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

PubMed

Namakula, Justine; Witter, Sophie

2014-09-01

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. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

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. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Teaching Conflict Management Skills to the Health Care Professionals.

ERIC Educational Resources Information Center

Wilcox, James R.; And Others

The health care organization, as a specialized organizational setting, has some characteristics that make it of special concern to the conflict theorist. In a health care setting, conflict may arise as a result of (1) the complexity of medicine and the bureaucracy of health care delivery, (2) the problems of acquiring relevant information from…

Perceived conflict of interest in health science partnerships

PubMed Central

McCright, Aaron M.; Zahry, Nagwan R.; Elliott, Kevin C.; Kaminski, Norbert E.; Martin, Joseph D.

2017-01-01

University scientists conducting research on topics of potential health concern often want to partner with a range of actors, including government entities, non-governmental organizations, and private enterprises. Such partnerships can provide access to needed resources, including funding. However, those who observe the results of such partnerships may judge those results based on who is involved. This set of studies seeks to assess how people perceive two hypothetical health science research collaborations. In doing so, it also tests the utility of using procedural justice concepts to assess perceptions of research legitimacy as a theoretical way to investigate conflict of interest perceptions. Findings show that including an industry collaborator has clear negative repercussions for how people see a research partnership and that these perceptions shape people’s willingness to see the research as a legitimate source of knowledge. Additional research aimed at further communicating procedures that might mitigate the impact of industry collaboration is suggested. PMID:28426697

Understanding effects of armed conflict on health outcomes: the case of Nepal

PubMed Central

2010-01-01

Objective There is abundance of literature on adverse effects of conflict on the health of the population. In contrast to this, sporadic data in Nepal claim improvements in most of the health indicators during the decade-long armed conflict (1996-2006). However, systematic information to support or reject this claim is scant. This study reviews Nepal's key health indicators before and after the violent conflict and explores the possible factors facilitating the progress. Methods A secondary analysis has been conducted of two demographic health surveys-Nepal Family Health Survey (NFHS) 1996 and Nepal Demographic and Health Survey (NDHS) 2006; the latter was supplemented by a study carried out by the Nepal Health Research Council in 2006. Results The data show Nepal has made progress in 16 out of 19 health indicators which are part of the Millennium Development Goals whilst three indicators have remained static. Our analysis suggests a number of conflict and non-conflict factors which may have led to this success. Conclusion The lessons learnt from Nepal could be replicable elsewhere in conflict and post-conflict environments. A nationwide large-scale empirical study is needed to further assess the determinants of Nepal's success in the health sector at a time the country experienced a decade of armed conflict. PMID:21122098

Mental health problems among conflict-affected adults in Grozny, Chechnya: a qualitative study.

PubMed

Nguyen, Amanda J; Feo, Concetta; Idrisov, Kyuri; Pintaldi, Giovanni; Lenglet, Annick; Tsatsaeva, Zalina; Bolton, Paul; Bass, Judith

2016-01-01

A decade of conflict in Chechnya destroyed infrastructure and resulted in widespread exposure to violence. Amidst substantial reconstruction, periodic violence has contributed to an ongoing atmosphere of insecurity. We conducted a qualitative study to understand the mental health and psychosocial problems affecting adult Chechens in this context to inform development of assessment tools for an evaluation study related to individual counseling. Data were collected in July 2014. A convenience sample of 59 Chechen adults was asked to Free List all problems affecting people in the area. Four problems were explored further in 19 Key Interviewee (KI) interviews, with respondents identified using snowball sampling. Data analysis was conducted in Russian by the Chechen interviewers. Multiple mental health and psychosocial problems emerged, including 'bad psychological health', 'depression', 'stress and nervous people', and 'problems in the family'. Aggression, 'emotional blowing', and 'not adequate' behavior were frequently reported indicators of these problems, with negative effects on the whole family. Chechens reported seeking help through informal social networks, psychiatric and psychological services, and Islamic Centers. Chechens reported mental health and psychosocial problems similar to those experienced in other post-conflict settings. The description of 'emotional blowing' mirrored prior findings in Chechen asylum seekers and fits within a cluster of cultural concepts of distress featuring anger that has been identified in other conflict-affected populations. Further exploration of the nature and prevalence of this construct, as well as evaluations of interventions aimed at reducing these symptoms, is warranted.

Collaboration and Teamwork in the Health Professions: Rethinking the Role of Conflict.

PubMed

Eichbaum, Quentin

2017-11-14

Whereas the business professions have long recognized that conflict can be a source of learning and innovation, the health professions still tend to view conflict negatively as being disruptive, inefficient, and unprofessional. As a consequence, the health professions tend to avoid conflict or resolve it quickly. This neglect to appreciate conflict's positive attributes appears to be driven in part by (1) individuals' fears about being negatively perceived and the potential negative consequences in an organization of being implicated in conflict, (2) constrained views and approaches to professionalism and to evaluation and assessment, and (3) lingering autocracies and hierarchies of power that view conflict as a disruptive threat.The author describes changing perspectives on collaboration and teamwork in the health professions, discusses how the health professions have neglected to appreciate the positive attributes of conflict, and presents three alternative approaches to more effectively integrating conflict into collaboration and teamwork in the health professions. These three approaches are (1) cultivating psychological safety on teams to make space for safe interpersonal risk taking, (2) viewing conflict as a source of expansive learning and innovation (via models such as activity theory), and (3) democratizing hierarchies of power through health humanities education ideally by advancing the health humanities to the core of the curriculum.The author suggests that understanding conflict's inevitability and its innovative potential, and integrating it into collaboration and teamwork, may have a reassuring and emancipating impact on individuals and teams. This may ultimately improve performance in health care organizations.

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.

Persistent work-life conflict and health satisfaction - a representative longitudinal study in Switzerland.

PubMed

Knecht, Michaela K; Bauer, Georg F; Gutzwiller, Felix; Hämmig, Oliver

2011-04-29

The objectives of the present study were (1) to track work-life conflict in Switzerland during the years 2002 to 2008 and (2) to analyse the relationship between work-life conflict and health satisfaction, examining whether long-term work-life conflict leads to poor health satisfaction. The study is based on a representative longitudinal database (Swiss Household Panel), covering a six-year period containing seven waves of data collection. The sample includes 1261 persons, with 636 men and 625 women. Data was analysed by multi-level mixed models and analysis of variance with repeated measures. In the overall sample, there was no linear increase or decrease of work-life conflict detected, in either its time-based or strain-based form. People with higher education were more often found to have a strong work-life conflict (time- and strain-based), and more men demonstrated a strong time-based work-life conflict than women (12.2% vs. 5%). A negative relationship between work-life conflict and health satisfaction over time was found. People reporting strong work-life conflict at every wave reported lower health satisfaction than people with consistently weak work-life conflict. However, the health satisfaction of those with a continuously strong work-life conflict did not decrease during the study period. Both time-based and strain-based work-life conflict are strongly correlated to health satisfaction. However, no evidence was found for a persistent work-life conflict leading to poor health satisfaction.

Learning About Conflict and Conflict Management Through Drama in Nursing Education.

PubMed

Arveklev, Susanna H; Berg, Linda; Wigert, Helena; Morrison-Helme, Morag; Lepp, Margret

2018-04-01

In the health care settings in which nurses work, involvement in some form of conflict is inevitable. The ability to manage conflicts is therefore necessary for nursing students to learn during their education. A qualitative analysis of 43 written group assignments was undertaken using a content analysis approach. Three main categories emerged in the analysis-to approach and integrate with the theoretical content, to step back and get an overview, and to concretize and practice-together with the overall theme, to learn by oscillating between closeness and distance. Learning about conflict and conflict management through drama enables nursing students to form new knowledge by oscillating between closeness and distance, to engage in both the fictional world and the real world at the same time. This helps students to form a personal understanding of theoretical concepts and a readiness about how to manage future conflicts. [J Nurs Educ. 2018;57(4):209-216.]. Copyright 2018, SLACK Incorporated.

A Multilevel Analysis of Professional Conflicts in Health Care Teams: Insight for Future Training.

PubMed

Bochatay, Naike; Bajwa, Nadia M; Cullati, Stéphane; Muller-Juge, Virginie; Blondon, Katherine S; Junod Perron, Noëlle; Maître, Fabienne; Chopard, Pierre; Vu, Nu Viet; Kim, Sara; Savoldelli, Georges L; Hudelson, Patricia; Nendaz, Mathieu R

2017-11-01

Without a proper understanding of conflict between health care professionals, designing effective conflict management training programs for trainees that reflect the complexity of the clinical working environment is difficult. To better inform the development of conflict management training, this study sought to explore health care professionals' experiences of conflicts and their characteristics. Between 2014 and early 2016, 82 semistructured interviews were conducted with health care professionals directly involved in first-line patient care in four departments of the University Hospitals of Geneva. These professionals included residents, fellows, certified nursing assistants, nurses, and nurse supervisors. All interviews were transcribed verbatim, and conventional content analysis was used to derive conflict characteristics. Six conflict sources were identified. Among these sources, disagreements on patient care tended to be the primary trigger of conflict, whereas sources related to communication contributed to conflict escalation without directly triggering conflict. A framework of workplace conflict that integrates its multidimensional and cyclical nature was subsequently developed. This framework suggests that conflict consequences and responses are interrelated, and might generate further tensions that could affect health care professionals, teams, and organizations, as well as patient care. Findings also indicated that supervisors' responses to contentious situations often failed to meet health care professionals' expectations. Understanding conflicts between health care professionals involves several interrelated dimensions, such as sources, consequences, and responses to conflict. There is a need to strengthen health care professionals' ability to identify and respond to conflict and to further develop conflict management programs for clinical supervisors.

Persistent work-life conflict and health satisfaction - A representative longitudinal study in Switzerland

PubMed Central

2011-01-01

Background The objectives of the present study were (1) to track work-life conflict in Switzerland during the years 2002 to 2008 and (2) to analyse the relationship between work-life conflict and health satisfaction, examining whether long-term work-life conflict leads to poor health satisfaction. Methods The study is based on a representative longitudinal database (Swiss Household Panel), covering a six-year period containing seven waves of data collection. The sample includes 1261 persons, with 636 men and 625 women. Data was analysed by multi-level mixed models and analysis of variance with repeated measures. Results In the overall sample, there was no linear increase or decrease of work-life conflict detected, in either its time-based or strain-based form. People with higher education were more often found to have a strong work-life conflict (time- and strain-based), and more men demonstrated a strong time-based work-life conflict than women (12.2% vs. 5%). A negative relationship between work-life conflict and health satisfaction over time was found. People reporting strong work-life conflict at every wave reported lower health satisfaction than people with consistently weak work-life conflict. However, the health satisfaction of those with a continuously strong work-life conflict did not decrease during the study period. Conclusions Both time-based and strain-based work-life conflict are strongly correlated to health satisfaction. However, no evidence was found for a persistent work-life conflict leading to poor health satisfaction. PMID:21529345

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.

Conflicting Online Health Information and Rational Decision Making: Implication for Cancer Survivors.

PubMed

Yoon, Heesoo; Sohn, Minsung; Choi, Mankyu; Jung, Minsoo

Although people in the social media age can access health information easier, they have difficulty judging conflicting rational information or summarizing the large amounts of health information available. Conflicting health information occurs when contrary assertions or information about a certain health issue comes from different information sources. This study examined the background knowledge and the current phenomenon of why conflicting health information occurs in real-world conditions. We also reviewed causes and solutions by reviewing the literature. In particular, we recommend a method that solves problems that patients have including cancer survivors who cannot themselves be active in seeking health information. Thus, we categorized the specific types of conflicting health information and analyzed the sociodemographic factors and information carrier factors that have an impact on the health information-seeking behavior of individuals.

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…

The roles of the health sector and health workers before, during and after violent conflict.

PubMed

Buhmann, Caecilie; Barbara, Joanna Santa; Arya, Neil; Melf, Klaus

2010-01-01

Starting with a view of war as a significant population health problem, this article explores the roles of health workers in relation to violent conflict. Four different roles are identified, defined by goals and values--military, development, humanitarian and peace. In addition, four dimensions of health work are seen as cross-cutting factors influencing health work in violent conflict-- whether the health worker is an insider or outsider to the conflict, whether they are oriented to primary, secondary or tertiary prevention of the mortality and morbidity of war, whether they take an individual clinical or a population health approach, and whether they are oriented to policy and whole-sector change or not. This article explores the nature of these roles, the influence of these cross-cutting dimensions, the challenges of each role and finally commonalities and possibilities for cooperation between roles.

The relation between concepts of quality-of-life, health and happiness.

PubMed

Musschenga, A W

1997-02-01

In the last two decades, the term "quality-of-life" has become popular in medicine and health care. There are, however, important differences in the meaning and the use of the term. The message of all quality-of-life talk is that medicine and health care are not valuable in themselves. They are valuable to the extent that they contribute to the quality of life of patients. The ultimate aims of medicine and health care are not health or prolongation of life as such, but preservation or improvement of the quality of life. The primary aims of medicine and health care, such as the prolongation of life, can--but need not always--come into conflict with the ultimate ones: medical treatments do not always benefit a patient. In this article I will, first, summarize the results of my explorations of the use and the meaning of the term "quality-of-life." The use and the meaning of the term turn out to depend on the contexts of medical decision-making in which it is used. I will show that there are at least three different concepts of quality-of-life. Second, I will argue that the different concepts of quality-of-life are not unrelated. They point to different components of and/or conditions for happiness. Third, I will analyze the relation between the three concepts of quality-of-life, health and happiness.

Conflict, forced displacement and health in Sri Lanka: a review of the research landscape.

PubMed

Siriwardhana, Chesmal; Wickramage, Kolitha

2014-01-01

Sri Lanka has recently emerged from nearly three decades of protracted conflict, which came to an end five years ago in 2009. A number of researchers have explored the devastating effect the conflict has had on public health, and its impact on Sri Lanka's health system - hailed as a success story in the South Asian region. Remarkably, no attempt has been made to synthesize the findings of such studies in order to build an evidence-informed research platform. This review aims to map the 'research landscape' on the impact of conflict on health in Sri Lanka. Findings highlight health status in select groups within affected communities and unmet needs of health systems in post-conflict regions. We contend that Sri Lanka's post-conflict research landscape requires exploration of individual, community and health system resilience, to provide better evidence for health programs and interventions after 26 years of conflict.

Zoonoses, One Health and complexity: wicked problems and constructive conflict.

PubMed

Waltner-Toews, David

2017-07-19

Infectious zoonoses emerge from complex interactions among social and ecological systems. Understanding this complexity requires the accommodation of multiple, often conflicting, perspectives and narratives, rooted in different value systems and temporal-spatial scales. Therefore, to be adaptive, successful and sustainable, One Health approaches necessarily entail conflicts among observers, practitioners and scholars. Nevertheless, these integrative approaches have, both implicitly and explicitly, tended to marginalize some perspectives and prioritize others, resulting in a kind of technocratic tyranny. An important function of One Health approaches should be to facilitate and manage those conflicts, rather than to impose solutions.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'. © 2017 The Authors.

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

PubMed

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

2017-10-01

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. Copyright © 2016 John Wiley & Sons, Ltd.

Appraisals of Marital Conflict and Children's Adjustment, Health, and Physiological Reactivity.

ERIC Educational Resources Information Center

El-Sheikh, Mona; Harger, JoAnn

2001-01-01

Examined children's appraisals of marital conflict as mediators of conflict and children's adjustment, health, and physiological reactivity. Found that higher self-blame and perceived threat were vulnerability factors for children's internalizing behaviors, health problems, and higher cardiovascular reactivity. Higher perceived threat was a…

Worker Health and Safety: An Area of Conflicts

ERIC Educational Resources Information Center

Ashford, Nicholas A.

1975-01-01

The article outlines four basic conflicts concerning occupational health and safety, discusses the nature and dimensions of health and safety problems, examines the generation of information and its diffusion, and deals briefly with some economic issues. (Author)

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.

Work, work-life conflict and health in an industrial work environment.

PubMed

Hämmig, O; Bauer, G F

2014-01-01

Work-life conflict has been poorly studied as a cause of ill-health in occupational medicine. To study associations between physical and psychosocial working conditions, including work-life conflict on the one hand and general, physical and mental health outcomes on the other. Cross-sectional data were used from an employee survey among the workforces of four medium-sized and large companies in Switzerland. Physical work factors included five demands and exposures such as heavy loads, repetitive work and poor posture. Psychosocial factors included 14 demands and limited resources such as time pressure, overtime, monotonous work, job insecurity, low job autonomy, low social support and work-life conflict. Health outcomes studied were self-rated health, sickness absence, musculoskeletal disorders, sleep disorders, stress and burnout. There was a response rate of 49%; 2014 employees participated. All adverse working conditions were positively associated with several poor health outcomes in both men and women. After mutual adjustment for all work factors and additional covariates, only a few, mainly psychosocial work factors remained significant as risk factors for health. Work-life conflict, a largely neglected work-related psychosocial factor in occupational medicine, turned out to be the only factor that was significantly and strongly associated with all studied health outcomes and was consistently found to be the strongest or second strongest of all the studied risk factors. Even in an industrial work environment, psychosocial work factors, and particularly work-life conflict, play a key role and need to be taken into consideration in research and workplace health promotion.

Conflict, health care and professional perseverance: a qualitative study in the West Bank.

PubMed

Sousa, Cindy; Hagopian, Amy

2011-01-01

The past three decades have been a time of considerable global conflict, affecting over 50 countries and causing substantial impacts on civilian health. While many effects are direct results of violence, conflict also impinges on health through indirect means. The restricted mobility of health care staff and patients, targeting of health care workers, and stressful working conditions disrupt the ability of health care workers in conflict zones to function effectively. This paper explores the challenges experienced by health care workers in West Bank, Palestine, as well as their strategies of persistence. Research activities included participant observation and interviews with health care providers, which were then analysed for common themes. Results demonstrated that the Israeli military occupation of the West Bank considerably impacts civilians' access to both urgent and preventive care. While attempting to deliver care, providers encountered disruptions, harassment and violence, which interrupted care and contributed to job stress. Professional perseverance was evident, but its influence was limited by enduring constraints. This study thus underscores the importance of accountability to international law regarding the rights of civilians to health care in conflict zones. Health professionals may play a particular role in advocating for just and dignified resolutions to conflicts.

Cultural diversity and conflict in the health care workplace.

PubMed

Lowenstein, A J; Glanville, C

1995-01-01

Cultural diversity issues affect the health care workplace and nursing practice. The Lowenstein-Glanville conflict model can be used for assessing and intervening in racial and status conflict in hospital settings. Implications for nursing practice include recognizing that cultural diversity will continue to grow in the health care workplace. Nurses must increase sensitivity, become aware of cultural nuances and issues, and make cultural assessment a routine part of their assessment and planning, not only for patient care, but also with their co-workers and subordinates.

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

PubMed

Zhang, Yuan; Punnett, Laura; Nannini, Angela

2017-07-01

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.

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.

Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey.

PubMed

Piko, Bettina F

2006-03-01

There is a growing interest in the psychosocial work environment of health care staff since they are at high risk for burnout, role conflict and job dissatisfaction. Burnout, as a type of prolonged response to chronic job-related stressors, has a special significance in health care where staff experience both psychological-emotional and physical stress. Burnout and the other negative aspects of the job of health care staff have major behavioural and health implications. The present study investigated the interrelationships among burnout, role conflict and job satisfaction in a sample of Hungarian health care staff. The study also investigated how these indicators of psychosocial work climate influence respondents' frequency of psychosomatic symptoms. A questionnaire survey (anonymous questionnaires) has been carried out to detect these interrelationships. Two major hospitals in Szeged, Hungary. Questionnaires were distributed to 450 health care staff among whom 55.7% were registered nurses. All together, 201 questionnaires were returned and analyzed, giving a response rate of 44.6%. Questionnaire contained items on work and health-related information (i.e., burnout, job satisfaction, role conflict, and psychosomatic symptoms) and on some basic sociodemographics. Beyond descriptive statistics, correlation and multiple regression analyses were computed. Findings show that emotional exhaustion and depersonalization scores were higher, while scores on personal accomplishment was lower as compared to Canadian, Norwegian or US samples. Burnout, particularly emotional exhaustion (p<.001), was found to be strongly related to job dissatisfaction. Schooling was inversely related to satisfaction with the job (p<.05). While job satisfaction was a negative predictor of each type of burnout subscale (p<.001), role conflict was a factor contributing positively to emotional exhaustion (p<.001) and depersonalization scores (p<.001). The study results underline the importance of the

State-building and human resources for health in fragile and conflict-affected states: exploring the linkages.

PubMed

Witter, Sophie; Falisse, Jean-Benoit; Bertone, Maria Paola; Alonso-Garbayo, Alvaro; Martins, João S; Salehi, Ahmad Shah; Pavignani, Enrico; Martineau, Tim

2015-05-15

Human resources for health are self-evidently critical to running a health service and system. There is, however, a wider set of social issues which is more rarely considered. One area which is hinted at in literature, particularly on fragile and conflict-affected states, but rarely examined in detail, is the contribution which health staff may or do play in relation to the wider state-building processes. This article aims to explore that relationship, developing a conceptual framework to understand what linkages might exist and looking for empirical evidence in the literature to support, refute or adapt those linkages. An open call for contributions to the article was launched through an online community. The group then developed a conceptual framework and explored a variety of literatures (political, economic, historical, public administration, conflict and health-related) to find theoretical and empirical evidence related to the linkages outlined in the framework. Three country case reports were also developed for Afghanistan, Burundi and Timor-Leste, using secondary sources and the knowledge of the group. We find that the empirical evidence for most of the linkages is not strong, which is not surprising, given the complexity of the relationships. Nevertheless, some of the posited relationships are plausible, especially between development of health cadres and a strengthened public administration, which in the long run underlies a number of state-building features. The reintegration of factional health staff post-conflict is also plausibly linked to reconciliation and peace-building. The role of medical staff as part of national elites may also be important. The concept of state-building itself is highly contested, with a rich vein of scepticism about the wisdom or feasibility of this as an external project. While recognizing the inherently political nature of these processes, systems and sub-systems, it remains the case that state-building does occur over time

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.

Health: A Developing Concept in Nursing.

PubMed

Alslman, Eman Tariq; Ahmad, Muayyad M; Bani Hani, Manar Ali; Atiyeh, Huda Mohammad

2017-04-01

The purpose of this paper is to evaluate the level of maturity of the concept of health in the nursing discipline. The four principles of Morse and colleagues were used to evaluate the level of maturity of the health concept-epistemological, logical, pragmatical, and linguistical. This evaluation suggests that the concept of health in nursing is immature, defined inconsistently, and with different instruments. Health is a central concept for nursing. Additional concept development and clarification are needed. For the concept of health to be conceptualized, it is important that nurses have consensus regarding the definition of health. The nursing discipline should define health in a manner that is consistent with its philosophical presuppositions. Further, it should be measurable, empirically based, and capture the outcomes that are sensitive to the nursing interventions. © 2015 NANDA International, Inc.

[Private foundations Global Health Philanthropy: the problem of conflicts of interest].

PubMed

2011-01-01

Private foundations Global Health Philanthropy: the problem of conflicts of interest. Private foundations are in a position where they are granted several privileges and are very powerful and able to influence global health. A recent article published on Plos Medicine, analyzing five of the largest health foundations highlights the network of interests and conflicts. Many private health foundations have associations with private food and pharmaceutical corporations. In some instances, these corporations directly benefit from foundations grants, and foundations in turn are invested in the corporations to which they award these grants.

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

PubMed

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.

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

The concept of collaborative health.

PubMed

Sandberg, Håkan

2010-11-01

Based on empirical research about teamwork in human service organizations in Sweden, the concept of collaborative health (CH) encapsulates the physical, psychological and social health resources the individual uses in teamwork; resources which at the same time are influenced by the teamwork. My argument built on empirical research leading up to identifying and defining the core concept in this article, is that teamwork affects team members' health and this in turn affects the teamwork and its outcome. In this paper collaborative health is viewed from a social constructionism perspective and discussed in relation to earlier concepts developed in social psychology and working life research, including psychosocial stress and burnout. The paper also introduces the concept of functional synergy, which in this context is defined as the simultaneous presence of sharp goal-orientation and synergy in teamwork. The need for a holistic team theory is emphasized as a tool in research on teamwork. Such a theory relies on identifying sound and illuminating constituent concepts. I suggest that collaborative health could be a useful concept for better understanding the complex collaborative and co-operative teamwork of human service organizations of today.

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.

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.

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.

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

PubMed

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

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. 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). 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. 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. 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.

Conflict and Conflict Resolution: Theory and Practice and the Army in the 21st Century

DTIC Science & Technology

2007-05-21

terms of the field are: conflict settlement, conflict management , and conflict resolution. Miall, Ramsbotham, and Woodhouse describe conflict...settlement and conflict management . These are useful terms because they describe situations where the endstate may be more in line with what the...doctrine concerning the concepts of theory and conflict and the addition ofa manual for conflict resolution. 16. SUBJECT TERMS Conflict, Conflict

Anxiety, Decision Conflict, and Health in Caregivers of Children with ADHD: A Survey.

PubMed

Chen, Jih Yuan; Clark, Mary Jo; Chang, Yong Yuan; Liu, Yea Ying

2015-01-01

The purpose of this study was to test a theoretical model to determine the effect of caregiver anxiety and decision conflict on the health of caregivers of children with ADHD. Cross-sectional analyses were conducted on data derived from caregivers (aged 24-70). Participants completed the Decision Conflict Scale, the Zung Anxiety Scale, the Duke Health Profile, and a demographic form. A path model that fit well indicated that anxiety and decision conflict had direct and indirect effects on the caregivers' health. Future study is needed to clarify factors contributing to uncertainty and to decrease emotional symptoms for caregivers, thus promoting their mental health. Copyright © 2015 Elsevier Inc. All rights reserved.

Social support, social conflict, and immigrant women's mental health in a Canadian context: a scoping review.

PubMed

Guruge, S; Thomson, M S; George, U; Chaze, F

2015-11-01

Social support has positive and negative dimensions, each of which has been associated with mental health outcomes. Social networks can also serve as sources of distress and conflict. This paper reviews journal articles published during the last 24 years to provide a consolidated summary of the role of social support and social conflict on immigrant women's mental health. The review reveals that social support can help immigrant women adjust to the new country, prevent depression and psychological distress, and access care and services. When social support is lacking or social networks act as a source of conflict, it can have negative effects on immigrant women's mental health. It is crucial that interventions, programmes, and services incorporate strategies to both enhance social support as well as reduce social conflict, in order to improve mental health and well-being of immigrant women. Researchers have documented the protective role of social support and the harmful consequences of social conflict on physical and mental health. However, consolidated information about social support, social conflict, and mental health of immigrant women in Canada is not available. This scoping review examined literature from the last 24 years to understand how social support and social conflict affect the mental health of immigrant women in Canada. We searched MEDLINE, PsycINFO, CINAHL, Healthstar, and EMBASE for peer-reviewed publications focusing on mental health among immigrant women in Canada. Thirty-four articles that met our inclusion criteria were reviewed, and are summarized under the following four headings: settlement challenges and the need for social support; social support and mental health outcomes; social conflict and reciprocity; and social support, social conflict, and mental health service use. The results revealed that social support can have a positive effect on immigrant women's mental health and well-being, and facilitate social inclusion and the use of

Bioethical conflicts between Muslim patients and German physicians and the principles of biomedical ethics.

PubMed

Ilkilic, Ilhan

2002-01-01

In the age of globalisation, more and more people who are members of different religions and cultures live in the same society. This situation tends to create many conflicts in different areas of life and not least in the health care system, a fact which raises a number of bioethical issues. The cultural and religious differences between patient and physician can be a cause of bioethical conflicts and therefore represent a challenge for biomedical ethics. The confrontation between Turkish Muslin patients and the German health care system is a convenient example of this situation. The Muslim Turks came to Germany 40 years ago as industrial workers. Their value system had been shaped by traditional and Islamic parameters in Turkey. With this value system, they now found themselves in the German modern health care system. In many fields of modern medicine there are areas of potential conflict of values, where a Muslin patient will argue differently from a secular or Christian person. In an ethical conflict between two individuals who are members of different cultures, it is necessary to make sure that the ethical concept which is to be used for resolving the problem is relevant. In this particular case, both the Islamic legal responses (fatwa) and the classical theories of biomedical ethics are often insufficient. This paper tries to give a brief outline of these bioethical conflicts and discuss these conflicts with regard to the principle of respect for autonomy in the concept of "principilism," as introduced by T.L. Beauchamp and J.F. Childress. The central question is whether this bioethical concept is able to analyse and to help solve the kinds of ethical conflicts which involve transcultural dimensions. This question is discussed with some consideration of the ongoing debate about universalism versus relativism in biomedical ethics.

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

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

PubMed

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

2014-04-23

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

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. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

Health Seeking in Men: A Concept Analysis.

