledge transfer. This partnership evolved from the conduct of process evaluations and is continuing to develop through joint collaboration on an Australian National Health & Medical Research Council grant. The South Australian research is not seeking to establish causality through statistical tests of correlations, but instead by creating a 'burden of evidence' which supports logically coherent chains of relations. These chains emerge through contrasting and comparing findings from many relevant and extant forms of evidence. As such, program logic is being used to attribute policy change to eventual health outcomes. The article presents the preliminary program logic model and describes the early work of applying the program logic approach to HiAP. The article concludes with an assessment of factors that have accounted for HiAP being sustained in South Australia from 2008 to 2013.

  13. Sexual Conflict in Hermaphrodites

    PubMed Central

    Schärer, Lukas; Janicke, Tim; Ramm, Steven A.

    2015-01-01

    Hermaphrodites combine the male and female sex functions into a single individual, either sequentially or simultaneously. This simple fact means that they exhibit both similarities and differences in the way in which they experience, and respond to, sexual conflict compared to separate-sexed organisms. Here, we focus on clarifying how sexual conflict concepts can be adapted to apply to all anisogamous sexual systems and review unique (or especially important) aspects of sexual conflict in hermaphroditic animals. These include conflicts over the timing of sex change in sequential hermaphrodites, and in simultaneous hermaphrodites, over both sex roles and the postmating manipulation of the sperm recipient by the sperm donor. Extending and applying sexual conflict thinking to hermaphrodites can identify general evolutionary principles and help explain some of the unique reproductive diversity found among animals exhibiting this widespread but to date understudied sexual system. PMID:25237131

  14. Changing concepts in lipid nutrition in health and disease.

    PubMed

    Chandrasekharan, N

    1999-09-01

    Fat remains a hot topic because of concerns over associations between consumption of fats and the incidence of some chronic conditions including coronary artery disease, diabetes, cancer and obesity. Dietary fats serve multiple purposes. The effects of dietary fats generally reflect the collective influences of multiple fatty acids in the diet or food. This presentation highlights some recent developments on the role of dietary fats and oils in health and disease. Debate continues over the role of dietary modification in coronary prevention by lipid lowering. The degree to which a recommended diet will result in health benefits for an individual is difficult to predict, because the outcome will depend on the influence of other factors such as a person's genetic constitution, level of physical activity and total diet composition. There can now be little doubt about the importance of genetic factors in the etiology of cardiovascular disease, diabetes, obesity and cancer. The importance of antioxidant status in the prevention of cardiovascular disease as well as many cancers is being increasingly recognised. It is now evident that not all saturated fatty acids are equally cholesterolemic. Recent accounts evaluating palm oil's effects on blood lipids and lipoproteins suggest that diets incorporating palm oil as the major dietary fat do not raise plasma total and LDL cholesterol levels to the extent expected from its fatty acid composition. Palm oil is endowed with a good mixture of natural antioxidants and together with its balanced composition of the different classes of fatty acids, makes it a safe, stable and versatile edible oil with many positive health and nutritional attributes. In recent times, adverse health concerns from the consumption of trans fatty acids arising from hydrogenation of oils and fats have been the subject of much discussion and controversy. Trans fatty acids when compared with cis fatty acids or unhydrogenated fats have been shown to lower

  15. Associations between Mental Health and Ebola-Related Health Behaviors: A Regionally Representative Cross-sectional Survey in Post-conflict Sierra Leone

    PubMed Central

    Betancourt, Theresa S.; Vinck, Patrick; VanderWeele, Tyler J.; Spencer-Walters, Dayo; Akinsulure-Smith, Adeyinka M.; Pham, Phuong

    2016-01-01

    Background Little attention has been paid to potential relationships between mental health, trauma, and personal exposures to Ebola virus disease (EVD) and health behaviors in post-conflict West Africa. We tested a conceptual model linking mental health and trauma to EVD risk behaviors and EVD prevention behaviors. Methods and Findings Using survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines associations between war exposures, post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, and personal EVD exposure (e.g., having family members or friends diagnosed with EVD) and EVD-related health behaviors among 1,008 adults (98% response rate) from 63 census enumeration areas of the Western Rural and Western Urban districts randomly sampled at the height of the EVD epidemic (January–April 2015). Primary outcomes were EVD risk behaviors (14 items, Cronbach’s α = 0.84) and EVD prevention behaviors (16 items, Cronbach’s α = 0.88). Main predictors comprised war exposures (8 items, Cronbach’s α = 0.85), anxiety (10 items, Cronbach’s α = 0.93), depression (15 items, Cronbach’s α = 0.91), and PTSD symptoms (16 items, Cronbach’s α = 0.93). Data were analyzed using two-level, population-weighted hierarchical linear models with 20 multiply imputed datasets. EVD risk behaviors were associated with intensity of depression symptoms (b = 0.05; 95% CI 0.00, 0.10; p = 0.037), PTSD symptoms (b = 0.10; 95% CI 0.03, 0.17; p = 0.008), having a friend diagnosed with EVD (b = −0.04; 95% CI −0.08, −0.00; p = 0.036), and war exposures (b = −0.09; 95% CI −0.17, −0.02; p = 0.013). EVD prevention behaviors were associated with higher anxiety (b = 0.23; 95% CI 0.06, 0.40; p = 0.008), having a friend diagnosed with EVD (b = 0.15; 95% CI 0.04, 0.27; p = 0.011), and higher levels of war exposure (b = 0.45; 95% CI 0.16, 0.74; p = 0.003), independent of mental health. PTSD symptoms

  16. Trends in Sugar-Sweetened Beverages: Are Public Health and the Market Aligned or in Conflict?

    PubMed Central

    Shrapnel, William

    2015-01-01

    Adverse health consequences of consuming sugar-sweetened beverages are frequently cited as an example of market failure, justifying government intervention in the marketplace, usually in the form of taxation. However, declining sales of sugar-sweetened beverages in Australia and a corresponding increase in sales of drinks containing non-nutritive sweeteners, in the absence of significant government regulation, appear to reflect market forces at work. If so, the public health challenge in relation to sugar-sweetened beverages may have less to do with regulating the market and more to do with harnessing it. Contrary to assertions that consumers fail to appreciate the links between their choice of beverage and its health consequences, the health conscious consumer appears to be driving the changes taking place in the beverage market. With the capacity to meet consumer expectations for convenience and indulgence without unwanted kilojoules, drinks containing non-nutritive sweeteners enable the “small change” in health behaviour that individuals are willing to consider. Despite the low barriers involved in perpetuating the current trend of replacing sugar-sweetened beverages with drinks containing non-nutritive sweeteners, some public health advocates remain cautious about advocating this dietary change. In contrast, the barriers to taxation of sugar-sweetened beverages appear high. PMID:26404369

  17. Trends in Sugar-Sweetened Beverages: Are Public Health and the Market Aligned or in Conflict?

    PubMed

    Shrapnel, William

    2015-09-23

    Adverse health consequences of consuming sugar-sweetened beverages are frequently cited as an example of market failure, justifying government intervention in the marketplace, usually in the form of taxation. However, declining sales of sugar-sweetened beverages in Australia and a corresponding increase in sales of drinks containing non-nutritive sweeteners, in the absence of significant government regulation, appear to reflect market forces at work. If so, the public health challenge in relation to sugar-sweetened beverages may have less to do with regulating the market and more to do with harnessing it. Contrary to assertions that consumers fail to appreciate the links between their choice of beverage and its health consequences, the health conscious consumer appears to be driving the changes taking place in the beverage market. With the capacity to meet consumer expectations for convenience and indulgence without unwanted kilojoules, drinks containing non-nutritive sweeteners enable the "small change" in health behaviour that individuals are willing to consider. Despite the low barriers involved in perpetuating the current trend of replacing sugar-sweetened beverages with drinks containing non-nutritive sweeteners, some public health advocates remain cautious about advocating this dietary change. In contrast, the barriers to taxation of sugar-sweetened beverages appear high.

  18. Prevalence and Health Correlates of Work-Life Conflict among Blue- and White-Collar Workers from Different Economic Sectors

    PubMed Central

    Hämmig, Oliver

    2014-01-01

    The research on work-life conflict (WLC) is largely neglected in occupational medicine and public health and typically limited to white-collar workers and public servants. This study therefore aims to explore possible differences in the prevalence of WLC and its association with health outcomes between white- and blue-collar workers from different work environments in Switzerland. Cross-sectional survey data collected in 2007 in the service sector and in 2010 in the industrial sector were used for statistical analyses. A subsample of university graduates employed by large service companies (N = 1,170) from the first survey’s population was taken and compared with a subsample of low or unskilled industrial and construction workers with no or only compulsory education (N = 489) from the second survey’s population. The results show almost consistently, and particularly in women, a lower prevalence of time- and strain-based forms and both causal directions of WLC in blue-collar workers. However, associations between different WLC measures and general, physical and mental health outcomes were found to be equally strong or even stronger among blue-collar workers compared to white-collar workers. Low or unskilled industrial and construction workers are less frequently affected by higher degrees of WLC but are then at no lower risk of suffering poor self-rated health or severe backaches and sleep disorders than university graduates working in the service sector with comparable exposure to WLC. In conclusion, it can be stated that WLC turned out to be much less prevalent but equally or even more detrimental to health in blue-collar workers, who therefore need to be considered in future studies. PMID:25426483

  19. Conflicts of interest matter and awareness is needed.

    PubMed

    Vineis, Paolo; Saracci, Rodolfo

    2015-10-01

    A conflict of interest arises by having two conflicting goals in one's research. The primary goal of research relevant to public health is to produce impartial evidence on health hazards for humans. Several entities - including industry - may have public health as a goal among others, but this is not their primary goal. Primary goals are in those cases profit or career, that conflict with the goal of health. It is a role of the State to foster research whose primary goal is impartial evidence on factors affecting population health. Disclosure of conflicts of interest is not enough: the view that disclosure solves all problems amounts to say that a declaration of having produced unbiased evidence is a self-fulfilling guarantee that the evidence will not be affected by conflicts of interest. This concept is seriously misleading. A conflict of interest arises from the circumstances in which research occurs and does not exist only in the opinion of some people or groups (or the authors of a paper).

  20. [Interaction between disease concepts and the organisation of health care].

    PubMed

    Gannik, Dorte Effersøe; Guassora, Ann Dorrit

    2011-03-14

    The biomedical model of disease which is codified in the medical diagnosis is closely tied to and dependent on the organizational system typically seen in hospitals, with centralization, specialization and standardized work procedures being the primary traits. In contrast, primary health care and general practice allow ways of dealing with disease which are inherently bio-psycho-social in nature. They do this, among others, by way of their organizational foundation, which favours small, local practices, doctors with generalist competencies, patients' free choice of doctor and a list system.

  1. How are Closeness and Conflict in Student-Teacher Relationships Associated with Demographic Factors, School Functioning and Mental Health in Norwegian Schoolchildren Aged 6-13?

    ERIC Educational Resources Information Center

    Drugli, May Britt

    2013-01-01

    This study explored the association between teacher-reported student-teacher relationship quality (closeness and conflict) and demographic factors, school functioning and child mental health in a cross-sectional study. The study was conducted among a national sample of Norwegian school children (N?=?825) in grades 1 to 7. Bivariate analyses and…

  2. Standardised tobacco packaging: a health policy case study of corporate conflict expansion and adaptation

    PubMed Central

    Hatchard, Jenny L; Fooks, Gary J; Gilmore, Anna B

    2016-01-01

    Objectives To investigate opposition to standardised tobacco packaging in the UK. To increase understanding of how transnational corporations are adapting to changes in their access to policymakers precipitated by Article 5.3 of the Framework Convention on Tobacco Control (FCTC). Design Case study web-based documentary analysis, using NVivo V.10. Examination of relationships between opponents of standardised packaging and transnational tobacco companies (TTCs) and of the volume, nature, transparency and timing of their activities. Setting UK standardised packaging policy debate 2011–2013. Participants Organisations selected on basis of opposition to, or facilitation thereof, standardised tobacco packaging in the UK; 422 associated documents. Results Excluding tobacco manufacturing and packaging companies (n=12), 109 organisations were involved in opposing standardised packaging, 82 (75%) of which had a financial relationship with 1 or more TTC. These 82 organisations (43 actively opposing the measure, 39 facilitating opposition) were responsible for 60% of the 404 activities identified, including the majority of public communications and research production. TTCs were directly responsible for 28% of total activities, predominantly direct lobbying, but also financially underwrote third party research, communication, mass recruitment and lobbying. Active organisations rarely reported any financial relationship with TTCs when undertaking opposition activities. Conclusions The multifaceted opposition to standardised packaging was primarily undertaken by third parties with financial relationships with major tobacco manufacturers. Low levels of transparency regarding these links created a misleading impression of diverse and widespread opposition. Countries should strengthen implementation of Article 5.3 of the FCTC by systematically requiring conflict of interest declarations from all organisations participating in political or media debates on tobacco control. PMID

  3. Dynamics of resilience in forced migration: a 1-year follow-up study of longitudinal associations with mental health in a conflict-affected, ethnic Muslim population

    PubMed Central

    Siriwardhana, Chesmal; Abas, Melanie; Siribaddana, Sisira; Sumathipala, Athula; Stewart, Robert

    2015-01-01

    Objective The concept of ‘resilience’ is of increasing interest in studies of mental health in populations facing adversity. However, lack of longitudinal data on the dynamics of resilience and non-usage of resilience-specific measurements have prevented a better understanding of resilience-mental health interactions. Hence, the present study was conducted to investigate the stability of levels of resilience and its associations with sociodemographic and mental health exposures in a conflict-affected internal-migrant population in Sri Lanka. Design A prospective follow-up study of 1 year. Setting Puttalam district of North Western province in postconflict Sri Lanka (baseline in 2011, follow-up in 2012). Participants An ethnic Muslim population internally displaced 20 years ago (in 1990) from Northern Sri Lanka, aged 18 or above and currently in the process of return migration. Measures It was hypothesised that levels of resilience would be associated with mental health outcomes. Resilience was measured on both occasions using the 14-item Resilience Scale (RS-14), social support by the Multidimensional Social Support Scale and Lubben Social Network Scale and common mental disorders by the Patient Health Questionnaire (PHQ). Results Of 450 participants interviewed at baseline in 2011, 338 (75.1%) were re-interviewed in 2012 after a 1-year follow-up. The mean resilience scores measured by RS-14 were 80.2 (95% CI 78.6 to 81.9) at baseline and 84.9 (83.5 to 86.3) at follow-up. At both time points, lower resilience was independently associated with food insecurity, lower social support availability and social isolation. At both time points, there were significant associations with common mental disorders (CMDs) in unadjusted analyses, but they only showed independence at baseline. The CMD prevalence, maintenance and incidence at follow-up was 8.3%, 28.2% and 2.2%, respectively. Conclusions In this displaced population facing a potential reduction in adversity

  4. Conflicts of interests, confidentiality and censorship in health risk assessment: the example of an herbicide and a GMO.

    PubMed

    Séralini, Gilles-Eric; Mesnage, Robin; Defarge, Nicolas; Spiroux de Vendômois, Joël

    2014-01-01

    We have studied the long-term toxicity of a Roundup-tolerant GM maize (NK603) and a whole Roundup pesticide formulation at environmentally relevant levels from 0.1 ppb. Our study was first published in Food and Chemical Toxicology (FCT) on 19 September, 2012. The first wave of criticisms arrived within a week, mostly from plant biologists without experience in toxicology. We answered all these criticisms. The debate then encompassed scientific arguments and a wave of ad hominem and potentially libellous comments appeared in different journals by authors having serious yet undisclosed conflicts of interests. At the same time, FCT acquired as its new assistant editor for biotechnology a former employee of Monsanto after he sent a letter to FCT to complain about our study. This is in particular why FCT asked for a post-hoc analysis of our raw data. On 19 November, 2013, the editor-in-chief requested the retraction of our study while recognizing that the data were not incorrect and that there was no misconduct and no fraud or intentional misinterpretation in our complete raw data - an unusual or even unprecedented action in scientific publishing. The editor argued that no conclusions could be drawn because we studied 10 rats per group over 2 years, because they were Sprague Dawley rats, and because the data were inconclusive on cancer. Yet this was known at the time of submission of our study. Our study was however never attended to be a carcinogenicity study. We never used the word 'cancer' in our paper. The present opinion is a summary of the debate resulting in this retraction, as it is a historic example of conflicts of interest in the scientific assessments of products commercialized worldwide. We also show that the decision to retract cannot be rationalized on any discernible scientific or ethical grounds. Censorship of research into health risks undermines the value and the credibility of science; thus, we republish our paper.

  5. Managing Conflicts of Interest in the UK National Institute for Health and Care Excellence (NICE) Clinical Guidelines Programme: Qualitative Study

    PubMed Central

    Graham, Tanya; Alderson, Phil; Stokes, Tim

    2015-01-01

    Background There is international concern that conflicts of interest (COI) may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs) are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence). Methods Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE’s guideline development centres and 6 chairs of guideline development groups (GDGs). We conducted a thematic analysis. Results Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take “on trust” the information they receive, certain types of COI (non-financial) are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills. Conclusions We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice. PMID:25811754

  6. After the Baby: Work-Family Conflict and Working Mothers' Psychological Health

    ERIC Educational Resources Information Center

    Marshall, Nancy L.; Tracy, Allison J.

    2009-01-01

    This study examines work and family characteristics and depressive symptomatology among over 700 working mothers of infants. Working mothers in poorer quality jobs, as well as working mothers who were single or whose infant's health was poorer than that of other infants, reported greater depressive symptomatology. The effect of job quality on…

  7. Darfur Refugees in Cairo: Mental Health and Interpersonal Conflict in the Aftermath of Genocide

    ERIC Educational Resources Information Center

    Meffert, Susan M.; Marmar, Charles R.

    2009-01-01

    Hundreds of thousands of Darfur people affected by the Sudanese genocide have fled to Cairo, Egypt, in search of assistance. Collaborating with Africa and Middle East Refugee Assistance (AMERA), the authors conducted a mental health care needs assessment among Darfur refugees in Cairo. Information was collected using individual and focus group…

  8. Embedding concepts of sex and gender health differences into medical curricula.

    PubMed

    Miller, Virginia M; Rice, Morrisa; Schiebinger, Londa; Jenkins, Marjorie R; Werbinski, Janice; Núñez, Ana; Wood, Susan; Viggiano, Thomas R; Shuster, Lynne T

    2013-03-01

    Sex, a biological variable, and gender, a cultural variable, define the individual and affect all aspects of disease prevention, development, diagnosis, progression, and treatment. Sex and gender are essential elements of individualized medicine. However, medical education rarely considers such topics beyond the physiology of reproduction. To reduce health care disparities and to provide optimal, cost-effective medical care for individuals, concepts of sex and gender health need to become embedded into education and training of health professionals. In September 2012, Mayo Clinic hosted a 2-day workshop bringing together leading experts from 13 U.S. schools of medicine and schools of public health, Health Resources and Services Administration Office of Women's Health (HRSA OWH), the National Institutes of Health (NIH) Office of Research on Women's Health (ORWH), and the Canadian Institute of Health and Gender. The purpose of this workshop was to articulate the need to integrate sex- and gender-based content into medical education and training, to identify gaps in current medical curricula, to consider strategies to embed concepts of sex and gender health into health professional curricula, and to identify existing resources to facilitate and implement change. This report summarizes these proceedings, recommendations, and action items from the workshop.

  9. Embedding Concepts of Sex and Gender Health Differences into Medical Curricula

    PubMed Central

    Rice, Morrisa; Schiebinger, Londa; Jenkins, Marjorie R.; Werbinski, Janice; Núñez, Ana; Wood, Susan; Viggiano, Thomas R.; Shuster, Lynne T.

    2013-01-01

    Abstract Sex, a biological variable, and gender, a cultural variable, define the individual and affect all aspects of disease prevention, development, diagnosis, progression, and treatment. Sex and gender are essential elements of individualized medicine. However, medical education rarely considers such topics beyond the physiology of reproduction. To reduce health care disparities and to provide optimal, cost-effective medical care for individuals, concepts of sex and gender health need to become embedded into education and training of health professionals. In September 2012, Mayo Clinic hosted a 2-day workshop bringing together leading experts from 13 U.S. schools of medicine and schools of public health, Health Resources and Services Administration Office of Women's Health (HRSA OWH), the National Institutes of Health (NIH) Office of Research on Women's Health (ORWH), and the Canadian Institute of Health and Gender. The purpose of this workshop was to articulate the need to integrate sex- and gender-based content into medical education and training, to identify gaps in current medical curricula, to consider strategies to embed concepts of sex and gender health into health professional curricula, and to identify existing resources to facilitate and implement change. This report summarizes these proceedings, recommendations, and action items from the workshop. PMID:23414074

  10. Structural Vulnerability: Operationalizing the Concept to Address Health Disparities in Clinical Care.

    PubMed

    Bourgois, Philippe; Holmes, Seth M; Sue, Kim; Quesada, James

    2017-03-01

    The authors propose reinvigorating and extending the traditional social history beyond its narrow range of risk behaviors to enable clinicians to address negative health outcomes imposed by social determinants of health. In this Perspective, they outline a novel, practical medical vulnerability assessment questionnaire that operationalizes for clinical practice the social science concept of "structural vulnerability." A structural vulnerability assessment tool designed to highlight the pathways through which specific local hierarchies and broader sets of power relationships exacerbate individual patients' health problems is presented to help clinicians identify patients likely to benefit from additional multidisciplinary health and social services. To illustrate how the tool could be implemented in time- and resource-limited settings (e.g., emergency department), the authors contrast two cases of structurally vulnerable patients with differing outcomes. Operationalizing structural vulnerability in clinical practice and introducing it in medical education can help health care practitioners think more clearly, critically, and practically about the ways social structures make people sick. Use of the assessment tool could promote "structural competency," a potential new medical education priority, to improve understanding of how social conditions and practical logistics undermine the capacities of patients to access health care, adhere to treatment, and modify lifestyles successfully. Adoption of a structural vulnerability framework in health care could also justify the mobilization of resources inside and outside clinical settings to improve a patient's immediate access to care and long-term health outcomes. Ultimately, the concept may orient health care providers toward policy leadership to reduce health disparities and foster health equity.

  11. Health journalism in the service of power: 'moral complacency' and the Hebrew media in the Gaza-Israel conflict.

    PubMed

    Birenbaum-Carmeli, Daphna

    2014-05-01

    The power of health news as a vehicle in the production of meaning in the service of power is the core of this article. Tracking the media coverage of a medical service, it shows how a routine practice can be invoked at a time of armed conflict so as to enhance a benevolent state image. The case at hand is the medical treatment of Gaza children in Israeli hospitals. A series of Internet searches revealed a group of publications on the subject in the Hebrew media, during and shortly after Israel's assault on Gaza in the winter of 2008-2009. In the press articles the treatments were invariably constituted as the epitome of Israel's compassion towards the enemy's children. This image relied, however, on a simultaneous silencing of other aspects of these treatments, which would have challenged this image. The monolithic depictions give rise to the notion of reversed moral panic or 'moral complacency', wherein the media amplifies a little-known social phenomenon into an epitome of societal values and charges it with significance on a national scale. The article ends with considering some features that possibly render health news an especially convenient domain for state-supportive media presentations.

  12. Concept mapping as an approach for expert-guided model building: The example of health literacy.

    PubMed

    Soellner, Renate; Lenartz, Norbert; Rudinger, Georg

    2017-02-01

    Concept mapping served as the starting point for the aim of capturing the comprehensive structure of the construct of 'health literacy.' Ideas about health literacy were generated by 99 experts and resulted in 105 statements that were subsequently organized by 27 experts in an unstructured card sorting. Multidimensional scaling was applied to the sorting data and a two and three-dimensional solution was computed. The three dimensional solution was used in subsequent cluster analysis and resulted in a concept map of nine "clusters": (1) self-regulation, (2) self-perception, (3) proactive approach to health, (4) basic literacy and numeracy skills, (5) information appraisal, (6) information search, (7) health care system knowledge and acting, (8) communication and cooperation, and (9) beneficial personality traits. Subsequently, this concept map served as a starting point for developing a "qualitative" structural model of health literacy and a questionnaire for the measurement of health literacy. On the basis of questionnaire data, a "quantitative" structural model was created by first applying exploratory factor analyses (EFA) and then cross-validating the model with confirmatory factor analyses (CFA). Concept mapping proved to be a highly valuable tool for the process of model building up to translational research in the "real world".

  13. Anthrax as an example of the One Health concept.

    PubMed

    Bengis, R G; Frean, J

    2014-08-01

    Anthrax is a peracute, acute or subacute multispecies bacterial infection that occurs on many continents. It is one of the oldest infectious diseases known; the biblical fifth and sixth plagues (Exodus chapters 7 to 9) that affected first livestock and then humans were probably anthrax. From the earliest historical records until development of an effective vaccine midway through the 20th Century, anthrax was one of the foremost causes of uncontrolled mortality in cattle, sheep, goats, horses and pigs, with 'spill over' into humans, worldwide. With the development of the Sterne spore vaccine, a sharp decline in anthrax outbreaks in livestock occurred during the 1930-1980 era. There were successful national vaccination programmes in many countries during this period, complemented by the liberal use of antibiotics and the implementation of quarantine regulations and carcass disposal. However, a resurgence of this disease in livestock has been reported recently in some regions, where complacency and a false sense of security have hindered vaccination programmes. The epidemiology of anthrax involves an environmental component, as well as livestock, wildlife and human components. This makes anthrax an ideal example for discussion in the One Health context. Many outbreaks of anthrax in wildlife are undetected or unreported, owing to surveillance inadequacies and difficulties. Human disease is generally acquired accidentally during outbreaks of anthrax in domestic livestock and wildlife. The exception is deliberate targeting of humans with anthrax in the course of biowarfare or bioterrorism.

  14. Environmental Health Disparities: A Framework Integrating Psychosocial and Environmental Concepts

    PubMed Central

    Gee, Gilbert C.; Payne-Sturges, Devon C.

    2004-01-01

    Although it is often acknowledged that social and environmental factors interact to produce racial and ethnic environmental health disparities, it is still unclear how this occurs. Despite continued controversy, the environmental justice movement has provided some insight by suggesting that disadvantaged communities face greater likelihood of exposure to ambient hazards. The exposure–disease paradigm has long suggested that differential “vulnerability” may modify the effects of toxicants on biological systems. However, relatively little work has been done to specify whether racial and ethnic minorities may have greater vulnerability than do majority populations and, further, what these vulnerabilities may be. We suggest that psychosocial stress may be the vulnerability factor that links social conditions with environmental hazards. Psychosocial stress can lead to acute and chronic changes in the functioning of body systems (e.g., immune) and also lead directly to illness. In this article we present a multidisciplinary framework integrating these ideas. We also argue that residential segregation leads to differential experiences of community stress, exposure to pollutants, and access to community resources. When not counterbalanced by resources, stressors may lead to heightened vulnerability to environmental hazards. PMID:15579407

  15. Environmental health disparities: a framework integrating psychosocial and environmental concepts.

    PubMed

    Gee, Gilbert C; Payne-Sturges, Devon C

    2004-12-01

    Although it is often acknowledged that social and environmental factors interact to produce racial and ethnic environmental health disparities, it is still unclear how this occurs. Despite continued controversy, the environmental justice movement has provided some insight by suggesting that disadvantaged communities face greater likelihood of exposure to ambient hazards. The exposure-disease paradigm has long suggested that differential "vulnerability" may modify the effects of toxicants on biological systems. However, relatively little work has been done to specify whether racial and ethnic minorities may have greater vulnerability than do majority populations and, further, what these vulnerabilities may be. We suggest that psychosocial stress may be the vulnerability factor that links social conditions with environmental hazards. Psychosocial stress can lead to acute and chronic changes in the functioning of body systems (e.g., immune) and also lead directly to illness. In this article we present a multidisciplinary framework integrating these ideas. We also argue that residential segregation leads to differential experiences of community stress, exposure to pollutants, and access to community resources. When not counterbalanced by resources, stressors may lead to heightened vulnerability to environmental hazards.

