Science.gov

Sample records for health evaluation ii

  1. [Willingness of Warsaw inhabitants to cooperate with health service. II. Evaluation of health and retirement security].

    PubMed

    Supranowicz, Piotr; Wysocki, Mirosław J; Car, Justyna; Debska, Anna; Gebska-Kuczerowska, Anita

    2012-01-01

    Providing citizens with health security is one of the main challenges for health policy. For the effective modifying the health an social care system it is very important to recognize how citizens themselves perceived their health and retirement assurance. The article presents the analysis of assessment of health care system, out-of-pocket payments for treatment, and retirement system by Warsaw inhabitants in relation to demographic characteristics and health indicators. Data were collected using not-addressed questionnaire. Our findings indicated that women, people aged 30-64 years, those having vocational education and unemployed, the others out of work as well as employed more negatively assessed health care system in comparison to the other demographic groups. The youngest and oldest people, those having elementary education and those who were economically inactive relatively frequently declared bearing very high expenses for treatment. The retirement system was more negatively assessed by women, people under 45 years, unemployed and the others out of work. The analysis of the relationship between perceived health and out-of-pocket payments for treatment and selected health indicators showed that people, who positively assessed existing health care and declared low expenses for treatment, higher evaluated their health, less frequently stayed at home because of ill-health, less frequently were in contact with physician and rarely were treated in hospital. Such differences were not noted (except one) for retirement security.

  2. Acute physiology and chronic health evaluation (APACHE II) and Medicare reimbursement

    PubMed Central

    Wagner, Douglas P.; Draper, Elizabeth A.

    1984-01-01

    This article describes the potential for the acute physiology score (APS) of acute physiology and chronic health evaluation (APACHE) II, to be used as a severity adjustment to diagnosis-related groups (DRG's) or other diagnostic classifications. The APS is defined by a relative value scale applied to 12 objective physiologic variables routinely measured on most hospitalized patients shortly after hospital admission. For intensive care patients, APS at admission is strongly related to subsequent resource costs of intensive care for 5,790 consecutive admissions to 13 large hospitals, across and within diagnoses. The APS could also be used to evaluate quality of care, medical technology, and the response to changing financial incentives. PMID:10311080

  3. Comparison of acute physiology and chronic health evaluation II and acute physiology and chronic health evaluation IV to predict intensive care unit mortality

    PubMed Central

    Parajuli, Bashu Dev; Shrestha, Gentle S.; Pradhan, Bishwas; Amatya, Roshana

    2015-01-01

    Context: Clinical assessment of severity of illness is an essential component of medical practice to predict the outcome of critically ill-patient. Acute Physiology and Chronic Health Evaluation (APACHE) model is one of the widely used scoring systems. Aims: This study was designed to evaluate the Performance of APACHE II and IV scoring systems in our Intensive Care Unit (ICU). Settings and Design: A prospective study in 6 bedded ICU, including 76 patients all above 15 years. Subjects and Methods: APACHE II and APACHE IV scores were calculated based on the worst values in the first 24 h of admission. All enrolled patients were followed, and outcome was recorded as survivors or nonsurvivors. Statistical Analysis Used: SPSS version 17. Results: The mean APACHE score was significantly higher among nonsurvivors than survivors (P < 0.005). Discrimination for APACHE II and APACHE IV was fair with area under receiver operating characteristic curve of 0.73 and 0.79 respectively. The cut-off point with best Youden index for APACHE II was 17 and for APACHE IV was 85. Above cut-off point, mortality was higher for both models (P < 0.005). Hosmer–Lemeshow Chi-square coefficient test showed better calibration for APACHE II than APACHE IV. A positive correlation was seen between the models with Spearman's correlation coefficient of 0.748 (P < 0.01). Conclusions: Discrimination was better for APACHE IV than APACHE II model however Calibration was better for APACHE II than APACHE IV model in our study. There was good correlation between the two models observed in our study. PMID:25722550

  4. The Effects of Head Start Health Services: Report of the Head Start Health Evaluation. Volume I and II.

    ERIC Educational Resources Information Center

    Fosburg, Linda B.; And Others

    In 1977, a longitudinal study was initiated to assess the effectiveness of health services provided by Head Start. The study provided for 10 domains: pediatric health examinations, health history recordings, dental evaluation, anthropometric assessment, diet and nutrition assessment, and hematology evaluations, as well as for developmental,…

  5. Acute Physiological and Chronic Health Evaluation II Score and its Correlation with Three Surgical Strategies for Management of Ileal Perforations

    PubMed Central

    Munghate, Anand; Kumar, Ashwani; Mittal, Sushil; Singh, Harnam; Sharma, Jyoti; Yadav, Manish

    2015-01-01

    Introduction: Ileal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. It is reported to constitute the fifth common cause of abdominal emergencies due to high incidence of enteric fever and tuberculosis in these management based on Acute Physiological and Chronic Health Evaluation II (APACHE II) score. Methods: The following study was conducted in the Department of General Surgery, Government Medical College, Patiala. A total of 57 patients were studied and divided in to Group I, II, and III. APACHE II score accessed and score between 10 and 19 were blindly randomized into three procedures primary closure, resection-anastomosis, and ileostomy. The outcome was compared. Results: Ileal perforations were most commonly observed in the third and fourth decade of life with male dominance. APACHE II score was accessed and out of total 57 patients, 6 patients had APACHE II score of 0–9, 48 patients had APACHE II score of 10–19, and 3 patients had APACHE II score of ≥20. In APACHE II score 10–19, 15 patients underwent primary closure, 16 patients underwent resection-anastomosis, and 17 patients underwent ileostomy. Discussion and Conclusion: Primary closure of perforation is advocated in patients with single, small perforation (<1 cm) with APACHE II score 10–19 irrespective of duration of perforation. Ileostomy is advocated in APACHE II score 10–19, where the terminal ileum is grossly inflamed with multiple perforations, large perforations (>1 cm), fecal peritonitis, matted bowel loops, intraoperative evidence of caseating lymph nodes, strictures, and an unhealthy gut due to edema. PMID:27512550

  6. Validation of acute physiologic and chronic health evaluation II scoring system software developed at The Aga Khan University, Pakistan.

    PubMed

    Hashmi, M; Asghar, A; Shamim, F; Khan, F H

    2016-01-01

    To assess the predictive performance of Acute Physiologic and Chronic Health Evaluation II (APACHE II) software available on the hospital intranet and analyze interrater reliability of calculating the APACHE II score by the gold standard manual method or automatically using the software. An expert scorer not involved in the data collection had calculated APACHE II score of 213 patients admitted to surgical Intensive Care Unit using the gold standard manual method for a previous study performed in the department. The same data were entered into the computer software available on the hospital intranet (http://intranet/apacheii) to recalculate the APACHE II score automatically along with the predicted mortality. Receiver operating characteristic curve (ROC), Hosmer-Lemeshow goodness-of-fit statistical test and Pearson's correlation coefficient was computed. The 213 patients had an average APACHE II score of 17.20 ± 8.24, the overall mortality rate was 32.8% and standardized mortality ratio was 1.00. The area under the ROC curve of 0.827 was significantly >0.5 (P < 0.01) and had confidence interval of 0.77-0.88. The goodness-of-fit test showed a good calibration (H = 5.46, P = 0.71). Interrater reliability using Pearson's product moment correlations demonstrated a strong positive relationship between the computer and the manual expert scorer (r = 0.98, P = 0.0005). APACHE II software available on the hospital's intranet has satisfactory calibration and discrimination and interrater reliability is good when compared with the gold standard manual method.

  7. Health risks of electromagnetic fields. Part II: Evaluation and assessment of radio frequency radiation.

    PubMed

    Habash, Riadh W Y; Brodsky, Lynn M; Leiss, William; Krewski, Daniel; Repacholi, Michael

    2003-01-01

    The increasing use of different radio frequency (RF)-emitting devices in residential and occupational settings has raised concerns about possible health effects of RF energy emitted by such devices. The debate about the potential risks associated with RF fields will persist with the prevalent network-connected wireless products and services targeting the marketplace for all kinds of consumer use. The aim of this article is to provide biomedical researchers with a review and critical evaluation of the current literature on acute and long-term health risks associated with RF radiation (RFR). Issues examined include safety standards for RFR; dosimetry and measurement surveys; and toxicological, epidemiological, and clinical studies of health outcomes that may be associated with RFR. Overall, the existing evidence for a causal relationship between RFR and adverse health effects is limited. Additional research is needed to clarify possible associations between RFR and biological effects noted in some studies. Particular attention should be directed toward long-term, low-level exposure to RFR.

  8. Evaluation of triclosan in Minnesota lakes and rivers: Part II - human health risk assessment.

    PubMed

    Yost, Lisa J; Barber, Timothy R; Gentry, P Robinan; Bock, Michael J; Lyndall, Jennifer L; Capdevielle, Marie C; Slezak, Brian P

    2017-08-01

    Triclosan, an antimicrobial compound found in consumer products, has been detected in low concentrations in Minnesota municipal wastewater treatment plant (WWTP) effluent. This assessment evaluates potential health risks for exposure of adults and children to triclosan in Minnesota surface water, sediments, and fish. Potential exposures via fish consumption are considered for recreational or subsistence-level consumers. This assessment uses two chronic oral toxicity benchmarks, which bracket other available toxicity values. The first benchmark is a lower bound on a benchmark dose associated with a 10% risk (BMDL10) of 47mg per kilogram per day (mg/kg-day) for kidney effects in hamsters. This value was identified as the most sensitive endpoint and species in a review by Rodricks et al. (2010) and is used herein to derive an estimated reference dose (RfD(Rodricks)) of 0.47mg/kg-day. The second benchmark is a reference dose (RfD) of 0.047mg/kg-day derived from a no observed adverse effect level (NOAEL) of 10mg/kg-day for hepatic and hematopoietic effects in mice (Minnesota Department of Health [MDH] 2014). Based on conservative assumptions regarding human exposures to triclosan, calculated risk estimates are far below levels of concern. These estimates are likely to overestimate risks for potential receptors, particularly because sample locations were generally biased towards known discharges (i.e., WWTP effluent). Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Research and Evaluations of the Health Aspects of Disasters, Part II: The Disaster Health Conceptual Framework Revisited.

    PubMed

    Birnbaum, Marvin L; Daily, Elaine K; O'Rourke, Ann P; Loretti, Alessandro

    2015-10-01

    A Conceptual Framework upon which the study of disasters can be organized is essential for understanding the epidemiology of disasters, as well as the interventions/responses undertaken. Application of the structure provided by the Conceptual Framework should facilitate the development of the science of Disaster Health. This Framework is based on deconstructions of the commonly used Disaster Management Cycle. The Conceptual Framework incorporates the steps that occur as a hazard progresses to a disaster. It describes an event that results from the changes in the release of energy from a hazard that may cause Structural Damages that in turn, may result in Functional Damages (decreases in levels of function) that produce needs (goods and services required). These needs can be met by the goods and services that are available during normal, day-to-day operations of the community, or the resources that are contained within the community's Response Capacity (ie, an Emergency), or by goods and services provided from outside of the affected area (outside response capacities). Whenever the Local Response Capacity is unable to meet the needs, and the Response Capacities from areas outside of the affected community are required, a disaster occurs. All responses, whether in the Relief or Recovery phases of a disaster, are interventions that use the goods, services, and resources contained in the Response Capacity (local or outside). Responses may be directed at preventing/mitigating further deterioration in levels of functions (damage control, deaths, injuries, diseases, morbidity, and secondary events) in the affected population and filling the gaps in available services created by Structural Damages (compromise in available goods, services, and/or resources; ie, Relief Responses), or may be directed toward returning the affected community and its components to the pre-event functional state (ie, Recovery Responses). Hazard Mitigation includes interventions designed to

  10. Evaluating Health Education Outcomes.

    ERIC Educational Resources Information Center

    Patty, Willard W.

    2001-01-01

    This 1949 paper considers the evaluation of health education outcomes. It describes the nature of health education, discusses whether it is possible to measure all health education outcomes, then examines how to evaluate student health habits and skills, health attitudes, and health knowledge. It concludes that it is important to evaluate health…

  11. Prognostic value of acute physiology and chronic health evaluation II and organ system failure in patients with acute renal failure requiring dialysis.

    PubMed

    Wang, I-Kuan; Wang, Shan-Tair; Chang, Hung-Yu; Lin, Chun-Liang; Kuo, Huey-Liang; Chen, Te-Chuan; Lee, Chih-Hsiung; Chuang, Feng-Rong

    2005-01-01

    Despite advances in modern technology of dialysis, prognosis of patients with acute renal failure (ARF) remains poor. To give the clinicians the most useful information, a model that accurately predicts outcome early in the course of ARF is required. However, because ARF is a heterogeneous syndrome and occurs in patients with diverse etiologies and some coexisting diseases, predicting outcome early is hard. The aim of this study is to evaluate prospectively the Acute Physiology and Chronic Health Evaluation (APACHE II) and organ system failure (OSF) models, evaluated prior to dialysis, in predicting hospital mortality. From June 2002 to March 2004, ARF patients requiring dialysis at Chang Gung Memorial Hospital, Chiayi, were prospectively recruited for this study. The worst clinical and laboratory data in the 24 hours before initiation of dialysis were prospectively evaluated, and the patients' APACHE II score and OSF number were assessed. A total of 61 patients (40 male and 21 female) were enrolled, of whom 38 (62.3%) died before discharge. By multivariate logistic regression, the APACHE II score (odds ratio 1.3 per increase in one score; P<0.001), or OSF number (odds ratio 1.9 per increase in one OSF; P<0.01) and oliguria (odds ratio 4.2; P=0.04), were found to be statistically significant prognostic factors for hospital mortality. Mortality increased progressively and significantly as OSF number (chi-square for trend; P=0.001) or the APACHE II score (chi-square for trend; P < 0.001) increased. By using Youden's index, the best cut-off value for APACHE II was 24, with 63% sensitivity and 96% specificity. The best cut-off value for OSF number was 2, with a sensitivity of 81.6% and a specificity of 60.9%. The areas under the receiver operating characteristic curves for APACHE II and OSF number were 0.847 (95% confidence interval (CI)=0.752-0.942; P<0.01) and 0.769 (95% CI=0.646-892; P<0.001), respectively, indicating good model discrimination. This study concludes

  12. Development and evaluation of a patient centered cardiovascular health education program for insured patients in rural Nigeria (QUICK - II).

    PubMed

    Odusola, Aina Olufemi; Hendriks, Marleen; Schultsz, Constance; Stronks, Karien; Lange, Joep; Osibogun, Akin; Akande, Tanimola; Alli, Shade; Adenusi, Peju; Agbede, Kayode; Haafkens, Joke

    2011-03-21

    In Sub Saharan Africa, the incidence of hypertension and other modifiable cardiovascular risk factors is growing rapidly. Poor adherence to prescribed prevention and treatment regimens by patients can compromise treatment outcomes. Patient-centered cardiovascular health education is likely to improve shortcomings in adherence. This paper describes a study that aims to develop a cardiovascular health education program for patients participating in a subsidized insurance plan in Nigeria and to evaluate the applicability and effectiveness in patients at increased risk for cardiovascular disease. The study has two parts. Part 1 will develop a cardiovascular health education program, using qualitative interviews with stakeholders. Part 2 will evaluate the effectiveness of the program in patients, using a prospective (pre-post) observational design. A rural primary health center in Kwara State, Nigeria. For part 1: 40 patients, 10 healthcare professionals, and 5 insurance managers. For part 2: 150 patients with uncontrolled hypertension or other cardiovascular risk factors after one year of treatment. Part 2: patient-centered cardiovascular health education program. Part 1: Semi-structured interviews to identify stakeholder perspectives. Part 2: Pre- and post-intervention assessments including patients' demographic and socioeconomic data, blood pressure, body mass index and self-reporting measures on medication adherence and perception of care. Feasibility of the intervention will be measured using process data. For program development (part 1): overview of healthcare professionals' perceptions on barriers and facilitators to care, protocol for patient education, and protocol implementation plan.For program evaluation (part 2): changes in patients' scores on adherence to medication and life style changes, blood pressure, and other physiological and self-reporting measures at six months past baseline. Part 1: content analytic technique utilizing MAXQDA software. Part 2

  13. Part II: Quantitative Evaluation of Choices Used in Setting Noncancer Chronic Human Health Reference Values Across Organizations.

    PubMed

    Holman, Elizabeth; Francis, Royce; Gray, George

    2017-05-01

    Environmental and public health organizations, including the World Health Organization (WHO) and the U.S. Environmental Protection Agency (USEPA), develop human health reference values (HHRV) that set "safe" levels of exposure to noncarcinogens. Here, we systematically analyze chronic HHRVs from four organizations: USEPA, Health Canada, RIVM (the Netherlands), and the U.S. Agency for Toxic Substances and Disease Registry. This study is an extension of our earlier work and both closely examines the choices made in setting HHRVs and presents a quantitative method for identifying the primary factors influencing HHRV agreement or disagreement.((1)) We evaluated 171 organizational comparisons, developing a quantitative method for identifying the factors to which HHRV agreement (that is, when both organizations considering the same data set the identical HHRV values) is most sensitive. To conduct this analysis, a Bayesian belief network was built using expert judgment, including the specific science policy choices analysis made in the context of setting an HHRV. Based on a sensitivity of findings analysis, HHRV agreement is most sensitive to the point of departure value, followed by the total uncertainty factor (UF), critical study, critical effect, animal model, and point of departure approach. This analysis also considered the specific impacts of individual UFs, with the database UF and the subchronic-to-chronic UF being identified as primary factors impacting the total UF differences observed across organizations. The sensitivity of findings analysis results were strengthened and confirmed by frequency analyses evaluating which choices most often disagreed when the HHRV and the total UF disagreed. © 2016 Society for Risk Analysis.

  14. Drug and Health Mediagraphy II: Mental Health.

    ERIC Educational Resources Information Center

    Dykstra, Ralph R.; Dirr, Peter J.

    The second in a series of bibliographies lists approximately 350 instructional materials for use in mental health education. It is noted that all of the materials listed were suggested by teachers after careful screening, including evaluation with handicapped children. Materials are grouped according to the following media forms: books (the major…

  15. [Evaluation of eight Clinical Protocols and Therapeutic Guidelines under the Brazilian Ministry of Health using the AGREE II instrument: a pilot study].

    PubMed

    Ronsoni, Ricardo De March; Pereira, Claudia Cristina de Aguiar; Stein, Airton Tetelbom; Osanai, Mário Henrique; Machado, Carla Jorge

    2015-06-01

    The number of clinical guidelines is increasing worldwide, while there are concerns regarding their quality. In 2000, the Brazilian Ministry of Health began its process of creating clinical guidelines, called Clinical Protocols and Therapeutic Guidelines (PCDT). The goal of this study was to assess the quality of Brazilian guidelines approved since 2009 using the AGREE II instrument (Appraisal of Guidelines for Research and Evaluation). We identified 59 PCDT from 2009 to 2012, of which eight were randomly selected and evaluated by three independent evaluators. For the item "recommends the guidelines", two evaluators recommended the use of all eight, but with modifications, and one did not recommend any to the guidelines. Regarding the item "global quality of the guidelines" (varying from 1 to 7), the mean was 4.25 (SD = 0.46). The results showed the need for adjustments in the PCDT in relation to AGREE II domains. However, due to the instrument's limitations, further studies are needed, including the quality of evidence used in the PCDT.

  16. Association of serum interleukin-6, interleukin-8, and Acute Physiology and Chronic Health Evaluation II score with clinical outcome in patients with acute respiratory distress syndrome

    PubMed Central

    Swaroopa, Deme; Bhaskar, Kakarla; Mahathi, T.; Katkam, Shivakrishna; Raju, Y. Satyanarayana; Chandra, Naval; Kutala, Vijay Kumar

    2016-01-01

    Background and Aim: Studies on potential biomarkers in experimental models of acute lung injury (ALI) and clinical samples from patients with ALI have provided evidence to the pathophysiology of the mechanisms of lung injury and predictor of clinical outcome. Because of the high mortality and substantial variability in outcomes in patients with acute respiratory distress syndrome (ARDS), identification of biomarkers such as cytokines is important to determine prognosis and guide clinical decision-making. Materials and Methods: In this study, we have included thirty patients admitted to Intensive Care Unit diagnosed with ARDS, and serum samples were collected on day 1 and 7 and were analyzed for serum interleukin-6 (IL-6) and IL-8 by ELISA method, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring was done on day 1. Results: The mortality in the patients observed with ARDS was 34%. APACHE II score was significantly higher in nonsurvivors as compared to survivors. There were no significant differences in gender and biochemical and hematological parameters among the survivors and nonsurvivors. Serum IL-6 and IL-8 levels on day 1 were significantly higher in all the ARDS patients as compared to healthy controls and these levels were returned to near-normal basal levels on day 7. The serum IL-6 and IL-8 levels measured on day 7 were of survivors. As compared to survivors, the IL-6 and IL-8 levels were significantly higher in nonsurvivors measured on day 1. Spearman's rank correlation analysis indicated a significant positive correlation of APACHE II with IL-8. By using APACHE II score, IL-6, and IL-8, the receiver operating characteristic curve was plotted and the provided predictable accuracy of mortality (outcome) was 94%. Conclusion: The present study highlighted the importance of measuring the cytokines such as IL-6 and IL-8 in patients with ARDS in predicting the clinical outcome. PMID:27688627

  17. Health Activities Project (HAP), Trial Edition II.

    ERIC Educational Resources Information Center

    Buller, Dave; And Others

    Contained within this Health Activities Project (HAP) trial edition (set II) are a teacher information folio and numerous student activity folios which center around the idea that students in grades 5-8 can control their own health and safety. Each student folio is organized into a Synopsis, Health Background, Materials, Setting Up, and Activities…

  18. Randomized noninferiority clinical trial evaluating 3 commercial dry cow mastitis preparations: II. Cow health and performance in early lactation.

    PubMed

    Arruda, A G; Godden, S; Rapnicki, P; Gorden, P; Timms, L; Aly, S S; Lehenbauer, T W; Champagne, J

    2013-10-01

    The objective of this randomized noninferiority clinical trial was to compare the effect of treatment with 3 different dry cow therapy formulations at dry-off on cow-level health and production parameters in the first 100 d in milk (DIM) in the subsequent lactation, including 305-d mature-equivalent (305 ME) milk production, linear score (LS), risk for the cow experiencing a clinical mastitis event, risk for culling or death, and risk for pregnancy by 100 DIM. A total of 1,091 cows from 6 commercial dairy herds in 4 states (California, Iowa, Minnesota, and Wisconsin) were randomly assigned at dry-off to receive treatment with 1 of 3 commercial products: Quartermaster (QT; Zoetis Animal Health, Madison, NJ), Spectramast DC (SP; Zoetis Animal Health) or ToMorrow Dry Cow (TM; Boehringer Ingelheim Vetmedica Inc., St Joseph, MO). All clinical mastitis, pregnancy, culling, and death events occurring in the first 100 DIM were recorded by farm staff using an on-farm electronic record-keeping system. Dairy Herd Improvement Association test-day records of milk production and milk component testing were retrieved electronically. Mixed linear regression analysis was used to describe the effect of treatment on 305ME milk production and LS recorded on the last Dairy Herd Improvement Association test day before 100 DIM. Cox proportional hazards regression analysis was used to describe the effect of treatment on risk for experiencing a case of clinical mastitis, risk for leaving the herd, and risk for pregnancy between calving and 100 DIM. Results showed no effect of treatment on adjusted mean 305 ME milk production (QT=11,759 kg, SP=11,574 kg, and TM=11,761 kg) or adjusted mean LS (QT=1.8, SP=1.9, and TM=1.6) on the last test day before 100 DIM. Similarly, no effect of treatment was observed on risk for a clinical mastitis event (QT=14.8%, SP=12.7%, and TM=15.0%), risk for leaving the herd (QT=7.5%, SP=9.2%, and TM=10.3%), or risk for pregnancy (QT=31.5%, SP=26.1%, and TM=26

  19. ESSENCE II and the framework for evaluating syndromic surveillance systems.

    PubMed

    Lombardo, Joseph S; Burkom, H; Pavlin, J

    2004-09-24

    The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE II) is a prototype syndromic surveillance system for capturing and analyzing public health indicators for early detection of disease outbreaks. This paper presents a preliminary evaluation of ESSENCE II according to a CDC framework for evaluating syndromic surveillance systems. Each major topic of the framework is addressed in this assessment of ESSENCE II performance. ESSENCE captures data in multiple formats, parses text strings into syndrome groupings, and applies multiple temporal and spatio-temporal outbreak-detection algorithms. During a recent DARPA evaluation exercise, ESSENCE algorithms detected a set of health events with a median delay of 1 day after the earliest possible detection opportunity. ESSENCE II has provided excellent performance with respect to the framework and has proven to be a useful and cost-effective approach for providing early detection of health events.

  20. Mobile Health Technology Evaluation

    PubMed Central

    Kumar, Santosh; Nilsen, Wendy J.; Abernethy, Amy; Atienza, Audie; Patrick, Kevin; Pavel, Misha; Riley, William T.; Shar, Albert; Spring, Bonnie; Spruijt-Metz, Donna; Hedeker, Donald; Honavar, Vasant; Kravitz, Richard; Lefebvre, R. Craig; Mohr, David C.; Murphy, Susan A.; Quinn, Charlene; Shusterman, Vladimir; Swendeman, Dallas

    2013-01-01

    Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and, (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, future possibilities and set a grand goal for the emerging field of mHealth research. PMID:23867031

  1. [Evaluation of health status in inhabitants of the protected zone near a steel mill. II. Overweight and obesity].

    PubMed

    Kolarzyk, E; Stepniewski, M; Targosz, D; Kieć, E; Wiater, M; Nyzio, B

    1990-01-01

    In the group of 232 inhabitants of the protective zone of Nowa Huta the Steel-Mill (181 women and 51 men) incidence of overweight and obesity was estimated using the Quetelet and Wot indices. The results were compared with appropriate data obtained for 37 men and 100 women, matched with age and occupation, inhabitants of Tokarnia village, known by favorable microclimate, rarely encountered in polluted areas of southern Poland. It was found that overweight and obesity was present in the group of the protective zone statistically more often than in Tokarnia. The differences were more pronounced for women than for men. Concentrations of serum cholesterol and triglycerides were also compared. Distribution of cholesterol in examined groups was similar to the distribution of the Quetelet index, differences of arithmetic means being statistically significant, whereas concentration of triglycerides was remarkably similar in all groups under investigation. In this paper rarely used method of data presentation was applied. From histograms of given parameter normalised curves were derived and served as a representation of parameter distribution in the studied population. This method grossly alleviated task of comparison and evaluation of obtained data.

  2. Introduction to Health Occupations Education II. Module No. I. Health Occupations Education II.

    ERIC Educational Resources Information Center

    Day, Nancy; And Others

    This package of seven modules that introduce health occupations II is one of six such packages containing a total of 46 modules that comprise Health Occupations Education II, the second course of a two-year course of study. Each module may contain some or all of the following components: introduction, directions, objectives, a list of learning…

  3. Health Hazard Evaluations

    MedlinePlus

    ... provide assistance and information by phone and in writing, or may visit the workplace to assess exposure and employee health. Based on their findings, NIOSH will recommend ways to reduce hazards and prevent work-related illness. The evaluation is done at no cost to the employees, ...

  4. Sample Exchange Evaluation (SEE) Report - Phase II

    SciTech Connect

    Winters, W.I.

    1994-09-28

    This report describes the results from Phase II of the Sample Exchange Evaluation (SEE) Program, a joint effort to compare analytical laboratory performance on samples from the Hanford Site`s high-level waste tanks. In Phase II, the program has been expanded to include inorganic constituents in addition to radionuclides. Results from Phase II that exceeded 20% relative percent difference criteria are identified.

  5. [Health technology assessment: II. Cost effectiveness analysis].

    PubMed

    Secoli, Silvia Regina; Nita, Marcelo Eidi; Ono-Nita, Suzane Kioko; Nobre, Moacyr

    2010-01-01

    New health technologies have made an impact in clinical and economic outcomes. Therefore, research methodologies that allow to evaluate the efficiency of these new technologies such as cost-effectiveness analysis are necessary. Cost-effectiveness analysis assess the value of health care interventions or drugs, the technology. Cost-effectiveness analysis is also deemed a determinant of modern health care practice, because the therapeutic options available at public (SUS) or private health care system must go through a formal health technology assessment in Brazil; thus, both the health care system and the health care professionals have to reevaluate the clinical consequences and costs of their actions to assure that the most efficient technologies are the one used in the practice. In this second article about health technology assessment we review the concepts of cost-effectiveness analysis, the steps involved in performing such analysis, and the criteria most frequently used to critically review the results.

  6. Augmented Fish Health Monitoring; Volume II of II, Completion Report.

    SciTech Connect

    Michak, Patty

    1991-12-01

    The Bonneville Power Administration (BPA) initiated the Augmented Fish Health Monitoring project in 1986. This project was a five year interagency project involving fish rearing agencies in the Columbia Basin. Participating agencies included: Washington Department of Fisheries (WDF), Oregon Department of Fish and Wildlife, Idaho Department of Fish and Game, and the US Fish and Wildlife Service (USFWS). This is the final data report for the Augmented Fish Health Monitoring project. Data collected and sampling results for 1990 and 1991 are presented within this report. An evaluation of this project can be found in Augmented Fish Health Monitoring, Volume 1, Completion Report.'' May, 1991. Pathogen detection methods remained the same from methods described in Augmented Fish Health Monitoring, Annual Report 1989,'' May, 1990. From January 1, 1990 to June 30, 1991 fish health monitoring sampling was conducted. In 1990 21 returning adult stocks were sampled. Juvenile pre-release exams were completed on 20 yearling releases, and 13 sub-yearling releases in 1990. In 1991 17 yearling releases and 11 sub-yearling releases were examined. Midterm sampling was completed on 19 stocks in 1990. Organosomatic analysis was performed at release on index station stocks; Cowlitz spring and fall chinook, Lewis river early coho and Lyons Ferry fall chinook.

  7. A comparison of the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Trauma-Injury Severity Score (TRISS) for outcome assessment in intensive care unit trauma patients.

    PubMed

    Wong, D T; Barrow, P M; Gomez, M; McGuire, G P

    1996-10-01

    To assess the ability of the Acute Physiology and Chronic Health Evaluation (APACHE II) system and Trauma-Injury Severity Scoring (TRISS) system in predicting group mortality in intensive care unit (ICU) trauma patients. Prospective study. A Canadian adult trauma tertiary referral hospital. Consecutive trauma patients admitted to the medical-surgical ICU or the neurosurgical ICU. None. For each patient, demographic data, mechanism of injury, and surgical status were collected. Revised Trauma Scores and Injury Severity Scores were calculated from emergency room and operative data. The APACHE II score was calculated based on the data from the first 24 hrs of ICU admission. The probability of death was calculated for each patient based on the APACHE II and TRISS equations. The ability to predict group mortality for APACHE II and TRISS was assessed by receiver operating characteristic curve analysis, two by two decision matrices, and calibration curve analysis. Four hundred seventy trauma patients were admitted to the ICU. Sixty-three (13%) patients died and 407 (87%) survived. There were significant differences between survivors and nonsurvivors in age, Glasgow Coma Scale, Revised Trauma Score, Injury Severity Score, and APACHE II score. By receiver operating characteristic curve analysis, the areas under the curves (+/- SEM) of APACHE II and TRISS were 0.92 +/- 0.02 and 0.89 +/- 0.02, respectively. Using two by two decision matrices with a decision criterion of 0.5, the sensitivities, specificities, and percentages correctly classified were 50.8%, 97.3%, and 91.1%, respectively, for APACHE II, and 50.8%, 97.1%, and 90.9%, respectively, for TRISS. From the calibration curves, the r2 value was .93 (p = .0001) for APACHE II and .67 (p = .004) for TRISS. Both APACHE II and TRISS scores were shown to accurately predict group mortality in ICU trauma patients. APACHE II and TRISS may be utilized for quality assurance in ICU trauma patients. However, neither APACHE II nor

  8. Evaluating Health Information

    MedlinePlus

    Millions of consumers get health information from magazines, TV or the Internet. Some of the information is reliable and up to date; some is not. ... a branch of the government, a university, a health organization, a hospital or a business? Focus on ...

  9. Comparison of thrombolysis in myocardial infarction, Global Registry of Acute Coronary Events, and Acute Physiology and Chronic Health Evaluation II risk scores in patients with acute myocardial infarction who require mechanical ventilation for more than 24 hours.

    PubMed

    Eran, Oren; Novack, Victor; Gilutz, Harel; Zahger, Doron

    2011-02-01

    The ability to provide an accurate prognosis in an intensive care unit is of major importance. Numerous risk scores have been developed to predict hospital mortality based on demographic, physiologic, and clinical data. These scores were universally developed in general medical or surgical intensive care units. Patients admitted to a cardiac care unit differ in many aspects from those admitted to general medical intensive care units. Few patients require mechanical ventilation and prolonged intensive care. Performance of risk scores developed for patients with acute myocardial infarction (AMI) in this subgroup is unknown. We prospectively studied 51 consecutive patients who were admitted to a cardiac care unit from September 2006 to March 2008 for AMI and received mechanical ventilation for >24 hours. Acute Physiology and Chronic Health Evaluation II (APACHE II), Thrombolysis In Myocardial Infarction, and Global Registry of Acute Coronary Events risk scores were calculated for each patient. Mortality rates were extrapolated based on these 3 risk scores. Twenty-two of 51 patients (43%) died in hospital. Age, mean arterial pressure, urea, albumin, hemoglobin, need for vasopressors, and estimated glomerular filtration rate were predictive of mortality. APACHE II and Global Registry of Acute Coronary Events scores were higher in nonsurvivors but Thrombolysis In Myocardial Infarction risk score was not predictive of mortality. APACHE II score had the highest value for area under receiver operator characteristics curve for mortality prediction. In conclusion, patients with AMI requiring mechanical ventilation have a high mortality rate. This risk is predicted by co-morbidities better than by direct cardiac parameters. Consequently, conventional AMI risk scores do not perform well in this very sick population and the APACHE II score better predicts their short-term outcome.

  10. Age influences the predictive value of Acute Physiology and Chronic Health Evaluation II and Intensive Care National Audit and Research Centre scoring models in patients admitted to Intensive Care Units after in-hospital cardiac arrest.

    PubMed

    Senaratne, D N S; Veenith, T

    2015-03-01

    Outcomes following in-hospital cardiac arrest (IHCA) are generally poor though different patient populations may benefit to different degrees from admission to Intensive Care Units (ICUs). Risk stratification algorithms may be useful in identifying patients who are most likely to benefit from ICU admission and so may aid allocation of this scarce resource. We aimed to compare the performance of the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Intensive Care National Audit and Research Centre (ICNARC) scoring systems in predicting outcome following ICU admission after IHCA in younger (≤69 years) and older (≥70 years) patients. We performed a retrospective observational study in two adult ICUs from January 2006 to February 2010 inclusive. Patients were divided into younger (≤69 years) and older (≥70 years) patients. The primary outcome measures were acute hospital mortality and area under the curve (AUC) calculation for receiver operating characteristic (ROC) analysis. Two hundred and sixty-one adult consecutive adult patients admitted following IHCA. Hospital mortality was 58.6%. ROC analysis demonstrated that ICNARC was more accurate than APACHE II in predicting acute hospital outcomes in the adult population (AUC 0.734 vs. 0.706). Both scoring systems performed weaker when predicting outcomes in younger patients compared to older patients (ICNARC AUC 0.655 vs. 0.810; APACHE II AUC 0.660 vs. 0.759). Both APACHE II and ICNARC predict outcome well in older patients. In younger patients, their value is less clear, and so they must be used with caution.

  11. Evaluation of APACHE II for cost containment and quality assurance.

    PubMed Central

    Civetta, J M; Hudson-Civetta, J A; Nelson, L D

    1990-01-01

    APACHE II (an acronym formed from acute physiology score and chronic health evaluation) has been proposed to limit intensive care unit (ICU) admissions ('cost containment') and to judge outcome ('quality assurance') of surgical patients. To judge its performance, a 6-month study of 372 surgical ICU patients was performed. When patients were divided by mean duration of stay, mortality rates rose from 1% (short stay) to 19% (long stay) (p less than 0.001) for patients with APACHE II scores less than 10, but decreased from 94% (short stay) to 60% (long stay) (p less than 0.01) for patients with APACHE II scores more than 24. Exclusion of patients by high or low APACHE scores would 'save' 6% of ICU days but risk increasing morbidity, hospital costs, and deaths. Grouped APACHE II scores did not correlate with total hospital charges (r = 0.05, p = 0.89) or ICU days used (r = 0.42, p = 0.17). Grouping by APACHE II score and duration of ICU stay showed neither symmetry nor uniformity of mortality rates. Surgical patients would not be well served by APACHE II for quality assurance or cost containment. PMID:2396881

  12. Dam health diagnosis and evaluation

    NASA Astrophysics Data System (ADS)

    Wu, Zhongru; Su, Huaizhi

    2005-06-01

    Based on the bionics principle in the life sciences field, we regard a dam as a vital and intelligent system. A bionics model is constructed to observe, diagnose and evaluate dam health. The model is composed of a sensing system (nerve), central processing unit (cerebrum) and decision-making implement (organism). In addition, the model, index system and engineering method on dam health assessment are presented. The proposed theories and methods are applied to evaluate dynamically the health of one concrete dam.

  13. Prediction of outcome from intensive care: a prospective cohort study comparing Acute Physiology and Chronic Health Evaluation II and III prognostic systems in a United Kingdom intensive care unit.