PubMed

Hooper, Gwendolyn L; Quallich, Susanne A

2016-01-01

This article describes the analysis of the concept of health seeking in men. Men have shorter life expectancies and utilize health services less often than women, leading to poor health outcomes, but a gendered basis for health seeking remains poorly defined. Walker and Avant’s framework was used to guide this concept analysis. Literature published in English from 1990-2015 was reviewed. Thematic analysis identified attributes, antecedents, and consequences of the concept. Based on the analysis, a contemporary definition for health seeking in men was constructed, rooted in the concept of health. The definition is based on the concept analysis and the defining attributes that were identified. This analysis provides a definition specifically for health seeking in American men, making it more specific and gender-based than the parent concept of “health.” This concept analysis provides conceptual clarity that can guide development of a conceptual framework that may be uniquely relevant to providers in urology. Further exploration will uncover specific cultural, social, sexual, and geographic perspectives.

Leaving no one behind: lessons on rebuilding health systems in conflict- and crisis-affected states.

PubMed

Martineau, Tim; McPake, Barbara; Theobald, Sally; Raven, Joanna; Ensor, Tim; Fustukian, Suzanne; Ssengooba, Freddie; Chirwa, Yotamu; Vong, Sreytouch; Wurie, Haja; Hooton, Nick; Witter, Sophie

2017-01-01

Conflict and fragility are increasing in many areas of the world. This context has been referred to as the 'new normal' and affects a billion people. Fragile and conflict-affected states have the worst health indicators and the weakest health systems. This presents a major challenge to achieving universal health coverage. The evidence base for strengthening health systems in these contexts is very weak and hampered by limited research capacity, challenges relating to insecurity and apparent low prioritisation of this area of research by funders. This article reports on findings from a multicountry consortium examining health systems rebuilding post conflict/crisis in Sierra Leone, Zimbabwe, northern Uganda and Cambodia. Across the ReBUILD consortium's interdisciplinary research programme, three cross-cutting themes have emerged through our analytic process: communities, human resources for health and institutions. Understanding the impact of conflict/crisis on the intersecting inequalities faced by households and communities is essential for developing responsive health policies. Health workers demonstrate resilience in conflict/crisis, yet need to be supported post conflict/crisis with appropriate policies related to deployment and incentives that ensure a fair balance across sectors and geographical distribution. Postconflict/crisis contexts are characterised by an influx of multiple players and efforts to support coordination and build strong responsive national and local institutions are critical. The ReBUILD evidence base is starting to fill important knowledge gaps, but further research is needed to support policy makers and practitioners to develop sustainable health systems, without which disadvantaged communities in postconflict and postcrisis contexts will be left behind in efforts to promote universal health coverage.

Health security as a public health concept: a critical analysis.

PubMed

Aldis, William

2008-11-01

There is growing acceptance of the concept of health security. However, there are various and incompatible definitions, incomplete elaboration of the concept of health security in public health operational terms, and insufficient reconciliation of the health security concept with community-based primary health care. More important, there are major differences in understanding and use of the concept in different settings. Policymakers in industrialized countries emphasize protection of their populations especially against external threats, for example terrorism and pandemics; while health workers and policymakers in developing countries and within the United Nations system understand the term in a broader public health context. Indeed, the concept is used inconsistently within the UN agencies themselves, for example the World Health Organization's restrictive use of the term 'global health security'. Divergent understandings of 'health security' by WHO's member states, coupled with fears of hidden national security agendas, are leading to a breakdown of mechanisms for global cooperation such as the International Health Regulations. Some developing countries are beginning to doubt that internationally shared health surveillance data is used in their best interests. Resolution of these incompatible understandings is a global priority.

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.

Occupational health: a classic example of class conflict.

PubMed

Kerr, L E

1990-01-01

The history of class conflict in occupational health in the United States is illustrated by the current Pittston Company attack on coal miners' health benefits, the silicosis and asbestosis controversies, the corporate restrictions on state workers' compensation laws, and the unremitting management opposition to the federal Coal Mine Health and Safety Act of 1969 and the Occupational Health and Safety Act of 1970. A positive action program is presented as the basis for convening the long-overdue White House Conference on Occupational Health and Safety. Mining engineers are urged to support that action program to prevent unnecessary work-related death and disability.

Interpersonal conflicts at work as a predictor of self-reported health outcomes and occupational mobility.

PubMed

De Raeve, L; Jansen, N W H; van den Brandt, P A; Vasse, R; Kant, I J

2009-01-01

The aim of this prospective study was to examine the relationship between interpersonal conflicts at work and subsequent self-reported health outcomes (self-reported general health, need for recovery, and prolonged fatigue) and occupational mobility (internal mobility ie, changing job function, and external mobility ie, changing employers). Data from the Maastricht Cohort Study on fatigue at work (n = 5582 for co-worker conflict; n = 5530 for supervisor conflict) were used. Interpersonal conflict with either co-workers or supervisors was assessed between baseline and 1-year follow-up. Outcomes were studied every 4 months between 1-year and 2-year follow-up. Logistic regression analyses using generalised estimating equations were conducted for each of the dichotomous outcomes, while controlling for demographic factors, the presence of a long-term illness, other workplace stressors, coping, and outcome at baseline. Analyses were conducted for men only. At baseline, conflicts with co-workers occurred in 7.2% of the study population, while conflicts with supervisors occurred in 9.5% of the study population. In general, this study showed that co-worker conflict was a statistically significant risk factor for the onset of an elevated need for recovery, prolonged fatigue, poor general health and external occupational mobility. Supervisor conflict was a significant risk factor for the onset of an elevated need for recovery, prolonged fatigue, external occupational mobility, and internal occupational mobility. The results of this study indicate a possible causal relationship between interpersonal conflicts at work and self-reported health and occupational mobility. Given the considerable impact of interpersonal conflicts at work on the individual worker and on the organisation, and the fact that interpersonal conflicts at work are highly prevalent, these findings underline the need for interventions aimed at preventing the occurrence of interpersonal conflicts at work, or

Making sense of the global health crisis: policy narratives, conflict, and global health governance.

PubMed

Ney, Steven

2012-04-01

Health has become a policy issue of global concern. Worried that the unstructured, polycentric, and pluralist nature of global health governance is undermining the ability to serve emergent global public health interests, some commentators are calling for a more systematic institutional response to the "global health crisis." Yet global health is a complex and uncertain policy issue. This article uses narrative analysis to explore how actors deal with these complexities and how uncertainties affect global health governance. By comparing three narratives in terms of their basic assumptions, the way they define problems as well as the solutions they propose, the analysis shows how the unstructured pluralism of global health policy making creates a wide scope of policy conflict over the global health crisis. This wide scope of conflict enables effective policy-oriented learning about global health issues. The article also shows how exclusionary patterns of cooperation and competition are emerging in health policy making at the global level. These patterns threaten effective learning by risking both polarization of the policy debate and unanticipated consequences of health policy. Avoiding these pitfalls, the analysis suggests, means creating global health governance regimes that promote openness and responsiveness in deliberation about the global health crisis.

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…

Conflict and professionalism: perceptions among nurses in Saudi Arabia.

PubMed

Zakari, N M; Al Khamis, N I; Hamadi, H Y

2010-09-01

To examine the relationship between nurses' perceptions of conflict and professionalism. In Saudi Arabia, health-care sectors are constantly undergoing major changes because of social, consumer-related, governmental, technological and economic pressures. These changes will influence the nature of health-care organizations, such as hospitals' work environment. The ability of nurses to practise in a professional manner may be influenced by their work environment and conflict level. A cross-sectional design was conducted in this study. A simple random selection of three health-care sectors in Saudi Arabia was performed and 346 nurse managers, as well as bedside nurses participated to provide information about conflict levels and professionalism. The Perceived Conflict Scale was used to assess the level of conflict, and the Valiga Concept of Nursing Scale was used to assess the professionalism perception among nurses. The intragroup/other department type of conflict had a statistically significant correlation with the perception of professionalism. In addition, the findings point to a low perception among the participating nurses regarding their professionalism. A number of factors might explain the low level of perception of professionalism. These relate to the workplace itself, as well as to the personal background of the nurses, which includes the personal interest in the nursing profession, as well as the family's, society's and the consumers' views of the profession. Given the findings of this study, nurse managers are encouraged to create a work environment that supports professionalism and minimizes conflict.

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.

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

Work-family conflicts and self-rated health among middle-aged municipal employees in Finland.

PubMed

Winter, Torsten; Roos, Eva; Rahkonen, Ossi; Martikainen, Pekka; Lahelma, Eero

2006-01-01

Work-family conflicts are common, but their effects on health are not well known. The aim of this study was to examine the associations between work-family conflicts and self-rated health among middle-aged municipal employees. In addition, the effect of social background factors on the association between work-family conflicts and self-rated health were examined. The data were based on cross-sectional postal surveys, which were carried out in 2001 and 2002, among female and male employees of the city of Helsinki, Finland. The participants were aged 40-60, and the response rate for women was 69%, and for men 60%. In the final analysis, 3,443 women and 875 men were included. For men and woman alike, work-to-family and family-to-work conflicts were associated with poor self-rated health. The association remained after adjusting for sociodemographic and socioeconomic factors. This study shows that a better balance between family life and work outside the home would probably have a health promoting effect.

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

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

Adolescent self-concept and health into adulthood.

PubMed

Park, Jungwee

2003-01-01

This article examines factors associated with adolescent self-concept and the impact of adolescent self-concept on psychological and physical health and health behaviour in young adulthood. The data are from the household cross-sectional (1994/95) and longitudinal (1994/95 to 2000/01) components of Statistics Canada's National Population Health Survey. Scores on self-concept indicators in 1994/95 were compared between the sexes and age groups (12 to 15 versus 16 to 19). Multivariate analyses were used to examine cross-sectional and longitudinal associations between adolescent self-concept and depression, self-perceived health, physical activity and obesity, controlling for other possible confounders. Self-concept tends to be low among girls compared with boys. Cross-sectionally, adolescent self-concept was associated with household income and emotional support. For girls and for young adolescents, a weak self-concept in 1994/95 was related to the incidence of depression over the next six years; it was also predictive of physical inactivity among boys, and obesity among both sexes. A strong self-concept had a positive long-term effect on girls' self-perceived health.

[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.

Understanding critical health literacy: a concept analysis.

PubMed

Sykes, Susie; Wills, Jane; Rowlands, Gillian; Popple, Keith

2013-02-18

Interest in and debates around health literacy have grown over the last two decades and key to the discussions has been the distinction made between basic functional health literacy, communicative/interactive health literacy and critical health literacy. Of these, critical health literacy is the least well developed and differing interpretations of its constituents and relevance exist. The aim of this study is to rigorously analyse the concept of critical health literacy in order to offer some clarity of definition upon which appropriate theory, well grounded practice and potential measurement tools can be based. The study uses a theoretical and colloquial evolutionary concept analysis method to systematically identify the features associated with this concept. A unique characteristic of this method is that it practically combines an analysis of the literature with in depth interviews undertaken with practitioners and policy makers who have an interest in the field. The study also analyses how the concept is understood across the contexts of time, place, discipline and use by health professionals, policy makers and academics. Findings revealed a distinct set of characteristics of advanced personal skills, health knowledge, information skills, effective interaction between service providers and users, informed decision making and empowerment including political action as key features of critical health literacy. The potential consequences of critical health literacy identified are in improving health outcomes, creating more effective use of health services and reducing inequalities in health thus demonstrating the relevance of this concept to public health and health promotion. While critical health literacy is shown to be a unique concept, there remain significant contextual variations in understanding particularly between academics, practitioners and policy makers. Key attributes presented as part of this concept when it was first introduced in the literature

Understanding critical health literacy: a concept analysis

PubMed Central

2013-01-01

Background Interest in and debates around health literacy have grown over the last two decades and key to the discussions has been the distinction made between basic functional health literacy, communicative/interactive health literacy and critical health literacy. Of these, critical health literacy is the least well developed and differing interpretations of its constituents and relevance exist. The aim of this study is to rigorously analyse the concept of critical health literacy in order to offer some clarity of definition upon which appropriate theory, well grounded practice and potential measurement tools can be based. Method The study uses a theoretical and colloquial evolutionary concept analysis method to systematically identify the features associated with this concept. A unique characteristic of this method is that it practically combines an analysis of the literature with in depth interviews undertaken with practitioners and policy makers who have an interest in the field. The study also analyses how the concept is understood across the contexts of time, place, discipline and use by health professionals, policy makers and academics. Results Findings revealed a distinct set of characteristics of advanced personal skills, health knowledge, information skills, effective interaction between service providers and users, informed decision making and empowerment including political action as key features of critical health literacy. The potential consequences of critical health literacy identified are in improving health outcomes, creating more effective use of health services and reducing inequalities in health thus demonstrating the relevance of this concept to public health and health promotion. Conclusions While critical health literacy is shown to be a unique concept, there remain significant contextual variations in understanding particularly between academics, practitioners and policy makers. Key attributes presented as part of this concept when it was

An In-Law Comes To Stay: Examination of Interdisciplinary Conflict in a School-Based Health Center.

ERIC Educational Resources Information Center

Fast, Jonathan D.

2003-01-01

Social workers often work in settings where other professions exert a higher level of control. The organizational literature on causes of conflict and conflict resolution is briefly reviewed. A case study of a newly opened school-based health center provides an opportunity to analyze conflicts between the school and health center personnel and…

Annual Research Review: Resilience and Mental Health in Children and Adolescents Living in Areas of Armed Conflict--A Systematic Review of Findings in Low- and Middle-Income Countries

ERIC Educational Resources Information Center

Tol, Wietse A.; Song, Suzan; Jordans, Mark J. D.

2013-01-01

Background: Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions. Methods: We performed a systematic…

A qualitative study exploring the determinants of maternal health service uptake in post-conflict Burundi and Northern Uganda.

PubMed

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-02-05

Armed conflict has been described as an important contributor to the social determinants of health and a driver of health inequity, including maternal health. These conflicts may severely reduce access to maternal health services and, as a consequence, lead to poor maternal health outcomes for a period extending beyond the conflict itself. As such, understanding how maternal health-seeking behaviour and utilisation of maternal health services can be improved in post-conflict societies is of crucial importance. This study aims to explore the determinants (barriers and facilitators) of women's uptake of maternal, sexual and reproductive health services (MSRHS) in two post-conflict settings in sub-Saharan Africa; Burundi and Northern Uganda, and how uptake is affected by exposure to armed conflict. This is a qualitative study that utilised in-depth interviews and focus group discussions (FGDs) for data collection. One hundred and fifteen participants took part in the interviews and FGDs across the two study settings. Participants were women of reproductive age, local health providers and staff of non-governmental organizations. Issues explored included the factors affecting women's utilisation of a range of MSRHS vis-à-vis conflict exposure. The framework method, making use of both inductive and deductive approaches, was used for analyzing the data. A complex and inter-related set of factors affect women's utilisation of MSRHS in post-conflict settings. Exposure to armed conflict affects women's utilisation of these services mainly through impeding women's health seeking behaviour and community perception of health services. The factors identified cut across the individual, socio-cultural, and political and health system spheres, and the main determinants include women's fear of developing pregnancy-related complications, status of women empowerment and support at the household and community levels, removal of user-fees, proximity to the health facility, and attitude

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.

Conflict Structures in Family Networks of Older Adults and Their Relationship With Health-Related Quality of Life

PubMed Central

Widmer, Eric D.; Girardin, Myriam; Ludwig, Catherine

2017-01-01

This study explores the interrelationships between health-related quality of life and conflict structures in family networks of older adults. Data were derived from a sample of 2,858 elders (aged 65 years and older) from the Vivre/Leben/Vivere study, a large survey addressing family life and health conditions of older people in Switzerland. Conflict density in family networks and the betweenness centrality of respondents in family conflict are significantly associated with health-related quality of life measures. Furthermore, the results demonstrate that conflict–health associations are mediated by the level of perceived individual stress where psychological health is concerned. Family conflict structures depend to a large extent on family composition and age. This study stresses the importance of older adults actively shaping the composition of their family contexts in ways that promote both conflict and stress avoidance. PMID:29593370

Work-Family Conflict and Oral and General Health-Related Quality of Life.

PubMed

Singh, Kiran A; Spencer, A John; Roberts-Thomson, Kaye F; Brennan, David S

2015-08-01

The characteristics of the work environment and relationships with family roles may impact on health and be of public health significance. The aims were to investigate the cross-sectional association of work-family conflict with oral- and general health-related quality of life, and well-being. A random sample of 45-54-year olds from Adelaide, South Australia, was surveyed by self-complete questionnaire in 2004-2005 (n = 879, response rate = 43.8%). Health-related quality of life was measured with the OHIP-14 and EQ-VAS instruments, and well-being by the Satisfaction With Life Scale. In adjusted analyses controlling for sex, income, education, tooth brushing frequency and social support, the higher Family Interferes with Work (FIW) tertile and the middle tertile of Work Interferes with Family (WIF) were associated with more oral health-related impacts as measured by OHIP-14 in relation to problems with teeth, mouth or dentures (Beta = 1.64, P < 0.05 and Beta = 2.85, P < 0.01). Both middle and higher tertiles of WIF were associated with lower general health (Beta = -4.20 and -5.71, P < 0.01) and well-being (Beta = -1.17 and -1.56, P < 0.01). Work-family conflict was associated with more oral health impacts and lower general health and well-being among employed middle-aged adults. This supports the view of work-family conflict as a psychosocial risk factor for health outcomes spanning function, health perceptions and well-being, and encompassing both oral health and general health.

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.

Working hours, work-life conflict and health in precarious and "permanent" employment.

PubMed

Bohle, Philip; Quinlan, Michael; Kennedy, David; Williamson, Ann

2004-12-01

The expansion of precarious employment in OECD countries has been widely associated with negative health and safety effects. Although many shiftworkers are precariously employed, shiftwork research has concentrated on full-time workers in continuing employment. This paper examines the impact of precarious employment on working hours, work-life conflict and health by comparing casual employees to full-time, "permanent" employees working in the same occupations and workplaces. Thirty-nine convergent interviews were conducted in two five-star hotels. The participants included 26 full-time and 13 casual (temporary) employees. They ranged in age from 19 to 61 years and included 17 females and 22 males. Working hours ranged from zero to 73 hours per week. Marked differences emerged between the reports of casual and full-time employees about working hours, work-life conflict and health. Casuals were more likely to work highly irregular hours over which they had little control. Their daily and weekly working hours ranged from very long to very short according to organisational requirements. Long working hours, combined with low predictability and control, produced greater disruption to family and social lives and poorer work-life balance for casuals. Uncoordinated hours across multiple jobs exacerbated these problems in some cases. Health-related issues reported to arise from work-life conflict included sleep disturbance, fatigue and disrupted exercise and dietary regimes. This study identified significant disadvantages of casual employment. In the same hotels, and doing largely the same jobs, casual employees had less desirable and predictable work schedules, greater work-life conflict and more associated health complaints than "permanent" workers.

Constructive Management of Conflict in Groups.

ERIC Educational Resources Information Center

Mitchell, Rex C.; Mitchell, Rie R.

1984-01-01

Provides a concise overview of important conflict management concepts and strategies for those working in group settings. Presents a brief conceptual basis for understanding conflict and group memebers' behavior when in conflict, followed by specific recommendations for managing and making use of conflict in groups. (JAC)

Review of attacks on health care facilities in six conflicts of the past three decades.

PubMed

Briody, Carolyn; Rubenstein, Leonard; Roberts, Les; Penney, Eamon; Keenan, William; Horbar, Jeffrey

2018-01-01

In the ongoing conflicts of Syria and Yemen, there have been widespread reports of attacks on health care facilities and personnel. Tabulated evidence does suggest hospital bombings in Syria and Yemen are far higher than reported in other conflicts but it is unclear if this is a reporting artefact. This article examines attacks on health care facilities in conflicts in six middle- to high- income countries that have occurred over the past three decades to try and determine if attacks have become more common, and to assess the different methods used to collect data on attacks. The six conflicts reviewed are Yemen (2015-Present), Syria (2011- Present), Iraq (2003-2011), Chechnya (1999-2000), Kosovo (1998-1999), and Bosnia and Herzegovina (1992-1995). We attempted to get the highest quality source(s) with summary data of the number of facilities attacked for each of the conflicts. The only conflict that did not have summary data was the conflict in Iraq. In this case, we tallied individual reported events of attacks on health care. Physicians for Human Rights (PHR) reported attacks on 315 facilities (4.38 per month) in Syria over a 7-year period, while the Monitoring Violence against Health Care (MVH) tool launched later by the World Health Organization (WHO) Turkey Health Cluster reported attacks on 135 facilities (9.64 per month) over a 14-month period. Yemen had a reported 93 attacks (4.65 per month), Iraq 12 (0.12 per month), Chechnya > 24 (2.4 per month), Kosovo > 100 (6.67 per month), and Bosnia 21 (0.41 per month). Methodologies to collect data, and definitions of both facilities and attacks varied widely across sources. The number of reported facilities attacked is by far the greatest in Syria, suggesting that this phenomenon has increased compared to earlier conflicts. However, data on attacks of facilities was incomplete for all of the conflicts examined, methodologies varied widely, and in some cases, attacks were not defined at all. A global

Darfur refugees in Cairo: mental health and interpersonal conflict in the aftermath of genocide.

PubMed

Meffert, Susan M; Marmar, Charles R

2009-11-01

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 interviews to identify gaps in mental health care and develop understandings of emotional and relationship problems. The refugee mental health care system has a piecemeal structure with gaps in outpatient services. There is moderate to severe emotional distress among many Darfur refugees, including symptoms of depression and trauma, and interpersonal conflict, both domestic violence and broader community conflict, elevated relative to pregenocide levels. Given the established relationships between symptoms of depression/traumatic stress and interpersonal violence, improving mental health is important for both preventing mental health decompensation and stemming future cycles of intra- and intergroup conflict.

Physicians in health care management: 10. Managing conflict through negotiation.

PubMed Central

Lemieux-Charles, L

1994-01-01

The recent focus on collaborative relationships in health care means that people and groups must cooperate to accomplish clinical and management tasks. This increasing interdependence may also cause increased organizational conflict. The management of conflicts is critical to the effectiveness of an organization. Negotiating strategies, based on Fisher and Ury's method of "principled negotiation," include establishing superordinate goals, separating the people from the problem, focussing on interests, inventing options, using objective criteria and defining success in terms of gains. PMID:7922944

[Mental Health: Concepts, Measures, Determinants].

PubMed

Doré, Isabelle; Caron, Jean

Objectives This article aims to situate the concept of mental health in a historical perspective. This article presents the most commonly used measurement tools in Canada and elsewhere in the world to assess specific and multiple dimensions of mental health; when available, psychometric properties are discussed. Finally, research findings on quality of life and mental health determinants are presented.Methods A literature review of concepts, measurement and determinants of mental health is presented in this paper. The selection of measurement scales presented is based on the findings of the research reports conducted by the second author, an expert on mental health measures, for Health Canada and Statistics Canada.Results Mental health is more than the absence of mental illness; rather it is a state of complete well-being, which refers to our ability to enjoy life and deal with the challenges we face. Accordingly, mental health and mental illness are not extremes of the same continuum, but distinct yet correlated concepts. The traditional conceptualization suggesting that mental health represents simply the absence of mental illness has been replaced, in the last few decades, by a more holistic characterization, which directly concerns public health. The components of mental health include emotional well-being/quality of life (QOL) and psychological and social well-being. Mental health influences the personal and social functioning of individuals, justifying the importance of intervening upstream to promote mental health. Specific scales are relevant for obtaining a detailed measure of one aspect of well-being in particular (emotional/quality of life, psychological or social well-being); however, to account for the global mental health status, measurement tools that integrate all three forms of well-being (emotional, psychological and social) should be privileged. A diversity of determinants at the individual, social and neighbourhood levels influence quality of

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.

[Cooperation and conflict in childbirth care: representations and practices of nurses and obstetricians].

PubMed

Angulo-Tuesta, Antonia; Giffin, Karen; Gama, Andréa de Sousa; d'Orsi, Eleonora; Barbosa, Gisele Peixoto

2003-01-01

In Brazil, where birthing generally occurs in hospitals and under the care of obstetricians, the incorporation of nurses is a strategy that has been used recently in an attempt to improve obstetric care. This study, conducted in two maternity hospitals in Rio de Janeiro, focuses on representations of obstetricians and nurses regarding teamwork and analyzes how the dimensions of power, cooperation/conflict, and technical autonomy are permeated by dualistic conceptions which influence the quality of health care for women during childbirth. On the one hand, the results show a consensus regarding the advantages of professional cooperation in the improvement of health care, assuming the existence of a clear definition of professional roles. At the same time, conflicts regarding therapeutic conduct during the birth process reflect the professionals' perceptions of autonomy and the influence of professional hierarchies, in which obstetric care is seen to depend on the "objective observation" of the women giving birth. The degree of conflict is differentiated according to the institutional context and related to dualistic conceptions such as objective/subjective, rational/emotional, and male/female.

Exploring the influence of the Global Fund and the GAVI Alliance on health systems in conflict-affected countries.

PubMed

Patel, Preeti; Cummings, Rachael; Roberts, Bayard

2015-01-01

Global Health Initiatives (GHIs) respond to high-impact communicable diseases in resource-poor countries, including health systems support, and are major actors in global health. GHIs could play an important role in countries affected by armed conflict given these countries commonly have weak health systems and a high burden of communicable disease. The aim of this study is to explore the influence of two leading GHIs, the Global Fund and the GAVI Alliance, on the health systems of conflict-affected countries. This study used an analytical review approach to identify evidence on the role of the Global Fund and the GAVI Alliance with regards to health systems support to 19 conflict-affected countries. Primary and secondary published and grey literature were used, including country evaluations from the Global Fund and the GAVI Alliance. The WHO heath systems building blocks framework was used for the analysis. There is a limited evidence-base on the influence of GHIs on health systems of conflict-affected countries. The findings suggest that GHIs are increasingly investing in conflict-affected countries which has helped to rapidly scale up health services, strengthen human resources, improve procurement, and develop guidelines and protocols. Negative influences include distorting priorities within the health system, inequitable financing of disease-specific services over other health services, diverting staff away from more essential health care services, inadequate attention to capacity building, burdensome reporting requirements, and limited flexibility and responsiveness to the contextual challenges of conflict-affected countries. There is some evidence of increasing engagement of the Global Fund and the GAVI Alliance with health systems in conflict-affected countries, but this engagement should be supported by more context-specific policies and approaches.

Health Education in Practice: Employee Conflict Resolution Knowledge and Conflict Handling Strategies

ERIC Educational Resources Information Center

Hackett, Alexis; Renschler, Lauren; Kramer, Alaina

2014-01-01

The purpose of this project was to determine if a brief workplace conflict resolution workshop improved employee conflict resolution knowledge and to examine which conflict handling strategies (Yielding, Compromising, Forcing, Problem-Solving, Avoiding) were most used by employees when dealing with workplace conflict. A pre-test/post-test control…

Evidence Regarding the Impact of Conflicts of Interest on Environmental and Occupational Health Research.

PubMed

Wells, Ellen M

2017-06-01

This review describes published literature providing evidence for financial conflicts of interest in environmental and occupational health research. Secondary goals were to describe evidence that (a) utilized quantitative methods to evaluate the association of conflicts with study outcomes, and (b) assessed undisclosed as well as disclosed conflicts of interest. Forty-three studies were identified which contained descriptions of the impact of financial conflicts of interest on research results; 11 of these conducted quantitative analyses to demonstrate these relationships. All 11 articles which quantified associations identified significant associations of the presence of financial conflicts of interest with study findings. In studies which measured undisclosed conflicts, these comprised a substantial proportion of all conflicts. Suggestions for improving understanding and interpretation of research results are presented.

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

PubMed

Johnson, Sandy A

2017-01-01

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. 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. 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. 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.

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

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.

Relations of Parenting Quality, Interparental Conflict, and Overnights with Mental Health Problems of Children in Divorcing Families with High Legal Conflict

PubMed Central

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

2013-01-01

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 come 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 both parenting by the other parent and number of overnights were considered 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. PMID:24098960

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

PubMed

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

2017-01-01

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.

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

The mental health of children affected by armed conflict: Protective processes and pathways to resilience

PubMed Central

Betancourt, Theresa Stichick; Khan, Kashif Tanveer

2008-01-01

This paper examines the concept of resilience in the context of children affected by armed conflict. Resilience has been frequently viewed as a unique quality of certain ‘invulnerable’ children. In contrast, this paper argues that a number of protective processes contribute to resilient mental health outcomes in children when considered through the lens of the child's social ecology. While available research has made important contributions to understanding risk factors for negative mental health consequences of war-related violence and loss, the focus on trauma alone has resulted in inadequate attention to factors associated with resilient mental health outcomes. This paper presents key studies in the literature that address the interplay between risk and protective processes in the mental health of war-affected children from an ecological, developmental perspective. It suggests that further research on war-affected children should pay particular attention to coping and meaning making at the individual level; the role of attachment relationships, caregiver health, resources and connection in the family, and social support available in peer and extended social networks. Cultural and community influences such as attitudes towards mental health and healing as well as the meaning given to the experience of war itself are also important aspects of the larger social ecology. PMID:18569183

The mental health of children affected by armed conflict: protective processes and pathways to resilience.