  16. Stress as a mediator between work-family conflict and psychological health among the nursing staff: Moderating role of emotional intelligence.

    PubMed

    Sharma, Jyoti; Dhar, Rajib Lochan; Tyagi, Akansha

    2016-05-01

    The study examined the extent to which work-family conflicts cause stress among nursing staff and its subsequent impact on their psychological health. It also examined if the emotional intelligence level of the nursing staff acted as a moderator between their level of stress and psychological health. A survey was carried out on 693 nursing staff associated with 33 healthcare institutions in Uttarakhand, India. A hierarchical multiple regression analysis was carried out to understand the relationships shared by independent (work-family conflicts) and dependent (psychological health) constructs with the mediator (stress) as well as the moderator (emotional intelligence). The results revealed that stress acted as a mediator between work-family conflict of the nursing staff and their psychological health. However, their emotional intelligence level acted as a moderator between their stress level and psychological health. To conclude, the crucial roles of emotional intelligence in controlling the impact of stress on psychological health along with the practical as well as theoretical implications are also discussed.

  17. Building the microbiome in health and disease: niche construction and social conflict in bacteria.

    PubMed

    McNally, Luke; Brown, Sam P

    2015-08-19

    Microbes collectively shape their environment in remarkable ways via the products of their metabolism. The diverse environmental impacts of macro-organisms have been collated and reviewed under the banner of 'niche construction'. Here, we identify and review a series of broad and overlapping classes of bacterial niche construction, ranging from biofilm production to detoxification or release of toxins, enzymes, metabolites and viruses, and review their role in shaping microbiome composition, human health and disease. Some bacterial niche-constructing traits can be seen as extended phenotypes, where individuals actively tailor their environment to their benefit (and potentially to the benefit of others, generating social dilemmas). Other modifications can be viewed as non-adaptive by-products from a producer perspective, yet they may lead to remarkable within-host environmental changes. We illustrate how social evolution and niche construction perspectives offer complementary insights into the dynamics and consequences of these traits across distinct timescales. This review highlights that by understanding the coupled bacterial and biochemical dynamics in human health and disease we can better manage host health.

  18. Building the microbiome in health and disease: niche construction and social conflict in bacteria

    PubMed Central

    McNally, Luke; Brown, Sam P.

    2015-01-01

    Microbes collectively shape their environment in remarkable ways via the products of their metabolism. The diverse environmental impacts of macro-organisms have been collated and reviewed under the banner of ‘niche construction’. Here, we identify and review a series of broad and overlapping classes of bacterial niche construction, ranging from biofilm production to detoxification or release of toxins, enzymes, metabolites and viruses, and review their role in shaping microbiome composition, human health and disease. Some bacterial niche-constructing traits can be seen as extended phenotypes, where individuals actively tailor their environment to their benefit (and potentially to the benefit of others, generating social dilemmas). Other modifications can be viewed as non-adaptive by-products from a producer perspective, yet they may lead to remarkable within-host environmental changes. We illustrate how social evolution and niche construction perspectives offer complementary insights into the dynamics and consequences of these traits across distinct timescales. This review highlights that by understanding the coupled bacterial and biochemical dynamics in human health and disease we can better manage host health. PMID:26150664

  19. [Historical changes in community concepts and the effect of such on community health nursing praxis].

    PubMed

    Yeh, Lily; Chen, Yi-Hsing

    2011-02-01

    In the 21st century, many healthcare programs are delivered in community settings. As such, successfully recruiting target members of the community to participate in programs represents a key challenge for the nursing profession. Although the "community" is not a new concept, its meaning has changed over the past century or more of public healthcare, which has had a profound effect on community health nursing praxis. This article describes changes in community concepts through history in order to define the significance of community participation in today's community health nursing practice.

  20. The global health concept of the German government: strengths, weaknesses, and opportunities

    PubMed Central

    Bozorgmehr, Kayvan; Bruchhausen, Walter; Hein, Wolfgang; Knipper, Michael; Korte, Rolf; Razum, Oliver; Tinnemann, Peter

    2014-01-01

    Recognising global health as a rapidly emerging policy field, the German federal government recently released a national concept note for global health politics (July 10, 2013). As the German government could have a significant impact on health globally by making a coherent, evidence-informed, and long-term commitment in this field, we offer an initial appraisal of the strengths, weaknesses, and opportunities for development recognised in this document. We conclude that the national concept is an important first step towards the implementation of a coherent global health policy. However, important gaps were identified in the areas of intellectual property rights and access to medicines. In addition, global health determinants such as trade, economic crises, and liberalisation as well as European Union issues such as the health of migrants, refugees, and asylum seekers are not adequately addressed. Furthermore, little information is provided about the establishment of instruments to ensure an effective inter-ministerial cooperation. Finally, because implementation aspects for the national concept are critical for the success of this initiative, we call upon the newly elected 2013 German government to formulate a global health strategy, which includes a concrete plan of action, a time scale, and measurable goals. PMID:24560258

  1. The global health concept of the German government: strengths, weaknesses, and opportunities.

    PubMed

    Bozorgmehr, Kayvan; Bruchhausen, Walter; Hein, Wolfgang; Knipper, Michael; Korte, Rolf; Razum, Oliver; Tinnemann, Peter

    2014-01-01

    Recognising global health as a rapidly emerging policy field, the German federal government recently released a national concept note for global health politics (July 10, 2013). As the German government could have a significant impact on health globally by making a coherent, evidence-informed, and long-term commitment in this field, we offer an initial appraisal of the strengths, weaknesses, and opportunities for development recognised in this document. We conclude that the national concept is an important first step towards the implementation of a coherent global health policy. However, important gaps were identified in the areas of intellectual property rights and access to medicines. In addition, global health determinants such as trade, economic crises, and liberalisation as well as European Union issues such as the health of migrants, refugees, and asylum seekers are not adequately addressed. Furthermore, little information is provided about the establishment of instruments to ensure an effective inter-ministerial cooperation. Finally, because implementation aspects for the national concept are critical for the success of this initiative, we call upon the newly elected 2013 German government to formulate a global health strategy, which includes a concrete plan of action, a time scale, and measurable goals.

  2. Healthy bodies, social bodies: men's and women's concepts and practices of health in everyday life.

    PubMed

    Saltonstall, R

    1993-01-01

    Using interview data from white, middle-class men and women, ages 35-55, the research explores the phenomenological, embodied aspects of health. Health is found to be grounded in a sense of self and a sense of body, both of which are tied to conceptions of past and future actions. Gender is a leitmotif. The body, as the focal point of self-construction as well as health construction, implicates gender in the everyday experience of health. The interplay between health, self, body, and gender at the individual level is linked to the creation of a sense of healthiness in the body politic of society. If social psychological theories of health are to reflect adequately the everyday experience of health, they must begin to take into account the body as individually and socially problematic.

  3. Central gender theoretical concepts in health research: the state of the art.

    PubMed

    Hammarström, Anne; Johansson, Klara; Annandale, Ellen; Ahlgren, Christina; Aléx, Lena; Christianson, Monica; Elwér, Sofia; Eriksson, Carola; Fjellman-Wiklund, Anncristine; Gilenstam, Kajsa; Gustafsson, Per E; Harryson, Lisa; Lehti, Arja; Stenberg, Gunilla; Verdonk, Petra

    2014-02-01

    Despite increasing awareness of the importance of gender perspectives in health science, there is conceptual confusion regarding the meaning and the use of central gender theoretical concepts. We argue that it is essential to clarify how central concepts are used within gender theory and how to apply them to health research. We identify six gender theoretical concepts as central and interlinked-but problematic and ambiguous in health science: sex, gender, intersectionality, embodiment, gender equity and gender equality. Our recommendations are that: the concepts sex and gender can benefit from a gender relational theoretical approach (i.e., a focus on social processes and structures) but with additional attention to the interrelations between sex and gender; intersectionality should go beyond additive analyses to study complex intersections between the major factors which potentially influence health and ensure that gendered power relations and social context are included; we need to be aware of the various meanings given to embodiment, which achieve an integration of gender and health and attend to different levels of analyses to varying degrees; and appreciate that gender equality concerns absence of discrimination between women and men while gender equity focuses on women's and men's health needs, whether similar or different. We conclude that there is a constant need to justify and clarify our use of these concepts in order to advance gender theoretical development. Our analysis is an invitation for dialogue but also a call to make more effective use of the knowledge base which has already developed among gender theorists in health sciences in the manner proposed in this paper.

  4. Policies around sexual and reproductive health and rights in Peru: conflict, biases and silence.

    PubMed

    Cáceres, C; Cueto, M; Palomino, N

    2008-01-01

    This study is aimed at examining how subsequent Peruvian governments, since 1990, have addressed reproductive rights, HIV/AIDS prevention and treatment, and sexual diversity rights, as well as the drastic policy shifts and its many contradictions. Abortion and contraception consistently generated the deepest public controversies and debates, which made progress in reproductive rights difficult. HIV/AIDS was often portrayed as having the potential to affect everyone, which allowed advocates and activists to achieve some success in advancing HIV/AIDS-related rights. Sexual diversity rights, perceived as a demand made by "others", were generally trivialised and disdained by politicians, officials, and the general population. Positive changes occurred as long as the issue was given a low political and institutional profile. The analysis of policy-making and programme implementation in these three areas reveals that: (1) Weaknesses in national institutional frameworks concerning reproductive health made it possible for governments to adopt two very different (even contradictory) approaches to the issue within the past 15 years; (2) Policies were presented as rights-based in order to garner political legitimacy when, in fact, they evidenced a clear disregard for the rights of individual citizens; and (3) By favouring low-profile "public health" discourses, and marginalising "the sexual" in official policies related to sexuality, advocacy groups sometimes created opportunities for legal changes but failed to challenge conservative powers opposing the recognition of sexual and reproductive rights and the full citizenship of women and sexual minorities.

  5. [Evolution of the concept of positive mental health: a systematic review].

    PubMed

    Muñoz, Cristóbal Ovidio; Restrepo, Diego; Cardona, Doris

    2016-03-01

    Objective Characterize the theoretical models that have underpinned empirical research on the concept of positive mental health from the time it first emerged in the field of health up to the present. Methods A systematic search of the literature was conducted in PubMed, EBSCO (including Academic Search Complete, ERIC, Academic Source, MasterFILE Premier, MedicLatina, MEDLINE, and the Psychology and Behavioral Sciences Collection), Science Direct, Psicodoc, Springer Link, Taylor & Francis, Wiley Online Library, Directory of Open Access Journals (DOAJ), Redalyc, SciELO, Ovid, Embase, and ProQuest (including Health and Medical Complete, the Nursing and Allied Health Source, Psychology Journals, and Social Science Journals). The search criterion was the descriptor "positive mental health." Results Of 51 studies consulted, 84% used a quantitative approach; 84% were published in English; and the same percentage were conducted between 2000 and 2014. The concept of positive mental health has been applied in essentially five different ways: as the absence of disease; as the subject of the Jahoda model; as a combination of factors on the Lluch scale; as a synonym of well-being; and as part of more complex scales of measurement. Conclusions Positive mental health should not be viewed as the opposite of a mental disorder, the absence of disease, or the sum of a given set of personal conditions. It is important to move forward in the development of conceptual models that will serve as a basis for approaching mental health from the perspective of health promotion.

  6. Population Health Measurement: Applying Performance Measurement Concepts in Population Health Settings

    PubMed Central

    Stoto, Michael A.

    2014-01-01

    Introduction: Whether the focus of population-health improvement efforts, the measurement of health outcomes, risk factors, and interventions to improve them are central to achieving collective impact in the population health perspective. And because of the importance of a shared measurement system, appropriate measures can help to ensure the accountability of and ultimately integrate the efforts of public health, the health care delivery sector, and other public and private entities in the community to improve population health. Yet despite its importance, population health measurement efforts in the United States are poorly developed and uncoordinated. Collaborative Measurement Development: To achieve the potential of the population health perspective, public health officials, health system leaders, and others must work together to develop sets of population health measures that are suitable for different purposes yet are harmonized so that together they can help to improve a community’s health. This begins with clearly defining the purpose of a set of measures, distinguishing between outcomes for which all share responsibility and actions to improve health for which the health care sector, public health agencies, and others should be held accountable. Framework for Population Health Measurement: Depending on the purpose of the analysis, then, measurement systems should clearly specify what to measure—in particular the population served (the denominator), what the critical health dimensions are in a measurement framework, and how the measures can be used to ensure accountability. Building on a clear understanding of the purpose and dimensions of population health that must be measured, developers can then choose specific measures using existing data or developing new data sources if necessary, with established validity, reliability, and other scientific characteristics. Rather than indiscriminately choosing among the proliferating data streams, this

  7. [AN EVALUATION OF JUSTICE AND RIGHT TO HEALTH CONCEPTS IN THE PERSPECTIVES OF ETHICAL THEORIES].

    PubMed

    Ekmekçi, Perihan Elif; Arda, Berna

    Right to health is considered as a fundamental human right. However the realization of right to health is facing obstacles due to the scarce resources which are needed for the provision of health services. Besides the vast technological improvements in medical area leads to the development of diagnosis and treatment possibilities each and every day. Thus, the provision of health services becomes a subject of distributive justice. To define the concept of justice, first one should identify the conditions of demanding right to have something and then determine how and who is obliged to give the deserved. Ethical theories form their own paradigms of acting right regarding their anchor points and priority values. The basic concepts such as justice or right to health are considered and conceptualized within the paradigms of the ethical theories. Thus some ethical theories consider right to health as a natural constituent of human being, while some may consider it contextual and others may reject it completely. In a similar vein, justice and related concepts of justice such as formal and material principles of justice differ regarding the paradigm of the ethical theory in which we position ourselves. The paradigms of ethical theories demand different approaches from each other both in defining the concepts and implementations in practical life. This paper sets forth how justice and right to health is conceptualized in the virtue ethics, deontological ethics, liberal ethical theory and communitarian ethical theories. To this end first the general frame of each ethical theory and how justice is conceptualized within this frame is defined. Following that a discussion of the possibility of justification of the right to health within the context of ethical theory is perused.

  8. Wealth and Health Behavior: Testing the Concept of a Health Cost

    PubMed Central

    Galama, Titus J.

    2014-01-01

    Wealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by exploiting both inheritances and lottery winnings to test a theory of health behavior. We distinguish between the direct monetary cost and the indirect health cost (value of health lost) of unhealthy consumption. The health cost increases with wealth and the degree of unhealthiness, leading wealthier individuals to consume more healthy and moderately unhealthy, but fewer severely unhealthy goods. The empirical evidence presented suggests that differences in health costs may indeed partially explain behavioral differences, and ultimately health outcomes, between wealth groups. PMID:25530621

  9. Conflict management: importance and implications.

    PubMed

    McKibben, Laurie

    2017-01-26

    Conflict is a consistent and unavoidable issue within healthcare teams. Despite training of nurse leaders and managers around areas of conflict resolution, the problem of staff relations, stress, sickness and retention remain. Conflict arises from issues with interpersonal relationships, change and poor leadership. New members of staff entering an already established healthcare team should be supported and integrated, to encourage mutual role respect between all team members and establish positive working relationships, in order to maximise patient care. This paper explores the concept of conflict, the importance of addressing causes of conflict, effective management, and the relevance of positive approaches to conflict resolution. Good leadership, nurturing positive team dynamics and communication, encourages shared problem solving and acceptance of change. Furthermore mutual respect fosters a more positive working environment for those in healthcare teams. As conflict has direct implications for patients, positive resolution is essential, to promote safe and effective delivery of care, whilst encouraging therapeutic relationships between colleagues and managers.

  10. Commentary: A delicate balance: weighing the effects of conflict-of-interest rules on intramural research at the National Institutes of Health.

    PubMed

    Gottesman, Michael M; Jaffe, Holli Beckerman

    2010-11-01

    In 2005, in response to increasing public concerns about potential conflicts of interest in biomedical research, the Department of Health and Human Services (DHHS) tightened its ethics rules to prohibit National Institutes of Health (NIH) employees from receiving consulting fees from "significantly affected organizations." In response, NIH took steps to implement these regulations and ensure that relationships between intramural NIH researchers and industry could proceed without threatening the integrity of federally funded research. Examples of these steps include creating an ethics advisory committee to review outside activities of NIH scientists and subjecting its researchers to special scrutiny to eliminate any perception of personal profit or conflict of interest. In the authors' experiences, interactions between NIH scientists and industry have continued relatively unaffected by these regulations. The continuing success of the technology transfer program at NIH and the number and types of cooperative research and development agreements with industry are good measures of the extent of productive interactions with industry since the implementation of the 2005 ethics rules. Although recruitment of outstanding scientists to the intramural program has continued, these regulations also have challenged NIH's ability to attract and retain some of the most qualified scientists, who fear they may miss certain opportunities because of the tighter regulations. As DHHS revises the regulations governing oversight of financial conflicts of interest in the extramural community, the authors recognize that the NIH intramural experience may provide valuable lessons about developing and implementing the next generation of financial conflict-of-interest rules.

  11. Consumer appeal of nutrition and health claims in three existing product concepts.

    PubMed

    Verbeke, Wim; Scholderer, Joachim; Lähteenmäki, Liisa

    2009-06-01

    This paper reports on consumers' reactions towards calcium-enriched fruit juice, omega-3 enriched spread and fibre-enriched cereals, each with a nutrition claim, health claim and reduction of disease risk claim. Cross-sectional data were collected in April 2006 from a sample of 341 consumers in Belgium. Consumers' reactions to the carrier product, functional ingredient and claim combinations were assessed as perceived convincingness of the claim, credibility of the product, attractiveness of the product, and intention to buy the product, while accounting for differences in product familiarity, attitudinal and demographic characteristics. Generally, health claims outperformed nutrition claims, and both of these claim types outperformed reduction of disease risk claims. Comparing consumer reactions across product concepts revealed clear preferences for fibre-enriched cereals as compared to the other two concepts. The interaction effects between claim type and product concept indicated that reduction of disease risk claims are perceived very well in omega-3 enriched spreads, particularly in terms of perceived convincingness of the claim, while not appealing to consumers in the other product concepts. Positive attitudes towards functional foods and familiarity with the concrete functional product category boosted the claim type and product ratings, whereas perceived control over own health and perceiving functional foods as a marketing scam decreased all product concept's appeal.

  12. The concepts of health and preventive health practices of Chinese Australian women in relation to cancer screening.

    PubMed

    Kwok, Cannas; Sullivan, Gerard

    2007-04-01

    Despite an emphasis on mammographic screening in Australia, Chinese Australian women have low participation rates. This qualitative study investigated how concepts of health and health promotion influence Chinese Australian women's decisions to participate in cancer screening, which is an important issue for nurses who work with multicultural populations. In-depth interviews were conducted with 20 Chinese Australian women. Using thematic data analysis, the findings showed that health and illness are taken-for-granted experiences of everyday life. When they were asymptomatic, most informants saw no reason to suspect that they may have diseases. Consistent with these health beliefs, the women focused on preserving and promoting health and overall well-being in everyday life rather than attempting to detect hidden disease by screening. These ideas and practices influenced behavior in relation to cancer diagnosis and in particular toward mammography.

  13. Sustainable improvement of animal health care by systematic quality risk management according to the HACCP concept.

    PubMed

    Noordhuizen, J P; Welpelo, H J

    1996-12-01

    This paper addresses the principles of the Hazard Analysis Critical Control Point (HACCP) concept as applied to animal health management strategy. Characteristics of the concept were analysed and compared with those of current animal health care strategies for disease risk identification and herd health management, insurance, and certification. HACCP is a hybrid strategy of quality control at both production process and product level. Animal health is considered a particular quality feature. We show that process control (expressed in terms of controlling both general and specific disease risk factors) and product control (expressed in terms of testing animals or animal products for specific disease agents) could form the basis for improving animal health. We conclude that HACCP provides ample opportunity for preventive health action and risk management at a relatively low cost in terms of labour, finance and documentation expenditure, at both the farm and sector level. Epidemiological field studies are currently needed to identify critical control points and to design HACCP procedures for livestock producers. In the long run, HACCP based animal health care can be further developed into a quality control systems approach to cover all aspects that are related, either directly or indirectly, to animal health.

  14. Cannabis, pesticides and conflicting laws: the dilemma for legalized States and implications for public health.

    PubMed

    Stone, Dave

    2014-08-01

    State laws on the legalization of medical and recreational cannabis are rapidly evolving. Similar to other crops, cannabis is susceptible to multiple pests during cultivation. Growers have an economic incentive to produce large yields and high quality plants, and may resort to pesticides to achieve these outcomes. Currently, there are no pesticides registered for cannabis in the United States, given its illegal status by the federal government. This discrepancy creates a regulatory vacuum and dilemma for States with legal medical and recreational cannabis that seek to balance lawful compliance with pesticides and worker or public health. Pesticide use presents occupational safety issues that can be mitigated through established worker protection measures. The absence of approved products for cannabis may result in consumer exposures to otherwise more hazardous pesticides or higher residue levels. While many legal and scientific hurdles exist to register conventional pesticides for use on cannabis, legalized States have explored other opportunities to leverage the present regulatory infrastructure. Stakeholder engagement and outreach to the cannabis industry from credible sources could mitigate pesticide misuse and harm.

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

    ERIC Educational Resources Information Center

    Nobiling, Brandye D.; Lyde, Adrian R.

    2015-01-01

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

  16. Concepts of Health and Sickness of Preschool and School Aged Children.

    ERIC Educational Resources Information Center

    Banks, Ellen

    An investigation was made of children's factual knowledge of health-related concepts and the cognitive implications of their answers to questionnaire items such as "What makes a person sick?", "What is medicine?", and "Do you know what a germ is?" Participants were 80 healthy children between approximately 3 and 15 years of age. An additional 61…

  17. Concepts of social inclusion, exclusion and mental health: a review of the international literature.

    PubMed

    Wright, N; Stickley, T

    2013-02-01

    Social inclusion and exclusion are concepts which have been widely associated with politics and policy in the first decade of the 2000s. People with mental health problems have become the focus of a range of social inclusion initiatives. A literature review was conducted to explore the peer-reviewed evidence relating social inclusion/exclusion and mental health. In total 36 papers were included in the review from the UK, Canada, Australia and Scandinavia. The papers had used a range of different approaches to research and evaluation. The included papers associated being socially included to: social roles and responsibilities such as employment, participation in social activities, environmental work and voting. Although some papers engaged in a critical discussion of the concept, many offered only simplistic accounts or definitions. Social inclusion is such a widely used term within political and policy discourses that it is surprising so little research is available within the mental health realm. There was a lack of clarity related to the concept of social exclusion and the qualitative studies focused entirely on the experiences of being excluded within an institutional or semi-institutional setting. The relationship between exclusion, inequality and injustice is identified and the relevance of the concept to current and future mental health policy is questioned.

  18. The prebiotic concept and human health: a changing landscape with riboflavin as a novel prebiotic candidate?

    PubMed

    Steinert, R E; Sadaghian Sadabad, M; Harmsen, H J M; Weber, P

    2016-12-01

    Emerging evidence suggests that the gut microbiota has a critical role in both the maintenance of human health and the pathogenesis of many diseases. Modifying the colonic microbiota using functional foods has attracted significant research effort and product development. The pioneering concept of prebiotics, as introduced by Gibson and Roberfroid in the 1990s, emphasized the importance of diet in the modulation of the gut microbiota and its relationships to human health. Increasing knowledge of the intestinal microbiota now suggests a more comprehensive definition. This paper briefly reviews the basics of the prebiotic concept with a discussion of recent attempts to refine the concept to open the door for novel prebiotic food ingredients, such as polyphenols, minerals and vitamins.

  19. Towards quality criteria for regional public health reporting: concept mapping with Dutch experts

    PubMed Central

    Achterberg, Peter W.; van de Goor, Ien A.M.; van Oers, Hans A.M.

    2012-01-01

    Background: In the Netherlands, municipal health assessments are carried out by 28 Regional Health Services, serving 418 municipalities. In the absence of guidelines, regional public health reports were developed in two pilot regions on the basis of the model and experience of national health reporting. Though they were well received and positively evaluated, it was not clear which specific characteristics determined ‘good public health reporting’. Therefore, this study was set up to develop a theoretical framework for the quality of regional public health reporting in The Netherlands. Methods: Using concept mapping as a standardized tool for conceptualization, 35 relevant reporting experts formulated short statements in two different brainstorming sessions, describing specific quality criteria of regional public health reports. After the removal of duplicates, the list was supplemented with international criteria, and the statements were sent to each participant for rating and sorting. The results were processed statistically and represented graphically. The output was discussed and interpreted, leading to the final concept map. Results: The final concept map consisted of 97 criteria, grouped into 13 clusters, and plotted in two dimensions: a ‘product’ dimension, ranging from ‘production’ to ‘content’, and a ‘context’ dimension, ranging from ‘science’ to ‘policy’. The three most important clusters were: (i) ‘solution orientation’, (ii) ‘policy relevance’ and (iii) ‘policy impact’. Conclusion: This study provided a theoretical framework for the quality of regional public health reporting, indicating relevant domains and criteria. Further work should translate domains and criteria into operational indicators for evaluating regional public health reports. PMID:21398660

  20. A window of opportunity for reform in post-conflict settings? The case of Human Resources for Health policies in Sierra Leone, 2002–2012

    PubMed Central

    2014-01-01

    Background It is recognized that decisions taken in the early recovery period may affect the development of health systems. Additionally, some suggest that the immediate post-conflict period may allow for the opening of a political ‘window of opportunity’ for reform. For these reasons, it is useful to reflect on the policy space that exists in this period, by what it is shaped, how decisions are made, and what are their long-term implications. Examining the policy trajectory and its determinants can be helpful to explore the specific features of the post-conflict policy-making environment. With this aim, the study looks at the development of policies on human resources for health (HRH) in Sierra Leone over the decade after the conflict (2002–2012). Methods Multiple sources were used to collect qualitative data on the period between 2002 and 2012: a stakeholder mapping workshop, a document review and a series of key informant interviews. The analysis draws from political economy and policy analysis tools, focusing on the drivers of reform, the processes, the contextual features, and the actors and agendas. Findings Our findings identify three stages of policy-making. At first characterized by political uncertainty, incremental policies and stop-gap measures, the context substantially changed in 2009. The launch of the Free Health Care Initiative provided to be an instrumental event and catalyst for health system, and HRH, reform. However, after the launch of the initiative, the pace of HRH decision-making again slowed down. Conclusions Our study identifies the key drivers of HRH policy trajectory in Sierra Leone: (i) the political situation, at first uncertain and later on more defined; (ii) the availability of funding and the stances of agencies providing such funds; (iii) the sense of need for radical change – which is perhaps the only element related to the post-conflict setting. It also emerges that a ‘windows of opportunity’ for reform did not open

  1. The concept of health - in the history of medicine and in the writings of Hahnemann.

    PubMed

    Schmidt, Josef M

    2010-07-01

    The number of notions of health is not infinite. In the history of medicine we can only find a number of different conceptions or paradigmatic ideas of health, in a variety of references and combinations. Health was seen as: 1. harmonious balance between principles or entities, 2. result of a struggle against opposing forces, 3. continuous dialectical process, 4. hierarchy of components or functions, 5. potential to perform and to develop, 6. transcendence towards higher levels of being, 7. result of conscious autonomous action, 8. optimal causal functioning, or 9. public task and responsibility. Hahnemann's view of health, as reflected in his writings, utilized virtually all of these elements. They reappear for instance as: 1. harmonious tuning of the life force, 2. defeat of pathogenetic influences, 3. admittance of aggravations, 4. autocracy of the spirit-like life principle, 5. reference to a higher goal of human existence, 6. perfecting character of medical service, 7. concern about dietetics and life style, 8. utilization of causality and natural science, and 9. appealing to governmental provisions and medical police. These paradigms have been repeatedly recombined and applied. The theory of medicine is the attempt to analyze, adjust, and develop concepts that meet the demand of contemporary medical practice. Medical theory lies between the fields of observable facts and metaphysical convictions. Distinguishing the levels of practice, theory, and metaphysics could allow the open discussion of theoretical issues, such as the concept of health or disease, without raising purely theoretical objections to well-established practice.