    PubMed

    Beck, D H; Taylor, B L; Millar, B; Smith, G B

    1997-01-01

    To evaluate the ability of two prognostic systems to predict hospital mortality in adult intensive care patients. Prospective cohort study. A mixed medical and surgical intensive care unit (ICU) in the United Kingdom. A total of 1,144 patients consecutively admitted to the study. None. Acute Physiology and Chronic Health Evaluation (APACHE) II and III prognostic systems were applied to assess probabilities of hospital mortality, which were compared with the actual outcome. The overall goodness-of-fit of both models was assessed. Hospital death rates were higher than those predicted by each system. Risk estimates showed a strong positive correlation between both systems (nonsurvivors r2 = 0.756, p < .0001; survivors r2 = 0.787, p < .0001). Calibration of APACHE II (chi 2 = 98.6, Lemeshow-Hosmer) was superior to that of APACHE III (chi 2 = 129.8, Lemeshow-Hosmer). The total correct classification rate of APACHE III was greater for all decision criteria applied; the best overall total correct classification rate was 80.6% for APACHE III and 77.9% for APACHE II (both for a decision criterion of 40%). The areas under the receiver operating characteristic curves were 0.806 and 0.847 for APACHE II and III, respectively, confirming the better discrimination of APACHE III. When patients were classified by diagnostic categories, risk predictions did not fit uniformly across the spectrum of disease groups. For both models, mortality ratios were highest for trauma patients and lowest for the group with respiratory disease. APACHE II predictions for patients with gastrointestinal disease were significantly better. Risk estimates for surgical admissions were superior with APACHE II (MR = 1.27) compared with APACHE III (MR = 1.56), but were similar for medical patients (1.22 vs. 1.28 for APACHE II and III, respectively). Bias induced by factors reflecting the clinical practice in an individual ICU (e.g., admission criteria, treatment before admission) may have considerable impact

  14. Evaluating Health Risk Models

    PubMed Central

    2010-01-01

    SUMMARY Interest in targeted disease prevention has stimulated development of models that assign risks to individuals, using their personal covariates. We need to evaluate these models and quantify the gains achieved by expanding a model to include additional covariates. This paper reviews several performance measures and shows how they are related. Examples are used to show that appropriate performance criteria for a risk model depend upon how the model is used. Application of the performance measures to risk models for hypothetical populations and for US women at risk of breast cancer illustrate two additional points. First, model performance is constrained by the distribution of risk-determining covariates in the population. This complicates the comparison of two models when applied to populations with different covariate distributions. Second, all summary performance measures obscure model features of relevance to its utility for the application at hand, such as performance in specific subgroups of the population. In particular, the precision gained by adding covariates to a model can be small overall, but large in certain subgroups. We propose new ways to identify these subgroups and to quantify how much they gain by measuring the additional covariates. Those with largest gains could be targeted for cost-efficient covariate assessment. PMID:20623821

  15. [Evaluation of selected features of the lifestyle being conducive to the state of health of 16-18 year old girls. Part II. Nutritional habits].

    PubMed

    Piotrowska, Ewa; Zechałko-Czajkowska, Alicja; Biernat, Jadwiga; Mikołajczak, Jolanta

    2009-01-01

    The aim of the study was to analyze nutritional habits of 409 16-18 year old girls from Wrocław. They are one of three elements shaping health attitude of girls. This research indicates mostly committing nutritional mistakes of the girls e.g.: irregularity of meals consumption 73% of girls, incorrect number of meals about 60% of girls, omission of breakfast about 15% of girls and lunch 20% of girls, movement of main meal up to late evening and night hours, and regular snaking meals 53.0% of girls.

  16. Health Education Teaching Ideas: Elementary. Volume II.

    ERIC Educational Resources Information Center

    Hakala, Jane, Ed.; Buckner, W. P., Jr., Ed.; King, Karen, Ed.

    This guide contains innovative learning activities and teaching ideas to enhance classroom instruction. The 40 papers are divided into 12 areas: "Health Attitudes and Values" (e.g., understanding elementary students' perceptions of health through art, narrative and discussion); "Mental Health" (e.g., building community through…

  17. Evaluation of health assessment skills.

    PubMed

    Wilbur, J

    1989-01-01

    This article presents the reliability and validity data on a checklist used to evaluate health assessment skills. In 1982, the nurse practitioner faculty at a large midwestern university acknowledged that health assessment skills were basic to the preparation of all nurses and made the decision to require these skills for entry into the graduate program. Because of the varying ways in which health assessment skills are acquired, the faculty saw the need to standardize the expected level of performance. An objective, three-page instrument to measure student competence in performing and recording a health history and physical examination for a client of any age is administered prior to beginning the nurse practitioner sequence of courses. The 91 objective items for this instrument are based on the traditional outline for writing up a client history and physical examination. Criteria for the items are located in an accompanying manual. The student achieves a "Yes" rating on an item if all the components of the item are performed and written according to the criteria. Reliability of the tool was assessed by 12 faculty members who participated in a simulated evaluation. The tool has been used to evaluate the skills of 165 nurses. Of these, 149 nurses were enrolled in a continuing education course, and 16 nurses tested out of a health assessment course.

  18. Health economic evaluation in England.

    PubMed

    Raftery, James

    2014-01-01

    The 2010 National Health Service Constitution for England specified rights and responsibilities, including health economic evaluation for the National Institute for Health and Care Excellence (NICE) and the Joint Committee on Vaccinations and Immunisations. The National Screening Committee and the Health Protection Agency also provide advice to the Government based on health economic evaluation. Each agency largely follows the methods specified by NICE. To distinguish the methods from neoclassical economics they have been termed "extra-welfarist". Key differences include measurement and valuation of both benefits (QALYs) and costs (healthcare related). Policy on discounting has also changed over time and by agency. The debate over having NICE's methods align more closely with neoclassical economics has been prominent in the ongoing development of "value based pricing". The political unacceptability of some decisions has led to special funding for technologies not recommended by NICE. These include the 2002 Multiple Sclerosis Risk Sharing Scheme and the 2010 Cancer Drugs Fund as well as special arrangements for technologies linked to the end of life and for innovation. Since 2009 Patient Access Schemes have made price reductions possible which sometimes enables drugs to meet NICE's cost-effectiveness thresholds. As a result, the National Health Service in England has denied few technologies on grounds of cost-effectiveness.

  19. Evaluation of a laboratory system intended for use in physicians' offices. II. Reliability of results produced by health care workers without formal or professional laboratory training.

    PubMed

    Belsey, R; Vandenbark, M; Goitein, R K; Baer, D M

    1987-07-17

    The Kodak DT-60 tabletop chemistry analyzer was evaluated with standardized protocols to determine the system's precision and accuracy when operated by four volunteers (a secretary, a licensed practical nurse, and two family medicine residents) in a simulated office laboratory. The variability of the results was found to be significantly greater than the variability of results produced by medical technologists who analyzed the same samples during the same study period with another DT-60 placed in the hospital laboratory. The source(s) of increased variance needs to be identified so the system can be modified or new control procedures can be developed to ensure the reliability of results used in patient care. Prospective purchasers, manufacturers, and patients need this kind of objective information about the reliability of results produced by systems intended for use in physicians' office laboratories.

  20. [Improving occupational health evaluation research].

    PubMed

    Berthelette, Diane; Bilodeau, Henriette; Leduc, Nicole

    2008-01-01

    A review of the existing occupational health literature reveals that several authors have proposed recommendations to increase the effectiveness of interventions that aim to prevent occupational disabilities. However, these recommendations are rarely evidence-based given that research carried out on such interventions is essentially epidemiological and that it generally produces too fragmented results. The contributing factors to explain this phenomenon are identified. The authors support the opinion that the community of occupational health academics should create more opportunities for researchers well-versed in evaluative research based on scientific methods complementary to epidemiology.

  1. Child disaster mental health interventions, part II

    PubMed Central

    Pfefferbaum, Betty; Sweeton, Jennifer L.; Newman, Elana; Varma, Vandana; Noffsinger, Mary A.; Shaw, Jon A.; Chrisman, Allan K.; Nitiéma, Pascal

    2014-01-01

    This review summarizes current knowledge on the timing of child disaster mental health intervention delivery, the settings for intervention delivery, the expertise of providers, and therapeutic approaches. Studies have been conducted on interventions delivered during all phases of disaster management from pre event through many months post event. Many interventions were administered in schools which offer access to large numbers of children. Providers included mental health professionals and school personnel. Studies described individual and group interventions, some with parent involvement. The next generation of interventions and studies should be based on an empirical analysis of a number of key areas. PMID:26295009

  2. Health Occupations: Grade 8. Cluster II.

    ERIC Educational Resources Information Center

    Calhoun, Olivia H.

    A curriculum guide for grade 8, the document is devoted to the occupational cluster "Health Occupations." It is divided into four units: the hospital, preventive medicine, drug use and abuse, and alcohol and tobacco. Each unit is introduced by a statement of the topic, the unit's purpose, main ideas, quests, and a list of career…

  3. Tse'ado'ii [Health Concepts].

    ERIC Educational Resources Information Center

    Dissemination and Assessment Center for Bilingual Education, Austin, TX.

    This children's reader in the Navajo language presents health concepts, such as the transmission of germs, through the use of illustrations and text describing the daily activities of a fly. The book is designed for children in kindergarten through third grade in a bilingual education setting. (Auth/NCR)

  4. Allied Health Occupations II (Health Careers--Core Curriculum).

    ERIC Educational Resources Information Center

    Middletown Public Schools, CT.

    This volume outlines the requirements and content of a second-year course in allied health occupations education that is designed to provide students with background informational material and practical skills used in various health fields. Addressed in the individual units of the course are the following topics: safety; ethical and legal…

  5. Allied Health Occupations II (Health Careers--Core Curriculum).

    ERIC Educational Resources Information Center

    Middletown Public Schools, CT.

    This volume outlines the requirements and content of a second-year course in allied health occupations education that is designed to provide students with background informational material and practical skills used in various health fields. Addressed in the individual units of the course are the following topics: safety; ethical and legal…

  6. Evaluation of ADINA. Part II. Operating Characteristics.

    DTIC Science & Technology

    1980-06-08

    Mooney Rivlin material, small/ large deformation i) static ii) dynamic iii) frequency (linear) 3. Spherical shell; elastic, plastic, concrete, small...Neighborhood of Buckling Zone 13 11-8 Typical Negative Stiffness Generated in Neighborhood of Buckling Zone 14 III-1 Rubber Sheet Geometry Material...Properties and Element Model 26 111-2 Global Energy Increment of Rubber Sheet (1st Load Step) 28 111-3 Global Energy Increment of Rubber Sheet (1st Load

  7. Design of the School Health Education Evaluation.

    ERIC Educational Resources Information Center

    Gunn, Walter J.; And Others

    1985-01-01

    The nation's public schools can systematically promote the knowledge, attitudes, and skills necessary for good health. The U.S. Department of Health and Human Services contracted to evaluate the School Health Curriculum Project and three other approaches. The design, implementation, and benefits of the School Health Education Evaluation (SHEE) are…

  8. Health care technology assessment: implications for modern medical practice. Part II. Decision making on technology adoption.

    PubMed

    Pierce, Read G; Bozic, Kevin J; Hall, Bruce Lee; Breivis, James

    2007-02-01

    Health care technology assessment, the multidisciplinary evaluation of clinical and economic aspects of technology, has come to have an increasingly important role in health policy and clinical decision-making. In Part I--Understanding Technology Adoption and Analyses--this review addressed the difficult challenges posed by assessment and provided a guide to the methodologies used. Part II presents the factors that drive the technology choices made by patients, by individual physicians, by provider groups, and by hospital administrators.

  9. Methodological Report: Transnational European Evaluation Project II (TEEP II). ENQA Occasional Papers 9

    ERIC Educational Resources Information Center

    ENQA (European Association for Quality Assurance in Higher Education), 2006

    2006-01-01

    The second Transnational European Evaluation Project (TEEP II) was undertaken between August 2004 and June 2006. A methodology for evaluating transnational programmes had previously been tested during 2002-2003 by ENQA (European Association for Quality Assurance in Higher Education) in the first Transnational European Evaluation Project (TEEP I).…

  10. [Stroke health care plan (ICTUS II. 2010)].

    PubMed

    Masjuan, J; Alvarez-Sabín, J; Arenillas, J; Calleja, S; Castillo, J; Dávalos, A; Díez Tejedor, E; Freijo, M; Gil-Núñez, A; Fernández, J C López; Maestre, J F; Martínez-Vila, E; Morales, A; Purroy, F; Ramírez, J M; Segura, T; Serena, J; Tejada, J; Tejero, C

    2011-09-01

    The Spanish Stroke Group published the "Plan for stroke healthcare delivery" in 2006 with the aim that all stroke patients could receive the same degree of specialised healthcare according to the stage of their disease, independently of where they live, their age, gender or ethnicity. This Plan needs to be updated in order to introduce new developments in acute stroke. A committee of 19 neurologists specialised in neurovascular diseases representing different regions of Spain evaluated previous experience with this Plan and the available scientific evidence according to published literature. The new organised healthcare system must place emphasis on the characteristics of the different care levels with promotion of Reference Stroke Hospitals, set up less restrictive Stroke Code activation criteria that include new therapeutic options, establish new standard measures for endovascular treatment and develop tele-medicine stroke networks. 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  11. Anatomy and Physiology. Module No. IV. Health Occupations Education II.

    ERIC Educational Resources Information Center

    Day, Nancy; And Others

    This package of 31 modules on anatomy and physiology is one of six such packages containing a total of 46 modules that comprise Health Occupations Education II, the second course of a two-year course of study. Each module may contain some or all of the following components: introduction, directions, objectives, a list of learning activities,…

  12. Microscope. Module No. VI. Health Occupations Education II.

    ERIC Educational Resources Information Center

    Day, Nancy; And Others

    This package, with one module on the microscope, is one of six such packages containing a total of 46 modules that comprise Health Occupations Education II, the second course of a two-year course of study. Each module may contain some or all of the following components: introduction, directions, objectives, a list of learning activities, student…

  13. Anatomy and Physiology. Module No. IV. Health Occupations Education II.

    ERIC Educational Resources Information Center

    Day, Nancy; And Others

    This package of 31 modules on anatomy and physiology is one of six such packages containing a total of 46 modules that comprise Health Occupations Education II, the second course of a two-year course of study. Each module may contain some or all of the following components: introduction, directions, objectives, a list of learning activities,…

  14. Augmented Fish Health Monitoring; Volume I of II, Completion Report.

    SciTech Connect

    Michak, Patty

    1991-05-01

    The Bonneville Power Administration (BPA) initiated the Augmented Fish Health Monitoring project in 1986. This project was a five year interagency project involving fish rearing agencies in the Columbia Basin. Historically, all agencies involved with fish health in the Columbia Basin were conducting various levels of fish health monitoring, pathogen screening and collection. The goals of this project were; to identify, develop and implement a standardized level of fish health methodologies, develop a common data collection and reporting format in the area of artificial production, evaluate and monitor water quality, improve communications between agencies and provide annual evaluation of fish health information for production of healthier smolts. This completion report will contain a project evaluation, review of the goals of the project, evaluation of the specific fish health analyses, an overview of highlights of the project and concluding remarks. 8 refs., 1 fig., 4 tabs.

  15. Microcomputer Applications for Health Care Professionals. Volume II. Curriculum Improvement Project. Region II.

    ERIC Educational Resources Information Center

    Bruce, Lucy

    This volume is one of three in a self-paced computer literacy course that gives allied health students a firm base of knowledge concerning computer usage in the hospital environment. It also develops skill in several applications software packages. Volume II contains materials for three one-hour courses on word processing applications, spreadsheet…

  16. EVALUATION OF GROUNDWATER EXTRACTION REMEDIES - VOLUME II

    EPA Science Inventory

    This volume was prepared as part of an evaluation of groundwater extraction remedies completed under EPA Contract No. 68-W8-0098. It presents 19 case studies of individual sites where ground-water extraction systems have been implemented. These case studies present site characte...

  17. Evaluating personal health care and health promotion web sites.

    PubMed

    Lang, J R; Collen, A

    2005-01-01

    An exemplary sample of web sites relevant to personal health care and health promotion was chosen and evaluated. Both quantitative and qualitative data were converged to assess and rank the sites on nine attributes. The sites provided a definitive range of value and variety of presentations, health care and health promotion information, and services covering the virtual choices currently available to users of the Internet. Discussion focused on methodological approaches and issues of web site evaluation serving the public interest, health care, and health promotion.

  18. AIDE II Integrated Design Evaluation program

    NASA Astrophysics Data System (ADS)

    Alexander, Richard V.

    1993-06-01

    The AIDE computer program (Aerojet's Integrated Design Evaluation) derives from the industry's earliest design optimization program for establishing propulsion requirements for Polaris. It is used to establish design requirements, solid rocket motor operating conditions, design details, and evaluate design alternatives for propulsion systems optimized to meet a wide range of systems requirements. AIDE uses detailed component design subroutines (when possible) to make preliminary designs. The program does in minutes what a large number of designers would take weeks to do. AIDE (or previous versions) have been used on every major solid rocket study/hardware program at Aerojet for the past 35 years. The versatility of AIDE was demonstrated in our SICBM work. Our first SICBM contract with AFRPL was to perform design optimization studies and evaluate alternative concepts in systems definition. It was then used to select optimum operating conditions for each of the three stages for which Aerojet submitted proposals. After winning a development contract, it was used during the next two years for sensitivity and trade studies refining our second stage SICBM design.

  19. Anniston Community Health Survey: Follow-Up and Dioxin Analyses (ACHS-II) - Methods

    PubMed Central

    Birnbaum, L.S.; Dutton, N.D.; Cusack, C.; Mennemeyer, S.T.; Pavuk, M.

    2015-01-01

    High serum concentrations of polychlorinated biphenyls (PCBs) have been reported previously among residents of Anniston, Alabama, where a PCB production facility was located in the past. As the second of two cross-sectional studies of these Anniston residents, the Anniston Community Health Survey: Follow-Up and Dioxin Analyses (ACHS-II) will yield repeated measurements to be used to evaluate changes over time in ortho-PCB concentrations and selected health indicators in study participants. Dioxins, non-ortho PCBs, other chemicals, heavy metals, and a variety of additional clinical tests not previously measured in the original ACHS cohort will be examined in ACHS-II. The follow-up study also incorporates a questionnaire with extended sections on diet and occupational history for a more comprehensive assessment of possible exposure sources. Data collection for ACHS-II from 359 eligible participants took place in 2014, seven to nine years after ACHS. PMID:25982988

  20. Anniston community health survey: Follow-up and dioxin analyses (ACHS-II)--methods.

    PubMed

    Birnbaum, Linda S; Dutton, N D; Cusack, C; Mennemeyer, S T; Pavuk, M

    2016-02-01

    High serum concentrations of polychlorinated biphenyls (PCBs) have been reported previously among residents of Anniston, Alabama, where a PCB production facility was located in the past. As the second of two cross-sectional studies of these Anniston residents, the Anniston Community Health Survey: Follow-Up and Dioxin Analyses (ACHS-II) will yield repeated measurements to be used to evaluate changes over time in ortho-PCB concentrations and selected health indicators in study participants. Dioxins, non-ortho PCBs, other chemicals, heavy metals, and a variety of additional clinical tests not previously measured in the original ACHS cohort will be examined in ACHS-II. The follow-up study also incorporates a questionnaire with extended sections on diet and occupational history for a more comprehensive assessment of possible exposure sources. Data collection for ACHS-II from 359 eligible participants took place in 2014, 7 to 9 years after ACHS.

  1. Measuring functional health among the elderly: development of the Japanese version of the World Health Organization Disability Assessment Schedule II.

    PubMed

    Tazaki, Miyako; Yamaguchi, Tesuo; Yatsunami, Mitsutoshi; Nakane, Yoshibumi

    2014-03-01

    The Japanese version of the World Health Organization Disability Assessment Schedule II (WHODAS II-J) was developed and its psychometric properties were evaluated, and then used to determine the influence of disability on quality of life among the elderly in Japan. The study included three phases: qualitative, preliminary and field. For the qualitative portion of the study, six key informants were interviewed before the translation/back-translation procedure. For the preliminary study, 17 healthy elderly individuals were interviewed using the 12-item interview version of the WHODAS II-J. For the field study, different versions of the WHODAS II-J and the Japanese version of the World Health Organization Quality of Life BREF (WHOQOL-BREF) were tested with different participants (the 36-item interview version with 30 participants living in a nursing home, the 36-item proxy version with 30 caregivers working in the nursing home, and the 12-item and 36-item self-report versions with 132 and 129 healthy elderly living in Kanto and Kinki regions, respectively). In total, 321 elderly individuals participated in the field study. Of these participants, physical or mental disabilities were present in 47. Cronbach's α scores calculated for each of six domains of the WHODAS II ranged from 0.67 to 0.98. A significant correlation was observed between the results of the WHODAS II-J and the degree of disability (P<0.01), and a negative correlation was observed between WHOQOL-BREF and WHODAS II-J scores (P<0.01). A significant difference was found between healthy elderly individuals and those with disabilities in three domains: getting around, self-care, and life activities (P<0.01). In conclusion, the WHODAS II-J is a reliable and valid instrument for assessment of function in the elderly population in Japan.

  2. [Evaluation model for municipal health planning management].

    PubMed

    Berretta, Isabel Quint; Lacerda, Josimari Telino de; Calvo, Maria Cristina Marino

    2011-11-01

    This article presents an evaluation model for municipal health planning management. The basis was a methodological study using the health planning theoretical framework to construct the evaluation matrix, in addition to an understanding of the organization and functioning designed by the Planning System of the Unified National Health System (PlanejaSUS) and definition of responsibilities for the municipal level under the Health Management Pact. The indicators and measures were validated using the consensus technique with specialists in planning and evaluation. The applicability was tested in 271 municipalities (counties) in the State of Santa Catarina, Brazil, based on population size. The proposed model features two evaluative dimensions which reflect the municipal health administrator's commitment to planning: the guarantee of resources and the internal and external relations needed for developing the activities. The data were analyzed using indicators, sub-dimensions, and dimensions. The study concludes that the model is feasible and appropriate for evaluating municipal performance in health planning management.

  3. Modeling the World Health Organization Disability Assessment Schedule II using non-parametric item response models.

    PubMed

    Galindo-Garre, Francisca; Hidalgo, María Dolores; Guilera, Georgina; Pino, Oscar; Rojo, J Emilio; Gómez-Benito, Juana

    2015-03-01

    The World Health Organization Disability Assessment Schedule II (WHO-DAS II) is a multidimensional instrument developed for measuring disability. It comprises six domains (getting around, self-care, getting along with others, life activities and participation in society). The main purpose of this paper is the evaluation of the psychometric properties for each domain of the WHO-DAS II with parametric and non-parametric Item Response Theory (IRT) models. A secondary objective is to assess whether the WHO-DAS II items within each domain form a hierarchy of invariantly ordered severity indicators of disability. A sample of 352 patients with a schizophrenia spectrum disorder is used in this study. The 36 items WHO-DAS II was administered during the consultation. Partial Credit and Mokken scale models are used to study the psychometric properties of the questionnaire. The psychometric properties of the WHO-DAS II scale are satisfactory for all the domains. However, we identify a few items that do not discriminate satisfactorily between different levels of disability and cannot be invariantly ordered in the scale. In conclusion the WHO-DAS II can be used to assess overall disability in patients with schizophrenia, but some domains are too general to assess functionality in these patients because they contain items that are not applicable to this pathology. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Safety and toxicological evaluation of undenatured type II collagen.

    PubMed

    Marone, Palma Ann; Lau, Francis C; Gupta, Ramesh C; Bagchi, Manashi; Bagchi, Debasis

    2010-05-01

    Previous research has shown that undenatured type II collagen is effective in the treatment of arthritis. The present study evaluated the broad-spectrum safety of UC-II by a variety of toxicological assays including acute oral, acute dermal, primary dermal irritation, and primary eye irritation toxicity. In addition, genotoxicity studies such as Ames bacterial reverse mutation assay and mouse lymphoma tests, as well as a dose-dependent 90-day sub-chronic toxicity study were conducted. Safety studies indicated that acute oral LD(50) of UC-II was greater than 5000 mg/kg in female Sprague-Dawley rats. No changes in body weight or adverse effects were observed following necropsy. Acute dermal LD(50) of UC-II was determined to be greater than 2000 mg/kg. Primary skin irritation tests conducted on New Zealand Albino rabbits classified UC-II as slightly irritating. Primary eye irritation tests conducted on rabbits indicated that UC-II was moderately irritating to the eye. UC-II did not induce mutagenicity in the bacterial reverse mutation test in five Salmonella typhimurium strains either with or without metabolic activation. Similarly, UC-II did not induce a mutagenic effect in the gene mutation test in mouse lymphoma cells either with or without metabolic activation. A dose-dependent 90-day sub-chronic toxicity study revealed no pathologically significant changes in selected organ weights individually or as percentages of body or brain weights. No significant changes were observed in hematology and clinical chemistry. Therefore, the results from the current study show a broad-spectrum safety profile of UC-II.

  5. The Health Behavior Schedule-II for Diabetes Predicts Self-Monitoring of Blood Glucose

    ERIC Educational Resources Information Center

    Frank, Maxwell T.; Cho, Sungkun; Heiby, Elaine M.; Lee, Chun-I; Lahtela, Adrienne L.

    2006-01-01

    The Health Behavior Schedule-II for Diabetes (HBS-IID) is a 27-item questionnaire that was evaluated as a predictor of self-monitoring of blood glucose (SMBG). The HBS-IID was completed by 96 adults with Type 2 diabetes. Recent glycosylated hemoglobin HbA1c and fasting blood glucose results were taken from participants' medical records. Only 31.3%…

  6. Course Evaluation. II: Interpretation of Student Performance on Evaluative Tests

    ERIC Educational Resources Information Center

    Aikenhead, Glen S.

    1974-01-01

    Reports the results of a comparative evaluation of Harvard Project Physics (HPP) and non-HPP student performance, and demonstrates the ability of a new test construction paradigm to generate valuable feedback for curriculum developers, teachers, and students. (JR)

  7. Client Outcome Evaluation in Mental Health Centers.

    ERIC Educational Resources Information Center

    Southern Regional Education Board, Atlanta, GA.

    Outcome evaluation assesses the results or benefits of mental health services received by clients or communities by comparing descriptive data on the mental health status of clients at different points in time. It aids clinicians and managers in planning programs and managing clinical services. A mental health center should establish goal-oriented…

  8. Evaluating Health Action in the Third World.

    ERIC Educational Resources Information Center

    Fontaine, Denis

    1992-01-01

    The theme of this serial issue is helping individuals involved in community health programs at the local level to devise and apply a protocol for the evaluation of a community health program. In the opening sections of the issue evaluation is defined, the difference between a direct quantifying measure and an indicator is clarified, obstacles to…

  9. Evaluating Health Action in the Third World.

    ERIC Educational Resources Information Center

    Fontaine, Denis

    1992-01-01

    The theme of this serial issue is helping individuals involved in community health programs at the local level to devise and apply a protocol for the evaluation of a community health program. In the opening sections of the issue evaluation is defined, the difference between a direct quantifying measure and an indicator is clarified, obstacles to…

  10. Measurement of costs for health economic evaluation.

    PubMed

    Riewpaiboon, Arthorn

    2014-05-01

    The provision of guidelines on cost measurement for health economic evaluations enable research to be more standardized and hence more comparable, which offers clear benefits for policy formulation and health management. The guidelines herein focus on three aspects-the cost of health intervention/health care programs, the cost of illness/health risks, and use of costs in health economic evaluation. For each aspect, the main concepts and methods are outlined, and recommendations for the Thai context are presented. There is particular focus on how to calculate various costs according to different evaluation methods and perspectives, how to evaluate source of cost data, how to make value adjustments and how to present cost measurement findings.

  11. The politics of evaluating Aboriginal Health Services.

    PubMed

    Moodie, R

    1989-01-01

    Evaluation of Aboriginal Health Services (AHSs) has become a topic of importance to service providers and governments in recent years. This paper examines some of the difficulties AHSs have in conducting evaluation and presents an example of an inappropriate evaluation methodology as proposed by the Commonwealth Department of Aboriginal Affairs (DAA) in 1986. The paper examines the contradictory nature of the DAA proposal and the mistrust it has engendered in many AHSs. It then highlights some of the political difficulties in developing meaningful national and community health objectives as a basis for sound evaluation of health services. The paper concludes by identifying some of the processes whereby more appropriate evaluation methodologies might be developed and suggests that negotiation and consultation with the Aboriginal communities and their health services are imperative to successful evaluation.

  12. Sense of coherence and physical health. A cross-sectional study using a new scale (SOC II).

    PubMed

    Flensborg-Madsen, Trine; Ventegodt, Søren; Merrick, Joav

    2006-10-09

    In this study, we constructed a new sense of coherence scale (SOC II), where we eliminated the notion of predictability (that life is meant to be predictable), which was present in the original SOC scale developed by Aaron Antonovsky (1923-1994) (SOC-29 and SOC-13). Our hypothesis was that SOC II would show a higher degree of association with physical health than the original SOC scale. In order to test this idea, we used a cross-sectional study including 4,648 Danes and used the three different health measures: self-evaluated physical health, physical symptoms, and self-evaluated psychological health. We found that SOC II was positively associated with all three health measures with the correlation coefficients 0.338, 0.282, and 0.578, respectively. Furthermore, we found dose response tendencies for all three health measures across groups of SOC, since health improved with a higher SOC. By means of regression analysis, we found that SOC was significantly associated with all three health measures after stratifying for demographic variables, life style variables, life form variables, and attitude variables, respectively. We conclude from this study that the SOC II scale we developed seems better associated with physical health than found with the original SOC scale. We also postulate that the concept of predictability was irrelevant, or even disturbing, and should not be included in the SOC scale.

  13. Mobile health technology evaluation: the mHealth evidence workshop.

    PubMed

    Kumar, Santosh; Nilsen, Wendy J; Abernethy, Amy; Atienza, Audie; Patrick, Kevin; Pavel, Misha; Riley, William T; Shar, Albert; Spring, Bonnie; Spruijt-Metz, Donna; Hedeker, Donald; Honavar, Vasant; Kravitz, Richard; Lefebvre, R Craig; Mohr, David C; Murphy, Susan A; Quinn, Charlene; Shusterman, Vladimir; Swendeman, Dallas

    2013-08-01

    Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, discuss future possibilities, and set a grand goal for the emerging field of mHealth research.

  14. Planning for national health information system evaluation.

    PubMed

    Hyppönen, Hannele; Doupi, Persephone; Hämäläinen, Päivi; Komulainen, Jorma; Nykänen, Pirkko; Suomi, Reima

    2009-01-01

    Most EU member states have a documented policy on eHealth. Documented follow-up and evaluation policies to assess reaching of the set aims, as well as evaluating outcomes of implemented systems at a national level are, however, rare. Methodologies for large scale information system assessment and evaluation are poorly established. In the workshop, the Finnish evaluation plans for the National Health Information System (NHIS) are used as a case in the workshop to reflect on core issues and challenges in large-scale evaluation for supporting system development, implementation and positive impacts. The results of the discussions are documented to be used in further refinement of the Finnish evaluation methodology and for enhancing networking of respective parties in different countries. The results will also benefit participants including policy makers, developers and researchers of national eHealth systems in pursuit of national evaluation activities.

  15. Challenges in evaluating rural health programs.

    PubMed

    Beaulieu, Joyce; Webb, John

    2002-01-01

    Complex community-based prevention programs are being held to scientific evidence of their effectiveness and rural public health departments that implement such programs often are not equipped to evaluate them. Rural public health departments are fettered by small budgets, small staffs, and less access to evaluation experts and similar resources. Community-based health promotion programs can include complex designs that may work differently in rural areas and evaluation of rural programs can be hampered by lack of control groups and the instability of results from small populations. The University of Kentucky has entered into a contract with the state Department for Public Health to implement an internal, participatory model of evaluation. In this model, the university evaluation expert trains local public health department staff in technical skills for program evaluation and acts as mentor and technical consultant to local public health departments on an ongoing basis. Through training and site visits, this model is one approach to addressing the challenges of evaluating rural health promotion programs.

  16. Multidisciplinary eHealth Survey Evaluation Methods

    ERIC Educational Resources Information Center

    Karras, Bryant T.; Tufano, James T.

    2006-01-01

    This paper describes the development process of an evaluation framework for describing and comparing web survey tools. We believe that this approach will help shape the design, development, deployment, and evaluation of population-based health interventions. A conceptual framework for describing and evaluating web survey systems will enable the…

  17. [Methods of health economic evaluation for health services research].

    PubMed

    Icks, A; Chernyak, N; Bestehorn, K; Brüggenjürgen, B; Bruns, J; Damm, O; Dintsios, C-M; Dreinhöfer, K; Gandjour, A; Gerber, A; Greiner, W; Hermanek, P; Hessel, F; Heymann, R; Huppertz, E; Jacke, C; Kächele, H; Kilian, R; Klingenberger, D; Kolominsky-Rabas, P; Krämer, H; Krauth, C; Lüngen, M; Neumann, T; Porzsolt, F; Prenzler, A; Pueschner, F; Riedel, R; Rüther, A; Salize, H J; Scharnetzky, E; Schwerd, W; Selbmann, H-K; Siebert, H; Stengel, D; Stock, S; Völler, H; Wasem, J; Schrappe, M

    2010-12-01

    On August 30, 2010, the German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e. V. (DNVF e. V.)] approved the Memorandum III "Methods for Health Services Research", supported by the member societies mentioned as authors and published in this Journal [Gesundheitswesen 2010; 72: 739-748]. The present paper focuses on methodological issues of economic evaluation of health care technologies. It complements the Memorandum III "Methods for Health Services Research", part 2. First, general methodological principles of the economic evaluations of health care technologies are outlined. In order to adequately reflect costs and outcomes of health care interventions in the routine health care, data from different sources are required (e. g., comparative efficacy or effectiveness studies, registers, administrative data, etc.). Therefore, various data sources, which might be used for economic evaluations, are presented, and their strengths and limitations are stated. Finally, the need for methodological advancement with regard to data collection and analysis and issues pertaining to communication and dissemination of results of health economic evaluations are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Assessment of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating mobile health (mHealth) technology.

    PubMed

    Brown, William; Yen, Po-Yin; Rojas, Marlene; Schnall, Rebecca

    2013-12-01

    Over two decades of research has been conducted using mobile devices for health related behaviors yet many of these studies lack rigor. There are few evaluation frameworks for assessing the usability of mHealth, which is critical as the use of this technology proliferates. As the development of interventions using mobile technology increase, future work in this domain necessitates the use of a rigorous usability evaluation framework. We used two exemplars to assess the appropriateness of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating the usability of mHealth technology. In the first exemplar, we conducted 6 focus group sessions to explore adolescents' use of mobile technology for meeting their health Information needs. In the second exemplar, we conducted 4 focus group sessions following an Ecological Momentary Assessment study in which 60 adolescents were given a smartphone with pre-installed health-related applications (apps). We coded the focus group data using the 9 concepts of the Health-ITUEM: Error prevention, Completeness, Memorability, Information needs, Flexibility/Customizability, Learnability, Performance speed, Competency, Other outcomes. To develop a finer granularity of analysis, the nine concepts were broken into positive, negative, and neutral codes. A total of 27 codes were created. Two raters (R1 and R2) initially coded all text and a third rater (R3) reconciled coding discordance between raters R1 and R2. A total of 133 codes were applied to Exemplar 1. In Exemplar 2 there were a total of 286 codes applied to 195 excerpts. Performance speed, Other outcomes, and Information needs were among the most frequently occurring codes. Our two exemplars demonstrated the appropriateness and usefulness of the Health-ITUEM in evaluating mobile health technology. Further assessment of this framework with other study populations should consider whether Memorability and Error prevention are necessary to include when evaluating mHealth

  19. Assessment of the Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Mobile Health (mHealth) Technology

    PubMed Central

    Brown, William; Yen, Po-Yin; Rojas, Marlene; Schnall, Rebecca

    2013-01-01

    Background Over two decades of research has been conducted using mobile devices for health related behaviors yet many of these studies lack rigor. There are few evaluation frameworks for assessing the usability of mHealth, which is critical as the use of this technology proliferates. As the development of interventions using mobile technology increase, future work in this domain necessitates the use of a rigorous usability evaluation framework. Methods We used two exemplars to assess the appropriateness of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating the usability of mHealth technology. In the first exemplar, we conducted 6 focus group sessions to explore adolescents’ use of mobile technology for meeting their health Information needs. In the second exemplar, we conducted 4 focus group sessions following an Ecological Momentary Assessment study in which 60 adolescents were given a smartphone with pre-installed health-related applications (apps). Data Analysis We coded the focus group data using the 9 concepts of the Health-ITUEM: Error prevention, Completeness, Memorability, Information needs, Flexibility/Customizability, Learnability, Performance speed, Competency, Other outcomes. To develop a finer granularity of analysis, the nine concepts were broken into positive, negative, and neutral codes. A total of 27 codes were created. Two raters (R1 & R2) initially coded all text and a third rater (R3) reconciled coding discordance between raters R1 and R2. Results A total of 133 codes were applied to Exemplar 1. In Exemplar 2 there were a total of 286 codes applied to 195 excerpts. Performance speed, Other outcomes, and Information needs were among the most frequently occurring codes. Conclusion Our two exemplars demonstrated the appropriateness and usefulness of the Health-ITUEM in evaluating mobile health technology. Further assessment of this framework with other study populations should consider whether Memorability and Error prevention

  20. Economic Evaluation Enhances Public Health Decision Making.

    PubMed

    Rabarison, Kristina M; Bish, Connie L; Massoudi, Mehran S; Giles, Wayne H

    2015-01-01

    Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking "how do investments in public health strategies influence or offset the need for downstream spending on medical care and/or social services?" is important when making decisions about resource allocation and scaling of interventions.