PubMed

Betancourt, Theresa Stichick; Khan, Kashif Tanveer

2008-06-01

This paper examines the concept of resilience in the context of children affected by armed conflict. Resilience has been frequently viewed as a unique quality of certain 'invulnerable' children. In contrast, this paper argues that a number of protective processes contribute to resilient mental health outcomes in children when considered through the lens of the child's social ecology. While available research has made important contributions to understanding risk factors for negative mental health consequences of war-related violence and loss, the focus on trauma alone has resulted in inadequate attention to factors associated with resilient mental health outcomes. This paper presents key studies in the literature that address the interplay between risk and protective processes in the mental health of war-affected children from an ecological, developmental perspective. It suggests that further research on war-affected children should pay particular attention to coping and meaning making at the individual level; the role of attachment relationships, caregiver health, resources and connection in the family, and social support available in peer and extended social networks. Cultural and community influences such as attitudes towards mental health and healing as well as the meaning given to the experience of war itself are also important aspects of the larger social ecology.

Social networks and mental health in post-conflict Mitrovica, Kosova.

PubMed

Nakayama, Risa; Koyanagi, Ai; Stickley, Andrew; Kondo, Tetsuo; Gilmour, Stuart; Arenliu, Aliriza; Shibuya, Kenji

2014-11-17

To investigate the relation between social networks and mental health in the post-conflict municipality of Mitrovica, Kosovo. Using a three-stage stratified sampling method, 1239 respondents aged 16 years or above were recruited in the Greater Mitrovica region. Social network depth was measured by the frequency of contacts with friends, relatives and strangers. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression was used to examine the association between social network depth and mental health. The analytical sample consisted of 993 respondents. The prevalence of depression (54.3%) and anxiety (64.4%) were extremely high. In multiple regression analysis, a lower depth of social network (contact with friends) was associated with higher levels of both depression and anxiety. This study has shown that only one variety of social network--contact with friends--was important in terms of mental health outcomes in a population living in an area heavily affected by conflict. This suggests that the relation between social networks and mental health may be complex in that the effects of different forms of social network on mental health are not uniform and may depend on the way social networks are operationalised and the particular context in which the relationship is examined.

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.

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).

Conflict management, Part 1. Conflict management checklist: a diagnostic tool for assessing conflict in organizations.

PubMed

Siders, C T; Aschenbrener, C A

1999-01-01

Complex interpersonal conflicts are inevitable in the high speed, high stakes, pressured work of health care. Poorly managed, conflict saps productivity, erodes trust, and spawns additional disputes. Well managed, conflict can enhance the self-confidence and self-esteem of the parties, build relationships, and engender creative solutions beyond expectations. Just as thoughtful differential diagnosis precedes optimum treatment in the doctor-patient relationship, management of conflict is greatly enhanced when preceded by careful assessment. In the first of two articles, the authors present a diagnostic approach, the Conflict Management Checklist, to increase self-awareness and decrease anxiety around conflict.

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.

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. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Health system functionality in a low-income country in the midst of conflict: the case of Yemen.

PubMed

Qirbi, Naseeb; Ismail, Sharif A

2017-07-01

 Although the literature on effects of armed conflict on population health is extensive, detailed assessments of effects on public health 'systems' are few. This article aims to help address this deficit through the medium of a case study on Yemen, describing health system and health outcome performance prior to the internationalisation of the conflict there in March 2015, before assessing the impact of war on health system functionality since that time. Review of peer- and non-peer reviewed literature from 2005 to 2016 from academic sources, multilateral organizations, donors and governmental and non-governmental organizations, augmented by secondary data analysis. Despite significant health system weaknesses and structural vulnerabilities pre-conflict, there were important improvements in selected health outcome measures in Yemen up to early 2015 (life expectancy, and infant and maternal mortality, e.g.), partly driven by a fragile health sector that was heavily reliant on out-of-pocket expenditure, and hampered by weak service penetration especially in rural areas. High intensity conflict has resulted in rising mortality and injury rates since March 2015, the first decline in life expectancy and increase in child and maternal mortality in Yemen for some years, and worsening levels of malnutrition. Service delivery has become increasingly challenging in the context of a funding crisis, destruction of health facilities, widespread shortages of essential medicines and equipment across the country, and governance fragmentation. Conflict in Yemen has resulted in humanitarian disaster on a wide scale in a short period of time, and crippled an already weak health system. Important areas of uncertainty remain, however, including the scale of health worker flight, and the extent to which alternative providers have stepped in to fill widening service gaps as the conflict has unfolded. Planning for longer-term health system reconstruction should begin as soon as possible

Health hybrid concept analysis in old people.

PubMed

Asadi Noughabi, Ahmadali; Alhani, Fatemeh; Piravi, Hamid

2013-10-31

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. 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. 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. 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.

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

Work-family conflict and self-rated health among dwellers in Minia, Egypt: Financial strain vs social support.

PubMed

Eshak, E S; Kamal, N N; Seedhom, A E; Kamal, N N

2018-04-01

Egypt's economic reform is accompanied by both financial and social strains. Due to lack of evidence, we examined the associations between work-family conflict in its 2 directions, work-to-family conflicts (WFCs), and family-to-work conflicts (FWCs) and self-rated health in Minia, Egypt, and whether the association will vary by being financially responsible for others and by the level of perceived social support. A cross-sectional study that included 1021 healthy participants aged 18-60 years from Minia district. Data on participants' work-family conflict, social, and demographic data and individual self-rated health were collected by a questionnaire survey. Multivariable logistic regression analyses were used to calculate the odds ratios (ORs) with its 95% confidence intervals (CIs) for poor self-rated health according to categories of work-family conflict. There were significant positive associations between the poor self-rated health and both high WFC and FWC. Compared with participants with low WFC and low FWC, participants with high WFC low FWC, low WFC high FWC, and high WFC high FWC had multivariable-adjusted ORs (95% CIs) for poor self-rated health of 6.93 (3.02-13.13), 2.09 (1.06-4.12), and 10.05 (4.98-20.27), respectively. Giving financial support to others but not the level of perceived social support from others was an effect modifier of the association. Work-family conflict was positively associated with the self-report of poor health, especially in those who were financially responsible for other family members. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Disentangling cognition and emotion in older adults: the role of cognitive control and mental health in emotional conflict adaptation.

PubMed

Hantke, Nathan C; Gyurak, Anett; Van Moorleghem, Katie; Waring, Jill D; Adamson, Maheen M; O'Hara, Ruth; Beaudreau, Sherry A

2017-08-01

Recent research suggests cognition has a bidirectional relationship with emotional processing in older adults, yet the relationship is still poorly understood. We aimed to examine a potential relationship between late-life cognitive function, mental health symptoms, and emotional conflict adaptation. We hypothesized that worse cognitive control abilities would be associated with poorer emotional conflict adaptation. We further hypothesized that a higher severity of mental health symptoms would be associated with poorer emotional conflict adaptation. Participants included 83 cognitively normal community-dwelling older adults who completed a targeted mental health and cognitive battery, and emotion and gender conflict-adaptation tasks. Consistent with our hypothesis, poorer performance on components of cognitive control, specifically attention and working memory, was associated with poorer emotional conflict adaptation. This association with attention and working memory was not observed in the non-affective-based gender conflict adaptation task. Mental health symptoms did not predict emotional conflict adaptation, nor did performance on other cognitive measures. Our findings suggest that emotion conflict adaptation is disrupted in older individuals who have poorer attention and working memory. Components of cognitive control may therefore be an important potential source of inter-individual differences in late-life emotion regulation and cognitive affective deficits. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

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.

The Effect of Armed Conflict on the Utilization of Maternal Health Services in Uganda: A Population-based Study.

PubMed

Namasivayam, Amrita; Arcos González, Pedro; Castro Delgado, Rafael; Chi, Primus Che

2017-10-03

Maternal mortality rates can be adversely affected by armed conflict, implying a greater level of vulnerability among women, and is often linked to the lack of or limited access to maternal healthcare during conflict. Previous research in Uganda has shown that armed conflict negatively impacts women's utilization of maternal healthcare services for a multitude of reasons at the individual, health-system and political levels. This study compared aggregated Demographic and Health Surveys data from 13 districts in Northern Uganda, a conflict-affected region, with data from the rest of the country, for the use of maternal healthcare services for the years 1988, 1995, 2000, 2006 and 2011, using statistical analyses and logistic regression. Specific indicators for maternal healthcare utilization included contraceptive use, antenatal care, skilled assistance at birth and institutional delivery. Use of contraception and institutional deliveries among women in Northern Uganda was significantly lower compared to the rest of the country. However, skilled assistance at birth among women in Northern Uganda was significantly higher. The findings in this study show that armed conflict can have a negative impact on aspects of maternal healthcare such as contraceptive use and institutional deliveries; however, other indicators such as skilled assistance at birth were seen to be better among conflict-affected populations. This reiterates the complex nature of armed conflict and the interplay of different factors such as conflict intensity, existing health systems and services, and humanitarian interventions that could influence maternal healthcare utilization. Armed conflict, maternal health utilization, Northern Uganda, contraception, skilled assistance at birth, antenatal care, institutional delivery.

Shared decision-making in the paediatric field: a literature review and concept analysis.

PubMed

Park, Eun Sook; Cho, In Young

2017-09-13

The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field. The attributes included active participation of the three: parents, children and health professionals; collaborative partnership; reaching a compromise; and common goal for child's health. Antecedents were existing several options with different possible outcomes; substantial decisional conflict; recognising child's health situations that decision-making is needed; and willingness to participate in decision-making. Finally, the consequences included decreased decisional conflict; mutual empowerment; improved child health status; and improved quality of paediatric health care. This study provides a theoretical understanding of the concept of shared decision-making in the paediatric field; furthermore, by integrating this concept into paediatric practice, it may help to reduce the gap between theory and practice. The analysis could also provide nursing researchers with insight into paediatric decision-making and establish a foundation to develop future interventions and situation-specific theory for promoting high-quality decision-making in the paediatric field. © 2017 Nordic College of Caring Science.

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. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

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

PubMed

MacEachren, Alan M; Stryker, Michael S; Turton, Ian J; Pezanowski, Scott

2010-05-18

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. 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. 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 geographic factors in public

Health Education a Conceptual Approach. Growing and Developing, Interacting, Decision Making. Concept 7: Personal Health Practices Are Affected by a Complexity of Forces, Often Conflicting. Teacher-Student Resources.

ERIC Educational Resources Information Center

Creswell, William H., Jr.; And Others

The following resource guide is one in a series which presents extensive bibliographic material oriented around a specific concept, in this guide, forces affecting personal health practices. A section is devoted to selected materials related to the concept; grade levels for which each resource might be useful are indicated beside each citation. A…

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. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Work–Family Conflict and Mental Health Among Female Employees: A Sequential Mediation Model via Negative Affect and Perceived Stress

PubMed Central

Zhou, Shiyi; Da, Shu; Guo, Heng; Zhang, Xichao

2018-01-01

After the implementation of the universal two-child policy in 2016, more and more working women have found themselves caught in the dilemma of whether to raise a baby or be promoted, which exacerbates work–family conflicts among Chinese women. Few studies have examined the mediating effect of negative affect. The present study combined the conservation of resources model and affective events theory to examine the sequential mediating effect of negative affect and perceived stress in the relationship between work–family conflict and mental health. A valid sample of 351 full-time Chinese female employees was recruited in this study, and participants voluntarily answered online questionnaires. Pearson correlation analysis, structural equation modeling, and multiple mediation analysis were used to examine the relationships between work–family conflict, negative affect, perceived stress, and mental health in full-time female employees. We found that women’s perceptions of both work-to-family conflict and family-to-work conflict were significant negatively related to mental health. Additionally, the results showed that negative affect and perceived stress were negatively correlated with mental health. The 95% confidence intervals indicated the sequential mediating effect of negative affect and stress in the relationship between work–family conflict and mental health was significant, which supported the hypothesized sequential mediation model. The findings suggest that work–family conflicts affected the level of self-reported mental health, and this relationship functioned through the two sequential mediators of negative affect and perceived stress. PMID:29719522

Work-Family Conflict and Mental Health Among Female Employees: A Sequential Mediation Model via Negative Affect and Perceived Stress.

PubMed

Zhou, Shiyi; Da, Shu; Guo, Heng; Zhang, Xichao

2018-01-01

After the implementation of the universal two-child policy in 2016, more and more working women have found themselves caught in the dilemma of whether to raise a baby or be promoted, which exacerbates work-family conflicts among Chinese women. Few studies have examined the mediating effect of negative affect. The present study combined the conservation of resources model and affective events theory to examine the sequential mediating effect of negative affect and perceived stress in the relationship between work-family conflict and mental health. A valid sample of 351 full-time Chinese female employees was recruited in this study, and participants voluntarily answered online questionnaires. Pearson correlation analysis, structural equation modeling, and multiple mediation analysis were used to examine the relationships between work-family conflict, negative affect, perceived stress, and mental health in full-time female employees. We found that women's perceptions of both work-to-family conflict and family-to-work conflict were significant negatively related to mental health. Additionally, the results showed that negative affect and perceived stress were negatively correlated with mental health. The 95% confidence intervals indicated the sequential mediating effect of negative affect and stress in the relationship between work-family conflict and mental health was significant, which supported the hypothesized sequential mediation model. The findings suggest that work-family conflicts affected the level of self-reported mental health, and this relationship functioned through the two sequential mediators of negative affect and perceived stress.

First do no harm: the impact of recent armed conflict on maternal and child health in Sub-Saharan Africa

PubMed Central

O'Hare, Bernadette A M; Southall, David P

2007-01-01

Objectives To compare the rates of under-5 mortality, malnutrition, maternal mortality and other factors which influence health in countries with and without recent conflict. To compare central government expenditure on defence, education and health in countries with and without recent conflict. To summarize the amount spent on SALW and the main legal suppliers to countries in Sub-Saharan African countries (SSA), and to summarize licensed production of Small Arms and Light Weapons (SALW) in these countries. Design We compared the under-5 mortality rate in 2004 and the adjusted maternal mortality ratio in SSA which have and have not experienced recent armed conflict (post-1990). We also compared the percentage of children who are underweight in both sets of countries, and expenditure on defence, health and education. Setting Demographic data and central government expenditure details (1994-2004) were taken from UNICEF's The State of the World's Children 2006 report. Main outcome measures Under-5 mortality, adjusted maternal mortality, and government expenditure. Results 21 countries have and 21 countries have not experienced recent conflict in this dataset of 42 countries in SSA. Median under-5 mortality in countries with recent conflict is 197/1000 live births, versus 137/1000 live births in countries without recent conflict. In countries which have experienced recent conflict, a median of 27% of under-5s were moderately underweight, versus 22% in countries without recent conflict. The median adjusted maternal mortality in countries with recent conflict was 1000/100,000 births versus 690/100,000 births in countries without recent conflict. Median reported maternal mortality ratio is also significantly higher in countries with recent conflict. Expenditure on health and education is significantly lower and expenditure on defence significantly higher if there has been recent conflict. Conclusions There appears to be an association between recent conflict and higher

Changes in size of populations and level of conflict since World War II: implications for health and health services.

PubMed

Garfield, Richard M; Polonsky, Jonathan; Burkle, Frederick M

2012-10-01

Armed conflicts include declared cross-border and internal wars and political, ethnic, and religious hostilities. The number of conflicts worldwide and their level of intensity have varied widely during the last 5 decades. Tracking conflicts throughout this period has focused predominantly on the number of individuals killed or displaced from these hostilities through count-based estimation systems, or establishing rates of excess mortality from demographic surveys. This report focuses on people living in areas with conflict by applying an estimated level of conflict intensity to data on the population of each territory with hostilities during 1946 to 2007. Data from the Uppsala Conflict Data Program/Peace Research Institute Oslo (UCDP/PRIO) Armed Conflict project database on 324 conflicts of any type in countries with populations greater than 500 000 were combined with conflict-intensity estimates from the Center for Systemic Peace and population data from the US Census Bureau International Data Base. More than half a billion people lived in conflict-affected areas in 2007. An increasing proportion of those affected by conflict lived in early postconflict areas, where hostilities were judged or declared during the last 5 years. In the past 2 decades, the average intensity of conflict among those living in areas with a current conflict has gradually declined. A burgeoning population lives in areas where conflict has recently ended, yet most of the world's large-scale medical responses to emergencies focus on high-intensity conflicts. Effective emergency and reconstruction activities in the health sector will depend on reorganizing services to increasingly focus on and transition to low-level and postconflict environments.

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.

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…

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…

Health and illness concepts among lower income Nicaraguan women.

PubMed

Ailinger, Rita L; Gonzalez, Rose; Zamora, Lidya

2007-03-01

Concepts of health and illness are culturally defined; however, few researchers have reported on these concepts among Latina women. A purposive sample of 14 lower income Nicaraguan women living in a squatter settlement is the focus of this qualitative study. The authors used in-depth, tape-recorded interviews in Spanish to gather data on the women's concepts of health and illness for adults and babies and of health maintenance activities. The authors analyzed the verbatim transcripts and analyzed them for themes. The women's concepts of health and illness included four themes: activities, disposition, eating, and appearance. Health maintenance activities included hygiene and sanitation, medical intervention, nutrition, and the appearance of cleanliness. Nurses and other health care providers will find these themes instructive in developing and providing health services for similar Latina women.

Does conflict between home and work explain the effect of multiple roles on mental health? A comparative study of Finland, Japan, and the UK.

PubMed

Chandola, Tarani; Martikainen, Pekka; Bartley, Mel; Lahelma, Eero; Marmot, Michael; Michikazu, Sekine; Nasermoaddeli, Ali; Kagamimori, Sadanobu

2004-08-01

Although there have been a number of studies on the effects of multiple roles on health and how a combination of work and family roles may be either advantageous (role enhancement) or disadvantageous (role strain) for health, there has been relatively little investigation on the psychosocial content of such roles. Work-to-family conflict and family-to-work conflict could arise from inability to combine multiple roles and result in stress and ill health. The question of whether both types of conflict mediate between the association of multiple roles with health has not been analysed before. This paper sets out to investigate whether: (1) work-to-family conflict or family-to-work conflict contributes towards explaining the association of multiple roles with mental health; (2) the effect of work-to-family conflict and family-to-work conflict on mental health varies by gender; (3) the effect of work-to-family and family-to-work conflict on mental health vary between countries with different welfare state arrangements and social norms. Cross-sectional data of economically active male and female public sector employees aged 35-60 in London (UK), Helsinki (Finland), and the West Coast of Japan. Linear regression models (separate for each gender and cohort) of SF-36 mental component scores were analysed with role combinations, family-to-work and work-to-family conflict as explanatory variables. Single fathers in all three cohorts and of single mothers in the Helsinki cohort had poor mental health, and this was partly explained by their higher levels family-to-work conflict. Both types of conflict affect the mental health of men and women independently of each other. Japanese women had the greatest conflict and poorest mental health while Helsinki women had the lowest conflict and best mental health. Both work-to-family and family-to-work conflict affect the mental health of men and women in three different countries. Work and family roles and the balance between the two

The concept of population health within the nursing profession.

PubMed

Radzyminski, Sharon

2007-01-01

Population health is a concept that has been developed over several centuries by many disciplines. Over time various aspects of the concept have dominated as issues related to behaviors and beliefs surrounding health practices have emerged. This has created a cadre of terms that are often used interchangeably but have different meanings among various disciplines. This paper will review the concept of population health within the discipline of nursing and discuss its relationship with public health, community health, and population-focused care.

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

PubMed Central

2010-01-01

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. PMID:20132546

Principles versus procedures in making health care coverage decisions: addressing inevitable conflicts.

PubMed

Sabik, Lindsay M; Lie, Reidar K

2008-01-01

It has been suggested that focusing on procedures when setting priorities for health care avoids the conflicts that arise when attempting to agree on principles. A prominent example of this approach is "accountability for reasonableness." We will argue that the same problem arises with procedural accounts; reasonable people will disagree about central elements in the process. We consider the procedural condition of appeal process and three examples of conflicts over coverage decisions: a patients' rights law in Norway, health technologies coverage recommendations in the UK, and care withheld by HMOs in the US. In each case a process is at the center of controversy, illustrating the difficulties in establishing procedures that are widely accepted as legitimate. Further work must be done in developing procedural frameworks.

How do health workers experience and cope with shocks? Learning from four fragile and conflict-affected health systems in Uganda, Sierra Leone, Zimbabwe and Cambodia.

PubMed

Witter, Sophie; Wurie, Haja; Chandiwana, Pamela; Namakula, Justine; So, Sovannarith; Alonso-Garbayo, Alvaro; Ssengooba, Freddie; Raven, Joanna

2017-11-01

This article is grounded in a research programme which set out to understand how to rebuild health systems post-conflict. Four countries were studied-Uganda, Sierra Leone, Zimbabwe and Cambodia-which were at different distances from conflict and crisis, as well as having unique conflict stories. During the research process, the Ebola epidemic broke out in West Africa. Zimbabwe has continued to face a profound economic crisis. Within our research on health worker incentives, we captured insights from 128 life histories and in-depth interviews with a variety of staff that had remained in service. This article aims to draw together lessons from these contexts which can provide lessons for enhancing staff and therefore health system resilience in future, especially in similarly fragile and conflict-affected contexts. We examine the reported effects, both personal and professional, of the three different types of shock (conflicts, epidemics and prolonged political-economic crises), and how staff coped. We find that the impact of shocks and coping strategies are similar between conflict/post-conflict and epidemic contexts-particularly in relation to physical threats and psychosocial threats-while all three contexts create challenges and staff responses for working conditions and remuneration. Health staff showed considerable inventiveness and resilience, and also benefited from external assistance of various kinds, but there are important gaps which point to ways in which they should be better protected and supported in the future. Health systems are increasingly fragile and conflict-prone, and shocks are often prolonged or repeated. Resilience should not be taken for granted or used as an excuse for abandoning frontline health staff. Strategies should be in place at local, national and international levels to prepare for predictable crises of various sorts, rather than waiting for them to occur and responding belatedly, or relying on personal sacrifices by staff to keep

Health Concepts, Guides for Health Instruction.

ERIC Educational Resources Information Center

American Association for Health, Physical Education, and Recreation, Washington, DC.

Concepts and supporting data pertaining to major health problems facing youth today as well as those anticipated in the next decade are enumerated in this resource. The material is designed as a reference for curriculum planners and classroom teachers in developing curriculum and teaching guides, units and instruction, and other curriculum…

Priority rules as solutions to conflicting health care rights.

PubMed

Andersson, Anna-Karin; Lindemark, Frode; Johansson, Kjell Arne

2017-03-01

Recent health legislation in Norway significantly increases access to specialist care within a legally binding time frame. The paper describes the contents of the new legislation and introduces some of the challenges with proliferations of rights to health care. The paper describes some of the challenges associated with the proliferation of legal rights to health care. It explains the benefits of assessing the new law in the light of a rights framework. It then analyses the problematic aspects of establishing additional priority rules as solutions to rights conflicts. It then defends adequacy criteria for acceptable priority rules when such rules are unavoidable. It finally defends our proposed method and explores concrete applications.

Army Officers’ Attitudes of Conflict Management.

DTIC Science & Technology

1976-06-11

The purpose of this study was to measure the attitudes of the middle level career Army officers relative to the concepts of conflict management . The...the literature concerning conflict management and its related fields of study, an exploratory analysis employing Hierarchical Clustering Schemes, and... conflict management . (2) No difference exists in the attitudes of conflict management according to the sample’s three branch groups: combat arms

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.

Addressing potential prior-data conflict when using informative priors in proof-of-concept studies.

PubMed

Mutsvari, Timothy; Tytgat, Dominique; Walley, Rosalind

2016-01-01

Bayesian methods are increasingly used in proof-of-concept studies. An important benefit of these methods is the potential to use informative priors, thereby reducing sample size. This is particularly relevant for treatment arms where there is a substantial amount of historical information such as placebo and active comparators. One issue with using an informative prior is the possibility of a mismatch between the informative prior and the observed data, referred to as prior-data conflict. We focus on two methods for dealing with this: a testing approach and a mixture prior approach. The testing approach assesses prior-data conflict by comparing the observed data to the prior predictive distribution and resorting to a non-informative prior if prior-data conflict is declared. The mixture prior approach uses a prior with a precise and diffuse component. We assess these approaches for the normal case via simulation and show they have some attractive features as compared with the standard one-component informative prior. For example, when the discrepancy between the prior and the data is sufficiently marked, and intuitively, one feels less certain about the results, both the testing and mixture approaches typically yield wider posterior-credible intervals than when there is no discrepancy. In contrast, when there is no discrepancy, the results of these approaches are typically similar to the standard approach. Whilst for any specific study, the operating characteristics of any selected approach should be assessed and agreed at the design stage; we believe these two approaches are each worthy of consideration. Copyright © 2015 John Wiley & Sons, Ltd.

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

The role of digital health in making progress toward Sustainable Development Goal (SDG) 3 in conflict-affected populations.

PubMed

Asi, Yara M; Williams, Cynthia

2018-06-01

The progress of the Millennium Development Goals (MDGs) shows that sustained global action can achieve success. Despite the unprecedented achievements in health and education, more than one billion people, many of them in conflict-affected areas, were unable to reap the benefits of the MDG gains. The recently developed Sustainable Development Goals (SDGs) are even more ambitious then their predecessor. SDG 3 prioritizes health and well-being for all ages in specific areas such as maternal mortality, communicable diseases, mental health, and healthcare workforce. However, without a shift in the approach used for conflict-affected areas, the world's most vulnerable people risk being left behind in global development yet again. We must engage in meaningful discussions about employing innovative strategies to address health challenges fragile, low-resource, and often remote settings. In this paper, we will argue that to meet the ambitious health goals of SDG 3, digital health can help to bridge healthcare gaps in conflict-affected areas. First, we describe the health needs of populations in conflict-affected environments, and how they overlap with the SDG 3 targets. Secondly, we discuss how digital health can address the unique needs of conflict-affected areas. Finally, we evaluate the various challenges in deploying digital technologies in fragile environments, and discuss potential policy solutions. Persons in conflict-affected areas may benefit from the diffusive nature of digital health tools. Innovations using cellular technology or cloud-based solutions overcome physical barriers. Additionally, many of the targets of SDG 3 could see significant progress if efficacious education and outreach efforts were supported, and digital health in the form of mHealth and telehealth offers a relatively low-resource platform for these initiatives. Lastly, lack of data collection, especially in conflict-affected or otherwise fragile states, was one of the primary limitations of

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.

Conflicts and conflict management in the collaboration between nurses and physicians - a qualitative study.

PubMed

Leever, A M; Hulst, M V D; Berendsen, A J; Boendemaker, P M; Roodenburg, J L N; Pols, J

2010-11-01

In health care, optimal collaboration between nurses and physicians is crucial in the quality of the care process – but not self-generating. Little is known about how health-care professionals cope with conflicts within their collaboration. This qualitative study investigates the way nurses and physicians cope with conflict and clarifies the determinants of conflict management styles. All respondents formulate clear expectations which in their opinion are essential to collaboration. When collaboration leads to disagreement, physicians and nurses choose between ignoring the conflict or engaging in it. Choice is determined by five factors: the influence of oneself, the influence of the other, the nature of the conflict, the context of conflict, and personal motives.

When Health Diplomacy Serves Foreign Policy: Use of Soft Power to Quell Conflict and Crises.

PubMed

Hosseini Divkolaye, Nasim Sadat; Radfar, Mohammad Hadi; Seighali, Fariba; Burkle, Frederick M

2016-10-01

Health diplomacy has increasingly become a crucial element in forging political neutrality and conflict resolution and the World Health Organization has strongly encouraged its use. Global turmoil has heightened, especially in the Middle East, and with it, political, religious, and cultural differences have become major reasons to incite crises. The authors cite the example of the human stampede and the deaths of over 2000 pilgrims during the 2015 annual Haj pilgrimage in Mecca. The resulting political conflict between Iran and Saudi Arabia had the potential to escalate into a more severe political and military crisis had it not been for the ministers of health from both countries successfully exercising "soft power" options. Global health security demands critical health diplomacy skills and training for all health providers. (Disaster Med Public Health Preparedness. 2016;page 1 of 4).

Circadian-Time Sickness: Time-of-Day Cue-Conflicts Directly Affect Health.

PubMed

van Ee, Raymond; Van de Cruys, Sander; Schlangen, Luc J M; Vlaskamp, Björn N S

2016-11-01

A daily rhythm that is not in synchrony with the environmental light-dark cycle (as in jetlag and shift work) is known to affect mood and health through an as yet unresolved neural mechanism. Here, we combine Bayesian probabilistic 'cue-conflict' theory with known physiology of the biological clock of the brain, entailing the insight that, for a functional pacemaker, it is sufficient to have two interacting units (reflecting environmental and internal time-of-day cues), without the need for an extra homuncular directing unit. Unnatural light-dark cycles cause a time-of-day cue-conflict that is reflected by a desynchronization between the ventral (environmental) and dorsal (internal) pacemaking signals of the pacemaker. We argue that this desynchronization, in-and-of-itself, produces health issues that we designate as 'circadian-time sickness', analogous to 'motion sickness'. Copyright © 2016 Elsevier Ltd. All rights reserved.