  2. Conflict resolution.

    PubMed

    Levin, Roger

    2006-03-01

    The sooner conflict is identified and confronted, the more quickly it can be resolved (and the sooner, the better). When this is accomplished calmly and objectively, many areas of conflict will be eliminated. Addressing conflict as it arises also sends a clear message to the team that the practice seeks resolution, not punishment or negative consequences. In addition, the dentist and the office manager need to lead by example by avoiding gossip and encouraging open communication. The goal is to go from a parent-child relationship with the dental team to an adult-adult relationship using this series of managerial conflict resolution steps.

  3. Analysis and implementation of a World Health Organization health report: methodological concepts and strategies.

    PubMed

    von Groote, Per Maximilian; Giustini, Alessandro; Bickenbach, Jerome Edmond

    2014-01-01

    A long-standing scientific discourse on the use of health research evidence to inform policy has come to produce multiple implementation theories, frameworks, models, and strategies. It is from this extensive body of research that the authors extract and present essential components of an implementation process in the health domain, gaining valuable guidance on how to successfully meet the challenges of implementation. Furthermore, this article describes how implementation content can be analyzed and reorganized, with a special focus on implementation at different policy, systems and services, and individual levels using existing frameworks and tools. In doing so, the authors aim to contribute to the establishment and testing of an implementation framework for reports such as the World Health Organization World Report on Disability, the World Health Organization International Perspectives on Spinal Cord Injury, and other health policy reports or technical health guidelines.

  4. Anthropology, health and illness: an introduction to the concept of culture applied to the health sciences.

    PubMed

    Langdon, Esther Jean; Wiik, Flávio Braune

    2010-01-01

    This article presents a reflection as to how notions and behavior related to the processes of health and illness are an integral part of the culture of the social group in which they occur. It is argued that medical and health care systems are cultural systems consonant with the groups and social realities that produce them. Such a comprehension is fundamental for the health care professional training.

  5. Media Health Literacy (MHL): development and measurement of the concept among adolescents.

    PubMed

    Levin-Zamir, Diane; Lemish, Dafna; Gofin, Rosa

    2011-04-01

    Increasing media use among adolescents and its significant influence on health behavior warrants in-depth understanding of their response to media content. This study developed the concept and tested a model of Media Health Literacy (MHL), examined its association with personal/socio-demographic determinants and reported sources of health information, while analyzing its role in promoting empowerment and health behavior (cigarette/water-pipe smoking, nutritional/dieting habits, physical/sedentary activity, safety/injury behaviors and sexual behavior). The school-based study included a representative sample of 1316 Israeli adolescents, grades 7, 9 and 11, using qualitative and quantitative instruments to develop the new measure. The results showed that the MHL measure is highly scalable (0.80) includes four sequenced categories: identification/recognition, critical evaluation of health content in media, perceived influence on adolescents and intended action/reaction. Multivariate analysis showed that MHL was significantly higher among girls (β = 1.25, P < 0.001), adolescents whose mothers had higher education (β = 0.16, P = 0.04), who report more adult/interpersonal sources of health information (β = 0.23, P < 0.01) and was positively associated with health empowerment (β = 0.36, P < 0.0005) and health behavior (β = 0.03, P = 0.05). The findings suggest that as a determinant of adolescent health behavior, MHL identifies groups at risk and may provide a basis for health promotion among youth.

  6. A positive concept of health - interviews with patients and practitioners in an integrative medicine clinic.

    PubMed

    Hunter, Jennifer; Marshall, Jack; Corcoran, Katherine; Leeder, Stephen; Phelps, Kerryn

    2013-11-01

    Using the phenomenography method, interviews with patients and practitioners were undertaken to explore their understanding of 'health that is more than the absence of disease'. The question was challenging and stimulating for all interviewees. A few were unable to conceptualise this positive definition of health, some perceived it as an optimum end-state, whereas others saw it as an ongoing process. Many positive attributes of health and its influencers were identified. The more advanced understandings of this concept were of a holistic, multidimensional, expansive state where the all dimensions of health are interdependent and positively reinforcing. The results affirmed that wellness is more than psychological wellbeing, 'happiness' and life satisfaction. Optimum physical and cognitive capacities along with spiritual, social and occupational wellness were equally as important. 'Energy and vitality' were sufficiently emphasised by patients and some practitioners to support the inclusion of the principles of vitalism in any discussion about health.

  7. Concept mapping as a method to enhance evidence-based public health.

    PubMed

    van Bon-Martens, Marja J H; van de Goor, Ien A M; van Oers, Hans A M

    2017-02-01

    In this paper we explore the suitability of concept mapping as a method for integrating knowledge from science, practice, and policy. In earlier research we described and analysed five cases of concept mapping procedures in the Netherlands, serving different purposes and fields in public health. In the current paper, seven new concept mapping studies of co-produced work are added to extend this analysis. For each of these twelve studies we analysed: (1) how the method was able to integrate knowledge from practice with scientific knowledge by facilitating dialogue and collaboration between different stakeholders in the field of public health, such as academic researchers, practitioners, policy-makers and the public; (2) how the method was able to bring theory development a step further (scientific relevance); and (3) how the method was able to act as a sound basis for practical decision-making (practical relevance). Based on the answers to these research questions, all but one study was considered useful for building more evidence-based public health, even though the extent to which they underpinned actual decision-making varied. The chance of actually being implemented in practice seems strongly related to the extent to which the responsible decision-makers are involved in the way the concept map is prepared and executed.

  8. [Health, death, illness, and nursing care concepts in Malagasi Antemoro Tribe].

    PubMed

    Gradellini, Martina; Fiaccadori, Cianzia

    2010-01-01

    A collaboration experience with the Fondation Médical d'Ampasimanjeva nurses, in an international cooperation project,permits to analyse the basic nursing concepts, starting from the local cultural approach. Research main outcome is to describe health, death, illness, and nursing care concepts in the Malgasi Antemoro tribe. Closing to the ethnographic research, work has been developed in three different moments: a first job organization starting from a spread literature analysis, the follow work on field about collecting data, and the last data elaboration and discussion Collecting data tool was the focus group which has done with the complete hospital nursing staff, divided by ward places. A fourth one was addressed to a twenty medical patients group. Focus group questions came from the Rising Sun Model guide, by Madeleine Leininger, adapted to the research own needs. Outcomes show an important traditional medicine influence, explained by the way people conceive health, illness, and even life, all elements directly affected the nursing care. It stands out a strong belief that health depends by the ability of person to work. The death concept is saw as a passage's phase to the Razana's spiritual condition. This is the reason supporting fatalism as approach to the death, that appear as an inevitable event managed by God. Disease's concept is related to traditional healers; as a matter of facts, it exists a strong belief that diseases find origin from magician.

  9. Patterns of Family Functioning and Diabetes-Specific Conflict in Relation to Glycemic Control and Health-Related Quality of Life Among Youth With Type 1 Diabetes.

    PubMed

    Rybak, Tiffany M; Ali, Jeanelle S; Berlin, Kristoffer S; Klages, Kimberly L; Banks, Gabrielle G; Kamody, Rebecca C; Ferry, Robert J; Alemzadeh, Ramin; Diaz-Thomas, Alicia M

    2016-08-28

    OBJECTIVE : General and diabetes-specific family functioning may be associated with youth's adaptation to type 1 diabetes (T1D); however, empirically derived patterns of family functioning and diabetes-specific conflict among youth have not been explored in relation to T1D adaptation.  METHODS:  Youth (N = 161, aged 12-18) with T1D and caregivers completed measures of family functioning and diabetes-specific conflict that served as indicators in latent profile analyses. Differences in glycemic control (measured by hemoglobin A1cs [HbA1c] and health-related quality of life [HRQoL]) were compared across profiles.  RESULTS : Four profiles that varied by levels of family functioning, diabetes-specific conflict, and congruence between youth and caregiver perspectives emerged and related to T1D adaptation differently. Greater agreement between caregiver and youth and lower diabetes-specific conflict was associated with lower HbA1c and greater HRQoL.  CONCLUSIONS : Person-centered approaches are useful to quantify how many individuals fit into a particular pattern and determine how specific family dynamics may function together differently in relation to T1D adaptation for various subgroups of the population.

  10. Disclosure of Financial Conflicts of Interests in Interventions to Improve Child Psychosocial Health: A Cross-Sectional Study.

    PubMed

    Eisner, Manuel; Humphreys, David K; Wilson, Philip; Gardner, Frances

    2015-01-01

    Academic journals increasingly request a full disclosure of financial conflict of interest (CoI). The Committee for Publication Ethics provides editors with guidance about the course of action in the case of suspected non-disclosure. No prior study has examined the extent to which journal articles on psychosocial interventions disclose CoI, and how journal editors process requests to examine suspected undisclosed CoI. Four internationally disseminated psychosocial interventions were examined. 136 articles related to an intervention, co-authored by intervention developers and published in health sciences journals were retrieved as requiring a CoI statement. Two editors refused consent to be included in the study. COI disclosures and editor responses were coded for 134 articles. Overall, 92/134 (71%) of all articles were found to have absent, incomplete or partly misleading CoI disclosures. Disclosure rates for the four programs varied significantly between 11% and 73%. Journal editors were contacted about 92 published articles with no CoI disclosure or a disclosure that was considered problematic. In 65/92 (71%) of all cases the editors published an 'erratum' or 'corrigendum'. In 16 of these cases the journal had mishandled a submitted disclosure. The most frequent reason for non-publication of an erratum was that the journal had no disclosure policy at the time of the publication (16 cases). Consumers of research on psychosocial interventions published in peer-reviewed journals cannot currently assume that CoI disclosures are adequate and complete. More efforts are needed to achieve transparency.

  11. Disclosure of Financial Conflicts of Interests in Interventions to Improve Child Psychosocial Health: A Cross-Sectional Study

    PubMed Central

    Eisner, Manuel; Humphreys, David K.; Wilson, Philip; Gardner, Frances

    2015-01-01

    Academic journals increasingly request a full disclosure of financial conflict of interest (CoI). The Committee for Publication Ethics provides editors with guidance about the course of action in the case of suspected non-disclosure. No prior study has examined the extent to which journal articles on psychosocial interventions disclose CoI, and how journal editors process requests to examine suspected undisclosed CoI. Four internationally disseminated psychosocial interventions were examined. 136 articles related to an intervention, co-authored by intervention developers and published in health sciences journals were retrieved as requiring a CoI statement. Two editors refused consent to be included in the study. COI disclosures and editor responses were coded for 134 articles. Overall, 92/134 (71%) of all articles were found to have absent, incomplete or partly misleading CoI disclosures. Disclosure rates for the four programs varied significantly between 11% and 73%. Journal editors were contacted about 92 published articles with no CoI disclosure or a disclosure that was considered problematic. In 65/92 (71%) of all cases the editors published an ‘erratum’ or ‘corrigendum’. In 16 of these cases the journal had mishandled a submitted disclosure. The most frequent reason for non-publication of an erratum was that the journal had no disclosure policy at the time of the publication (16 cases). Consumers of research on psychosocial interventions published in peer-reviewed journals cannot currently assume that CoI disclosures are adequate and complete. More efforts are needed to achieve transparency. PMID:26606667

  12. [The concept of social marketing--potential and limitations for health promotion and prevention in Germany].

    PubMed

    Loss, J; Lang, K; Ultsch, S; Eichhorn, C; Nagel, E

    2006-07-01

    "Social marketing" is the use of marketing principles to design and implement programmes to promote socially beneficial behaviour changes. In the field of health promotion and prevention, the systematic planning process of social marketing can offer new ideas and perspectives to the traditions of social science. Major characteristics of social marketing encompass continuous market research focussing on attitudes, motives and behavioural patterns of the target group, an integrated mix of strategic key elements, and the perpetual evaluation of all procedures. So far, however, it is unclear in how far social marketing is actually more effective than other concepts of programme planning. Furthermore, it has to be discussed whether the underlying philosophy of social marketing and its implicit understanding of relationships to the public are reconcilable with health promotion principles. In Anglo-Saxon countries, the social marketing concept has achieved widespread application and is subject to controversial scientific discussions, whereas this approach is hardly considered in German health promotion research and practice. Given the increasing call for quality management and evaluation of health promotion interventions, the social marketing concept may contribute useful insights at an operational level and thus add to a discussion on effective approaches for programme planning.

  13. Unravelling the concept of consumer preference: implications for health policy and optimal planning in primary care.

    PubMed

    Foster, Michele M; Earl, Peter E; Haines, Terry P; Mitchell, Geoffrey K

    2010-10-01

    Accounting for consumer preference in health policy and delivery system design makes good economic sense since this is linked to outcomes, quality of care and cost control. Probability trade-off methods are commonly used in policy evaluation, marketing and economics. Increasingly applied to health matters, the trade-off preference model has indicated that consumers of health care discriminate between different attributes of care. However, the complexities of the health decision-making environment raise questions about the inherent assumptions concerning choice and decision-making behavior which frame this view of consumer preference. In this article, we use the example of primary care in Australia as a vehicle to examine the concept of 'consumer preference' from different perspectives within economics and discuss the significance of how we model preferences for health policy makers. In doing so, we question whether mainstream thinking, namely that consumers are capable of deliberating between rival strategies and are willing to make trade-offs, is a reliable way of thinking about preferences given the complexities of the health decision-making environment. Alternative perspectives on preference can assist health policy makers and health providers by generating more precise information about the important attributes of care that are likely to enhance consumer engagement and optimise acceptability of health care.

  14. Managing Conflict.

    ERIC Educational Resources Information Center

    Labovitz, George H.

    1980-01-01

    Examines the causes of conflict and various methods of managing it. Argues that by confronting disputes and providing a process that encourages their productive management, managers may help guarantee that the healthy aspects of conflict flourish in their organization. Available from Business Horizons, School of Business, Indiana University,…

  15. When Task Conflict Becomes Personal

    PubMed Central

    Guenter, Hannes; van Emmerik, Hetty; Schreurs, Bert; Kuypers, Tom; van Iterson, Ad; Notelaers, Guy

    2016-01-01

    Although potentially beneficial, task conflict may threaten teams because it often leads to relationship conflict. Prior research has identified a set of interpersonal factors (e.g., team communication, team trust) that help attenuate this association. The purpose of this article is to provide an alternative perspective that focuses on the moderating role of performance-related factors (i.e., perceived team performance). Using social identity theory, we build a model that predicts how task conflict associates with growth in relationship conflict and how perceived team performance influences this association. We test a three-wave longitudinal model by means of random coefficient growth modeling, using data from 60 ongoing teams working in a health care organization. Results provide partial support for our hypotheses. Only when perceived team performance is low, do task conflicts relate with growth in relationship conflict. We conclude that perceived team performance seems to enable teams to uncouple task from relationship conflict. PMID:28190944

  16. Primary health concept revisited: where do people seek health care in a rural area of Vietnam?

    PubMed

    Khe, N D; Toan, N V; Xuan, L T T; Eriksson, B; Höjer, B; Diwan, V K

    2002-07-01

    The government of Vietnam is committed to promote and secure equity in access to health care for all citizens. The current rapid changes towards a market economy may challenge the government's wish for maintaining equity, especially for low income and vulnerable groups. The aim of this study was to investigate aspects of access and utilisation of health care of rural people. The study included a random sample of 1075 out of the 11,547 households in the Field Laboratory in Bavi district, northern Vietnam and a structured questionnaire was used. The results indicate that self-treatment is common practice and private providers are an important source of health services not only for those who are better off but also for poor households. The costs for health care are substantial for households, and lower income groups spent a significantly higher proportion of their income on health care than the rich did. The poor are deterred from seeking health care more often than the rich and for financial reason. As regards sources for payments, the poor relied much more on borrowing money to pay for their health care needs, while those who are better off relied mostly on household savings. A burden of high cost for treatment implies high risks for families to fall into a 'medical poverty trap'. Our findings suggest a need for developing risk-sharing schemes (co-payment, pre-payment and insurance), and appropriate allocation of scarce public resources. We suggest that the private health care sector needs both support and regulations to improve the quality and access to health care by the poor.

  17. Assessing health of the Bay of Fundy--concepts and framework.

    PubMed

    Wells, Peter G

    2003-09-01

    A discussion of health and ecosystem health (EH) concepts and a conceptual framework for assessing health of the Bay of Fundy are presented. The framework includes:Concepts--What is health? What is EH and marine ecosystem health (MEH)? How does EH relate to other closely related concepts and principles i.e. environmental quality (especially marine or MEQ), ecosystem integrity, and ecosystem sustainability?Importance--Why is EH important, and what are the linkages to people i.e. human health?Approaches and techniques--How do we monitor and measure EH, and in that context, ecosystem or ecological change? i.e. What are the monitoring approaches and tools? What is an appropriate set of EH indicators and indices for the Bay of Fundy and Gulf of Maine? At the present time, can we make unequivocal statements about the status and trends in EH measures of the Bay of Fundy? Do we have adequate guidelines, objectives and standards for assessing environmental quality and EH?Connecting with management needs--Do we have adequate mechanisms in place to address MEH, marine environmental quality (MEQ), and environmental sustainability in the Bay of Fundy? What is the role of periodic marine assessments (state of the marine environment reports) in this activity? What kinds of new directions and new ecosystem science should be given priority? What kinds of other new activities should be pursued?For the Bay of Fundy Coastal Forum at the recent 5th BOFEP Bay of Fundy Science Workshop (May 2002), five core questions flowing from the health framework served to initiate and focus the discussions:Current state--What is the present health or condition of the Bay of Fundy?Changes--Are conditions improving or deteriorating?Indicators--What kinds of indicators do we consider most useful in trying to answer these questions?Existing resources--Are there adequate resources (e.g. institutional, financial, scientific, regulatory) to protect or restore the health of the Bay?Needs--What kinds of new

  18. [Using the health literacy concept to promote self-management in a chronic kidney disease patient].

    PubMed

    Sun, Jia-Hui; Lin, Chiu-Chu

    2014-02-01

    Patients with chronic kidney disease (CKD) must learn and use self-management skills to control their disease and delay disease progression. Comprehension of instructions is thus critical to integrating self-management principles into daily life. In this case report, the client had difficulty implementing the behavioral changes necessary to control diet and blood sugar due to the lack of proper and sufficient information. The authors applied health literacy concepts to assess the client's knowledge and skills related to disease control and then provided health teaching at a level appropriate to the client's health literacy level. This individualized care enhanced the client's confidence and motivation to implement self-care activities. Healthcare professionals should help patients overcome barriers to reading and verbal communication to help low-health-literacy patients successfully self-manage their chronic disease. Clients may thus learn to report their symptoms clearly and accurately.

  19. What Causes Environmental Inequalities and Related Health Effects? An Analysis of Evolving Concepts

    PubMed Central

    Kruize, Hanneke; Droomers, Mariël; van Kamp, Irene; Ruijsbroek, Annemarie

    2014-01-01

    Early environmental justice studies were exposure-oriented, lacked an integrated approach, and did not address the health impact of environmental inequalities. A coherent conceptual framework, needed to understand and tackle environmental inequalities and the related health effects, was lacking. We analyzed the more recent environmental justice literature to find out how conceptual insights have evolved. The conceptual framework of the WHO Commission on Social Determinants of Health (CSDH) was analyzed for additional explanations for environmental inequalities and the related health effects. This paper points out that recent environmental justice studies have broadened their scope by incorporating a broader set of physical and social environmental indicators, and by focusing on different geographic levels and on health impacts of environmental inequalities. The CSDH framework provided additional elements such as the role of structural determinants, the role of health-related behavior in relation to the physical and social environment, access to health care, as well as the life course perspective. Incorporating elements of the CSDH framework into existing environmental justice concepts, and performing more empirical research on the interactions between the different determinants at different geographical levels would further improve our understanding of environmental inequalities and their health effects and offer new opportunities for policy action. PMID:24886752

  20. On the concept of a socialist health system: a question of Marxist epistemology.

    PubMed

    Segall, M

    1983-01-01

    This paper concerns the best approach to the concept of a socialist health system. It first criticizes a narrow empiricism, which reduces the subject to a phenomenalistic study of existing health systems in socialist countries, paying insufficient attention to historical contexts and developments and to the worldwide evolution of socialist ideas. Such a rightist empiricism, separating practice from theory, is then contrasted with a leftist idealism, which separates theory from practice. The latter approach entails abstract models of an ideal socialist health system with many characteristics, without specifying which are the necessary and sufficient ones for applying the global designation "socialist." This leads to epistemological confusion and a deterministic view of the relation of the social formation to the health system, which is in fact complex. A socialist health system is best seen as an aspect of socialist theory rather than as an actual social entity. Viewed this way, it can act as a continuing guide to social practice and be enriched by that practice. Taking an appropriate class standpoint, socialist health theory should relate to social factors in the causation of disease and in the capacity of peoples to undertake health-related activities and to the social control of health care services and related industries.

  1. [The concept and program of health improvement for children and teenagers].

    PubMed

    Dzheus, A V

    2005-01-01

    Described in the paper is the activity of the Russian national children's recreation facility "Orlenok", where up to 16 000 children (mainly teenagers) come annually for recreation and recovery. Information on history, evolution as well on the structure of health-improving, preventive and educational measures is presented. The major provisions and stages of the Concept of development of "Orlenok"--a recreational, methodological, medical and cultural facility--are defined. The recreational facility is regarded as an experimental center, where pilot projects targeted at health improvement and prevention of diseases among the growing generation are tested.

  2. Integrating health education and physical activity programming for cardiovascular health promotion among female inmates: A proof of concept study.

    PubMed

    Nair, Uma S; Jordan, Jeremy S; Funk, Daniel; Gavin, Kristin; Tibbetts, Erica; Collins, Bradley N

    2016-05-01

    Female inmate populations in the United States tend to be overweight, physically inactive, experience high stress, and have a history of nicotine and other drug dependence. Thus, they bear an elevated risk of cardiovascular (CV) disease than the general population. However, few evidence-based health interventions exist for this population. This study will test proof of concept, feasibility, and potential efficacy of a multiple health behavior change intervention that integrates CV-health promotion education delivered during a physical activity (PA) program (indoor cycling) tailored to this population. This study uses a quasi-experimental 2-group design with two measurement time-points: baseline and 8-week end of treatment. N=120 incarcerated women (18-59years of age) who are medically cleared for participation in PA will be enrolled. Indoor cycling instructors will be trained to deliver five health education topics over an 8-week period during twice-weekly cycling classes. Topics match the American Heart Association recommendations for CV health: (a) nutrition, (b) PA promotion, (c) weight management, (d) stress management, and (e) smoking cessation and relapse prevention. Modes of intervention include instructor advice, written materials and audio/video clips reviewed during class. CV-related and mental health measures will be assessed at both time-points. Results will guide a full scale efficacy study. Future research in this area has potential to impact the health of female inmates, a high-risk population. Moreover, this multiple health behavior change intervention model represents a community approach to health promotion that could generalize to other underserved populations who may benefit most from similar intervention efforts.

  3. [Developmental origins of adult health and disease: an important concept for social inequalities in health].

    PubMed

    Charles, M-A

    2013-08-01

    According to the theory of the developmental origins of adult health and disease, development in utero and in the first years of life are critical phases during which susceptibility to many chronic diseases is set. Diseases eventually occur only if the environment and lifestyle in later life is favorable. Exposure to chemicals (environmental or drug), to infectious agents, unbalanced nutrition, or psychosocial stress prenatally or in the first months/years of life are all factors which have been shown to impact long-term health of individuals. The consequences, however, are not limited to health. A demonstrative example was provided by the study of the influenza epidemic of 1918-1919 in the United States. Nationwide, it was estimated that the loss of income over a lifetime for individuals exposed during fetal life to this epidemic amounted to 14 billion dollars. This example demonstrates that an exposure during fetal life, which is not socially differentiated, may affect the social situation of individuals in adulthood. In many situations, it is much more difficult to separate the specific effect of a given exposure from the overall effect of the social environment. Indeed, it has been shown that socioeconomic status in childhood is associated with increased risk of mortality in adulthood, even after accounting for the socioeconomic status and risky behaviors in adulthood. Among the explanations, the theory of developmental origins of health credits of biological plausibility the model of critical periods early in which the individual is particularly vulnerable to certain exposures. Thus, ensuring the best conditions for the biological, physical, emotional and cognitive development of children in early life will enable them to reach their potential in terms of health and socioeconomic return to society. Investment in this period also brings the hope of reducing the perpetuation of social inequalities and health from generation to generation.

  4. [The power of the notion of resistance in the mental health field: a case study on the life of rural communities whitin the Colombian armed conflict].

    PubMed

    Arias López, Beatriz Elena

    2014-08-01

    The objective of this study is to identify individual, family and/or community responses of resistance within protracted armed conflict. We conducted a case study with members of rural communities in the municipality of San Francisco, in the eastern area of Antioquia, Colombia, combining biographical and ethnographical approaches. The primary results show that, along with the suffering generated by the experience of armed conflict, rural community members also display a repertoire of multiple and diverse resistance strategies. Resistance is for them an active response and a way to re-weave the fabric torn by the experience. As a type of affirmative opposition, resistance is a powerful category for the entire mental health field, in that it highlights the creativity and capacity for transformation of individuals. In this way, the category allows for overcoming the limits of the conventional biomedical view that tends to pathologize individual and social responses in scenarios of severe distress.