  1. Evaluation of community health assessment in Kansas.

    PubMed

    Curtis, Denice C

    2002-07-01

    This article evaluates the status of community health assessment in Kansas. It describes community characteristics associated with community health assessment completion, factors contributing to success, as well as barriers and limitations that prevented Kansas communities from initiating a community health assessment or completing the process. Survey findings show that certain community characteristics such as interagency cooperation, history of success at problem solving, and shared decision-making power are strongly associated with completion of a community health assessment. Results also indicate that factors such as lack of leadership, money, and time as well as poor functioning coalitions may hinder the completion of community health assessment.

  2. Validation of the World Health Organization Assessment Schedule II Chinese Traditional Version (WHODAS II CT) in persons with disabilities and chronic illnesses for Chinese population.

    PubMed

    Cheung, Mike K T; Hung, Anchor T F; Poon, Peter K K; Fong, Daniel Y T; Li, Leonard S W; Chow, Eddie S L; Qiu, Zhuo-Ying; Liou, Tsan-Hon

    2015-01-01

    The aim of this study is to test the psychometric properties and validity of the World Health Organization Assessment Schedule II Chinese Traditional Version (WHODAS II CT) in Traditional Chinese-speaking persons with disabilities and chronic illnesses. The WHODAS II CT has been administrated to a sample of 1020 persons with disabilities and chronic illnesses. The construct validity, internal consistency, concurrent validity and convergent validity were evaluated. WHODAS II CT showed a satisfactory model fit for the second-order confirmatory factor analysis model (χ(2)/df = 3.05, root means square error of approximation = 0.053, comparative fit index = 0.912, standardized root mean square residual = 0.076), high internal consistency (Cronbach's α = 0.98), high correlation with all domains of Dartmouth Primary Care Cooperative Research Network/World Organization of National Colleges, Academies, and Academic Associations of General Practices/Family Physicians (COOP/WONCA) charts (partial correlation coefficient ranged from 0.26 to 0.74) and significance between persons with and without co-morbidity (all regression coefficients >0). WHODAS II CT is a reliable and valid instrument to measure the disability in persons with disabilities and chronic illnesses among Traditional Chinese-speaking population. A further study is required to validate the short version of WHODAS II in order to enhance its applicability in usual and clinical practices. Implications for Rehabilitation This is the first study to evaluate the reliability and validity of WHODAS II in persons with disability and chronic illnesses among Traditional Chinese-speaking population. The WHODAS II CT is a valid instrument in Chinese adults with disabilities and chronic illnesses. The WHODAS II CT is recommended to be used in population-based survey to investigate the health needs of persons with disabilities and chronic illnesses as well as in the rehabilitation programs as an outcome

  3. Mental Health and High-Cost Health Care Utilization: New Evidence from Axis II Disorders

    PubMed Central

    Maclean, Johanna Catherine; Xu, Haiyong; French, Michael T; Ettner, Susan L

    2014-01-01

    Objective To analyze the associations between Axis II (A2) disorders and two measures of health care utilization with relatively high cost: emergency department (ED) episodes and hospital admissions. Data Source/Study Setting Wave I (2001/2002) and Wave II (2004/2005) of the National Longitudinal Survey on Alcohol and Related Conditions (NESARC). Study Design A national probability sample of adults. Gender-stratified regression analysis adjusted for a range of covariates associated with health care utilization. Data Collection The target population of the NESARC is the civilian noninstitutionalized population aged 18 years and older residing in the United States. The cumulative survey response rate is 70.2 percent with a response rate of 81 percent (N = 43,093) in Wave I and 86.7 percent (N = 34,653) in Wave II. Principal Findings Both men and women with A2 disorders are at elevated risk for ED episodes and hospital admissions. Associations are robust after adjusting for a rich set of confounding factors, including Axis I (clinical) psychiatric disorders. We find evidence of a dose–response relationship, while antisocial and borderline disorders exhibit the strongest associations with both measures of health care utilization. Conclusions This study provides the first published estimates of the associations between A2 disorders and high-cost health care utilization in a large, nationally representative survey. The findings underscore the potential implications of these disorders on health care expenditures. PMID:24117342

  4. Cost-benefit evaluation of a preventive intervention on the biological risk in health: the accidental puncture during the administration of insulin in the University Hospital "Federico II" of Naples.

    PubMed

    Montella, E; Schiavone, D; Apicella, L; Di Silverio, P; Gaudiosi, M; Ambrosone, E; Moscaritolo, E; Triassi, M

    2014-01-01

    The occupational exposure to biological risk is a frequent event that affects millions of workers in the health sector. Operators are exposed to accidental contact with blood and other potentially infectious biological materials with a frequency higher than that observed in the population (occupational exposure). The pathogens most frequently implicated are the human immunodeficiency virus (HIV), hepatitis C (HCV) and hepatitis B (HBV) viruses. The World Health Organization estimates that each year more than 3 million health workers hurt themselves with an object/edge definitely contaminated with at least one HIV (about 170,000 exposures), hepatitis B (approximately 2,000,000 exposures) and hepatitis C (approximately 900,000 exposures). In Italy approximately 100,000 percutaneous exposures/year are estimated to take place. The needlestick injuries in health care workers are, in large part, preventable by adopting measures such as the use of instrumental needlesticks Prevention Devices - NPDs. The adoption of the NPDs is extremely effective in reducing occupational exposure to biological risk (from 63 % to 100 % reduction). The aim of this study was to evaluate whether the adoption of NPDs for insulin therapy is costeffective in terms of prevention of accidents by Biohazard, compared to administration of insulin with traditional methods (syringe + vial). The estimation is carried out both in the light of current legislation (European Directive 2010/32 and 81/08 Italian Law) and epidemiological data and cost of accidents (according to frequency) and alternative interventions. The evaluation of cost-effectiveness included the construction of an economic model that would allow the weighting of the costs of accidents that can occur following the administration of insulin therapy with traditional methods. The economic model was developed taking into account the international literature on the phenomenon of "accidental puncture" and allowed the financial quantification of

  5. Women's Health. Report of the Public Health Service Task Force on Women's Health Issues. Volume II.

    ERIC Educational Resources Information Center

    Public Health Service (DHHS), Rockville, MD.

    This report identifies a broad spectrum of issues affecting women's health and is divided into four sections: (1) social factors affecting women's health; (2) women's physical health and well-being; (3) health concerns of older women; and (4) issues related to alcohol, drug use and abuse, and the mental health of women. The Public Health Service…

  6. Evaluating Health Information Systems Using Ontologies

    PubMed Central

    Anderberg, Peter; Larsson, Tobias C; Fricker, Samuel A; Berglund, Johan

    2016-01-01

    Background There are several frameworks that attempt to address the challenges of evaluation of health information systems by offering models, methods, and guidelines about what to evaluate, how to evaluate, and how to report the evaluation results. Model-based evaluation frameworks usually suggest universally applicable evaluation aspects but do not consider case-specific aspects. On the other hand, evaluation frameworks that are case specific, by eliciting user requirements, limit their output to the evaluation aspects suggested by the users in the early phases of system development. In addition, these case-specific approaches extract different sets of evaluation aspects from each case, making it challenging to collectively compare, unify, or aggregate the evaluation of a set of heterogeneous health information systems. Objectives The aim of this paper is to find a method capable of suggesting evaluation aspects for a set of one or more health information systems—whether similar or heterogeneous—by organizing, unifying, and aggregating the quality attributes extracted from those systems and from an external evaluation framework. Methods On the basis of the available literature in semantic networks and ontologies, a method (called Unified eValuation using Ontology; UVON) was developed that can organize, unify, and aggregate the quality attributes of several health information systems into a tree-style ontology structure. The method was extended to integrate its generated ontology with the evaluation aspects suggested by model-based evaluation frameworks. An approach was developed to extract evaluation aspects from the ontology that also considers evaluation case practicalities such as the maximum number of evaluation aspects to be measured or their required degree of specificity. The method was applied and tested in Future Internet Social and Technological Alignment Research (FI-STAR), a project of 7 cloud-based eHealth applications that were developed and

  7. Evaluating Health Information Systems Using Ontologies.

    PubMed

    Eivazzadeh, Shahryar; Anderberg, Peter; Larsson, Tobias C; Fricker, Samuel A; Berglund, Johan

    2016-06-16

    There are several frameworks that attempt to address the challenges of evaluation of health information systems by offering models, methods, and guidelines about what to evaluate, how to evaluate, and how to report the evaluation results. Model-based evaluation frameworks usually suggest universally applicable evaluation aspects but do not consider case-specific aspects. On the other hand, evaluation frameworks that are case specific, by eliciting user requirements, limit their output to the evaluation aspects suggested by the users in the early phases of system development. In addition, these case-specific approaches extract different sets of evaluation aspects from each case, making it challenging to collectively compare, unify, or aggregate the evaluation of a set of heterogeneous health information systems. The aim of this paper is to find a method capable of suggesting evaluation aspects for a set of one or more health information systems-whether similar or heterogeneous-by organizing, unifying, and aggregating the quality attributes extracted from those systems and from an external evaluation framework. On the basis of the available literature in semantic networks and ontologies, a method (called Unified eValuation using Ontology; UVON) was developed that can organize, unify, and aggregate the quality attributes of several health information systems into a tree-style ontology structure. The method was extended to integrate its generated ontology with the evaluation aspects suggested by model-based evaluation frameworks. An approach was developed to extract evaluation aspects from the ontology that also considers evaluation case practicalities such as the maximum number of evaluation aspects to be measured or their required degree of specificity. The method was applied and tested in Future Internet Social and Technological Alignment Research (FI-STAR), a project of 7 cloud-based eHealth applications that were developed and deployed across European Union

  8. Evaluation of population health short courses: implications for developing and evaluating population health professional development initiatives.

    PubMed

    Naccarella, Lucio; Greenstock, Louise; Butterworth, Iain

    2016-01-01

    Population health as an approach to planning is key to improving the health and well-being of whole populations and to reduce inequities within and between population groups. The Victorian Department of Health North and West Metropolitan Region, in collaboration with The University of Melbourne (School of Population Health), have delivered four annual population health short courses. The short courses were designed to equip participants with knowledge and skills to implement population health approaches upon their return to their workplaces. For three consecutive years, online surveys (n=41) and semi-structured interviews (n=35), underpinned by participatory and realist evaluation approaches, were conducted to obtain the perceptions and experiences of the population health short course participants. Evaluation findings indicate that participants' understanding of population health concepts increased; however, there were mixed outcomes in assisting participants' implementation of population health approaches upon their return to their workplaces. A core list of perceived requirements, enablers and barriers emerged at an individual, organisational and system level as influencing the capability of participants to implement population health approaches. Evaluation recommendations and actions taken to revise short course iterations are presented, providing evidence that the evaluation approaches were appropriate and increased the use of evaluation learnings. Implications of evaluation findings for professional development practice (i.e. shift from a 'Course' as a one-off event to a Population Health 'Program' of inter-dependent components) and evaluation (i.e. participatory realist evaluation approaches) are presented.

  9. Vijana Vijiweni II: a cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intimate partner violence prevention among social networks of young men in Dar es Salaam.

    PubMed

    Kajula, Lusajo; Balvanz, Peter; Kilonzo, Mrema Noel; Mwikoko, Gema; Yamanis, Thespina; Mulawa, Marta; Kajuna, Deus; Hill, Lauren; Conserve, Donaldson; Reyes, Heathe Luz McNaughton; Leatherman, Sheila; Singh, Basant; Maman, Suzanne

    2016-02-03

    Intimate partner violence (IPV) and sexually transmitted infections (STIs), including HIV, remain important public health problems with devastating health effects for men and women in sub-Saharan Africa. There have been calls to engage men in prevention efforts, however, we lack effective approaches to reach and engage them. Social network approaches have demonstrated effective and sustained outcomes on changing risk behaviors in the U.S. Our team has identified and engaged naturally occurring social networks comprised mostly of young men in Dar es Salaam in an intervention designed to jointly reduce STI incidence and the perpetration of IPV. These stable networks are locally referred to as "camps." In a pilot study we demonstrated the feasibility and acceptability of a combined microfinance and peer health leadership intervention within these camp-based peer networks. We are implementing a cluster-randomized trial to evaluate the efficacy of an intervention combining microfinance with health leadership training in 60 camps in Dar es Salaam, Tanzania. Half of the camps have been randomized to the intervention arm, and half to a control arm. The camps in the intervention arm will receive a combined microfinance and health leadership intervention for a period of two years. The camps in the control arm will receive a delayed intervention. We have enrolled 1,258 men across the 60 study camps. Behavioral surveys will be conducted at baseline, 12-months post intervention launch and 30-month post intervention launch and biological samples will be drawn to test for Neisseria gonorrhea (NG), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV) at baseline and 30-months. The primary endpoints for assessing intervention impact are IPV perpetration and STI incidence. This is the first cluster-randomized trial targeting social networks of men in sub-Saharan Africa that jointly addresses HIV and IPV perpetration and has both biological and behavioral endpoints. Effective

  10. [Evaluation of the effectiveness of health care].

    PubMed

    Strnad, L

    1990-01-01

    During the last two decades, the economic aspects of health care acquired an outstanding attentiveness in all developed countries. Simultaneously, the methods have been searched for a more intensive and perfect application of internal health sources, i.e. manpower, materials and money. New approaches in evaluating health care efficacy (conception of health provision as a branch of national economy) have been made. In accord with them, the efficiency of either individual or partial health actions such as health care programs, preventive measures, diagnostical and curative procedures etc.) is measured. All these questions are the up to date topic for Health care of Czechoslovakia which now is far to dispose of sources comparable with the majority of economically developed countries in Europe. At present, they are approximately similar in supplying 1 person health care needs with 500-1000 dol. a year and even more in several countries, whereas Czechoslovakia spends about 200 dol. on health needs of 1 inhabitant a year. This fact is closely connected with relatively low efficacy of our economy incapable to produce the sufficient sources for providing health care on one hand, and on the other it is due both to the budgetary politics as practiced now and the conception of national product division. The shortage in Health care sources is manifested mainly in retardation of material and technical base of health service altogether with low levelled renumeration of health workers consequential in psychologic, social and political problems. The consequences of this condition are reflected negatively in a level of health service provision. This is as far important as the czechoslovac population health status viewed from the so-called strategic health indices (averaged life expectancy, specific mortality, occurrence of cardiovascular diseases and malignancies etc.) is not favourable due to a number of factors, and its improvement will require considerable efforts from both the

  11. Qualitative Evaluation of Health Information Exchange Efforts

    PubMed Central

    Ash, Joan S.; Guappone, Kenneth P.

    2007-01-01

    Because most health information exchange (HIE) initiatives are as yet immature, formative evaluation is recommended so that what is learned through evaluation can be immediately applied to assist in HIE development efforts. Qualitative methods can be especially useful for formative evaluation because they can guide ongoing HIE growth while taking context into consideration. This paper describes important HIE-related research questions and outlines appropriate qualitative research techniques for addressing them. PMID:17904914

  12. Intraoperative evaluation of the HeartMate II flow estimator.

    PubMed

    Slaughter, Mark S; Bartoli, Carlo R; Sobieski, Mike A; Pantalos, George M; Giridharan, Guruprasad A; Dowling, Robert D; Prabhu, Sumanth D; Farrar, David J; Koenig, Steven C

    2009-01-01

    Direct measurement of blood flow output has been incorporated into ventricular assist devices (VADs), but long-term reliability of the additional device components has raised concerns regarding sensor drift and failure. As an alternative approach, the HeartMate II axial VAD (Thoratec Corp, Pleasanton, CA) estimates device flow output from power consumption and rotational speed of the device motor. This study evaluated the accuracy of HeartMate II flow estimation at the time of implantation. In 20 patients, intraoperative blood flow measurement of the HeartMate II flow estimator was compared with flow values obtained with an ultrasonic flow probe placed around the device outflow graft. Estimated and measured VAD flow data were simultaneously recorded and digitally stored while the device motor speed varied from 7,800 to 11,000 rpm and while achieving device flow outputs of 2 to 7 liters/min. Estimated and measured flows were compared using linear regression analyses and root mean square error. HeartMate II flow estimation (FE) demonstrated a linear correlation with ultrasonic flow probe (FP) measurements: FE = 0.74 FP + 0.99 (R(2) = 0.56, p = 0.0001). A root mean square error of 0.8 liters/min was observed between flow estimation and direct flow measurement and suggests a 15% to 20% difference at flows of 4 of 6 liters/min. These results suggest that HeartMate II flow estimation may be used to provide directional information for trend purposes rather than absolute values of device blood flow output. Patient management should include but not be limited to this information.

  13. Reference frameworks for the health management of measles, breast cancer and diabetes (type II).

    PubMed

    Brand, Helmut; Schröder, Peter; Davies, John K; Escamilla, Ixhel; Hall, Caroline; Hickey, Kieran; Jelastopulu, Eleni; Mechtler, Reli; Yared, Wendy Tse; Volf, Jaroslav; Weihrauch, Birgit

    2006-03-01

    This paper presents reference frameworks which order effective and feasible policies and interventions for the health management of measles, breast cancer and diabetes (type II). These reference frameworks can be used to rapidly appraise regional health policy documents and existing health management systems. Furthermore, the reference frameworks can serve health policy makers for the planning of health management measures.

  14. [Clinical practice guidelines in Peru: evaluation of its quality using the AGREE II instrument].

    PubMed

    Canelo-Aybar, Carlos; Balbin, Graciela; Perez-Gomez, Ángela; Florez, Iván D

    2016-01-01

    To evaluate the methodological quality of clinical practice guidelines (CPGs) put into practice by the Peruvian Ministry of Health (MINSA), 17 CPGs from the ministry, published between 2009 and 2014, were independently evaluated by three methodologic experts using the AGREE II instrument. The score of AGREE II domains was low and very low in all CPGs: scope and purpose (medium, 44%), clarity of presentation (medium, 47%), participation of decision-makers (medium, 8%), methodological rigor (medium, 5%), applicability (medium, 5%), and editorial independence (medium, 8%). In conclusion, the methodological quality of CPGs implemented by the MINSA is low. Consequently, its use could not be recommended. The implementation of the methodology for the development of CPGs described in the recentlypublished CPG methodological preparation manual in Peru is a pressing need.

  15. [Municipalities Stratification for Health Performance Evaluation].

    PubMed

    Calvo, Maria Cristina Marino; Lacerda, Josimari Telino de; Colussi, Claudia Flemming; Schneider, Ione Jayce Ceola; Rocha, Thiago Augusto Hernandes

    2016-01-01

    to propose and present a stratification of Brazilian municipalities into homogeneous groups for evaluation studies of health management performance. this was a methodological study, with selected indicators which classify municipalities according to conditions that influence the health management and population size; data for the year 2010 were collected from demographic and health databases; correlation tests and factor analysis were used. seven strata were identified - Large-sized; Medium-sized with favorable, regular or unfavorable influences; and Small-sized with favorable, regular or unfavorable influences -; there was a concentration of municipalities with favorable influences in strata with better purchasing power and funding, as well as a concentration of municipalities with unfavorable influences in the North and Northeast regions. the proposed classification grouped similar municipalities regarding influential factors in health management, which allowed the identification of comparable groups of municipalities, setting up a consistent alternative to performance evaluation studies.

  16. Evaluating the Fraser Health Balanced Scorecard--a formative evaluation.

    PubMed

    Barnardo, Catherine; Jivanni, Amin

    2009-01-01

    Fraser Health (FH), a large, Canadian, integrated health care network, adopted the Balanced Scorecard (BSC) approach to monitor organizational performance in 2006. This paper reports on the results of a formative evaluation, conducted in April, 2008, to assess the usefulness of the BSC as a performance-reporting system and a performance management tool. Results indicated that the BSC has proven to be useful for reporting performance but is not currently used for performance management in a substantial way.

  17. Quality of life in systemic sclerosis: psychometric properties of the World Health Organization Disability Assessment Schedule II.

    PubMed

    Hudson, Marie; Steele, Russell; Taillefer, Suzanne; Baron, Murray

    2008-02-15

    To determine the validity of the World Health Organization Disability Assessment Schedule II (WHODAS II) in systemic sclerosis (SSc). Patients enrolled in the Canadian Scleroderma Research Group registry participated in a standardized evaluation and completed the WHODAS II. Criterion validity was assessed by comparing the WHODAS II with the Medical Outcomes Study Short Form 36 (SF-36), construct validity was assessed by examining how it relates to common measures of outcome in SSc, and discriminative validity was assessed by examining how it distinguishes patients with more severe disease from those with less severe disease. A total of 402 patients with SSc were included (mean +/- SD age 55 +/- 13 years, 87% women, mean +/- SD disease duration 11 +/- 9 years). The mean +/- SD WHODAS II score was 24.6 +/- 17.4, and the greatest impairments were in life activities and mobility. There were moderate to good correlations between the WHODAS II and the SF-36 Physical Component Summary score (r = -0.44), the SF-36 Mental Component Summary score (r = -0.41), and measures of function (r = 0.54), depression (r = 0.44), pain (r = 0.40), and fatigue (r = -0.49, P < 0.0001 for all). The WHODAS II was able to consistently distinguish patients with milder disease from those with more severe disease. The WHODAS II had good psychometric properties in patients with SSc and should be considered a valid measure of health-related quality of life in SSc.

  18. Usability Evaluation of a Personal Health Record

    PubMed Central

    Segall, Noa; Saville, Jeffrey G.; L’Engle, Pete; Carlson, Boyd; Wright, Melanie C.; Schulman, Kevin; Tcheng, James E.

    2011-01-01

    The electronic personal health record (PHR) has been championed as a mediator of patient-centered care, yet its usability and utility to patients, key predictors of success, have received little attention. Human-centered design (HCD) offers validated methods for studying systems effects on users and their cognitive tasks. In HCD, user-centered activities allow potential users to shape the design of the end product and enhance its usability. We sought to evaluate the usability and functionality of HealthView, the PHR of the Duke University Health System, using HCD methods. Study participants were asked to think aloud as they carried out tasks in HealthView. They then completed surveys and interviews eliciting their reactions to the web portal. Findings were analyzed to generate redesign recommendations, which will be incorporated in a future release of HealthView. PMID:22195184

  19. Unpaid work in health economic evaluations.

    PubMed

    Krol, Marieke; Brouwer, Werner

    2015-11-01

    Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Towards a unified theory of health-disease: II. Holopathogenesis.

    PubMed

    Almeida Filho, Naomar

    2014-04-01

    This article presents a systematic framework for modeling several classes of illness-sickness-disease named as Holopathogenesis. Holopathogenesis is defined as processes of over-determination of diseases and related conditions taken as a whole, comprising selected facets of the complex object Health. First, a conceptual background of Holopathogenesis is presented as a series of significant interfaces (biomolecular-immunological, physiopathological-clinical, epidemiological-ecosocial). Second, propositions derived from Holopathogenesis are introduced in order to allow drawing the disease-illness-sickness complex as a hierarchical network of networks. Third, a formalization of intra- and inter-level correspondences, over-determination processes, effects and links of Holopathogenesis models is proposed. Finally, the Holopathogenesis frame is evaluated as a comprehensive theoretical pathology taken as a preliminary step towards a unified theory of health-disease.

  1. Towards a unified theory of health-disease: II. Holopathogenesis

    PubMed Central

    Almeida-Filho, Naomar

    2014-01-01

    This article presents a systematic framework for modeling several classes of illness-sickness-disease named as Holopathogenesis. Holopathogenesis is defined as processes of over-determination of diseases and related conditions taken as a whole, comprising selected facets of the complex object Health. First, a conceptual background of Holopathogenesis is presented as a series of significant interfaces (biomolecular-immunological, physiopathological-clinical, epidemiological-ecosocial). Second, propositions derived from Holopathogenesis are introduced in order to allow drawing the disease-illness-sickness complex as a hierarchical network of networks. Third, a formalization of intra- and inter-level correspondences, over-determination processes, effects and links of Holopathogenesis models is proposed. Finally, the Holopathogenesis frame is evaluated as a comprehensive theoretical pathology taken as a preliminary step towards a unified theory of health-disease. PMID:24897040

  2. Aroma evaluation of transgenic, thaumatin II-producing cucumber fruits.

    PubMed

    Zawirska-Wojtasiak, R; Gośliński, M; Szwacka, M; Gajc-Wolska, J; Mildner-Szkudlarz, S

    2009-04-01

    Fruits of transgenic cucumber lines expressing preprothaumatin II gene were evaluated concerning their aroma. Four homozygous lines, that is, 210 06, 212 01, 224 09, and 225 03 with different levels of transgene expression were selected. Recipient line cv. Borszczagowski, which was formed by inbred line of Cucumis sativus L., was used as a control. The experiment was carried out in a greenhouse and an outdoor experimental plot. The aroma of cucumber fruits was evaluated by GC/MS, as well as GC/MS/TOF in the distillates and by SPME. Irrespective of the isolation/separation technique used, the differences between aroma compounds in transgenic cucumbers and the control were quantitative, and not qualitative. Modified samples showed higher concentrations of volatiles, particularly of the main cucumber fruits odorant (E, Z)-2,6 nonadienal. Transgenic expression of the thaumatin II gene resulted not only in a sweeter taste of fruits in comparison with the control, but also higher aroma acceptability. This was shown by sensory profile analysis. Also electronic nose measurements differentiated between transgenic lines and the control.

  3. A Blueprint to Evaluate One Health.

    PubMed

    Rüegg, Simon R; McMahon, Barry J; Häsler, Barbara; Esposito, Roberto; Nielsen, Liza Rosenbaum; Ifejika Speranza, Chinwe; Ehlinger, Timothy; Peyre, Marisa; Aragrande, Maurizio; Zinsstag, Jakob; Davies, Philip; Mihalca, Andrei Daniel; Buttigieg, Sandra C; Rushton, Jonathan; Carmo, Luís P; De Meneghi, Daniele; Canali, Massimo; Filippitzi, Maria E; Goutard, Flavie Luce; Ilieski, Vlatko; Milićević, Dragan; O'Shea, Helen; Radeski, Miroslav; Kock, Richard; Staines, Anthony; Lindberg, Ann

    2017-01-01

    One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation of resources, the development of transdisciplinary approaches requires effort and perseverance. Therefore, there is a need to provide evidence on the added value of OH for governments, researchers, funding bodies, and stakeholders. This paper outlines a conceptual framework of what OH approaches can encompass and the added values they can provide. The framework was developed during a workshop conducted by the "Network for Evaluation of One Health," an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring and monitoring the integration of disciplines, sectors, and stakeholders in health initiatives. The framework identifies the social, economic, and environmental drivers leading to integrated approaches to health and illustrates how these evoke characteristic OH operations, i.e., thinking, planning, and working, and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone, and their alignment with aspects of sustainable development based on society, environment, and economy.

  4. A Blueprint to Evaluate One Health

    PubMed Central

    Rüegg, Simon R.; McMahon, Barry J.; Häsler, Barbara; Esposito, Roberto; Nielsen, Liza Rosenbaum; Ifejika Speranza, Chinwe; Ehlinger, Timothy; Peyre, Marisa; Aragrande, Maurizio; Zinsstag, Jakob; Davies, Philip; Mihalca, Andrei Daniel; Buttigieg, Sandra C.; Rushton, Jonathan; Carmo, Luís P.; De Meneghi, Daniele; Canali, Massimo; Filippitzi, Maria E.; Goutard, Flavie Luce; Ilieski, Vlatko; Milićević, Dragan; O’Shea, Helen; Radeski, Miroslav; Kock, Richard; Staines, Anthony; Lindberg, Ann

    2017-01-01

    One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation of resources, the development of transdisciplinary approaches requires effort and perseverance. Therefore, there is a need to provide evidence on the added value of OH for governments, researchers, funding bodies, and stakeholders. This paper outlines a conceptual framework of what OH approaches can encompass and the added values they can provide. The framework was developed during a workshop conducted by the “Network for Evaluation of One Health,” an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring and monitoring the integration of disciplines, sectors, and stakeholders in health initiatives. The framework identifies the social, economic, and environmental drivers leading to integrated approaches to health and illustrates how these evoke characteristic OH operations, i.e., thinking, planning, and working, and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone, and their alignment with aspects of sustainable development based on society, environment, and economy. PMID:28261580

  5. [Evaluation of an online health promotion Diploma].

    PubMed

    Salinas, Judith; Muñoz, Carolina; Albagli, Andrea; Vio, Fernando

    2014-02-01

    Health promotion in Chile is essential, considering its current epidemiologic status where chronic diseases are predominant. To report the evaluation of an on-line Diploma in health promotion for Primary Health Care professionals. Two hundred sixty four professionals from all regions of the country (40% rural and 60% urban) took the Diploma. It lasted 8 months with 248 academic hours distributed in 5 modules with a total of 15 units. The program was evaluated with four surveys answered by the students (general description of participants, mid-term, final and follow-up). Students were highly satisfied with the program and especially with its interactive methodology which included tutorials, individual and group assignments, online discussions and a final project. The drawbacks were time restrictions and limited internet access. Ninety percent of students completed the course with an overall mean grade of 5.57 (out of a 1-7 scale). The follow-up survey showed that students implemented the new health promotion knowledge acquired, and put in practice their final assignment in their local counties. Also, most students improved their working conditions. The on-line interactive and participative methodology applied in this Diploma had positive results and the evaluation model can be applied in other health promotion on-line education programs.

  6. F-35 Lightning II Program Quality Assurance and Corrective Action Evaluation

    DTIC Science & Technology

    2015-03-11

    No. DODIG-2015-092 M A R C H 1 1 , 2 0 1 5 F ‑ 35 Lightning II Program Quality Assurance and Corrective Action Evaluation Report Documentation...3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE F - 35 Lightning II Program Quality Assurance and Corrective Action Evaluation... F ‑ 35 Lightning II Program Quality Assurance and Corrective Action Evaluation Objective We inspected the F - 35 Lightning II Program ( F - 35 Program) at

  7. Abortion and Mental Health: Evaluating the Evidence

    ERIC Educational Resources Information Center

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-01-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…

  8. Evaluation of a Child Health Associate Program

    ERIC Educational Resources Information Center

    Dungy, Claiborne I.; Sander, Daryl L.

    1977-01-01

    The staff of the University of Colorado Child Health Associate Program critically reviewed the effectiveness of the program's structure and content during an intensive two-day seminar. Focus was on basic and clinical sciences, psychosocial skills, and proficiency testing, and the evaluations were used to improve the program. (Editor/LBH)

  9. Evaluating Multidisciplinary Education in Health Care.

    ERIC Educational Resources Information Center

    Pirrie, Anne; Wilson, Valerie; Elsegood, John; Hall, John; Hamilton, Sheila; Harden, Ronald; Lee, Diana; Stead, Joan

    A 2-year study evaluated students' and course organizers' perceptions of the effectiveness of multidisciplinary education (ME) in health care and factors that facilitate or inhibit its development. The study had three phases: a survey of ME provision in the United Kingdom; 42 qualitative interviews and focus groups in 14 sites; and data feedback.…

  10. Evaluating the Health of Your House.

    ERIC Educational Resources Information Center

    Berthold-Bond, Annie; Dadd, Debra Lynn

    1993-01-01

    Presents a framework from which individuals can evaluate the health environment in their homes. Questions are arranged to examine the general location of the house, the house's immediate surroundings and building shell, and the finishings. Provides a resource directory for air filters, building consultants, and building supplies. (MDH)

  11. Evaluating Potential Health Risks in Relocatable Classrooms.

    ERIC Educational Resources Information Center

    Katchen, Mark; LaPierre, Adrienne; Charlin, Cary; Brucker, Barry; Ferguson, Paul

    2001-01-01

    Only limited data exist describing potential exposures to chemical and biological agents when using portable classrooms or outlining how to assess and reduce associated health risks. Evaluating indoor air quality involves examining ventilating rates, volatile organic compounds, and microbiologicals. Open communication among key stakeholders is…

  12. Evaluating Multidisciplinary Education in Health Care.

    ERIC Educational Resources Information Center

    Pirrie, Anne; Wilson, Valerie; Elsegood, John; Hall, John; Hamilton, Sheila; Harden, Ronald; Lee, Diana; Stead, Joan

    A 2-year study evaluated students' and course organizers' perceptions of the effectiveness of multidisciplinary education (ME) in health care and factors that facilitate or inhibit its development. The study had three phases: a survey of ME provision in the United Kingdom; 42 qualitative interviews and focus groups in 14 sites; and data feedback.…

  13. Evaluating the Health of Your House.

    ERIC Educational Resources Information Center

    Berthold-Bond, Annie; Dadd, Debra Lynn

    1993-01-01

    Presents a framework from which individuals can evaluate the health environment in their homes. Questions are arranged to examine the general location of the house, the house's immediate surroundings and building shell, and the finishings. Provides a resource directory for air filters, building consultants, and building supplies. (MDH)

  14. Abortion and Mental Health: Evaluating the Evidence

    ERIC Educational Resources Information Center

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-01-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…

  15. Evaluating Potential Health Risks in Relocatable Classrooms.

    ERIC Educational Resources Information Center

    Katchen, Mark; LaPierre, Adrienne; Charlin, Cary; Brucker, Barry; Ferguson, Paul

    2001-01-01

    Only limited data exist describing potential exposures to chemical and biological agents when using portable classrooms or outlining how to assess and reduce associated health risks. Evaluating indoor air quality involves examining ventilating rates, volatile organic compounds, and microbiologicals. Open communication among key stakeholders is…

  16. Health perceptions among urban American Indians with type II diabetes.

    PubMed

    Patel, Sachin; Davila, Javier; Patel, Sonam; Norman, Dennis

    2014-01-01

    Since the 1940s, American Indians (AIs) have increasingly urbanized, moving off of reservations in large part due to federal policies of tribal termination and relocation. Though previous AI research has largely focused on reservation-associated challenges, many of these same challenges persist among urban AI populations. One mutual concern is the growing prevalence and incidence of type II diabetes mellitus (T2DM). While behavioral, genetic, and socioeconomic determinants of T2DM have been explored, much less is known about the influence of cultural and psychosocial factors. Recent studies suggest that the way AIs perceive diabetes may affect their health trajectory and explain their poor prognosis. Through the use of the Illness Perception Questionnaire, we explored this hypothesis in a pilot study of urban AI with T2DM living in Los Angeles County. We found that the majority of participants have a neutral perception about their diabetes: They view their condition to be long lasting yet treatable and indicate reasonable understanding of its symptoms and progression. We also identified "personal control," the level of perceived control one has over his or her disease, as a strong correlate of overall illness perception and, thus, a potentially useful psychological metric.

  17. The China Mental Health Survey: II. Design and field procedures.

    PubMed

    Liu, Zhaorui; Huang, Yueqin; Lv, Ping; Zhang, Tingting; Wang, Hong; Li, Qiang; Yan, Jie; Yu, Yaqin; Kou, Changgui; Xu, Xiufeng; Lu, Jin; Wang, Zhizhong; Qiu, Hongyan; Xu, Yifeng; He, Yanling; Li, Tao; Guo, Wanjun; Tian, Hongjun; Xu, Guangming; Xu, Xiangdong; Ma, Yanjuan; Wang, Linhong; Wang, Limin; Yan, Yongping; Wang, Bo; Xiao, Shuiyuan; Zhou, Liang; Li, Lingjiang; Tan, Liwen; Chen, Hongguang; Ma, Chao

    2016-11-01

    China Mental Health Survey (CMHS), which was carried out from July 2013 to March 2015, was the first national representative community survey of mental disorders and mental health services in China using computer-assisted personal interview (CAPI). Face-to-face interviews were finished in the homes of respondents who were selected from a nationally representative multi-stage disproportionate stratified sampling procedure. Sample selection was integrated with the National Chronic Disease and Risk Factor Surveillance Survey administered by the National Centre for Chronic and Non-communicable Disease Control and Prevention in 2013, which made it possible to obtain both physical and mental health information of Chinese community population. One-stage design of data collection was used in the CMHS to obtain the information of mental disorders, including mood disorders, anxiety disorders, and substance use disorders, while two-stage design was applied for schizophrenia and other psychotic disorders, and dementia. A total of 28,140 respondents finished the survey with 72.9% of the overall response rate. This paper describes the survey mode, fieldwork organization, procedures, and the sample design and weighting of the CMHS. Detailed information is presented on the establishment of a new payment scheme for interviewers, results of the quality control in both stages, and evaluations to the weighting.

  18. [Health economic evaluation of disease management programs].

    PubMed

    Greiner, W

    2006-01-01

    Disease management has become an important element in the improvement of care for people with chronic illnesses and has become embedded in the discussion on health policy in recent years. The approach has been introduced very differently to the health systems worldwide. Since 1 January 2003 accredited disease management programs (DMPs) have been a part of the risk structure compensation scheme of the German statutory health insurance. This is seen as the first step to a morbidity orientation of the risk structure compensation. DMPs have to be evaluated according the German Social Law, especially whether the objectives of the programs and the criteria for inclusion of the patients have been met and the quality of care for the patients is insured. The criteria for evaluation are threefold: medical issues, economic issues and subjective quality of life of the patients. Due to the immense amounts of data which can be expected the evaluation of the German DMPs is a huge logistical challenge. Until now not very much is known about the data quality. The evaluation is focused on the perspective of the sickness funds as e.g. information about indirect cost is not collected. In the article the methods for evaluation are described and critically discussed.

  19. [Evaluation of Mexican 'Sicalidad' health quality program].