The evolving role of traditional birth attendants in maternal health in post-conflict Africa: A qualitative study of Burundi and northern Uganda.

PubMed

Chi, Primus Che; Urdal, Henrik

2018-01-01

Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of 'birth companions'. In this capacity they undertake maternal health promotion activities within their communities. In northern Uganda, on

Mental health and psychosocial wellbeing of Syrians affected by armed conflict.

PubMed

Hassan, G; Ventevogel, P; Jefee-Bahloul, H; Barkil-Oteo, A; Kirmayer, L J

2016-04-01

This paper is based on a report commissioned by the United Nations High Commissioner for Refugees, which aims to provide information on cultural aspects of mental health and psychosocial wellbeing relevant to care and support for Syrians affected by the crisis. This paper aims to inform mental health and psychosocial support (MHPSS) staff of the mental health and psychosocial wellbeing issues facing Syrians who are internally displaced and Syrian refugees. We conducted a systematic literature search designed to capture clinical, social science and general literature examining the mental health of the Syrian population. The main medical, psychological and social sciences databases (e.g. Medline, PubMed, PsycInfo) were searched (until July 2015) in Arabic, English and French language sources. This search was supplemented with web-based searches in Arabic, English and French media, and in assessment reports and evaluations, by nongovernmental organisations, intergovernmental organisations and agencies of the United Nations. This search strategy should not be taken as a comprehensive review of all issues related to MHPSS of Syrians as some unpublished reports and evaluations were not reviewed. Conflict affected Syrians may experience a wide range of mental health problems including (1) exacerbations of pre-existing mental disorders; (2) new problems caused by conflict related violence, displacement and multiple losses; as well as (3) issues related to adaptation to the post-emergency context, for example living conditions in the countries of refuge. Some populations are particularly vulnerable such as men and women survivors of sexual or gender based violence, children who have experienced violence and exploitation and Syrians who are lesbian, gay, bisexual, transgender or intersex. Several factors influence access to MHPSS services including language barriers, stigma associated with seeking mental health care and the power dynamics of the helping relationship. Trust

Providing health services during a civil war: the experience of a garrison town in South Sudan.

PubMed

Kevlihan, Rob

2013-10-01

The impact of conflict, particularly conflict arising during civil wars, on the provision of healthcare is a subject that has not been widely considered in conflict-related research. Combatants often target health services to weaken or to defeat the enemy, while attempts to maintain or improve health systems also can comprise part of counter-insurgency 'hearts-and-minds' strategies. This paper describes the dynamics associated with the provision of health services in Malakal, an important garrison town in South Sudan, during the second Sudanese civil war (1983-2005). Drawing on the concepts of opportunity hoarding and exploitation, it explores the social and political dynamics of service provision in and around the town during the war. These concepts provide a useful lens with which to understand better how health services are affected by conflict, while the empirical case study presented in the paper illustrates dynamics that may be repeated in other contexts. The concepts and case study set out in this paper should prove useful to healthcare providers working in conflict zones, including humanitarian aid agencies and their employees, increasing their understanding of the social and political dynamics that they are likely to face during future conflict-related complex emergencies. © 2013 The Author(s). Disasters © Overseas Development Institute, 2013.

Values in Health Policy - A Concept Analysis.

PubMed

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

2016-08-17

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. 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. 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. 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-makers in their policy-making process, to help

Dimensions and profiles of the generalized health-related self-concept.

PubMed

Wiesmann, Ulrich; Niehörster, Gabriele; Hannich, Hans-Joachim; Hartmann, Ute

2008-11-01

We explore the significance of health as a potentially self-relevant category from the perspective of dynamic self-concept theory. Our intention was to describe the dimensional structure of the generalized health-related self-concept, to identify particular prototypes of health-related self-definition, and to see if these prototypes would differ with respect to appraisals of health behaviour and subjective health. We conducted a cross-sectional questionnaire study involving 545 college students (23.3% male) at the mean age of 22 years. The self-administered questionnaire assessed a relevant spectrum of health-related cognitions denoting their generalized declarative knowledge about their health (the generalized health-related self-concept). Additionally, participants rated their multiple health behaviour, their perceived health, and their anticipated vulnerability. A principal components analysis of the health-related cognitions revealed the following five dimensions: health-protective dispositions, health-protective motivation, vulnerability, health-risky habits, and external, avoidant motivation. A two-step cluster analysis of the five components identified six profiles of health-related self-concept: careless/carefree, omnipotents, risk-takers, mentally affected, reluctant-avoidant, and medically fragile. These prototypes could be successfully reclassified (97.6%). The six profiles differed with respect to their health behaviour and subjective health appraisals. The dimensional structure represents both resources and deficits with respect to an individual's health-related self-concept. An individual's profile of these dimensions might correspond to a characteristic set of particular health needs and motivations. Successful health communications should follow a complementary strategy of affirming the self-concept.

[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.

Giving birth and returning to work: the impact of work-family conflict on women's health after childbirth.

PubMed

Grice, Mira M; Feda, Denise; McGovern, Patricia; Alexander, Bruce H; McCaffrey, David; Ukestad, Laurie

2007-10-01

Since 1970, women of childbearing age have increasingly participated in the workforce. However, literature on work-family conflict has not specifically addressed the health of postpartum women. This study examined the relationship between work-family conflict and mental and physical health of employed mothers 11 weeks after childbirth. Employed women, 18 years and older, were recruited while in the hospital for childbirth (N = 817; 71% response rate). Mental and physical health at 11 weeks postpartum was measured using SF-12 version 2. General linear models estimated the associations between the independent variables and health. A priori causal models and directed acyclic graphs guided selection of confounding variables. Analyses revealed that high levels of work interference with family were associated with significantly lower mental health scores. Medium and high levels of family interference with work revealed a dose-response relationship resulting in significantly worse mental health scores. Coworker support was strongly and positively associated with better physical health. Work-family conflict was negatively associated with mental health but not significantly associated with physical health. Availability of social support may relieve the burden women can experience when balancing work roles and family obligations.

The securitization of health in the context of the war on terror. National security and global health: the conflict of imperatives.

PubMed

Chung, Ryoa

2017-03-01

In this article, I want to show that the securitization of health issues in the name of national interests led to the militarization of health care in the context of the war against terrorism. However, the connection between health and security also gave way to the emergence of the notion of human security, thus, converging with the human right to health approach and the cosmopolitan discourse on global health. These two perspectives on the relation between health and security lead to conflicting imperatives in the current state of counter-terrorism operations. I argue that when the securitization of health concerns in the name of national security conflicts with the provision of health care in the name of universal human rights, the higher moral end must trump the prudential one. Moreover, it is a duty to promote the human right to health when liberal democracies in foreign policies directly violate this moral ideal in the name of national security.

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

Reinventing the political role of health professionals in conflict prevention & reconciliation: the Sudanese model.

PubMed

Salih, Alaaddin M; Ahmed, Jasim M; Mohamed, Jamal F; Alfaki, Musaab M

2016-01-01

Given the persistent recurrence of armed conflict, influential actors owe it to the affected communities to take action. The legitimacy of health professionals to mitigate the effects of conflict relates to their ability to save lives and address the physical and mental consequences of armed conflict during which thousands of lives may be lost. Medical professionals have unique and potentially far-reaching skills. These become crucial during wartime and disasters in terms of providing medical services and humanitarian aid. However, they are insufficiently used in one area: involvement in politics as a tool to foster peace. Despite this, Sudanese individuals from medical backgrounds have participated actively in conflict resolution and peace-building processes. In fact, their political actions throughout the last six decades have aimed to prevent conflict at four different levels, which are described by Yusuf et al. in their article on the political involvement of health professionals in prevention. Their stand against President Nimeiri's Sharia laws was primordial prevention of religious conflict at the national level. Their leading role in the second Sudanese Intifada uprising was a key factor in saving the country from civil war, and another example of primary prevention. Sudanese physicians were also involved in secondary prevention by being influentially involved in almost all national peace agreements. Avoiding disputes at the tertiary level represents the weakest link in their repeated efforts. This paper outlines the different roles Sudanese medical personnel have taken in peacemaking. It also critically evaluates them in order to consider new methods of political involvement that suit future challenges.

Health financing in fragile and post-conflict states: what do we know and what are the gaps?

PubMed

Witter, Sophie

2012-12-01

There has been a growing concern with post-conflict and fragile states over the past decade, both in relation to their high level of health and development needs but also for the risk they pose to the wider international community. This paper presents an exploratory literature review to analyse the themes and findings of recent writing on one important pillar of the health system--health financing--in these countries. It finds that here is a growing but still very limited literature. Most of the insights from existing literature relate to the role of donors. There is a need for more work on access to care and equity over the post-conflict period, the mix and sequencing of financing mechanisms, resource allocation, regulation, public financial management, payment systems and incentives at facility and health worker levels, and on overall health financing strategies and their possible contribution to wider state-building. Topics which have received attention, such as contracting and non-state actors, could benefit from more rigorous analysis with a longer time perspective. A longitudinal approach, which examines how decisions taken in the immediate post-conflict period may or may not influence longer term developments, would provide important insights. As health systems in fragile and post-conflict states are often forced to innovate, they can generate useful lessons for other settings too. Copyright © 2012 Elsevier Ltd. All rights reserved.

Clarifying conflict of interest.

PubMed

Brody, Howard

2011-01-01

As the debate over how to manage or discourage physicians' financial conflicts of interest with the drug and medical device industries has become more heated, critics have questioned or dismissed the concept of "conflict of interest" itself. A satisfactory definition relates conflict of interest to concerns about maintaining social trust and distinguishes between breaches of ethical duty and temptations to breach duty. Numerous objections to such a definition have been offered, none of which prevails on further analysis. Those concerned about conflicts of interest have contributed to misunderstandings, however, by failing to demonstrate when social arrangements leading to temptations to breach duties are in themselves morally blameworthy. Clarifying "conflict of interest" is important if we are eventually going to develop productive modes of engagement between medicine and for-profit industry that avoid the serious ethical pitfalls now in evidence.

Resolving conflict realistically in today's health care environment.

PubMed

Smith, S B; Tutor, R S; Phillips, M L

2001-11-01

Conflict is a natural part of human interaction, and when properly addressed, results in improved interpersonal relationships and positive organizational culture. Unchecked conflict may escalate to verbal and physical violence. Conflict that is unresolved creates barriers for people, teams, organizational growth, and productivity, leading to cultural disintegration within the establishment. By relying on interdependence and professional collaboration, all parties involved grow and, in turn, benefit the organization and population served. When used in a constructive manner, conflict resolution can help all parties involved see the whole picture, thus allowing freedom for growth and change. Conflict resolution is accomplished best when emotions are controlled before entering into negotiation. Positive confrontation, problem solving, and negotiation are processes used to realistically resolve conflict. Everyone walks away a winner when conflict is resolved in a positive, professional manner (Stone, 1999).

Postpartum sexual health: a principle-based concept analysis.

PubMed

O'Malley, Deirdre; Higgins, Agnes; Smith, Valerie

2015-10-01

The aim of this study is to report an analysis of the concept of postpartum sexual health. Postpartum sexual health is a minimally understood concept, most often framed within physical/biological dimensions or as a 'checklist' task in postpartum information provision. This has the potential to leave women unprepared to manage transient or normative sexual health changes after childbirth. For meaningful discussions, clarity and understanding of postpartum sexual health is required. A principle-based method of concept analysis. The databases of PubMed, CINAHL, Maternity and Infant Care, PsychInfo, Web of Science, EMBASE, SCOPUS and Social Science Index were systematically searched, from their earliest dates, using a combination of key terms, including; 'sexual health', 'sexual function', 'dyspareunia', 'sexuality', 'sexual desire', 'sexual dysfunction', 'postnatal' and 'postpartum', resulting in a final included dataset of 91 studies. Using the principle-based approach, postpartum sexual health was analysed under the four philosophical principles of epistemological, pragmatic, linguistic and logical. Philosophically, postpartum sexual health is underdeveloped as a concept. A precise theoretical definition remains elusive and, presently, postpartum sexual health cannot be separated theoretically from sexuality and sexual function. Identified antecedents include an instrument free birth, an intact perineum and avoidance of episiotomy. Attributes include sexual arousal, desire, orgasm, sexual satisfaction and resumption of sexual intercourse. Outcomes are sexual satisfaction and a satisfying intimate relationship with one's partner. Postpartum sexual health is conceptually immature with limited applicability in current midwifery practice. © 2015 John Wiley & Sons Ltd.

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…

The evolving role of traditional birth attendants in maternal health in post-conflict Africa: A qualitative study of Burundi and northern Uganda

PubMed Central

Urdal, Henrik

2018-01-01

Objectives: Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. Methods: A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Results: Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of ‘birth companions’. In this capacity they undertake maternal health promotion activities within their

[Collective health, territorial and environmental conflicts: bases for a critical socio-environmental approach].

PubMed

Porto, Marcelo Firpo de Souza; da Rocha, Diogo Ferreira; Finamore, Renan

2014-10-01

The phenomenon of globalization and the increase in neo-extractivism in the global periphery intensify the search for new territories and natural resources for the economy, resulting in significant impacts on ecosystems and on the lives of vulnerable populations. It is considered that the environmental crisis imposes new challenges and requires an updating of the theoretical and methodological foundations of collective health and the social determinants of health. The scope of this paper is to present theoretical contributions to the construction of a critical socio-environmental approach from a review of the literature structured around previous work on the mapping of environmental conflicts, and conducting empirical studies in conflicting areas. The contributions of sociology, political ecology, postcolonial studies and geography is summarized for the discussion of the socio-environmental determinants of health, as well as experiences that integrate emancipatory knowledge, political subjects, resistances and alternatives for society.

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.

Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: an exploratory prospective study.

PubMed

Presseau, Justin; Francis, Jill J; Campbell, Neil C; Sniehotta, Falko F

2011-07-15

The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland) to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate). Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively) in behaviour over and above intention and perceived behavioural control. Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better understand health professional behaviour.

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

Mortality, nutrition and health in Lofa County Liberia five years post-conflict.

PubMed

Doocy, Shannon; Lewy, Daniela; Guenther, Tanya; Larrance, Ryan

2010-01-01

Liberia remains in transition from a state of humanitarian emergency to development, and Lofa County was the epicentre of recent conflict. This study aimed to estimate mortality and malnutrition and evaluate access to health services, water and sanitation. The survey was conducted in April 2009 and employed a 46 cluster×20 design (n=920 households) with probability proportional to size sampling. The crude mortality rate was 24.3/1000/year (CI: 19.0 to 29.6) or 0.67/10,000/day (CI: 0.52 to 0.81). The global acute malnutrition rate was 7.9% (CI: 5.4 to 8.9), and the severe acute malnutrition rate was 4.5% (CI: 2.9 to 6.7). Access to basic health services was relatively good according to a variety of indicators; however, access to sanitation was low, with 39.5% of households reporting access to toilets or latrines. Despite high rates of displacement and infrastructure destruction, population health appears to be relatively stable 5 years post-conflict, though a continued focus on reconstruction and development is needed.

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

PubMed

Hernandez-Aguado, Ildefonso; Zaragoza, G A

2016-04-18

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. 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. 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%). 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 issue. Published by the BMJ Publishing

Collision Avoidance for Airport Traffic Concept Evaluation

NASA Technical Reports Server (NTRS)

Jones, Denise R.; Prinzel, Lawrence J., III; Otero, Sharon D.; Barker, Glover D.

2009-01-01

An initial Collision Avoidance for Airport Traffic (CAAT) concept for the Terminal Maneuvering Area (TMA) was evaluated in a simulation study at the National Aeronautics and Space Administration (NASA) Langley Research Center. CAAT is being designed to enhance surface situation awareness and provide cockpit alerts of potential conflicts during runway, taxi, and low altitude air-to-air operations. The purpose of the study was to evaluate the initial concept for an aircraft-based method of conflict detection and resolution (CD&R) in the TMA focusing on conflict detection algorithms and alerting display concepts. This paper gives an overview of the CD&R concept, simulation study, and test results.

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

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.

Concept Analysis: Health-Promoting Behaviors Related to Human Papilloma Virus (HPV) Infection.

PubMed

McCutcheon, Tonna; Schaar, Gina; Parker, Karen L

2015-01-01

The concept of health-promoting behaviors incorporates ideas presented in the Ottawa Charter of Public Health and the nursing-based Health Promotion Model. Despite the fact that the concept of health-promoting behaviors has a nursing influence, literature suggests nursing has inadequately developed and used this concept within nursing practice. A further review of literature regarding health promotion behaviors and the human papilloma virus suggest a distinct gap in nursing literature. This article presents a concept analysis of health-promoting behaviors related to the human papilloma virus in order to encourage the application of the concept into nursing practice, promote continued nursing research regarding this concept, and further expand the application of health-promoting behaviors to other situations and populations within the nursing discipline. Attributes of health-promoting behaviors are presented and include empowerment, participation, community, and a positive concept of health. Antecedents, consequences, and empirical referents are also presented, as are model, borderline, and contrary cases to help clarify the concept. Recommendations for human papilloma virus health-promoting behaviors within the nursing practice are also provided. © 2014 Wiley Periodicals, Inc.

Mental Health and Coping Patterns in Jewish Gay Men in Israel: The Role of Dual Identity Conflict, Religious Identity, and Partnership Status.

PubMed

Zeidner, Moshe; Zevulun, Attara

2018-01-01

This study examined the effects of dual-identity conflict, religious identity (religious/spiritual vs. sexual), and partnership status on the coping strategies and mental health of gay Jewish men in modern Israeli society. Participants were 73 religious and 71 secular gay men recruited via e-mail, social networking sites, and online resources targeting sexual minority men. Participants were assessed via measures of identity conflict, mental health, and coping strategies. Jewish gay men who reported more severe identity conflict also reported using less problem-focused and avoidance coping and more emotion-focused coping strategies and reported poorer mental health than their less identity-conflicted counterparts. Furthermore, gay men who self-identified as religious reported poorer mental health as well as less problem-focused coping and more emotion-focused coping compared to secular men. Religious gay men in romantic relationships reported lower intensities of dual-identity conflict and better mental health compared to their nonpartnered counterparts.

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.

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

Predicting the impact of the 2011 conflict in Libya on population mental health: PTSD and depression prevalence and mental health service requirements.

PubMed

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

2012-01-01

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). 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. 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. This is the first attempt to predict the mental

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

PubMed

Cadman, Kathleen Paco

2017-10-01

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. © 2017 Wiley Periodicals, Inc.

An evolutionary concept analysis of futility in health care.

PubMed

Morata, Lauren

2018-06-01

To report a concept analysis of futility in health care. Each member of the healthcare team: the physician, the nurse, the patient, the family and all others involved perceive futility differently. The current evidence and knowledge in regard to futility in health care manifest a plethora of definitions, meanings and interpretations without consensus. Concept analysis. Databases searched included Medline, Cumulative Index of Nursing and Allied Health Literature, Academic Search Premier, Cochrane Database of Systematic Reviews and PsycINFO. Search terms included "futil*," "concept analysis," "concept," "inefficacious," "non-beneficial," "ineffective" and "fruitless" from 1935-2016 to ensure a historical perspective of the concept. A total of 106 articles were retained to develop the concept. Rogers' evolutionary concept analysis was used to evaluate the concept of futility from ancient medicine to the present. Seven antecedents (the patient/family autonomy, surrogate decision-making movement, the patient-family/physician relationship, physician authority, legislation and court rulings, catastrophic events and advancing medical technology) lead to four major attributes (quantitative, physiologic, qualitative, and disease-specific). Ultimately, futile care could lead to consequences such as litigation, advancing technology, increasing healthcare costs, rationing, moral distress and ethical dilemmas. Futility in health care demonstrates components of a cyclical process and a consensus definition is proposed. A framework is developed to clarify the concept and articulate relationships among attributes, antecedents and consequences. Further testing of the proposed definition and framework are needed. © 2018 John Wiley & Sons Ltd.

Targeted doctors, missing patients: obstetric health services and sectarian conflict in northern Pakistan.

PubMed

Varley, Emma

2010-01-01

The spectre of exclusionary medical service provision, restricted clinic access and physician targeting in sectarian-divided Iraq underscores the crucial and timely need for qualitative research into the inter-relationship between conflict, identity and health. In response, this paper provides a critical ethnography of obstetric service provision and patient access during Shia-Sunni hostilities in Gilgit Town, capital of Pakistan's Northern Areas (2005). I analyse how services were embedded in and constrained by sectarian affiliation in ways that detrimentally impacted Sunni women patients and hospital staff, resulting in profoundly diminished clinic access, reduced physician coverage and a higher observed incidence of maternal morbidity and mortality. The paper first situates obstetric medicine at the interstices of contested sectarian terrain and competing historical projects of sectarian identity. Gilgiti Sunnis' high clinical reliance is argued to be a response to and consequence of, inter-sectarian dissonance and the ascendance of biomedicine during three decades of regional development. In 2005, conflict-incurred service deprivations and the enactment and strategic use of sectarian identity in clinical settings were associated with differential treatment and patient-perceived adverse health outcomes, leading Sunnis to generate alternative sect-specific health services. Obstetric morbidity and mortality during sectarian conflict are analyzed as distinctive manifestations of the wide range of direct harms routinely associated with violence and political strife.

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.

Rethinking intractable conflict: the perspective of dynamical systems.

PubMed

Vallacher, Robin R; Coleman, Peter T; Nowak, Andrzej; Bui-Wrzosinska, Lan

2010-01-01

Intractable conflicts are demoralizing. Beyond destabilizing the families, communities, or international regions in which they occur, they tend to perpetuate the very conditions of misery and hate that contributed to them in the first place. Although the common factors and processes associated with intractable conflicts have been identified through research, they represent an embarrassment of riches for theory construction. Thus, the current task in this area is integrating these diverse factors into an account that provides a coherent perspective yet allows for prediction and a basis for conflict resolution in specific conflict settings. We suggest that the perspective of dynamical systems provides such an account. This article outlines the key concepts and hypotheses associated with this approach. It is organized around a set of basic questions concerning intractable conflict for which the dynamical perspective offers fresh insight and testable propositions. The questions and answers are intended to provide readers with basic concepts and principles of complexity and dynamical systems that are useful for rethinking the nature of intractable conflict and the means by which such conflict can be transformed. Copyright 2010 APA, all rights reserved.

The gendered health workforce: mixed methods analysis from four fragile and post-conflict contexts

PubMed Central

Witter, Sophie; Namakula, Justine; Wurie, Haja; Chirwa, Yotamu; So, Sovanarith; Vong, Sreytouch; Ros, Bandeth; Buzuzi, Stephen; Theobald, Sally

2017-01-01

Abstract It is well known that the health workforce composition is influenced by gender relations. However, little research has been done which examines the experiences of health workers through a gender lens, especially in fragile and post-conflict states. In these contexts, there may not only be opportunities to (re)shape occupational norms and responsibilities in the light of challenges in the health workforce, but also threats that put pressure on resources and undermine gender balance, diversity and gender responsive human resources for health (HRH). We present mixed method research on HRH in four fragile and post-conflict contexts (Sierra Leone, Zimbabwe, northern Uganda and Cambodia) with different histories to understand how gender influences the health workforce. We apply a gender analysis framework to explore access to resources, occupations, values, decision-making and power. We draw largely on life histories with male and female health workers to explore their lived experiences, but complement the analysis with evidence from surveys, document reviews, key informant interviews, human resource data and stakeholder mapping. Our findings shed light on patterns of employment: in all contexts women predominate in nursing and midwifery cadres, are under-represented in management positions and are clustered in lower paying positions. Gendered power relations shaped by caring responsibilities at the household level, affect attitudes to rural deployment and women in all contexts face challenges in accessing both pre- and in-service training. Coping strategies within conflict emerged as a key theme, with experiences here shaped by gender, poverty and household structure. Most HRH regulatory frameworks did not sufficiently address gender concerns. Unless these are proactively addressed post-crisis, health workforces will remain too few, poorly distributed and unable to meet the health needs of vulnerable populations. Practical steps need to be taken to identify

[Health equity: a critical analysis of concepts].

PubMed

Vieira-da-Silva, Ligia Maria; Almeida Filho, Naomar de

2009-01-01

Health inequalities have been studied mainly from an epidemiological perspective, with limited attention to conceptual issues. The terms 'equity' and 'equality' have often been used as synonyms, as have their opposites, 'inequity' and 'inequality'. The few attempts to establish their meanings have been either purely descriptive or have failed to add to an understanding of the underlying dynamics in health-disease-related phenomena. The present essay explores the semantic series that includes difference, diversity, distinction, inequality, and inequity and its relationship to health phenomena in light of Perelman's concept of equity, Bourdieu's sociology, and some arguments in Heller's theory of justice, with the aim of contributing to the development of these concepts, while discussing their implications for policymaking in health.

42 CFR 35.46 - Conflicting claims.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Conflicting claims. 35.46 Section 35.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Disposal of Money and Effects of Deceased Patients § 35.46 Conflicting...

42 CFR 35.46 - Conflicting claims.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Conflicting claims. 35.46 Section 35.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Disposal of Money and Effects of Deceased Patients § 35.46 Conflicting...

42 CFR 35.46 - Conflicting claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Conflicting claims. 35.46 Section 35.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Disposal of Money and Effects of Deceased Patients § 35.46 Conflicting...

[Stigma and Mental Health in Victims of Colombia's Internal Armed Conflict in Situation of Forced Displacement].

PubMed

Campo-Arias, Adalberto; Herazo, Edwin

2014-01-01

The prolonged sociopolitical phenomenon of Colombian violence generated a high number of victims, many of whom suffered a continual process of internal displacement and stigma-discrimination complex. To postulate possible mechanisms by which victims of Colombia's internal armed conflict in a situation of forced displacement were stigmatized and discriminated. Stigma affects mental health, not only because it represents a major stressor for discriminated individuals and groups, but also because it accounts for inequalities and inequities in health. Initially, as the victims of the internal armed conflict in situation of forced displacement were not considered as such, but as responsible for the situation. Thus, they had to cope with the social and economic inequalities, explained partially by low categorization or status that they received, possibly due to poor construction of social capital in the country. Also, victims of the internal armed conflict suffer from intersectional stigma and discrimination due to other characteristics such as gender, sexual orientation, ethnic-racial origin, or meeting criteria for a mental disorder. An active process of inclusive social development is required for the displaced victims of the armed conflict,in order to reduce multiple stigma and ensure their mental health. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: An exploratory prospective study

PubMed Central

2011-01-01

Background The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Methods Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland) to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Results Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate). Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively) in behaviour over and above intention and perceived behavioural control. Conclusions Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better understand health professional

Agreement and disagreement on health care quality concepts among academic health professionals: the Saudi case.

PubMed

Mahrous, Mohamed Saad

2014-01-01

A systematic and rigorous implementation of quality improvement processes is likely to improve the well-being of staff members and heighten their job satisfaction. Assessing professionals' perceptions of health care quality should lead to the betterment of health care services. In Saudi Arabia, no previous studies examine how university health professionals view health care quality concepts. A cross-sectional analytical study employing a self-administered questionnaire with 43 statements assessing quality perceptions of academic health care professionals was used. Despite the agreement of health professionals on numerous quality concepts addressed in this study, there was insufficient agreement on 10 core quality concepts, 3 of which were the following: "quality focuses on customers" (50%), "quality is tangible and therefore measurable" (29.3%), and "quality is data-driven" (62%). Hence, providing health professionals with relevant training likely will generate a better understanding of quality concepts and optimize their performance.

Sexual violence against men and boys in conflict and forced displacement: implications for the health sector.

PubMed

Chynoweth, Sarah K; Freccero, Julie; Touquet, Heleen

2017-11-01

Sexual violence against men and boys is commonplace in many conflict-affected settings and may be frequent in relation to forced displacement as well. Adolescent boys, forming the majority of unaccompanied minors globally, are a particularly vulnerable group. Yet sensitised health services for adult and adolescent male sexual violence survivors are scarce, and barriers to accessing care remain high. We describe current challenges and gaps in the provision of health care for male survivors in settings affected by conflict and forced displacement, and provide suggestions on how to improve service provision and uptake.

Conflict, displacement and sexual and reproductive health services in Mali: analysis of 2013 health resources availability mapping system (HeRAMS) survey.