  5. Advancing One Health Policy and Implementation Through the Concept of One Medicine One Science

    PubMed Central

    Cardona, Carol; Travis, Dominic A.; Berger, Kavita; Coat, Gwenaële; Kennedy, Shaun; Steer, Clifford J.; Murtaugh, Michael P.

    2015-01-01

    Numerous interspecies disease transmission events, Ebola virus being a recent and cogent example, highlight the complex interactions between human, animal, and environmental health and the importance of addressing medicine and health in a comprehensive scientific manner. The diversity of information gained from the natural, social, behavioral, and systems sciences is critical to developing and sustainably promoting integrated health approaches that can be implemented at the local, national, and international levels to meet grand challenges. The Concept of One Medicine One Science (COMOS) as outlined herein describes the interplay between scientific knowledge that underpins health and medicine and efforts toward stabilizing local systems using 2 linked case studies: the food system and emerging infectious disease. Forums such as the International Conference of One Medicine One Science (iCOMOS), where science and policy can be debated together, missing pieces identified, and science-based collaborations formed among industry, governmental, and nongovernmental policy makers and funders, is an essential step in addressing global health. The expertise of multiple disciplines and research foci to support policy development is critical to the implementation of one health and the successful achievement of global health security goals. PMID:26421234

  6. Advancing One Health Policy and Implementation Through the Concept of One Medicine One Science.

    PubMed

    Cardona, Carol; Travis, Dominic A; Berger, Kavita; Coat, Gwenaële; Kennedy, Shaun; Steer, Clifford J; Murtaugh, Michael P; Sriramarao, P

    2015-09-01

    Numerous interspecies disease transmission events, Ebola virus being a recent and cogent example, highlight the complex interactions between human, animal, and environmental health and the importance of addressing medicine and health in a comprehensive scientific manner. The diversity of information gained from the natural, social, behavioral, and systems sciences is critical to developing and sustainably promoting integrated health approaches that can be implemented at the local, national, and international levels to meet grand challenges. The Concept of One Medicine One Science (COMOS) as outlined herein describes the interplay between scientific knowledge that underpins health and medicine and efforts toward stabilizing local systems using 2 linked case studies: the food system and emerging infectious disease. Forums such as the International Conference of One Medicine One Science (iCOMOS), where science and policy can be debated together, missing pieces identified, and science-based collaborations formed among industry, governmental, and nongovernmental policy makers and funders, is an essential step in addressing global health. The expertise of multiple disciplines and research foci to support policy development is critical to the implementation of one health and the successful achievement of global health security goals.

  7. Trauma and mental health of medics in eastern Myanmar’s conflict zones: a cross-sectional and mixed methods investigation

    PubMed Central

    2013-01-01

    Background In conflict and disaster settings, medical personnel are exposed to psychological stressors that threaten their wellbeing and increase their risk of developing burnout, depression, anxiety, and PTSD. As lay medics frequently function as the primary health providers in these situations, their mental health is crucial to the delivery of services to afflicted populations. This study examines a population of community health workers in Karen State, eastern Myanmar to explore the manifestations of health providers’ psychological distress in a low-resource conflict environment. Methods Mental health screening surveys were administered to 74 medics, incorporating the 12-item general health questionnaire (GHQ-12) and the posttraumatic checklist for civilians (PCL-C). Semi-structured qualitative interviews were conducted with 30 medics to investigate local idioms of distress, sources of distress, and the support and management of medics’ stressors. Results The GHQ-12 mean was 10.7 (SD 5.0, range 0–23) and PCL-C mean was 36.2 (SD 9.7, range 17–69). There was fair internal consistency for the GHQ-12 and PCL-C (Cronbach’s alpha coeffecients 0.74 and 0.80, respectively) and significant correlation between the two scales (Pearson’s R-correlation 0.47, P<0.001). Qualitative results revealed abundant evidence of stressors, including perceived inadequacy of skills, transportation barriers, lack of medical resources, isolation from family communities, threats of military violence including landmine injury, and early life trauma resulting from conflict and displacement. Medics also discussed mechanisms to manage stressors, including peer support, group-based and individual forms of coping. Conclusions The results suggest significant sources and manifestations of mental distress among this under-studied population. The discrepancy between qualitative evidence of abundant stressors and the comparatively low symptom scores may suggest marked mental resilience

  8. Parenting Conflicts

    MedlinePlus

    ... her strength, so the decision-making responsibilities are divided within the family. Overt Conflict Too often, parents ... think, "The kids require so much of our attention now; once they're grown, we'll have ...

  9. Basic Concepts in the Taxonomy of Health-Related Behaviors, Habits and Lifestyle

    PubMed Central

    Salvador-Carulla, Luis; Alonso, Federico; Gomez, Rafael; Walsh, Carolyn O.; Almenara, José; Ruiz, Mencía; Abellán, María José

    2013-01-01

    Background: Health-related Habits (HrH) are a major priority in healthcare. However there is little agreement on whether exercise, diet, smoking or dental hygiene are better described as lifestyles, habits or behaviors, and on what is their hierarchical relationship. This research is aimed at representing the basic concepts which are assumed to constitute the conceptual framework enabling us to interpret and organize the field of HrH. Methods: A group of 29 experts with different backgrounds agreed on the definition and hierarchy of HrH following an iterative process which involved framing analysis and nominal group techniques. Results: Formal definitions of health-related behavior, habit, life-style and life-style profile were produced. In addition a series of basic descriptors were identified: health reserve, capital, risk and load. Six main categories of HrH were chosen based on relevance to longevity: diet/exercise, vitality/stress, sleep, cognition, substance use and other risk. Attributes of HrH are clinical meaningfulness, quantifiability, temporal stability, associated morbidity, and unitarity (non-redundancy). Two qualifiers (polarity and stages of change) have also been described. Conclusions: The concepts represented here lay the groundwork for the development of clinical and policy tools related to HrH and lifestyle. An adaptation of this system to define targets of health interventions and to develop the classification of person factors in ICF may be needed in the future. PMID:23670578

  10. The Concept of Sasang Health Index and Constitution-Based Health Assessment: An Integrative Model with Computerized Four Diagnosis Methods

    PubMed Central

    Kim, Jaeuk U.; Ku, Boncho; Kim, Young-Min; Do, Jun-Hyeong; Jang, Eunsu; Jeon, Young Ju; Kim, Keun Ho; Kim, Jong Yeol

    2013-01-01

    Sasang constitutional medicine (SCM) shares its philosophy with that of personalized medicine: it provides constitution-specific treatment and healthcare individualized for each patient. In this work, we propose the concept of the Sasang Health Index (SHI) as an attempt to assess the individualized health status in the framework of SCM. From the target population of females in their fifties and older, we recruited 298 subjects and collected their physiological data, including complexion, radial pulse, and voice, and their questionnaire responses. The health status of each subject was evaluated by two Korean medical doctors independently, and the SHI model was obtained by combining all the integrative features of the phenotype data using a regression technique. As a result, most subjects belonged to either the healthy, subhealthy, or slightly diseased group, and the intraclass correlation coefficient between the two doctors' health scoring reached 0.95. We obtained an SHI model for each constitution type with adjusted R-squares of 0.50, 0.56, and 0.30, for the TE, SE, and SY constitution types, respectively. In the proposed SHI model, the significant characteristics used in the health assessment consisted of constitution-specific features in accordance with the classic literature and features common to all the constitution types. PMID:23843888

  11. Recovery: what mental health nurses and service users say about the concept of recovery.

    PubMed

    Aston, V; Coffey, M

    2012-04-01

    This study presents a thematic analysis of focus group talk to examine what recovery in mental health means to service users and nurses. Data were collected from two focus groups, one group of service users and one group of nurses. The service user group (n=6) were adults with previous or recent experience of inpatient mental health services. The nursing group were registered nurses (n=5) of various grades and experience currently working in inpatient mental health services in one region of the U.K. Thematic analysis using Krueger and Casey's framework led to four themes being developed. These were 'understandings of recovery', 'semantics', 'therapeutics' and 'a journey'. While the recovery concept was not new to either group, understandings of recovery were vague and contradictory.

  12. [Imputing missing data in public health: general concepts and application to dichotomous variables].

    PubMed

    Hernández, Gilma; Moriña, David; Navarro, Albert

    2017-03-15

    The presence of missing data in collected variables is common in health surveys, but the subsequent imputation thereof at the time of analysis is not. Working with imputed data may have certain benefits regarding the precision of the estimators and the unbiased identification of associations between variables. The imputation process is probably still little understood by many non-statisticians, who view this process as highly complex and with an uncertain goal. To clarify these questions, this note aims to provide a straightforward, non-exhaustive overview of the imputation process to enable public health researchers ascertain its strengths. All this in the context of dichotomous variables which are commonplace in public health. To illustrate these concepts, an example in which missing data is handled by means of simple and multiple imputation is introduced.

  13. Chemical Pesticides and Human Health: The Urgent Need for a New Concept in Agriculture

    PubMed Central

    Nicolopoulou-Stamati, Polyxeni; Maipas, Sotirios; Kotampasi, Chrysanthi; Stamatis, Panagiotis; Hens, Luc

    2016-01-01

    The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production, which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken. PMID:27486573

  14. Chemical Pesticides and Human Health: The Urgent Need for a New Concept in Agriculture.

    PubMed

    Nicolopoulou-Stamati, Polyxeni; Maipas, Sotirios; Kotampasi, Chrysanthi; Stamatis, Panagiotis; Hens, Luc

    2016-01-01

    The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production, which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken.

  15. [Team work in a family health care program: the team process concept and operational teams].

    PubMed

    Fortuna, Cinira Magali; Mishima, Silvana Martins; Matumoto, Silvia; Pereira, Maria José Bistafa

    2005-01-01

    This work is a theoretical revision of team work in a family Health Care Program. We define team work in the health care field as a relationship network among people, power, knowledge, affection, and wishes, when there is a possibility of identifying group processes. We deal with concepts of Operational Group from the Argentinean School, which might help health professionals to get training in team work. We have visible (spoken) and invisible (unspoken) tasks within teams, which are modified and need to be combined and known. Communication, learning, the feeling of belonging, the atmosphere, the actions' pertinence for the team's purpose and power relations may help the team to get to know and analyze each other and to build a team. External supervision may help the team to turn itself into an operational team, working towards a life care project.

  16. Diarrheal illnesses on the Ecuadorian coast: socio-environmental changes and health concepts

    PubMed Central

    Trostle, James A.; Yépez-Montufar, Jeanneth Alexandra; Corozo-Angulo, Betty; Rodríguez, Marylin

    2013-01-01

    The authors present an ethnoepidemiological study of diarrheal illnesses in 21 communities on the northern coast of Ecuador, where numerous social and environmental changes have taken place since 2001 due to a new highway. As communities realize that nature itself is changing, changes occur in their interpretations of health and disease, which the authors present through a taxonomic classification of diarrheal illnesses. Given the high incidence of diarrheal diseases, alternative concepts have emerged (as compared to those of biomedicine) in relation to causes, symptoms, and treatments. The non-biomedical and biomedical systems overlap, with mixtures of coexistence and resistance. Recognizing this reality means understanding a series of challenges for the official health system, including the indiscriminate use of antibiotics, non-use of health services for some diseases, and perceived relations between environmental contamination and the efficacy of modern and traditional medicines. PMID:20694359

  17. Adjustment of Siblings of Children with Mental Health Problems: Behaviour, Self-Concept, Quality of Life and Family Functioning

    ERIC Educational Resources Information Center

    Barnett, R. A.; Hunter, M.

    2012-01-01

    This study examined the adjustment of siblings of children with mental health problems. The participants had brothers or sisters receiving treatment at a Child and Adolescent Mental Health Service within the Hunter New England Health Service, New South Wales, Australia. Seventy-five siblings completed questionnaires on their self-concept, quality…

  18. Thinking shift on health systems: from blueprint health programmes towards resilience of health systems Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".

    PubMed

    Blanchet, Karl

    2015-03-03

    International health is still highly dominated by equilibrium approaches. The emergence of systems thinking in international health provides a great avenue to develop innovative health interventions adapted to changing contexts. The public health community, nevertheless, has the responsibility to translate concepts related to systems thinking and complexity into concrete research methods and interventions. One possibility is to consider the properties of systems such as resilience and adaptability as entry points to better understand how health systems react to shocks.

  19. Concepts about infant health, growth, and weaning: a comparison between nutritional scientists and Madurese mothers.

    PubMed

    Launer, L J; Habicht, J P

    1989-01-01

    Nutrition education is a critical component of programs designed to improve nutritional status, yet it often fails because of differences in the concepts underlying the educational message and those motivating mothers' behavior. To illustrate this discrepancy in the context of infant feeding we compare the views of nutritional scientists' and mothers in Madura, Indonesia on (a) health and disease and (b) the relationship of foods to the concepts of state-of-health, infancy and growth. The relationship of these concepts to mothers' practices and nutritional scientists' recommendations are also explored. Views of the nutritional scientist were drawn from the published literature and those for the Madurese mothers' from ethnographic and survey data gathered between February 1983 and June 1984. While mothers and nutritional scientists both seek to give a diet appropriate for a stage of infancy, their definitions of key concepts differed. Nutritional scientists recommend feeding infants high quality clean foods in amounts sufficient for maintenance, activity and growth. Underlying these recommendations are the concepts of disease as a deviation from the norm, food as a source of pathogens as well as nutrients, infancy as a period of physiological growth, and poor growth as an indicator of disease. All infants have the same type of nutrient requirements. Madurese mothers perceive health and its components as a process of balance. Balance is partly attained either by feeding rice soon after birth or by withholding rice until after one year of age. This concept results in two distinct but coexisting types of requirement and weaning patterns for infants. The important development during an infant's first year of life is 'growth' from a vulnerable state in the 'neonatal' period (40 days) to a state of independence and reason (akal) in late infancy (greater than 7 months). To foster 'growth' in rice-fed infants, mothers force-feed increasing amounts of quality foods. Once

  20. [Is ageism a relevant concept for health care practice in the elderly?].

    PubMed

    Masse, Marie; Meire, Philippe

    2012-09-01

    With the demographic aging, the older adults' needs for assistance and care will inevitably increase. Therefore, it is important to explore the beliefs and attitudes of the health care professionals toward the elderly. This paper discusses the notion of ageism and its paradoxes in health care practices for the elderly. First, the concept of ageism is defined through its cognitive, affective and behavioral components. Second, on the basis of the literature review, different "age biases" induced by ageism are described, which can influence the assessment of health condition of the elderly, the treatment decisions, but also the attitudes of the health care workers with out-patients as with institutionalized subjects. Third, the potential negative effects of ageist stereotypes on the health status and psychological well-being of the elderly are examined. Finally, some propositions are made to oppose ageism in health care practices for the elderly, including continuing education, better knowledge of the diversity of aging processes, reflexion on professionals' own prejudices, values and beliefs, promotion of relational attitudes which sustain autonomy.

  1. Universal norms and conflicting values.

    PubMed

    Selgelid, Michael J

    2005-09-01

    While UNESCO's Universal Draft Declaration on Bioethics and Human Rights highlights appropriate ethical values, its principles are stated in absolute terms and conflict with one another. The Draft Declaration fails to sufficiently address the possibility of conflict between principles, and it provides no real guidance on how to strike a balance between them in cases where conflict occurs. The document's inadequate treatment of conflicting values is revealed by examination of cases where principles aimed at the promotion of autonomy and liberty conflict with those aimed at benefit maximization and harm minimization. I argue that liberty (and autonomy) may be less important in the context of health care than in other contexts, and I conclude by suggesting specific ways in which some of UNESCO's principles should be revised in order to better address the reality of conflicting values.

  2. Sexual and gender-based violence in areas of armed conflict: a systematic review of mental health and psychosocial support interventions

    PubMed Central

    2013-01-01

    Background Sexual and other forms of gender-based violence are common in conflict settings and are known risk factors for mental health and psychosocial wellbeing. We present findings from a systematic review of the academic and grey literature focused on the effectiveness of mental health and psychosocial support interventions for populations exposed to sexual and other forms of gender-based violence in the context of armed conflicts. Methods We searched the Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PubMed/ Medline, psycINFO, and PILOTS, as well as grey literature to search for evaluations of interventions, without date limitations. Results Out of 5,684 returned records 189 full text papers were assessed for eligibility. Seven studies met inclusion criteria: 1 non-randomized controlled study; 3 non-controlled pre- post-test designs; 1 retrospective cohort with a matched comparison group; and 2 case studies. Studies were conducted in West and Central Africa; Albania; UK and USA, included female participants, and focused on individual and group counseling; combined psychological, medical, social and economic interventions; and cognitive behavioral therapy (two single case studies). Conclusions The seven studies, while very limited, tentatively suggest beneficial effects of mental health and psychosocial interventions for this population, and show feasibility of evaluation and implementation of such interventions in real-life settings through partnerships with humanitarian organizations. Robust conclusions on the effectiveness of particular approaches are not possible on the basis of current evidence. More rigorous research is urgently needed. PMID:23915821

  3. Socio-ecological correlates of mental health among ethnic minorities in areas of political conflict: a study of Druze adolescents in Israel.

    PubMed

    Scrimin, Sara; Moscardino, Ughetta; Natour, Miras

    2014-04-01

    Children and youths living in areas of political conflict are at increased risk of mental health problems, but little is known about psychosocial adjustment among ethnic minorities living in war-afflicted settings. This cross-sectional study used an ecological approach to investigate the unique contributions of child, family/social, and minority related factors as well as traumatic exposure and perceived discrimination to the mental health of 167 Druze adolescents in Northern Israel. Outcome measures included participants' self-reported posttraumatic stress disorder symptoms, psychological distress, and emotional and behavioral problems. Adolescents reported high indirect exposure, moderate discrimination, strong ethnic identity and high religious involvement. Regression analyses showed that female gender, number of traumatic events, and perceived discrimination were associated with more severe mental health outcomes. In addition, low social support and high religious involvement predicted increased PTSD symptom severity, while stronger ethnic identity was associated with less emotional and behavioral problems. Findings are discussed in terms of the cultural characteristics of the Druze community and highlight the need to consider additional stressors, such as discrimination, when working with ethnic minority youth in conflict zones.

  4. An integrative review of the concept of spirituality in the health sciences.

    PubMed

    Chiu, Lyren; Emblen, Julia D; Van Hofwegen, Lynn; Sawatzky, Rick; Meyerhoff, Heather

    2004-06-01

    Spirituality is a universal human phenomenon, yet confusion and incomprehension of the concept is ever-present. The purpose of this study was to explore how research on the concept of spirituality has been reported in the health literature in the past decade and develop an ontological and theoretical understanding of spirituality. The examination was based on quantitative and qualitative integrative review approaches, which integrated empirical research on spirituality. The sample included 73 spirituality research articles, which were published in English between January 1990 and September 2000. An electronic data-collection tool was designed for use in this project and formatted using Excel software for transfer of coded data into the NVivo software for the data analysis. The results identified essential elements of spirituality, current use of operational definitions and instruments, conceptual frameworks used in spirituality research, and cultural aspects of spirituality. Historical comparison among decades and barriers in researching spirituality are discussed.

  5. A Concept of Operations for an Integrated Vehicle Health Assurance System

    NASA Technical Reports Server (NTRS)

    Hunter, Gary W.; Ross, Richard W.; Berger, David E.; Lekki, John D.; Mah, Robert W.; Perey, Danie F.; Schuet, Stefan R.; Simon, Donald L.; Smith, Stephen W.

    2013-01-01

    This document describes a Concept of Operations (ConOps) for an Integrated Vehicle Health Assurance System (IVHAS). This ConOps is associated with the Maintain Vehicle Safety (MVS) between Major Inspections Technical Challenge in the Vehicle Systems Safety Technologies (VSST) Project within NASA s Aviation Safety Program. In particular, this document seeks to describe an integrated system concept for vehicle health assurance that integrates ground-based inspection and repair information with in-flight measurement data for airframe, propulsion, and avionics subsystems. The MVS Technical Challenge intends to maintain vehicle safety between major inspections by developing and demonstrating new integrated health management and failure prevention technologies to assure the integrity of vehicle systems between major inspection intervals and maintain vehicle state awareness during flight. The approach provided by this ConOps is intended to help optimize technology selection and development, as well as allow the initial integration and demonstration of these subsystem technologies over the 5 year span of the VSST program, and serve as a guideline for developing IVHAS technologies under the Aviation Safety Program within the next 5 to 15 years. A long-term vision of IVHAS is provided to describe a basic roadmap for more intelligent and autonomous vehicle systems.

  6. Operationalizing the new concept of sexual and reproductive health in Indonesia.

    PubMed

    Ford, N J; Siregar, K N

    1998-03-01

    The new politics of family planning in the 1990s has involved the articulation of a comprehensive concept of sexual and reproductive health (SRH). Following the ratification of the SRH concept and goals at recent international conferences, one major issue is how governments translate the broad statements into operational policies and programs. The authors consider the ways in which the process is occurring in Indonesia, defining SRH, and reviewing the levels of its attainment in 8 of its components in Indonesia. The policy process in Indonesia is explored with regard to pre-existing reassessments, setting important priorities and moralistic and pragmatic policy orientations. The following SRH components are discussed: family planning, infertility, maternal and child health, HIV/AIDS, sexually transmitted diseases, adolescents' needs, sexual health, and gender issues. In terms of SRH, Indonesia has achieved considerable success in addressing family planning and infant and child mortality, limited success in addressing maternal mortality and HIV/AIDS, and very little progress in addressing STDs, adolescent needs, and positive sexuality. There are few data on gender issues.

  7. Synergising Public Health Concepts with the Sendai Framework for Disaster Risk Reduction: A Conceptual Glossary

    PubMed Central

    Phibbs, Suzanne; Kenney, Christine; Severinsen, Christina; Mitchell, Jon; Hughes, Roger

    2016-01-01

    The Sendai Framework for Disaster Risk Reduction (2015) is a global strategy for addressing disaster risk and resilience that has been ratified by member countries of the United Nations. Its guiding principles emphasise building resilience through inter-sectoral collaboration, as well as partnerships that facilitate community empowerment and address underlying risk factors. Both public health and the emergency management sector face similar challenges related to developing and implementing strategies that involve structural change, facilitating community resilience and addressing individual risk factors. Familiarity with public health principles enables an understanding of the holistic approach to risk reduction that is outlined within the Sendai Framework. We present seven concepts that resonate with contemporary public health practice, namely: the social determinants of health; inequality and inequity; the inverse care law; community-based and community development approaches; hard to reach communities and services; the prevention paradox; and the inverse prevention law. These ideas from public health provide a useful conceptual base for the ”new” agenda in disaster risk management that underpins the 2015 Sendai Framework. The relevance of these ideas to disaster risk management and research is illustrated through drawing on the Sendai Framework, disaster literature and exemplars from the 2010–2011 earthquakes in Canterbury, New Zealand. PMID:27983666

  8. Expanding the concept of significant choice through consideration of health literacy during crises.

    PubMed

    Wickline, Morgan; Sellnow, Timothy L

    2013-11-01

    Nilsen defined the concept of the ethic of significant as "choice making that is voluntary, free from physical or mental coercion . . . based on all the information available when the decision must be made." This study highlights the importance of speakers in crisis situations not only meeting the ethical stipulations of significant choice but also taking into consideration the health literacy of their audience. Health literacy is defined as the ability of individuals to gather, interpret, and understand information regarding health matters. To advance this claim, a case study involving a food recall is examined. Television news coverage was analyzed to observe the importance of both significant choice and health literacy in such public communication. The findings, from the standpoint of significant choice and health literacy, indicate that the messages disseminated during this crisis failed to account for a notable portion of the audience. From a practical standpoint this study asserts that clear and open communication cannot be considered only from the perspective of the party sending the message. Rather, careful consideration of the audience's ability to comprehend and act on the information is equally important.

  9. Synergising Public Health Concepts with the Sendai Framework for Disaster Risk Reduction: A Conceptual Glossary.

    PubMed

    Phibbs, Suzanne; Kenney, Christine; Severinsen, Christina; Mitchell, Jon; Hughes, Roger

    2016-12-14

    The Sendai Framework for Disaster Risk Reduction (2015) is a global strategy for addressing disaster risk and resilience that has been ratified by member countries of the United Nations. Its guiding principles emphasise building resilience through inter-sectoral collaboration, as well as partnerships that facilitate community empowerment and address underlying risk factors. Both public health and the emergency management sector face similar challenges related to developing and implementing strategies that involve structural change, facilitating community resilience and addressing individual risk factors. Familiarity with public health principles enables an understanding of the holistic approach to risk reduction that is outlined within the Sendai Framework. We present seven concepts that resonate with contemporary public health practice, namely: the social determinants of health; inequality and inequity; the inverse care law; community-based and community development approaches; hard to reach communities and services; the prevention paradox; and the inverse prevention law. These ideas from public health provide a useful conceptual base for the "new" agenda in disaster risk management that underpins the 2015 Sendai Framework. The relevance of these ideas to disaster risk management and research is illustrated through drawing on the Sendai Framework, disaster literature and exemplars from the 2010-2011 earthquakes in Canterbury, New Zealand.

  10. [The concept of disease and preservation of health of a population of teachers and first grade students].

    PubMed

    Boruchovitch, E; Felix-Sousa, I C; Schall, V T

    1991-12-01

    In view of the fact that information about how teachers and students conceptualize illness and their ideas of health preservation have important implications of health education, these two concepts were studied in a sample population of teachers and pupils, of a school course of up to 14-year-olds, representative of the northern area of Rio de Janeiro County. The results obtained are discussed in the light of two approaches: (a) the contributions from the cognitive theories of concept formation; (b) the influence of the social context in the acquisition, development and characterization of the concepts studied. This study was undertaken with a view to contributing to the field of health education by means of critical review and reflection on the concept of the health illness process in schools, in view of the complex and multidimensional aspects involved in the process.

  11. Proof-of-Concept Application of Impedance-Based Health Monitoring on Space Shuttle Ground Structures

    NASA Technical Reports Server (NTRS)

    Peairs, Daniel M.; Grisso, Benjamin; Inman, Daniel J.; Page, Kenneth R.; Athman, Robert; Margasahayam, Ravi N.

    2003-01-01

    Many of the structures responsible for the launch, ground systems and support operations of the space shuttle are still being used well past their nominal expected design life. This has led to an increased interest in monitoring these structures in order to decrease the risk of eventual breakdown or structural failure. One monitoring method, which has shown promising results for such applications, is the impedance-based structural health monitoring technique. This paper presents results from proof-of-concept tests on the launch pad's orbiter access arm bolted connection, solid rocket booster hold down post, mobile launch platform heat shield and crawler transporter bearing. Modification for future tests are suggested.