    PubMed

    Rivera-Buendía, Frida; Bello-Chavolla, Omar Y; Zubieta-Zavala, Adriana; Hernández-Ramírez, Luz; Zepeda-Tena, Carolina; Durán-Arenas, Luis

    2015-01-01

    To analize the implementation of the Sistema Integral de Calidad en Salud (Sicalidad) program of the Ministry of Health in the 2011. The study follows a cross sectional design, hybrid, with a qualitative and quantitative components. A cluster probabilístic sample was used with two stages. A total of 3 034 interviews were carried out in 13 states to evaluate the implementation of the eight components of the Sicalidad program. General indexes of performance (GIP) were formulated for structure process and satisfaction of users, physicians and nurses with the program. The GIP with the lower score was accreditation of health facilities with a range of scores between 25.4 and 28% in the medical units evaluated; The highest range of scores was in the component of nosocomial infection prevention between 78.3 and 92%. In brief the Sicalidad components evaluated suggest problems with both structure and critical process elements in the implementation of the quality initiatives.

  20. Cyber security evaluation of II&C technologies

    SciTech Connect

    Thomas, Ken

    2014-11-01

    The Light Water Reactor Sustainability (LWRS) Program is a research and development program sponsored by the Department of Energy, which is conducted in close collaboration with industry to provide the technical foundations for licensing and managing the long-term, safe and economical operation of current nuclear power plants The LWRS Program serves to help the US nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. Within the LWRS Program, the Advanced Instrumentation, Information, and Control (II&C) Systems Technologies Pathway conducts targeted research and development (R&D) to address aging and reliability concerns with the legacy instrumentation and control and related information systems of the U.S. operating light water reactor (LWR) fleet. The II&C Pathway is conducted by Idaho National Laboratory (INL). Cyber security is a common concern among nuclear utilities and other nuclear industry stakeholders regarding the digital technologies that are being developed under this program. This concern extends to the point of calling into question whether these types of technologies could ever be deployed in nuclear plants given the possibility that the information in them can be compromised and the technologies themselves can potentially be exploited to serve as attack vectors for adversaries. To this end, a cyber security evaluation has been conducted of these technologies to determine whether they constitute a threat beyond what the nuclear plants already manage within their regulatory-required cyber security programs. Specifically, the evaluation is based on NEI 08-09, which is the industry’s template for cyber security programs and evaluations, accepted by the Nuclear Regulatory Commission (NRC) as responsive to the requirements of the nuclear power plant cyber security regulation found in 10 CFR 73.54. The evaluation was conducted by a

  1. Cardiovascular health knowledge of the Polish population. Comparison of two national multi-centre health surveys: WOBASZ and WOBASZ II.

    PubMed

    Piwońska, Aleksandra; Piotrowski, Walerian; Piwoński, Jerzy; Kozela, Magdalena; Nadrowski, Paweł; Bielecki, Wojciech; Kozakiewicz, Krystyna; Pająk, Andrzej; Tykarski, Andrzej; Zdrojewski, Tomasz; Drygas, Wojciech

    2017-01-01

    To compare the cardiovascular health knowledge (CHK) of the adult Polish population in the years 2003-2005 and 2013-2014, and to evaluate the CHK determinants in the Polish adult population. Data came from the two random samples of the Polish population, screened in 2003-2005 in the WOBASZ health survey (6392 men and 7153 women, aged 20-74 years) and in 2013-2014 in the WOBASZ II health survey (2751 men and 3418 women, aged 20+ years). For the present analysis, the population of WOBASZ II was limited to persons aged 20-74 years. A CHK score (CHKs) was constructed based on questionnaire answers of responders, and the results of physical examination and ranged from -1 (lowest knowledge) to +6 (highest knowledge). Women had greater CHK than men. In both studies, about 30% of women and 40% of men did not know their blood pressure (BP). About 20% of men and women that declared their BP awareness was not able to classify it correctly to the normal or high category. Most persons that declared body weight awareness could give their body weight to within 2 kg and could correctly classify it as normal or overweight/obesity. The mean CHKs raised in men from 1.74 in WOBASZ to 1.93 in WOBASZ II (in women, respectively, from 2.10 to 2.23). The chance of having CHK greater than mean value of CHKs increased in men by 31% and in women by 27% in WOBASZ II compared to WOBASZ (ORCHK = 1.31, p < 0.0001 in men; ORCHK = 1.27, p < 0.0001 in women). Younger, better educated persons and men with coronary artery disease history and persons with familial history of death from myocardial infarction or stroke had greater health knowledge. Since 2003 Polish adults significantly advanced their knowledge and awareness of cardiovascular risk factors. Gender, age, education level, coronary artery disease history, and family history of cardiovascular disease death are significant determinants of CHK. From 20% to 30% of studied persons who declared their awareness, were shown to be unaware of their

  2. Evaluating interventions in health: a reconciliatory approach.

    PubMed

    Wolff, Jonathan; Edwards, Sarah; Richmond, Sarah; Orr, Shepley; Rees, Geraint

    2012-11-01

    Health-related Quality of Life measures have recently been attacked from two directions, both of which criticize the preference-based method of evaluating health states they typically incorporate. One attack, based on work by Daniel Kahneman and others, argues that 'experience' is a better basis for evaluation. The other, inspired by Amartya Sen, argues that 'capability' should be the guiding concept. In addition, opinion differs as to whether health evaluation measures are best derived from consultations with the general public, with patients, or with health professionals. And there is disagreement about whether these opinions should be solicited individually and aggregated, or derived instead from a process of collective deliberation. These distinctions yield a wide variety of possible approaches, with potentially differing policy implications. We consider some areas of disagreement between some of these approaches. We show that many of the perspectives seem to capture something important, such that it may be a mistake to reject any of them. Instead we suggest that some of the existing 'instruments' designed to measure HR QoLs may in fact successfully already combine these attributes, and with further refinement such instruments may be able to provide a reasonable reconciliation between the perspectives. © 2011 Blackwell Publishing Ltd.

  3. Health metrics and evaluation: strengthening the science.

    PubMed

    Murray, Christopher J L; Frenk, Julio

    2008-04-05

    With the growing importance of health in the global agenda comes the responsibility to develop a scientific foundation of metrics and evaluation. The scope of this emerging field can be viewed in terms of key topics, including health outcomes, other social outcomes related to health systems, health services, resource inputs, evaluations of programmes and systems, and analyses to support policy choice. It can also be defined in terms of key activities that are needed to strengthen the scientific basis of the field: development of new methods, instruments, software, and hardware; setting global norms and standards for data collection; increasing the availability of high-quality primary data; systematic analysis and synthesis of existing datasets; strengthening national capacity to obtain, analyse, and use data; and reporting and disseminating results. We explore in depth topics with major scientific challenges and institutional and cultural barriers that are slowing the development of the field. Cutting across the various topical areas and disciplinary approaches to these problems are some common scientific issues, including limited comparability of measurement, uncorrected known biases in data, no standard approach to missing data, unrealistic uncertainty estimates, and the use of disease models that have not been properly validated. Only through concerted action will it be possible to assure the production, reproduction, and use of knowledge that is crucial to the advancement of global health.

  4. Multi-centre National Population Health Examination Survey (WOBASZ II study): assumptions, methods, and implementation.

    PubMed

    Drygas, Wojciech; Niklas, Arkadiusz A; Piwońska, Aleksandra; Piotrowski, Walerian; Flotyńska, Anna; Kwaśniewska, Magdalena; Nadrowski, Paweł; Puch-Walczak, Aleksandra; Szafraniec, Krystyna; Bielecki, Wojciech; Kozakiewicz, Krystyna; Pająk, Andrzej; Tykarski, Andrzej; Zdrojewski, Tomasz

    Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in developed countries. Despite the progress in diagnostics and treatment, it is expected that CVD will still be the main cause of death worldwide until at least 2030. From 1991 CVD mortality in Poland systematically decreased, but it is still higher than the average in Western Europe. In 2013 CVDs were the cause of 46% of all deaths in Poland (40.9% in men and 51.1% in women) and 26.9% of deaths among persons under 65 years of age. The epidemiologic assessment of prevalence, control and treatment of CVD risk factors, and monitoring of healthy behaviour and morbidity due to diseases like coronary artery disease, hypertension and diabetes is very important for health policy planning. The WOBASZ II is the newest Polish population based survey, performed in 2013-2014 to evaluate prevalence, control, treatment, and morbidity. The study was the continuation of WOBASZ (2003-2005). To describe the goals and methods of the WOBASZ II study and to present the results of the recruitment. The WOBASZ II study was planned as a cross-sectional survey of a random sample of Polish residents aged over 20 years. The selection, using the National Identity Card Registry of the Ministry of Internal Affairs, was made as a three-stage sampling, stratified according to administrative units (voivodeships), type of urbanisation (commune), and gender. The study protocol consisted of a questionnaire used in face-to-face interviews, physical examination, and blood samples. WOBASZ II was coordinated by the Department of Epidemiology, Cardiovascular Diseases Prevention and Health Promotion of the Institute of Cardiology in Warsaw in cooperation with medical universities in Gdansk, Katowice, Krakow, Lodz, and Poznan. Out of 15,120 persons, 1557 persons were not eligible. Out of eligible persons, 6170 (2760 men and 3410 women) were examined (the response rate 45.5%). The highest response rates were observed in Warminsko

  5. Yakima River Basin Phase II Fish Screen Evaluations, 2002

    SciTech Connect

    Carter, Jessica A.; McMichael, Geoffrey A.; Chamness, Mickie A.

    2003-03-01

    In 2002, the Pacific Northwest National Laboratory evaluated 23 Phase II fish screen sites in the Yakima River Basin as part of a multi-year project for the Bonneville Power Administration on the effectiveness of fish screening devices. Pacific Northwest National Laboratory collected data to determine whether velocities in front of the screens and in the bypasses met National Marine Fisheries Service criteria to promote safe and timely fish passage and whether bypass outfall conditions allowed fish to safely return to the river. In addition, Pacific Northwest National Laboratory conducted underwater video surveys to evaluate the environmental and operational conditions of the screen sites with respect to fish passage. Based on evaluations in 2002, PNNL concluded that: (1) In general, water velocity conditions at the screen sites met fish passage criteria set by the National Marine Fisheries Service. (2) Conditions at most facilities would be expected to provide for safe juvenile fish passage. (3) Conditions at some facilities indicate that operation and/or maintenance should be modified to increase safe juvenile fish passage. (4) Automated cleaning brushes generally functioned properly; chains and other moving parts were typically well greased and operative. (5) Removal of sediment buildup and accumulated leafy and woody debris should be improved at some sites.

  6. Yakima River Basin Phase II Fish Screen Evaluations, 2003

    SciTech Connect

    Vucelick, Jessica A.; McMichael, Geoffrey A.; Chamness, Mickie A.

    2004-05-01

    In 2003, the Pacific Northwest National Laboratory (PNNL) evaluated 23 Phase II fish screen sites in the Yakima River Basin as part of a multi-year project for the Bonneville Power Administration on the effectiveness of fish screening devices. PNNL collected data to determine whether velocities in front of the screens and in the bypasses met the Nation Oceanic and Atmospheric Administration Fisheries (NOAA Fisheries, formerly the National Marine Fisheries Service (NMFS)) criteria to promote safe and timely fish passage. In addition, PNNL conducted underwater video surveys to evaluate the environmental and operational conditions of the screen sites with respect to fish passage. Based on evaluations in 2003, PNNL concluded that: (1) In general, water velocity conditions at the screen sites met fish passage criteria set by the National Oceanic and Atmospheric Administration Fisheries. (2) Conditions at most facilities would be expected to provide for safe juvenile fish passage. (3) Conditions at some facilities indicate that operation and/or maintenance should be modified to improve juvenile fish passage conditions. (4) Automated cleaning brushes generally functioned properly; chains and other moving parts were typically well greased and operative. (5) Removal of sediment buildup and accumulated leafy and woody debris could be improved at some sites.

  7. [Collaboration among health professionals (II). Usefulness of a model].

    PubMed

    D'Amour, Danielle; San Martín Rodríguez, Leticia

    2006-09-01

    This second article provides a model which helps one to better understand the process of collaboration by interprofessional teams and makes it possible to evaluate the quality of the aforementioned collaboration. To this end, the authors first present a structural model of inter-professional collaboration followed by a typology of collaboration which is derived from the functionality of said model. This model is composed by four interrelated dimensions; the functionality of these has given rise to a typology of collaboration at three intensities: in action, in construction and collaboration during inertia. The model and the typology constitute a useful tool for managers and for health professionals since they help to better understand, manage and develop collaboration among the distinct professionals inside of the same organization as among those who belong to distinct organizations.

  8. Alternate Reductant Cold Cap Evaluation Furnace Phase II Testing

    SciTech Connect

    Johnson, F. C.; Stone, M. E.; Miller, D. H.

    2014-09-03

    Savannah River Remediation (SRR) conducted a Systems Engineering Evaluation (SEE) to determine the optimum alternate reductant flowsheet for the Defense Waste Processing Facility (DWPF). Specifically, two proposed flowsheets (nitric–formic–glycolic and nitric–formic–sugar) were evaluated based upon results from preliminary testing. Comparison of the two flowsheets among evaluation criteria indicated a preference towards the nitric–formic–glycolic flowsheet. Further research and development of this flowsheet eliminated the formic acid, and as a result, the nitric–glycolic flowsheet was recommended for further testing. Based on the development of a roadmap for the nitric–glycolic acid flowsheet, Waste Solidification Engineering (WS-E) issued a Technical Task Request (TTR) to address flammability issues that may impact the implementation of this flowsheet. Melter testing was requested in order to define the DWPF flammability envelope for the nitric-glycolic acid flowsheet. The Savannah River National Laboratory (SRNL) Cold Cap Evaluation Furnace (CEF), a 1/12th scale DWPF melter, was selected by the SRR Alternate Reductant project team as the melter platform for this testing. The overall scope was divided into the following sub-tasks as discussed in the Task Technical and Quality Assurance Plan (TTQAP): Phase I - A nitric–formic acid flowsheet melter test (unbubbled) to baseline the CEF cold cap and vapor space data to the benchmark melter flammability models; Phase II - A nitric–glycolic acid flowsheet melter test (unbubbled and bubbled) to: Define new cold cap reactions and global kinetic parameters in support of the melter flammability model development; Quantify off-gas surging potential of the feed; Characterize off-gas condensate for complete organic and inorganic carbon species. After charging the CEF with cullet from Phase I CEF testing, the melter was slurry-fed with glycolic flowsheet based SB6-Frit 418 melter feed at 36% waste

  9. GAGES-II: Geospatial Attributes of Gages for Evaluating Streamflow

    USGS Publications Warehouse

    Falcone, James A.

    2011-01-01

    This dataset, termed "GAGES II", an acronym for Geospatial Attributes of Gages for Evaluating Streamflow, version II, provides geospatial data and classifications for 9,322 stream gages maintained by the U.S. Geological Survey (USGS). It is an update to the original GAGES, which was published as a Data Paper on the journal Ecology's website (Falcone and others, 2010b) in 2010. The GAGES II dataset consists of gages which have had either 20+ complete years (not necessarily continuous) of discharge record since 1950, or are currently active, as of water year 2009, and whose watersheds lie within the United States, including Alaska, Hawaii, and Puerto Rico. Reference gages were identified based on indicators that they were the least-disturbed watersheds within the framework of broad regions, based on 12 major ecoregions across the United States. Of the 9,322 total sites, 2,057 are classified as reference, and 7,265 as non-reference. Of the 2,057 reference sites, 1,633 have (through 2009) 20+ years of record since 1950. Some sites have very long flow records: a number of gages have been in continuous service since 1900 (at least), and have 110 years of complete record (1900-2009) to date. The geospatial data include several hundred watershed characteristics compiled from national data sources, including environmental features (e.g. climate – including historical precipitation, geology, soils, topography) and anthropogenic influences (e.g. land use, road density, presence of dams, canals, or power plants). The dataset also includes comments from local USGS Water Science Centers, based on Annual Data Reports, pertinent to hydrologic modifications and influences. The data posted also include watershed boundaries in GIS format. This overall dataset is different in nature to the USGS Hydro-Climatic Data Network (HCDN; Slack and Landwehr 1992), whose data evaluation ended with water year 1988. The HCDN identifies stream gages which at some point in their history had

  10. Factorial and diagnostic validity of the Beck Depression Inventory-II (BDI-II) in Croatian primary health care.

    PubMed

    Jakšić, Nenad; Ivezić, Ena; Jokić-Begić, Nataša; Surányi, Zsuzsanna; Stojanović-Špehar, Stanislava

    2013-09-01

    The aim of this study was to examine the factorial and diagnostic validity of the Beck Depression Inventory-Second Edition (BDI-II) in Croatian primary health care. Data were collected using a medical outpatient sample (N = 314). Reliability measured by internal consistency proved to be high. While the Velicer MAP Test showed that extraction of only one factor is satisfactory, confirmatory factor analysis indicated the best fit for a 3-factor structure model consisting of cognitive, affective and somatic dimensions. Receiver operating characteristics (ROC) analysis demonstrated the BDI-II to have a satisfactory diagnostic validity in differentiating between healthy and depressed individuals in this setting. The area under the curve (AUC), sensitivity and specificity were high with an optimal cut-off score of 15/16. The implications of these findings are discussed regarding the use of the BDI-II as a screening instrument in primary health care settings.

  11. Yakima River Basin Phase II Fish Screen Evaluations, 2001.

    SciTech Connect

    Carter, J.A.; McMichael, Geoffrey A.; Chamness, M.A.

    2002-01-01

    In the summer and fall of 2001 the Pacific Northwest National Laboratory (PNNL) evaluated 23 Phase II fish screen sites in the Yakima River Basin as part of a multi-year study for the Bonneville Power Administration (BPA) on the effectiveness of fish screening devices. Data were collected to determine if velocities in front of the screens and in the bypasses met current National Marine Fisheries Service (NMFS) criteria to promote safe and timely fish passage and whether bypass outfall conditions allowed fish to safely return to the river. Based on our studies in 2001, we concluded that: in general, water velocity conditions at the screen sites met fish passage criteria set forth by the NMFS; most facilities efficiently protected juvenile fish from entrainment, impingement, or migration delay; automated cleaning brushes generally functioned properly; chains and other moving parts were well greased and operative; and removal of sediment build-up and accumulated leafy and woody debris are areas that continue to improve. Continued periodic screen evaluations will increase the effectiveness of screen operation and maintenance practices by confirming the effectiveness (or ineffectiveness) of screen operating procedures at individual sites. Where procedures are being followed and problems still occur, evaluation results can be used to suggest means to better protect fish at screening facilities. There has been a progressive improvement in the maintenance and effectiveness of fish screen facilities in the Yakima River Basin during the last several years, in part, as a result of regular screen evaluations and the rapid feedback of information necessary to improve operations and design of these important fish protection devices. Continued periodic screen evaluations will increase the effectiveness of screen operation and maintenance practices by confirming the effectiveness (or ineffectiveness) of screen operating procedures at individual sites. Where procedures are being

  12. A critical review of health-related economic evaluations in Australia: implications for health policy.

    PubMed

    Salkeld, G; Davey, P; Arnolda, G

    1995-02-01

    In Australia, as in many other countries, economic evaluation is increasingly seen by health care policy makers as a useful aid to priority setting and resource allocation. In Australia, economic evaluation is now a requirement for new drugs to be listed on the Pharmaceutical Benefits Scheme which provides a government subsidy on the price of listed drugs for purchasers. Yet, despite recognition of the importance of economic evaluation by policy makers, there is a paucity of published evaluations in Australia. We reviewed all of the 33 health-related economic evaluations conducted in Australia and subsequently published since 1978. This study assesses how well informed decision makers might be if they used the results and conclusions of published economic evaluations as an aid to resource allocation. The review highlights several issues: (i) it is difficult to interpret the conclusions or assess the generalisability of individual papers without information on the context of the original study; (ii) the choice of comparator(s) was often unexplained and most papers did not employ marginal analysis; (iii) in the absence of marginal analysis, the comparability of cost-effectiveness ratios in league tables must be questioned as well as the completeness (were all the relevant alternatives included?) of studies; and (iv) the quality of effectiveness evidence varies enormously, with some authors content to use the best available evidence (even if it is of poor quality). The development of standards for economic evaluation methods might ensure a more consistent and scientific approach to evaluative work, but they cannot guarantee it. A more concerted effort to disseminate the principles and methods of economic evaluation to policy makers and non-economist evaluators might be a more important precursor to improving the credibility and usefulness of economic evaluations in priority setting.

  13. Parent's Evaluation of Developmental Status (PEDS) detects developmental problems compared to Denver II.

    PubMed

    Theeranate, Kanjana; Chuengchitraks, Supichaya

    2005-11-01

    The early detection of developmental and behavioral problems in children is crucial for early intervention. The effectiveness of early detection depends on skills and interest of clinicians. Parents are the precious sources of information. The suspicions of parents about their children's development should be considered. The success of early identification is influenced by pediatricians who elicit, recognize, select clinical information and judge how to manage. The purpose of the present pilot study was to assess whether parents can be the sources of clinical information in detecting developmental problems of their children. Parent's Evaluation of developmental status (PEDS) is used to elicit parents which is the useful and widely used tool for developmental screening by measuring the sensitivity and sensitivity of PEDS. The additional goal is to find the prevalence of developmental problems in this population. A total of 216 parent-child dyads, children 0-72 months of age, were recruited from the Pediatrics Outpatient Clinic and Child Health Supervision Clinic at Phramongkutklao Hospital from 1 July 2001 to 31 July 2002. Children who were chronically ill or had known developmental delay were excluded. Data regarding prenatal, perinatal and postnatal risk factors, health status, childrearing practice, parental education and family income were gathered. The Parents Evaluations of Developmental Status (PEDS) was completed by interview. The developmental screening test was administered by using Denver II. The authors compared the items of language, fine motor adaptive and gross motor skills. Descriptive statistic for demographic data was used and diagnostic test was performed in order to detect sensitivity and specificity. The Kappa was administered for analyzing the relationship between PEDS and Denver II. Certain concern in developmental delay was 4.1 % and suspected Denver II was 3.24 %. Forty-two point five percent of the children who were suspected in Denver II

  14. Study Guide for the Regents External Degree Examination in Health Support--Area II (4 Credits).

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Regents External Degree Program.

    A study guide for the Health Support Area II examination of the University of the State of New York Regents External Degree Program is presented. The examination tests the use of the nursing process to support the health of the client at risk for major health problems throughout the life cycle. Emphasis is placed on nursing actions related to…

  15. Study Guide for the Regents External Degree Examination in Health Support--Area II (4 Credits).

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Regents External Degree Program.

    A study guide for the Health Support Area II examination of the University of the State of New York Regents External Degree Program is presented. The examination tests the use of the nursing process to support the health of the client at risk for major health problems throughout the life cycle. Emphasis is placed on nursing actions related to…

  16. Assessing Intentions to Eat a Healthful Diet Among National Collegiate Athletic Association Division II Collegiate Athletes.

    PubMed

    Karpinski, Christine A; Milliner, Kellianne

    2016-01-01

    Many athletes fail to obtain the optimal levels of energy and nutrients to support health and performance. The constructs underlying the Theory of Planned Behavior (TPB) may help identify barriers to healthful eating that can be addressed in nutrition-education programs. To use the TPB to examine factors regarding collegiate male and female student-athletes' intentions of eating a healthful diet. Cross-sectional study. Online survey tool. The survey was taken by 244 male and female National Collegiate Athletic Association Division II athletes, and data from 201 were analyzed. Mean age of the athletes was 20 ± 1.31 years (range, 18-24 years); most were white (86.1%) and female (78.6%). We assessed predictive strength of attitude, subjective norms, and perceived behavioral control on behavioral intentions. Regression analysis evaluated how the variables of TPB were valued and how they predict behavioral intentions. The combination of attitude, subjective norms, and perceived behavioral controls accounted for 73.4% (R 2) of the variance in behavioral intention (F = 180.82, P < .001). Attitude had the greatest influence on behavioral intentions (β = .534, P < .001). Understanding both the intentions of collegiate athletes to eat healthfully and how highly they value nutrition is crucial for the development of effective nutrition education and counseling programs.

  17. Assessing Intentions to Eat a Healthful Diet Among National Collegiate Athletic Association Division II Collegiate Athletes

    PubMed Central

    Karpinski, Christine A.; Milliner, Kellianne

    2016-01-01

    Context Many athletes fail to obtain the optimal levels of energy and nutrients to support health and performance. The constructs underlying the Theory of Planned Behavior (TPB) may help identify barriers to healthful eating that can be addressed in nutrition-education programs. Objective To use the TPB to examine factors regarding collegiate male and female student-athletes' intentions of eating a healthful diet. Design Cross-sectional study. Setting Online survey tool. Patients or Other Participants The survey was taken by 244 male and female National Collegiate Athletic Association Division II athletes, and data from 201 were analyzed. Mean age of the athletes was 20 ± 1.31 years (range, 18–24 years); most were white (86.1%) and female (78.6%). Main Outcome Measure(s) We assessed predictive strength of attitude, subjective norms, and perceived behavioral control on behavioral intentions. Regression analysis evaluated how the variables of TPB were valued and how they predict behavioral intentions. Results The combination of attitude, subjective norms, and perceived behavioral controls accounted for 73.4% (R 2) of the variance in behavioral intention (F = 180.82, P < .001). Attitude had the greatest influence on behavioral intentions (β = .534, P < .001). Conclusions Understanding both the intentions of collegiate athletes to eat healthfully and how highly they value nutrition is crucial for the development of effective nutrition education and counseling programs. PMID:26752168

  18. Evaluating health interventions: exploiting the potential.

    PubMed

    Maynard, Alan; McDaid, David

    2003-02-01

    The importance of the evaluation of health care interventions (EHI) including formal health technology assessment (HTA) cannot be over-emphasised, as its results can inform and improve resource allocation decisions in all parts of the health care system, public and private. At present, fragmented and inefficient resource allocation processes are a universal problem and, as a consequence, patients are deprived of care from which they could benefit. Such outcomes are not only inefficient but also unethical. In this paper we focus on HTA, which emphasises the need to link evidence to policy and practice, but our conclusions can be applied to all types of EHI. There is a need for greater use of economic evidence within HTA. Four principle characteristics of HTA are discussed in this paper: types of knowledge and evaluation, and commissioning and knowledge utilisation. Policy-makers must invest in improving research and receptor capacities for producing and using knowledge, improve quality control, and invest in research into dissemination and implementation mechanisms. The potential of HTA is great, and its use has increased, but it remains largely unexploited in most countries.

  19. [Comparative evaluation of health services outcomes].

    PubMed

    Agabiti, Nera; Davoli, Marina; Fusco, Danilo; Stafoggia, Massimo; Perucci, Carlo A

    2011-01-01

    This introductory guide represents an operative tool to conduct epidemiological studies in the area of comparative outcomes evaluation. It is based on the experience of epidemiological research in this field conducted in Italy within national (BPAC-Esiti del bypass aortocoronarico, Progetto mattoni outcome, Progetto Progressi) or regional (P.Re.Val.E. Programma Regionale di Valutazione degli Esiti, Lazio) health care outcomes projects and the National outcome programme. This guide is aimed to all those interested in conducting or interpreting health care outcomes studies within different levels of the Italian NHS. It gives an introductory description of the operative steps to build outcome indicators and to perform comparative analyses, with the general objective of measuring and promoting improvement in health care. A specific emphasis is given to the use of routinely collected health care databases that have found widespread use for epidemiological purposes. This guide has two parts: part A includes an introduction and comments on critical methodological points, part B shows three example of epidemiological studies (A. Complications after cholecystectomy: comparison between two surgical techniques, B. 30-day mortality after acute myocardial infarction: comparison among hospitals, C. 30-day mortality after acute myocardial infarction: comparison between time periods). The online version of this guide is organised as a hypertext as practical instrument of appraisal.

  20. World Health Organization guideline development: an evaluation.

    PubMed

    Sinclair, David; Isba, Rachel; Kredo, Tamara; Zani, Babalwa; Smith, Helen; Garner, Paul

    2013-01-01

    Research in 2007 showed that World Health Organization (WHO) recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization's own "Guidelines for Guidelines". In response, the WHO established a "Guidelines Review Committee" (GRC) to implement and oversee internationally recognized standards. We examined the impact of these changes on WHO guideline documents and explored senior staff's perceptions of the new procedures. We used the AGREE II guideline appraisal tool to appraise ten GRC-approved guidelines from nine WHO departments, and ten pre-GRC guidelines matched by department and topic. We interviewed 20 senior staff across 16 departments and analyzed the transcripts using the framework approach. Average AGREE II scores for GRC-approved guidelines were higher across all six AGREE domains compared with pre-GRC guidelines. The biggest changes were noted for "Rigour of Development" (up 37.6%, from 30.7% to 68.3%) and "Editorial Independence" (up 52.7%, from 20.9% to 73.6%). Four main themes emerged from the interviews: (1) high standards were widely recognized as essential for WHO credibility, particularly with regard to conflicts of interest; (2) views were mixed on whether WHO needed a single quality assurance mechanism, with some departments purposefully bypassing the procedures; (3) staff expressed some uncertainties in applying the GRADE approach, with departmental staff concentrating on technicalities while the GRC remained concerned the underlying principles were not fully institutionalized; (4) the capacity to implement the new standards varied widely, with many departments looking to an overstretched GRC for technical support. Since 2007, WHO guideline development methods have become more systematic and transparent. However, some departments are bypassing the procedures, and as yet neither the GRC, nor the quality assurance standards they have set, are fully embedded within the

  1. Further Evaluation of the Psychometric Properties of the Acceptance and Action Questionnaire-II

    ERIC Educational Resources Information Center

    Fledderus, Martine; Oude Voshaar, Martijn A. H.; ten Klooster, Peter M.; Bohlmeijer, Ernst T.

    2012-01-01

    The Acceptance and Action Questionnaire-II (AAQ-II) is a self-report measure designed to assess experiential avoidance as conceptualized in acceptance and commitment therapy (ACT). The current study is the first to evaluate the psychometric properties of the AAQ-II in a large sample of adults (N = 376) with mild to moderate levels of depression…

  2. Further Evaluation of the Psychometric Properties of the Acceptance and Action Questionnaire-II

    ERIC Educational Resources Information Center

    Fledderus, Martine; Oude Voshaar, Martijn A. H.; ten Klooster, Peter M.; Bohlmeijer, Ernst T.

    2012-01-01

    The Acceptance and Action Questionnaire-II (AAQ-II) is a self-report measure designed to assess experiential avoidance as conceptualized in acceptance and commitment therapy (ACT). The current study is the first to evaluate the psychometric properties of the AAQ-II in a large sample of adults (N = 376) with mild to moderate levels of depression…

  3. Evaluation of knowledge and plaque scores in school children before and after health education

    PubMed Central

    Hebbal, Mamata; Ankola, Anil V.; Vadavi, Deepti; Patel, Kunal

    2011-01-01

    Background: Health education is a process of transmission of knowledge and skills necessary for improvement in quality of life. The purpose of the present study was to evaluate the oral hygiene related knowledge and plaque scores of 12-year-old school children in Belgaum city before and after health education. Methods: Three schools of Belgaum city were randomly selected and assigned into one of three health educational groups – group I (audiovisual aids), group II (chalk and blackboard) and group III (no health education). Oral health related knowledge and plaque scores were assessed in all the groups before and after health education. Results: The mean knowledge score before intervention in group I was 7.94, in group II was 7.86 and in group III was 7.74 (P=0.86). After intervention, the mean knowledge score was 14.42 in group I, 12.7 in group II and 9.58 in group III (P<0.001). Plaque scores in the three groups were similar and statistically nonsignificant at baseline. After the oral health education, the mean plaque scores were 0.627 in group I, 0.8826 in group II and 1.0156 in group III. Within the group comparisons revealed a statistically improved oral hygiene with decreased plaque scores in all the three groups. Conclusion: Health education by audiovisual aids could be an effective preventive measure against plaque-related oral diseases. PMID:22135690

  4. [Evaluation of health policies and plans].

    PubMed

    Villalbí, Joan R; Tresserras, Ricard

    2011-06-01

    Evaluation of plans and policies is a key element in their administration and must be performed under real conditions. Such evaluation is complex, as plans and policies include a diverse set of components that operate simultaneously. Moreover, external factors frequently influence those same issues that programs attempt to change. Unless plans and policies are evaluated under real conditions, a policy that effectively reduces the effects of a problem may be deemed ineffective (if the problem increases due to the influence of factors the program does not attempt to affect), or a policy that is unable to influence the problem it attempts to solve may be judged useful (if the magnitude of the problem is being reduced through the influence of factors other than the policy). The present article discusses evaluation of health policies, plans or complex programs, with emphasis on effectiveness assessment, using data from real examples. Among other issues, the need to identify the distinct components of policies and plans is reviewed. This article also describes how to evaluate the outcome or results of a program with indicators from other sources. Aspects related to the timing of evaluation and assessment indicators are analyzed. We discuss situations in which the launch of a new policy or intervention is followed by an increase in the reported magnitude of the problem it attempts to solve. These situations are illustrated by cases in which this increase is attributable to improved detection and by others in which the increase is related to factors external to the intervention. The frequent confusion of the effects of the intervention with other events is covered, with data from some examples. Finally, evaluation of plans that include a wide range of objectives is also addressed. Copyright © 2011 Sociedad Española de Salud Pública y Administración Sanitaria. Published by Elsevier Espana. All rights reserved.

  5. Evaluating a Sexual Health Patient Education Resource

    PubMed Central

    Matzo, Marianne; Troup, Sandi; Hijjazi, Kamal; Ferrell, Betty

    2015-01-01

    This article shares the findings of an evaluation of a patient teaching resource for sexual health entitled Everything Nobody Tells You About Cancer Treatment and Your Sex Life: From A to Z, which was accomplished through systematic conceptualization, construction, and evaluation with women diagnosed with breast or gynecologic cancer. This resource, which has evolved from patient-focused research and has been tested in the clinical setting, can be used in patient education and support. Oncology professionals are committed to addressing quality-of-life concerns for patients across the trajectory of illness. Sexuality is a key concern for patients and impacts relationships and overall quality of life. Through careful assessment, patient education, and support, clinicians can ensure that sexuality is respected as an essential part of patient-centered care. PMID:26557411

  6. Psychometric Evaluation of the Beck Depression Inventory-II.

    ERIC Educational Resources Information Center

    Dozois, David J. A.; Ahnberg, Jamie L.; Dobson, Keith S.

    1998-01-01

    Provides psychometric information on the second edition of the Beck Depression Inventory (BDI-II) (A. Beck, R. Steer, and G. Brown, 1996) for internal consistency, factorial validity, and gender differences. Results indicate that the BDI-II is a stronger instrument than its predecessor in terms of factor structure. (SLD)

  7. A Framework for Including Family Health Spillovers in Economic Evaluation.

    PubMed

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-02-01

    Health care interventions may affect the health of patients' family networks. It has been suggested that these "health spillovers" should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the "health care perspective"). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society.

  8. Evaluating Diabetes Health Policies Using Natural Experiments

    PubMed Central

    Ackermann, Ronald T.; Duru, O. Kenrik; Albu, Jeanine B.; Schmittdiel, Julie A.; Soumerai, Stephen B.; Wharam, James F.; Ali, Mohammed K.; Mangione, Carol M.; Gregg, Edward W.

    2016-01-01

    The high prevalence and costs of type 2 diabetes makes it a rapidly evolving focus of policy action. Health systems, employers, community organizations, and public agencies have increasingly looked to translate the benefits of promising research interventions into innovative polices intended to prevent or control diabetes. Though guided by research, these health policies provide no guarantee of effectiveness and may have opportunity costs or unintended consequences. Natural experiments use pragmatic and available data sources to compare specific policies to other policy alternatives or predictions of what would likely have happened in the absence of any intervention. The Natural Experiments for Translation in Diabetes (NEXT-D) Study is a network of academic, community, industry, and policy partners, collaborating to advance the methods and practice of natural experimental research, with a shared aim of identifying and prioritizing the best policies to prevent and control diabetes. This manuscript describes the NEXT-D Study group's multi-sector natural experiments in areas of diabetes prevention or control as case examples to illustrate the selection, design, analysis, and challenges inherent to natural experimental study approaches to inform development or evaluation of health policies. PMID:25998925

  9. Evaluating the effectiveness of health care teams.

    PubMed

    Mickan, Sharon M

    2005-05-01

    While it is recognised that effective health care teams are associated with quality patient care, the literature is comparatively sparse in defining the outcomes of effective teamwork. This literature review of the range of organisational, team and individual benefits of teamwork complements an earlier article which summarised the antecedent conditions for (input) and team processes (throughput) of effective teams. This article summarises the evidence for a range of outcome measures of effective teams. Organisational benefits of teamwork include reduced hospitalisation time and costs, reduced unanticipated admissions, better accessibility for patients, and improved coordination of care. Team benefits include efficient use of health care services, enhanced communication and professional diversity. Patients report benefits of enhanced satisfaction, acceptance of treatment and improved health outcomes. Finally, team members report enhanced job satisfaction, greater role clarity and enhanced well-being. Due to the inherent complexity of teamwork, a constituency model of team evaluation is supported where key stakeholders identify and measure the intended benefits of a team.

  10. Health Inequities: Evaluation of Two Paradigms

    ERIC Educational Resources Information Center

    Ashcroft, Rachelle

    2010-01-01

    Social work practice in health is shaped by underlying paradigms. To effectively target health inequities, practitioners need to consider appropriate paradigms. In this exploration of how six health paradigms shape theory and practice, the two health paradigms that most attended to health inequalities are social determinants of health and…

  11. Health Inequities: Evaluation of Two Paradigms

    ERIC Educational Resources Information Center

    Ashcroft, Rachelle

    2010-01-01

    Social work practice in health is shaped by underlying paradigms. To effectively target health inequities, practitioners need to consider appropriate paradigms. In this exploration of how six health paradigms shape theory and practice, the two health paradigms that most attended to health inequalities are social determinants of health and…

  12. 76 FR 25723 - Proposed Information Collection for Growing America Through Entrepreneurship (GATE) II Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-05

    ... Entrepreneurship (GATE) II Evaluation; Comment Request AGENCY: Employment and Training Administration, Labor... that investigated the impact of providing entrepreneurship training services to individuals interested..., K., & Kahvecioglu, D. ``Growing America Through Entrepreneurship: Findings from the Evaluation of...