PubMed

Tunçalp, Özge; Fall, Ibrahima Socé; Phillips, Sharon J; Williams, Inga; Sacko, Massambou; Touré, Ousmane Boubacar; Thomas, Lisa J; Say, Lale

2015-01-01

Little is known specifically about the effects of conflict and displacement on provision of sexual and reproductive health (SRH) services. We aimed to understand the association between levels of conflict and displacement and the availability of SRH services in post-conflict Mali. A national assessment was conducted between April and May 2013 employing Health Systems Availability Mapping System (HeRAMS). Data from 1581 primary care facilities were analysed, focusing on SRH services. Descriptive analyses and multivariable logistic regression models were used to examine the availability of SRH services by different levels of conflict and displacement. Of 1581 facilities, 1551 had data available to identify the details of service provision. The majority of the facilities were part of the public sector (79.1 %), identified as basic community primary care facilities (71.9 %). Overall 15.7 % of the facilities were in the zones under occupation, 40.3 % in the areas with high concentration of displaced population and 44 % in areas with low concentration of displaced populations. Between zones of low concentration of displaced populations and under occupation the likelihood of service availability varied between OR: 2.9 (95 % CI 2.0-4.4) for basic emergency obstetric care and OR: 41.7 (95 % CI 20.4-85.3) for family planning. All of the services within the three domains of SRH were more likely to be available in the low and high concentration displaced population areas compared to the facilities in the under occupation zones, after adjusting for other facility-related variables. Areas with high concentration of displaced population had less service availability, and areas formerly under occupation had the least service availability. This suggests that those living in conflict areas, and many of those who are internally displaced, have poor access to essential SRH interventions. The systematic measurement of the availability of health services, including SRH, is

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. Copyright © 2013 Elsevier Ltd. All rights reserved.

Political Socialization of Young Children in Intractable Conflicts: Conception and Evidence

ERIC Educational Resources Information Center

Bar-Tal, Daniel; Diamond, Aurel Harrison; Nasie, Meytal

2017-01-01

This article examines the political socialization of young children who live under conditions of intractable conflict. We present four premises: First, we argue that, within the context of intractable conflict, political socialization begins earlier and faster than previously suspected, and is evident among young children. Second, we propose that…

Epistemological beliefs and therapeutic health concepts of physiotherapy students and professionals.

PubMed

Bientzle, Martina; Cress, Ulrike; Kimmerle, Joachim

2014-10-01

Health knowledge develops fast and includes a lot of ambiguous or tentative information. In their daily routine, both health care students and professionals continuously have to make judgments about the viability of health knowledge. People's epistemological beliefs (EBs) and their therapeutic health concepts are factors that influence how they deal with health knowledge. However, very little is known about the occurrence of these factors at different stages of people's career. The present study examines the EBs and therapeutic health concepts of physiotherapy students in their vocational training and the EBs and therapeutic health concepts of professionals. In a cross-sectional study physiotherapy students and professional physiotherapists filled in a questionnaire that measured their personal EBs about physiotherapy and medicine, as well as their biomedical and biopsychosocial therapeutic health concepts. We compared the participants' EBs regarding both knowledge domains, and their therapeutic health concepts using paired samples t-tests. We also examined the differences between first-year students, advanced students, and professionals regarding their EBs and their therapeutic health concepts using ANOVAs. Eighty-three students and 84 professionals participated in this study, 114/167 (68%) participants were female. EBs as well as therapeutic health concepts differed depending upon the participants' training status. Professionals had more sophisticated EBs than students regarding both knowledge in physiotherapy (F(2, 164) = 6.74, P = 0.002, η(2)(p) = 0.08) and knowledge in medicine (F(2, 164) = 5.93, P = 0.003, η(2)(p) = 0.07). In addition, high values in a biopsychosocial therapeutic health concept already occurred in an early phase of training (F(2, 164) = 5.39, P = 0.005, η(2)(p) = 0.06), whereas increased values in a biomedical concept did not occur until people's professional life (F(2, 164) = 10.99, P < 0.001, �

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

PubMed

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

2007-02-01

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

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…

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.

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

PubMed

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

2017-01-01

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. 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. 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). 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.

Service user involvement in mental health care: an evolutionary concept analysis.

PubMed

Millar, Samantha L; Chambers, Mary; Giles, Melanie

2016-04-01

The concept of service user involvement is an evolving concept in the mental health-care literature. This study sought to explore and analyse the concept of service user involvement as used in within the field of mental health care. An evolutionary concept analysis was conducted using a literature-based sample extracted from an electronic database search. One hundred and thirty-four papers met the inclusion criteria and were analysed to discover key attributes, antecedents and consequences of service user involvement and to produce a definition of the concept. Five key attributes of service user involvement within the context of mental health care were identified: a person-centred approach, informed decision making, advocacy, obtaining service user views and feedback and working in partnership. Clarity of the attributes and definition of the concept of service user involvement aims to promote understanding of the concept among key stakeholders including mental health professionals, service users and community and voluntary organizations. The findings of the research have utility in the areas of theory and policy development, research on service user involvement in mental health care and service user involvement in mental health practice. Directions for further research regarding the concept are identified. © 2015 John Wiley & Sons Ltd.

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

PubMed Central

Boness, Christian

2011-01-01

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

Social Capital and Mental Health in Post-Disaster/Conflict Contexts: A Systematic Review.

PubMed

Noel, Pia; Cork, Cliodhna; White, Ross G

2018-03-21

Social capital (SC) is highlighted as an important factor for post-crisis mental health outcomes. However, the heterogeneous nature of the construct makes it difficult to get a clear picture of the evidence concerning the association between SC indices and mental health. This review examines how SC is conceptualized and measured, and the relationships with other variables in quantitative empirical studies investigating the associations between SC and mental health in post-disaster and post-conflict contexts. It includes primary data studies focusing on this association in civilian populations. Studies were identified by searching electronic databases, bibliographic mining, cited reference searching, and personal contact with experts. In total, 15 studies were included: 12 in post-natural disaster contexts and 3 in conflict-affected settings. Findings suggested that individual cognitive SC had an inverse association with post-traumatic stress disorder, anxiety, and depression, and that ecological cognitive SC was positively associated with mental well-being. Individual structural SC (in the form of community networks) may be psychologically protective. However, most of the evidence was cross-sectional, limiting conclusions about causal relationships. More clarity and consistency is needed in the conceptualization and measurement of SC in order to inform post-crisis mental health interventions. (Disaster Med Public Health Preparedness. 2018;page 1 of 12).

Conflict of interest in Health Technology Assessment decisions: case law in France and impact on reimbursement decisions.

PubMed

Frybourg, Sandrine; Remuzat, Cécile; Kornfeld, Åsa; Toumi, Mondher

2015-01-01

The slow reaction of French authorities to the so-called Mediator® saga in 2009 in France led to investigations that questioned the way conflicts of interest are reported. France implemented the Loi Bertrand ('Bertrand Law') in May 2013, known as the 'French Sunshine Act', with the aim of specifying the scope of disclosure obligations. This policy research reviewed the Loi Bertrand and reported case law from the French Council of State (COS) related to conflicts of interest in French Health technology assessment (HTA) opinion. The Loi Bertrand requires the publication of most of the agreements concluded between health-care professionals and companies and covers a vast range of health products. Commercial sales agreements of goods and services concluded between manufacturers and health-care professionals are a strong exception to this disclosure obligation. Six cases examined by the COS were analyzed, most of them related to the publication of guidelines or the removal of products from the list of reimbursed drugs and devices. These cases have been reviewed, as well as the impact of the ruling on reimbursement decisions. Four cases led to suspension or invalidation of decisions based on the Haute Autorité de Santé (HAS) recommendations due to conflicts of interest. In the two other cases, the HAS provided post hoc declarations of interest when required by the COS, and the COS considered the conflicts of interest as irrelevant for the decision. It appears that the COS based its decisions on two main criteria: the acknowledgement of negative conflicts of interest (a link with competitors) and the absence of declarations of conflicts of interest, which have to be presented when required by legal authorities irrespective of when they were completed (even posterior to the HAS opinion). However, the number of cases that have been decided against the HAS remains very limited with respect to the volume of assessments performed yearly. The strengthening of the regulation

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

The high cost of conflict.

PubMed

Forté, P S

1997-01-01

Conflict is inevitable, especially in highly stressed environments. Clinical environments marked by nurse-physician conflict (and nurse withdrawal related to conflict avoidance) have been proven to be counterproductive to patients. Clinical environments with nurse-physician professional collegiality and respectful communication show decreased patient morbidity and mortality, thus enhancing outcomes. The growth of managed care, and the organizational turmoil associated with rapid change, makes it imperative to structure the health care environment so that conflict can be dealt with in a safe and healthy manner. Professional health care education programs and employers have a responsibility to provide interactive opportunities for multidisciplinary audiences through which conflict management skills can be learned and truly change the interpersonal environment. Professionals must be free to focus their energy on the needs of the patient, not on staff difficulties.

Conflict management in public hospitals: the Cyprus case.

PubMed

Pavlakis, A; Kaitelidou, D; Theodorou, M; Galanis, P; Sourtzi, P; Siskou, O

2011-06-01

Conflict among health-care personnel has been identified as an issue within health-care settings around the world. To investigate the existence and management of conflict among health-care personnel in public hospitals in Cyprus; to assess the factors leading to conflict among staff members; to evaluate the consequences of conflict arising; and to consider the management strategies. A self-administered questionnaire was completed by a random sample of 1037 health-care professionals in all (seven) state-run hospitals in Cyprus in 2008. Mean age of respondents was 41 years, and 75% were female. Sixty-four per cent of respondents reported that they had never been informed about conflict management strategies, with physicians being the least informed as the relative percentage was 79.8% (χ(2) = 33, P < 0.001). Sixty per cent of health-care professionals reported conflict at work with other health-care personnel one to five times per week, and 37% of the respondents stated that they devote 90 min (mean value) from work during their shift in conflict resolution, meaning that managing conflicts may absorb 19% of working time daily. The majority of respondents agreed that organizational problems and communication gaps were the main issues creating conflict. Avoidance and collaboration were the preferable strategies for conflict resolution, used by 36.6% and 37.5% of the respondents, respectively.   Better communication, fair management practices and clear job descriptions and expectations may be needed in order to facilitate change and reverse the negative atmosphere that exists. Further education in conflict management for physicians, nurses and their managers may also be needed. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

[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

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.

Health promotion for people with intellectual disabilities - A concept analysis.

PubMed

Roll, Anne E

2018-03-01

Whereas 'health promotion' is a well-known concept for healthcare professionals, the concept of 'health promotion for people with intellectual disabilities' and its unique associated challenges are not well understood. This article provides a systematic analysis of how health promotion is being conceptualised for people with intellectual disabilities and how health promotion can work best in the light of this group's specific needs and limitations. Rodgers' evolutionary concept analysis. MEDLINE, PsycINFO, CINAHL and SocINDEX were searched using the search terms 'health promotion', 'people with intellectual disabilities' and 'developmental disabilities'. This review includes studies published between 1992 and 2014. A total of 52 articles were included. Health promotion for people intellectual disabilities, as discussed in the literature, focuses on four aspects, namely supporting a healthy lifestyle, providing health education, involving supporters and being person-centred. Antecedents of the concept 'health promotion for people with intellectual disabilities' were healthcare access and sensitised healthcare providers. The outcomes were improved health, being empowered, enhanced quality of life and reduced health disparities. This analysis provides a solid foundation for healthcare stakeholders' planning, implementing and evaluating health-promotion activities for people with intellectual disabilities at the policy level and in the community. © 2017 Nordic College of Caring Science.

Market orientation: a concept for health libraries.

PubMed

Sen, Barbara

2006-03-01

This paper is the result of exploratory research forming part of ongoing study into the value and relevance of market orientation as a strategic option for library managers. The aim of the study is to gain an understanding of the concept of market orientation relative to the health library sector. A focus group was used to gather data from health librarians working at different levels in the sector. The data was coded and categorized by an expert panel and analysed using a taxonomic map developed during the study. Health library professionals define and understand market orientation in the same way as the concept is defined in the management literature. Their understanding of the concept is developing. A greater emphasis is given to some aspects of market orientation than others. There are implications for further research. Methods used to measure market orientation in other domains are likely to be relevant for libraries. Research should be extended to different sectors to explore any cross-sector differences. Fostering an organizational culture that supports market orientation has implications for service management and development.

Work-Family Conflict and Self-Rated Health: the Role of Gender and Educational Level. Baseline Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

PubMed

Griep, Rosane Härter; Toivanen, Susanna; van Diepen, Cornelia; Guimarães, Joanna M N; Camelo, Lidyane V; Juvanhol, Leidjaira Lopes; Aquino, Estela M; Chor, Dóra

2016-06-01

This study examined gender differences in the association between work-family conflict and self-rated health and evaluated the effect of educational attainment. We used baseline data from ELSA-Brasil, a cohort study of civil servants from six Brazilian state capitals. Our samples included 12,017 active workers aged 34-72 years. Work-family conflict was measured by four indicators measuring effects of work on family, effects of family in work and lack of time for leisure and personal care. Women experienced more frequent work-family conflict, but in both genders, increased work-family conflict directly correlated with poorer self-rated health. Women's educational level interacted with three work-family conflict indicators. For time-based effects of work on family, highly educated women had higher odds of suboptimal self-rated health (OR = 1.54; 95 % CI = 1.19-1.99) than less educated women (OR = 1.14; 95 % CI = 0.92-1.42). For strain-based effects of work on family, women with higher and lower education levels had OR = 1.91 (95 % CI 1.48-2.47) and OR = 1.40 (95 % CI 1.12-1.75), respectively. For lack of time for leisure and personal care, women with higher and lower education levels had OR = 2.60 (95 % CI = 1.95-3.47) and OR = 1.11 (95 % CI = 0.90-1.38), respectively. Women's education level affects the relationship between work-family conflict and self-rated health. The results may contribute to prevention activities.

Matrix Management: Is It Really Conflict Management.

DTIC Science & Technology

1976-11-01

ru— A036 516 DEFENSE SYSTEMS MANAGEMENT COLL FORT BELVOIR VA - FIG 5/1 MATRIX MANAGEMENT: IS IT REALLY CONFLICT MANAGEMENT . (U) NOV 76 R P... conflict management .” As a result , sensitivity training for managers and their subordinates was conducted in order to implement the matrix concept...Wilemon. “ Conflict Management in ProJect Life Cycles ,” Sloan ~anagement Review , Vol. 16,Spring , 1975, pp . 3 1—5 0. Thamhain , Hans J. and David L

The gendered health workforce: mixed methods analysis from four fragile and post-conflict contexts.

PubMed

Witter, Sophie; Namakula, Justine; Wurie, Haja; Chirwa, Yotamu; So, Sovanarith; Vong, Sreytouch; Ros, Bandeth; Buzuzi, Stephen; Theobald, Sally

2017-12-01

It is well known that the health workforce composition is influenced by gender relations. However, little research has been done which examines the experiences of health workers through a gender lens, especially in fragile and post-conflict states. In these contexts, there may not only be opportunities to (re)shape occupational norms and responsibilities in the light of challenges in the health workforce, but also threats that put pressure on resources and undermine gender balance, diversity and gender responsive human resources for health (HRH). We present mixed method research on HRH in four fragile and post-conflict contexts (Sierra Leone, Zimbabwe, northern Uganda and Cambodia) with different histories to understand how gender influences the health workforce. We apply a gender analysis framework to explore access to resources, occupations, values, decision-making and power. We draw largely on life histories with male and female health workers to explore their lived experiences, but complement the analysis with evidence from surveys, document reviews, key informant interviews, human resource data and stakeholder mapping. Our findings shed light on patterns of employment: in all contexts women predominate in nursing and midwifery cadres, are under-represented in management positions and are clustered in lower paying positions. Gendered power relations shaped by caring responsibilities at the household level, affect attitudes to rural deployment and women in all contexts face challenges in accessing both pre- and in-service training. Coping strategies within conflict emerged as a key theme, with experiences here shaped by gender, poverty and household structure. Most HRH regulatory frameworks did not sufficiently address gender concerns. Unless these are proactively addressed post-crisis, health workforces will remain too few, poorly distributed and unable to meet the health needs of vulnerable populations. Practical steps need to be taken to identify gender

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.

Conflict management: a primer for doctors in training

PubMed Central

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. PMID:16397073

Maternal mental health priorities, help-seeking behaviors, and resources in post-conflict settings: a qualitative study in eastern Uganda.

PubMed

Tol, Wietse A; Ebrecht, BreeOna; Aiyo, Rebecca; Murray, Sarah M; Nguyen, Amanda J; Kohrt, Brandon A; Ndyanabangi, Sheila; Alderman, Stephen; Musisi, Seggane; Nakku, Juliet

2018-02-07

Limited knowledge exists to inform the selection and introduction of locally relevant, feasible, and effective mental health interventions in diverse socio-cultural contexts and health systems. We examined stakeholders' perspectives on mental health-related priorities, help-seeking behaviors, and existing resources to guide the development of a maternal mental health component for integration into non-specialized care in Soroti, eastern Uganda. We employed rapid ethnographic methods (free listing and ranking; semi-structured interviews; key informant interviews and pile sorting) with community health workers (n = 24), primary health workers (n = 26), perinatal women (n = 24), traditional and religious healers (n = 10), and mental health specialists (n = 9). Interviews were conducted by trained Ateso-speaking interviewers. Two independent teams conducted analyses of interview transcripts following an inductive and thematic approach. Smith's Salience Index was used for analysis of free listing data. When asked about common reasons for visiting health clinics, the most salient responses were malaria, general postnatal care, and husbands being absent. Amongst the free listed items that were identified as mental health problems, the three highest ranked concerns were adeka na aomisio (sickness of thoughts); ipum (epilepsy), and emalaria (malaria). The terms epilepsy and malaria were used in ways that reflected both biomedical and cultural concepts of distress. Sickness of thoughts appeared to overlap substantially with major depression as described in international classification, and was perceived to be caused by unsupportive husbands, intimate partner violence, chronic poverty, and physical illnesses. Reported help-seeking for sickness of thoughts included turning to family and community members for support and consultation, followed by traditional or religious healers and health centers if the problem persisted. Our findings add to existing

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

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.

Co-operation and conflict in a hospital: interprofessional differences in perception and management of conflicts.

PubMed

Skjørshammer, M

2001-02-01

This article presents a case study of a Norwegian hospital, analysing how health professionals manage conflicts related to work co-operation. Altogether, 29 health professionals working in the hospital were interviewed, and data was analysed according to a grounded theory approach. When in conflict, health professionals seem to use three major approaches to handling the situation: avoidance, forcing and negotiation, and usually in that order. Avoidance behaviour or suppression is the most common reaction to an emerging conflict. If the use of power does not re-establish a balance between the participants, one negotiates. These conflict styles seem to be determined by two major factors: the perceived interdependence between parties and the perceived urgency of doing something about the situation. Nurses and physicians in particular seem to differ considerably in their perception of what is a conflict and when to do something about it. Such differences in perceptions and the extensive use of avoidance represent important challenges to managers and clinical leaders when it comes to advancing interprofessional co-operation.

Fragile and conflict affected states: report from the Consultation on Collaboration for Applied Health Research and Delivery

PubMed Central

2014-01-01

Fragile and Conflict Affected States present difficult contexts to achieve health system outcomes and are neglected in health systems research. This report presents key debates from the Consultation of the Collaboration for Applied Health Research and Delivery, Liverpool, June, 2014.

An explanatory model for the concept of mental health in Iranian youth

PubMed Central

Chinekesh, Ahdieh; Hosseini, Seyed Ali; Mohammadi, Farahnaz; Motlagh, Mohammad Esmael; Baradaran Eftekhari, Monir; Djalalinia, Shirin; Ardalan, Gelayol

2018-01-01

Background: Mental health is considered as an integral and essential component of overall health. Its determinants and related factors are one of the most important research priorities, especially in adolescents and young people. Using a qualitative approach, the present study aimed to identify factors affecting the mental health of youth in Iran. Methods: In 2017, following content analysis principles, and using semi-structured in-depth interviews, we conducted a qualitative study exploring the opinions of young people about mental health. A targeted sampling method was used, and participants were young volunteers aged 18 to 30 who were selected from Tehran province, Iran. Inclusion criteria for participants was willingness to participate in the study, and ability to express their experiences. Data collection was done with individual in-depth interviews. According to the explanatory model, the interviews were directed toward the concept of mental health and path of causality and auxiliary behaviors. Results: 21 young adults participated, who met the study inclusion criteria, of whom 12 participants were male. Their mean age was 24.4 ± 0.41 years and their education varied from primary school to Master’s degree. Mental health was considered as mental well-being and a sense of satisfaction and efficacy, not only the presence of a disease or mental disorder. Based on the opinions of the interviewees, three factors of personal characteristics, family and society are involved in mental health. Individual factors were associated with behavioral and physical problems. One of the most important issues was revealed as tensions in societal and family conflicts. Economic problems and unemployment of young people were also extracted from the social factor. Conclusion: In Iran, social factors such as jobs for the unemployed and job security are considered as important determinants in the mental health of young people. PMID:29560255

A scoping review of the associations between mental health and factors related to HIV acquisition and disease progression in conflict-affected populations.

PubMed

Koegler, Erica; Kennedy, Caitlin E

2018-01-01

The association between poor mental health and factors related to HIV acquisition and disease progression (also referred to as HIV-related factors) may be stronger among conflict-affected populations given elevated rates of mental health disorders. We conducted a scoping review of the literature to identify evidence-based associations between mental health (depression, anxiety, and post-traumatic stress disorder [PTSD]) and factors related to HIV acquisition and progression in conflict-affected populations. Five electronic databases were searched on October 10, 2014 and updated on March 7, 2017 to identify peer-reviewed publications presenting primary data from January 1, 1994 to March 7, 2017. Articles were included if: 1) depression, anxiety, and/or PTSD was assessed using a validated scale, 2) HIV or HIV-related factors were a primary focus, 3) quantitative associations between depression/anxiety/PTSD and HIV or HIV-related factors were assessed, and 4) the study population was conflict-affected and from a conflict-affected setting. Of 714 citations identified, 33 articles covering 110,818 participants were included. Most were from sub-Saharan Africa ( n  = 25), five were from the USA, and one each was from the Middle East, Europe, and Latin America. There were 23 cross-sectional, 3 time-series, and 7 cohort studies. The search identified that mental health has been quantitatively associated with the following categories of HIV-related factors in conflict-affected populations: markers of HIV risk, HIV-related health status, sexual risk behaviors, and HIV risk exposures (i.e. sexual violence). Further, findings suggest that symptoms of poor mental health are associated with sexual risk behaviors and HIV markers, while HIV risk exposures and health status are associated with symptoms of poor mental health. Results suggest a role for greater integration and referrals across HIV and mental health programs for conflict-affected populations.

Diversity, Conflict, and Recognition in Hospital Medical Practice.

PubMed

Fortin, Sylvie; Maynard, Serge

2018-03-01

The hospital is a place of encounter between health care providers, patients and family members, the healthy and the suffering, migrants and non-migrants, as well as social and cultural minorities, and majorities of various backgrounds. It is also a space where multiple conceptions of care, life, quality of life, and death are enacted, sometimes inhibiting mutual understanding between caregivers and the cared for, a scenario that in turn may provoke conflict. Through the lens of conflict, we explore in this article the theme of Otherness within the clinic, basing analysis on an ethnographic study conducted in recent years in three cosmopolitan Canadian cities. Daily practices and-on a larger scale-the social space of the clinic become material here for reflecting on recognition (and non-recognition) of the Other as actors in the clinical encounter. The examination of structural and situational conditions that contribute to the emergence of conflict offers an understanding of the diversity of values that pervade the clinic. By way of conclusion, we argue that recognition of diversity, at least on the part of practitioners, is a key condition for the emergence of a pluralist normativity in the social space of the clinic.

Automated Conflict Resolution For Air Traffic Control

NASA Technical Reports Server (NTRS)

Erzberger, Heinz

2005-01-01

The ability to detect and resolve conflicts automatically is considered to be an essential requirement for the next generation air traffic control system. While systems for automated conflict detection have been used operationally by controllers for more than 20 years, automated resolution systems have so far not reached the level of maturity required for operational deployment. Analytical models and algorithms for automated resolution have been traffic conditions to demonstrate that they can handle the complete spectrum of conflict situations encountered in actual operations. The resolution algorithm described in this paper was formulated to meet the performance requirements of the Automated Airspace Concept (AAC). The AAC, which was described in a recent paper [1], is a candidate for the next generation air traffic control system. The AAC's performance objectives are to increase safety and airspace capacity and to accommodate user preferences in flight operations to the greatest extent possible. In the AAC, resolution trajectories are generated by an automation system on the ground and sent to the aircraft autonomously via data link .The algorithm generating the trajectories must take into account the performance characteristics of the aircraft, the route structure of the airway system, and be capable of resolving all types of conflicts for properly equipped aircraft without requiring supervision and approval by a controller. Furthermore, the resolution trajectories should be compatible with the clearances, vectors and flight plan amendments that controllers customarily issue to pilots in resolving conflicts. The algorithm described herein, although formulated specifically to meet the needs of the AAC, provides a generic engine for resolving conflicts. Thus, it can be incorporated into any operational concept that requires a method for automated resolution, including concepts for autonomous air to air resolution.

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.

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

Modeling and Simulating Airport Surface Operations with Gate Conflicts

NASA Technical Reports Server (NTRS)

Zelinski, Shannon; Windhorst, Robert

2017-01-01

The Surface Operations Simulator and Scheduler (SOSS) is a fast-time simulation platform used to develop and test future surface scheduling concepts such as NASA's Air Traffic Demonstration 2 of time-based surface metering at Charlotte Douglass International Airport (CLT). Challenges associated with CLT surface operations have driven much of SOSS development. Recently, SOSS functionality for modeling harsdstand operations was developed to address gate conflicts, which occur when an arrival and departure wish to occupy the same gate at the same time. Because surface metering concepts such as ATD2 have the potential to increase gates conflicts as departures are held at their gates, it is important to study the interaction between surface metering and gate conflict management. Several approaches to managing gate conflicts with and without the use of hardstands were simulated and their effects on surface operations and scheduler performance compared.

Modeling and Simulating Airport Surface Operations with Gate Conflicts

NASA Technical Reports Server (NTRS)

Zelinski, Shannon; Windhorst, Robert

2017-01-01

The Surface Operations Simulator and Scheduler (SOSS) is a fast-time simulation platform used to develop and test future surface scheduling concepts such as NASAs Air Traffic Demonstration 2 of time-based surface metering at Charlotte Douglas International Airport (CLT). Challenges associated with CLT surface operations have driven much of SOSS development. Recently, SOSS functionality for modeling hardstand operations was developed to address gate conflicts, which occur when an arrival and departure wish to occupy the same gate at the same time. Because surface metering concepts such as ATD2 have the potential to increase gates conflicts as departure are held at their gates, it is important to study the interaction between surface metering and gate conflict management. Several approaches to managing gate conflicts with and without the use of hardstands were simulated and their effects on surface operations and scheduler performance compared.

Health in the service of state-building in fragile and conflict affected contexts: an additional challenge in the medical-humanitarian environment.

PubMed

Philips, Mit; Derderian, Katharine

2015-01-01

Global health policy and development aid trends also affect humanitarian health work. Reconstruction, rehabilitation and development initiatives start increasingly earlier after crisis, unleashing tensions between development and humanitarian paradigms. Recently, development aid shows specific interest in contexts affected by conflict and fragility, with increasing expectations for health interventions to demonstrate transformative potential, including towards more resilient health systems as a contribution to state-building agendas. Current drives towards state-building opportunities in health interventions is mainly based on political aspirations, with little conclusive evidence on linking state-building efforts to conflict prevention, neither on transformative effects of health systems support. Moreover, negative consequences are possible in such volatile environments. We explore how to anticipate, discuss and monitor potential negative effects of current state-building approaches on health interventions, including on humanitarian aid. Overriding health systems approaches might increase tension in fragile and conflict affected contexts, because at odds with goals typically associated with immediate emergency response to populations' needs. Especially in protracted crisis, quality and timeliness of humanitarian response can be compromised, with strain on impartiality, targeting the most vulnerable, prioritising direct health benefits and most effective strategies. State-building focus could shift health aid priorities away from sick people and disease. Precedence of state institutions support over immediate, effective health service delivery can reduce population level results. As consequence people might question health workers' intention to privilege health above political, ethnic or other alliances, altering health and humanitarian workers' perception. Particularly in conflict, neither health system nor state are impartial bystanders. In spite of scarce

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 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... standards and requirements of the Federal Acquisition Regulation organizational conflict of interest...

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 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... standards and requirements of the Federal Acquisition Regulation organizational conflict of interest...

Managing complex workplace stress in health care organizations: leaders' perceived legitimacy conflicts.

PubMed

Dellve, Lotta; Wikström, Ewa

2009-12-01

To conceptualize how health care leaders' strategies to increase their influence in their psychosocial work environment are experienced and handled, and may be supported. The complex nature of the psychosocial work environment with increased stress creates significant challenges for leaders in today's health care organizations. Interviews with health care leaders (n = 39) were analysed in accordance with constructivist grounded theory. Compound identities, loyalty commitments and professional interests shape conditions for leaders' influence. Strategies to achieve legitimacy were either to retain clinical skills and a strong occupational identity or to take a full leadership role. Ethical stress was experienced when organizational procedural or consequential legitimacy norms were in conflict with the leaders' own values. Leadership support through socializing processes and strategic support structures may be complementary or counteractive. Support programmes need to have a clear message related to decision-making processes and should facilitate communication between top management, human resource departments and subordinate leaders. Ethical stress from conflicting legitimacy principles may be moderated by clear policies for decision-making processes, strengthened sound networks and improved communication. Supportive programmes should include: (1) sequential and strategic systems for introducing new leaders and mentoring; (2) reflective dialogue and feedback; (3) team development; and (4) decision-making policies and processes.