  12. Culture Shock—A Review of Vietnamese Culture and Its Concepts of Health and Disease

    PubMed Central

    Nguyen, Maj Duong

    1985-01-01

    Misunderstandings of Vietnamese culture and beliefs have led to many unfortunate incidents in the United States, including court cases for child abuse and even suicide. These can be avoided by an awareness of the cultural background of the Vietnamese, their philosophy of life and the influence of religion and beliefs on their personalities, both as individual persons and as members of extended family units. The Vietnamese concepts of health and disease are presented, along with brief descriptions of certain folk medicines that are frequently misconstrued by American physicians. PMID:3993022

  13. Contamination, misuse and abuse of the global oceans leading to ecosystem damage and destruction, health consequences and international conflict

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Unregulated uses of the oceans may threaten the global ecological balance, alter plant and animal life and significantly impact the global climatic systems. Recent plans to locate large scale structures on the oceans and to exploit the mineral riches of the seas pose even greater risk to the ecological system. Finally, increasing use of the oceans for large scale transport greatly enhances the probability of collision, polluting spills and international conflict.

  14. Conflict management: difficult conversations with difficult people.

    PubMed

    Overton, Amy R; Lowry, Ann C

    2013-12-01

    Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed.

  15. Conflict Management: Difficult Conversations with Difficult People

    PubMed Central

    Overton, Amy R.; Lowry, Ann C.

    2013-01-01

    Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed. PMID:24436688

  16. Diplomatic and operational adaptations to global health programmes in post-conflict settings: contributions of monitoring and evaluation systems to health sector development and 'nation-building' in South Sudan.

    PubMed

    Kevany, Sebastian; Hatfield, Amanda; Workneh, Nibretie Gobezie; Durrani, Bilal Aurang Zeb; Bekele, Yonas; Khan, Usma; White, Karen; Myrick, Roger

    2012-01-01

    Monitoring and evaluation (M&E) systems are an essential element of functioning and accountable global health programmes. In post-conflict settings, the role of M&E systems is also critical to ensure that health services are being delivered to those populations and regions most in need. Given the inherent challenges of health service delivery in such environments, a range of both diplomatic and operational adaptations to M&E procedures are necessary. Using the '12 components' of a functioning M&E system as a conceptual and analytical framework, we observed and reviewed the key challenges to M&E systems in South Sudan as part of a broader review of United Nations Development Programme (UNDP) activities supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. Based on additional interview-based reviews and analyses of M&E activities, a list of adaptations to standardized M&E procedures in response to post-conflict environmental challenges was developed. The study concludes that development and implementation of M&E systems in post-conflict environments requires extensive adaptations to conventional procedures. Flexible and adaptable as well as 'diplomatically sensitized' M&E systems are considered to be essential to the successful completion of M&E-related activities, and may also contribute to broader international relations, 'nation-building', and peace-keeping goals.

  17. Risk selection in a regulated health insurance market: a review of the concept, possibilities and effects.

    PubMed

    van Kleef, Richard C; van de Ven, Wynand P M M; van Vliet, René C J A

    2013-12-01

    The Dutch basic health insurance is based on the principles of regulated competition. This implies that insurers and providers compete on price and quality while the regulator sets certain rules to achieve public objectives such as solidarity. Two regulatory aspects of this scheme are that insurers are not allowed to risk rate their premiums and are compensated for predictable variation in individual medical expenses (i.e., risk equalization). Research, however, indicates that the current risk equalization is imperfect, which confronts insurers and consumers with incentives for risk selection. The goal of this paper is to review the concept, possibilities and potential effects of risk selection in the Dutch basic health insurance. We conclude that the possibilities for risk selection are numerous and a potential threat to solidarity, efficiency and quality of care. Regulators should be aware that measurement of risk selection is a methodological and data-demanding challenge.

  18. Physicians' Self-Conceptions of Their Expertise in Statutory Health Insurance and Social Security Systems.

    PubMed

    Seger, Wolfgang; Nüchtern, Elisabeth

    2015-07-01

    Medical experts who practice social medicine have a strong ethical approach for their professional positions. Their reports must reflect an objective, independent, high-quality assessment of interactions between health status and the disability of individuals. However, they must simultaneously consider the societal involvement of these individuals when determining the framework of the Statutory Health Insurance and Social Security Systems. Their task is to recommend sociomedical benefits that are tailored to suit personal needs and that respect the individual life situations of the persons involved, thus complementing the efforts of healthcare professionals in clinical settings. The editorial describes the self-conception of this medical specialty on behalf of the German Society of Social Medicine and Prevention (DGSMP). Policy makers in social insurances and social security systems generally must respect independent sociomedical recommendations as a crucial point for further realistic development activities.

  19. One Health concept for strengthening public health surveillance and response through Field Epidemiology and Laboratory Training in Ghana.

    PubMed

    Wurapa, Frederick; Afari, Ebenezer; Ohuabunwo, Chima; Sackey, Samuel; Clerk, Christine; Kwadje, Simon; Yebuah, Nathaniel; Amankwa, Joseph; Amofah, George; Appiah-Denkyira, Ebenezer

    2011-01-01

    scientific conferences. The Ghana FELTP (GFELTP) has promoted the introduction of the One Health concept into FELTP. It hosted the first USAID-supported workshop in West Africa to further integrate and strengthen collaboration of the animal and human health sectors in the FETP model. GFELTP has also taken the lead in hosting the first AFENET Center for Training in Public Health Leadership and Management, through which the short course on Management for Improving Public Health Interventions was developed for AFENET member countries. The GFELTP pre-tested the Integrated Avian Influenza Outbreak and Pandemic Influenza course in preparation for introducing the materials into the curriculum of other FELTP in the network. The leadership positions to which the graduates of the program have been appointed in the human and animal Public Health Services, improvement in disease surveillance, outbreak investigation and response along with the testimony of the health authorities about their appreciation of the outputs of the graduates at various fora, is a strong indication that the GFELTP is meeting its objectives.

  20. Health Care Assistants in Primary Care Depression Management: Role Perception, Burdening Factors, and Disease Conception

    PubMed Central

    Gensichen, Jochen; Jaeger, Cornelia; Peitz, Monika; Torge, Marion; Güthlin, Corina; Mergenthal, Karola; Kleppel, Vera; Gerlach, Ferdinand M.; Petersen, Juliana J.

    2009-01-01

    PURPOSE In primary care, the involvement of health care assistants (HCAs) in clinical depression management is an innovative approach. Little is known, however, about how HCAs experience their new tasks. We wanted to describe the perceptions and experiences of HCAs who provided case management to patients with depression in small primary care practices. METHODS This qualitative study was nested in the Primary Care Monitoring for Depressive Patients Trial on case management in Germany. We used a semi-structured instrument to interview 26 HCAs and undertook content analysis. We focussed on 3 key aspects: role perception, burdening factors, and disease conception. RESULTS Most HCAs said their new role provided them with personal and professional enrichment, and they were interested in improving patient-communication skills. They saw their major function as interacting with the patient and considered support for the family physician to be of less importance. Even so, some saw their role as a communication facilitator between family physician and patient. Burdening factors implementing the new tasks were the increased workload, the work environment, and difficulties interacting with depressed patients. HCAs’ disease conception of depression was heterogeneous. After 1 year HCAs believed they were sufficiently familiar with their duties as case managers in depression management. CONCLUSION HCAs were willing to extend their professional responsibilities from administrative work to more patient-centred work. Even if HCAs perform only monitoring tasks within the case management concept, the resulting workload is a limiting factor. PMID:19901310

  1. Adjustment Disorders Are Uniquely Suited for eHealth Interventions: Concept and Case Study

    PubMed Central

    Bachem, Rahel C; Lorenz, Louisa; Moser, Christian T; Berger, Thomas

    2015-01-01

    Background Adjustment disorders (also known as mental distress in response to a stressor) are among the most frequently diagnosed mental disorders in psychiatry and clinical psychology worldwide. They are also commonly diagnosed in clients engaging in deliberate self-harm and in those consulting general practitioners. However, their reputation in research-oriented mental health remains weak since they are largely underresearched. This may change when the International Statistical Classification of Diseases-11 (ICD-11) by the World Health Organization is introduced, including a new conceptualization of adjustment disorders as a stress-response disorder with positively defined core symptoms. Objective This paper provides an overview of evidence-based interventions for adjustment disorders. Methods We reviewed the new ICD-11 concept of adjustment disorder and discuss the the rationale and case study of an unguided self-help protocol for burglary victims with adjustment disorder, and its possible implementation as an eHealth intervention. Results Overall, the treatment with the self-help manual reduced symptoms of adjustment disorder, namely preoccupation and failure to adapt, as well as symptoms of depression, anxiety, and stress. Conclusions E-mental health options are considered uniquely suited for offering early intervention after the experiences of stressful life events that potentially trigger adjustment disorders. PMID:26543920

  2. The Indian concepts of lifestyle and mental health in old age

    PubMed Central

    Tiwari, S. C.; Pandey, Nisha M.

    2013-01-01

    Lifestyle is the perception of a particular person or entire society towards life and it is the way people live, think and behave. In Indian lifestyle, principles of Karma (action) and dharma (the righteous way to perform the work) are given significant value. In India, earlier, the life of an individual was being regulated harmoniously according to the stages (Ashrams) of life, i.e., studentship (Brahmcharya); householder (Grihstha); forest dweller (Vanprasth); ascetic (Sanyas) and was meant to maintain the discipline, peace and harmony in the family and society. However, revolution in the social milieu and political scenario changed the patterns of religious beliefs and lifestyle of individuals. And thus, the Indian lifestyle got colored with shadows of cults and cultures. The lifestyle affects the longevity and health in old age. Lifestyles also have role in developing cognitive disorders like Alzheimer's disease (AD). AD found to be more common in socially isolated older adults. Deteriorations in health (especially mental health) are often the results of faulty lifestyles like smoking, alcohol intake, improper diet and lack of exercise as well as an adverse psycho-social milieu. Adopting the advocated principles of Indian concepts of lifestyle and paying proper attention to mental illnesses of older adults and recognizing their problems may preserve mental health in old age. PMID:23858270

  3. The Indian concepts of lifestyle and mental health in old age.

    PubMed

    Tiwari, S C; Pandey, Nisha M

    2013-01-01

    Lifestyle is the perception of a particular person or entire society towards life and it is the way people live, think and behave. In Indian lifestyle, principles of Karma (action) and dharma (the righteous way to perform the work) are given significant value. In India, earlier, the life of an individual was being regulated harmoniously according to the stages (Ashrams) of life, i.e., studentship (Brahmcharya); householder (Grihstha); forest dweller (Vanprasth); ascetic (Sanyas) and was meant to maintain the discipline, peace and harmony in the family and society. However, revolution in the social milieu and political scenario changed the patterns of religious beliefs and lifestyle of individuals. And thus, the Indian lifestyle got colored with shadows of cults and cultures. The lifestyle affects the longevity and health in old age. Lifestyles also have role in developing cognitive disorders like Alzheimer's disease (AD). AD found to be more common in socially isolated older adults. Deteriorations in health (especially mental health) are often the results of faulty lifestyles like smoking, alcohol intake, improper diet and lack of exercise as well as an adverse psycho-social milieu. Adopting the advocated principles of Indian concepts of lifestyle and paying proper attention to mental illnesses of older adults and recognizing their problems may preserve mental health in old age.

  4. Towards a ‘patient-centred’ operationalisation of the new dynamic concept of health: a mixed methods study

    PubMed Central

    Huber, M; van Vliet, M; Giezenberg, M; Winkens, B; Heerkens, Y; Dagnelie, P C; Knottnerus, J A

    2016-01-01

    Objective To evaluate among stakeholders the support for the new, dynamic concept of health, as published in 2011: ‘Health as the ability to adapt and to self-manage’, and to elaborate perceived indicators of health in order to make the concept measurable. Design A mixed methods study: a qualitative first step with interviews and focus groups, followed by a quantitative survey. Participants Representatives of seven healthcare stakeholder domains, for example, healthcare providers, patients with a chronic condition and policymakers. The qualitative study involved 140 stakeholders; the survey 1938 participants. Results The new concept was appreciated, as it addresses people as more than their illness and focuses on strengths rather than weaknesses. Caution is needed as the concept requires substantial personal input of which not everyone is capable. The qualitative study identified 556 health indicators, categorised into six dimensions: bodily functions, mental functions and perception, spiritual/existential dimension, quality of life, social and societal participation, and daily functioning, with 32 underlying aspects. The quantitative study showed all stakeholder groups considering bodily functions to represent health, whereas for other dimensions there were significant differences between groups. Patients considered all six dimensions almost equally important, thus preferring a broad concept of health, whereas physicians assessed health more narrowly and biomedically. In the qualitative study, 78% of respondents considered their health indicators to represent the concept. Conclusions To prevent confusion with health as ‘absence of disease’, we propose the use of the term ‘positive health’ for the broad perception of health with six dimensions, as preferred by patients. This broad perception deserves attention by healthcare providers as it may support shared decision-making in medical practice. For policymakers, the broad perception of

  5. [The role of workplace health promotion in the concept of corporate social responsibility].

    PubMed

    Wojtaszczyk, Patrycja

    2008-01-01

    Workplace health promotion (WHP) is an idea that was conceived over 25 years ago. At its very core is the wellbeing of employees. The development and dissemination of this notion, as well as the implementation of its basic principles have always been challenged by various theories and practices derived from the field of human resources management. The corporate social responsibility (CSR) is one of such new concepts promulgated within the European Union Based on the literature review, especially European Commission documents, articles retrieved in the EBSCO database, guidelines and guidebooks published by the CSR Forum, other NGOs active in the field, and the publications of the Nofer Institute of Occupational Medicine, the author makes an attempt to compare these two ideas and discuss the coherence between their assumptions. The primary hypothesis was that WHP is an element of CSR. The comparison between CSR and WHP concepts confirm a hypothesis that the latter is an element of the former, which means that activities aimed at taking care of health and well-being of employees contribute to the creation of a socially responsible company. It indicates that the implementation of both ideas requires multidisciplinary and holistic approach. In addition, the role of social dialog and workers' participation in the company management are strongly emphasized.

  6. Lay Concepts of the Relative Importance of Different Influences on Health; Are There Major Socio-Demographic Variations?

    ERIC Educational Resources Information Center

    Macintyre, Sally; McKay, Laura; Ellaway, Anne

    2006-01-01

    There is an extensive literature within anthropology, sociology and psychology about lay concepts of determinants of health and illness. Many of these studies have used single sex or social class samples, often in narrow age bands, and many are qualitative in approach. We asked respondents in a health survey to say how important (on a five-point…

  7. Identifying Multi-Level Culturally Appropriate Smoking Cessation Strategies for Aboriginal Health Staff: A Concept Mapping Approach

    ERIC Educational Resources Information Center

    Dawson, Anna P.; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

    2013-01-01

    Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco…

  8. Using Organization Development Concept to Conduct Administrative Assessment of Health Promoting Schools in Taiwan--A Preliminary Study

    ERIC Educational Resources Information Center

    Huang, Jen-Jen; Yeh, Gwo-Liang; Tseng, Chie-Chien; Chen, Wei William; Hwu, Yin-Jinn; Jiang, Donald Dah-Shyong

    2009-01-01

    The Health Promoting School (HPS) programs in Taiwan were initiated and implemented with funding from Department of Health and Ministry of Education during the initial phase. The purpose of this article was to describe the application of organization development (OD) concept in the administrative assessment of HPS programs and to present results…

  9. Politics and Power in Global Health: The Constituting Role of Conflicts: Comment on "Navigating Between Stealth Advocacy and Unconscious Dogmatism: The Challenge of Researching the Norms, Politics and Power of Global Health".

    PubMed

    Askheim, Clemet; Heggen, Kristin; Engebretsen, Eivind

    2015-10-15

    In a recent article, Gorik Ooms has drawn attention to the normative underpinnings of the politics of global health. We claim that Ooms is indirectly submitting to a liberal conception of politics by framing the politics of global health as a question of individual morality. Drawing on the theoretical works of Chantal Mouffe, we introduce a conflictual concept of the political as an alternative to Ooms' conception. Using controversies surrounding medical treatment of AIDS patients in developing countries as a case we underline the opportunity for political changes, through political articulation of an issue, and collective mobilization based on such an articulation.

  10. Health and healthy human being in Islamic thought: Reflection on application for the nursing concept – A philosophical inquiry

    PubMed Central

    Alimohammadi, Nasrollah; Taleghani, Fariba

    2015-01-01

    Introduction: Health and healthy human being as a core concept of nursing have attracted considerable attention in the Western literature but have received less attention in the context of Eastern philosophy contexts. Methods: This study was done based on philosophical inquiry; this method could be accomplished by means of different approaches like philosophical analysis through concept analysis. There are different methods for concept analysis. Mors's method was employed to analyze the concept of health and healthy human being, we sought to clarify them according to ideas deriving from the Islamic thought. To achieve the research objective, Islamic texts were studied and analyzed based on the criteria of concept analysis (definition, attributes/characteristics, and beaneries). Results: Our analysis revealed in the Islamic thought human being is an integrated entity. Therefore, his health not only consists of each single dimension, but also the full health together with the health of society gets meaning in a balanced and coordinated set. Conclusion: Based on the results, in this study, there are a series of similarities and differences with the perspectives of health in Islamic thought and holism paradigm available in nursing. PMID:27462615

  11. Equity and health policy in Africa: Using concept mapping in Moore (Burkina Faso)

    PubMed Central

    Ridde, Valéry

    2008-01-01

    Background This methodological article is based on a health policy research project conducted in Burkina Faso (West Africa). Concept mapping (CM) was used as a research method to understand the local views of equity among stakeholders, who were concerned by the health policy under consideration. While this technique has been used in North America and elsewhere, to our knowledge it has not yet been applied in Africa in any vernacular language. Its application raises many issues and certain methodological limitations. Our objective in this article is to present its use in this particular context, and to share a number of methodological observations on the subject. Methods Two CMs were done among two different groups of local stakeholders following four steps: generating ideas, structuring the ideas, computing maps using multidimensional scaling and cluster analysis methods, and interpreting maps. Fifteen nurses were invited to take part in the study, all of whom had undergone training on health policies. Of these, nine nurses (60%) ultimately attended the two-day meeting, conducted in French. Of 45 members of village health committees who attended training on health policies, only eight were literate in the local language (Moore). Seven of these (88%) came to the meeting. Results The local perception of equity seems close to the egalitarian model. The actors are not ready to compromise social stability and peace for the benefit of the worst-off. The discussion on the methodological limitations of CM raises the limitations of asking a single question in Moore and the challenge of translating a concept as complex as equity. While the translation of equity into Moore undoubtedly oriented the discussions toward social relations, we believe that, in the context of this study, the open-ended question concerning social justice has a threefold relevance. At the same time, those limitations were transformed into strengths. We understand that it was essential to resort to the

  12. Disruptive staff interactions: a serious source of inter-provider conflict and stress in health care settings.

    PubMed

    Stecker, Mona; Stecker, Mark M

    2014-07-01

    This study sought to explore the prevalence of workplace stress, gender differences, and the relationship of workplace incivility to the experience of stress. Effects of stress on performance have been explored for many years. Work stress has been at the root of many physical and psychological problems and has even been linked to medical errors and suboptimal patient outcomes. In this study, 617 respondents completed a Provider Conflict Questionnaire (PCQ) as well as a ten-item stress survey. Work was the main stressor according to 78.2% of respondents. The stress index was moderately high, ranging between 10 and 48 (mean = 25.5). Females demonstrated a higher stress index. Disruptive behavior showed a significant positive correlation with increased stress. This study concludes that employees of institutions with less disruptive behavior exhibited lower stress levels. This finding is important in improving employee satisfaction and reducing medical errors. It is difficult to retain experienced nurses, and stress is a significant contributor to job dissatisfaction. Moreover, workplace conflict and its correlation to increased stress levels must be managed as a strategy to reduce medical errors and increase job satisfaction.

  13. Intergenerational cultural conflict, mental health, and educational outcomes among Asian and Latino/a Americans: Qualitative and meta-analytic review.

    PubMed

    Lui, P Priscilla

    2015-03-01

    Among immigrant Asian and Latino groups, the contrast between collectivism in traditional heritage and individualism in the mainstream American cultures presents unique challenges for their family relationships. This systematic review was designed to answer 3 fundamental questions: to what extent do(es) (a) acculturation mismatch (AM) correlate with intergenerational cultural conflict (ICC); (b) ICC correlate with offspring's mental health and educational outcomes; and (c) demographic and study characteristics moderate these relationships. Sixty-one research reports were reviewed, with 68 independent study samples (N = 14,453; 41 and 27 Asian and Latino/a samples, respectively) subjected to 3 meta-analyses. AM positively correlated with ICC (r = .23), which in turn negatively correlated with offspring mental health (r = -.20) and educational outcomes (r = -.09). Findings provided support for acculturation gap-distress theory. While these effect size estimates were small, participant and methodological variables affected their magnitude. Contrary to findings on intergenerational conflict within mainstream non-immigrant families, the relationships among AM, ICC, and mental health were larger in young adult than adolescent groups within immigrant families. ICC significantly correlated with internalizing problems and adaptive functioning, but not externalizing problems. AM was more closely related to ICC among women and second-generation immigrant offspring. AM and ICC were more problematic among offspring who were low-risk and lived in less ethnically disperse regions, particularly when studied in cross-sectional studies. Effect sizes also differed significantly across measurement tools for the key constructs. Limitations to generalizability (few studies on educational outcomes, relative under-representation of Latino/a to Asian American samples), and implications for intervention and future research are discussed.

  14. Conflict engagement: collaborative processes.

    PubMed

    Gerardi, Debra

    2015-05-01

    This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE; www.aone.org), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care.

  15. Conflict engagement: workplace dynamics.

    PubMed

    Gerardi, Debra

    2015-04-01

    This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care.

  16. From Sociocultural Disintegration to Community Connectedness Dimensions of Local Community Concepts and Their Effects on Psychological Health of Its Residents

    PubMed Central

    Sørensen, Tom; Kleiner, Robert; Ngo, Paul; Sørensen, Andreas; Bøe, Nils

    2013-01-01

    In a series of community mental health promotion studies in Lofoten, Norway, the concept of sociocultural integration is used to describe properties of a local community that are related to people's psychological health. Starting with Durkheim's description of a cohesive society, we compare different concepts that are related to sociocultural integration, for example, sense of community, social capital, and social cohesion. We then examine the relationship of various individual oriented social psychological concepts to sociocultural integration. These concepts often share theoretical and operational definitions. The concept of sociocultural integration in the Lofoten studies was proved to be very valuable in understanding how the properties of a community can affect people's mental health and their social psychological properties. It has also shown its value in the planning of mental health services and demonstrating its success in concrete community-based mental health promotion projects. Thus they could make important contributions to further studies and actions in local communities where the intersection between the individual, their social network, and their local community occurs. PMID:24236288

  17. An overview of conflict.

    PubMed

    Kelly, Jacinta

    2006-01-01

    Conflict is found in all aspects of society and nursing is not immune. Conflict is also found in critical care units. However, conflict within the nursing profession has traditionally generated negative feelings and many nurses use avoidance as a coping mechanism. This article will provide an overview of conflict, conflict management, and conflict resolution.

  18. Research Priorities for Fertility and Conception Research as Identified by Multidisciplinary Health Care Practitioners and Researchers.

    PubMed

    Moran, Lisa J; Spencer, Laura; Russell, Darryl L; Hull, Mary Louise; Robertson, Sarah A; Varcoe, Tamara J; Davies, Michael J; Brown, Hannah M; Rodgers, Raymond J

    2016-01-13

    The Robinson Research Institute of the University of Adelaide convened a multidisciplinary group of n = 33 clinicians, researchers and representatives of government organisations on the 2 October 2014 for a workshop entitled "Promoting fertility and healthy conception. How do we generate greater reproductive health awareness?" The key aim of the workshop was to assess the body of knowledge that informs clinical practice and government policy, and to identify questions and additional information needed by health practitioners and government representatives working in the field of reproductive health and to frame future research and policy. The workshop identified topics that fell mostly into three categories: lifestyle-related, societal and biological factors. The lifestyle topics included nutrition and diet, exercise, obesity, shift work and other factors deemed to be modifiable at the level of the individual. The societal topics included discussions of matters that are structural, and resistant to change by individuals, including specific ethical issues, social disadvantage, government and educational policies. The biological factors are intrinsic physical states of the individual, and included many factors where there is a dense body of scientific knowledge which may not be readily accessible in less academic language. This workshop thus provided an opportunity to identify further actions that could be undertaken to meet the needs of diverse organisations and groups of professionals with an interest in human fertility. Since so many factors in our social and biological environment can impact fertility and preconception health, it is imperative to involve many disciplines or levels of government or societal organisations that have not traditionally been involved in this area.

  19. Research Priorities for Fertility and Conception Research as Identified by Multidisciplinary Health Care Practitioners and Researchers

    PubMed Central

    Moran, Lisa J.; Spencer, Laura; Russell, Darryl L.; Hull, Mary Louise; Robertson, Sarah A.; Varcoe, Tamara J.; Davies, Michael J.; Brown, Hannah M.; Rodgers, Raymond J.

    2016-01-01

    The Robinson Research Institute of the University of Adelaide convened a multidisciplinary group of n = 33 clinicians, researchers and representatives of government organisations on the 2 October 2014 for a workshop entitled “Promoting fertility and healthy conception. How do we generate greater reproductive health awareness?” The key aim of the workshop was to assess the body of knowledge that informs clinical practice and government policy, and to identify questions and additional information needed by health practitioners and government representatives working in the field of reproductive health and to frame future research and policy. The workshop identified topics that fell mostly into three categories: lifestyle-related, societal and biological factors. The lifestyle topics included nutrition and diet, exercise, obesity, shift work and other factors deemed to be modifiable at the level of the individual. The societal topics included discussions of matters that are structural, and resistant to change by individuals, including specific ethical issues, social disadvantage, government and educational policies. The biological factors are intrinsic physical states of the individual, and included many factors where there is a dense body of scientific knowledge which may not be readily accessible in less academic language. This workshop thus provided an opportunity to identify further actions that could be undertaken to meet the needs of diverse organisations and groups of professionals with an interest in human fertility. Since so many factors in our social and biological environment can impact fertility and preconception health, it is imperative to involve many disciplines or levels of government or societal organisations that have not traditionally been involved in this area. PMID:26771633

  20. Utilizing Rogers' Theory of Self-Concept in mental health nursing.

    PubMed

    Hosking, P

    1993-06-01

    The work of mental health nurse is interactive in nature, the priority of which is the effective development and maintenance of a therapeutic relationship with clients. This field of nursing bases its practice on theories from many schools of thought in order to provide clients with the highest quality of care. One such theory is that of Carl Rogers whose practice as a psychotherapist was based on his Theory of Self-Concept. This paper examines the development of the Theory of Self-Concept from the works of Cooley, Mead, Allport and Rogers and relates to the therapeutic alliance between a primary nurse and a client who has been medically diagnosed as being 'depressed'. The implications for practice are considered and some of the difficulties of utilizing Rogers' theory on an in-patient unit are explored. The paper emphasizes the need for nurses to be aware of the use of such theories in order to enrich the care that clients receive. It also highlights the need for nurses to be aware of their own 'self' when working with clients, a state that can only be achieved if the nurses themselves have adequate clinical supervision and an environment which is supportive of such work.