  13. Units of Instruction. Health Occupations Education. Volume II. [Teacher's Guide].

    ERIC Educational Resources Information Center

    East Texas State Univ., Commerce. Occupational Curriculum Lab.

    Ten units on health occupations are presented in this teacher's guide. The units are the following: special procedures; assisting with diagnostic procedures (e.g., collecting specimens); transporting patients; charting; medical laboratory procedures; giving standard first aid treatment; metrics for health occupations; human relations; safety; and…

  14. A comprehensive health service evaluation and monitoring framework.

    PubMed

    Reeve, Carole; Humphreys, John; Wakerman, John

    2015-12-01

    To develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services. A targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders. The framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable. Data collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Validation of the nutrition screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II' among octogenarians.

    PubMed

    Wham, C A; Redwood, K M; Kerse, N

    2014-01-01

    To determine the validity of the nutrition screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II' (SCREEN II) among a purposive sample of octogenarians. Cross-sectional validation study. Bay of Plenty, New Zealand. Forty-five community-living residents aged 85-86 years. Equal proportions of participants were recruited at low, medium and high nutrition risk based on their SCREEN II score 12 months prior. Nutrition risk was assessed using SCREEN II. Demographic and health data were established. Using established criterion a dietitian's nutrition risk rating assessment ranked participants from low risk (score of 1) to high risk (score of 10). The assessment included a medical history, anthropometric measures and dietary intake. Dietary intake was established from three 24 hour multiple pass recalls (MPR). A Spearman's correlation determined the association between the SCREEN II score and the dietitian's risk score. Receiver operating characteristic (ROC) curves were completed to determine the sensitivity and specificity of the cut-off point for high nutrition risk. The SCREEN II score was significantly correlated with the dietitian's risk rating (rs = -0.76 (p<0.01). A newly defined cut-off point <49 was established for high nutrition risk derived from ROC curves and AUC (0.87, p < 0.01); sensitivity 90% and specificity 86%. SCREEN II is a simple, easy to use, 14 item questionnaire and appears to be a valid tool for detection of nutrition risk people aged 85-86 years.

  16. PERISTAT: indicators for monitoring and evaluating perinatal health in Europe.

    PubMed

    Zeitlin, Jennifer; Wildman, Katherine; Bréart, Gérard; Alexander, Sophie; Barros, Henrique; Blondel, Béatrice; Buitendijk, Simone; Gissler, Mika; Macfarlane, Alison

    2003-09-01

    The PERISTAT project aimed to develop an indicator set for monitoring and describing perinatal health in Europe. The challenge was to define indicators that cover common concerns and have the same meaning within the different European health care systems. PERISTAT included i) a review of existing recommendations on perinatal health indicators, ii) a DELPHI consensus process with a scientific advisory committee composed of a clinician and an epidemiologist or statistician from each European member state as well as with a panel of midwives, and iii) a study of the availability of national statistics to construct recommended indicators. This article describes the first two components. The review identified 10 international and 13 national recommended indicator sets. It also included indicators routinely compiled by WHO, EUROSTAT and OECD. Because of the methodological limits to using existing indicators for European comparisons, a high priority was placed on improving indicators already collected. Using the DELPHI method based on the results of the review, the scientific committee achieved a consensus on ten core and 23 recommended indicators, including 12 requiring further development. The PERISTAT project was successful in identifying a set of indicators, which drew on and consolidated previous work. Consensus was not achieved on precise indicators in areas where uncertainty about appropriate indicators was high, although areas were targeted for future development. Finally, the feasibility study, which is in progress, is an essential part of the project, since it will enable member states to evaluate their capacity to produce these indicators.

  17. Snohomish Estuary Wetlands Study. Volume II. Basic Information and Evaluation

    DTIC Science & Technology

    1978-08-01

    potentially unfit for certification by the State Departmnent of Social and Health Ser- vices. Fish may also be affected by water quality degradation...Fisheries Department of Natural Resources Departiient of Highways Department of Social and Health Services Parks and Recreation Commission Office of... Health Services (DSHS) 30. The Department of Social and Health Services is the public j health authority for the state under RCW 43.20. DSHS management

  18. [Semantic and conceptual equivalences of the Portuguese version of the National College Health Assessment II].

    PubMed

    Guedes, Dartagnan Pinto; Teixeira, Márcio

    2012-04-01

    The objective of this study was to describe the semantic and conceptual equivalences of the National College Health Assessment II (NCHA II). The original version of the NCHA II was translated into Portuguese and back-translated into English. A committee of experts analyzed the different versions of the questionnaire. The version of the translated NCHA II questionnaire was experimentally administered to a sample of 64 university students of both sexes. After minor changes identified in the translation process, the committee of experts concluded that the Portuguese version of the NCHA II showed semantic and conceptual equivalences. In conclusion, the initial stages of the process of cross-cultural adaptation of the NCHA II questionnaire were satisfactory. Future studies are necessary to identify psychometric properties and validation indicators prior to the effective recommendation of the instrument for safe use.

  19. Health Occupations Education I. Module No. II-A to II-D.

    ERIC Educational Resources Information Center

    Dunmeyer, Kathryn; And Others

    This set of 4 modules on vital signs is 1 of 11 sets in the Health Occupations Education I instructional package for the first year of a 2-year course of study. The materials are designed to prepare students, through individualized instruction for entry-level job opportunities on health care teams in a variety of practice settings. Each module may…

  20. Health Occupations Education I. Module No. II-A to II-D.

    ERIC Educational Resources Information Center

    Dunmeyer, Kathryn; And Others

    This set of 4 modules on vital signs is 1 of 11 sets in the Health Occupations Education I instructional package for the first year of a 2-year course of study. The materials are designed to prepare students, through individualized instruction for entry-level job opportunities on health care teams in a variety of practice settings. Each module may…

  1. Ageing and Health Status in Adults with Intellectual Disabilities: Results of the European POMONA II Study

    ERIC Educational Resources Information Center

    Haveman, Meindert; Perry, Jonathan; Salvador-Carulla, Luis; Walsh, Patricia Noonan; Kerr, Mike; Lantman-De Valk, Henny Van Schrojenstein; Van Hove, Geert; Berger, Dasa Moravec; Azema, Bernard; Buono, Serafino; Cara, Alexandra Carmen; Germanavicius, Arunas; Linehan, Christine; Maatta, Tuomo; Tossebro, Jan; Weber, Germain

    2011-01-01

    Background: POMONA II was a European Commission public health-funded project. The research questions in this article focus on age-specific differences relating to environmental and lifestyle factors, and the 17 medical conditions measured by the POMONA Checklist of Health Indicators (P15). Method: The P15 was completed in a cross-sectional design…

  2. Strand II: Sociological Health Problems. Prototype Curriculum Materials for the Elementary and Secondary Grades.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

    These publications contain three of the topics for Strand II, Sociological Health Problems, which have been prepared as part of the kindergarten through twelve health syllabus revision project. The material included is intended for use in grades four through twelve. The topics covered are alcohol education, drugs and narcotics, and smoking. The…

  3. Professionalism behind barbed wire: health care in World War II Japanese-American concentration camps.

    PubMed

    Nakayama, Don K; Jensen, Gwenn M

    2011-04-01

    Physicians and nurses of Japanese ancestry provided health care to 110000 persons incarcerated by the US government during World War II. They faced immense public health challenges created by overcrowding and inadequate resources. Their extraordinary service to their community reflected their professional devotion to their patients and the values of their Japanese homeland.

  4. Ageing and Health Status in Adults with Intellectual Disabilities: Results of the European POMONA II Study

    ERIC Educational Resources Information Center

    Haveman, Meindert; Perry, Jonathan; Salvador-Carulla, Luis; Walsh, Patricia Noonan; Kerr, Mike; Lantman-De Valk, Henny Van Schrojenstein; Van Hove, Geert; Berger, Dasa Moravec; Azema, Bernard; Buono, Serafino; Cara, Alexandra Carmen; Germanavicius, Arunas; Linehan, Christine; Maatta, Tuomo; Tossebro, Jan; Weber, Germain

    2011-01-01

    Background: POMONA II was a European Commission public health-funded project. The research questions in this article focus on age-specific differences relating to environmental and lifestyle factors, and the 17 medical conditions measured by the POMONA Checklist of Health Indicators (P15). Method: The P15 was completed in a cross-sectional design…

  5. Spectroscopic evaluation of Co(II), Ni(II) and Cu(II) complexes derived from thiosemicarbazone and semicarbazone.

    PubMed

    Chandra, Sulekh; Kumar, Anil

    2007-12-31

    Co(II), Ni(II) and Cu(II) complexes were synthesized with thiosemicarbazone (L(1)) and semicarbazone (L(2)) derived from 2-acetyl furan. These complexes were characterized by elemental analysis, molar conductance, magnetic moment, mass, IR, electronic and EPR spectral studies. The molar conductance measurement of the complexes in DMSO corresponds to non-electrolytic nature. All the complexes are of high-spin type. On the basis of different spectral studies six coordinated geometry may be assigned for all the complexes except Co(L)(2)(SO(4)) and Cu(L)(2)(SO(4)) [where L=L(1) and L(2)] which are of five coordinated square pyramidal geometry.

  6. Preliminary evaluation of alternative waste form solidification processes. Volume II. Evaluation of the processes

    SciTech Connect

    Not Available

    1980-08-01

    This Volume II presents engineering feasibility evaluations of the eleven processes for solidification of nuclear high-level liquid wastes (HHLW) described in Volume I of this report. Each evaluation was based in a systematic assessment of the process in respect to six principal evaluation criteria: complexity of process; state of development; safety; process requirements; development work required; and facility requirements. The principal criteria were further subdivided into a total of 22 subcriteria, each of which was assigned a weight. Each process was then assigned a figure of merit, on a scale of 1 to 10, for each of the subcriteria. A total rating was obtained for each process by summing the products of the subcriteria ratings and the subcriteria weights. The evaluations were based on the process descriptions presented in Volume I of this report, supplemented by information obtained from the literature, including publications by the originators of the various processes. Waste form properties were, in general, not evaluated. This document describes the approach which was taken, the developent and application of the rating criteria and subcriteria, and the evaluation results. A series of appendices set forth summary descriptions of the processes and the ratings, together with the complete numerical ratings assigned; two appendices present further technical details on the rating process.

  7. [Changes necessary for continuing health reform: II. The "internal" change].

    PubMed

    Martín Martín, J; de Manuel Keenoy, E; Carmona López, G; Martínez Olmos, J

    1990-01-01

    The article desired organizational and managerial changes in Primary Health Care, so as to develop a sound and feasible social marketing strategy. Key elements that should be changed are: 1. Rigid and centralized administrative structures and procedures. 2. Incentives system centralized and dissociated from the managerial structure. 3. Primary Health Care management units immersed in political conflict. 4. Absence of alternative in the margin. Users cannot choose. 5. Lack of an internal marketing strategy. Several ways of internal markets simulation are assessed as potential means for internal change. The need for an administration reform leading to a less inflexible system in the Spanish national and regional health services in reviewed too. Three changes are considered essential: a) Payment systems in Primary Health Care. b) Modifications in the personnel contracts. c) Reform of the budgeting processes. Specific strategies in each of these issues are suggested, making emphasizing the need of their interrelationship and coherence.

  8. Programmatic Environmental, Safety, and Health Evaluation (PESHE) Guide

    DTIC Science & Technology

    2007-11-02

    Elements 1. System Safety & Health Explosive Safety Orbital Debris 2. NEPA 3. Env. Compliance 4. Hazardous Materials 5. Pollution Prevention STEP 4... orbital debris , collision avoidance, laser clearing-house functions, environmental hazards, and safety procedures. D. Explosive Safety: 1...System Safety and Health a. Explosive Safety b. Orbital Debris ii. Environmental compliance iii. NEPA iv. Hazardous Materials Management v. Pollution

  9. Evaluation of a Sectoral Approach to Integrated Assessment Modelling (EuroDelta II)

    NASA Astrophysics Data System (ADS)

    Cuvelier, C.; Thunis, P.

    2009-04-01

    The EURODELTA II (ED II) project is the second phase of the EuroDelta co-operation project. The EuroDelta co-operation is intended to support the design of air pollution control strategies in Europe, both under the European Commission and under the Convention on Long-range Transboundary Air Pollution. The EuroDelta approach is to investigate the robustness of source-receptor relationships used in Integrated Assessment (IA) modelling by introducing an ensemble of models. The project is based on a collaboration between the European Commission Joint Research Centre (JRC) at Ispra (Italy) , five air quality modelling teams at Ineris (France), the Free University of Berlin (Germany), Met.no (Norway), TNO (Netherlands) and SMHI (Sweden) and the Oil Companies' European Organization for Environment, Health and Safety (CONCAWE). While the first phase of EuroDelta, ED I, examined the feasibility of using model ensembles to evaluate the robustness of source-receptor calculations in predicting recent (2000) and future (2020) air quality in Europe, the second phase ED II investigates the consequences of introducing sectoral approaches in integrated assessment modelling. A total of 60 different emission scenario calculations were evaluated to determine how the different models represent the impacts on a European scale of applying emission reductions to individual emission sectors. Emission reductions from power combustion, industry, residential and traffic sources were investigated independently and additional efforts were also addressed to investigate the effect of shipping emission control in the Mediterranean Sea. The main conclusion is that the impact of emission reductions in individual sectors is more appropriately described with the help of sectorally disaggregated source- receptor calculations. The recommendation is to incorporate sectoral weights to integrated assessment modelling in order to better support future revisions of European air pollution control policies

  10. Evaluating health knowledge: an alternative approach.

    PubMed

    Power, J G

    1996-01-01

    Health campaigns concerned with HIV and AIDS confront two important barriers: the stigmatized nature of the disease and cultural values that exacerbate the taboo nature of the information disseminated. The use of surveys in HIV and AIDS research requires respondents to provide descriptions of sexual acts and body parts as measures of their knowledge. Focus groups and interviews require respondents to speak publicly about these topics. Although many young people know about HIV and AIDS, they may not have the vocabulary to express their complete knowledge either textually or verbally. This article describes an alternative approach designed to evaluate HIV and AIDS knowledge among 587 adolescents in Mexico, where the number of official cases of AIDS has increased steadily since 1981. Participants stratified on sex and social class were required to draw modes of HIV transmission. The drawings were categorized into drawings of objects and persons, focusing on behaviors or cognitions, with a relational or contextual emphasis. The utility of this method for measuring knowledge about HIV infection and AIDS in education campaigns and evaluation research is discussed.

  11. How to Evaluate Mobile Health Applications: A Scoping Review.

    PubMed

    Fiore, Pasquale

    2017-01-01

    Evaluating mobile health applications requires specific criteria. Research suggests evaluation grids and online web sites are available to provide a quick sense of ease for the health care professional wanting to use a mobile application without worrying about the quality, efficacy, and safety of the mobile application. This article will present a scoping review and explore the available resources for health care professionals.

  12. Health Occupations Module. The Skeletal System--II.

    ERIC Educational Resources Information Center

    Temple Univ., Philadelphia, PA. Div. of Vocational Education.

    This module on the skeletal system is one of eight modules designed for individualized instruction in health occupations education programs at both the secondary and postsecondary levels. This module contains an introduction to the module topic, two objectives (e.g., list the types of joints and movements, and give examples), and two learning…

  13. An Annotated Bibliography on Refugee Mental Health. Volume II.

    ERIC Educational Resources Information Center

    Peterson, Susan C.; And Others

    The second volume of this annotated bibliography contains primarily materials in published scientific literature on refugee mental health. References have been grouped into five major sections. Section 1, Understanding Refugees in Context, provides important background material in five categories: cultural and related information about different…

  14. Health Information System Simulation. Curriculum Improvement Project. Region II.

    ERIC Educational Resources Information Center

    Anderson, Beth H.; Lacobie, Kevin

    This volume is one of three in a self-paced computer literacy course that gives allied health students a firm base of knowledge concerning computer usage in the hospital environment. It also develops skill in several applications software packages. This volume contains five self-paced modules that allow students to interact with a health…

  15. Health Occupations Module. The Skeletal System--II.

    ERIC Educational Resources Information Center

    Temple Univ., Philadelphia, PA. Div. of Vocational Education.

    This module on the skeletal system is one of eight modules designed for individualized instruction in health occupations education programs at both the secondary and postsecondary levels. This module contains an introduction to the module topic, two objectives (e.g., list the types of joints and movements, and give examples), and two learning…

  16. Health of the Disadvantaged. Chart Book-II.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHHS/PHS), Hyattsville, MD.

    The tables and charts in this book act as resources for information on the health status of racial and ethnic minorities and the poor. The four minority groups referred to are blacks, Hispanic Americans, Native Americans, and Asian Americans. The poor are defined as those whose income falls below the poverty line specified by the Census Bureau.…

  17. School-Based Health Education Project: Implementation Stage II.

    ERIC Educational Resources Information Center

    Seffrin, John R.; And Others

    1979-01-01

    Two units of the School Based Health Education Project in Howard County, Indiana, have been revised. The Little Smoky unit on smoking for second graders stresses the effects of smoking on the body systems while the Counter Conscious unit examines the uses of over-the-counter substances. (JMF)

  18. An Annotated Bibliography on Refugee Mental Health. Volume II.

    ERIC Educational Resources Information Center

    Peterson, Susan C.; And Others

    The second volume of this annotated bibliography contains primarily materials in published scientific literature on refugee mental health. References have been grouped into five major sections. Section 1, Understanding Refugees in Context, provides important background material in five categories: cultural and related information about different…

  19. Health Occupations Education. Units of Instruction. Teacher's Guide. Volume II.

    ERIC Educational Resources Information Center

    Williams, Catherine

    This manual is the second part of a two-volume teacher's guide to a series of instructional units for use in health occupations education programs in Texas. Covered in the 10 units included in this volume are the following topics: special procedures (administering oxygen to patients; using elastic bandages; assisting with postural drainage; and…

  20. AIDS, public health and the panic reaction (Part II).

    PubMed

    Priya, R

    1994-01-01

    Salient points of AIDS control in India are summarized. An autonomous national AIDS control organization has been set up, which received a sizable loan from the World Bank. As a result, the central health budget became skewed with one-fourth of its expenditures going for AIDS and not enough spent on general health services. Among issues inadequately addressed are: 1) HIV surveillance; 2) diagnosis of AIDS; 3) appropriate and safe medical care; 4) wasteful expenditure; 5) educating health workers; and 6) blood bank services. HIV surveillance and testing centers have been attached to a few large hospitals and medical colleges, but more testing and treatment services will be needed. The World Health Organization (WHO) recommends testing only after informed consent has been obtained; however, in India this is impossible because of the high rate of illiteracy. Instead, counseling is provided by special social workers and testing is prescribed by doctors. Special AIDS clinics might be the solution, although they lead to isolation and stigmatization of patients. Doctors and nurses should be made aware about the importance of informed consent and counseling to encourage voluntary and anonymous testing. The present WHO definition of AIDS for diagnosis is too general and is based on the African experience. Its use may lead to misdiagnosis of many cases of tuberculosis, diarrhea, and malnutrition as AIDS. Clinical criteria applicable to the Indian reality need to be developed urgently. Private practitioners have also entered HIV testing, but often they rely only on the ELISA test without confirmation which might result in a high rate of false positives. General medical care of AIDS cases have to be strengthened with routine sterilization to avoid wasteful expenditures, health workers have to be reeducated, blood bank services need to be streamlined, and more AIDS-related research is also required.

  1. The Great Lakes Center's health hazard evaluation program: promoting community environmental health through partnerships between academic and public health departments.

    PubMed

    Cali, Salvatore; Scheff, Peter; Mucha, Amy; Nickels, Leslie; Oliynyk, Irene; Hryhorczuk, Daniel

    2007-01-01

    The Great Lakes Center of Excellence in Environmental Health (GLCEEH), an innovative capacity-building component of the University of Illinois, performs health hazard evaluations in collaboration with the Illinois Department of Public Health and local health departments. GLCEEH has provided state and local health departments with faculty, industrial-hygiene expertise, and research expertise to help them investigate a variety of environmental health issues. This article describes health hazard evaluations performed with support from the National Center for Environmental Health, lessons learned, and recommendations for successful collaboration between academic and public health departments. From the academic perspective, health hazard evaluations are beneficial because they provide faculty and students with the opportunity to engage in public health practice and encounter new issues that advance the science of environmental health through research. From the perspective of a public health department, health hazard evaluations are beneficial because they address priority environmental health concerns and build the capacity of department personnel to conduct health hazard evaluations with internal resources. A collaborative health hazard evaluation program increases public health capacity by developing new approaches to environmental health problems and by sharing limited resources.

  2. [Students awareness of health teaching: evaluation of "health education" course and the occupational health nursing practice].

    PubMed

    Horikawa, Junko; Majima, Yukie; Ishihara, Itsuko

    2003-09-01

    The "health education" course is an important part of the baccalaureate curriculum in nursing. It is essential to teach students effective health education in a client oriented way. In order to improve the quality and content of this course, we extracted students descriptions from records of 44 students who had carried out group health education during nursing practice for the occupational health nursing course. We then analyzed students written sentences on their views concerning health teaching. After sentence analysis, we categorized these concepts into groups and titled them. The results of clarification of categories showed that the most common student awareness was in regard to technical and instructional skills, such as precise and suitable language selection for laymen, and utilization of teaching devices or mediums, during implementation of health teaching(43.6%). Secondly, assessment of health needs for a certain working population(10.3%), and effective teaching types such as instructional participant volunteers and full participation(9.2%) were deemed important. Thirdly, identification of the role of the occupational nurse(7.7%), and lastly the necessity of evaluation(2.3%) were considered necessary. Over all, in this study we found that students were most concerned about the instructional skills during the presentation of health education. Also, these results suggest that development of contents in the "health education" course to reinforce students assessment and evaluative abilities should be incorporated into the course. Furthermore, faculties who teach a "health education" course should provide a large variety of teaching materials and creative instructional methods for the students.

  3. The Value of Upward Evaluation in Libraries--Part II.

    ERIC Educational Resources Information Center

    Perkins, Gay Helen

    1995-01-01

    Examines the value of upward evaluation by reviewing historical outcomes of upward evaluations in industrial psychology/business literature and library literature. Also discusses the utilization of upward evaluation in libraries and focuses on results of the Western Kentucky University Libraries' annual process of supervisor evaluation. Appendixes…

  4. Alberta Education Energy Conservation Project. Phase II: Internal Evaluation.

    ERIC Educational Resources Information Center

    Sundmark, Dana

    This report is based on the Alberta Education Energy Conservation Project - Phase II. The project was a follow-up to an earlier study, extending from June 1980 to June 1983, in which government funding and engineering manpower were used to conduct an energy management program in 52 selected pilot schools in 5 areas of the province. The report…

  5. Peer Sexual Health Education: Interventions for Effective Programme Evaluation

    ERIC Educational Resources Information Center

    Sriranganathan, Gobika; Jaworsky, Denise; Larkin, June; Flicker, Sarah; Campbell, Lisa; Flynn, Susan; Janssen, Jesse; Erlich, Leah

    2012-01-01

    Peer education is used as a health promotion strategy in a number of areas, including sexual health. Although peer education programmes have been around for some time, published systematic evaluations of youth sexual health peer education programmes are rare. This article discusses the advantages and disadvantages of youth sexual health peer…

  6. Peer Sexual Health Education: Interventions for Effective Programme Evaluation

    ERIC Educational Resources Information Center

    Sriranganathan, Gobika; Jaworsky, Denise; Larkin, June; Flicker, Sarah; Campbell, Lisa; Flynn, Susan; Janssen, Jesse; Erlich, Leah

    2012-01-01

    Peer education is used as a health promotion strategy in a number of areas, including sexual health. Although peer education programmes have been around for some time, published systematic evaluations of youth sexual health peer education programmes are rare. This article discusses the advantages and disadvantages of youth sexual health peer…

  7. The Mental Health Recovery Movement and Family Therapy, Part II: A Collaborative, Appreciative Approach for Supporting Mental Health Recovery

    ERIC Educational Resources Information Center

    Gehart, Diane R.

    2012-01-01

    A continuation of Part I, which introduced mental health recovery concepts to family therapists, Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts. This approach draws primarily upon postmodern therapies, which have numerous social justice and strength-based practices that are easily…

  8. The Mental Health Recovery Movement and Family Therapy, Part II: A Collaborative, Appreciative Approach for Supporting Mental Health Recovery

    ERIC Educational Resources Information Center

    Gehart, Diane R.

    2012-01-01

    A continuation of Part I, which introduced mental health recovery concepts to family therapists, Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts. This approach draws primarily upon postmodern therapies, which have numerous social justice and strength-based practices that are easily…

  9. Managing Evaluation in a Federal Public Health Setting

    ERIC Educational Resources Information Center

    Schooley, Michael W.

    2009-01-01

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

  10. Printed health information materials: evaluation of readability and suitability.

    PubMed

    Shieh, Carol; Hosei, Barbara

    2008-01-01

    This study examined readability and suitability of printed health information materials colleted from multiple sources. In phase I, nursing students used Simple Measure of Gobbledygook (SMOG; McLaughlin, 1969) to assess the readability of 21 materials collected from the community. In phases II and III, nursing students and registered nurses used SMOG and the Suitability Assessment of Materials (SAM; Doak, Doak, & Root, 1996) to evaluate 15 prenatal materials from a Healthy Start program. SMOG assigns a reading grade level based on the number of words with 3 or more syllables. SAM has 22 items in 6 evaluation areas: content, literacy demand, graphics, layout and typography, learning stimulation and motivation, and cultural appropriateness. Major findings included that 53% to 86% of the printed materials had a reading level at or higher than 9th grade; materials lacked summary, interaction, and modeled behaviors, and registered nurses rated more materials as not suitable and fewer as superior for suitability qualities than students. Improving printed materials to have lower reading levels and better suitability qualities are indicated.

  11. Evaluation in Adult Literacy Research. Project ALERT. Phase II.

    ERIC Educational Resources Information Center

    Ntiri, Daphne Williams, Ed.

    This document contains an evaluation handbook for adult literacy programs and feedback from/regarding the evaluation instruments developed during the project titled Adult Literacy and Evaluation Research Team (also known as Project ALERT), a two-phase project initiated by the Detroit Literacy Coalition (DLC) for the purpose of developing and…

  12. Evaluation of LEAA Funded Courts Training Programs. Volume II.

    ERIC Educational Resources Information Center

    McManis Associates, Inc., Washington, DC.

    These appendixes to the final report of the evaluation of eight Law Enforcement Assistance Administration (LEAA)-funded courts training institutes contain individual case studies, survey instruments, a manual for conducting an ongoing evaluation, and a discussion of training and its evaluation. The twelve case studies presented in the first…

  13. [Clinical Practice Guidelines for Management of Schizophrenia: Evaluation Using AGREE II].

    PubMed

    de la Hoz Bradford, Ana María; Ávila, Mauricio J; Bohórquez Peñaranda, Adriana Patricia; García Valencia, Jenny; Arenas Borrero, Álvaro Enrique; Vélez Traslaviña, Ángela; Jaramillo González, Luis Eduardo; Gómez-Restrepo, Carlos

    2014-01-01

    Colombia is developing multiple national practice guidelines from a range of diseases. Clinical practice guidelines represent a very useful tool to be able to take decision over a patient care that is widely available for the clinician. In psychiatry there are a good number of international clinical guidelines for the treatment of schizophrenia nevertheless there is no article that evaluate them scientifically In the settings of developing a Colombian schizophrenia practice guideline, a systematic search was performed in multiple databases and the results were then evaluated by two trained persons. We present the results globally and by domains. We found 164 matches for possible guidelines. After screening 7 guidelines were evaluated with the AGREE II instrument. Globally and by the different domains, the National Institute for Health and Care Excellence (NICE) was the guideline that got the best score. From the guidelines that were reviewed, 4 were from Europe and only 2 were from Latin America. None of the guidelines used GRADE methodology for the recommendations. The diversity of the schizophrenia treatment guidelines does not allow an easy adoption of the recommendation by a psychiatrist in Colombia. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  14. Health-Related Quality of Life in Patients with MPS II.

    PubMed

    Needham, Mary; Packman, Wendy; Quinn, Natasha; Rappoport, Maxwell; Aoki, Christa; Bostrom, Alan; Cordova, Matthew; Macias, Sandra; Morgan, Cynthia; Packman, Seymour

    2015-08-01

    Mucopolysaccharidosis type II (MPS II), also known as Hunter syndrome, is a chronic and progressive X-linked lysosomal disease that mainly affects males. The National MPS Society (2013) reports that MPS II affects 1 in 100,000 to 1 in 150,000 males worldwide. Two distinct forms of the disease are based on age of onset and clinical course: attenuated and severe. MPS II affects many organ systems including the nervous, cardiovascular, gastrointestinal and respiratory systems. Clinical manifestations can include progressive hearing loss, mental impairment, and enlarged liver and spleen. This study focuses on the health-related quality of life of individuals (HRQOL) with MPS II as measured by the parent and self-report versions of the Pediatric Quality of Life Inventory (PedsQL™). Both parents of patients with MPS II as well as patients themselves reported lower scores on all domains of the PedsQL™ (physical, emotional, social and school functioning) indicating that children with MPS II have an overall lower HRQOL when compared to a healthy sample. When compared with patients with other chronic illnesses (cancer, MSUD, galactosemia,), the MPS II sample had significantly lower scores on a number of PedsQL™ scales, suggesting an overall lower HRQOL. No significant relationships were found using scores from parent or self report PedsQL™ measures and length of time on ERT.

  15. A framework and case studies for evaluation of enzyme ontogeny in children's health risk evaluation.

    PubMed

    Ginsberg, Gary; Vulimiri, Suryanarayana V; Lin, Yu-Sheng; Kancherla, Jayaram; Foos, Brenda; Sonawane, Babasaheb

    2017-01-01

    Knowledge of the ontogeny of Phase I and Phase II metabolizing enzymes may be used to inform children's vulnerability based upon likely differences in internal dose from xenobiotic exposure. This might provide a qualitative assessment of toxicokinetic (TK) variability and uncertainty pertinent to early lifestages and help scope a more quantitative physiologically based toxicokinetic (PBTK) assessment. Although much is known regarding the ontogeny of metabolizing systems, this is not commonly utilized in scoping and problem formulation stage of human health risk evaluation. A framework is proposed for introducing this information into problem formulation which combines data on enzyme ontogeny and chemical-specific TK to explore potential child/adult differences in internal dose and whether such metabolic differences may be important factors in risk evaluation. The framework is illustrated with five case study chemicals, including some which are data rich and provide proof of concept, while others are data poor. Case studies for toluene and chlorpyrifos indicate potentially important child/adult TK differences while scoping for acetaminophen suggests enzyme ontogeny is unlikely to increase early-life risks. Scoping for trichloroethylene and aromatic amines indicates numerous ways that enzyme ontogeny may affect internal dose which necessitates further evaluation. PBTK modeling is a critical and feasible next step to further evaluate child-adult differences in internal dose for a number of these chemicals.

  16. [Position of health at international relations. Part II. Organizational dimensions of health].

    PubMed

    Cianciara, Dorota; Wysocki, Mirosław J

    2011-01-01

    The aim of this article was: (1) the analysis of some concepts and definitions related with "set up of health", used in UN international arrangements; (2) an attempt to explain the evolution of organizational dimensions of health at worldwide agenda. The following organizational dimensions of health were discussed: (a) health for all, (b) health promotion, intersectoral and multisectoral actions, health in all policies, (c) health development, health as an element of human development, (d) investment for health, (e) health diplomacy and (f) mainstreaming of health. The analysis was based on World Health Assembly and UN General Assembly resolutions as well as supranational reports and statements available through conventional channels, not grey literature. It is apparent that some of notions are not in common use in Poland, some seems to be unknown. It was argued that some general and discreet thoughts and statements concerning organizational aspects of health were expressed in the preamble of WHO Constitution. Nevertheless they are not comparable with later propositions and proceedings. The first modern concepts and notions related as process were developed at late seventies. They originated from efforts to realize a vision of health for all and formulate national policies, strategies and plans of action for attaining this goal. The turning point was in 1981, when WHA adopted Global Strategy for Heath for All by the Year 2000. Since then one can observe considerable progress and new concepts came into existence, more and more precise and better reflecting the sense of health actions. The evolution of organizational dimensions of health was described in the context of brand positioning. It was assumed that first step of positioning was concentrated on structural dimensions of health. That served to awareness raise, attitudes change and motivation to action. That made a foundation to the next step--positioning based on process approach to health. Among others the

  17. Quinolones and non-steroidal anti-inflammatory drugs interacting with copper(II), nickel(II), cobalt(II) and zinc(II): structural features, biological evaluation and perspectives.

    PubMed

    Psomas, George; Kessissoglou, Dimitris P

    2013-05-14

    The structural features of copper(II), nickel(II), cobalt(II) and zinc(II) complexes with the antimicrobial drugs quinolones and non-steroidal anti-inflammatory drugs (NSAIDs) as ligands are discussed. The binding properties of these complexes to biomolecules (calf-thymus DNA, bovine or human serum albumin) are presented and evaluated. The biological activity (antimicrobial, antioxidant and antiproliferative) of selected complexes is investigated. Further perspectives concerning the synthesis and the biological activity of novel complexes with quinolones or NSAIDs attractive to synthetic chemists, biochemists and/or biologists are presented.

  18. Best practices in evaluating worksite health promotion programs.

    PubMed

    Grossmeier, Jessica; Terry, Paul E; Cipriotti, Aldo; Burtaine, Jeffrey E

    2010-01-01

    Program evaluation is generally recognized as a "best practice" activity for worksite health promotion programs. The importance of "best practice" worksite health promotion programming is increasing with the stakes anticipated by health care reform. Volvo's health promotion activities are used as an example of "best practice" programming with a particular focus on creating a dashboard of evaluation metrics that can meet the accountability needs of senior management. The role of a comprehensive evaluation framework using nine components is explored along with reasonable expectations for program outcomes. Finally, stakeholder utility from the evaluation approach is explored.

  19. Advancing oral health in physician assistant education: evaluation of an innovative interprofessional oral health curriculum.

    PubMed

    Bowser, Jonathan; Sivahop, Jacqueline; Glicken, Anita

    2013-01-01

    The impact of an oral health curriculum was evaluated by measuring increases in knowledge about oral health topics and implementation of oral health skills in the clinical year. A 3-year, longitudinal oral health curriculum was developed and implemented. Student knowledge of oral health concepts was evaluated before and 2 years after the curriculum was implemented. Student performance of oral health skills was evaluated in the clinical year by electronic patient logging. Students demonstrated significant and persistent gains in knowledge following the initiation of the curriculum. Students used oral health skills in the clinical year, particularly in the area of patient education about oral health. Incorporation of an oral health curriculum can lead to lasting knowledge about basic oral health concepts and increased performance of oral health skills in the clinical year.

  20. Design, synthesis and characterization of macrocyclic ligand based transition metal complexes of Ni(II), Cu(II) and Co(II) with their antimicrobial and antioxidant evaluation

    NASA Astrophysics Data System (ADS)

    Gull, Parveez; Malik, Manzoor Ahmad; Dar, Ovas Ahmad; Hashmi, Athar Adil

    2017-04-01

    Three new complexes Ni(II), Cu(II) and Co(II) were synthesized of macrocyclic ligand derived from 1, 4-dicarbonyl-phenyl-dihydrazide and O-phthalaldehyde in the ratio of 2:2. The synthesized compounds were characterized by elemental analyses, molar conductance, magnetic susceptibility measurements, FTIR, UV-Vis., Mass and 1H NMR spectral studies. The electronic spectra of the metal complexes indicate a six coordinate octahedral geometry of the central metal ion. These metal complexes and the ligand were evaluated for antimicrobial activity against bacteria (E. coli, B. subtilis, S. aureus) and fungi (A. niger, A. flavus, C. albicans) and compared against standard drugs chloramphenicol and nystatin respectively. In addition, the antioxidant activity of the compounds was also investigated through scavenging effect on DPPH radicals.

  1. Health and safety implications of alternative energy technologies. II. Solar

    NASA Astrophysics Data System (ADS)

    Etnier, E. L.; Watson, A. P.