Terroir as a Concept to Improve Human Health

NASA Astrophysics Data System (ADS)

Brevik, Eric C.; Steffan, Joshua J.; Burgess, Lynn C.; Cerdà, Artemi; Pereg, Lily

2017-04-01

Soil is important to human health because of the ability of healthy soils to supply nutrients through food products, medications derived from soil, its ability to clean water, and for many other positive reasons. On the other hand, degraded soils can have negative impacts on human health through processes such as dust generation and by acting as a point of human contact with heavy metals, organic chemicals, and pathogens. Despite the definite links between soil and human health, it is likely that most people don't think about soil when considering human health issues. In fact, there appears to be a disconnect between most people in our modern society and soil, and when people do notice soil it often seems to be in a negative context, leading to terms such as "soiled", "dirty", "dirt poor", etc. People pay attention to and care for things that matter to them, and creating a more positive public image of soil has the possibility of improving human health by leading to careful and caring treatment of the soil resource. The concept of terroir is a good example of a setting within which soils have a more positive image. While terroir originally established a connection between those who love wine and the soils that produce those wines, the concept has been expanded to many additional products such as cacao, cheese, coffee, fruits, olive oil, and vegetables. If the terroir concept could be expanded to include additional products that are important to people and expanded into parts of the world where it is not currently well known, that may provide an increased positive perception of soil, and thereby indirectly improve human health. It may even be possible to provide a terroir link to direct health benefits, such as medications derived from a given soil environment, and therefore provide a very focused emphasis on soil and human health issues. Therefore, we advocate a concerted effort to expand the terroir concept as a means to improve overall human health.

Perceived conflict in the couple and chronic illness management: preliminary analyses from the Quebec Health Survey.

PubMed

Soubhi, Hassan; Fortin, Martin; Hudon, Catherine

2006-10-19

The quality of the relationship with the spouse/partner appears crucial among patients with multiple chronic conditions where illness management is complex and multifaceted. This study draws on data from the Quebec Health Survey (QHS) to examine, among patients with one or more chronic conditions, the relation between marital status, the perceived conflict with the spouse/partner, and what the patients do to manage their illness as well as how they perceive their health. Data from the QHS 1998 were used. The sample included 7547 coupled adults who had one or more chronic health problems lasting more than 6 months. Independent variables included marital status, perceived conflict with the spouse/partner, and the number of chronic conditions. Illness management was defined broadly as a measure of the patient's efforts at self-care and an illness status indicator, including visits to the generalist and the specialist, the use of telephone health line in the last 12 months, self-rated general health, mental health, and a measure of psychological distress. Linkages between the independent variables and illness management were assessed for males and females separately with logistic regressions, while accounting for the survey sampling design and household clustering. Female patients who did not live with their partner and had never been married were more likely to report a negative perception of their general health and a higher psychological distress than those who were married. Perceived conflict with the partner was linked to a negative perception of mental health and a higher psychological distress among both men and women. Compared to patients with only one chronic condition, males who reported more than one chronic condition were more likely to have consulted a generalist prior to the survey and used the telephone health line, whereas females were more likely to have consulted a specialist. Both males and females with more than one chronic condition were more

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. Copyright © 2015 Elsevier Ltd. All rights reserved.

Well-being and fairness in the distribution of scarce health resources.

PubMed

Segev, Re'em

2005-06-01

Based on a general thesis regarding the proper resolution of interpersonal conflicts, this paper suggests a normative framework for the distribution of scarce health resources. The proposed thesis includes two basic ideas. First, individual well-being is the fundamental value. Second, interpersonal conflicts affecting well-being should be resolved in light of several conceptions of fairness, reflecting the independent value of persons and the moral significance of responsibility of individuals for the existence of interpersonal conflicts. These ideas are elaborated in several principles that are applied with respect to the distribution of scarce health resources.

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…

Work-family conflict, health services and medication use among dual-income couples in Europe.

PubMed

Christiaens, Wendy; Bracke, Piet

2014-03-01

Combination pressure or work-life imbalance is linked to adverse health. However, it remains unclear how work-family conflict is related to healthcare utilisation. Does work-family conflict function as a barrier or as a facilitator in relation to the use of health services and prescription medication? Lack of time may prevent people from visiting a doctor when they feel unwell. However, combination pressure can also be expected to intensify the use of health services, as the need for a quick fix is prioritised. Further, do women and men differ in their susceptibility to medicalisation and time pressure resulting from work-life imbalance? This article investigates the use of health services and prescription medication of dual-income couples with children, based on data from 23 countries in the European Social Survey round 2 (N(women) = 3755; N(men) = 3142). It was found that medical services and prescription medications are used more frequently in dual-income couples experiencing work-to-family spillover, but for women only this is irrespective of their self-reported health. Family-to-work spillover does not result in increased health service or medication use for either men or women. While women opt for a medical response to work-life imbalance, men's reluctance to seek formal health support is confirmed. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Evolution of policies on human resources for health: opportunities and constraints in four post-conflict and post-crisis settings.

PubMed

Witter, Sophie; Bertone, Maria Paola; Chirwa, Yotamu; Namakula, Justine; So, Sovannarith; Wurie, Haja R

2016-01-01

Few studies look at policy making in the health sector in the aftermath of a conflict or crisis and even fewer specifically focus on Human Resources for Health, which is a critical domain for health sector performance. The main objective of the article is to shed light on the patterns and drivers of post-conflict policy-making. In particular, we explore whether the post -conflict period offers increased chances for the opening of 'windows for opportunity' for change and reform and the potential to reset health systems. This article uses a comparative policy analysis framework. It is based on qualitative data, collected using three main tools - stakeholder mapping, key informant interviews and document reviews - in Uganda, Sierra Leone, Cambodia and Zimbabwe. We found that HRH challenges were widely shared across the four cases in the post-conflict period but that the policy trajectories were different - driven by the nature of the conflicts but also the wider context. Our findings suggest that there is no formula for whether or when a 'window of opportunity' will arise which allows health systems to be reset. Problems are well understood in all four cases but core issues - such as adequate pay, effective distribution and HRH management - are to a greater or lesser degree unresolved. These problems are not confined to post-conflict settings, but underlying challenges to addressing them - including fiscal space, political consensus, willingness to pursue public objectives over private, and personal and institutional capacity to manage technical solutions - are liable to be even more acute in these settings. The role of the MoH emerged as weaker than expected, while the shift from donor dependence was clearly not linear and can take a considerable time. Windows of opportunity for change and reform can occur but are by no means guaranteed by a crisis - rather they depend on a constellation of leadership, financing, and capacity. Recognition of urgency is certainly a

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…

One health in Switzerland: a visionary concept at a crossroads?

PubMed

Meisser, Andrea; Schelling, Esther; Zinsstag, Jakob

2011-05-13

One Health stands for the health of humans, animals and the environment. There is only one health in our entire ecosystem, and the equation for its promotion is in interdisciplinary cooperation. One Health benefits from synergies to generate added value and is a promising strategy to strengthen health systems. A growing number of One Health conferences worldwide bear witness to a spirit of optimism which should result in the implementation of a sustainable One Health policy globally, regionally, nationally and locally. The purpose of this study was to investigate the opportunities for implementation of the One Health concept in Switzerland. Between April and August 2010, semi-structured face-to-face interviews were conducted with 16 key experts selected from among the leading personalities in the Swiss health system. The experts confirmed the potential of the One Health concept for Switzerland. Barriers such as cultural differences, absence of evidence, federal structures and a relatively low degree of suffering were identified and a road map established, including research activities, capacity-building and a stakeholder approach to joint preparation and tailored implementation of the One Health concept in Switzerland. These data suggest that One Health can support the opinion leaders in their quest for solutions. The detailed and unbiased description of potential barriers and a clear guide for a step-by-step action plan represent suggestions for a realistic way forward. Experience gained and lessons learnt in Switzerland may be of interest to other countries and help communicate and promote the One Health concept.

Conflict and HIV: A framework for risk assessment to prevent HIV in conflict-affected settings in Africa

PubMed Central

Mock, Nancy B; Duale, Sambe; Brown, Lisanne F; Mathys, Ellen; O'Maonaigh, Heather C; Abul-Husn, Nina KL; Elliott, Sterling

2004-01-01

In sub-Saharan Africa, HIV/AIDS and violent conflict interact to shape population health and development in dramatic ways. HIV/AIDS can create conditions conducive to conflict. Conflict can affect the epidemiology of HIV/AIDS. Conflict is generally understood to accelerate HIV transmission, but this view is simplistic and disregards complex interrelationships between factors that can inhibit and accelerate the spread of HIV in conflict and post conflict settings, respectively. This paper provides a framework for understanding these factors and discusses their implications for policy formulation and program planning in conflict-affected settings. PMID:15679919

A system dynamics approach to understanding the One Health concept

PubMed Central

Liu, Wenbao; Anderson, Benjamin D.; Liu, Xiaorong; Gray, Gregory C.

2017-01-01

There have been many terms used to describe the One Health concept, including movement, strategy, framework, agenda, approach, among others. However, the inter-relationships of the disciplines engaged in the One Health concept have not been well described. To identify and better elucidate the internal feedback mechanisms of One Health, we employed a system dynamics approach. First, a systematic literature review was conducted via searches in PubMed, Web of Knowledge, and ProQuest with the search terms: ‘One Health’ and (concept* or approach*). In addition, we used the HistCite® tool to add significant articles on One Health to the library. Then, of the 2368 articles identified, 19 were selected for evaluating the inter-relationships of disciplines engaged in One Health. Herein, we report a visually rich, theoretical model regarding interactions of various disciplines and complex problem descriptors engaged in One Health problem solving. This report provides a conceptual framework for future descriptions of the interdisciplinary engagements involved in One Health. PMID:28877267

Category Change in the Absence of Cognitive Conflict

ERIC Educational Resources Information Center

Ramsburg, Jared T.; Ohlsson, Stellan

2016-01-01

The cognitive conflict hypothesis asserts that information that directly contradicts a prior conception is 1 of the prerequisites for conceptual change and other forms of nonmonotonic learning. There have been numerous attempts to support this hypothesis by adding a conflict intervention to learning scenarios with weak outcomes. Outcomes have been…

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. Copyright © 2015 Elsevier Inc. All rights reserved.

Oral health technicians in Brazilian primary health care: potentials and constraints.

PubMed

Aguiar, Dulce Maria Lucena de; Tomita, Nilce Emy; Machado, Maria de Fátima Antero Sousa; Martins, Cleide Lavieri; Frazão, Paulo

2014-07-01

Different perspectives on the role of mid-level workers in health care might represent a constraint to health policies. This study aimed to investigate how different agents view the participation of oral health technicians in direct activities of oral healthcare with the goal of understanding the related symbolic dispositions. Theoretical assumptions related to inter-professional collaboration and conflicts in the field of healthcare were used for this analysis. A researcher conducted 24 in-depth interviews with general dental practitioners, oral health technicians and local managers. The concepts of Pierre Bourdieu supported the data interpretation. The results indicated inter-professional relations marked by collaboration and conflict that reflect an action space related to different perspectives of primary care delivery. They also unveiled the symbolic devices related to the participation of oral health technicians that represent a constraint to the implementation of oral health policy, thus reducing the potential of primary health care in Brazil.

Health disparities and health equity: concepts and measurement.

PubMed

Braveman, Paula

2006-01-01

There is little consensus about the meaning of the terms "health disparities," "health inequalities," or "health equity." The definitions can have important practical consequences, determining the measurements that are monitored by governments and international agencies and the activities that will be supported by resources earmarked to address health disparities/inequalities or health equity. This paper aims to clarify the concepts of health disparities/inequalities (used interchangeably here) and health equity, focusing on the implications of different definitions for measurement and hence for accountability. Health disparities/inequalities do not refer to all differences in health. A health disparity/inequality is a particular type of difference in health (or in the most important influences on health that could potentially be shaped by policies); it is a difference in which disadvantaged social groups-such as the poor, racial/ethnic minorities, women, or other groups who have persistently experienced social disadvantage or discrimination-systematically experience worse health or greater health risks than more advantaged social groups. ("Social advantage" refers to one's relative position in a social hierarchy determined by wealth, power, and/or prestige.) Health disparities/inequalities include differences between the most advantaged group in a given category-e.g., the wealthiest, the most powerful racial/ethnic group-and all others, not only between the best- and worst-off groups. Pursuing health equity means pursuing the elimination of such health disparities/inequalities.

Ethical conflicts over access to services: patient effects and worker influence in home health.

PubMed

Egan, Marcia; Kadushin, Goldie

2002-01-01

A survey of home health social workers (N = 51) explored the effects on patients of ethical conflicts over access to services. The findings suggest that patients were as likely to be discharged or not receive services as they were to receive the services without paying a fee. Social workers rated themselves as moderately influential in the resolution of the conflict. Their influence was significantly correlated with patients more often receiving services and less often being discharged. Social work influence was enhanced by recognition of professional expertise and/or through informal networking within the agency. Implications for practice and education are discussed.

Vulnerability related to oral health in early childhood: a concept analysis.

PubMed

Mattheus, Deborah J

2010-09-01

This article is a report of the analysis of the concept of vulnerability and its relationship to oral health in early childhood. Poor oral health is a continued problem for children worldwide. Vulnerability increases the probability of poor oral health outcomes. The lack of clarity of the concept of vulnerability creates difficulty in understanding this multi-factoral condition. Data source included 34 articles covering the period 2000-2009 from a variety of disciplines, including nursing, dentistry, medicine and public health. The concept analysis was conducted using Rodgers' evolutionary method. The literature was analysed and a social ecology model was used to frame the discussion, recognizing family and community influences on children's oral health. The context of oral health in early childhood contributes to the changes in the concept vulnerability. The attributes are closely related to family and community factors and identified as limited parental income, parental education, community-based services and fluoride; and exposure to poor parental habits, parental neglect and harmful toxins. The primary antecedent is identified as a form of limited protection from exposure to various circumstances. Children with limited protection have increased vulnerability and greater probability of poor health outcomes. Nurses who understand the concept of vulnerability related to oral health and can identify factors that create protection and are capable of decreasing vulnerability through parent education, community awareness and policy changes that support children and families.

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.

Advanced Airspace Concept

NASA Technical Reports Server (NTRS)

Erzberger, Heinz

2002-01-01

A general overview of the Advanced Airspace Concept (AAC) is presented. The topics include: 1) Limitations of the existing system; 2) The Advanced Airspace Concept; 3) Candidate architecture for the AAC; 4) Separation assurance and conflict avoidance system (TSAFE); and 5) Ground-Air Interactions. This paper is in viewgraph form.

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

USDA-ARS?s Scientific Manuscript database

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...

Chinese concepts of euthanasia and health care.

PubMed

Sleeboom-Faulkner, Margaret

2006-08-01

This article argues that taking concepts of euthanasia out of their political and economic contexts leads to violations of the premises on which the Stoic ideal of euthanasia is based: 'a quick, gentle and honourable death.' For instance, the transplantation of the narrowly defined concept of euthanasia developed under the Dutch welfare system into a developing country, such as the People's Republic of China (PRC), seems inadequate. For it cannot deal with questions of anxiety about degrading forms of dying and suffering without reference to its economic rationale, demanded by a scarcity (unequal distribution) of health care resources. The weakness of health care provisions for the terminally ill in Mainland China has become increasingly poignant since the collapse of collective health care institutions in the countryside since the reforms of the late-1980s. As in most cases where health care facilities are wanting, it is difficult to apply the criteria of gentleness and dignity at reaching death. Its solution lies not in a faster relief from suffering by euthanasia, but in extending the quality of life through distributive justice within Chinese healthcare policy-making. This paper begins with a brief description of the Dutch euthanasia law, after which it discusses Chinese conceptions of euthanasia in biomedical textbooks, the media and in surveys. It concludes by pointing out the need for a transnational framework in which both the specifics and generalities of euthanasia can be discussed.

Conflict control in task conflict and response conflict.

PubMed

Braverman, Ami; Meiran, Nachshon

2015-03-01

Studies have suggested that conflict control can modulate conflict effects in response to differing levels of conflict context. The current study probed, in two experiments of proportion congruence, the relevance of both task conflict (between a currently relevant task and irrelevant task alternatives) and response conflict (between a currently relevant response and irrelevant response alternatives) to conflict control. In Experiment 1, proportion congruence between blocks was manipulated and in Experiment 2, proportion congruence was manipulated between items. The response conflict effect was smaller when proportion of incongruence was high, regardless if task conflict or response conflict proportions were manipulated. These findings suggest that both task conflict and response conflict are monitored but that only response conflict is being influenced by this monitoring process. Theoretical implications are discussed.

Health worker experiences of and movement between public and private not-for-profit sectors-findings from post-conflict Northern Uganda.

PubMed

Namakula, Justine; Witter, Sophie; Ssengooba, Freddie

2016-05-05

Northern Uganda suffered 20 years of conflict which devastated lives and the health system. Since 2006, there has been investment in reconstruction, which includes efforts to rebuild the health workforce. This article has two objectives: first, to understand health workers' experiences of working in public and private not-for-profit (PNFP) sectors during and after the conflict in Northern Uganda, and second, to understand the factors that influenced health workers' movement between public and PNFP sectors during and after the conflict. A life history approach was used with 26 health staff purposively selected from public and PNFP facilities in four districts of Northern Uganda. Staff with at least 10 years' experience were selected, which resulted in a sample which was largely female and mid-level. Two thirds were currently employed in the public sector and just over a third in the PNFP sector. A thematic data analysis was guided by the framework analysis approach, analysis framework stages and ATLAS.ti software version 7.0. Analysis reveals that most of the current staff were trained in the PNFP sector, which appears to offer higher quality training experiences. During the conflict period, the PNFP sector also functioned more effectively and was relatively better able to support its staff. However, since the end of the conflict, the public sector has been reconstructed and is now viewed as offering a better overall package for staff. Most reported movement has been in that direction, and many in the PNFP sector state intention to move to the public sector. While there is sectoral loyalty on both sides and some bonds created through training, the PNFP sector needs to become more competitive to retain staff so as to continue delivering services to deprived communities in Northern Uganda. There has been limited previous longitudinal analysis of how health staff perceive different sectors and why they move between them, particularly in conflict-affected contexts

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.

Do health professionals have a prototype concept of disease? The answer is no.

PubMed

Hofmann, Bjørn

2017-09-11

Health and disease are core concepts in health care and have attracted substantial interest and controversy. In recent and interesting contributions to the debate it has been argued that the challenges with the concept of disease can be resolved by a prototype concept of disease. As a robin is a more prototypical of a bird than a penguin, some diseases are more prototypical than others. If disease is a prototype concept, it would change nosology, but also health care and the study of health and disease. However, the statement that "disease is a prototype concept" forms an empirically testable hypothesis. Therefore, this study aims to test the hypothesis that health professionals have a prototype concept of disease. Two hundred twenty-three health care professionals in Norway were invited to participate in a survey where they were asked to rank a wide range of diseases according to how typical they considered them to be as diseases. Results were analysed with descriptive statistics. The response rate was 90%. Lung cancer, leukemia, colon cancer, myocardial infarction, and AIDS are the diseases ranged to be most typical, while homosexuality, pregnancy, drapetomania, dissidence, and nostalgia are considered to be the least typical diseases. The results also show that the answers to how typical various diseases are vary greatly, even amongst a relatively homogenous group of health professionals. This study falsifies the hypothesis that disease is a prototype concept for health professionals. This has implications for the debate on core concepts for health care. If health professionals do not have a prototype concept of disease, it is unlikely that there is a prototype concept of disease in general. Consequently, nosologies should not be based on prototypes.

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. Copyright © 2016. Published by Elsevier Ltd.

Conflicts of interest in translational research

PubMed Central

Parks, Malcolm R; Disis, Mary L

2004-01-01

Translational research requires a team approach to scientific inquiry and product development. Translational research teams consist of basic and clinical scientists who can be members of both academic and industrial communities. The conception, pre-clinical testing, and clinical evaluation of a diagnostic or therapeutic approach demands an intense interaction between investigators with diverse backgrounds. As the barriers between industry and academia are removed, issues of potential conflict of interest become more complex. Translational researchers must become aware of the situations which constitute conflict of interest and understand how such conflicts can impact their research programs. Finally, the translational research community must participate in the dialogue ongoing in the public and private sectors and help shape the rules that will govern conflicts that arise during the evolution of their research programs. PMID:15301694

Montana Health Enhancement...An Expanded Concept: Assessment and Planning.

ERIC Educational Resources Information Center

Montana State Dept. of Public Instruction, Helena.

Comprehensive health enhancement programs (CHEPs) are a curricular area required by new Montana accreditation standards. The curriculum combines the disciplines of health and physical education into an integrated, holistic, health-oriented program. A CHEP incorporates an expanded concept of health services--healthy school environment, employee…

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.

Conflicts of quarantine the case of Jewish immigrants to the Jewish state.

PubMed

Seidelman, Rhona D

2012-02-01

Shaar Haaliya--Israel's Ellis Island during the mass immigration of the 1950s--is a case study that challenges the historian's understanding of the concept of quarantine. It was isolated and fenced off for declared health purposes and was widely referred to as a quarantine, but archival and historiographical documentation suggest that Israeli public health policy did not define it as such. I track the discussion and conflict surrounding Shaar Haaliya's function and perception as a quarantine. This is a story that illuminates the way fear of disease converged with fear of immigration as well as the way defiance of public health institutions took shape in a unique framework of citizenship and during a unique wave of migration.

The preventive-curative conflict in primary health care.

PubMed

De Sa, C

1993-04-01

Approximately 80% of the rural population in developing countries do not have access to appropriate curative care. The primary health care (PHC) approach emphasizes promotive and preventive services. Yet most people in developing countries consider curative care to be more important. Thus, PHC should include curative and rehabilitative care along with preventive and promotive care. The conflict between preventive and curative care is apparent at the community level, among health workers from all levels of the health system, and among policy makers. Community members are sometimes willing to pay for curative services but not preventive services. Further, they believe that they already know enough to prevent illness. Community health workers (CHWs), the mainstays of most PHC projects are trained in preventive efforts, but this hinders their effectiveness, since the community expects curative care. Besides, 66% of villagers' health problems require curative care. Further, CHWs are isolated from health professionals, adding to their inability to effect positive change. Health professionals are often unable to set up a relationship of trust with the community, largely due to their urban-based medical education. They tend not to explain treatment to patients or to simplify explanations in a condescending manner. They also mystify diseases, preventing people from understanding their own bodies and managing their illnesses. National governments often misinterpret national health policies promoting PHC and implement them from a top-down approach rather than from the bottom-up PHC-advocated approach. Nongovernmental organizations (NGOs) and international agencies also interpret PHC in different ways. Still, strong partnerships between government, NGOs, private sector, and international agencies are needed for effective implementation of PHC. Yet, many countries continue to have complex hierarchical social structures, inequitable distribution, and inadequate resources, making

Examining the need & potential for biomedical engineering to strengthen health care delivery for displaced populations & victims of conflict.

PubMed

Nadkarni, Devika; Elhajj, Imad; Dawy, Zaher; Ghattas, Hala; Zaman, Muhammad H

2017-01-01

Conflict and the subsequent displacement of populations creates unique challenges in the delivery of quality health care to the affected population. Equitable access to quality care demands a multi-pronged strategy with a growing need, and role, for technological innovation to address these challenges. While there have been significant contributions towards alleviating the burden of conflict via data informatics and analytics, communication technology, and geographic information systems, little has been done within biomedical engineering. This article elaborates on the causes for gaps in biomedical innovation for refugee populations affected by conflict, tackles preconceived notions, takes stock of recent developments in promising technologies to address these challenges, and identifies tangible action items to create a stronger and sustainable pipeline for biomedical technological innovation to improve the health and well-being of an increasing group of vulnerable people around the world.

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

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.

[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.

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…

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 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Review Board to assist in resolving organizational conflicts of interest. (b) Resolution: Resolution of...

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 421.312 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Review Board to assist the contracting officer in resolving organizational conflicts of interest. (b...

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 421.310 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... (FAR) organizational conflict of interest guidance specified under 48 CFR subpart 9.5. (b) The...

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 421.310 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... (FAR) organizational conflict of interest guidance specified under 48 CFR subpart 9.5. (b) The...

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 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Review Board to assist in resolving organizational conflicts of interest. (b) Resolution: Resolution of...

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 421.312 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Review Board to assist the contracting officer in resolving organizational conflicts of interest. (b...

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.

[Concepts associated to systematization of nursing care in Brazilian journals].

PubMed

Fuly, Patrícia Dos Santos Claro; Leite, Joséte Luzia; Lima, Suzinara Beatriz Soares

2008-01-01

This study is a research that has as objective analyze the bibliographical production about the Systematization of Nursing Care in order to discuss concepts associated to the subject. Were analyzed books and national articles published in the database of the Virtual Library in Health, Medline, Lilacs and Scielo, in the period of January of 2000 to January of 2008. Were analyzed 11 articles, having been identified three distinct kind of thought to define concepts associated to Systematization of Nursing Care. Such fact aims for the difficulty of theoretical and pratical articulation, evidenced by the conflicts existing in the literature.

A concept analysis of children's agency within the health literature.

PubMed

Montreuil, Marjorie; Carnevale, Franco A

2015-12-14

The capacity of children to act as agents is being increasingly recognized and has important implications for health research and practice. However, there are various discrepancies in how children's agency is defined in the literature. The aim of this analysis was to examine the concept of children's agency within the health-related literature, using Rodgers evolutionary method. The following questions were addressed: How did the concept of agency become associated with children in the health-related literature? What are the sociocultural and legal contexts that surround the concept of children's agency? What is the meaning of children's agency? Forty-five articles were included in the analysis. An inductive approach was used to identify the attributes of children's agency as well as the temporal, disciplinary, and paradigmatic trends in its conceptualization. The concept of children's agency first appeared in the health literature in the 1980s and was defined as an ability children could gradually develop. Later on, children's agency was used to refer to the capacity of all children to influence their own and others' health-care needs and is now increasingly used to refer to children as active agents who reflect on and construct their social worlds. © The Author(s) 2015.

Impact of Family Conflict on Adult Child Caregivers.

ERIC Educational Resources Information Center

Strawbridge, William J.; Wallhagen, Margaret I.

1991-01-01

In study of 100 adult child caregivers, 40 percent were experiencing conflict with another family member, usually sibling. Most conflict arose because relative failed to provide sufficient help. Caregivers experiencing family conflict had significantly higher perceived burden and poorer mental health than did caregivers without conflict.…

Unravelling the concept of integrated public health policy: Concept mapping with Dutch experts from science, policy, and practice.

PubMed

Tubbing, Luuk; Harting, Janneke; Stronks, Karien

2015-06-01

While expectations of integrated public health policy (IPHP) promoting public health are high, assessment is hampered by the concept's ambiguity. This paper aims to contribute to conceptual clarification of IPHP as first step in further measurement development. In an online concept mapping procedure, we invited 237 Dutch experts, 62 of whom generated statements on characteristics of IPHP. Next, 100 experts were invited, 24 of whom sorted the statements into piles according to their perceived similarity and rated the statements on relevance and measurability. Data was analyzed using concept mapping software. The concept map consisted of 97 statements, grouped into 11 clusters and five themes. Core themes were 'integration', concerning 'policy coherence' and 'organizing connections', and 'health', concerning 'positioning health' and 'addressing determinants'. Peripheral themes were 'generic aspects', 'capacities', and 'goals and setting', which respectively addressed general notions of integrated policy making, conditions for IPHP, and the variety in manifestations of IPHP. Measurability ratings were low compared to relevance. The concept map gives an overview of interrelated themes, distinguishes core from peripheral dimensions, and provides pointers for theories of the policy process. While low measurability ratings indicate measurement difficulties, the core themes provide pointers for systematic insight into IPHP through measurement. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Relationships between work-family and family-work conflicts and health of nurses--buffering effects of social support].

PubMed

Baka, Łukasz

2013-01-01

The aim of the study was to investigate the relationships between work-family conflict (WFC), family-work conflict (FWC) and health, as well as the moderating effect of social support. The study was based on the Job Demands-Resources model. There were 567 nurses from 21 Polish hospitals participating in the study. To verify the hypothesis four scales, which measured WFC, FWC, social support, physical complaints and job burnout, were used. The results partially support the hypothesis. As predicted, high WFC and FWC were correlated with low physical (H1) and mental health (H2). Social support moderated negative effects of WFC (but not FWC) on mental health (H3). The effects of WFC and FWC on physical health were not moderated by social support (H4). The results also partially support the notion of the Job Demands-Resources model and provide further insight into processes leading to the high well-being of nurses in the workplace.