  1. An application of the Sentinel Health Event (Occupational) concept to death certificates.

    PubMed Central

    Lalich, N R; Schuster, L L

    1987-01-01

    This article describes a computer-based application of the Sentinel Health Event (Occupational) [SHE(O)] concept, developed in conjunction with five states, to monitor deaths which are occupationally related. The states have coded their state death certificate files for industry and occupation, using the decedent's usual occupation and industry as reported on the death certificate. From these files, the SHE(O) computer program selects deaths which are likely to be work-related, based on a previously published SHE(O) list of 50 disease rubrics and associated industries and occupations. The computer program matches the SHE(O) list with the recorded industry, occupation, and underlying cause of death. The program has been tested using 1984 death certificate data from Maine, upstate New York (excluding New York City), North Carolina, Pennsylvania, and Rhode Island. Approximately 1 to 2 per cent of all deaths were selected by the program, with lung cancer and coal workers' pneumoconiosis being the most frequent cause of death. The SHE(O) program may be useful for identifying deaths which are potentially occupationally related, but its utility and its application to death certificates needs further evaluation before recommending widespread use. Limitations are discussed, as well as plans for improving the application of the SHE(O) concept to death certificates. PMID:3631365

  2. International Consensus on Key Concepts and Data Definitions for Mass-gathering Health: Process and Progress.

    PubMed

    Turris, Sheila A; Steenkamp, Malinda; Lund, Adam; Hutton, Alison; Ranse, Jamie; Bowles, Ron; Arbuthnott, Katherine; Anikeeva, Olga; Arbon, Paul

    2016-04-01

    Mass gatherings (MGs) occur worldwide on any given day, yet mass-gathering health (MGH) is a relatively new field of scientific inquiry. As the science underpinning the study of MGH continues to develop, there will be increasing opportunities to improve health and safety of those attending events. The emerging body of MG literature demonstrates considerable variation in the collection and reporting of data. This complicates comparison across settings and limits the value and utility of these reported data. Standardization of data points and/or reporting in relation to events would aid in creating a robust evidence base from which governments, researchers, clinicians, and event planners could benefit. Moving towards international consensus on any topic is a complex undertaking. This report describes a collaborative initiative to develop consensus on key concepts and data definitions for a MGH "Minimum Data Set." This report makes transparent the process undertaken, demonstrates a pragmatic way of managing international collaboration, and proposes a number of steps for progressing international consensus. The process included correspondence through a journal, face-to-face meetings at a conference, then a four-day working meeting; virtual meetings over a two-year period supported by online project management tools; consultation with an international group of MGH researchers via an online Delphi process; and a workshop delivered at the 19thWorld Congress on Disaster and Emergency Medicine held in Cape Town, South Africa in April 2015. This resulted in an agreement by workshop participants that there is a need for international consensus on key concepts and data definitions.

  3. Conflict management: a primer for doctors in training.

    PubMed

    Saltman, D C; O'Dea, N A; Kidd, M R

    2006-01-01

    Conflict in the health arena is a growing concern and is well recognised for doctors in training. Its most extreme expression, workplace violence is on the increase. There is evidence that many conflicts remain unsatisfactorily resolved or unresolved, and result in ongoing issues for staff morale. This paper describes the nature of conflict in the health care system and identifies the difference between conflict and disagreement. Using a conflict resolution model, strategies for dealing with conflict as it arises are explored and tips are provided on how to effectively manage conflict to a satisfactory resolution for all parties.

  4. The historical origins of the basic concepts of health promotion and education: the role of ancient Greek philosophy and medicine.

    PubMed

    Tountas, Yannis

    2009-06-01

    Although it is commonly accepted that the basic concepts of 'Health Promotion' have been developed in the last two decades, they have their roots in ancient civilizations and in particular in Greek antiquity. As evident from medical and philosophical documents of the sixth to fourth centuries B.C., the ancient Greeks were the first to break with the supernatural conceptions of health and disease that had so far dominated human societies. The ancient Greeks developed the physiocratic school of thought, realizing that maintaining good health and fighting illness depend on natural causes and that health and disease cannot be dissociated from particular physical and social environments nor from human behavior. In this context, they defined health as a state of dynamic equilibrium between the internal and the external environment, they took under consideration the physical and social determinants of health, they empowered individuals and communities through new democratic and participatory institutions, they gave emphasis in health education and skill development, they recognized the importance of supportive environments and of healthy public policy and they re-oriented medicine toward a more naturalistic and humanistic perspective. The aim of the present study is to highlight such core concepts from these early times that helped establishing the foundations for health promotion and education in the modern era according to the Ottawa Charter.

  5. Use of concurrent mixed methods combining concept mapping and focus groups to adapt a health equity tool in Canada.

    PubMed

    Guichard, Anne; Tardieu, Émilie; Dagenais, Christian; Nour, Kareen; Lafontaine, Ginette; Ridde, Valéry

    2017-04-01

    The aim of this project was to identify and prioritize a set of conditions to be considered for incorporating a health equity tool into public health practice. Concept mapping and focus groups were implemented as complementary methods to investigate the conditions of use of a health equity tool by public health organizations in Quebec. Using a hybrid integrated research design is a richer way to address the complexity of questions emerging from intervention and planning settings. This approach provides a deeper, operational, and contextualized understanding of research results involving different professional and organizational cultures, and thereby supports the decision-making process. Concept mapping served to identify and prioritize in a limited timeframe the conditions to be considered for incorporation into a health equity tool into public health practices. Focus groups then provided a more refined understanding of the barriers, issues, and facilitating factors surrounding the tools adoption, helped distinguish among participants' perspectives based on functional roles and organizational contexts, and clarified some apparently contradictory results from the concept map. The combined use of these two techniques brought the strengths of each approach to bear, thereby overcoming some of the respective limitations of concept mapping and focus groups. This design is appropriate for investigating targets with multiple levels of complexity.

  6. 42 CFR 421.312 - Conflict of interest resolution.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conflict of interest resolution. 421.312 Section... Conflict of interest resolution. (a) Review Board. CMS may establish and convene a Conflicts of Interest Review Board to assist the contracting officer in resolving organizational conflicts of interest....

  7. 42 CFR 455.240 - Conflict of interest resolution.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Conflict of interest resolution. 455.240 Section... § 455.240 Conflict of interest resolution. (a) Review Board: CMS may establish a Conflicts of Interest Review Board to assist in resolving organizational conflicts of interest. (b) Resolution: Resolution...

  8. 42 CFR 455.240 - Conflict of interest resolution.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Conflict of interest resolution. 455.240 Section... § 455.240 Conflict of interest resolution. (a) Review Board: CMS may establish a Conflicts of Interest Review Board to assist in resolving organizational conflicts of interest. (b) Resolution: Resolution...

  9. 42 CFR 455.240 - Conflict of interest resolution.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Conflict of interest resolution. 455.240 Section... § 455.240 Conflict of interest resolution. (a) Review Board: CMS may establish a Conflicts of Interest Review Board to assist in resolving organizational conflicts of interest. (b) Resolution: Resolution...

  10. 42 CFR 421.312 - Conflict of interest resolution.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Conflict of interest resolution. 421.312 Section... Conflict of interest resolution. (a) Review Board. CMS may establish and convene a Conflicts of Interest Review Board to assist the contracting officer in resolving organizational conflicts of interest....

  11. 42 CFR 455.240 - Conflict of interest resolution.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Conflict of interest resolution. 455.240 Section... § 455.240 Conflict of interest resolution. (a) Review Board: CMS may establish a Conflicts of Interest Review Board to assist in resolving organizational conflicts of interest. (b) Resolution: Resolution...

  12. 42 CFR 455.240 - Conflict of interest resolution.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Conflict of interest resolution. 455.240 Section... § 455.240 Conflict of interest resolution. (a) Review Board: CMS may establish a Conflicts of Interest Review Board to assist in resolving organizational conflicts of interest. (b) Resolution: Resolution...

  13. A conflict of responsibilities: a grounded theory study of clinical psychologists' experience of client non-attendance within the British National Health Service.

    PubMed

    Tweed, A E; Salter, D P

    2000-12-01

    Within psychotherapy process research, the effects of client non-attendance upon therapists has been neglected. The present study interviewed six clinical psychologists concerning their experiences of client non-attendance in health service practice in the UK. Their accounts were analysed using a grounded theory method. A core category was identified and termed 'responsibility'. This highlighted conflicting relationships between participants' responsibilities in several areas. A process model pertaining to non-attendance was also developed. Client non-attendance was seen to produce a level of disruption, experienced as an affective reaction and often experienced in terms of negative affect. In response, re-organizational strategies were used to restore equilibrium. Reasons are suggested as to why negative affective reactions were experienced. These include factors concerning therapeutic competency, but also reflect upon the profession's espousal of an 'all-knowing' expert identity. This is seen to be incongruent to the complexities of clinical practice.

  14. Learning outcomes for health professions: the concept of the swiss competencies framework.

    PubMed

    Sottas, Beat

    2011-01-01

    Modern conceptions of education are based on normative goals concerning learning outcomes in terms of competencies to acquire. The objective of the Swiss competencies framework was to define general and profession-specific learning outcomes for Bachelor's and Master's degree programmes in nursing, physiotherapy, occupational therapy (ergotherapy), midwifery, nutrition counselling, and technicians in medical radiology. In addition, national authorities needed an instrument that allowed the integration of the old professional trainings into a nationally-harmonised education system and that showed the specificities of the levels (higher vocational education; bachelor and master degree at university level). While the general learning outcomes were derived from legal bases, the profession-specific learning outcomes are elaborated according to the competency-based CanMEDS framework. In the CanMEDS framework, knowledge, skills, and attitudes are condensed into meta-competencies which in turn are divided into seven roles, including the medical expert (central role). Taxonomic characteristics and indicators were elaborated in an iterative process that involved regulators, the universities of applied sciences and professional organisations. For the degree programmes mentioned above, the framework developed focuses not only on professional expertise, but also on collaboration with other health professions. Moreover, the interface-management in care taking processes is a critical success factor. Based on this conception, three levels of objectives were identified: general competencies, profession-specific learning outcomes and learning objectives to be implemented in the universities of applied sciences. The general competencies are composed of four dimensions and apply to all health professionals. The profession-specific learning outcomes for the Bachelor's and Master's degree programmes are outlined with 3 to 5 indicators each in all seven professions concerned. The

  15. Telling the story of role conflict among Black nurses and Black nursing students: a literature review.

    PubMed

    Robinson, Ora V

    2013-09-01

    Racism continues to affect minority nursing students and nurses in professional roles. A selective review of the literature published from 1992 to 2011 was conducted using the Cumulative Index of Literature in Nursing and Allied Health, ScienceDirect, and EBSCOhost. Keywords used included racism within nursing, minority nurses and role conflict, cultural diversity within nursing, racism, and diversity. The purpose of this review is to describe Black nurses' and Black nursing students' experiences of role conflict as an outcome of perceived racism within the nursing profession to gain an understanding of factors that contribute to perceived racism and role conflict. Noblit's and Hare's framework for metasynthesis of the data was used to identify and synthesize key concepts. The role perspectives of Hardy and Conway guided the review to develop a conceptual framework for minority role conflict and the nursing implications discussed herein.

  16. Timing of cyber conflict.

    PubMed

    Axelrod, Robert; Iliev, Rumen

    2014-01-28

    Nations are accumulating cyber resources in the form of stockpiles of zero-day exploits as well as other novel methods of engaging in future cyber conflict against selected targets. This paper analyzes the optimal timing for the use of such cyber resources. A simple mathematical model is offered to clarify how the timing of such a choice can depend on the stakes involved in the present situation, as well as the characteristics of the resource for exploitation. The model deals with the question of when the resource should be used given that its use today may well prevent it from being available for use later. The analysis provides concepts, theory, applications, and distinctions to promote the understanding strategy aspects of cyber conflict. Case studies include the Stuxnet attack on Iran's nuclear program, the Iranian cyber attack on the energy firm Saudi Aramco, the persistent cyber espionage carried out by the Chinese military, and an analogous case of economic coercion by China in a dispute with Japan. The effects of the rapidly expanding market for zero-day exploits are also analyzed. The goal of the paper is to promote the understanding of this domain of cyber conflict to mitigate the harm it can do, and harness the capabilities it can provide.

  17. Timing of cyber conflict

    PubMed Central

    Axelrod, Robert; Iliev, Rumen

    2014-01-01

    Nations are accumulating cyber resources in the form of stockpiles of zero-day exploits as well as other novel methods of engaging in future cyber conflict against selected targets. This paper analyzes the optimal timing for the use of such cyber resources. A simple mathematical model is offered to clarify how the timing of such a choice can depend on the stakes involved in the present situation, as well as the characteristics of the resource for exploitation. The model deals with the question of when the resource should be used given that its use today may well prevent it from being available for use later. The analysis provides concepts, theory, applications, and distinctions to promote the understanding strategy aspects of cyber conflict. Case studies include the Stuxnet attack on Iran’s nuclear program, the Iranian cyber attack on the energy firm Saudi Aramco, the persistent cyber espionage carried out by the Chinese military, and an analogous case of economic coercion by China in a dispute with Japan. The effects of the rapidly expanding market for zero-day exploits are also analyzed. The goal of the paper is to promote the understanding of this domain of cyber conflict to mitigate the harm it can do, and harness the capabilities it can provide. PMID:24474752

  18. Malaria in rural Burkina Faso: local illness concepts, patterns of traditional treatment and influence on health-seeking behaviour

    PubMed Central

    Beiersmann, Claudia; Sanou, Aboubakary; Wladarsch, Evelyn; De Allegri, Manuela; Kouyaté, Bocar; Müller, Olaf

    2007-01-01

    Background The literature on health care seeking behaviour in sub-Saharan Africa for children suffering from malaria is quite extensive. This literature, however, is predominately quantitative and, inevitably, fails to explore how the local concepts of illness may affect people's choices. Understanding local concepts of illness and their influence on health care-seeking behaviour can complement existing knowledge and lead to the development of more effective malaria control interventions. Methods In a rural area of Burkina Faso, four local concepts of illness resembling the biomedical picture of malaria were described according to symptoms, aetiology, and treatment. Data were collected through eight focus group discussions, 17 semi-structured interviews with key informants, and through the analysis of 100 verbal autopsy questionnaires of children under-five diagnosed with malaria. Results Sumaya, dusukun yelema, kono, and djoliban were identified as the four main local illness concepts resembling respectively uncomplicated malaria, respiratory distress syndrome, cerebral malaria, and severe anaemia. The local disease categorization was found to affect both treatment and provider choice. While sumaya is usually treated by a mix of traditional and modern methods, dusukun yelema and kono are preferably treated by traditional healers, and djoliban is preferably treated in modern health facilities. Besides the conceptualization of illness, poverty was found to be another important influencing factor of health care-seeking behaviour. Conclusion The findings complement previous evidence on health care-seeking behaviour, by showing how local concepts of illness strongly influence treatment and choice of provider. Local concepts of illness need to be considered when developing specific malaria control programmes. PMID:17686147

  19. Another Wrinkle in the Debate about Successful Aging: The Undervalued Concept of Resilience and the Lived Experience of Dementia

    ERIC Educational Resources Information Center

    Harris, Phyllis Braudy

    2008-01-01

    The concept of "successful aging" is a contested discourse in gerontology. Two conflicting paradigms dominate the discussion: a health promotion activity model, and a model critical of the concept of successful aging. However, this study takes a different perspective and proposes that perhaps we have been striving for the wrong goal. The true…

  20. Work–Family Conflict and Health Among Working Parents: Potential Linkages for Family Studies and Social Neuroscience

    PubMed Central

    Grzywacz, Joseph G.; Smith, Amy M.

    2016-01-01

    In this paired article the authors review research on paid work, parenting, and health in order to isolate fundamental questions and issues that remain unaddressed. Next, consistent with the theme of this special issue, the authors introduce social neuroscience and highlight how this emerging multidisciplinary science offers substantial promise for advancing key unresolved issues in the paid work, parenting, and health literature. The article concludes with suggestions for promising areas of research wherein family scientists and social neuroscientists could build collaborative research to address gaps in the work–family literature. PMID:27840467

  1. Designing health care environments: Part I. Basic concepts, principles, and issues related to evidence-based design.

    PubMed

    Cesario, Sandra K

    2009-06-01

    A 2001 Institute of Medicine report captured the nation's attention regarding the dangers that can result from the health care environment. This report, fueled by the need for new facilities to be constructed, led to an explosion of research that now links the physical structure and design of health care facilities to the health and well-being of patients, nurses, other health care workers, and visitors. Continuing nursing education that highlights the importance of evidence-based design has been associated with measurable improvement in health care facilities' clinical outcomes, economic performance, employee productivity, customer satisfaction, and cultural congruency. Three major categories of outcomes can be impacted by evidence-based design: stress reduction, safety, and overall health care quality and ecology. In this article, Part I of a two-part series, the basic concepts, principles, and issues related to evidence-based design are introduced. Part II will describe continuing education programs available for nurses.

  2. Conflict Resolution Automation and Pilot Situation Awareness

    NASA Technical Reports Server (NTRS)

    Dao, Arik-Quang V.; Brandt, Summer L.; Bacon, Paige; Kraut, Josh; Nguyen, Jimmy; Minakata, Katsumi; Raza, Hamzah; Rozovski, David; Johnson, Walter W.

    2010-01-01

    This study compared pilot situation awareness across three traffic management concepts. The Concepts varied in terms of the allocation of traffic avoidance responsibility between the pilot on the flight deck, the air traffic controllers, and a conflict resolution automation system. In Concept 1, the flight deck was equipped with conflict resolution tools that enable them to fully handle the responsibility of weather avoidance and maintaining separation between ownship and surrounding traffic. In Concept 2, pilots were not responsible for traffic separation, but were provided tools for weather and traffic avoidance. In Concept 3, flight deck tools allowed pilots to deviate for weather, but conflict detection tools were disabled. In this concept pilots were dependent on ground based automation for conflict detection and resolution. Situation awareness of the pilots was measured using online probes. Results showed that individual situation awareness was highest in Concept 1, where the pilots were most engaged, and lowest in Concept 3, where automation was heavily used. These findings suggest that for conflict resolution tasks, situation awareness is improved when pilots remain in the decision-making loop.

  3. Prototype Food and Nutrient Database for Dietary Studies: Branded Food Products Database for Public Health Proof of Concept

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Prototype Food and Nutrient Database for Dietary Studies (Prototype FNDDS) Branded Food Products Database for Public Health is a proof of concept database. The database contains a small selection of food products which is being used to exhibit the approach for incorporation of the Branded Food ...

  4. The Effect of Educational Disequilibrium in Field Work on Graduate Social Work Students' Self-Concept and Mental Health

    ERIC Educational Resources Information Center

    Ying, Yu-Wen

    2011-01-01

    The author used a mixed methods design to assess field work-related educational disequilibrium and its effect on the self-concept and mental health of MSW students. Twenty-eight advanced, fourth-semester MSW students were compared with 37 entering, first-semester MSW students in practice-related sense of accomplishment. Compared with first-year…

  5. Staff Perspectives on the Use of a Computer-Based Concept for Lifestyle Intervention Implemented in Primary Health Care

    ERIC Educational Resources Information Center

    Carlfjord, Siw; Johansson, Kjell; Bendtsen, Preben; Nilsen, Per; Andersson, Agneta

    2010-01-01

    Objective: The aim of this study was to evaluate staff experiences of the use of a computer-based concept for lifestyle testing and tailored advice implemented in routine primary health care (PHC). Design: The design of the study was a cross-sectional, retrospective survey. Setting: The study population consisted of staff at nine PHC units in the…

  6. Conflict and Compromise in Public Health Policy: Analysis of Changes Made to Five Competitive Food Legislative Proposals Prior to Adoption

    ERIC Educational Resources Information Center

    Dinour, Lauren M.

    2015-01-01

    Competitive foods in schools have historically been scrutinized for their ubiquity and poor nutritional quality, leading many states to enact legislation limiting the availability and accessibility of these items. Evaluations of these policy approaches show their promise in improving the healthfulness of school food environments, considered an…

  7. Out of the Shadows: The Health and Well-Being of Private Contractors Working in Conflict Environments

    DTIC Science & Technology

    2013-01-01

    stress among military personnel. Yet, despite anec- dotal evidence of similar problems among contractors, there has been very little study of this...61 Access to Company-Provided Stress Management Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63...75 Increase Access to Stress Management and Mental Health Resources

  8. Bed Sharing, SIDS Research, and the Concept of Confounding: A Review for Public Health Nurses.

    PubMed

    Keys, Elizabeth M; Rankin, James A

    2015-01-01

    Confounding is an important concept for public health nurses (PHNs) to understand when considering the results of epidemiological research. The term confounding is derived from Latin, confundere, which means to "mix-up" or "mix together". Epidemiologists attempt to derive a cause and effect relationship between two variables traditionally known as the exposure and disease (e.g., smoking and lung cancer). Confounding occurs when a third factor, known as a confounder, leads to an over- or underestimate of the magnitude of the association between the exposure and disease. An understanding of confounding will facilitate critical appraisal of epidemiological research findings. This knowledge will enable PHNs to strengthen their evidence-based practice and better prepare them for policy development and implementation. In recent years, researchers and clinicians have examined the relationship between bed sharing and sudden infant death syndrome (SIDS). The discussion regarding the risk of bed sharing and SIDS provides ample opportunity to discuss the various aspects of confounding. The purpose of this article is to use the bed sharing and SIDS literature to assist PHNs to understand confounding and to apply this knowledge when appraising epidemiological research. In addition, strategies that are used to control confounding are discussed.

  9. Mental health services for children exposed to armed conflict: Médecins Sans Frontières’ experience in the Democratic Republic of Congo, Iraq and the occupied Palestinian territory

    PubMed Central

    Lokuge, K; Shah, T; Pintaldi, G; Thurber, K; Martínez-Viciana, C; Cristobal, M; Palacios, L; Dear, K; Banks, E

    2013-01-01

    Background: Armed conflict has broad-ranging impacts on the mental health and wellbeing of children and adolescents. Mental health needs greatly exceed service provision in conflict settings, particularly for these age groups. The provision and targeting of appropriate services requires better understanding of the characteristics and requirements of children and adolescents exposed to armed conflict. Methods: Routine patient and programme monitoring data were analysed for patients <20 years of age attending mental health services provided by Médecins Sans Frontières (MSF) in three countries affected by armed conflict: the Democratic Republic of Congo (DRC), Iraq and the occupied Palestinian territory (oPt). The demographic characteristics, presenting mental health complaint, attributed precipitating event, services provided and short-term outcomes for mental health services users in each country are described. Results: Between 2009 and 2012, 3025 individuals <20 years of age presented for care in DRC and Iraq, and in 2012 in oPt, constituting 14%, 17·5% and 51%, respectively, of all presentations to MSF mental health services in those three countries. The most common precipitating event was sexual violence in DRC (36·5%), domestic violence in Iraq (17·8%) and incarceration or detention in oPt (33%). Armed conflict-related precipitants were reported by 25·9%, 55·0% and 76·4% of youths in DRC, Iraq and oPt, respectively. The most common presenting complaints in children and adolescents were anxiety-related, followed by mood-related, behaviour-related and somatisation problems; these varied according to country and precipitating event. Although a high proportion (45·7%) left programmes early, 97% of those who completed care self-reported improvement in their presenting complaint. Conclusions: Brief trauma-focused therapy, the current MSF mental health therapeutic intervention, appears to be effective in reducing symptoms arising from the experience of trauma

  10. Sexual Self-Concept and General Health in Rheumatoid Arthritis Patients

    PubMed Central

    Saadat, Seyed Hassan; Ramezani, Arash; Ahmadi, Khodabakhsh

    2015-01-01

    Background: There are several studies regarding sexual dysfunction in chronic diseases such as diabetes and renal failure; however, no significant study has been done on Iranian rheumatoid arthritis (RA) patients. Objectives: In this study, we aimed to identify and compare sexual dysfunction between RA patients and the normal population. Patients and Methods: In this case-control study, two groups of females (87 RA patients and 89 controls) were randomly selected from the rheumatology clinic of Baqiyatallah Hospital, Tehran, Iran. General health questionnaire (GHQ-28) and multidimensional sexual self-concept questionnaire (MSSCQ) were used to evaluate RA patients. We used SPSS for statistical analysis mainly by the t-test and chi-square test. P values less than 0.05 were considered significant. Results: In the GHQ-28 evaluation, RA patients had lower social function; however somatization rated higher in normal patients (P < 0.05). Sexual health was lower in the RA population (P < 0.05). No significant difference was found in sexual desire. Except sexual pain, other sexual health parameters were lower in RA patients. The scores were as follow: sensation 13.6 ± 4.4 vs. 12.2 ± 4.5, P = 0.024; lubrication 6.9 ± 2.1 vs. 6.2 ± 2.1, P = 0.017; orgasm 10.4 ± 2.8 vs. 9.5 ± 3.2, P = 0.37; pain 10.1 ± 2.2 vs. 10.8 ± 1.9, P = 0.013; enjoyment 23.8 ± 5.8 vs. 21.3 ± 7.5, P = 0.009 and partner related 8.5 ± 1.7 vs. 7.6 ± 2.4, P = 0.005. Furthermore, the concern of losing their sexual partner was higher in the normal population. Conclusions: Our study demonstrated that almost all GHQ and MSSCQ parameters were lower in RA patients, which indicates lower quality sexual life in RA patients. We recommend further consideration for the treatment and care of these patients. PMID:26568849

  11. Scarcity, Conflict, and Equity in Allocating Public Recreation Resources.

    ERIC Educational Resources Information Center

    Shelby, Bo; Danley, Mark

    The conflict between the interests of commercial outfitters and private boaters in the use of whitewater rivers is examined. A discussion is presented on the literature on scarcity, allocation, and conflict among groups. These concepts are applied to the allocation of public resources on whitewater rivers. The conflicting interest groups are…

  12. Conflict and human African trypanosomiasis.

    PubMed

    Berrang-Ford, Lea; Lundine, Jamie; Breau, Sebastien

    2011-02-01

    Human African Trypanosomiasis (HAT) has reemerged in sub-Saharan Africa as a disease of major public health importance. The success of HAT elimination in sub-Saharan Africa is subject to the feasibility of controlling, eliminating, or mitigating the determinants of incidence in affected countries. Conflict has been widely recognized and cited as a contributing factor to the resurgence of HAT in many countries, as well as to continuing HAT incidence in politically unstable and resource-poor regions. Despite extensive anecdotal and qualitative recognition of the role of conflict, there has been no quantitative research of this topic at the population level in affected African countries. We characterize the qualitative and quantitative associations between HAT incidence and conflict-related processes in HAT-affected African countries over the past 30 years. HAT and conflict-related data were collected for 35 affected countries in sub-Saharan Africa for the years 1976-2004. Descriptive and univariate inferential statistics, as well as negative binomial regression modeling, are used to assess the associations between HAT and conflict. A space-time scan statistic is used to identify significant incidence clusters. Clusters of HAT incidence over the past 30 years have predominantly coincided with periods of conflict or socio-political instability. HAT cases occurred significantly more often in countries and during years with conflict, high political terror, and internationalized civil war. The results indicate a lag period between the start of conflict events and a peak in incidence of approximately 10 years. We recommend explicit consideration and quantification of socio-political measures such as conflict and terror indices in GIS (Geographic Information Systems)-based risk assessments for HAT policy and intervention.