    1981-09-01

    No energy technology is risk free when all aspects of its utilization are taken into account. Every energy technology has some attendant direct and indirect health and safety concerns. Solar technologies examined in this paper are wind, ocean thermal energy gradients, passive, photovoltaic, satellite power systems, low- and high-temperature collectors, and central power stations, as well as tidal power. For many of these technologies, insufficient historical data are available from which to assess the health risks and environmental impacts. However, their similarities to other projects make certain predictions possible. For example, anticipated problems in worker safety in constructing ocean thermal energy conversion systems will be similar to those associated with other large-scale construction projects, like deep-sea oil drilling platforms. Occupational hazards associated with photovoltaic plant operation would be those associated with normal electricity generation, although for workers involved in the actual production of photovoltaic materials, there is some concern for the toxic effects of the materials used, including silicon, cadmium, and gallium arsenide. Satellite power systems have several unique risks. These include the effects of long-term space travel for construction workers, effects on the ozone layer and the attendant risk of skin cancer in the general public, and the as-yet-undetermined effects of long-term, low-level microwave exposure. Hazards may arise from three sources in solar heating and cooling systems: water contamination from corrosion inhibitors, heat transfer fluids, and bactericides; collector over-heating, fires, and “out-gassing” and handling and disposal of system fluids and wastes. Similar concerns exist for solar thermal power systems. Even passive solar systems may increase indoor exposure levels to various air pollutants and toxic substances, eitherdirectly from the solar system itself or indirectly by trapping released

  2. Capitalizing on the characteristics of mHealth to evaluate its impact.

    PubMed

    Mechael, Patricia; Nemser, Bennett; Cosmaciuc, Roxana; Cole-Lewis, Heather; Ohemeng-Dapaah, Seth; Dusabe, Schadrack; Kaonga, Nadi Nina; Namakula, Patricia; Shemsanga, Muhadili; Burbach, Ryan; Kanter, Andrew S

    2012-01-01

    The field of mHealth has made significant advances in a short period of time, demanding a more thorough and scientific approach to understanding and evaluating its progress. A recent review of mHealth literature identified two primary research needs in order for mHealth to strengthen health systems and promote healthy behaviors, namely health outcomes and cost-benefits (Mechael et al., 2010 ). In direct response to the gaps identified in mHealth research, the aim of this paper is to present the study design and highlight key observations and next steps from an evaluation of the mHealth activities within the electronic health (eHealth) architecture implemented by the Millennium Villages Project (MVP) by leveraging data generated through mobile technology itself alongside complementary qualitative research and costing assessments. The study, funded by the International Development and Research Centre (IDRC) as part of the Open Architecture Standards and Information Systems research project (OASIS II) (Sinha, 2009 ), is being implemented on data generated by 14 MVP sites in 10 Sub-Saharan African countries including more in-depth research in Ghana, Rwanda, Tanzania, and Uganda. Specific components of the study include rigorous quantitative case-control analyses and other epidemiological approaches (such as survival analysis) supplemented by in-depth qualitative interviews spread out over 18 months, as well as a costing study to assess the impact of mHealth on health outcomes, service delivery, and efficiency.

  3. Adult day health care evaluation study: methodology and implementation. Adult Day Health Care Evaluation Development Group.

    PubMed Central

    Hedrick, S C; Rothman, M L; Chapko, M; Inui, T S; Kelly, J R; Ehreth, J

    1991-01-01

    The Adult Day Health Care Evaluation Study was developed in response to a congressional mandate to study the medical efficacy and cost effectiveness of the Adult Day Health Care (ADHC) effort in the Department of Veterans Affairs (VA). Four sites providing ADHC in VA facilities are participating in an ongoing randomized controlled trial. Three years of developmental work prior to the study addressed methodological issues that were problematic in previous studies. This developmental work resulted in the methodological approaches described here: (1) a patient recruitment process that actively recruits and screens all potential candidates using empirically developed admission criteria based on predictors of nursing home placement in VA; (2) the selection and development of measures of medical efficacy that assess a wide range of patient and caregiver outcomes with sufficient sensitivity to detect small but clinically important changes; and (3) methods for detailed, accurate, and efficient measurement of utilization and costs of health care within and outside VA. These approaches may be helpful to other researchers and may advance the methodological sophistication of long-term care program evaluation. PMID:1991678

  4. Health Evaluation of Experimental Laboratory Mice

    PubMed Central

    Burkholder, Tanya; Foltz, Charmaine; Karlsson, Eleanor; Linton, C Garry; Smith, Joanne M

    2012-01-01

    Good science and good animal care go hand in hand. A sick or distressed animal does not produce the reliable results that a healthy and unstressed animal produces. This unit describes the essentials of assessing mouse health, colony health surveillance, common conditions, and determination of appropriate endpoints. Understanding the health and well-being of the mice used in research enables the investigator to optimize research results and animal care. PMID:22822473

  5. Evaluating Integrated Mental Health Care Programs for Children and Youth.

    PubMed

    Wissow, Lawrence S; Brown, Jonathan D; Hilt, Robert J; Sarvet, Barry D

    2017-10-01

    Evaluations of integrated care programs share many characteristics of evaluations of other complex health system interventions. However, evaluating integrated care for child and adolescent mental health poses special challenges that stem from the broad range of social, emotional, and developmental problems that need to be addressed; the need to integrate care for other family members; and the lack of evidence-based interventions already adapted for primary care settings. Integrated care programs for children's mental health need to adapt and learn on the fly, so that evaluations may best be viewed through the lens of continuous quality improvement rather than evaluations of fixed programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Evaluating Efficacy and Validating Games for Health.

    PubMed

    Kato, Pamela M

    2012-02-01

    The field of games for health is growing rapidly, but many games for health are not validated for their use as a tool to improve outcomes. The few research studies that do exist are often poorly designed, and their conclusions cannot be considered valid evidence to support or refute efficacy. Based on lessons learned from the field of digital game-based learning in education and recent efforts to systematically review games for health in meta-analyses, guidelines are suggested for conducting high-quality efficacy studies on games for health.

  7. A health literacy and usability heuristic evaluation of a mobile consumer health application.

    PubMed

    Monkman, Helen; Kushniruk, Andre

    2013-01-01

    Usability and health literacy are two critical factors in the design and evaluation of consumer health information systems. However, methods for evaluating these two factors in conjunction remain limited. This study adapted a set of existing guidelines for the design of consumer health Web sites into evidence-based evaluation heuristics tailored specifically for mobile consumer health applications. In order to test the approach, a mobile consumer health application (app) was then evaluated using these heuristics. In addition to revealing ways to improve the usability of the system, this analysis identified opportunities to augment the content to make it more understandable by users with limited health literacy. This study successfully demonstrated the utility of converting existing design guidelines into heuristics for the evaluation of usability and health literacy. The heuristics generated could be applied for assessing and revising other existing consumer health information systems.

  8. FEMORAL NECK FRACTURES GARDEN I AND II: EVALUATION OF THE DEVIATION IN LATERAL VIEW.

    PubMed

    Leonhardt, Natália Zalc; Melo, Lucas da Ponte; Nordon, David Gonçalves; Silva, Fernando Brandão de Andrade E; Kojima, Kodi Edson; Silva, Jorge Santos

    2017-01-01

    To evaluate the rate of deviation in the lateral radiographic incidence in patients with femoral neck fracture classified as non-diverted in the anteroposterior view (Garden I and II). Nineteen selected patients with femoral neck fractures classified as Garden I and II were retrospectively evaluated, estimating the degree of deviation in the lateral view. Fifteen cases (79%) presented deviations in lateral view, with a mean of 18.6 degrees (±15.5). Most fractures of the femoral neck classified as Garden I and II present some degree of posterior deviation in the X-ray lateral view. Level of Evidence III, Retrospective Comparative Study.

  9. Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature

    PubMed Central

    van den Putte, Bas; Giani, Stefano; van Weert, Julia CM

    2015-01-01

    Background Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. Objective The main aim of this study was to review existing evidence on the association between low health literacy and (1) people’s ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Methods Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. Results After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. Conclusions The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly

  10. Low health literacy and evaluation of online health information: a systematic review of the literature.

    PubMed

    Diviani, Nicola; van den Putte, Bas; Giani, Stefano; van Weert, Julia Cm

    2015-05-07

    Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review

  11. Rhode Island Model Evaluation & Support System: Support Professional. Edition II

    ERIC Educational Resources Information Center

    Rhode Island Department of Education, 2015

    2015-01-01

    Rhode Island educators believe that implementing a fair, accurate, and meaningful evaluation and support system for support professionals will help improve student outcomes. The primary purpose of the Rhode Island Model Support Professional Evaluation and Support System (Rhode Island Model) is to help all support professionals do their best work…

  12. Managing the care of health and the cure of disease--Part II: Integration.

    PubMed

    Glouberman, S; Mintzberg, H

    2001-01-01

    The development of appropriate levels of integration in the system of health care and disease cure will require stronger collective cultures and enhanced communication among the key actors. Part II of this paper uses this line of argument to reframe four major issues in this system: coordination of acute cure and of community care, and collaboration in institutions and in the system at large.

  13. Physical and Psychological Health in Persons with Deafblindness that Is due to Usher Syndrome Type II

    ERIC Educational Resources Information Center

    Wahlqvist, Moa; Moller, Claes; Moller, Kerstin; Danermark, Berth

    2013-01-01

    Introduction: The objectives of the study reported here were to describe the physical and psychological health of persons with Usher syndrome Type II (USH2) and to explore any differences in terms of gender. Methods: The participants were recruited from the Swedish Usher database. In the first step, 122 persons received the questionnaire by mail,…

  14. Further considerations on the evaluation of potential reduced-risk tobacco products. Part II: Re-assessment of a heuristic using the CPS-II database.

    PubMed

    Murrelle, Lenn; Coggins, Christopher R E; Gennings, Chris; Carchman, Richard A; Lee, Peter N; Zedler, Barbara K; Heidbreder, Christian

    2010-06-01

    In a previous analysis (see Part I) we proposed a heuristic for assessing the efficacy of potential reduced-risk tobacco products (PRRPs) on lung cancer (LC) rates, using smoking cessation data published in a report from the Iowa Women's Health Study (IWHS) as a basis for sample size estimates. In this study, an additional analysis was performed using cessation data from the much larger Cancer Prevention Study II (CPS-II), which also provides data on different durations of cessation. Statistical methods were used to assess whether smokers switching to a PRRP would reduce their risk of LC. Furthermore, non-inferiority tests compared the LC risk in switchers to that in smokers who had quit smoking. The present work shows that similar sample size estimates were obtained whether the analysis was based on the IWHS or the CPS-II data sets, suggesting that the heuristic may be generally applicable to prospective real-life studies to evaluate PRRPs. Non-inferiority testing of switchers compared with quitters required approximately 10-fold more subjects than did superiority testing of switchers compared with smokers. Altogether, these estimates indicate that it is feasible, in terms of study duration and sample size, to clinically assess the LC risk-reducing potential of a PRRP.

  15. Report on the Intermediate Evaluation Project--Phase II.

    ERIC Educational Resources Information Center

    1978

    A series of tests was administered to Ontario, Canada students who had completed the eighth grade: mathematics, reading, language, written English, social studies, science, health, physical fitness, French as a second language, French as a first language, written French, values, moral reasoning, problem solving, and attitudes. Approximately 50…

  16. Synthesis, spectral characterization and biological evaluation of Mn(II), Co(II), Ni(II), Cu(II), Zn(II) and Cd(II) complexes with thiosemicarbazone ending by pyrazole and pyridyl rings

    NASA Astrophysics Data System (ADS)

    Yousef, T. A.; Abu El-Reash, G. M.; Al-Jahdali, M.; El-Rakhawy, El-Bastawesy R.

    2014-08-01

    Here we present the synthesis of the new Mn(II), Co(II), Ni(II), Cu(II), Zn(II) and Cd(II) complexes with chelating ligand (Z)-(2-((1,3-diphenyl-1H-pyrazol-4-yl)methylene) hydrazinyl)(pyridin-2-ylamino)methanethiol. All the complexes were characterized by elemental analysis, IR, 1H NMR, UV-vis, magnetic susceptibility measurements and EPR spectral studies. IR spectra of complexes showed that the ligand behaves as NN neutral bidentate, NSN mononegative tridentate and NSNN mononegative tetradentate. The electronic spectra and the magnetic measurements suggested the octahedral geometry for all complexes as well as the EPR confirmed the tetragonal distorted octahedral for Cu(II) complex. Cd(II) complex showed the highest inhibitory antioxidant activity either using ABTS method. The SOD-like activity exhibited those Cd(II) and Zn(II) complexes have strong antioxidative properties. We tested the synthesized compounds for antitumor activity and showed that the ability to kill liver (HePG2) and breast (MCF-7) cancer cells definitely.

  17. Monitoring 'monitoring' and evaluating 'evaluation': an ethical framework for monitoring and evaluation in public health.

    PubMed

    Gopichandran, Vijayaprasad; Indira Krishna, Anil Kumar

    2013-01-01

    Monitoring and evaluation (M&E) is an essential part of public health programmes. Since M&E is the backbone of public health programmes, ethical considerations are important in their conduct. Some of the key ethical considerations are avoiding conflicts of interest, maintaining independence of judgement, maintaining fairness, transparency, full disclosure, privacy and confidentiality, respect, responsibility, accountability, empowerment and sustainability. There are several ethical frameworks in public health, but none focusing on the monitoring and evaluation process. There is a need to institutionalise the ethical review of M&E proposals. A theoretical framework for ethical considerations is proposed in this paper. This proposed theoretical framework can act as the blueprint for building the capacity of ethics committees to review M&E proposals. A case study is discussed in this context. After thorough field testing, this practical and field-based ethical framework can be widely used by donor agencies, M&E teams, institutional review boards and ethics committees.

  18. Building a Partnership to Evaluate School-Linked Health Services: The Cincinnati School Health Demonstration Project

    ERIC Educational Resources Information Center

    Rose, Barbara L.; Mansour, Mona; Kohake, Kelli

    2005-01-01

    The Cincinnati School Health Demonstration Project was a 3-year collaboration that evaluated school-linked health services in 6 urban elementary (kindergarten to eighth grade) schools. Partners from the Cincinnati Health Department, Cincinnati Public Schools, Cincinnati Children's Hospital Medical Center, and The Health Foundation of Greater…

  19. Building a Partnership to Evaluate School-Linked Health Services: The Cincinnati School Health Demonstration Project

    ERIC Educational Resources Information Center

    Rose, Barbara L.; Mansour, Mona; Kohake, Kelli

    2005-01-01

    The Cincinnati School Health Demonstration Project was a 3-year collaboration that evaluated school-linked health services in 6 urban elementary (kindergarten to eighth grade) schools. Partners from the Cincinnati Health Department, Cincinnati Public Schools, Cincinnati Children's Hospital Medical Center, and The Health Foundation of Greater…

  20. Understanding Evaluation Training in Schools and Programs of Public Health

    ERIC Educational Resources Information Center

    Fierro, Leslie A.; Christie, Christina A.

    2011-01-01

    This study provides an understanding of how the coursework required for attaining a Masters of Public Health (MPH) degree in epidemiology or health education from accredited schools or programs of public health prepares students to evaluate programs or interventions. Study data were generated using a content analysis of required coursework…

  1. Understanding Evaluation Training in Schools and Programs of Public Health

    ERIC Educational Resources Information Center

    Fierro, Leslie A.; Christie, Christina A.

    2011-01-01

    This study provides an understanding of how the coursework required for attaining a Masters of Public Health (MPH) degree in epidemiology or health education from accredited schools or programs of public health prepares students to evaluate programs or interventions. Study data were generated using a content analysis of required coursework…

  2. EBR-II Primary Tank Wash-Water Alternatives Evaluation

    SciTech Connect

    Demmer, R. L.; Heintzelman, J. B.; Merservey, R. H.; Squires, L. N.

    2008-05-01

    The EBR-II reactor at Idaho National Laboratory was a liquid sodium metal cooled reactor that operated for 30 years. It was shut down in 1994; the fuel was removed by 1996; and the bulk of sodium metal coolant was removed from the reactor by 2001. Approximately 1100 kg of residual sodium remained in the primary system after draining the bulk sodium. To stabilize the remaining sodium, both the primary and secondary systems were treated with a purge of moist carbon dioxide. Most of the residual sodium reacted with the carbon dioxide and water vapor to form a passivation layer of primarily sodium bicarbonate. The passivation treatment was stopped in 2005 and the primary system is maintained under a blanket of dry carbon dioxide. Approximately 670 kg of sodium metal remains in the primary system in locations that were inaccessible to passivation treatment or in pools of sodium that were too deep for complete penetration of the passivation treatment. The EBR-II reactor was permitted by the Idaho Department of Environmental Quality (DEQ) in 2002 under a RCRA permit that requires removal of all remaining sodium in the primary and secondary systems by 2022. The proposed baseline closure method would remove the large components from the primary tank, fill the primary system with water, react the remaining sodium with the water and dissolve the reaction products in the wash water. This method would generate a minimum of 100,000 gallons of caustic, liquid, low level radioactive, hazardous waste water that must be disposed of in a permitted facility. On February 19-20, 2008, a workshop was held in Idaho Falls, Idaho, to look at alternatives that could meet the RCRA permit clean closure requirements and minimize the quantity of hazardous waste generated by the cleanup process. The workshop convened a panel of national and international sodium cleanup specialists, subject matter experts from the INL, and the EBR-II Wash Water Project team that organized the workshop. The

  3. Coded Statutory Data Sets for Evaluation of Public Health Law

    ERIC Educational Resources Information Center

    Costich, Julia Field

    2012-01-01

    Background and objectives: The evaluation of public health law requires reliable accounts of underlying statutes and regulations. States often enact public health-related statutes with nonuniform provisions, and variation in the structure of state legal codes can foster inaccuracy in evaluating the impact of specific categories of law. The optimal…

  4. Meta-Evaluation of Worksite Health Promotion Economic Return Studies.

    ERIC Educational Resources Information Center

    Chapman, Larry S.

    2003-01-01

    This meta-evaluation provides a standardized look at the quality of the economic evaluation literature for multi-component worksite health promotion programs. Analysis of 42 studies suggests that the evidence is very strong for average reductions in sick leave, health plan costs, and workers' compensation and disability costs of slightly more than…

  5. Coded Statutory Data Sets for Evaluation of Public Health Law

    ERIC Educational Resources Information Center

    Costich, Julia Field

    2012-01-01

    Background and objectives: The evaluation of public health law requires reliable accounts of underlying statutes and regulations. States often enact public health-related statutes with nonuniform provisions, and variation in the structure of state legal codes can foster inaccuracy in evaluating the impact of specific categories of law. The optimal…

  6. Quality and Evaluation in a Comprehensive Health Organization.

    ERIC Educational Resources Information Center

    Anderson, Malcolm; Brazil, Kevin

    1995-01-01

    An innovative approach to delivering health care is being developed in several Ontario (Canada) communities. This report describes the initial framework for quality and evaluation for a comprehensive health organization (CHO). As CHOs become operational, there is great opportunity to develop a comprehensive approach to quality and evaluation. (SLD)

  7. Evaluating web sites: reliable child health resources for parents.

    PubMed

    Golterman, Linda; Banasiak, Nancy C

    2011-01-01

    This article describes a framework for evaluating the quality of health care information on the Internet and identifies strategies for accessing reliable child health resources. A number of methods are reviewed, including how to evaluate Web sites for quality using the Health Information Technology Institute evaluation criteria, how to identify trustworthy Web sites accredited by Health On the Net Foundation Code of Conduct, and the use of portals to access prescreened Web sites by organizations, such as the Medical Library Association. Pediatric nurses can use one or all of these strategies to develop a list of reliable Web sites as a supplement to patient and family teaching.

  8. Participation in planning and evaluating mental health services: building capacity.

    PubMed

    Restall, Gayle; Strutt, Carolyn

    2008-01-01

    The participation of people who use mental health services in service planning and evaluation has become increasingly important in recent years. Health planners and people who use services are seeking information about how to enable participation that is meaningful and impacts positively on service delivery. This qualitative study explored the perspectives of people who use mental health services on participation in mental health service planning and evaluation. Sixty-three people from diverse backgrounds participated in either a focus group or interview. Themes were extracted from the data and resulted in a conceptual framework that can be used to guide the development and evaluation of participation.

  9. Training Effectiveness Assessment. Volume II. Problems, Concepts, and Evaluation Alternatives.

    DTIC Science & Technology

    1976-12-01

    arize train i ng mana gers and poter t iai training evaluators wit h the general requ i rements and procedures for ma~ing suchassessments . EVALUATION...Performance Te stin A Practical Guide for Test Makers. January 1971 . Educationa Testing Service , Princeton , NJ. Harris , J . H., Campbell , R. C...1970. American Institutes for Research , P i tts bur gh , PA. pp. 48-66. Harris , C. (Ed.) Problems in Measuring Change. 1963. Univers ity of Wi

  10. Rethinking Evaluations of Health Equity Initiatives: an introduction to the special issue.

    PubMed

    Sridharan, Sanjeev; Tannahill, Carol

    2013-02-01

    This paper is an introduction to a special issue on "Re-thinking Evaluations of Health Equity Initiatives." The papers in this volume aim to build understanding of how evaluations can contribute to addressing inequities and how evaluation design can develop a better understanding and also better respond to: (i) policy maker and practitioner needs; (ii) the systemic and complex nature of the interventions necessary to impact inequities; (iii) an understanding of the processes that generate inequities. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Leadership for health improvement--implementation and evaluation.

    PubMed

    Carr, Susan M; Carr, Sue; Lhussier, Monique; Reynolds, Joanna; Hunter, David J; Hannaway, Catherine

    2009-01-01

    The purpose of this paper is to present a co-authored reflection on the health improvement leadership development programme and the key evaluation messages derived from piloting in an English National Health Service region. It highlights the specific attributes of this approach to health improvement leadership development and clarifies health improvement development issues. Appreciative inquiry and soft systems methodology are combined in an evaluation approach designed to capture individual as well as organisation learning and how it impacts on leadership in specific contexts. The evaluation exposes the health improvement leadership needs of a multi-organisation cohort, offers some explanations for successful achievement of learning needs while also exposing of the challenges and paradoxes faced in this endeavour. There are limited reported templates of how to develop leadership for health improvement. This paper details a whole systems approach, acknowledging the impact of context on leadership and an approach to evaluating such complex initiatives.

  12. Evaluation of Telephone Health Coaching of German Health Insurants with Chronic Conditions

    ERIC Educational Resources Information Center

    Härter, Martin; Dwinger, Sarah; Seebauer, Laura; Simon, Daniela; Herbarth, Lutz; Siegmund-Schultze, Elisabeth; Temmert, Daniel; Bermejo, Isaac; Dirmaier, Jörg

    2013-01-01

    Objective: This study aimed to investigate how patients with chronic conditions evaluate telephone health coaching provided by their health insurance company. Methods: A retrospective survey was conducted among coaching participants ("n" = 834). Outcomes included the general evaluation of the coaching, the evaluation of process and…

  13. Evaluation of Telephone Health Coaching of German Health Insurants with Chronic Conditions

    ERIC Educational Resources Information Center

    Härter, Martin; Dwinger, Sarah; Seebauer, Laura; Simon, Daniela; Herbarth, Lutz; Siegmund-Schultze, Elisabeth; Temmert, Daniel; Bermejo, Isaac; Dirmaier, Jörg

    2013-01-01

    Objective: This study aimed to investigate how patients with chronic conditions evaluate telephone health coaching provided by their health insurance company. Methods: A retrospective survey was conducted among coaching participants ("n" = 834). Outcomes included the general evaluation of the coaching, the evaluation of process and…

  14. A Framework for Including Family Health Spillovers in Economic Evaluation

    PubMed Central

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-01-01

    Health care interventions may affect the health of patients’ family networks. It has been suggested that these “health spillovers” should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the “health care perspective”). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society. PMID:26377370

  15. Health effects of war stress on Norwegian World War II resistance groups: a comparative study.

    PubMed

    Major, Ellinor F

    2003-12-01

    The main aim of this study was to investigate the extent to which adverse long-term health effects of World War II stress exposure were present in 3 groups of resistance veterans. The groups had been exposed to different types of war stressors: concentration camp incarceration, resistance participation within the illegal press, and a secret military organization. With the differences in war stressors as a basis, we assumed that those incarcerated in a concentration camp would display more adverse health effect compared to the resistance veterans. The findings point to a relationship between the severity of war stressors and postwar health in all 3 groups.

  16. Urban sprawl, physical activity, and body mass index: Nurses' Health Study and Nurses' Health Study II.

    PubMed

    James, Peter; Troped, Philip J; Hart, Jaime E; Joshu, Corinne E; Colditz, Graham A; Brownson, Ross C; Ewing, Reid; Laden, Francine

    2013-02-01

    We evaluated the association between the county sprawl index, a measure of residential density and street accessibility, and physical activity and body mass index (BMI). We conducted a multilevel cross-sectional analysis in a sample of Nurses' Health Study participants living throughout the United States in 2000 to 2001 (n = 136 592). In analyses adjusted for age, smoking status, race, and husband's education, a 1-SD (25.7) increase in the county sprawl index (indicating a denser, more compact county) was associated with a 0.13 kilograms per meters squared (95% confidence interval [CI] = -0.18, -0.07) lower BMI and 0.41 (95% CI = 0.17, 0.65) more metabolic equivalent (MET) hours per week of total physical activity, 0.26 (95% CI = 0.19, 0.33) more MET hours per week of walking, and 0.47 (95% CI = 0.34, 0.59) more MET hours per week of walking, bicycling, jogging, and running. We detected potential effect modification for age, previous disease status, husband's education level (a proxy for socioeconomic status), and race. Our results suggest that living in a dense, compact county may be conducive to higher levels of physical activity and lower BMI in women.

  17. Urban Sprawl, Physical Activity, and Body Mass Index: Nurses’ Health Study and Nurses’ Health Study II

    PubMed Central

    Troped, Philip J.; Hart, Jaime E.; Joshu, Corinne E.; Colditz, Graham A.; Brownson, Ross C.; Ewing, Reid; Laden, Francine

    2013-01-01

    Objectives. We evaluated the association between the county sprawl index, a measure of residential density and street accessibility, and physical activity and body mass index (BMI). Methods. We conducted a multilevel cross-sectional analysis in a sample of Nurses’ Health Study participants living throughout the United States in 2000 to 2001 (n = 136 592). Results. In analyses adjusted for age, smoking status, race, and husband’s education, a 1-SD (25.7) increase in the county sprawl index (indicating a denser, more compact county) was associated with a 0.13 kilograms per meters squared (95% confidence interval [CI] = −0.18, −0.07) lower BMI and 0.41 (95% CI = 0.17, 0.65) more metabolic equivalent (MET) hours per week of total physical activity, 0.26 (95% CI = 0.19, 0.33) more MET hours per week of walking, and 0.47 (95% CI = 0.34, 0.59) more MET hours per week of walking, bicycling, jogging, and running. We detected potential effect modification for age, previous disease status, husband’s education level (a proxy for socioeconomic status), and race. Conclusions. Our results suggest that living in a dense, compact county may be conducive to higher levels of physical activity and lower BMI in women. PMID:22698015

  18. A complex postnatal mental health intervention: Australian translational formative evaluation.

    PubMed

    Rowe, Heather J; Wynter, Karen H; Burns, Joanna K; Fisher, Jane R W

    2016-01-07

    Reducing the burden of postnatal maternal mental health problems is an international public health priority. We developed What Were We Thinking (WWWT), a psychoeducation programme for primary postnatal health care that addresses known but neglected risks. We then demonstrated evidence of its effects in a before-and-after controlled study in preventing maternal postnatal mental health problems among women without a psychiatric history participating in the intervention compared to usual care (AOR 0.43; 95% CI 0.21, 0.89) when conducted by specialist nurses. Testing its effectiveness when implemented in routine primary care requires changes at practitioner, organizational and health system levels. This paper describes a programme of translational formative evaluation to inform the protocol for a cluster RCT. Following the UK Medical Research Council (MRC) Guidance for evaluating complex interventions, we conducted a translational formative evaluation using mixed methods. Collection and analysis of postnatal health service documents, semi-structured interviews, group discussions and an online survey were used to investigate service provision, consumers' needs and expectations, clinicians' attitudes and clinical practice, and the implications for health service delivery. Participants were expectant parents, health care providers, health service managers and government policy makers. Results documented current clinical practice, staff training needs, necessary service modifications to standardize advice to parents and include fathers, key priorities and drivers of government health policy, and informed a model of costs and expected health and social outcomes. Implementation of WWWT into routine postnatal care requires adjustments to clinical practice. Staff training, modifications to service opening hours and economic implications for the health system also need to be considered. The MRC Guidance for developing and evaluating complex interventions is a useful framework

  19. Quantitative analysis of topoisomerase II{alpha} to rapidly evaluate cell proliferation in brain tumors

    SciTech Connect

    Oda, Masashi; Arakawa, Yoshiki; Kano, Hideyuki; Kawabata, Yasuhiro; Katsuki, Takahisa; Shirahata, Mitsuaki; Ono, Makoto; Yamana, Norikazu; Hashimoto, Nobuo; Takahashi, Jun A. . E-mail: jat@kuhp.kyoto-u.ac.jp

    2005-06-17

    Immunohistochemical cell proliferation analyses have come into wide use for evaluation of tumor malignancy. Topoisomerase II{alpha} (topo II{alpha}), an essential nuclear enzyme, has been known to have cell cycle coupled expression. We here show the usefulness of quantitative analysis of topo II{alpha} mRNA to rapidly evaluate cell proliferation in brain tumors. A protocol to quantify topo II{alpha} mRNA was developed with a real-time RT-PCR. It took only 3 h to quantify from a specimen. A total of 28 brain tumors were analyzed, and the level of topo II{alpha} mRNA was significantly correlated with its immuno-staining index (p < 0.0001, r = 0.9077). Furthermore, it sharply detected that topo II{alpha} mRNA decreased in growth-inhibited glioma cell. These results support that topo II{alpha} mRNA may be a good and rapid indicator to evaluate cell proliferate potential in brain tumors.

  20. The Long Reach of Childhood Health and Circumstance: Evidence from the Whitehall II Study. NBER Working Paper No. 15640

    ERIC Educational Resources Information Center

    Case, Anne; Paxson, Christina

    2010-01-01

    We use data from the Whitehall II study to examine the potential role played by early-life health and circumstances in determining health and employment status in middle and older ages. The population from which the Whitehall II cohort was drawn consisted almost exclusively of white collar civil servants. We demonstrate that estimates of the…

  1. The Long Reach of Childhood Health and Circumstance: Evidence from the Whitehall II Study. NBER Working Paper No. 15640

    ERIC Educational Resources Information Center

    Case, Anne; Paxson, Christina

    2010-01-01

    We use data from the Whitehall II study to examine the potential role played by early-life health and circumstances in determining health and employment status in middle and older ages. The population from which the Whitehall II cohort was drawn consisted almost exclusively of white collar civil servants. We demonstrate that estimates of the…

  2. [Spanish version of the new World Health Organization Disability Assessment Schedule II (WHO-DAS-II): initial phase of development and pilot study. Cantabria disability work group].

    PubMed

    Vázquez-Barquero, J L; Vázquez Bourgón, E; Herrera Castanedo, S; Saiz, J; Uriarte, M; Morales, F; Gaite, L; Herrán, A; Ustün, T B

    2000-01-01

    The aim of the present paper is to present the initial phases of the development of the Spanish version of the "World Health Organization Disablement Assessment Schedule II" WHO-DAS-II and also to describe the quantitative and qualitative methodological strategies used in the elaboration process of an instrument: i) compatible with the new International Classification of Functioning and Disability -ICIDH-2- of the World Health Organisation; ii) with criteria of cross-cultural applicability and; iii) to allow us to assess the disability in all its dimensions.

  3. A plea for a discipline of health and medical evaluation.

    PubMed

    Henderson, M M; Meinert, C L

    1975-03-01

    There is an expanding need for quantitative information to evaluate health and medical care procedures. Existing methods for designing and carrying out evaluation studies need to be improved to provide better techniques for answering questions on efficacy of health and medical procedures, and in providing a more adequate information base on which to set healthy policy. This paper reviews some of the problems in the design and conduct of evaluation research, and makes a plea for creation of a special discipline to support and develop the field of health and medical care evaluation.

  4. Narrowing the gap between medical and mental health evaluation.

    PubMed

    Linn, M W; Linn, S B

    1975-07-01

    Some of the problems facing evaluators of medical care have been dealt with by individuals examining mental health programs. Mental health research has focused more on outcome studies that include a multidimensional approach in evaluation. Techniques have been devised in that field that make the evaluative process patient specific and goal oriented. Borrowing some of these methods to make medical care evaluation include a problem-oriented outcome, which incorporates patient satisfaction, compliance with medical therapy, and relief of symptoms, could lead to more accurate data on the health delivery system.

  5. An evaluation of mobile health application tools.

    PubMed

    Sama, Preethi R; Eapen, Zubin J; Weinfurt, Kevin P; Shah, Bimal R; Schulman, Kevin A

    2014-05-01

    The rapid growth in the number of mobile health applications could have profound significance in the prevention of disease or in the treatment of patients with chronic disease such as diabetes. The objective of this study was to describe the characteristics of the most common mobile health care applications available in the Apple iTunes marketplace. We undertook a descriptive analysis of a sample of applications in the "health and wellness" category of the Apple iTunes Store. We characterized each application in terms of its health factor and primary method of user engagement. The main outcome measures of the analysis were price, health factors, and methods of user engagement. Among the 400 applications that met the inclusion criteria, the mean price of the most frequently downloaded paid applications was US $2.24 (SD $1.30), and the mean price of the most currently available paid applications was US $2.27 (SD $1.60). Fitness/training applications were the most popular (43.5%, 174/400). The next two most common categories were health resource (15.0%, 60/400) and diet/caloric intake (14.3%, 57/400). Applications in the health resource category constituted 5.5% (22/400) of the applications reviewed. Self-monitoring was the most common primary user engagement method (74.8%, 299/400). A total of 20.8% (83/400) of the applications used two or more user engagement approaches, with self-monitoring and progress tracking being the most frequent. Most of the popular mobile health applications focus on fitness and self-monitoring. The approaches to user engagement utilized by these applications are limited and present an opportunity to improve the effectiveness of the technology.

  6. Importance of Economic Evaluation in Health Care: An Indian Perspective.

    PubMed

    Dang, Amit; Likhar, Nishkarsh; Alok, Utkarsh

    2016-05-01

    Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems.

  7. Evaluating complex community-based health promotion: addressing the challenges.

    PubMed

    Jolley, Gwyneth

    2014-08-01

    Community-based health promotion is poorly theorised and lacks an agreed evidence-base. This paper examines characteristics of community-based health promotion and the challenges they present to evaluation. A review of health promotion evaluation leads to an exploration of more recent approaches, drawing on ideas from complexity theory and developmental evaluation. A reflexive analysis of three program evaluations previously undertaken as an evaluation consultant is used to develop a conceptual model to help in the design and conduct of health promotion evaluation. The model is further explored by applying it retrospectively to one evaluation. Findings suggest that the context-contingent nature of health promotion programs; turbulence in the community context and players; multiple stakeholders, goals and strategies; and uncertainty of outcomes all contribute to the complexity of interventions. Bringing together insights from developmental evaluation and complexity theory can help to address some evaluation challenges. The proposed model emphasises recognising and responding to changing contexts and emerging outcomes, providing rapid feedback and facilitating reflexive practice. This will enable the evaluator to gain a better understanding of the influence of context and other implementation factors in a complex setting. Use of the model should contribute to building cumulative evidence and knowledge in order to identify the principles of health promotion effectiveness that may be transferable to new situations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. [Health economic evaluation reporting guideline and application status].

    PubMed

    Xiao, J; Sun, J F; Wang, Q Q; Qi, X; Yao, H Y

    2017-03-06

    Using the guidelines of health economic evaluation reporting is conducive to regulating the contents of this reporting, improving the quality of studies into health economics evaluation. This article summarized the history of the guidelines and specified the instrument used to study " Quality of Health Economic Studies (QHES)" and the checklist about Consolidated Health Economics Evaluation Reporting Standards (CHEERS)-the two specific evaluation contents in this guideline, the article also introduced its present application status of the guideline and its pros and cons. The checklist of CHEERS emphasized the evaluation of this report, while QHES instrument focused on quantitative evaluation on the quality of economic studies. Despite different emphasis, the two guides are actually mutually complemented.

  9. [Application of multilevel models in the evaluation of bioequivalence (II).].

    PubMed

    Liu, Qiao-lan; Shen, Zhuo-zhi; Li, Xiao-song; Chen, Feng; Yang, Min

    2010-03-01

    The main purpose of this paper is to explore the applicability of multivariate multilevel models for bioequivalence evaluation. Using an example of a 4 x 4 cross-over test design in evaluating bioequivalence of homemade and imported rosiglitazone maleate tablets, this paper illustrated the multivariate-model-based method for partitioning total variances of ln(AUC) and ln(C(max)) in the framework of multilevel models. It examined the feasibility of multivariate multilevel models in directly evaluating average bioequivalence (ABE), population bioequivalence (PBE) and individual bioequivalence (IBE). Taking into account the correlation between ln(AUC) and ln(C(max)) of rosiglitazone maleate tablets, the proposed models suggested no statistical difference between the two effect measures in their ABE bioequivalence via joint tests, whilst a contradictive conclusion was derived based on univariate multilevel models. Furthermore, the PBE and IBE for both ln(AUC) and ln(C(max)) of the two types of tablets were assessed with no statistical difference based on estimates of variance components from the proposed models. Multivariate multilevel models could be used to analyze bioequivalence of multiple effect measures simultaneously and they provided a new way of statistical analysis to evaluate bioequivalence.

  10. A prevention and management aid. Evaluation of the Nimbus II mattress.

    PubMed

    Dealey, C

    1994-09-01

    1. Pressure relief is an important aspect of pressure sore prevention. 2. There are insufficient controlled clinical trials of the many pressure-relieving products available for use. 3. Clinical evaluations of new products can elicit useful information. 4. Evaluation of the Nimbus II Dynamic Flotation System found it to be useful in pressure sore prevention and management.

  11. Project Care Phase II: A Case Study in the Evaluation of Communication and Learning Materials.

    ERIC Educational Resources Information Center

    Williams, Frederick; And Others

    Phase II was a field evaluation of a communication and learning system package of films, simulation games, discussion questions, and posters designed to promote career awareness in junior high school children. It was proposed that this evaluation serves as a prototype for the assessment of the effects of learning systems on the affective and…

  12. A Comparison of Two Methods for Evaluating Primary Class II Cavity Preparations.

    ERIC Educational Resources Information Center

    Goepferd, Stephen J.; Kerber, Paul E.