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. Copyright © 2012 Elsevier Ltd. All rights reserved.

Global Health in Conflict Understanding Opposition to Vitamin A Supplementation in India

PubMed Central

Wallace, Sarah K.

2012-01-01

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. PMID:22594752

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.

Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review.

PubMed

Lassi, Zohra S; Aftab, Wafa; Ariff, Shabina; Kumar, Rohail; Hussain, Imtiaz; Musavi, Nabiha B; Memon, Zahid; Soofi, Sajid B; Bhutta, Zulfiqar A

2015-01-01

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare

Enablement in health care context: a concept analysis.

PubMed

Hudon, Catherine; St-Cyr Tribble, Denise; Bravo, Gina; Poitras, Marie-Eve

2011-02-01

The enablement process is defined as a professional intervention aiming to recognize, support and emphasize the patient's capacity to have control over her or his health and life. The purpose of this article was to study the enablement concept through a concept analysis in the health care context to identify: (1) its attributes and (2) its antecedents and consequents. A concept analysis was performed according to the method of Rodgers. The literature was reviewed from 1980 to June 2008, using search strategies adapted to the databases Cinahl, Medline, Embase, PsycInfo and Social Works Abstract, and hand searching. All articles contributing to a deeper understanding of the concept were included. The analysis was carried out according to a thematic analysis procedure, as described by Miles & Huberman. The search identified 1305 citations. After in-depth assessment of 148 potentially eligible citations, 61 articles were included in the review. Five articles were added with hand searching. Sixty-seven per cent of these articles were related to nursing. The attributes of the enablement concept included: contribution to the therapeutic relationship; consideration of the person as a whole; facilitation of learning; valorization of the person's strengths; implication and support to decision making; and broadening of the possibilities. These attributes could be used as a basis for other studies on enablement. Conceptual and empirical work is still needed to better position this concept among others such as patient-centred care, shared decision making and patient's participation. © 2010 Blackwell Publishing Ltd.

Work-to-family conflict and family-to-work conflict among Japanese dual-earner couples with preschool children: a spillover-crossover perspective.

PubMed

Shimazu, Akihito; Kubota, Kazumi; Bakker, Arnold; Demerouti, Eva; Shimada, Kyoko; Kawakami, Norito

2013-01-01

This study among Japanese dual-earner couples examined the independent and combined associations of work-to-family conflict (WFC) and family-to-work conflict (FWC) with psychological health of employees and their partners and the relationship quality between partners. The matched responses of 895 couples were analyzed with logistic regression analysis to examine whether there were differences among the four work-family conflict groups (i.e., no conflict, WFC, FWC and both conflicts groups) in terms of own psychological distress, social undermining (i.e., negative behaviors directed toward the target person) reported by partners and partner's psychological distress. The no conflicts group was used as the reference group. The both conflicts group had the highest odds ratios for own psychological distress and social undermining towards the partner for both genders. In addition, for husbands, the both conflicts group had the highest odds ratio for partner's psychological distress, whereas for wives, it did not. Dual experiences of WFC and FWC have adverse associations with psychological health of employees and relationship quality between partners of both genders. In addition, dual experiences in husbands have an adverse association with psychological health of their partners (i.e., wives), whereas this is not the case for wives.

Knowledge translation in health care: a concept analysis.

PubMed

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

2014-01-01

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. 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. 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.

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

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. Copyright © 2014 Elsevier Ltd. All rights reserved.

Conflicts of Quarantine The Case of Jewish Immigrants to the Jewish State

PubMed Central

Seidelman, Rhona D.

2012-01-01

Shaar Haaliya—Israel's Ellis Island during the mass immigration of the 1950s—is a case study that challenges the historian's understanding of the concept of quarantine. It was isolated and fenced off for declared health purposes and was widely referred to as a quarantine, but archival and historiographical documentation suggest that Israeli public health policy did not define it as such. I track the discussion and conflict surrounding Shaar Haaliya's function and perception as a quarantine. This is a story that illuminates the way fear of disease converged with fear of immigration as well as the way defiance of public health institutions took shape in a unique framework of citizenship and during a unique wave of migration. PMID:22390439

The Rhetoric of Conflict. The Bobbs-Merrill Series in Composition and Rhetoric.

ERIC Educational Resources Information Center

Johnston, Kenneth R., Ed.; Lhamon, W. T., Jr., Ed.

The concept that conflict generates rhetoric prompted this collection of 11 essays on three critical conflicts--war, race, and education--which are arranged to present an historical understanding of the rhetoric of each conflict and to include a variety of techniques. The four selections on war are by Woodrow Wilson, Walt Whitman Rostow, and…

Can conflict be energizing? a study of task conflict, positive emotions, and job satisfaction.

PubMed

Todorova, Gergana; Bear, Julia B; Weingart, Laurie R

2014-05-01

Scholars have assumed that the presence of negative emotions during task conflict implies the absence of positive emotions. However, emotions researchers have shown that positive and negative emotions are not 2 ends of a bipolar continuum; rather, they represent 2 separate, orthogonal dimensions. Drawing on affective events theory, we develop and test hypotheses about the effects of task conflict on positive emotions and job satisfaction. To this end, we distinguish among the frequency, intensity, and information gained from task conflict. Using field data from 232 employees in a long-term health care organization, we find that more frequent mild task conflict expression engenders more information acquisition, but more frequent intense task conflict expression hinders it. Because of the information gains from mild task conflict expression, employees feel more active, energized, interested, and excited, and these positive active emotions increase job satisfaction. The information gained during task conflict, however, is not always energizing: It depends on the extent to which the behavioral context involves active learning and whether the conflict is cross-functional. We discuss theoretical implications for conflict, emotions, and job satisfaction in organizations. (c) 2014 APA, all rights reserved.

Should medical students track former patients in the electronic health record? An emerging ethical conflict.

PubMed

Brisson, Gregory E; Neely, Kathy Johnson; Tyler, Patrick D; Barnard, Cynthia

2015-08-01

Medical students are increasingly using electronic health records (EHRs) in clerkships, and medical educators should seek opportunities to use this new technology to improve training. One such opportunity is the ability to "track" former patients in the EHR, defined as following up on patients in the EHR for educational purposes for a defined period of time after they have left one's direct care. This activity offers great promise in clinical training by enabling students to audit their diagnostic impressions and follow the clinical history of illness in a manner not possible in the era of paper charting. However, tracking raises important questions about the ethical use of protected health information, including concerns about compromising patient autonomy, resulting in a conflict between medical education and patient privacy. The authors offer critical analysis of arguments on both sides and discuss strategies to balance the ethical conflict by optimizing outcomes and mitigating harms. They observe that tracking improves training, thus offering long-lasting benefits to society, and is supported by the principle of distributive justice. They conclude that students should be permitted to track for educational purposes, but only with defined limits to safeguard patient autonomy, including obtaining permission from patients, having legitimate educational intent, and self-restricting review of records to those essential for training. Lastly, the authors observe that this conflict will become increasingly important with completion of the planned Nationwide Health Information Network and emphasize the need for national guidelines on tracking patients in an ethically appropriate manner.

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

Conceptions on pharmaceutical services in Brazilian primary health care

PubMed Central

Costa, Ediná Alves; Araújo, Patrícia Sodré; Penaforte, Thais Rodrigues; Barreto, Joslene Lacerda; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Alvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair

2017-01-01

ABSTRACT OBJECTIVE To identify and discuss the conceptions of pharmaceutical services in Brazilian Primary Health Care, according to different subjects. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), which is composed of an information survey in a representative sample of cities, stratified according to Brazilian regions, and a subsample of primary health care services. Municipal secretaries of health, those responsible for pharmaceutical services, and those responsible for medicine delivery in pharmacies/dispensing units of the selected services were interviewed. The questionnaires included one question about the understanding of the interviewee regarding pharmaceutical services. The content analysis technique was used to apprehend, in the statements, the meanings attributed to pharmaceutical services, which were subsequently classified into categories according to their main conceptions. RESULTS Among the wide diversity of conceptions on pharmaceutical services (PS), we highlight the ones focused on 1) logistic control of medicines with activities concerning guidance or information on their use and 2) guidance or information to users on the use of medicine. The findings reveal a shifting tendency from a medicine-focused conception to one that considers the users and their needs as the final recipient of these actions. However, the lack of references to conceptions regarding care management and integrality point out the slowness of this change; after all, this is a social and historical process that comprises the production of meanings that transcend legal, logistic, and technical arrangements in pharmaceutical services. CONCLUSIONS The diversity of conceptions expresses the several meanings attributed to pharmaceutical services; we also identified, in their

[Nurse's concept in the managerial conception of a basic health unit].

PubMed

Passos, Joanir Pereira; Ciosak, Suely Itsuko

2006-12-01

This study is part of a larger survey called "Use of indicators in nurses' managerial practice in Basic Health Care Units in the city of Rio de Janeiro", which was carried out in the Basic Health Care Units of the Planning Area 5.3 and whose objectives were to identify nurses' conception regarding the tools required for management in those units and to discuss the role of management in organizing health services. The study is descriptive and data were collected in interviews with seven nurse managers. The results show that health services actions are organized and directed to the purpose of the working process through the relationship established between the object, the instruments and the final product, and that for those nurses the end result to be achieved is client's satisfaction and the quality of medical and nursing care.

Conflict of interest: nurses at risk!

PubMed

Erlen, Judith A

2008-01-01

Conflict of interest as it relates to healthcare is gaining increasing attention. Pharmaceutical companies and manufacturers that produce medical devices are coming under greater scrutiny because of the influence that their marketing practices may have on the patient management decisions made by healthcare professionals. The result is that healthcare agency administrators are developing conflict of interest policies and procedures for their professional employees. The driving force behind many of these policies is the need to maintain the trust of the public by refraining from questionable professional conduct. This article presents 2 hypothetical cases to provide nurses with an understanding of the concept of conflict of interest and the ethical considerations this issue raises, and describes the subtle and not-so-subtle influences on professional practice decisions. Recommendations are offered to help nurses avoid conflict of interest and preserve their professional integrity. It is incumbent upon nurses to become cognizant of the types of situations that may present a conflict of interest for them and to take the necessary steps to avoid such professional impropriety.

Quality dimensions in health evaluation: manager's conceptions.

PubMed

Bosi, Maria Lúcia Magalhães; Pontes, Ricardo José Soares; Vasconcelos, Suziana Martins de

2010-04-01

To understand manager's perceptions and experiences in regards to qualitative evaluations in basic health care. A qualitative study, based on the critical interpretive approach, was performed in 2006, in the city of Fortaleza, Northeastern Brazil. The sample consisted of the group responsible for planning basic health care at the state level. In order to obtain the empirical data, the focus group technique was utilized. Two central themes emerged concerning the perceptions about quality and the dimensions of quality employed in health evaluations, which were revealed in distinct ways. The concepts of quality evaluation and qualitative evaluation did not appear clearly understood, confusing qualitative evaluation with formal quality evaluations. Likewise, the inherent multidimensionality of quality was not recognized. Despite the criticism expressed by the participants regarding the improper quantification of certain dimensions, the necessary technical skills and understanding were not observed for the approach to include the distinct dimensions of quality in the evaluation process. The conceptions of managers responsible for the planning of basic health care at the state level revealed an important disassociation from the premises of qualitative evaluation, especially those evaluations oriented by the fourth generation approach. Therefore, the model adopted by these actors for the evaluation of program and service quality did not consider their multidimensionality.

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. Copyright © 2014 Elsevier Ltd. All rights reserved.

42 CFR 51.26 - Conflicts of interest.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Conflicts of interest. 51.26 Section 51.26 Public... Priorities § 51.26 Conflicts of interest. The P&A system must develop appropriate policies and procedures to avoid actual or apparent conflict of interest involving clients, employees, contractors and...

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

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.

A Holding Function for Conflict Probe Appiications

NASA Technical Reports Server (NTRS)

McNally, Dave; Walton, Joe

2004-01-01

Conflict Alerts for aircraft in holding patterns are often missed or in error due to fact that holding trajectories are not modeled in Conflict Alert or Conflict Probe logic. In addition, a controller in one sector may not know when aircraft are holding in a neighboring sector. These factors can lead to an increased potential for loss of separation while aircraft are flying in holding patterns. A holding function for conflict probe applications has been developed and tested with air traffic data from Fort Worth Center. The holding function automatically determines when an aircraft enters a holding pattern, builds a holding region around the pattern and then probes the region for conflict with other traffic. The operational concept of use assumes that air traffic controllers are very busy during periods when aircraft are in holding and therefore don't have time to manually enter information which defines a holding pattern and activates conflict probing. For this reason, it is important the holding function automatically detect aircraft in holding and compute a holding region for conflict analysis. The controller is then alerted if other aircraft are predicted to fly through the holding region at the holding altitude.

Joint issues – conflicts of interest, the ASR hip and suggestions for managing surgical conflicts of interest

PubMed Central

2014-01-01

Background Financial and nonfinancial conflicts of interest in medicine and surgery are troubling because they have the capacity to skew decision making in ways that might be detrimental to patient care and well-being. The recent case of the Articular Surface Replacement (ASR) hip provides a vivid illustration of the harmful effects of conflicts of interest in surgery. Discussion We identify financial and nonfinancial conflicts of interest experienced by surgeons, hospitals and regulators in the ASR case. These conflicts may have impacted surgical advice, decision-making and evidence gathering with respect to the ASR prosthesis, and contributed to the significant harms experienced by patients in whom the hip was implanted. Drawing on this case we explore shortcomings in the standard responses to conflicts of interest – disclosure and recusal. We argue disclosure is necessary but by no means sufficient to address conflicts of interest. Using the concept of recusal we develop remedies including second opinions and third party consent which may be effective in mitigating conflicts, but their implementation introduces new challenges. Summary Deployment of the ASR hip is a case of surgical innovation gone wrong. As we show, there were multiple conflicts of interest involved in the introduction of the ASR hip into practice and subsequent attempts to gloss over the mounting body of evidence about its lack of safety and effectiveness. Conflicts of interest in surgery are often not well managed. We suggest strategies in this paper which can minimise the conflicts of interest associated with surgical innovation. PMID:25128372

The Relationship between Sexual Selection and Sexual Conflict

PubMed Central

Kokko, Hanna; Jennions, Michael D.

2014-01-01

Evolutionary conflicts of interest arise whenever genetically different individuals interact and their routes to fitness maximization differ. Sexual selection favors traits that increase an individual’s competitiveness to acquire mates and fertilizations. Sexual conflict occurs if an individual of sex A’s relative fitness would increase if it had a “tool” that could alter what an individual of sex B does (including the parental genes transferred), at a cost to B’s fitness. This definition clarifies several issues: Conflict is very common and, although it extends outside traits under sexual selection, sexual selection is a ready source of sexual conflict. Sexual conflict and sexual selection should not be presented as alternative explanations for trait evolution. Conflict is closely linked to the concept of a lag load, which is context-dependent and sex-specific. This makes it possible to ask if one sex can “win.” We expect higher population fitness if females win. PMID:25038050

The relationship between sexual selection and sexual conflict.

PubMed

Kokko, Hanna; Jennions, Michael D

2014-07-18

Evolutionary conflicts of interest arise whenever genetically different individuals interact and their routes to fitness maximization differ. Sexual selection favors traits that increase an individual's competitiveness to acquire mates and fertilizations. Sexual conflict occurs if an individual of sex A's relative fitness would increase if it had a "tool" that could alter what an individual of sex B does (including the parental genes transferred), at a cost to B's fitness. This definition clarifies several issues: Conflict is very common and, although it extends outside traits under sexual selection, sexual selection is a ready source of sexual conflict. Sexual conflict and sexual selection should not be presented as alternative explanations for trait evolution. Conflict is closely linked to the concept of a lag load, which is context-dependent and sex-specific. This makes it possible to ask if one sex can "win." We expect higher population fitness if females win. Copyright © 2014 Cold Spring Harbor Laboratory Press; all rights reserved.

The human body as field of conflict between discourses.

PubMed

Kimsma, Gerrit K; Leeuwen, Evert van

2005-01-01

The approach to AIDS as a disease and a threat for social discrimination is used as an example to illustrate a conceptual thesis. This thesis is a claim that concerns what we call a medical issue or not, what is medicalised or needs to be demedicalised. In the friction between medicalisation and demedicalisation as discursive strategies the latter approach can only be effected through the employment of discourses or discursive strategies other than medicine, such as those of the law and of economics. These discourses each realise different values, promote a different subject, and have a different concept of man. The concept of discourse is briefly outlined against concepts such as the linear growth concept of science and the growth model of science as changes in paradigm. The issue of testing for AIDS shows a conflict between the medical and the legal discourse and illustrates the title of our contribution: the human body as field of conflict between discourses.

Middle Eastern Conflicts: Implications for Refugee Health in the European Union and Middle Eastern Host Countries

PubMed Central

Daher, Michel; Kebudi, Rejin; Nimri, Omar; Al-Jadiry, Mazin; Baider, Lea

2016-01-01

Until very recently, health care in conflict settings was based on a model developed in the second half of the twentieth century. Things have changed, and present civil wars, such as those that are currently taking place in the Middle East, do not address the complexity of the ongoing armed conflicts in countries such as Syria, Iraq, and Afghanistan. These conflicts have caused a significant increase in the number of refugees in the region, as well as in Europe. Hundreds of thousands of refugees succeed in settling in mid- and north-European countries, and their health issues are becoming of great importance. Refugees in Europe in the twenty-first century do not suffer so much from infectious diseases but more from noninfectious chronic diseases such as diabetes, cardiac disease, and cancer. These facts profoundly alter the demographics and disease burden of hostility-derived migrants. Thus, host European countries face situations they have never faced before. Hence, new approaches and strategies are urgently needed to cope with this new situation. The efforts to absorb refugees of different traditions and cultural backgrounds often cause increasing ethnic and religious tensions, which frequently escort the emergence of social violence. To date, little attention has been paid to the overall load of distress being experienced, especially among the first-generation refugees. The current ongoing hostilities in the Middle East induce a long-term health impact on people expelled from their homes, communities, traditions, and cultural environment. The realization of collective suffering forces communities and governmental health agencies to develop new programs that include social determinants to overcome the severe cultural gaps of the newcomers in their new European host countries. PMID:28717729

Middle Eastern Conflicts: Implications for Refugee Health in the European Union and Middle Eastern Host Countries.

PubMed

Silbermann, Michael; Daher, Michel; Kebudi, Rejin; Nimri, Omar; Al-Jadiry, Mazin; Baider, Lea

2016-12-01

Until very recently, health care in conflict settings was based on a model developed in the second half of the twentieth century. Things have changed, and present civil wars, such as those that are currently taking place in the Middle East, do not address the complexity of the ongoing armed conflicts in countries such as Syria, Iraq, and Afghanistan. These conflicts have caused a significant increase in the number of refugees in the region, as well as in Europe. Hundreds of thousands of refugees succeed in settling in mid- and north-European countries, and their health issues are becoming of great importance. Refugees in Europe in the twenty-first century do not suffer so much from infectious diseases but more from noninfectious chronic diseases such as diabetes, cardiac disease, and cancer. These facts profoundly alter the demographics and disease burden of hostility-derived migrants. Thus, host European countries face situations they have never faced before. Hence, new approaches and strategies are urgently needed to cope with this new situation. The efforts to absorb refugees of different traditions and cultural backgrounds often cause increasing ethnic and religious tensions, which frequently escort the emergence of social violence. To date, little attention has been paid to the overall load of distress being experienced, especially among the first-generation refugees. The current ongoing hostilities in the Middle East induce a long-term health impact on people expelled from their homes, communities, traditions, and cultural environment. The realization of collective suffering forces communities and governmental health agencies to develop new programs that include social determinants to overcome the severe cultural gaps of the newcomers in their new European host countries.

Improving health care, Part 4: Concepts for improving any clinical process.

PubMed

Batalden, P B; Mohr, J J; Nelson, E C; Plume, S K

1996-10-01

One promising method for streamlining the generation of "good ideas" is to formulate what are sometimes called change concepts-general notions or approaches to change found useful in developing specific ideas for changes that lead to improvement. For example, in current efforts to reduce health care costs by discounting provider charges, the underlying generic concept is "reducing health care costs," and the specific idea is "discounting provider charges." Short-term gains in health care cost reduction can occur by pursuing discounts. After some time, however, limits to such reduction in costs are experienced. Persevering and continuing to travel down the "discounting provider charges" path is less likely to produce further substantial improvement than returning to the basic concept of "reducing health care costs." An interdisciplinary team aiming to reduce costs while improving quality of care for patients in need of hip joint replacement generated ideas for changing "what's done (process) to get better results." After team members wrote down their improvement ideas, they deduced the underlying change concepts and used them to generate even more ideas for improvement. Such change concepts include reordering the sequence of steps (preadmission physical therapy "certification"), eliminating failures at hand-offs between steps (transfer of information from physician's office to hospital), and eliminating a step (epidural pain control). Learning about making change, encouraging change, managing the change within and across organizations, and learning from the changes tested will characterize the sustainable, thriving health systems of the future.

Psychosocial support for adolescent girls in post-conflict settings: beyond a health systems approach

PubMed Central

Samuels, Fiona; Jones, Nicola; Abu Hamad, Bassam

2017-01-01

Abstract Adaptive and adequately resourced health systems are necessary to achieve good health outcomes in post-conflict settings, however domains beyond the health system are also critical to ensure broader wellbeing. This paper focuses on the importance of psychosocial support services for adolescent girls in fragile contexts. Its starting point is that adolescence is a pivotal time in the life course but given the physical, cognitive and emotional changes triggered by the onset of puberty, it can also be a period of heightened sensitivity and vulnerability to trauma, social isolation, bullying by peers, a lack of supportive adults and gender-based and sexual violence. Our findings highlight why humanitarian and biomedical approaches in their current form are inadequate to address these complexities. Drawing on qualitative fieldwork (consisting of in-depth and key informant interviews as well as group discussions in Gaza, Liberia and Sri Lanka involving a total of 386 respondents across the three countries), we argue that going beyond biomedical approaches and considering the social determinants of health, including approaches to tackle discriminatory gendered norms and barriers to service access, are critical for achieving broader health and wellbeing. While all three case study countries are classified as post-conflict, the political economy dynamics vary with associated implications for experiences of psychosocial vulnerabilities and the service environment. The study concludes by reflecting on actions to address psychosocial vulnerabilities facing adolescent girls. These include: tailoring services to ensure gender and age-sensitivity; investing in capacity building of service providers to promote service uptake; and enhancing strategies to regulate and coordinate actors providing mental health and psychosocial support services. PMID:29244106

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.

Autonomous Aircraft Operations using RTCA Guidelines for Airborne Conflict Management

NASA Technical Reports Server (NTRS)

Krishnamurthy, Karthik; Wing, David J.; Barmore, Bryan E.; Barhydt, Richard; Palmer, Michael T.; Johnson, Edward J.; Ballin, Mark G.; Eischeid, Todd M.

2003-01-01

A human-in-the-loop experiment was performed at the NASA Langley Research Center to study the feasibility of DAG-TM autonomous aircraft operations in highly constrained airspace. The airspace was constrained by a pair of special-use airspace (SUA) regions on either side of the pilot's planned route. Traffic flow management (TFM) constraints were imposed as a required time of arrival and crossing altitude at an en route fix. Key guidelines from the RTCA Airborne Conflict Management (ACM) concept were applied to autonomous aircraft operations for this experiment. These concepts included the RTCA ACM definitions of distinct conflict detection and collision avoidance zones, and the use of a graded system of conflict alerts for the flight crew. Three studies were conducted in the course of the experiment. The first study investigated the effect of hazard proximity upon pilot ability to meet constraints and solve conflict situations. The second study investigated pilot use of the airborne tools when faced with an unexpected loss of separation (LOS). The third study explored pilot interactions in an over-constrained conflict situation, with and without priority rules dictating who should move first. Detailed results from these studies were presented at the 5th USA/Europe Air Traffic Management R&D Seminar (ATM2003). This overview paper focuses on the integration of the RTCA ACM concept into autonomous aircraft operations in highly constrained situations, and provides an overview of the results presented at the ATM2003 seminar. These results, together with previously reported studies, continue to support the feasibility of autonomous aircraft operations.

Steps Towards the Integration of Conflict Resolution with Metering and Scheduling

NASA Technical Reports Server (NTRS)

McNally, B. David; Edwards, Thomas (Technical Monitor)

1998-01-01

NASA Ames Research Center is developing decision support tool technology for air traffic controllers to improve the efficiency and capacity of National Airspace System. The goal is to provide technology, tools and procedures that result in the highest possible level of user preferred trajectories whenever possible with safe and efficient traffic management when necessary. The work is being conducted under the NASA Advanced Air Transportation Technology Program in cooperation with the FAA through the Inter-Agency Integrated Product Team. The objective is to develop technology and procedures that lead towards a seamless integration of conflict resolution with metering and scheduling for arrival aircraft and en route aircraft that are under metering restrictions. A requirement is that the integration incorporate user preferred trajectories. The ultimate goal is the implementation and validation of the Descent Advisor (DA) concept which provides clearance advisories to a sector controller that simultaneously meet metering constraints, are conflict free, incorporate a user preferred (e.g., minimum fuel) descent profile, and generally require no further corrective clearance as the aircraft transitions from en route cruise into the TRACON. The DA concept may also be applied to en route aircraft under metering constraints, e.g., miles-in-trail. To achieve the DA concept a stepwise development and field evaluation is anticipated. This paper addresses the initial steps towards implementation of the DA. The Traffic Management Advisor (TMA) computes arrival time sequence and required delay information for display to the sector controller during periods when arrivals must be metered due to landing rate restrictions at the airport. The Initial Conflict Probe (ICP) compares trajectory predictions for all aircraft and alerts the controller when any two aircraft are predicted to violate separation standards (5 mi. and 2000 ft. in en route airspace). ICP also includes a trial

Mediating the effects of work-life conflict between transformational leadership and health-care workers' job satisfaction and psychological wellbeing.

PubMed

Munir, Fehmidah; Nielsen, Karina; Garde, Anne H; Albertsen, Karen; Carneiro, Isabella G

2012-05-01

To explore the mediating effects of work-life conflict between transformational leadership and job satisfaction and psychological wellbeing. The importance of work-life balance for job satisfaction and wellbeing among health-care employees is well-recognized. Evidence shows that transformational leadership style is linked to psychological wellbeing. It is possible that transformational leadership is also associated with employees' perceptions of work-life conflict, thereby influencing their job satisfaction and wellbeing. A longitudinal design was used where staff working within Danish elderly care completed a questionnaire at baseline and 18-month follow-up (N=188). Regression analyses showed that transformational leadership style was directly associated with perceptions of work-life conflict, job satisfaction and psychological wellbeing. Work-life conflict mediated between transformational leadership and wellbeing, but not job satisfaction. The findings suggest transformational leadership style may improve perceptions of work-life balance and employee wellbeing. Managers should adopt transformational leadership styles to reduce work-life conflict and enhance the wellbeing of their staff. © 2011 Blackwell Publishing Ltd.

Concepts in health promotion: the notion of relativism.

PubMed

de Leeuw, E

1989-01-01

'Health promotion' is a new and powerful concept. By some professionals in the field as well as by actors in the policy making spheres, though, the notion may be received with considerable scepticism. We have attributed this scepticism, as well as barriers to include notions of health promotion in day-to-day work, to a lack of knowledge of essential concepts in the health promotion context. In this article we first explore the quintessential nature of 'health' (a capacity of people, rather than an end product of medical care) before we set out to analyze some crucial components of health promotion: integral-ness, intersectorality, holism, and ecology. Integral intervention mixes appear to have synergetic, and therefore cost-effective, results. An intersectoral approach will be necessary to address all determinants of health in an adequate way. Alas, neither integral, nor intersectoral health programs have been documented in depth. The notions of holism and ecology seem to suffer from obscurantism and esoteric elitism, though commendable in their scope. Here, we introduce 'relativism' to combine various valuable approaches into one more comprehensive scheme. Moreover, a 'relativist' approach to health promotion might induce better and more fruitful cooperation among professions. Finally, some research gaps have been identified. Policy development studies remain to have top priority in development of health promotion. Better documentation of efforts in this field will be of crucial importance. Further development of, and research on how to apply relativist approaches may be recommended. Cooperation, and opening up a dialogue between different professions and actors is of great importance in this field.

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.

Too Much of a Good Thing? Emotional Intelligence and Interpersonal Conflict Behaviors.

PubMed

Moeller, Christin; Kwantes, Catherine T

2015-01-01

Research suggests that the outcomes of interpersonal conflict are determined not only by the conflict itself, but also by the way in which it is handled. Confrontational and domineering tactics have been found to magnify the adverse impact of conflict. Thus, investigations of determinants of aggressive conflict management behaviors are of considerable interest. This study extends the literature by examining the relationship between conflict management preferences and conflict management behaviors and by examining how emotional intelligence (EI) shapes this preference-behavior relationship. Individuals' conflict management preferences predicted actual conflict management behaviors. EI was found to moderate this relationship. However, some of these moderating effects run contrary to the popular view of EI as a prosocial concept. Specifically, some EI facets were found to strengthen the link between aggressive conflict management preferences and subsequent conflict management behaviors.