  13. Varieties of Organizational Conflict

    ERIC Educational Resources Information Center

    Pondy, Louis R.

    1969-01-01

    The viewpoints and findings of the seven empirical studies of organizational conflict contained in this issue are compared and contrasted. A distinction is made between conflict within a stable organization structure and conflict aimed at changing the organization structure. (Author)

  14. Ethics, morality, and conflicting interests: how questionable professional integrity in some scientists supports global corporate influence in public health.

    PubMed

    Baur, Xaver; Budnik, Lygia Therese; Ruff, Kathleen; Egilman, David S; Lemen, Richard A; Soskolne, Colin L

    2015-01-01

    Clinical and public health research, education, and medical practice are vulnerable to influence by corporate interests driven by the for-profit motive. Developments over the last 10 years have shown that transparency and self-reporting of corporate ties do not always mitigate bias. In this article, we provide examples of how sound scientific reasoning and evidence-gathering are undermined through compromised scientific enquiry resulting in misleading science, decision-making, and policy intervention. Various medical disciplines provide reference literature essential for informing public, environmental, and occupational health policy. Published literature impacts clinical and laboratory methods, the validity of respective clinical guidelines, and the development and implementation of public health regulations. Said literature is also used in expert testimony related to resolving tort actions on work-related illnesses and environmental risks. We call for increased sensitivity, full transparency, and the implementation of effective ethical and professional praxis rules at all relevant regulatory levels to rout out inappropriate corporate influence in science. This is needed because influencing the integrity of scientists who engage in such activities cannot be depended upon.

  15. The biopsychosocial model in medical research: the evolution of the health concept over the last two decades.

    PubMed

    Alonso, Yolanda

    2004-05-01

    The object of this study was to assess the change towards a biopsychosocial health concept among medical researchers in the last two decades, after the explicit criticism of the biomedical model in the late 1970s because of its somatic reductionism. The concepts of 'health' or 'healthy status of an individual' as reported as variable in empirical articles published in the journal The Lancet over the years 1978-1982 (period a) and 1996-2000 (period b) were searched by means of Medline and compared for their definition of these variables. None of the 52 examined papers set out a positive and replicable definition of 'health' (seven papers) or 'healthy status' (45). No difference was found between the two periods studied except for the failure of reports to describe 'healthy status' at all (65.5% in a, 19% in b). Most articles do it in an indirect way, namely through exclusion conditions of subjects taking part in treatment or control groups. Only three studies include psychological dimensions in their measures of 'healthy status' (two in a, one in b). Concerning 'health', all seven examined papers include psychological or both psychological and social dimensions. Although a change towards a more holistic concept of health has occurred in academic and institutional contexts over the last few decades, there does not appear to have been a parallel change in the practical domains of medicine. Possible reasons are discussed, specially the difficulty of applying the biopsychosocial model in medical care and the difficulty of competing with the traditional biomedical concept of health, which has proved fruitful and dominant in medicine over the past three centuries.

  16. A concept mapping exploration of social workers' and mental health nurses' understanding of the role of the Approved Mental Health Professional.

    PubMed

    Bressington, Daniel T; Wells, Harvey; Graham, Matthew

    2011-08-01

    This study uses concept mapping and participant interviews to explore how differing professional viewpoints and levels of knowledge held by social workers and mental health nurses affect perceptions of the Approved Mental Health Professional (AMHP) role during an interprofessional training programme. The results suggest that social workers entering the programme had a greater understanding of the role in comparison to mental health nurses; however, on completion of the programme, both professional groups demonstrated similar levels of learning. The study challenges assumptions that nurses may be inherently disadvantaged by their professional background in terms of learning about a role that is traditionally associated with social work practice. Study participants valued the concept mapping process and felt that the approach may be a valuable tool for clinical supervision.

  17. [Developmental origin of health and adult diseases (DOHaD): evolution of a concept over three decades].

    PubMed

    Charles, Marie-Aline; Delpierre, Cyrille; Bréant, Bernadette

    2016-01-01

    In the 1980s, D. Barker and his team proposed the hypothesis of a fetal origin of adult diseases. The concept subsequently evolved into the developmental origins of health and diseases. Progresses in various domains such as social epidemiology, neuroscience, toxicology have contributed to establish the early years of life as a key period for future health. Finally, epigenetics has provided biological plausibility to long-term programming of health by early exposures. The convergence of all these currents has led to conceptualize human health in a complex and dynamic continuum, the Lifecourse Health Development, beginning in the prenatal period and covering the whole life. Many animal models have been developed to try to unravel the mechanisms involved. Their contributions are described in this paper with the example of type 2 diabetes.

  18. Who Can Afford Health Care? Evaluating the Socio-Economic Conditions and the Ability to Contribute to Health Care in a Post-Conflict Area in DR Congo

    PubMed Central

    Gerstl, Sibylle; Sauter, Justin; Kasanda, Joseph; Kinzelbach, Alfred

    2013-01-01

    Introduction The Democratic Republic of the Congo is today one of the poorest countries in the world; the health status of the population ranks among the worst in Sub-Saharan Africa. Public health services charge user fees and drug prices. Since 2008, north-eastern Congo is facing a guerrilla war. Malteser International is assisting with free health care for internally displaced persons as well as the general population. Before the incursion the health system was based on user fees. The aim of this study was to determine the socio-economic conditions of the population and to assess their ability to contribute to health care. Methodology Heads of 552 randomly selected households in 23 clusters in two health zones were interviewed using a standardised questionnaire. Findings The demographic description and socio-economic conditions of the study population were homogenous. Major source of income was agriculture (57%); 47% of the households earned less than US$ 5.5/week. Ninety-two percent of the interviewed households estimated that they would be able to contribute to consultation fees (maximum amount of US$ 0.27) and 79% to the drug prices (maximum amount of US$ 1.10). Six percent opted for free consultations and 19% for free drugs. Conclusions Living conditions were very basic; the estimated income of the study population was low. Almost half of the population perceived their current living situation as fairly good/good. More than 90% of the study population estimated to be able to contribute to consultation fees and 80% to drug prices. As a result Malteser International suggested introducing flat-rates for health care services. Once the project ends, the population will have to pay again for their health service. One solution would be the introduction of a health care financing system with the goal to reach universal coverage to health care. PMID:24204819

  19. Concepts of functioning and health important to people with systemic sclerosis: a qualitative study in four European countries

    PubMed Central

    Stamm, Tanja A; Mattsson, Malin; Mihai, Carina; Stöcker, Juliane; Binder, Alexa; Bauernfeind, Bettina; Stummvoll, Georg; Gard, Gunvor; Hesselstrand, Roger; Sandqvist, Gunnel; Draghicescu, Oana; Gherghe, Ana Maria; Voicu, Malina; Machold, Klaus P; Distler, Oliver; Smolen, Josef S; Boström, Carina

    2011-01-01

    Objective To describe the experiences of people with systemic sclerosis (SSc) in different European countries of functioning and health and to link these experiences to the WHO International Classification of Functioning, Disability and Health (ICF) to develop a common understanding from a bio-psycho-social perspective. Method A qualitative multicentre study with focus-group interviews was performed in four European countries: Austria, Romania, Sweden and Switzerland. The qualitative data analysis followed a modified form of ‘meaning condensation’ and the concepts that emerged in the analysis were linked to the ICF. Results 63 people with SSc participated in 13 focus groups. In total, 86 concepts were identified. 32 (37%) of these were linked to the ICF component body functions and structures, 21 (24%) to activities and participation, 26 (30%) to environmental factors, 6 (7%) to personal factors and 1 (1%) to the health condition itself. 19 concepts (22%) were identified in all four countries and included impaired hand function, household activities, paid work, drugs, climate and coldness, support from others and experiences with healthcare institutions, non-pharmacological treatment, social security and benefits. Conclusion Concepts identified in all four countries could be used for guiding clinical assessment, as well as interdisciplinary team care and rheumatological rehabilitation for patients with SSc. For a full understanding of the aspects of the disease that were most relevant to people with SSc, people with SSc from multiple countries needed to be involved. PMID:21540204

  20. Effects of Pilates-based exercise on life satisfaction, physical self-concept and health status in adult women.

    PubMed

    Cruz-Ferreira, Ana; Fernandes, Jorge; Gomes, Dulce; Bernardo, Lisa Marie; Kirkcaldy, Bruce D; Barbosa, Tiago M; Silva, António

    2011-05-01

    The objective of this study was to determine the effect of Pilates-based mat exercises on life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept, and perception of health status in healthy women. A randomized controlled trial was conducted in Evora, Portugal, in 2008, in which 62 healthy adult women were randomized to a Pilates-based mat (experimental group) (n = 38, mean age ± SD, 41.08 ± 6.64 years) or a control group (n = 24, mean age ± SD, 40.25 ± 7.70 years). Experimental group participants performed the Initial Mat of Body Control Pilates twice per week, 60-minutes per session. Repeated measurements were performed at baseline, 3 months and 6 months. No significant differences between the two groups were observed in life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept, and perception of health status at three time point measures (baseline, after 3 months, and after 6 months). No significant differences were observed in the control group over time. The experimental group showed significant improvements between baseline and six months in life satisfaction (p = .04), perception of appreciation by other people (p = .002), perception of physical appearance (p = .001), perception of functionality (p = .01), total physical self-concept (p = .001), perception of health status (p = .013) and between three and six months in life satisfaction (p = .002), perception of appreciation by other people (p = .05), perception of physical appearance (p = .001), perception of functionality (p = .02), and total physical self-concept (p = .001). Life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept and perception of health status may improve after 6 months of Pilates-based mat

  1. Structural Health Management of Damaged Aircraft Structures Using the Digital Twin Concept

    NASA Technical Reports Server (NTRS)

    Seshadri, Banavara R.; Krishnamurthy, Thiagarajan

    2017-01-01

    The development of multidisciplinary integrated Structural Health Management (SHM) tools will enable accurate detection, and prognosis of damaged aircraft under normal and adverse conditions during flight. As part of the digital twin concept, methodologies are developed by using integrated multiphysics models, sensor information and input data from an in-service vehicle to mirror and predict the life of its corresponding physical twin. SHM tools are necessary for both damage diagnostics and prognostics for continued safe operation of damaged aircraft structures. The adverse conditions include loss of control caused by environmental factors, actuator and sensor faults or failures, and structural damage conditions. A major concern in these structures is the growth of undetected damage/cracks due to fatigue and low velocity foreign object impact that can reach a critical size during flight, resulting in loss of control of the aircraft. To avoid unstable, catastrophic propagation of damage during a flight, load levels must be maintained that are below a reduced load-carrying capacity for continued safe operation of an aircraft. Hence, a capability is needed for accurate real-time predictions of damage size and safe load carrying capacity for structures with complex damage configurations. In the present work, a procedure is developed that uses guided wave responses to interrogate damage. As the guided wave interacts with damage, the signal attenuates in some directions and reflects in others. This results in a difference in signal magnitude as well as phase shifts between signal responses for damaged and undamaged structures. Accurate estimation of damage size, location, and orientation is made by evaluating the cumulative signal responses at various pre-selected sensor locations using a genetic algorithm (GA) based optimization procedure. The damage size, location, and orientation is obtained by minimizing the difference between the reference responses and the

  2. Non-Residential Father-Child Involvement, Interparental Conflict and Mental Health of Children Following Divorce: A Person-Focused Approach

    PubMed Central

    Elam, Kit K.; Sandler, Irwin; Wolchik, Sharlene; Tein, Jenn-Yun

    2015-01-01

    Variable-centered research has found complex relationships between child well-being and two critical aspects of the post-divorce family environment: the level of non-residential father involvement (i.e., contact and supportive relationship) with their children and the level of conflict between the father and mother. However, these analyses fail to capture individual differences based on distinct patterns of interparental conflict, father support and father contact. Using a person-centered latent profile analysis, the present study examined (1) profiles of non-residential father contact, support, and interparental conflict in the two years following divorce (N = 240), when children (49% female) were between 9 and 12 years of age and (2) differences across profiles in concurrent child adjustment outcomes as well as outcomes six years later. Four profiles of father involvement were identified: High Contact – Moderate Conflict – Moderate Support, Low Contact – Moderate Conflict – Low Support, High Conflict – Moderate Contact –Moderate Support, and Low Conflict – Moderate Contact – Moderate Support. Concurrently, children with fathers in the group with high conflict were found to have significantly greater internalizing and externalizing problems compared to all other groups. Six years later, children with fathers in the group with low contact and low support were found to have greater internalizing and externalizing problems compared to children with fathers in the high conflict group, and also greater internalizing problems compared to children with fathers in the low conflict group. These results provide insight into the complex relationship among non-residential fathers’ conflict, contact, and support in child adjustment within divorcing families. PMID:26692236

  3. Non-Residential Father-Child Involvement, Interparental Conflict and Mental Health of Children Following Divorce: A Person-Focused Approach.

    PubMed

    Elam, Kit K; Sandler, Irwin; Wolchik, Sharlene; Tein, Jenn-Yun

    2016-03-01

    Variable-centered research has found complex relationships between child well-being and two critical aspects of the post-divorce family environment: the level of non-residential father involvement (i.e., contact and supportive relationship) with their children and the level of conflict between the father and mother. However, these analyses fail to capture individual differences based on distinct patterns of interparental conflict, father support and father contact. Using a person-centered latent profile analysis, the present study examined (1) profiles of non-residential father contact, support, and interparental conflict in the 2 years following divorce (N = 240), when children (49 % female) were between 9 and 12 years of age and (2) differences across profiles in concurrent child adjustment outcomes as well as outcomes 6 years later. Four profiles of father involvement were identified: High Contact-Moderate Conflict-Moderate Support, Low Contact-Moderate Conflict-Low Support, High Conflict-Moderate Contact-Moderate Support, and Low Conflict-Moderate Contact-Moderate Support. Concurrently, children with fathers in the group with high conflict were found to have significantly greater internalizing and externalizing problems compared to all other groups. Six years later, children with fathers in the group with low contact and low support were found to have greater internalizing and externalizing problems compared to children with fathers in the high conflict group, and also greater internalizing problems compared to children with fathers in the low conflict group. These results provide insight into the complex relationship among non-residential fathers' conflict, contact, and support in child adjustment within divorcing families.

  4. Conflicting Interpretations of Scientific Pedagogy

    NASA Astrophysics Data System (ADS)

    Galamba, Arthur

    2016-05-01

    Not surprisingly historical studies have suggested that there is a distance between concepts of teaching methods, their interpretations and their actual use in the classroom. This issue, however, is not always pitched to the personal level in historical studies, which may provide an alternative insight on how teachers conceptualise and engage with concepts of teaching methods. This article provides a case study on this level of conceptualisation by telling the story of Rómulo de Carvalho, an educator from mid-twentieth century Portugal, who for over 40 years engaged with the heuristic and Socratic methods. The overall argument is that concepts of teaching methods are open to different interpretations and are conceptualised within the melting pot of external social pressures and personal teaching preferences. The practice and thoughts of Carvalho about teaching methods are scrutinised to unveil his conflicting stances: Carvalho was a man able to question the tenets of heurism, but who publicly praised the heurism-like "discovery learning" method years later. The first part of the article contextualises the arrival of heurism in Portugal and how Carvalho attacked its philosophical tenets. In the second part, it dwells on his conflicting positions in relation to pupil-centred approaches. The article concludes with an appreciation of the embedded conflicting nature of the appropriation of concepts of teaching methods, and of Carvalho's contribution to the development of the philosophy of practical work in school science.

  5. What could a strengthened right to health bring to the post-2015 health development agenda?: interrogating the role of the minimum core concept in advancing essential global health needs

    PubMed Central

    2013-01-01

    Background Global health institutions increasingly recognize that the right to health should guide the formulation of replacement goals for the Millennium Development Goals, which expire in 2015. However, the right to health’s contribution is undercut by the principle of progressive realization, which links provision of health services to available resources, permitting states to deny even basic levels of health coverage domestically and allowing international assistance for health to remain entirely discretionary. Discussion To prevent progressive realization from undermining both domestic and international responsibilities towards health, international human rights law institutions developed the idea of non-derogable “minimum core” obligations to provide essential health services. While minimum core obligations have enjoyed some uptake in human rights practice and scholarship, their definition in international law fails to specify which health services should fall within their scope, or to specify wealthy country obligations to assist poorer countries. These definitional gaps undercut the capacity of minimum core obligations to protect essential health needs against inaction, austerity and illegitimate trade-offs in both domestic and global action. If the right to health is to effectively advance essential global health needs in these contexts, weaknesses within the minimum core concept must be resolved through innovative research on social, political and legal conceptualizations of essential health needs. Summary We believe that if the minimum core concept is strengthened in these ways, it will produce a more feasible and grounded conception of legally prioritized health needs that could assist in advancing health equity, including by providing a framework rooted in legal obligations to guide the formulation of new health development goals, providing a baseline of essential health services to be protected as a matter of right against governmental claims of

  6. A Pilot Study to Explore the Challenges of Changing Children's Food and Health Concepts

    ERIC Educational Resources Information Center

    Bullen, Kathryn; Benton, David

    2004-01-01

    Objective: To investigate the effect of a nutrition education intervention and four hours of related teaching on the nutrition concepts of a sample of 9 year-old children. Design: Prepost test design. Children's food classification concepts were assessed before and after the intervention and nutrition teaching. Setting: Year 4 class of a suburban…

  7. Conflicts Between Parents and Health Professionals About a Child's Medical Treatment: Using Clinical Ethics Records to Find Gaps in the Bioethics Literature.

    PubMed

    McDougall, Rosalind; Notini, Lauren; Phillips, Jessica

    2015-09-01

    Clinical ethics records offer bioethics researchers a rich source of cases that clinicians have identified as ethically complex. In this paper, we suggest that clinical ethics records can be used to point to types of cases that lack attention in the current bioethics literature, identifying new areas in need of more detailed bioethical work. We conducted an analysis of the clinical ethics records of one paediatric hospital in Australia, focusing specifically on conflicts between parents and health professionals about a child's medical treatment. We identified, analysed, and compared cases of this type from the clinical ethics records with cases of this type discussed in bioethics journals. While the cases from journals tended to describe situations involving imminent risk to the child's life, a significant proportion of the clinical ethics records cases involved different stakes for the child involved. These included distress, poorer functional outcome, poorer psychosocial outcome, or increased risk of surgical complications. Our analysis suggests that one type of case that warrants more detailed ethics research is parental refusal of recommended treatment, where the refusal does not endanger the child's life but rather some other aspect of the child's well-being.

  8. Child Emotional Security and Interparental Conflict.

    ERIC Educational Resources Information Center

    Davies, Patrick T.; Harold, Gordon T.; Goeke-Morey, Marcie C.; Cummings, E. Mark

    2002-01-01

    Four studies tested a theory that high interparental conflict increases child mental health risk by shaking children's sense of security in the family. Findings showed that children's fear, avoidance, and involvement were prominent responses, especially relative to reactions predicted by other theories. Interparental conflict related to greater…

  9. Integrating the disaster cycle model into traditional disaster diplomacy concepts.

    PubMed

    Callaway, David W; Yim, Eugene S; Stack, Colin; Burkle, Frederick M

    2012-03-01

    Disaster diplomacy is an evolving contemporary model that examines how disaster response strategies can facilitate cooperation between parties in conflict. The concept of disaster diplomacy has emerged during the past decade to address how disaster response can be leveraged to promote peace, facilitate communication, promote human rights, and strengthen intercommunity ties in the increasingly multipolar modern world. Historically, the concept has evolved through two camps, one that focuses on the interactions between national governments in conflict and another that emphasizes the grassroots movements that can promote change. The two divergent approaches can be reconciled and disaster diplomacy further matured by contextualizing the concept within the disaster cycle, a model well established within the disaster risk management community. In particular, access to available health care, especially for the most vulnerable populations, may need to be negotiated. As such, disaster response professionals, including emergency medicine specialists, can play an important role in the development and implementation of disaster diplomacy concepts.

  10. An insight into the drinking-water access in the health institutions at the Saharawi refugee camps in Tindouf (Algeria) after 40years of conflict.

    PubMed

    Vivar, M; Pichel, N; Fuentes, M; Martínez, F

    2016-04-15

    Drinking water access in the Saharawi refugee camps located in the Algerian desert is a challenge that is still an on-going problem after 40years of conflict. This work presents an analysis of the situation with emphasis on the water supply in health institutions (quantity and quality) including both sanitary inspections and a comprehensive water quality study. Results from sanitary inspections show that only half of the water supply installations at the hospitals are in adequate conditions and the rest present high risk of microbiological contamination. Water access in small medical community centres on the other hand present issues related to the non-availability of food-grade water tanks for the institutions (70%), the use of small 10l containers as the main water supply (40%), poor maintenance (60% under antihygienic conditions and 30% with damaged covers), and insufficient chlorine levels that prevent microbiological contamination. Regarding water quality analyses, raw water supply in Smara, El Aiun and Awserd camps present high conductivity and high levels of fluoride, chloride, nitrate and sulphate, but dropping to normal levels within the drinking-water standards after water treatment via reverse osmosis plants. But for the case of El Aiun and Awserd, the reverse osmosis plant only provides treated water to the population each 20days, so the population receives raw water directly and health risks should be evaluated. Finally, Dakhla water supply is the best in terms of physico-chemical parameters quality, currently providing safe drinking water after a chlorination stage. In summary, drinking water access has improved dramatically in the last years due to the efforts of local and international authorities but several issues remain to be solved: access to treated water for all the population, improved water quality controls (especially in Dakhla), expansion of distribution networks, and adequate storage systems and maintenance.

  11. [Socio-economic model and the quality of life: an approximation to the concept of social health].

    PubMed

    Huertas, R; Maestro, A

    1993-01-01

    After a brief analysis of the principal contradictions in the model of the National Health Service in the industrialised, capitalist countries which, after the second world war, acceded to the Welfare State, we shall study, within the framework of the so-called "epidemiological revolution", the way in which a degradation of the medical model of Social Security and the configuration of an ideological view directed at the individualisation of health problems, is recorded following a crisis in the Welfare State. Finally the concept of Social Health shall be expounded as a category of analysis which may permit the understanding of the methodological inexactitude which involves creating the characteristics and possibilities of a health service outside the socio-economic model.

  12. Automated conflict resolution issues

    NASA Technical Reports Server (NTRS)

    Wike, Jeffrey S.

    1991-01-01

    A discussion is presented of how conflicts for Space Network resources should be resolved in the ATDRSS era. The following topics are presented: a description of how resource conflicts are currently resolved; a description of issues associated with automated conflict resolution; present conflict resolution strategies; and topics for further discussion.

  13. Can consumer choice replace trust in the National Health Service in England? Towards developing an affective psychosocial conception of trust in health care.

    PubMed

    Fotaki, Marianna

    2014-11-01

    Trust has long been regarded as a vitally important aspect of the relationship between health service providers and patients. Recently, consumer choice has been increasingly advocated as a means of improving the quality and effectiveness of health service provision. However, it is uncertain how the increase of information necessary to allow users of health services to exercise choice, and the simultaneous introduction of markets in public health systems, will affect various dimensions of trust, and how changing relations of trust will impact upon patients and services. This article employs a theory-driven approach to investigate conceptual and material links between choice, trust and markets in health care in the context of the National Health Service in England. It also examines the implications of patient choice on systemic, organisational and interpersonal trust. The article is divided into two parts. The first argues that the shift to marketisation in public health services might lead to an over-reliance on rational-calculative aspects of trust at the expense of embodied, relational and social attributes. The second develops an alternative psychosocial conception of trust: it focuses on the central role of affect and accounts for the material and symbolic links between choice, trust and markets in health care.

  14. Refocusing and prioritizing HIV programmes in conflict and post-conflict settings: funding recommendations.

    PubMed

    Hanson, Brent W; Wodak, Alex; Fiamma, Agnès; Coates, Thomas J

    2008-08-01

    Conflict and post-conflict settings pose specific challenges to HIV prevention and care efforts. Whereas armed conflicts have decreased very considerably in number, the interactions between HIV epidemiology and conflict remain problematic. This review describes factors that affect HIV in conflict and post-conflict settings, identifies challenges to addressing HIV, and presents actionable and measurable programming and funding recommendations that can be implemented immediately. Funding priorities include prevention and care efforts such as the provision and monitoring of universal precautions for HIV infection, health services for sexual violence and antiretroviral therapy. Policy efforts should prioritize enforcing appropriate conduct by peacekeepers and aid workers, interventions targeted at specific phases and contexts of conflicts, supporting the continuity of programmes from emergency to post emergency and reconstruction efforts and simplifying and accelerating funding mechanisms.

  15. Hunting happiness or promoting health? Why positive psychology deserves a place in health promotion.

    PubMed

    Bull, Torill

    2008-09-01

    This commentary asks the question of whether positive psychology represents an egoistic pursuit of happiness, which is in conflict with basic values within health promotion. A look at key concepts and research findings within positive psychology reveals common ground with health promotion. Similarities are evident in conceptualization of health, resource focus, value focus and consequences for policy. Some influences of happiness on health and functioning are described.

  16. Conflict and Emerging Infectious Diseases

    PubMed Central

    Legros, Dominique; Formenty, Pierre; Connolly, Maire A.

    2007-01-01

    Detection and control of emerging infectious diseases in conflict situations are major challenges due to multiple risk factors known to enhance emergence and transmission of infectious diseases. These include inadequate surveillance and response systems, destroyed infrastructure, collapsed health systems and disruption of disease control programs, and infection control practices even more inadequate than those in resource-poor settings, as well as ongoing insecurity and poor coordination among humanitarian agencies. This article outlines factors that potentiate emergence and transmission of infectious diseases in conflict situations and highlights several priority actions for their containment and control. PMID:18217543

  17. [Systematic review about the concept of access to health services: planning contributions].

    PubMed

    de Jesus, Washington Luiz Abreu; Assis, Marluce Maria Araújo

    2010-01-01

    This article aims to discuss the category access to health services and the Planning contributions to building it on SUS. The central discourse axis refers to the connection between theoretic and practice planning on the Collective Health field related to different analysis dimensions of access: economic, technical-assistential, political and symbolic, described theorists in the field. The dimensions evidence contributions of subjects/authors for greatest approximation to the health reality of country; regarding the understanding of symbolic elements that determinate intervention in health-disease process, as well as regarding the different ways of organization of the Health System and policies, observed in its political, economic, technical-assistential components.

  18. [Mobile Health Units: An Analysis of Concepts and Implementation Requirements in Rural Regions.