    1980-01-01

    A study of an analytical system for evaluating class II cavity preparations in primary teeth was developed, tested, and compared with the traditional global evaluation method with respect to intraexaminer and interexaminer reliability. Interexaminer reliability was improved with the analytical system. (Author/MLW)

  13. Chapter I, Chapter II, And State Compensatory Education Program Evaluations, 1983-84.

    ERIC Educational Resources Information Center

    Wallace, Sherry; And Others

    This report contains administrative summaries for program evaluations of these 11 1983-84 Chapter I, Chapter II, and state compensatory education programs in the Fort Worth Independent School District, Texas. The programs evaluated are the Elementary Resource Teacher/Aide Program; the Chapter I Parochial Reading and Mathematics Program; the…

  14. Connected-Health Algorithm: Development and Evaluation.

    PubMed

    Vlahu-Gjorgievska, Elena; Koceski, Saso; Kulev, Igor; Trajkovik, Vladimir

    2016-04-01

    Nowadays, there is a growing interest towards the adoption of novel ICT technologies in the field of medical monitoring and personal health care systems. This paper proposes design of a connected health algorithm inspired from social computing paradigm. The purpose of the algorithm is to give a recommendation for performing a specific activity that will improve user's health, based on his health condition and set of knowledge derived from the history of the user and users with similar attitudes to him. The algorithm could help users to have bigger confidence in choosing their physical activities that will improve their health. The proposed algorithm has been experimentally validated using real data collected from a community of 1000 active users. The results showed that the recommended physical activity, contributed towards weight loss of at least 0.5 kg, is found in the first half of the ordered list of recommendations, generated by the algorithm, with the probability > 0.6 with 1 % level of significance.

  15. Frameworks for evaluating health research capacity strengthening: a qualitative study.

    PubMed

    Boyd, Alan; Cole, Donald C; Cho, Dan-Bi; Aslanyan, Garry; Bates, Imelda

    2013-12-14

    Health research capacity strengthening (RCS) projects are often complex and hard to evaluate. In order to inform health RCS evaluation efforts, we aimed to describe and compare key characteristics of existing health RCS evaluation frameworks: their process of development, purpose, target users, structure, content and coverage of important evaluation issues. A secondary objective was to explore what use had been made of the ESSENCE framework, which attempts to address one such issue: harmonising the evaluation requirements of different funders. We identified and analysed health RCS evaluation frameworks published by seven funding agencies between 2004 and 2012, using a mixed methods approach involving structured qualitative analyses of documents, a stakeholder survey and consultations with key contacts in health RCS funding agencies. The frameworks were intended for use predominantly by the organisations themselves, and most were oriented primarily towards funders' internal organisational performance requirements. The frameworks made limited reference to theories that specifically concern RCS. Generic devices, such as logical frameworks, were typically used to document activities, outputs and outcomes, but with little emphasis on exploring underlying assumptions or contextual constraints. Usage of the ESSENCE framework appeared limited. We believe that there is scope for improving frameworks through the incorporation of more accessible information about how to do evaluation in practice; greater involvement of stakeholders, following evaluation capacity building principles; greater emphasis on explaining underlying rationales of frameworks; and structuring frameworks so that they separate generic and project-specific aspects of health RCS evaluation. The third and fourth of these improvements might assist harmonisation.

  16. [Principles of health economic evaluation for use by caregivers].

    PubMed

    Derumeaux-Burel, Hélène; Derancourt, Christian; Rambhojan, Christine; Branchard, Olivier; Hayes, Nathalie; Bénard, Antoine

    2017-01-01

    The aim of health economic evaluation is to maximize health gains from limited resources. By definition, health economic evaluation is comparative, based on average costs and outcomes of compared interventions. Incremental costs and outcomes are used to calculate the cost-effectiveness ratio, which represents the average incremental cost per gained unit of effectiveness (i.e.: a year of life) with the evaluated intervention compared to the reference. The health economic rationale applies to all health domains. We cannot spend collective resources (health insurance) without asking ourselves about their potential alternative uses. This reasoning is useful to caregivers for understanding resources allocation decisions and healthcare recommandations. Caregivers should grab this field of expertise because they are central in this strategic reflection for defining the future French healthcare landscape. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. The health of Canada's children. Part II: Health mechanisms and pathways.

    PubMed

    Raphael, Dennis

    2010-02-01

    The present article provides models that explain how exposures to differing quality living circumstances result in health inequalities among children. Living circumstances - the social determinants of health - operate through a variety of mechanisms to shape children's health and cognitive, emotional and social development. Specific processes set children off on trajectories such that these exposures - in interaction with their environments - not only shape their health as children but also provide the foundations for their health status as adults. In addition to specifying the mechanisms that mediate the relationship between living circumstances and health outcomes, the article also identifies some of the economic and political factors that shape the quality of the living circumstances to which Canadian children are exposed.

  18. Impact of hospital type II violent events: use of psychotropic drugs and mental health services.

    PubMed

    Dement, John M; Lipscomb, Hester J; Schoenfisch, Ashley L; Pompeii, Lisa A

    2014-06-01

    While violence can adversely affect mental health of victims, repercussions of violence against workers is not as well characterized. We explored relationships between workplace violent events perpetrated by patients or visitors (Type II) against hospital employees and the employee use of psychotropic medications or mental health services using a data system that linked violent events with health claims. Significant associations were observed between reported Type II workplace violent events and employee prescription claims for anti-depressants and anxiolytics combined (RR = 1.45, 95% CI = 1.01-2.33) and anti-depressants alone (RR = 1.65, 95% CI = 1.10-2.48). No significant association between reported violent events and health claims for treatment of depression or anxiety was observed. Type II violence experienced by hospital workers may lead to increased use of psychotropic drugs, particularly anti-depressants but also anxiolytics. Our results suggest an important role of employee assistance programs in mitigating the psychological consequences of workplace violent events. © 2014 Wiley Periodicals, Inc.

  19. Medical Education: Barefoot Doctors, Health Care, Health Education, Nursing Education, Pharmacy Education, Part II.

    ERIC Educational Resources Information Center

    Parker, Franklin

    1987-01-01

    This is Part II of a two-part annotated bibliography of selected references on medical education in the People's Republic of China. The references date from 1913 to 1982. Most of the references are from the 1960's and 1970's. (RH)

  20. Reducing concussion symptoms among teenage youth: Evaluation of a mobile health app.

    PubMed

    Worthen-Chaudhari, Lise; McGonigal, Jane; Logan, Kelsey; Bockbrader, Marcia A; Yeates, Keith O; Mysiw, W Jerry

    2017-06-30

    To evaluate whether a mobile health application that employs elements of social game design could compliment medical care for unresolved concussion symptoms. Phase I and Phase II (open-label, non-randomized, ecological momentary assessment methodology). Outpatient concussion clinic. Youth, aged 13-18 years, with concussion symptoms 3+ weeks after injury; Phase I: n = 20; Phase II: n = 19. Participants received standard of care for concussion. The experimental group also used a mobile health application as a gamified symptoms journal. Phase I: feasibility and satisfaction with intervention (7-point Likert scale, 1 high). Phase II: change in SCAT-3 concussion symptoms (primary), depression and optimism. Phase 1: A plurality of participants completed the intervention (14 of 20) with high use (110 +/- 18% play) and satisfaction (median +/- interquartile range (IQR) = 2.0+/- 0.0). Phase II: Groups were equivalent on baseline symptoms, intervention duration, gender distribution, days since injury and medication prescription. Symptoms and optimism improved more for the experimental than for the active control cohort (U = 18.5, p = 0.028, effect size r = 0.50 and U = 18.5, p = 0.028, effect size r = 0.51, respectively). Mobile apps incorporating social game mechanics and a heroic narrative may promote health management among teenagers with unresolved concussion symptoms.

  1. Defining a framework for health information technology evaluation.

    PubMed

    Eisenstein, Eric L; Juzwishin, Don; Kushniruk, Andre W; Nahm, Meredith

    2011-01-01

    Governments and providers are investing in health information technologies with little evidence as to their ultimate value. We present a conceptual framework that can be used by hospitals, clinics, and health care systems to evaluate their health information technologies. The framework contains three dimensions that collectively define generic evaluation types. When these types are combined with contextual considerations, they define specific evaluation problems. The first dimension, domain, determines whether the evaluation will address the information intervention or its outcomes. The second dimension, mechanism, identifies the specific components of the new information technology and/or its health care system that will be the subject of the evaluation study. And, the third dimension, timing, determines whether the evaluation occurs before or after the health information technology is implemented. Answers to these questions define a set of evaluation types each with generic sets of evaluation questions, study designs, data collection requirements, and analytic methods. When these types are combined with details of the evaluation context, they define specific evaluation problems.

  2. Evaluation of a Student Health Project

    ERIC Educational Resources Information Center

    Johnson, Patricia C.; and others

    1969-01-01

    Analyzes the reaction of 53 medical students to their work experience in 3 poverty areas of California during the summer of 1967. They and 50 students from other professional schools were placed by The Student Health Organization in dental, community, and Planned Parenthood clinics, county hospitals, school districts, and Head Start programs. (WM)

  3. Evaluating Implementation Fidelity in Health Information Technology Interventions

    PubMed Central

    Eisenstein, Eric L.; Lobach, David F.; Montgomery, Paul; Kawamoto, Kensaku; Anstrom, Kevin J.

    2007-01-01

    Health information technology evaluators need to distinguish between intervention efficacy as assessed in the ideal circumstances of clinical trials and intervention effectiveness as assessed in the real world circumstances of actual practice. Because current evaluation study designs do not routinely allow for this distinction, we have developed a framework for evaluation of implementation fidelity that considers health information technologies as complex interventions and makes use of common intervention components as defined in the Oxford Implementation Index. We also propose statistical methods for the evaluation of interventions at the system and component level using the Rubin Causal Model. We then describe how to apply this framework to evaluate an ongoing clinical trial of three health information technology interventions currently implemented in a 17,000 patient community-based health network caring for Medicaid beneficiaries in Durham County, North Carolina. PMID:18693828

  4. Adult air pollution exposure and risk of infertility in the Nurses' Health Study II

    PubMed Central

    Mahalingaiah, S.; Hart, J.E; Laden, F.; Farland, L.V.; Hewlett, M.M.; Chavarro, J.; Aschengrau, A.; Missmer, S.A

    2016-01-01

    STUDY QUESTION Is there an association between air pollution exposures and incident infertility? SUMMARY ANSWER Increased exposure to air pollution is associated with an increased incidence of infertility. WHAT IS KNOWN ALREADY Exposures to air pollution have been associated with lower conception and fertility rates. However, the impact of pollution on infertility incidence is unknown. STUDY DESIGN, SIZE, DURATION Prospective cohort study using data collected from 116 430 female nurses from September 1989 to December 2003 as part of the Nurses' Health Study II cohort. PARTICIPANTS/MATERIALS, SETTING, METHODS Infertility was defined by report of attempted conception for ≥12 months without success. Participants were able to report if evaluation was sought and if so, offer multiple clinical indications for infertility. After exclusion, 36 294 members were included in the analysis. Proximity to major roadways and ambient exposures to particulate matter less than 10 microns (PM10), between 2.5 and 10 microns (PM2.5–10), and less than 2.5 microns (PM2.5) were determined for residential addresses for the 36 294 members between the years of 1993 and 2003. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using multivariable adjusted Cox proportional hazard models with time-varying covariates. MAIN RESULTS AND THE ROLE OF CHANCE Over 213 416 person-years, there were 2508 incident reports of infertility. Results for overall infertility were inconsistent across exposure types. We observed a small increased risk for those living closer to compared to farther from a major road, multivariable adjusted HR = 1.11 (CI: 1.02–1.20). This was consistent for those reporting primary or secondary infertility. For women living closer to compared to farther from a major road, for primary infertility HR = 1.05 (CI: 0.94–1.17), while for secondary infertility HR = 1.21 (CI: 1.07–1.36). In addition, the HR for every 10 µg/m3 increase in cumulative PM2.5–10

  5. Adult air pollution exposure and risk of infertility in the Nurses' Health Study II.

    PubMed

    Mahalingaiah, S; Hart, J E; Laden, F; Farland, L V; Hewlett, M M; Chavarro, J; Aschengrau, A; Missmer, S A

    2016-03-01

    Is there an association between air pollution exposures and incident infertility? Increased exposure to air pollution is associated with an increased incidence of infertility. Exposures to air pollution have been associated with lower conception and fertility rates. However, the impact of pollution on infertility incidence is unknown. Prospective cohort study using data collected from 116 430 female nurses from September 1989 to December 2003 as part of the Nurses' Health Study II cohort. Infertility was defined by report of attempted conception for ≥12 months without success. Participants were able to report if evaluation was sought and if so, offer multiple clinical indications for infertility. After exclusion, 36 294 members were included in the analysis. Proximity to major roadways and ambient exposures to particulate matter less than 10 microns (PM10), between 2.5 and 10 microns (PM2.5-10), and less than 2.5 microns (PM2.5) were determined for residential addresses for the 36 294 members between the years of 1993 and 2003. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using multivariable adjusted Cox proportional hazard models with time-varying covariates. Over 213 416 person-years, there were 2508 incident reports of infertility. Results for overall infertility were inconsistent across exposure types. We observed a small increased risk for those living closer to compared to farther from a major road, multivariable adjusted HR = 1.11 (CI: 1.02-1.20). This was consistent for those reporting primary or secondary infertility. For women living closer to compared to farther from a major road, for primary infertility HR = 1.05 (CI: 0.94-1.17), while for secondary infertility HR = 1.21 (CI: 1.07-1.36). In addition, the HR for every 10 µg/m(3) increase in cumulative PM2.5-10 among women with primary infertility was 1.10 (CI: 0.96-1.27), and similarly was 1.10 (CI: 0.94-1.28) for those with secondary infertility. Within the 2 year window of

  6. Public health law in a new century: part II: public health powers and limits.

    PubMed

    Gostin, L O

    2000-06-14

    The Constitution allocates public health powers among the federal government and the states. Federal public health powers include the authority to tax, spend, and regulate interstate commerce. These powers enable the federal government to raise revenues, allocate resources, economically penalize risk behavior, and broadly regulate in the public's interest. States have an inherent authority to protect, preserve, and promote the health, safety, morals, and general welfare of the people, termed police powers. Police powers enable states to preserve the public health in areas ranging from injury and disease prevention to sanitation, waste disposal, and environmental protection. The Rehnquist Court has emphasized the limits of federal powers and the primacy of states in public health issues affecting local concerns. Finally, the Constitution safeguards individual interests in autonomy, privacy, liberty, and property. The Supreme Court often defers to public health authorities in matters of public health, but engages in strict scrutiny if government interferes with fundamental freedoms or discriminates against a suspect class. Provided that they act justly and reasonably to avert a serious health threat, the Court should cede to agencies the power to act for the communal good. JAMA. 2000.

  7. Evaluated Kinetic Data for Combustion Modeling: Supplement II

    NASA Astrophysics Data System (ADS)

    Baulch, D. L.; Bowman, C. T.; Cobos, C. J.; Cox, R. A.; Just, Th.; Kerr, J. A.; Pilling, M. J.; Stocker, D.; Troe, J.; Tsang, W.; Walker, R. W.; Warnatz, J.

    2005-09-01

    This compilation updates and expands two previous evaluations of kinetic data on elementary, homogeneous, gas phase reactions of neutral species involved in combustion systems [J. Phys. Chem. Ref Data 21, 411 (1992); 23, 847 (1994)]. The work has been carried out under the auspices of the IUPAC Commission on Chemical Kinetics and the UK Engineering and Physical Sciences Research Council. Individual data sheets are presented for most reactions but the kinetic data for reactions of C2, C, ethyl, i-propyl, t-butyl, and allyl radicals are summarized in tables. Each data sheet sets out relevant thermodynamic data, experimental kinetic data, references, recommended rate parameters with their error limits and a brief discussion of the reasons for their selection. Where appropriate the data are displayed on an Arrhenius diagram or by fall-off curves. Tables summarizing the recommended rate data and the thermodynamic data for the reactant and product species are given, and their sources referenced. As in the previous evaluations the reactions considered relate largely to the combustion in air of organic compounds containing up to three carbon atoms and simple aromatic compounds. Thus the data base has been expanded, largely by dealing with a substantial number of extra reactions within these general areas.

  8. [Continuing evaluation of health educational activities in Aarau and Nyon].

    PubMed

    1980-11-01

    In view of the numerous and diverse health-education interventions within the NRP 1A, a comparably diverse set of evaluation instruments had to be developed. The continuing evaluation of health-education technics is a complex and resource-consuming process. However, it has the advantage to deliver continuously the data base for the optimization of the different activities. The two main aspects of the continuing health-education evaluation system within the NRP 1A are the statistical documentation of all participating individuals and the measurement of the effects of mass-media campaigns.

  9. Predicting carer health effects for use in economic evaluation.

    PubMed

    Al-Janabi, Hareth; Manca, Andrea; Coast, Joanna

    2017-01-01

    Illnesses and interventions can affect the health status of family carers in addition to patients. However economic evaluation studies rarely incorporate data on health status of carers. We investigated whether changes in carer health status could be 'predicted' from the health data of those they provide care to (patients), as a means of incorporating carer outcomes in economic evaluation. We used a case study of the family impact of meningitis, with 497 carer-patient dyads surveyed at two points. We used regression models to analyse changes in carers' health status, to derive predictive algorithms based on variables relating to the patient. We evaluated the predictive accuracy of different models using standard model fit criteria. It was feasible to estimate models to predict changes in carers' health status. However, the predictions generated in an external testing sample were poorly correlated with the observed changes in individual carers' health status. When aggregated, predictions provided some indication of the observed health changes for groups of carers. At present, a 'one-size-fits-all' predictive model of carer outcomes does not appear possible and further research aimed to identify predictors of carer's health status from (readily available) patient data is recommended. In the meanwhile, it may be better to encourage the targeted collection of carer data in primary research to enable carer outcomes to be better reflected in economic evaluation.

  10. Understanding online health information: Evaluation, tools, and strategies.

    PubMed

    Beaunoyer, Elisabeth; Arsenault, Marianne; Lomanowska, Anna M; Guitton, Matthieu J

    2017-02-01

    Considering the status of the Internet as a prominent source of health information, assessing online health material has become a central issue in patient education. We describe the strategies available to evaluate the characteristics of online health information, including readability, emotional content, understandability, usability. Popular tools used in assessment of readability, emotional content and comprehensibility of online health information were reviewed. Tools designed to evaluate both printed and online material were considered. Readability tools are widely used in online health material evaluation and are highly covariant. Assessment of emotional content of online health-related communications via sentiment analysis tools is becoming more popular. Understandability and usability tools have been developed specifically for health-related material, but each tool has important limitations and has been tested on a limited number of health issues. Despite the availability of numerous assessment tools, their overall reliability differs between readability (high) and understandability (low). Approaches combining multiple assessment tools and involving both quantitative and qualitative observations would optimize assessment strategies. Effective assessment of online health information should rely on mixed strategies combining quantitative and qualitative evaluations. Assessment tools should be selected according to their functional properties and compatibility with target material. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Dental Health Evaluation of Children in Kosovo

    PubMed Central

    Begzati, Agim; Meqa, Kastriot; Siegenthaler, David; Berisha, Merita; Mautsch, Walter

    2011-01-01

    Objectives: The aim of this study was to assess caries prevalence of preschool and school children in Kosovo. Methods: The assessment, which was carried out between 2002 and 2005, included measurements of early childhood caries, deft and DMFT. Results: In total, 1,237 preschool and 2,556 school children were examined. The mean deft of preschool children was 5.9, and the mean DMFT of school children aged 12 was 5.8. The caries prevalence for 2- to 6-year-old preschool children was 91.2%, and the prevalence for 7- to 14-year-old school children was 94.4%. The prevalence of early childhood caries was 17.6%, with a mean deft of 10.6. Conclusions: All data assessed showed the very poor oral health status of children in Kosovo. Interviews with children and teachers indicated poor knowledge regarding oral health. Significant measures must be taken to improve this situation. PMID:21228954

  12. Benzalkonium chloride. Health hazard evaluation report

    SciTech Connect

    Bernholc, N.M.

    1984-01-01

    Health hazards associated with the use of benzalkonium chlorides (BAC) are reviewed. Benzalkonium chloride is extensively used as a cationic disinfectant. It is found in a great many over-the-counter and prescription eye products, disinfectants, shampoos, and deodorants, and is used in concentrations that range from 0.001 to 0.01% in eyedrops, up to 2.5% in concentrated liquid disinfectants. Solutions of 0.03 to 0.04% BAC may cause temporary eye irritation in humans but are unlikely to cause any skin response except in persons allergic to quaternary ammonium compounds. Inhalation of a vaporized 10% solution of BAC produced a bronchospasmodic reaction in a previously sensitized individual. At present no other human health effects from BAC have been documented or inferred from exposure to such dilute concentrations.

  13. Trust evaluation in health information on the World Wide Web.

    PubMed

    Moturu, Sai T; Liu, Huan; Johnson, William G

    2008-01-01

    The impact of health information on the web is mounting and with the Health 2.0 revolution around the corner, online health promotion and management is becoming a reality. User-generated content is at the core of this revolution and brings to the fore the essential question of trust evaluation, a pertinent problem for health applications in particular. Evolving Web 2.0 health applications provide abundant opportunities for research. We identify these applications, discuss the challenges for trust assessment, characterize conceivable variables, list potential techniques for analysis, and provide a vision for future research.

  14. Perioral soft tissue evaluation of skeletal Class II Division 1: A lateral cephalometric study.

    PubMed

    Lee, Young-Joo; Park, Jong-Tae; Cha, Jung-Yul

    2015-09-01

    To obtain the balance and harmony of the soft tissue facial profile in orthodontic treatment, it is necessary to identify the characteristics of overlying soft tissues according to the horizontal and vertical skeletal patterns. The aim of this study was to evaluate the perioral soft tissue characteristics of skeletal Class II Division 1 subjects (group II) with various vertical patterns compared with skeletal Class I subjects (group I). Lateral cephalograms of 99 Korean adults (44 women, 45 men; mean age, 23.4 years) were divided into 4 groups based on horizontal and vertical skeletal pattern (SN-MP angle): group I, 22 subjects; group II-low angle (<27°), 14 subjects; group II-normal angle (27°-36°), 33 subjects; and group II-high angle (>37°), 30 subjects. The correlations and multiple linear regression tests were used to determine the skeletal and dental variables influencing soft tissue characteristics. Group II-high angle showed significantly greater values than did group II-low angle for basic lower lip thickness and lower lip length. The perioral soft tissue measurements of group II were correlated with the inclination and anteroposterior position of the maxillary and mandibular incisors along with facial depth (N-Go) and facial length (S-Gn). Upper lip strain of group II was not influenced by any skeletal variables but only by the inclination and anteroposterior position of the maxillary incisors. Clinicians need to evaluate lip strain and lip thickness based on the skeletal pattern as well as dental inclination to obtain balance in the perioral muscle activity. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  15. Can health insurance improve employee health outcome and reduce cost? An evaluation of Geisinger's employee health and wellness program.

    PubMed

    Maeng, Daniel D; Pitcavage, James M; Tomcavage, Janet; Steinhubl, Steven R

    2013-11-01

    To evaluate the impact of a health plan-driven employee health and wellness program (known as MyHealth Rewards) on health outcomes (stroke and myocardial infarction) and cost of care. A cohort of Geisinger Health Plan members who were Geisinger Health System (GHS) employees throughout the study period (2007 to 2011) was compared with a comparison group consisting of Geisinger Health Plan members who were non-GHS employees. The GHS employee cohort experienced a stroke or myocardial infarction later than the non-GHS comparison group (hazard ratios of 0.73 and 0.56; P < 0.01). There was also a 10% to 13% cost reduction (P < 0.05) during the second and third years of the program. The cumulative return on investment was approximately 1.6. Health plan-driven employee health and wellness programs similarly designed as MyHealth Rewards can potentially have a desirable impact on employee health and cost.

  16. Resource requirements for evaluating ambulatory health care.

    PubMed Central

    Thompson, M S; Palmer, R H; Rothrock, J K; Strain, R; Brachman, L H; Wright, E A

    1984-01-01

    We implemented the most frequently used form of quality assurance activity: abstracting information on the quality of patient care from medical records and communicating findings to providers in 16 ambulatory care groups. Site providers accepted the evaluation criteria, agreed that deficiencies in care were detected, and, for some medical tasks, effected improvements in care. Direct costs in 1980 dollars for the quality assurance cycle including data system development were $46 per evaluated case. Per-case costs varied considerably among tasks, decreased with larger numbers of cases and as experience grew, and were reduced through computerization. Measured costs were high due to: a demanding research design; our extended accounting of direct, indirect, and induced costs; and the substantial resource requirements of rigorously performed evaluations. PMID:6496817

  17. The Effects of World War II on Economic and Health Outcomes across Europe.

    PubMed

    Kesternich, Iris; Siflinger, Bettina; Smith, James P; Winter, Joachim K

    2014-03-01

    We investigate long-run effects of World War II on socio-economic status and health of older individuals in Europe. We analyze data from SHARELIFE, a retrospective survey conducted as part of SHARE in Europe in 2009. SHARELIFE provides detailed data on events in childhood during and after the war for over 20,000 individuals in 13 European countries. We construct several measures of war exposure-experience of dispossession, persecution, combat in local areas, and hunger periods. Exposure to war and more importantly to individual-level shocks caused by the war significantly predicts economic and health outcomes at older ages.

  18. The Effects of World War II on Economic and Health Outcomes across Europe

    PubMed Central

    Kesternich, Iris; Siflinger, Bettina; Smith, James P.; Winter, Joachim K.

    2013-01-01

    We investigate long-run effects of World War II on socio-economic status and health of older individuals in Europe. We analyze data from SHARELIFE, a retrospective survey conducted as part of SHARE in Europe in 2009. SHARELIFE provides detailed data on events in childhood during and after the war for over 20,000 individuals in 13 European countries. We construct several measures of war exposure—experience of dispossession, persecution, combat in local areas, and hunger periods. Exposure to war and more importantly to individual-level shocks caused by the war significantly predicts economic and health outcomes at older ages. PMID:24850973

  19. Assisting allied health in performance evaluation: a systematic review.

    PubMed

    Lizarondo, Lucylynn; Grimmer, Karen; Kumar, Saravana

    2014-11-14

    Performance evaluation raises several challenges to allied health practitioners and there is no agreed approach to measuring or monitoring allied health service performance. The aim of this review was to examine the literature on performance evaluation in healthcare to assist in the establishment of a framework that can guide the measurement and evaluation of allied health clinical service performance. This review determined the core elements of a performance evaluation system, tools for evaluating performance, and barriers to the implementation of performance evaluation. A systematic review of the literature was undertaken. Five electronic databases were used to search for relevant articles: MEDLINE, Embase, CINAHL, PsychInfo, and Academic Search Premier. Articles which focussed on any allied health performance evaluation or those which examined performance in health care in general were considered in the review. Content analysis was used to synthesise the findings from individual articles. A total of 37 articles were included in the review. The literature suggests there are core elements involved in performance evaluation which include prioritising clinical areas for measurement, setting goals, selecting performance measures, identifying sources of feedback, undertaking performance measurement, and reporting the results to relevant stakeholders. The literature describes performance evaluation as multi-dimensional, requiring information or data from more than one perspective to provide a rich assessment of performance. A range of tools or instruments are available to capture various perspectives and gather a comprehensive picture of health care quality. Every allied health care delivery system has different performance needs and will therefore require different approaches. However, there are core processes that can be used as a framework to evaluate allied health performance. A careful examination of barriers to performance evaluation and subsequent tailoring of

  20. Phase II evaluation of Lonidamine in patients with advanced malignancy.

    PubMed

    Evans, W K; Shepherd, F A; Mullis, B

    1984-01-01

    Lonidamine, a substituted indazole carboxylic acid with unique effects on cellular respiration, was studied in 27 patients with advanced malignancies. Of the 18 evaluable patients, 5 had small-cell lung cancer, 3 had non-small-cell lung cancer, 3 sarcoma, 2 breast cancer, and 5 other tumour types. All but 1 had had extensive prior treatment. A partial response was seen in 1 patient with metastatic synovial sarcoma, and tumour growth inhibition was demonstrated in 2 other cases. The major toxicity encountered was myalgia (66.6%) which was incompletely ameliorated by prednisone and required dose reduction in 2 patients and cessation of drug in 3. Other toxicities included auditory changes, anorexia, nausea and vomiting, diarrhoea, skin sensitivity, and conjunctivitis. No added toxicity was seen, when Lonidamine was combined with other chemotherapeutic agents. No correlation between Lonidamine dose and serum lactate levels was seen, although 4 patients showed a progressive increase in lactate levels over time, thought to be related to their increasing tumour burden. 5 patients demonstrated a dramatic fall in serum testosterone levels 4-8 weeks after starting Lonidamine which was accompanied by an increase in luteinizing hormone levels in 3 patients. In summary, modest antitumour activity was demonstrated in 3 patients; moderate toxicity was seen in most patients, but was usually tolerable. Further studies of Lonidamine are warranted in less heavily treated patients, alone or in combination with other chemotherapeutic agents.

  1. Evaluation of health effects from hazardous waste sites

    SciTech Connect

    Andelman, J.B.; Underhill, D.W.

    1986-01-01

    This information and data for evaluating health effects from hazardous waste sites stems from the efforts of specialists representing leading research centers, hospitals, universities, government agencies and includes consultant as well as corporate viewpoints. The work evolved from the Fourth Annual Symposium on Environmental Epidemiology sponsored by the Center for Environmental Epidemiology at the University of Pittsburgh and the U.S. EPA. Contents-One: Scope of the Hazardous Wastes Problems. Evaluating Health Effects at Hazardous Waste Sites. Historical Perspective on Waste Disposal. Two: Assessment of Exposure to Hazardous Wastes. Chemical Emissions Assessment for Hazardous Waste Sites. Assessing Pathways to Human Populations. Methods of Defining Human Exposures. Three: Determining Human Health Effects. Health Risks of Concern. Expectations and Limitations of Human Health Studies and Risk Assessment. Four: Case Studies. Love Canal. Hardeman County, Tennessee. Cannonsburg, Pennsylvania. Five: Defining Health Risks at Waste Sites. Engineering Perspectives from an Industrial Viewpoint. Role of Public Groups. Integration of Governmental Resources in Assessment of Hazards.

  2. Building bridges between health economics research and public policy evaluation.

    PubMed

    Debrand, Thierry; Dourgnon, Paul

    2010-12-01

    The Institut de Recherche et Documentation en Economie de la Santé (IRDES) Workshop on Applied Health Economics and Policy Evaluation aims at disseminating health economic research's newest findings and enhancing the community's capacity to address issues that are relevant to public policy. The 2010 program consisted of 16 articles covering a vast range of topics, such as health insurance, social health inequalities and health services research. While most of the articles embedded theoretical material, all had to include empirical material in order to favor more applied and practical discussions and results. The 2010 workshop is to be the first of a series of annual workshops in Paris gathering together researchers on health economics and policy evaluation. The next workshop is to be held at IRDES in June 2011.

  3. Linking combat and physical health: the legacy of World War II in men's lives.

    PubMed

    Elder, G H; Shanahan, M J; Clipp, E C

    1997-03-01

    This longitudinal study investigated the health effects of experiences during World War II among veterans by examining how well-being changed across the postwar years and varied by prewar individual attributes. The subjects were men from the Stanford-Terman data archives who served in World War II and were born before 1925 (N = 328). Of these veterans, 236 were known to have been overseas during the war, and 64 had remained in the United States; 204 of the men who had been sent overseas experienced combat. Life history records were used to construct measures that described physical and emotional health over a range of time points and intervals in the postwar years. Exposure to combat predicted that a subject would experience physical decline or death during the postwar interval from 1945 to 1960, after the effects of self-reported physical health in 1945 and birth cohort were controlled. Rank and theater of engagement, however, were of little consequence, either additively or in interaction with combat. Self-worth before the war did not moderate the risk of physical decline or death that was associated with combat. Combat in World War II predicted that in the 15 years after the war, a subject would experience physical decline or death. There was no evidence that the effect of combat was more pronounced among men of different ranks, theaters of engagement, or levels of self-worth in 1940.

  4. Methodological Approaches for Determining Health Manpower Supply and Requirements. Volume II. Practical Planning Manual.

    ERIC Educational Resources Information Center

    Kriesberg, Harriet M.; And Others

    This second of a two-volume monograph, which describes and evaluates various methods used to determine present and future health manpower supply and requirements, is intended to contribute to planners' understanding of the state of the art and to the improvement of health manpower planning. The methodologies presented, chosen after a review of the…

  5. Population-based public health interventions: innovations in practice, teaching, and management. Part II.

    PubMed

    Keller, Linda Olson; Strohschein, Susan; Schaffer, Marjorie A; Lia-Hoagberg, Betty

    2004-01-01

    The Intervention Wheel is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. The Intervention Wheel, previously known as the Public Health Intervention Model, was originally introduced in 1998 by the Minnesota Department of Health, Section of Public Health Nursing (PHN). The model has been widely disseminated and used throughout the United States since that time. The evidence supporting the Intervention Wheel was recently subjected to a rigorous critique by regional and national experts. This critical process, which involved hundreds of public health nurses, resulted in a more robust Intervention Wheel and established the validity of the model. The critique also produced basic steps and best practices for each of the 17 interventions. Part I describes the Intervention Wheel, defines population-based practice, and details the recommended modifications and validation process. Part II provides examples of the innovative ways that the Intervention Wheel is being used in public health/PHN practice, education, and administration. The two articles provide a foundation and vision for population-based PHN practice and direction for improving population health.

  6. PUBLIC HEALTH AIR SURVEILLANCE EVALUATION (PHASE) - A SUMMARY

    EPA Science Inventory

    NERL's Human Exposure and Atmospheric Sciences Division and other participants in the Public Health Air Surveillance Evaluation (PHASE) project will be discussing their results with European Commission, Directorate General Environment, and

    French Agency for Environment an...

  7. PUBLIC HEALTH AIR SURVEILLANCE EVALUATION (PHASE) - A SUMMARY

    EPA Science Inventory

    NERL's Human Exposure and Atmospheric Sciences Division and other participants in the Public Health Air Surveillance Evaluation (PHASE) project will be discussing their results with European Commission, Directorate General Environment, and

    French Agency for Environment an...

  8. Arthritis Patient Education: How Economic Evaluations Can Inform Health Policy.

    ERIC Educational Resources Information Center

    Clarke, Ann E.

    1997-01-01

    A cost-effectiveness evaluation of an Arthritis Self-Management Program assessed direct and indirect costs through self-reporting of health services use. Diminished productivity and effectiveness were measured through a visual analog scale and the health status dimensions of the Canadian Medical Outcomes Study short form. (JOW)

  9. A TRANSDISCIPLINARY APPROACH TO HEALTH POLICY RESEARCH AND EVALUATION.

    PubMed

    Wan, Thomas T H

    2014-01-01

    An integrated perspective consists of macro- and micro-level approaches to health policy research and evaluation is presented. Analytical strategies are suggested for policy analysis, targeting on health disparities at individual and population levels. This systems approach enables investigators to view how scientific public policy analysis can be implemented to assess policy impacts. In this special issue, five papers are introduced.

  10. Evaluation of HIV Prevention and Comprehensive Health Education Activities.

    ERIC Educational Resources Information Center

    Fisher, Gloria; And Others

    This study was undertaken to evaluate Human Immunodeficiency Virus (HIV) prevention and comprehensive health activities in public secondary schools in Mississippi. The Comprehensive School Health Curriculum (CSHC), for implementation in junior, middle, and senior high schools, was designed to promote improved knowledge and behaviors related to the…

  11. Evaluating the Environmental Health Work Force. Final Report.

    ERIC Educational Resources Information Center

    Levine Associates, Inc., Rockville, MD.

    This report contains all materials pertinent to an intensive evaluation of the environmental health work force conducted in 1986 and 1987. The materials relate to a workshop that was one of the key tools used in conducting the study to estimate environmental health personnel supply, demand, and need. The report begins with an overview and…

  12. Evaluation of Consumer Health Training and Education Programs.

    ERIC Educational Resources Information Center

    Kellogg, Muriel; And Others

    PL89-749, passed in 1966, included a number of provisions for increasing participation of consumers in the improvement of the health care delivery system, including development of training programs to equip consumers for participation in the health planning process. The evaluation attempts to ascertain the direct effect of training programs on…

  13. A TRANSDISCIPLINARY APPROACH TO HEALTH POLICY RESEARCH AND EVALUATION

    PubMed Central

    Wan, Thomas T.H.

    2014-01-01

    An integrated perspective consists of macro- and micro-level approaches to health policy research and evaluation is presented. Analytical strategies are suggested for policy analysis, targeting on health disparities at individual and population levels. This systems approach enables investigators to view how scientific public policy analysis can be implemented to assess policy impacts. In this special issue, five papers are introduced. PMID:25419221

  14. Arthritis Patient Education: How Economic Evaluations Can Inform Health Policy.

    ERIC Educational Resources Information Center

    Clarke, Ann E.

    1997-01-01

    A cost-effectiveness evaluation of an Arthritis Self-Management Program assessed direct and indirect costs through self-reporting of health services use. Diminished productivity and effectiveness were measured through a visual analog scale and the health status dimensions of the Canadian Medical Outcomes Study short form. (JOW)

  15. Virginia Western Community College's Health Technology Admissions Evaluation System.

    ERIC Educational Resources Information Center

    Houston, Charles A.; Sellers, Harry

    Due to factors such as high enrollment demands, limited institutional space, and high program costs, certain admissions requirements in the guidance/selection of students for health technology programs at Virginia Western Community College (VWCC) have become necessary. A Health Technology Admissions Evaluation System was created to develop and…

  16. Immigrant and refugee health: medical evaluation.

    PubMed

    Rew, Karl T; Clarke, S Lindsey; Gossa, Weyinshet; Savin, Daniel

    2014-08-01

    Overseas medical screening by panel physicians for conditions that might jeopardize US public health is required for admission to the United States by immigrant visa or refugee status. According to protocols established by the Centers for Disease Control and Prevention, conditions such as active tuberculosis and substance dependence, when detected, prohibit entry to the United States, whereas close medical follow-up after arrival is required for individuals with other conditions. Refugees and asylees should undergo further medical assessment by a US civil surgeon as soon as possible after arrival. Applicants for legal permanent residence in the United States, whether by immigrant visa or adjustment of status, must receive vaccinations comparable to those recommended for citizens. When immigrants and refugees present to a primary care physician, the vaccination process may not be complete, and documentation of the extent to which it is complete might be lacking. Immigrants and refugees may have a variety of unrecognized or untreated musculoskeletal conditions, mental health conditions, infectious diseases, and chronic conditions. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  17. eHealth interoperability evaluation using a maturity model.