Trauma and mental health of medics in eastern Myanmar's conflict zones: a cross-sectional and mixed methods investigation.

PubMed

Lim, Andrew George; Stock, Lawrence; Shwe Oo, Eh Kalu; Jutte, Douglas P

2013-07-30

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. 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. 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. 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 among subjects. The observed symptom score means in

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.

Reproductive, maternal, neonatal and child health in conflict: a case study on Syria using Countdown indicators

PubMed Central

DeJong, Jocelyn; Ghattas, Hala; Bashour, Hyam; Mourtada, Rima; Akik, Chaza; Reese-Masterson, Amelia

2017-01-01

Introduction Women and children account for a disproportionate morbidity burden among conflict-affected populations, and yet they are not included in global accountability frameworks for women’s and children’s health. We use Countdown to 2015 (Millennium Development Goals) health indicators to provide an up-to-date review and analysis of the best available data on Syrian refugees in Jordan, Lebanon and Turkey and internally displaced within Syria and explore data challenges in this conflict setting. Methods We searched Medline, PubMed, Scopus, Popline and Index Medicus for WHO Eastern Mediterranean Region Office and relevant development/humanitarian databases in all languages from January 2011 until December 2015. We met in person or emailed relevant key stakeholders in Lebanon, Jordan, Syria and Turkey to obtain any unpublished or missing data. We convened a meeting of experts working with these populations to discuss the results. Results The following trends were found based on available data for these populations as compared with preconflict Syria. Birth registration in Syria and in host neighbouring countries decreased and was very low in Lebanon. In Syria, the infant mortality rate and under-five mortality rate increased, and coverage of antenatal care (one visit with a skilled attendant), skilled birth attendance and vaccination (except for DTP3 vaccine) declined. The number of Syrian refugee women attending more than four antenatal care visits was low in Lebanon and in non-camp settings in Jordan. Few data were available on these indicators among the internally displaced. In conflict settings such as that of Syria, coverage rates of interventions are often unknown or difficult to ascertain because of measurement challenges in accessing conflict-affected populations or to the inability to determine relevant denominators in this dynamic setting. Conclusion Research, monitoring and evaluation in humanitarian settings could better inform public health

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

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.

Environmental Systems Conflict Resolution

NASA Astrophysics Data System (ADS)

Hipel, K. W.

2017-12-01

The Graph Model for Conflict Resolution (GMCR) is applied to a real-life groundwater contamination dispute to demonstrate how one can realistically model and analyze the controversy in order to obtain an enhanced understanding and strategic insights for permitting one to make informed decisions. This highly divisive conflict is utilized to explain a rich range of inherent capabilities of GMCR, as well as worthwhile avenues for extensions, which make GMCR a truly powerful decision technology for addressing challenging conflict situations. For instance, a flexible preference elicitation method called option prioritization can be employed to obtain the relative preferences of each decision maker (DM) in the dispute over the states or scenarios which can occur, based upon preference statements regarding the options or courses of actions available to the DMs. Solution concepts, reflecting the way a chess player thinks in terms of moves and counter-moves, are defined to mirror the ways humans may behave under conflict, varying from short to long term thinking. After ascertaining the best outcome that a DM can achieve on his or her own in a conflict, coalition analysis algorithms are available to check if a DM can fare even better via cooperating with others. The ability of GMCR to take into account emotions, strength of preference, attitudes, misunderstandings (referred to as hypergames), and uncertain preferences (unknown, fuzzy, grey and probabilistic) greatly broadens its scope of applicability. Techniques for tracing how a conflict can evolve over time from a status quo state to a final specified outcome, as well as how to handle hierarchical structures, such as when a central government interacts with its provinces or states, further enforces the comprehensive nature of GMCR. Within ongoing conflict research mimicking how physical systems are analyzed, methods for inverse engineering of preferences are explained for determining the preferences required by one or

The Elephant Vanishes: impact of human-elephant conflict on people's wellbeing.

PubMed

Jadhav, Sushrut; Barua, Maan

2012-11-01

Human-wildlife conflicts impact upon the wellbeing of marginalised people, worldwide. Although tangible losses from such conflicts are well documented, hidden health consequences remain under-researched. Based on preliminary clinical ethnographic inquiries and sustained fieldwork in Assam, India, this paper documents mental health antecedents and consequences including severe untreated psychiatric morbidity and substance abuse. The case studies presented make visible the hidden mental health dimensions of human-elephant conflict. The paper illustrates how health impacts of conflicts penetrate far deeper than immediate physical threat from elephants, worsens pre-existing mental illness of marginalised people, and leads to newer psychiatric and social pathologies. These conflicts are enacted and perpetuated in institutional spaces of inequality. The authors argue that both wildlife conservation and community mental health disciplines would be enhanced by coordinated intervention. The paper concludes by generating questions that are fundamental for a new interdisciplinary paradigm that bridges ecology and the clinic. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

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. Copyright © 2015 John Wiley & Sons, Ltd.

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. Copyright © 2011 John Wiley & Sons, Ltd.

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. Copyright © 2016 Elsevier Ltd. All rights reserved.

Political violence, ethnic conflict, and contemporary wars: broad implications for health and social well-being.

PubMed

Pedersen, Duncan

2002-07-01

Ethnic conflict, political violence and wars that presently shape many parts of world have deep-seated structural causes. In poor and highly indebted countries, economic and environmental decline, asset depletion, and erosion of the subsistence base lead to further impoverishment and food insecurity for vast sectors of the population. Growing ethnic and religious tensions over a shrinking resource base often escort the emergence of predatory practices, rivalry, political violence, and internal wars. The nature of armed conflict has changed substantially over time and most strategic analysts agree that in the second half of the 20th century, contemporary wars are less of a problem of relations between states than a problem within states. Despite the growing number of armed conflicts and wars throughout the world, not enough attention has been paid to the local patterns of distress being experienced and the long-term health impact and psychosocial consequences of the various forms of political violence against individuals, communities, or specific ethnic groups. The short or long-term impact assessment on civilian populations of poor countries affected by war have been scarce, and studies focussing on experiences of collective suffering and trauma-related disorders among survivors are beginning to emerge in the scientific literature. The medicalization of collective suffering and trauma reflects a poor understanding of the relationships among critically important social determinants and the range of possible health outcomes of political violence.

Examining the Role of Facilitated Conflict on Student Learning Outcomes in a Diversity Education Course

ERIC Educational Resources Information Center

Ross, Sabrina N.

2013-01-01

Building on the Piagetian concept of disequilibrium (i.e., cognitive conflict) and empirical research documenting relationships between cognitive conflict and transformative learning, this article explores the influence of facilitated conflict (i.e., intentional efforts by the instructor to help students reflect on and work through the intergroup…

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 of...

Understanding processes of risk and protection that shape the sexual and reproductive health of young women affected by conflict: the price of protection.

PubMed

Hutchinson, Aisha; Waterhouse, Philippa; March-McDonald, Jane; Neal, Sarah; Ingham, Roger

2017-01-01

It is assumed that knowing what puts young women at risk of poor sexual health outcomes and, in turn, what protects them against these outcomes, will enable greater targeted protection as well as help in designing more effective programmes. Accordingly, efforts have been directed towards mapping risk and protective factors onto general ecological frameworks, but these currently do not take into account the context of modern armed conflict. A literature overview approach was used to identify SRH related risk and protective factors specifically for young women affected by modern armed conflict. A range of keywords were used to identify academic articles which explored the sexual and reproductive health needs of young women affected by modern armed conflict. Selected articles were read to identify risk and protective factors in relation to sexual and reproductive health. While no articles explicitly identified 'risk' or 'protective' factors, we were able to extrapolate these through a thorough engagement with the text. However, we found that it was difficult to identify factors as either 'risky' or 'protective', with many having the capacity to be both risky and protective (i.e. refugee camps or family). Therefore, using an ecological model, six environments that impact upon young women's lives in contexts of modern armed conflict are used to illustrate the dynamic and complex operation of risk and protection - highlighting processes of protection and the 'trade-offs' between risks. We conclude that there are no simple formulaic risk/protection patterns to be applied in every conflict and post-conflict context. Instead, there needs to be greater recognition of the 'processes' of protection, including the role of 'trade-offs' (what we term as 'protection at a price'), in order to further effective policy and practical responses to improve sexual and reproductive health outcomes during or following armed conflict. Focus on specific 'factors' (such as 'female headed

Integrating mental health into post-conflict rehabilitation: the case of Sierra Leonean and Liberian 'child soldiers'.

PubMed

Medeiros, Emilie

2007-05-01

This report discusses the relationship between mental health care and post-conflict rehabilitation in Sierra Leone and Liberia. Data were collected during the author's involvement in mental health programmes for extremely distressed so called 'child soldiers' in both countries, as well as involvement in co-ordinating and supporting professionals in charge of the war-affected population. Analysis suggested that mental health was neglected. However consideration of mental health is crucial to rehabilitation efforts because it facilitates understanding and appropriate responses to the difficulties encountered by both professionals and demobilized youth, and needs to be incorporated into designing policy, training and interventions.

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…

Concepts for the translation of genome-based innovations into public health: a comprehensive overview.

PubMed

Syurina, Elena V; Schulte In den Bäumen, Tobias; Brand, Angela; Ambrosino, Elena; Feron, Frans Jm

2013-03-01

Recent vast and rapid development of genome-related sciences is followed by the development of different assessment techniques or attempts to adapt the existing ones. The aim of this article is to give an overview of existing concepts for the assessment and translation of innovations into healthcare, applying a descriptive analysis of their present use by public health specialists and policy makers. The international literature review identified eight concepts including Health Technology Assessment, analytic validity, clinical validity, clinical utility, ethical, legal and social implications, Public Health Wheel and others. This study gives an overview of these concepts (including the level of current use) applying a descriptive analysis of their present use by public health specialists and policy makers. Despite the heterogeneity of the analyzed concepts and difference in use in everyday healthcare practice, the cross-integration of these concepts is important in order to improve translation speed and quality. Finally, some recommendations are made regarding the most applicable translational concepts.

The Role of Datasets on Scientific Influence within Conflict Research.

PubMed

Van Holt, Tracy; Johnson, Jeffery C; Moates, Shiloh; Carley, Kathleen M

2016-01-01

We inductively tested if a coherent field of inquiry in human conflict research emerged in an analysis of published research involving "conflict" in the Web of Science (WoS) over a 66-year period (1945-2011). We created a citation network that linked the 62,504 WoS records and their cited literature. We performed a critical path analysis (CPA), a specialized social network analysis on this citation network (~1.5 million works), to highlight the main contributions in conflict research and to test if research on conflict has in fact evolved to represent a coherent field of inquiry. Out of this vast dataset, 49 academic works were highlighted by the CPA suggesting a coherent field of inquiry; which means that researchers in the field acknowledge seminal contributions and share a common knowledge base. Other conflict concepts that were also analyzed-such as interpersonal conflict or conflict among pharmaceuticals, for example, did not form their own CP. A single path formed, meaning that there was a cohesive set of ideas that built upon previous research. This is in contrast to a main path analysis of conflict from 1957-1971 where ideas didn't persist in that multiple paths existed and died or emerged reflecting lack of scientific coherence (Carley, Hummon, and Harty, 1993). The critical path consisted of a number of key features: 1) Concepts that built throughout include the notion that resource availability drives conflict, which emerged in the 1960s-1990s and continued on until 2011. More recent intrastate studies that focused on inequalities emerged from interstate studies on the democracy of peace earlier on the path. 2) Recent research on the path focused on forecasting conflict, which depends on well-developed metrics and theories to model. 3) We used keyword analysis to independently show how the CP was topically linked (i.e., through democracy, modeling, resources, and geography). Publically available conflict datasets developed early on helped shape the

A qualitative study of college student responses to conflicting messages in advertising: anti-binge drinking public service announcements versus wine promotion health messages.

PubMed

Ahn, Ho-Young; Wu, Lei; Kelly, Stephanie; Haley, Eric

2011-06-01

The purpose of this study was to investigate how college students deal with conflicting health messages in advertising regarding binge drinking and wine promotion. Phenomenological in-depth long interviews were conducted beyond the point of redundancy (N = 16). The results of this study indicated that students' meaning making regarding the conflicting messages relied greatly upon how consistent either message was with their prior beliefs about alcohol. Additionally, not all students perceived the messages to be contradictory; these students saw the messages as being constructed for different purposes and as such incomparable. Overall, students who perceived conflict responded to the topic with apathy fueled by advertising skepticism. Employing qualitative methodology to understand how college students respond to conflicting messages will assist health promotion practitioners develop more effective alcohol abuse prevention messages and provide suggestions for researchers for studying this phenomenon from other perspectives in the future. Implications are further discussed within.

Bringing urban governance back in: Neighborhood conflicts and depression.

PubMed

Fu, Qiang

2018-01-01

Urban governance and its impact on contentious politics have received remarkably little attention in existing studies on mental health. Drawing on a measure of neighborhood conflicts developed in a survey of thirty-nine urban neighborhoods in Guangzhou, China, this article investigates the potential link between urban governance and mental health. Net of sociodemographic, relational, and environmental measures, it finds that among residents' conflicts with different entities of urban governance, only those with local/grassroots governments are significantly associated with more depressive symptoms. Moreover, these subgroups of government-oriented conflicts associated with more depressive symptoms are related to neighborhood planning and communal properties, reflecting a dilemma in the Chinese model of urban governance. By offering a relational interpretation of neighborhood conflicts, this study not only challenges the previous view that community building in China improves mental health, but calls attention to the significance of urban governance in research on mental health. Copyright © 2017 Elsevier Ltd. All rights reserved.

[A concept analysis of assertiveness].

PubMed

Park, Hyoung-Sook; Yang, Young-Ok

2006-06-01

The purpose of this study was to analyze and clarify the meaning of the concept, assertiveness. This study used Walker and Avant's process of concept analysis. 1. Attributes of assertiveness were defined as 1) Self-esteem 2) Comprehension to others 3) Clarification of the subject 4) Verbal communication 5) Non-verbal communication. 2. The antecedents of assertiveness consist of these facts 1) The occurrence of a conflict situation 2) The occurrence of will to stick to one's opinions. 3. There are consequences occurring as a result of assertiveness 1) Positive self-confidence 2) Increased comprehension or consideration to others 3) Expand of mutual respect 4) Maintenance of continuously cooperative relationship with each other 5) Output of acceptable results to each other. Assertiveness is a core human behavior and is key to interpersonal relationships. Using the components of the concept of assertiveness, many conflicts in a nursing situation can be effectively prevented.

Conjugal conflict and violence: a review and theoretical paradigm.

PubMed

Smilkstein, G; Aspy, C B; Quiggins, P A

1994-02-01

Conjugal violence has been described as having multiple etiologies. The variables are so numerous that intervention and research protocols are difficult to effect. This paper proposes a paradigm that establishes conjugal conflict and violence as separate entities. According to the paradigm, conjugal conflict is viewed as "an inevitable part of human association," whereas conjugal violence is determined to be a learned behavioral tactic that is employed as a coping strategy when an individual's conflict threshold potential is exceeded. Evidence will be offered that violence is learned from family of origin and from observing what is common or accepted practice in the community. Use of this paradigm would give primacy to community education programs that advance the concept of conflict resolution through rational discourse.

[The Bremen periodic health exam - feasibility of a new concept].

PubMed

Schmiemann, Guido; Biesewig-Siebenmorgen, Jürgen; Gebhardt, Klaus; Egidi, Günther

2014-01-01

All members of the Statutory Health Insurance are entitled to receive preventive health examinations. The current concept, however, does not take individual risk factors into account systematically. To improve this, the "Bremen Health Examination" was developed. The central component is a screening questionnaire to be completed by the patient, which is stratified by age, i.e., 35 to 69 years and ≥ 70 years. The feasibility and acceptance of this concept have been assessed. In a prospective observational study, a selected sample of general practitioners (GPs) was asked to implement the questionnaires during all preventive health examinations within a four-week period. The GPs subsequently answered content-related questions as well as Likert-scaled questions on the relevance of the issues addressed, and the feasibility of the new concept. 17 out of 20 GPs approached for the study included a total of 171 patients. On average, the patients in the two groups were 52 and 75 years of age, respectively, and answered 4.4 prompting questions positively. Age and gender had no significant effect on the frequency of "positively" answered questions. Implementing the questionnaire extended the duration of the health examination, however, GPs overall rated the time required for discussing newly assessed problems as adequate (four-level Likert scale, 1=yes; 4=no; Ø 1.59; SD 0.77). The implementation of the Bremen Health Examination appears to be feasible from the GP perspective. Copyright © 2014. Published by Elsevier GmbH.

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.

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.

Learning community health nursing concepts from clinical experience.

PubMed

Lasater, Kathie; Luce, Linda; Volpin, Miriam; Terwilliger, Allison; Wild, Jackson

2007-01-01

Clinical faculty often struggle to design competency demonstrations that promote quality learning experiences. A nursing program in Oregon combined mental health and community health nursing practica and required well-planned, integrated competency demonstrations. This requirement became the impetus for students to promote the health of clients and learn clinical concepts that are difficult to experience in a typical term. Faculty coached students to make a significant contribution that would last beyond their clinical practica. A case study in competency demonstration design is described, and implications for curriculum development are presented.

[Uses of scientific information and conflicts of interest].

PubMed

Vineis, Paolo

2016-02-01

Conflicts of interest are defined as a situation in which a primary goal (such as individual or collective health, or access to information) conflicts with a secondary goal. Conflicts of interest arise for several reasons and under different circumstances: not only in relation to private profits, but also for reasons related to career or social roles. Conflicts of interest are very common and require increasing awareness in democratic societies that pursue primary goals such as health and independent information. The increasing role of profit-oriented private industry and interactions between private enterprises and public research institutions (for example in research on drugs or alternative sources of energy) require that the safeguard role of the State be strengthened. Also State institutions, however, may be affected by conflicts of interest. Simple disclosure of conflicts is necessary but not sufficient to tackle them. These themes are discussed in the paper referring to two recent examples: an alleged access of total mortality in Italy in 2015, and the carcinogenicity of red meat.

Western Australian women's perceptions of conflicting advice around breast feeding.

PubMed

Hauck, Yvonne L; Graham-Smith, Catherine; McInerney, Justine; Kay, Sue

2011-10-01

to explore women's perceptions of conflicting advice around breast feeding from formal support networks, specifically health professionals involved in postnatal support. a qualitative exploratory design was employed using the critical incident technique. Data were obtained from 62 Western Australian women who responded to an invitation to share incidents of receiving conflicting advice. Women who had breast fed a child within the past 12 months shared their experience through a telephone interview (n = 50) or completing a brief questionnaire (n = 12) addressing the following questions: Describe a situation in detail where you felt you received conflicting advice about breast feeding from a health professional. How did this situation affect you and/or your breast feeding? a modified constant comparison method was used to analyse the critical incidents revealing commonalities under who offered conflicting advice; what contributed to advice being perceived as conflicting; topic areas more inclined to being regarded as conflicting; what protected against advice being perceived as conflicting; the consequences of receiving conflicting advice; and strategies that women used to manage these incidents. advice that was viewed as conflicting extended beyond the provision of information that was inconsistent or directly contradictory, and included issues around information overload and disparities between the mother's and health professional's expectations. The manner of presenting information or advice, the skills of using effective communication, demonstration of a caring attitude with an empathic approach and focusing upon the woman as an individual were seen to be important to minimise these incidents. Attention to women's perceptions and the consequences of conflicting advice must be addressed, otherwise the credibility and confidence in health professionals' knowledge and ability to support breast feeding is questioned, resulting in a valuable support network being

Properties of Air Traffic Conflicts for Free and Structured Routing

NASA Technical Reports Server (NTRS)

Bilimoria, Karl D.; Lee, Hilda Q.

2001-01-01

This paper analyzes the properties of air traffic conflicts in a future free routing system against those in the current structured routing system. Simulation of en route air traffic operations (above 18,000 ft) over the contiguous United States for a 24-hour period, constructed with initial conditions from actual air traffic data, were conducted using the Future ATM Concepts Evaluation Tool (FACET). Free routes were modeled as great circle (direct) routes from origin to destination, and structured routes were derived from actual flight plans along the current system of air routes. The conflict properties analyzed in this study include: (1) Total number of conflicts; (2) Distributions of key conflict parameters; and, (3) Categorization of conflicts into independent conflicts and two types of interacting conflicts. Preliminary results (for Denver Center traffic) indicate that conflict properties in a free routing system are different from those in the current structured routing system. In particular, a free routing system has significantly fewer conflicts, involving a correspondingly smaller number of aircraft, compared to the current structured routing system. Additionally, the conflict parameter distributions indicate that free routing conflicts are less intrusive than structured routing conflicts, and would therefore require small trajectory deviations for resolution.

Managing the conflict between individual needs and group interests--ethical leadership in health care organizations.

PubMed

Shale, Suzanne

2008-03-01

This paper derives from a grounded theory study of how Medical Directors working within the UK National Health Service manage the moral quandaries that they encounter as leaders of health care organizations. The reason health care organizations exist is to provide better care for individuals through providing shared resources for groups of people. This creates a paradox at the heart of health care organization, because serving the interests of groups sometimes runs counter to serving the needs of individuals. The paradox presents ethical dilemmas at every level of the organization, from the boardroom to the bedside. Medical Directors experience these organizational ethical dilemmas most acutely by virtue of their position in the organization. As doctors, their professional ethic obliges them to put the interests of individual patients first. As executive directors, their role is to help secure the delivery of services that meet the needs of the whole patient population. What should they do when the interests of groups of patients, and of individual patients, appear to conflict? The first task of an ethical healthcare organization is to secure the trust of patients, and two examples of medical ethical leadership are discussed against this background. These examples suggest that conflict between individual and population needs is integral to health care organization, so dilemmas addressed at one level of the organization inevitably re-emerge in altered form at other levels. Finally, analysis of the ethical activity that Medical Directors have described affords insight into the interpersonal components of ethical skill and knowledge.

Measurement of attacks and interferences with health care in conflict: validation of an incident reporting tool for attacks on and interferences with health care in eastern Burma.

PubMed

Haar, Rohini J; Footer, Katherine Ha; Singh, Sonal; Sherman, Susan G; Branchini, Casey; Sclar, Joshua; Clouse, Emily; Rubenstein, Leonard S

2014-01-01

Attacks on health care in armed conflict and other civil disturbances, including those on health workers, health facilities, patients and health transports, represent a critical yet often overlooked violation of human rights and international humanitarian law. Reporting has been limited yet local health workers working on the frontline in conflict are often the victims of chronic abuse and interferences with their care-giving. This paper reports on the validation and revision of an instrument designed to capture incidents via a qualitative and quantitative evaluation method. Based on previous research and interviews with experts, investigators developed a 33-question instrument to report on attacks on healthcare. These items would provide information about who, what, where, when, and the impact of each incident of attack on or interference with health. The questions are grouped into 4 domains: health facilities, health workers, patients, and health transports. 38 health workers who work in eastern Burma participated in detailed discussion groups in August 2013 to review the face and content validity of the instrument and then tested the instrument based on two simulated scenarios. Completed forms were graded to test the inter-rater reliability of the instrument. Face and content validity were confirmed with participants expressing that the instrument would assist in better reporting of attacks on health in the setting of eastern Burma where they work. Participants were able to give an accurate account of relevant incidents (86% and 82% on Scenarios 1 and 2 respectively). Item-by-item review of the instrument revealed that greater than 95% of participants completed the correct sections. Errors primarily occurred in quantifying the impact of the incident on patient care. Revisions to the translated instrument based on the results consisted primarily of design improvements and simplification of some numerical fields. This instrument was validated for use in eastern

Formal Verification of a Conflict Resolution and Recovery Algorithm

NASA Technical Reports Server (NTRS)

Maddalon, Jeffrey; Butler, Ricky; Geser, Alfons; Munoz, Cesar

2004-01-01

New air traffic management concepts distribute the duty of traffic separation among system participants. As a consequence, these concepts have a greater dependency and rely heavily on on-board software and hardware systems. One example of a new on-board capability in a distributed air traffic management system is air traffic conflict detection and resolution (CD&R). Traditional methods for safety assessment such as human-in-the-loop simulations, testing, and flight experiments may not be sufficient for this highly distributed system as the set of possible scenarios is too large to have a reasonable coverage. This paper proposes a new method for the safety assessment of avionics systems that makes use of formal methods to drive the development of critical systems. As a case study of this approach, the mechanical veri.cation of an algorithm for air traffic conflict resolution and recovery called RR3D is presented. The RR3D algorithm uses a geometric optimization technique to provide a choice of resolution and recovery maneuvers. If the aircraft adheres to these maneuvers, they will bring the aircraft out of conflict and the aircraft will follow a conflict-free path to its original destination. Veri.cation of RR3D is carried out using the Prototype Verification System (PVS).

[Conflict management in the workplace].

PubMed

Mola Sanna, Bruna; Igual Ayerbe, Blanca

2010-02-01

Our sanitary system and our health organizations have to confront the conflicts which have derived from the successive social and sanitary changes which have developed over the most recent decades. These new realities in the health fields oblige the professionals dedicated to them, the administrators of our organizations, the politicians, and society in general, as those who make use of the health services provided, to search for strategies and resources for the prevention, and transformation of those conflicts which can develop due to these situations, having as their final objective to preserve the basic principle of universal health care which is included in our Constitution. For this reason, the authors propose a profile for mediators in the health field, understanding that for mediation to really be useful, and to avoid or reduce improper litigation in our health system, values which belong to the culture of peace should be introduced into the culture of our health organizations. To that end, it is essential to count on not only professional mediators but also on an elenchus of natural mediators and informal mediators.

Conceptions of learning factors in postgraduate health sciences master students: a comparative study with non-health science students and between genders.

PubMed

Campos, Fernando; Sola, Miguel; Santisteban-Espejo, Antonio; Ruyffelaert, Ariane; Campos-Sánchez, Antonio; Garzón, Ingrid; Carriel, Víctor; de Dios Luna-Del-Castillo, Juan; Martin-Piedra, Miguel Ángel; Alaminos, Miguel

2018-06-07

The students' conceptions of learning in postgraduate health science master studies are poorly understood. The aim of this study was to compare the factors influencing conceptions of learning in health sciences and non-health sciences students enrolled in postgraduate master programs in order to obtain information that may be useful for students and for future postgraduate programs. A modified version of the Learning Inventory Conception Questionnaire (COLI) was used to compare students' conception learning factors in 131 students at the beginning of their postgraduate studies in health sciences, experimental sciences, arts and humanities and social sciences. The present study demonstrates that a set of factors may influence conception of learning of health sciences postgraduate students, with learning as gaining information, remembering, using, and understanding information, awareness of duty and social commitment being the most relevant. For these students, learning as a personal change, a process not bound by time or place or even as acquisition of professional competences, are less relevant. According to our results, this profile is not affected by gender differences. Our results show that the overall conceptions of learning differ among students of health sciences and non-health sciences (experimental sciences, arts and humanities and social sciences) master postgraduate programs. These finding are potentially useful to foster the learning process of HS students, because if they are metacognitively aware of their own conception or learning, they will be much better equipped to self-regulate their learning behavior in a postgraduate master program in health sciences.

Health promoting leadership - different views of the concept.

PubMed

Eriksson, Andrea; Axelsson, Runo; Axelsson, Susanna Bihari

2011-01-01

To describe and analyse different views of health promoting leadership among actors involved in workplace health promotion in eight Swedish municipalities. Twenty individuals were interviewed and their views were analysed according to the methodology of phenomenograpic research, exploring how health promoting leadership was described, what motives were expressed, and what critical conditions were perceived for developing such leadership. The informants described health promoting leadership in three ways: organising health promoting activities, having a supportive leadership style, and developing a health promoting workplace. The motives mentioned for developing health promoting leadership were instrumental motives and improved health. The critical conditions for health promoting leadership were organisational conditions, characteristics of individual managers, and support to managers. It seems that the concept of health promoting leadership was often used to link ideas about good leadership to the health of employees. Organisational goals and management trends may also have influenced the motives as well as the conditions for development of health promoting leadership.

Cash income, intrahousehold cooperative conflict, and child health in central Mozambique.

PubMed

Pfeiffer, James

2003-01-01

This study presents qualitative data on individual cash income generation and intrahousehold bargaining in a sample of 100 households in central Mozambique. It is now recognized that intrahousehold resource allocation patterns can be critical determinants of children's health in the developing world. Recently developed "bargaining-power" models suggest that individual incomes are often not pooled in households and that decisions are the result of a bargaining process that involves cooperation and conflict between men and women. Women's income, many believe, is more often spent on child welfare. Development projects should target benefits to women for greater impact on child health. Some argue that households consist of separate, gendered spheres of economic responsibility that intersect through a "conjugal contract" that defines the terms of cooperation. The findings here support the "separate-spheres" depiction of the household and reveal women's subordinated position in the external cash economy, which undermines their intrahousehold bargaining power.