    PubMed

    Hämel, K; Kutzner, J; Vorderwülbecke, J

    2015-12-22

    Background: Access to health services in rural regions represents a challenge. The development of care models that respond to health service shortages and pay particular attention to the increasing health care needs of the elderly is an important concern. A model that has been implemented in other countries is that of mobile health units. But until now, there is no overview of their possible objectives, functions and implementation requirements. Method: This paper is based on a literature analysis and an internet research on mobile health units in rural regions. Results: Mobile health units aim to avoid regional undersupply and address particularly vulnerable population groups. In the literature, mobile health units are described with a focus on specific illnesses, as well as those that provide comprehensive, partly multi-professional primary care that is close to patients' homes. The implementation of mobile health units is demanding; the key challenges are (a) alignment to the needs of the regional population, (b) user-oriented access and promotion of awareness and acceptance of mobile health units by the local population, and (c) network building within existing care structures to ensure continuity of care for patients. To fulfill these requirements, a community-oriented program development and implementation is important. Conclusions: Mobile health units could represent an interesting model for the provision of health care in rural regions in Germany. International experiences are an important starting point and should be taken into account for the further development of models in Germany.

  19. Concepts and trends in the preparation of health educators in the US.

    PubMed

    Hamburg, M V

    1980-01-01

    Traditionally, health educators in the United States were categorized as either school or community-based and were prepared separately in two kinds of institutions: schools of education and schools of public health. The standards for the two kinds of health education preparation were established by two separate agencies: State Education Departments and the American Public Health Association. In the past decade, schools of education have begun to offer training for community health educators as well as for teachers of health. Where this has occurred, programmes have many similarities, but the field work differs. Also a new type of health education specialist has emerged: one who works with patients. The field work for this category of health educator is usually in a health care institution. This situation has made it important to develop standards for professional preparation and practice that can be applied to all types of health educators. A group of professionals have reached agreement that a common core curriculum should be established for the entry level, and guidelines developed for specialized preparation at the advanced levels. A national study is underway to delineate roles of health educators. The future will probably bring competency-based curricula with unified standards for the profession as a whole. There will be more institutions of higher education offering community health education programmes and they can be expected to develop concentrations on special topics such as occupational health or patient education according to their resources. A viable accrediting system can be expected to be developed and widely used. However, the number of students will remain stable until the job market for health educators expands.

  20. Prototype Conflict Alerting Logic for Free Flight

    NASA Technical Reports Server (NTRS)

    Yang, Lee C.; Kuchar, James K.

    1997-01-01

    This paper discusses the development of a prototype alerting system for a conceptual Free Flight environment. The concept assumes that datalink between aircraft is available and that conflicts are primarily resolved on the flight deck. Four alert stages are generated depending on the likelihood of a conflict. If the conflict is not resolved by the flight crews, Air Traffic Control is notified to take over separation authority. The alerting logic is based on probabilistic analysis through modeling of aircraft sensor and trajectory uncertainties. Monte Carlo simulations were used over a range of encounter situations to determine conflict probability. The four alert stages were then defined based on probability of conflict and on the number of avoidance maneuvers available to the flight crew. Preliminary results from numerical evaluations and from a piloted simulator study at NASA Ames Research Center are summarized.

  1. Lessons From Rocket Science: Reframing the Concept of the Physician Health Advocate.

    PubMed

    Hubinette, Maria M; Regehr, Glenn; Cristancho, Sayra

    2016-10-01

    Health advocacy is a prominent component of health professionals' training internationally and is frequently discussed in the medical education literature. Despite this, it continues to be a problematic and challenging topic for medical educators, health professionals, and trainees alike. Borrowing from the field of systems engineering, the authors suggest a need to reconceptualize health advocacy using a systems mind-set rather than a physician-centric perspective. Conceptualizing health advocacy as a systemic, collective effort requires educators, practitioners, and trainees to challenge the assumption that the role of a competent physician health advocate can be fully defined without regard to the larger system or collective within which physicians function. Further, this implies a substantially more dynamic understanding of physicians' and other participants' parts in the collective activity.Of course, this new way of conceptualizing physicians' practices is not limited to health advocacy. The current education paradigm trains physicians for individual competency but expects them to practice collectively. Defining physician competen cies, or the competencies of any health care provider, in isolation from the particular system of which that individual is an integral part implicitly places that health care provider as the central focus of that system. Thus, academic medicine needs to move its educational and research efforts forward in a manner that recognizes that a systems engineering approach to health improvement will allow the various players to maximize their individual efforts to more effectively support the collective activity.

  2. 42 CFR 414.912 - Conflicts of interest

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Conflicts of interest 414.912 Section 414.912... Biologicals Under Part B § 414.912 Conflicts of interest (a) Approved CAP vendors and applicants that bid to participate in the CAP are subject to the following: (1) The conflict of interest standards and...

  3. 42 CFR 421.310 - Conflict of interest requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conflict of interest requirements. 421.310 Section... Conflict of interest requirements. Offerors for MIP contracts and MIP contractors are subject to the following: (a) The conflict of interest standards and requirements of the Federal Acquisition...

  4. 42 CFR 455.238 - Conflict of interest.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Conflict of interest. 455.238 Section 455.238... Conflict of interest. (a) Offerors for Medicaid integrity audit program contracts, and Medicaid integrity audit program contractors, are subject to the following requirements: (1) The conflict of...

  5. 42 CFR 421.312 - Conflict of interest resolution.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Conflict of interest resolution. 421.312 Section... Contractors § 421.312 Conflict of interest resolution. (a) Review Board. CMS may establish and convene a Conflicts of Interest Review Board to assist the contracting officer in resolving organizational...

  6. 42 CFR 438.58 - Conflict of interest safeguards.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Conflict of interest safeguards. 438.58 Section 438... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE State Responsibilities § 438.58 Conflict of interest... safeguards against conflict of interest on the part of State and local officers and employees and agents...

  7. 42 CFR 421.310 - Conflict of interest requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Conflict of interest requirements. 421.310 Section... Conflict of interest requirements. Offerors for MIP contracts and MIP contractors are subject to the following: (a) The conflict of interest standards and requirements of the Federal Acquisition...

  8. 42 CFR 455.238 - Conflict of interest.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Conflict of interest. 455.238 Section 455.238... Conflict of interest. (a) Offerors for Medicaid integrity audit program contracts, and Medicaid integrity audit program contractors, are subject to the following requirements: (1) The conflict of...

  9. 42 CFR 438.58 - Conflict of interest safeguards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Conflict of interest safeguards. 438.58 Section 438... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE State Responsibilities § 438.58 Conflict of interest... safeguards against conflict of interest on the part of State and local officers and employees and agents...

  10. 42 CFR 455.238 - Conflict of interest.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Conflict of interest. 455.238 Section 455.238... Conflict of interest. (a) Offerors for Medicaid integrity audit program contracts, and Medicaid integrity audit program contractors, are subject to the following requirements: (1) The conflict of...

  11. 42 CFR 438.58 - Conflict of interest safeguards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Conflict of interest safeguards. 438.58 Section 438... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE State Responsibilities § 438.58 Conflict of interest... safeguards against conflict of interest on the part of State and local officers and employees and agents...

  12. 42 CFR 421.310 - Conflict of interest requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Conflict of interest requirements. 421.310 Section... Contractors § 421.310 Conflict of interest requirements. Offerors for MIP contracts and MIP contractors are subject to the following: (a) The conflict of interest standards and requirements of the...

  13. 42 CFR 438.58 - Conflict of interest safeguards.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Conflict of interest safeguards. 438.58 Section 438... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE State Responsibilities § 438.58 Conflict of interest... safeguards against conflict of interest on the part of State and local officers and employees and agents...

  14. 42 CFR 414.912 - Conflicts of interest

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Conflicts of interest 414.912 Section 414.912... Drugs and Biologicals Under Part B § 414.912 Conflicts of interest (a) Approved CAP vendors and applicants that bid to participate in the CAP are subject to the following: (1) The conflict of...

  15. 42 CFR 421.312 - Conflict of interest resolution.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Conflict of interest resolution. 421.312 Section... Contractors § 421.312 Conflict of interest resolution. (a) Review Board. CMS may establish and convene a Conflicts of Interest Review Board to assist the contracting officer in resolving organizational...

  16. 42 CFR 455.238 - Conflict of interest.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Conflict of interest. 455.238 Section 455.238... Conflict of interest. (a) Offerors for Medicaid integrity audit program contracts, and Medicaid integrity audit program contractors, are subject to the following requirements: (1) The conflict of...

  17. 42 CFR 421.310 - Conflict of interest requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Conflict of interest requirements. 421.310 Section... Contractors § 421.310 Conflict of interest requirements. Offerors for MIP contracts and MIP contractors are subject to the following: (a) The conflict of interest standards and requirements of the...

  18. 42 CFR 414.912 - Conflicts of interest

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Conflicts of interest 414.912 Section 414.912... Drugs and Biologicals Under Part B § 414.912 Conflicts of interest (a) Approved CAP vendors and applicants that bid to participate in the CAP are subject to the following: (1) The conflict of...

  19. 42 CFR 421.312 - Conflict of interest resolution.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Conflict of interest resolution. 421.312 Section... Contractors § 421.312 Conflict of interest resolution. (a) Review Board. CMS may establish and convene a Conflicts of Interest Review Board to assist the contracting officer in resolving organizational...

  20. 42 CFR 438.58 - Conflict of interest safeguards.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Conflict of interest safeguards. 438.58 Section 438... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE State Responsibilities § 438.58 Conflict of interest... safeguards against conflict of interest on the part of State and local officers and employees and agents...

  1. 42 CFR 421.310 - Conflict of interest requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Conflict of interest requirements. 421.310 Section... Contractors § 421.310 Conflict of interest requirements. Offerors for MIP contracts and MIP contractors are subject to the following: (a) The conflict of interest standards and requirements of the...

  2. 42 CFR 455.238 - Conflict of interest.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Conflict of interest. 455.238 Section 455.238... Conflict of interest. (a) Offerors for Medicaid integrity audit program contracts, and Medicaid integrity audit program contractors, are subject to the following requirements: (1) The conflict of...

  3. Sense of coherence and physical health. A "Copenhagen interpretation" of Antonovsky's SOC concept.

    PubMed

    Endler, P Christian; Haug, Thomas M; Spranger, Heinz

    2008-04-20

    According to Antonovsky's (Aaron Antonovsky, 1923-1994) sense of coherence (SOC) model, persons with a high SOC have the ability to benefit from their general defense mechanisms in order to overcome stressful situations. In a health-disease continuum, this leads to the development towards health. However, Antonovsky's global hypothesis that the strength of the SOC may influence the physical health status of a person could not be proven. Flensborg-Madsen et al. from Copenhagen were able to provide a new access regarding SOC and health. They investigated the mixture of emotional aspects and mental constructions as a possible cause for fairly low correlation between SOC and physical health. Thus, in an empirical way, they described "emotional coherence" in relation to physical health, while "mental coherence" was linked to psychological health. These authors introduced the idea of applying a shortened version of the original 29-item SOC questionnaire, but have not yet developed or tested the shortened questionnaire. Backed by their important findings, it appears to be promising to consider the use of the SOC questionnaire as standardized by Antonovsky, but cleared of the items regarding "predictability", i.e., Flensborg-Madsen et al. suggested that the items on "predictability" be excluded from the SOC scale when a correlation to physical health is to be investigated. Further investigations in this area of research will be of high impact, not only for health sciences, but also for medical practice.

  4. Prophetic Pragmatism? Post-Conflict Educational Development in Aceh and Mindanao

    ERIC Educational Resources Information Center

    Milligan, Jeffrey Ayala

    2009-01-01

    This essay critically examines the relevance of Cornel West's (1989) conception of "prophetic pragmatism" as a theoretical framework for educational development in post-conflict settings torn by religious, socioeconomic, and cultural tensions. It examines the concept through the conflict and post-conflict experiences of the Indonesian…

  5. Functional validity of a judgment skills measure within the concept of health literacy for sleeping disorder patients.

    PubMed

    Dubowicz, Arthur; Schulz, Peter J

    2014-10-17

    The concept of health literacy has been widened to include higher order aspects such as patient decision-making skills while its measurement continued to rely narrowly on reading and numeracy skills, known as functional health literacy. We developed a Judgment Skills measure, designed to assess patients' ability to make appropriate decisions with regard to their condition. The measure offers scenarios with answer options ranked for biomedical adequacy. This study aims to examine the psychometric properties and the functional validity of the Judgment Skills measure. A self-administered survey among 87 primary insomnia patients in the Italian-speaking part of Switzerland was conducted. The extensive path model included variables such as functional health literacy, coping with the medical condition, experience of the scenario, sleep quality, duration suffering, education, and age. Correlation analyses were conducted to link the variables. The Judgment Skills measure showed the expected significant correlations. In general, higher Judgment Skills were related to coping strategies leading to better health outcomes. Functional health literacy correlated highly with education, while Judgment Skills did not, which confirmed the conceptual difference of these skills. The findings propose a model for conducting research that does embrace the broader conceptualization of health literacy.

  6. Health Care Students' Differing Conceptions of Expertise: A Challenge for Inter-Professional Care

    ERIC Educational Resources Information Center

    Makinen, Jarkko; Petersson, Gunilla; Nurmi, Raija; Lonka, Kirsti

    2007-01-01

    The aim of the study was to examine do health care students, who study at different programs, value similar expert qualities. To investigate this issue, a questionnaire was administered among health care students in a Finnish polytechnic (two cohorts, total n = 466), consisting of a scale for rating the importance of different expert qualities.…

  7. Bringing the concepts of peer coaches and local health workers from Africa to Harlem.

    PubMed

    Singh, Prabhjot

    2012-12-01

    Prabhjot Singh, a PhD scientist and medical resident, saw the effectiveness of community health workers while working in Africa. Now he helps run a New York-based organization that trains peer coaches to help struggling Americans manage their health.

  8. Health Care Policy and Part H Services: Early Intervention as a Concept (Not a Separate Program).

    ERIC Educational Resources Information Center

    Shonkoff, Jack P.

    This paper argues that there is a critical need to reframe the fundamental policy questions which fragment early childhood intervention services and health care, in order to construct an integrated system of comprehensive services that includes basic health care and developmental support for all children and their families and that provides…

  9. Perinatal health care in a conflict-affected setting: evaluation of health-care services and newborn outcomes at a regional medical centre in Iraq.

    PubMed

    Ahamadani, F A B; Louis, H; Ugwi, P; Hines, R; Pomerleau, M; Ahn, R; Burke, T F; Nelson, B D

    2015-02-02

    A field-based assessment was conducted to assess maternal and newborn health-care services, perinatal and newborn outcomes and associated risk factors at Bint Al-Huda Maternal and Newborn Teaching Hospital, a large referral hospital in southern Iraq. The multi-method approach used interviews, discussions, observation and review of perinatal and newborn outcome data. There is limited assessment of maternal vital signs, labour pattern, fetal response, and complications during pregnancy and labour. Perinatal and neonatal mortality rates are 27.4/1000 births and 30.9/1000 live births respectively. Associated neonatal mortality factors were gestational age < 37 weeks, male sex, birth weight < 2.5 kg, maternal age > 35 years, rural maternal residence and vaginal delivery. Improving birth outcomes in southern Iraq requires evidence-based clinical guidelines, additional supplies and equipment, quality improvement initiatives and in-service training.

  10. Associations of Conflict-Related Trauma and Ongoing Stressors with the Mental Health and Functioning of West Papuan Refugees in Port Moresby, Papua New Guinea (PNG).

    PubMed

    Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Lahe, Sylvester; Kitau, Russell; David, Kura; Sonoling, Joyce; Silove, Derrick

    2015-01-01

    Documentation is limited in relation to the mental health of the people of West Papua, a territory that has been exposed to decades-long political persecution. We examined associations of traumatic events (TEs) and current stressors with mental disorder and functioning, amongst 230 West Papuan refugees residing in six settlements in Port Morseby, Papua New Guinea (PNG). We used culturally adapted modules to assess exposure to TEs and mental disorders. Current stressors and functioning were assessed using modifications of measures developed by the World Health Organization (WHO). 129 of 230 respondents (56%) reported exposure to at least one traumatic event (TE), including: political upheaval (36.5%), witnessing or hearing about family members tortured and murdered (33.9%), and not being able to access medical care for family members (33%). One fifth of respondents (47, 20.4%) experienced exposure to high levels of TEs (16 to 23). 211 (91.7%) endorsed at least one or more ongoing stressors, including: exposure to illicit substance use in the community (91.7%), problems with safety and the protection of women (89.6%), no access to legal rights and citizenship (88.3%), and lack of adequate shelter and facilities (85.2%). A quarter (26.9%) met criteria for one or more current mental disorder, and 69.1% reported functional impairment ranging from mild to extreme. Mental disorder was associated with being male (adjusted odds ratio=2.00; 95% CI=1.01-3.97), and exposure to the highest category of ongoing stressors (AOR=2.89; 95% CI=1.08-7.72). The TE count showed a dose-response pattern in its relationship with functional impairment, the greatest risk (AOR=11.47; 95% CI=2.11-62.37) being for those experiencing the highest level of TE exposure (16-23 events). West Papuans living in settlements in Port Moresby reported a range of TEs, ongoing stressors and associated mental disorders characteristic of populations exposed to mass conflict and persecution, prolonged

  11. Using Design Principles to Foster Understanding of Complex Health Concepts in Consumer Informatics Tools

    PubMed Central

    Misra, Rupananda; Mark, Jessica H.; Khan, Sharib; Kukafka, Rita

    2010-01-01

    Consumer health informatics tools can only be effective if patients comprehend their content. Optimal design may foster better patient comprehension and health literacy, which can improve health outcomes. We developed a patient-centric decision aid, Tailored Lifestyle Conversations (TLC), to help patients comprehend behavioral risks and set behavior change priorities for reducing risk of cardiovascular disease. The TLC decision aid was developed using a design framework based on Gestalt Principles of Perception. Further iteration was informed by qualitative user feedback. Preliminary analysis showed that the TLC decision aid helped patients understand their risk and supported their decisions on health behavior change. We identified design elements that supported patient comprehension, and other elements that were not effective, to inform iterative revision. This paper describes an effective methodology for the development of consumer health informatics tools that includes grounding in design principles complemented by iterative revision based on user testing and feedback. PMID:21347027

  12. Caring Disposition and Subordination. Swedish Health and Social Care Teachers' Conceptions of Important Vocational Knowledge

    ERIC Educational Resources Information Center

    Rehn, Helena; Eliasson, Eva

    2015-01-01

    Based on the increasing demands for vocational training in upper secondary school to adapt to workplace conditions, the aim of this article is to explore vocational teachers' conceptions regarding vocational knowledge. Drawing on a social constructionist perspective, this study analysed data from 17 interviews. The study showed how power dynamics,…

  13. Interparental Conflict and Adolescents' Romantic Relationship Conflict

    ERIC Educational Resources Information Center

    Simon, Valerie A.; Furman, Wyndol

    2010-01-01

    This study examined associations between interparental conflict and adolescents' romantic relationship conflict. High school seniors (N = 183) who lived with married parents completed questionnaires about their parents' marriage and their own romantic relationships. A subset of 88 adolescents was also observed interacting with their romantic…

  14. Community concepts of poverty: an application to premium exemptions in Ghana’s National Health Insurance Scheme

    PubMed Central

    2013-01-01

    Background Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana’s National Health Insurance Scheme. Methods We employed participatory wealth ranking (PWR) a qualitative tool for the exploration of community concepts, identification and ranking of households into socioeconomic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty. Results Community defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behavior, social exclusion and marginalization. The poverty indicators discussed shared commonalities but contrasted in the patterns of ranking per community. Conclusion The in-depth nature of the PWR process precludes it from being used for identification of the poor on a large national scale in a program such as the NHIS. However, PWR can provide valuable qualitative input to enrich discussions, development and implementation of policies, programs and tools for large scale interventions and targeting of the poor for social welfare programs such as premium exemption for health care. PMID:23497484

  15. Application of a marketing concept to patient-centered care: co-producing health with heart failure patients.

    PubMed

    Leone, Robert P; Walker, Charles A; Curry, Linda Cox; Agee, Elizabeth J

    2012-04-03

    Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of 'one size fits all,' a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients.

  16. UICC International Session: What are the implications of sharing the concept of Universal Health Coverage for cancer in Asia?

    PubMed

    Akaza, Hideyuki; Roh, Jae Kyung; Hao, Xishan; Wibulpolprasert, Suwit; Nozaki, Shinjiro; Park, Eun-Cheol; Fukuda, Takashi; Sonoda, Shigeto; Kawahara, Norie

    2016-04-01

    The Japan National Committee for the Union for International Cancer Control (UICC) and UICC - Asia Regional Office organized an international session as part of the 74th Annual Meeting of the Japanese Cancer Association on the topic "What are the implications of sharing the concept of Universal Health Coverage for cancer in Asia?" Universal Health Coverage (UHC) is included in the United Nations' Sustainable Development Goals and aims to ensure that all people can receive high-quality medical services, are protected from public health risks, and are prevented from falling into poverty due to medical costs or loss of income arising from illness. The session discussed the growing cost of cancer and the challenges that this poses to the establishment and deployment of UHC in the Asian region, where countries face budgetary and other systemic constraints in tackling and controlling cancer. It was noted how sharing concepts on UHC will assist mutual learning among Asian countries and help in the formation of guidelines that can be adapted to national and regional realities. Presentations included a status report on UHC for cancer control in Thailand, and a report from the WHO Kobe Centre concerning prospects for collaborative research on UHC. Also discussed were the current status of cancer burden and control in China and Korea and Japan's progress in systemizing cost-effectiveness evaluation. The final presentation highlighted the importance of gathering social and economic data across Asia in order to build a picture of commonalities and differences in the region.

  17. Public Health Aspects of the Family Medicine Concepts in South Eastern Europe

    PubMed Central

    Masic, Izet; Hadziahmetovic, Miran; Donev, Doncho; Pollhozani, Azis; Ramadani, Naser; Skopljak, Amira; Pasagic, Almir; Roshi, Enver; Zunic, Lejla; Zildzic, Muharem

    2014-01-01

    Introduction: Family medicine as a part of the primary health care is devoted to provide continuous and comprehensive health care to the individuals and families regardless of age, gender, types of diseases and affected system or part of the body. Special emphasis in such holistic approach is given to the prevention of diseases and health promotion. Family Medicine is the first step/link between doctors and patients within patients care as well as regular inspections/examinations and follow-up of the health status of healthy people. Most countries aspire to join the European Union and therefore adopting new regulations that are applied in the European Union. Aim: The aim of this study is to present the role and importance of family medicine, or where family medicine is today in 21 Century from the beginning of development in these countries. The study is designed as a descriptive epidemiological study with data from 10 countries of the former Communist bloc, Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo, Albania, Bulgaria, Romania, Czech Republic, Slovakia and Hungary, just about half of them are members of the EU. We examined the following variables: socio-organizational indicators, health and educational indicators and health indicators. The data used refer to 2002 and as a source of data are used official data from reference WebPages of family medicine doctors associations, WONCA website (EURACT, EQuiP, EGPRN), WebPages of Bureau of Statistics of the countries where the research was conducted as well as the Ministries of Health. Results: Results indicates that the failures and shortcomings of health care organizations in Southeast Europe. Lack of money hinders the implementation of health care reform in all mentioned countries, the most of them that is more oriented to Bismarck financing system. Problems in the political, legal and economic levels are obstacles for efficient a problem reconstructing health care system toward

  18. Peri-conceptional supplementation of folic acid-knowledge and practices of pregnant women and health providers

    PubMed Central

    Saxena, Vartika; Naithani, Manisha; Kumari, Ranjeeta; Singh, Richa; Das, Pranoti

    2016-01-01

    Context: Neural tube defects (NTDs) are one of the most common congenital anomalies. NTDs are preventable if folic acid (FA) is supplemented before and during conception. Knowledge and supplementation of FA by pregnant women as well as it's timely provision by health providers is crucial in reducing the burden of NTDs in the community. Aim: To study the knowledge and supplementation of FA by pregnant women and it's prescription/provision by health providers. Settings and Design: A cross-sectional study was conducted in the block Doiwala, District Dehradun, Uttarakhand. Subjects and Methods: A total of 400 pregnant women and 121 government health providers (5 medical officers, 25 auxiliary nurse midwives [ANMs], and 91 accredited social health activists [ASHAs]) were interviewed on predesigned, pretested questionnaire by study/field investigator. Statistical Analysis Used: Proportion of different variables calculated and Chi-square test with Yates correction was applied. Results: Of 400, 73.50% of women had heard of FA. Overall, knowledge scores suggested intermediate to low level of knowledge about FA. Totally 94.25% of women had planned pregnancies; however, only 4.75% of women reported FA supplementation before conception. This indicates that if these women would have been properly counseled and prescribed FA, they might have taken it. About 60% of medical officers, 4% of ANMs, and 3.3% of ASHAs knew FA deficiency as one of the causes of NTD. None of the health providers reported to be prescribing/counseling FA to pregnant women. FA was out of supply on the block at the time of the study. Conclusions: Knowledge and supplementation practices related with FA are poor. PMID:27843847

  19. The utilisation of health research in policy-making: concepts, examples and methods of assessment

    PubMed Central

    Hanney, Stephen R; Gonzalez-Block, Miguel A; Buxton, Martin J; Kogan, Maurice

    2003-01-01

    The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies. PMID:12646071

  20. Toward Semantic Interoperability in Home Health Care: Formally Representing OASIS Items for Integration into a Concept-oriented Terminology

    PubMed Central

    Choi, Jeungok; Jenkins, Melinda L.; Cimino, James J.; White, Thomas M.; Bakken, Suzanne

    2005-01-01

    Objective: The authors aimed to (1) formally represent OASIS-B1 concepts using the Logical Observation Identifiers, Names, and Codes (LOINC) semantic structure; (2) demonstrate integration of OASIS-B1 concepts into a concept-oriented terminology, the Medical Entities Dictionary (MED); (3) examine potential hierarchical structures within LOINC among OASIS-B1 and other nursing terms; and (4) illustrate a Web-based implementation for OASIS-B1 data entry using Dialogix, a software tool with a set of functions that supports complex data entry. Design and Measurements: Two hundred nine OASIS-B1 items were dissected into the six elements of the LOINC semantic structure and then integrated into the MED hierarchy. Each OASIS-B1 term was matched to LOINC-coded nursing terms, Home Health Care Classification, the Omaha System, and the Sign and Symptom Check-List for Persons with HIV, and the extent of the match was judged based on a scale of 0 (no match) to 4 (exact match). OASIS-B1 terms were implemented as a Web-based survey using Dialogix. Results: Of 209 terms, 204 were successfully dissected into the elements of the LOINC semantics structure and integrated into the MED with minor revisions of MED semantics. One hundred fifty-one OASIS-B1 terms were mapped to one or more of the LOINC-coded nursing terms. Conclusion: The LOINC semantic structure offers a standard way to add home health care data to a comprehensive patient record to facilitate data sharing for monitoring outcomes across sites and to further terminology management, decision support, and accurate information retrieval for evidence-based practice. The cross-mapping results support the possibility of a hierarchical structure of the OASIS-B1 concepts within nursing terminologies in the LOINC database. PMID:15802480