    PubMed

    Guédria, Wded; Bouzid, Hanan; Bosh, Guido; Naudet, Yannick; Chen, David

    2012-01-01

    To further improve individual health and well-being, access to high quality and safe services, eHealth interoperability is a fundamental prerequisite. A mature interoperability between health systems will support health services organization and delivery, and improve citizens' awareness of how to prevent disease and preserve good health. Within this context, health institutions have to solve interoperability problems or prevent them to appear, and if possible avoid them before they occur by adapting good practices toward interoperability. This paper proposes an evaluation of the potential health interoperability using the MMEI methodology (Maturity Model for Enterprise Interoperability). It discusses how the MMEI model can be used to help institutions to avoid interoperability problems. A use case for a particular hospital is more closely examined.

  18. Evaluating Youth Sexual Health Peer Education Programs: "Challenges and Suggestions for Effective Evaluation Practices"

    ERIC Educational Resources Information Center

    Jaworsky, Denise; Larkin, June; Sriranganathan, Gobika; Clout, Jerri; Janssen, Jesse; Campbell, Lisa; Flicker, Sarah; Stadnicki, Dan; Erlich, Leah; Flynn, Susan

    2013-01-01

    Although peer sexual health education is a common form of sexual health promotion for youth, systematic reviews of these programs are relatively rare. In this study we interviewed youth peer educators to inquire about their experience of program evaluation and their perception of what is needed to develop effective evaluation practices. Data were…

  19. Five Years of HHS Home Health Care Evaluations: Using Evaluation to Change National Policy

    ERIC Educational Resources Information Center

    Brandon, Paul R.; Smith, Nick L.; Grob, George F.

    2012-01-01

    In 1997, American Evaluation Association member George Grob, now retired from the U.S. Department of Health and Human Services (HHS) and currently President of the Center for Public Program Evaluation, made a testimony on Medicare home health care fraud and abuse before the U.S. Senate Special Committee on Aging. The occasion was to announce the…

  20. Five Years of HHS Home Health Care Evaluations: Using Evaluation to Change National Policy

    ERIC Educational Resources Information Center

    Brandon, Paul R.; Smith, Nick L.; Grob, George F.

    2012-01-01

    In 1997, American Evaluation Association member George Grob, now retired from the U.S. Department of Health and Human Services (HHS) and currently President of the Center for Public Program Evaluation, made a testimony on Medicare home health care fraud and abuse before the U.S. Senate Special Committee on Aging. The occasion was to announce the…

  1. Utility of the World Health Organization Disability Assessment Schedule II in schizophrenia.

    PubMed

    Guilera, Georgina; Gómez-Benito, Juana; Pino, Oscar; Rojo, J Emilio; Cuesta, Manuel J; Martínez-Arán, Anabel; Safont, Gemma; Tabarés-Seisdedos, Rafael; Vieta, Eduard; Bernardo, Miguel; Crespo-Facorro, Benedicto; Franco, Manuel; Rejas, Javier

    2012-07-01

    The World Health Organization Disability Assessment Schedule II (WHODAS II) was developed for assessing disability. This study provides data on the validity and utility of the Spanish version of the WHODAS II in a large sample of patients with schizophrenia. The sample included 352 patients with a schizophrenia spectrum disorder. They completed a comprehensive assessment battery including measures of psychopathology, functionality and quality-of-life. A sub-sample of 36 patients was retested after six months to assess its temporal stability. Participation in society (6.3%) and Life activities (4.0%) were the domains with the highest percentage of missing data. The internal consistency (Cronbach's alpha) of the total scale was 0.94, and the test-retest stability reached an intraclass correlation coefficient of 0.92. It became apparent that the six primary factor models represent a better fit with reality than other competing models. Relationships between the WHODAS and measures of symptomatology, social and work-related functionality, and quality-of-life were in the expected direction and the scale was ultimately found to be able to differentiate among patients with different degrees of disease severity and different work status. Assessment of disability using appropriate tools is a crucial aspect in the context of mental health and, in this regard, the Spanish version of the WHODAS II shows ample evidence of validity in patients with schizophrenia. The most important contribution of this study is that it is the first analyzing the Spanish version of the WHODAS II (36-item version) in a large sample of patients with schizophrenia. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Evaluating student learning outcomes in oral health knowledge and skills.

    PubMed

    Lewis, Adrienne; Edwards, Suzanne; Whiting, Glenda; Donnelly, Frank

    2017-09-22

    The aim was to evaluate whether a set of oral health resources designed for workforce training was relevant for students undertaking an entry-level nursing or aged care qualification. Oral health is one of the most neglected aspects of nursing care experienced by older people. Despite efforts to improve aged care worker oral health knowledge and skills, one-off training and rapid staff turnover have hindered the success of workplace programs. Inadequate oral health content in entry-level nursing and aged care qualifications has perpetuated this. Kirkpatrick's training and evaluation model was used to evaluate the resources developed by a project called Building Better Oral Health Communities. Students used them as prescribed study materials and completed pre- and post-intervention questionnaires. Educators were interviewed to obtain their feedback. Quantitative data were analysed using descriptive and inferential statistics. Qualitative data were collated according to relevance to learning, presentation style and interest. Evaluation showed high levels of student and educator satisfaction. Student learning outcomes demonstrated consistently positive attitudes and significant self-reported improvements in oral health knowledge and skills. Irrespective of course type, students gained similar levels of oral health knowledge and skills following use of the resources. Nurses and care workers must be able to provide consistent standards of oral health care as a fundamental part of caring for patients. Validated as an effective learning and teaching package, it is recommended that these resources be utilised to strengthen the oral health content of entry-level nursing and aged care qualifications. Building the oral health capacity of nurses and care workers is one way of reversing oral health neglect and improving the quality of care provided to older people. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights

  3. Clinical evaluation of guided tissue regeneration procedure in the treatment of grade II mandibular molar furcations.

    PubMed

    Prathibha, P K; Faizuddin, M; Pradeep, A R

    2002-01-01

    The management of furcation defects remains a challenge in periodontal therapy, Traditionally, furcation therapy involved scaling, rootplaning, furcation plasty and resective techniques. The purpose of this study was to clinically evaluate the potential of guided tissue regeneration in the treatment of mandibular molar grade II furcations using a nonresorbable barrier, TefGen-GTR and compare it with open flap debridement alone. Ten patients with similar bilateral grade II furcation lesions participated in the study. TefGen-GTR was placed in the experimental sites while the contralateral sites served as controls. Treatment effects were evaluated at six months reentry. Both groups showed gain in vertical and horizontal open probing attachment and defect depth reduction when compared to baseline values, with experimental sites showing statistically significant improvement over the controls. The results suggest that the nonresorbable Teflon barrier, TefGen-GTR, may be used as an alternative for treatment of grade II furcation invasions.

  4. Associations among rotating night shift work, sleep and skin cancer in Nurses' Health Study II participants.

    PubMed

    Heckman, Carolyn J; Kloss, Jacqueline D; Feskanich, Diane; Culnan, Elizabeth; Schernhammer, Eva S

    2017-03-01

    Night shift work and sleep duration have been associated with breast and other cancers. Results from the few prior studies of night shift work and skin cancer risk have been mixed and not fully accounted for other potentially important health-related variables (eg, sleep characteristics). This study evaluated the relationship between rotating night shift work and skin cancer risk and included additional skin cancer risk factors and sleep-related variables. The current study used data from 74 323 Nurses' Health Study (NHS) II participants. Cox proportional hazards models were used to estimate multivariable-adjusted HRs and 95% CIs for skin cancers across categories of shift work and sleep duration. Over 10 years of follow-up, 4308 basal cell carcinoma (BCC), 334 squamous cell carcinoma (SCC) and 212 melanoma cases were identified. Longer duration of rotating night shifts was associated with a linear decline in risk of BCC (HR=0.93, 95% CI 0.90 to 0.97 per 5-year increase). Shift work was not significantly associated with either melanoma (HR=1.02, 95% CI 0.86 to 1.21) or SCC (HR=0.92, 95% CI 0.80 to 1.06). A short sleep duration (≤6 hours per day) was associated with lower risks of melanoma (HR=0.68, 95% CI 0.46 to 0.98) and BCC (HR=0.93, 95% CI 0.86 to 1.00) compared with the most common report of 7 hours. SCC was not associated with duration of sleep (HR=0.94, 95% CI 0.83 to 1.06). Longer duration of rotating night shift work and shorter sleep duration were associated with lower risk of some skin cancers. Further research is needed to confirm and identify the mechanisms underlying these associations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Reliability and construct validity of the Health-Promoting Lifestyle Profile II in an adult Turkish population.

    PubMed

    Pinar, Rukiye; Celik, Raziye; Bahcecik, Nefise

    2009-01-01

    Little is known about health-promoting lifestyle behaviors among Turkish people, who are experiencing a lifestyle transition from a developing country to one undergoing rapid modernization, although health promotion is receiving increasing attention regarding its prominent role in healthcare. Use of the Health-Promoting Lifestyle Profile II (HPLPII) has the advantage of allowing comparison of different international populations, although cultural adaptations are needed. The aims of this study were to adapt the HPLPII culturally and to assess its psychometric properties. Analyzed were internal reliability among 972 adults and test-retest stability among 160 adults. Construct validity was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Samples sizes for EFA and CFA were 420 and 500, respectively. Cronbach's alpha coefficients surpassed .70 for HPLPII and six subscales. All items, except one, had acceptable item-total correlations of >.20. Test-retest results showed stability for HPLPII and for subscales. Varimax rotation yielded five factors with eigenvalues >1, explaining 41% of the variance. Two items were excluded because their factor loadings differed by <.30 or they had cross-factor loadings. The CFA five-factor model based on EFA represented an acceptable fit. Testing of latent construct measurement models reduced the number of items from 52 to 48. The revised 48-item six-factor model had perfect fit. The HPLPII had satisfactory psychometric properties. It can be used to measure health-promoting lifestyle in the Turkish population.

  6. [Tridimensional evaluation model of health promotion in school -- a proposition].

    PubMed

    Kulmatycki, Lesław

    2005-01-01

    A good school health programme can be one of the most cost effective investments for simultaneously improving education and health. The general direction of WHO's European Network of Health Promoting Schools and Global Schools Health Initiative is guided by the holistic approach and the Ottawa Charter for Health Promotion (1986). A health promoting school strives to improve the health and well-being of school pupils as well as school personnel, families and community members; and works with community leaders to help them understand how the community contributes to health and education. Evaluation research is essential to describe the nature and effectiveness of school health promoting activity. The overall aim of this paper is to help school leaders and health promotion coordinators to measure their work well and effectively. The specific aim is to offer a practical three-dimensional evaluation model for health promoting schools. The material is presented in two sections. The first one is a 'theoretical base' for health promotion which was identified from broad based daily health promotion practical activities, strategies and intersectional interventions closely related to the philosophy of the holistic approach. The three dimensions refer to: 1. 'areas' -- according to the mandala of health. 2. 'actions' -- according to Ottawa Charter strategies which should be adapted to the local school networks. 3. 'data'-- according to different groups of evidence (process, changes and progress). The second one, as a result of the mentioned base, represents the three 'core elements': standards, criteria and indicators. In conclusion, this article provides a practical answer to the dilemma of the evaluation model in the network of local school environment. This proposition is addressed to school staff and school health promotion providers to make their work as effective as possible to improve pupils health. Health promoting school can be characterized as a school constantly

  7. Health-economic evaluation in implant trials: design considerations.

    PubMed

    Alt, Volker; Pavlidis, Theodoros; Szalay, Gabor; Heiss, Christian; Schnettler, Reinhard

    2009-01-01

    In today's world, demonstration of the safety, efficacy, and quality of a new treatment strategy is no longer sufficient in many countries for market entry and reimbursement in the public healthcare system. This implies that new implants in orthopedic and orthopedic trauma surgery not only must be shown to lead to better medical outcome compared with the standard of care implant, but also must be shown to exhibit "good value" for the money for the public health-care system based on sound economic data from health-economic studies. The purpose of this article is to elucidate a framework for health-economic aspects alongside implant trials, with the assumption that the new implant is more costly but potentially better than the control implant. Cost-effectiveness, cost-utility, and cost-benefit studies are suitable for the assessment of the health-economic value of a new implant. The following criteria should be considered for a health-economic study design in the context with an implant: i) it should state medical benefits of the new implant compared with the control implant; ii) it should precise the type of health economic study; iii) it should define the methodological approach, perspective of the study, and types of costs; iv) if necessary, it should state discount costs and/benefits; and v) a sound sensitivity analysis should be included. Furthermore, close cooperation between researchers, clinicians, and health economists is essential.

  8. Electronic health records in an occupational health setting-Part II. Global deployment.

    PubMed

    Bey, Jean M; de Magalhães, Josiane S; Bojórquez, Lorena; Lin, Karen

    2013-03-01

    Electronic medical record systems are being used by more multi-national corporations. This article describes one corporation's considerations and process in successfully deploying a global electronic medical record system to international facilities in Brazil, Mexico, Singapore, and Taiwan. This article summarizes feedback from the experiences of occupational health nurse superusers in these countries. Copyright 2013, SLACK Incorporated.

  9. Rural Health Abstracts and Citations 1980-1987. Part II: Indian Health Care.

    ERIC Educational Resources Information Center

    North Dakota Univ., Grand Forks. Center for Rural Health.

    Over 300 articles concerning rural health as it pertains to American Indians and Alaska Natives are cited in this bibliography. Most of the articles were published between 1980 and 1988. Abstracts are reprinted verbatim and the bibliography is organized into sections by subject matter. Within each section, annotated citations are listed…

  10. [Evaluation auditing of the quality of health care in accreditation of health facilities].

    PubMed

    Paim, Chennyfer da Rosa Paino; Zucchi, Paola

    2011-01-01

    This article shows how many health insurance companies operating in the Greater São Paulo have been performing auditing of the quality of their health care services, professionals, and which criteria are being employed to do so. Because of the legislation decreeing that health insurance companies have legal co-responsibility for the health care services and National Health Agency control the health services National Health Agency, auditing evaluations have been implemented since then. The survey was based on electronic forms e-mailed to all health insurance companies operating in the Greater São Paulo. The sample consisted of 125 health insurance companies; 29 confirmed that had monitoring and evaluation processes; 26 performed auditing of their services regularly; from those, 20 used some type of form or protocol for technical visits; all evaluation physical and administrative structure and 22 included functional structure. Regarding the professionals audited 21 were nurses, 13 administrative assistants; 04 managers and 02 doctors. Regarding criteria for accreditation the following were highlighted: region analysis (96%), localization (88.88%) and cost (36%). We conclude that this type of auditing evaluation is rather innovative and is being gradually implemented by the health insurance companies, but is not a systematic process.

  11. Imino-phosphine palladium(II) and platinum(II) complexes: synthesis, molecular structures and evaluation as antitumor agents.

    PubMed

    Motswainyana, William M; Onani, Martin O; Madiehe, Abram M; Saibu, Morounke; Thovhogi, Ntevheleni; Lalancette, Roger A

    2013-12-01

    The imino-phosphine ligands L1 and L2 were prepared via condensation reaction of 2-(diphenylphosphino)benzaldehyde with substituted anilines and obtained in very good yields. An equimolar reaction of L1 and L2 with either PdCl2(cod) or PtCl2(cod) gave new palladium(II) and platinum(II) complexes 1-4. The compounds were characterized by elemental analysis, IR, (1)H and (31)P NMR spectroscopy. The molecular structures of 2, 3 and 4 were confirmed by X-ray crystallography. All the three molecular structures crystallized in monoclinic C2/c space system. The coordination geometry around the palladium and platinum atoms in respective structures exhibited distorted square planar geometry at the metal centers. The complexes were evaluated in vitro for their cytotoxic activity against human breast (MCF-7) and human colon (HT-29) cancer cells, and they exhibited growth inhibitory activities and selectivity that were superior to the standard compound cisplatin.

  12. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website: (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years.

  13. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-03-25

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years.

  14. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement

    PubMed Central

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (http://www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23531108

  15. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement

    PubMed Central

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (http://www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23531194

  16. Evaluation of Geographic Indices Describing Health Care Utilization.

    PubMed

    Kim, Agnus M; Park, Jong Heon; Kang, Sungchan; Kim, Yoon

    2017-01-01

    The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

  17. Evaluation of Geographic Indices Describing Health Care Utilization

    PubMed Central

    Park, Jong Heon

    2017-01-01

    Objectives The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit. PMID:28173689

  18. Making Accountability Less Painful: Program Evaluation in Allied Health Education.

    ERIC Educational Resources Information Center

    Rovezzi-Carroll, Susan; Fitz, Polly

    1985-01-01

    The School of Allied Health Professions at the University of Connecticut conducted a comprehensive program evaluation of its undergraduate programs in physical therapy, medical technology, and clinical dietetics. The evaluation process is described as well as a model that appears to meet the unique needs of postsecondary programs in allied health…

  19. Watershed health: An evaluation index for New Mexico

    Treesearch

    Bill Fleming

    1999-01-01

    Although watersheds are not equally healthy, there are no generally accepted criteria for evaluating and comparing them. This paper suggests several criteria which numerically evaluate watersheds in four ways: (1) riparian health, (2) aquatic macroinvertebrate biodiversity, (3) hillslope soil loss and (4) upland land use/flood peak potential. Each criterion is...

  20. Community Arts for Health: An Evaluation of a District Programme

    ERIC Educational Resources Information Center

    South, Jane

    2006-01-01

    Purpose: The purpose of this paper is to present an evaluation of a community arts for health programme in the UK involving the delivery of three separate projects targeted at disadvantaged areas. Design/methodology/approach: Evaluation plans were drawn up for each project, which linked long-term goals, objectives, indicators of success and data…

  1. Frameworks for evaluating health research capacity strengthening: a qualitative study

    PubMed Central

    2013-01-01

    Background Health research capacity strengthening (RCS) projects are often complex and hard to evaluate. In order to inform health RCS evaluation efforts, we aimed to describe and compare key characteristics of existing health RCS evaluation frameworks: their process of development, purpose, target users, structure, content and coverage of important evaluation issues. A secondary objective was to explore what use had been made of the ESSENCE framework, which attempts to address one such issue: harmonising the evaluation requirements of different funders. Methods We identified and analysed health RCS evaluation frameworks published by seven funding agencies between 2004 and 2012, using a mixed methods approach involving structured qualitative analyses of documents, a stakeholder survey and consultations with key contacts in health RCS funding agencies. Results The frameworks were intended for use predominantly by the organisations themselves, and most were oriented primarily towards funders’ internal organisational performance requirements. The frameworks made limited reference to theories that specifically concern RCS. Generic devices, such as logical frameworks, were typically used to document activities, outputs and outcomes, but with little emphasis on exploring underlying assumptions or contextual constraints. Usage of the ESSENCE framework appeared limited. Conclusions We believe that there is scope for improving frameworks through the incorporation of more accessible information about how to do evaluation in practice; greater involvement of stakeholders, following evaluation capacity building principles; greater emphasis on explaining underlying rationales of frameworks; and structuring frameworks so that they separate generic and project-specific aspects of health RCS evaluation. The third and fourth of these improvements might assist harmonisation. PMID:24330628

  2. The Clinical Teacher for Special Education. Final Report: Volume II; Evaluating the Model.

    ERIC Educational Resources Information Center

    Schwartz, Louis; Oseroff, Andrew

    Effectiveness of the clinical teaching model (CTM) developed at Florida State University is documented in Volume II of the project's final report. Reviewed is literature related to teacher effectiveness and conceptual changes, conceptual models and instructional systems, and evaluation research in education. Research design and procedures are…

  3. A Report on Longitudinal Evaluations of Preschool Programs. Volume II: Is Early Intervention Effective?

    ERIC Educational Resources Information Center

    Bronfenbrenner, Urie

    This document is the second part in a report on longitudinal evaluations of preschool programs. Part I reviewed long-term, controlled studies in order to generally assess the impact of preschool intervention. Part II reviews follow-up data in order to resolve the following five questions: (1) Do children in experimental programs continue to gain…

  4. The Clinical Teacher for Special Education. Final Report: Volume II; Evaluating the Model.

    ERIC Educational Resources Information Center

    Schwartz, Louis; Oseroff, Andrew

    Effectiveness of the clinical teaching model (CTM) developed at Florida State University is documented in Volume II of the project's final report. Reviewed is literature related to teacher effectiveness and conceptual changes, conceptual models and instructional systems, and evaluation research in education. Research design and procedures are…

  5. Safety evaluation for packaging transport of LSA-II liquids in MC-312 cargo tanks

    SciTech Connect

    Carlstrom, R.F.

    1996-09-11

    This safety evaluation for packaging authorizes the onsite transfer of bulk LSA-II radioactive liquids in the 222-S Laboratory Cargo Tank and Liquid Effluent Treatment Facility Cargo Tanks (which are U.S. Department of Transportation MC-312 specification cargo tanks) from their operating facilities to tank farm facilities.

  6. Washington Phase II Fish Diversion Screen Evaluations in the Yakima River Basin, 1998.

    SciTech Connect

    Blanton, S.L.; McMichael, Geoffrey A.; Neitzel, D.A.

    1999-12-01

    Pacific Northwest National Laboratory (PNNL) evaluated 19 Phase II screen sites in the Yakima River Basin as part of a multi-year study for the Bonneville Power Administration (BPA) on the effectiveness of fish screening devices. The sites were examined to determine if they were being effectively operated and maintained to provide fish a safe, efficient return to the Yakima River.

  7. EVALUATION AND INTERPRETATION OF MATERNAL TOXICITY IN SEGMENT II STUDIES: ISSUES, SOME ANSWERS AND DATA NEEDS

    EPA Science Inventory

    Rogers, J.M., and N. Chernoff. Reproductive Toxicology Division, NHEERL, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, U.S.A. Evaluation and interpretation of maternal toxicity in Segment II studies: Issues, s...

  8. Evaluation Dimensions for Full-Time Head Coaches at NCAA Division II Institutions.

    ERIC Educational Resources Information Center

    Gorney, Blaine; Ness, R. Gary

    2000-01-01

    Athletic directors, intercollegiate head coaches, and student athletes (n=34) participated in a Delphi study to determine dimensions that should be included in the evaluation of full-time head coaches at National Collegiate Athletic Association Division II institutions. Responses were used to develop a 15-category, 91-dimension tool representing…

  9. Evaluation of a Trainer for Sensor Operators on Gunship II Aircraft.

    ERIC Educational Resources Information Center

    Cream, Bertram W.

    This report describes the design, development, and evaluation of a training device intended to enable ground-based practice of equipment operation and target-tracking skills that are required by the Forward-Looking Infrared (FLIR) and Low Light Level TV (LLLTV) sensor operators assigned to Gunship II aircraft. This trainer makes use of a…

  10. Evaluation of health information outreach: theory, practice, and future direction*

    PubMed Central

    Whitney, Wanda; Dutcher, Gale A.; Keselman, Alla

    2013-01-01

    Objective: Convincing evidence of the effectiveness of health information outreach projects is essential to ensure their continuity. This paper reviews the current state of health information outreach evaluation, characterizes strengths and weaknesses in projects' ability to measure their impact, and assesses enablers of and barriers to projects' success. It also relates the projects' characteristics to evaluation practices. The paper then makes recommendations for strengthening evaluation. Methods: Upon conducting a literature search, the authors identified thirty-three articles describing consumer health information outreach programs, published between 2000 and 2010. We then analyzed the outreach projects with respect to their goals and characteristics, evaluation methods and measures, and reported outcomes. Results: The results uncovered great variation in the quality of evaluation methods, outcome measures, and reporting. Outcome measures did not always match project objectives; few quantitative measures employed pretests or reported statistical significance; and institutional change was not measured in a structured way. While papers reported successful outcomes, greater rigor in measuring and documenting outcomes would be helpful. Conclusion: Planning outcome evaluation carefully and conducting research into mediators between health information and behavior will strengthen the ability to identify best practices and develop a theoretical framework and practical guidance for health information outreach. PMID:23646029

  11. Evaluation of health information outreach: theory, practice, and future direction.

    PubMed

    Whitney, Wanda; Dutcher, Gale A; Keselman, Alla

    2013-04-01

    Convincing evidence of the effectiveness of health information outreach projects is essential to ensure their continuity. This paper reviews the current state of health information outreach evaluation, characterizes strengths and weaknesses in projects' ability to measure their impact, and assesses enablers of and barriers to projects' success. It also relates the projects' characteristics to evaluation practices. The paper then makes recommendations for strengthening evaluation. Upon conducting a literature search, the authors identified thirty-three articles describing consumer health information outreach programs, published between 2000 and 2010. We then analyzed the outreach projects with respect to their goals and characteristics, evaluation methods and measures, and reported outcomes. The results uncovered great variation in the quality of evaluation methods, outcome measures, and reporting. Outcome measures did not always match project objectives; few quantitative measures employed pretests or reported statistical significance; and institutional change was not measured in a structured way. While papers reported successful outcomes, greater rigor in measuring and documenting outcomes would be helpful. Planning outcome evaluation carefully and conducting research into mediators between health information and behavior will strengthen the ability to identify best practices and develop a theoretical framework and practical guidance for health information outreach.

  12. Health Research Evaluation and its Role on Knowledge Production

    PubMed Central

    Djalalinia, Sh; Owlia, P; Forouzan, A Setareh; Habibi, E; Dejman, M; Eftekhari, M Baradaran; Ghanei, M; Malekafzali, H; Peykari, N

    2012-01-01

    Background: Knowledge production and evaluation are two important functions of health research system (HRS). In this article, we aimed to reveal the correlation between evaluation of health research organizations and health knowledge production promotion. Methods: A comprehensive evaluation system was developed to evaluate the academic performance of national medical science universities on an annual basis. It assess following domains; stewardship, capacity building and knowledge production. Measurable indicators for each domain were assigned, a ‘research profile’ for each department was provided. In this study, we compared the results of annually national Health Research System evaluation findings during 2005–2008. Results: The number of scientific articles has been increased from 4672 to 8816 during 2005 to 2008. It is mentionable that, the number of articles which has been published in indexed data bases has risen too. This fact could be related to directed policy for more international publication of scientific articles from Iran. The proportion of total articles to the number of academic members was 1.14 in 2008, comparing to 0.84 in 2005. It means that this proportion have increased about twice (0.7 Vs 0.45) during mentioned time. Moreover, other scientific products such as authored books based on domestic researches and cited articles in textbooks have increased according to special attention to knowledge production by policy makers. Conclusion: We conclude that Health System Research evaluation could be used as a mean for implementing policies and promoting knowledge production. PMID:23113133

  13. Conceptual evaluation of population health surveillance programs: method and example.

    PubMed

    El Allaki, Farouk; Bigras-Poulin, Michel; Ravel, André

    2013-03-01

    Veterinary and public health surveillance programs can be evaluated to assess and improve the planning, implementation and effectiveness of these programs. Guidelines, protocols and methods have been developed for such evaluation. In general, they focus on a limited set of attributes (e.g., sensitivity and simplicity), that are assessed quantitatively whenever possible, otherwise qualitatively. Despite efforts at standardization, replication by different evaluators is difficult, making evaluation outcomes open to interpretation. This ultimately limits the usefulness of surveillance evaluations. At the same time, the growing demand to prove freedom from disease or pathogen, and the Sanitary and Phytosanitary Agreement and the International Health Regulations require stronger surveillance programs. We developed a method for evaluating veterinary and public health surveillance programs that is detailed, structured, transparent and based on surveillance concepts that are part of all types of surveillance programs. The proposed conceptual evaluation method comprises four steps: (1) text analysis, (2) extraction of the surveillance conceptual model, (3) comparison of the extracted surveillance conceptual model to a theoretical standard, and (4) validation interview with a surveillance program designer. This conceptual evaluation method was applied in 2005 to C-EnterNet, a new Canadian zoonotic disease surveillance program that encompasses laboratory based surveillance of enteric diseases in humans and active surveillance of the pathogens in food, water, and livestock. The theoretical standard used for evaluating C-EnterNet was a relevant existing structure called the "Population Health Surveillance Theory". Five out of 152 surveillance concepts were absent in the design of C-EnterNet. However, all of the surveillance concept relationships found in C-EnterNet were valid. The proposed method can be used to improve the design and documentation of surveillance programs. It

  14. Value for money: an evaluation of health spending in Canada.

    PubMed

    Ariste, Ruolz; Di Matteo, Livio

    2017-01-03

    The long-term increase in international health spending sparked concerns about sustainability of health care systems but also the impact of such spending and the value for money from health spending. The period since 1975 has witnessed an increase in per capita health spending in Canada along with improvements in health outcomes. This paper is an economic evaluation of health spending in Canada-an analysis of the cost-effectiveness of aggregate health spending. Estimates of the cost per quality-adjusted life-year (QALY) are made for the whole 1980-2012 period and for four sub-periods of time-1980-1989; 1989-1998; 1998-2007 and 2007-2012. This is done for both the general population as well as Canadian seniors. Under a medium contribution of health spending to life expectancy scenario for the 1980-2012 period, the costs per QALY gained averaged $16,977 and $14,968, respectively for the general population and the seniors. This suggests that the Canadian health system produces relatively good value for money, especially for the seniors. After applying separate adjustments to match total health spending in the US and NHS health spending in the UK, we found that costs per QALY gained in Canada were generally lower than those found for the US, but not for the UK.

  15. Maintaining exercise and healthful eating in older adults: the SENIOR project II: study design and methodology.

    PubMed

    Clark, Phillip G; Blissmer, Bryan J; Greene, Geoffrey W; Lees, Faith D; Riebe, Deborah A; Stamm, Karen E

    2011-01-01

    The Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR) Project II is an intervention study to promote the maintenance of both exercise and healthful eating in older adults. It is the second phase of an earlier study, SENIOR Project I, that originally recruited 1277 community-dwelling older adults to participate in behavior-specific interventions designed to increase exercise and/or fruit and vegetable consumption. The general theoretical framework for this research is the Transtheoretical Model (TTM) of Health Behavior Change. The current intervention occurs over a 48-month period, using a manual, newsletters, and phone coaching calls. Annual assessments collect standardized data on behavioral outcomes (exercise and diet), TTM variables (stage of change and self-efficacy), psychosocial variables (social support, depression, resilience, and life satisfaction), physical activity and functioning (SF-36, Up and Go, Senior Fitness Test, and disability assessment), cognitive functioning (Trail Making Test and Forward and Backward Digit Span), physical measures (height, weight, and waist circumference), and demographics. The SENIOR Project II is designed to answer the following question as its primary objective: (1) Does an individualized active-maintenance intervention with older adults maintain greater levels of healthful exercise and dietary behaviors for 4years, compared to a control condition? In addition, there are two secondary objectives: (2) What are the psychosocial factors associated with the maintenance of health-promoting behaviors in the very old? (3) What are the effects of the maintenance of health-promoting behaviors on reported health outcomes, psychosocial measures, anthropometrics, and cognitive status? Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Maintaining Exercise and Healthful Eating in Older Adults: The SENIOR Project II: Study Design and Methodology

    PubMed Central

    Clark, Phillip G.; Blissmer, Bryan J.; Greene, Geoffrey W.; Lees, Faith D.; Riebe, Deborah A.; Stamm, Karen E.

    2015-01-01

    The Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR) Project II is an intervention study to promote the maintenance of both exercise and healthful eating in older adults. It is the second phase of an earlier study, SENIOR Project I, that originally recruited 1,277 community-dwelling older adults to participate in behavior-specific interventions designed to increase exercise and/or fruit and vegetable consumption. The general theoretical framework for this research is the Transtheoretical Model (TTM) of Health Behavior Change. The current intervention occurs over a 48-month period, using a manual, newsletters, and phone coaching calls. Annual assessments collect standardized data on behavioral outcomes (exercise and diet), TTM variables (stage of change and self-efficacy), psychosocial variables (social support, depression, resilience, and life satisfaction), physical activity and functioning (SF-36, Up and Go, Senior Fitness Test, and disability assessment), cognitive functioning (Trail Making Test and Forward and Backward Digit Span), physical measures (height, weight, and waist circumference), and demographics. The SENIOR Project II is designed to answer the following question as its primary objective: (1) Does an individualized active-maintenance intervention with older adults maintain greater levels of healthful exercise and dietary behaviors for four years, compared to a control condition? In addition, there are two secondary objectives: (2) What are the psychosocial factors associated with the maintenance of health-promoting behaviors in the very old? and (3) What are the effects of the maintenance of health-promoting behaviors on reported health outcomes, psychosocial measures, anthropometrics, and cognitive status? PMID:20955821

  17. Health economic analysis of costs of laparoscopic and open surgery for rectal cancer within a randomized trial (COLOR II).

    PubMed

    Gehrman, Jacob; Björholt, Ingela; Angenete, Eva; Andersson, John; Bonjer, Jaap; Haglind, Eva

    2017-03-01

    Previous studies regarding the comparative costs of laparoscopic and open surgery for rectal cancer provide ambiguous conclusions, and there are no large randomized trials or long-term follow-up. A prospective cost-minimization analysis was carried out by using data of clinical resource use from the randomized controlled trial COLOR II. Some data needed for the health economic evaluation were not collected in the clinical trial; therefore, a retrospective data collection was made for COLOR II-patients operated at the largest participating Swedish hospital (n = 105). Sick leave information was provided by the Swedish social insurance agency. Unit costs were collected from Swedish sources. The primary outcome was the difference in mean cost between laparoscopic and open surgery. The COLOR II-trial enrolled 1044 rectal cancer patients randomized between laparoscopic and open surgery 2:1. At the 3-year follow-up data for the clinical variables used in the analysis were available for 74-89 % of patients. Laparoscopic surgery costs the health care sector more than the open technique, both at 28 days ($1910, 95 % CI 677-3143) and 3 years ($3854, 95 % CI 1527-6182) after surgery. There were, however, no differences in long-term costs to society between laparoscopic and open surgery ($684, 95 % CI -5799 to 7166). Though the study found short- and long-term cost differences for the healthcare sector, there was no difference in regard to the long-term societal perspective. Future research is suggested to investigate the effects of sick leave costs using material from a greater number of patients.

  18. [Decision modeling for economic evaluation of health technologies].

    PubMed

    de Soárez, Patrícia Coelho; Soares, Marta Oliveira; Novaes, Hillegonda Maria Dutilh

    2014-10-01

    Most economic evaluations that participate in decision-making processes for incorporation and financing of technologies of health systems use decision models to assess the costs and benefits of the compared strategies. Despite the large number of economic evaluations conducted in Brazil, there is a pressing need to conduct an in-depth methodological study of the types of decision models and their applicability in our setting. The objective of this literature review is to contribute to the knowledge and use of decision models in the national context of economic evaluations of health technologies. This article presents general definitions about models and concerns with their use; it describes the main models: decision trees, Markov chains, micro-simulation, simulation of discrete and dynamic events; it discusses the elements involved in the choice of model; and exemplifies the models addressed in national economic evaluation studies of diagnostic and therapeutic preventive technologies and health programs.

  19. An Evaluation Tool for Agricultural Health and Safety Mobile Applications.

    PubMed

    Reyes, Iris; Ellis, Tammy; Yoder, Aaron; Keifer, Matthew C

    2016-01-01

    As the use of mobile devices and their software applications, or apps, becomes ubiquitous, use amongst agricultural working populations is expanding as well. The smart device paired with a well-designed app has potential for improving workplace health and safety in the hands of those who can act upon the information provided. Many apps designed to assess workplace hazards and implementation of worker protections already exist. However, the abundance and diversity of such applications also presents challenges regarding evaluation practices and assignation of value. This is particularly true in the agricultural workspace, as there is currently little information on the value of these apps for agricultural safety and health. This project proposes a framework for developing and evaluating apps that have potential usefulness in agricultural health and safety. The evaluation framework is easily transferable, with little modification for evaluation of apps in several agriculture-specific areas.

  20. Gestational Age, Infant Birth Weight, and Subsequent Risk of Type 2 Diabetes in Mothers: Nurses' Health Study II

    MedlinePlus

    ... Birth Weight, and Subsequent Risk of Type 2 Diabetes in Mothers: Nurses’ Health Study II Navigate This ... as 10 pounds or more at term. Gestational diabetes In the NHSII 1989 baseline questionnaire and subsequent ...

  1. Modified Class II open sandwich restorations: evaluation of interfacial adaptation and influence of different restorative techniques.

    PubMed

    Andersson-Wenckert, Ingrid E; van Dijken, Jan W V; Hörstedt, Per

    2002-06-01

    The sandwich technique with resin-modified glass ionomer cement (RMGIC) has been proposed to relieve the contraction stresses of direct resin composite (RC) restorations. The aim of this study was to evaluate the interfacial adaptation to enamel and dentin of modified Class II open RMGIC/RC sandwich restorations and the influence of different light curing techniques and matrix bands. Forty box-shaped Class II fillings were placed in vivo in premolars scheduled for extraction after one month. In groups I and II, a metal matrix was used; RC was inserted with horizontal (group I) and diagonal (group II) increments and cured with indirect/direct light. Group III was performed as group II, but a transparent matrix was used. Group IV was as group II, but with a separating liner between RMGIC and RC. Group V was a closed sandwich restoration. Interfacial quality was studied using SEM replica technique. Gap-free interfacial adaptation to enamel was observed for RMGIC in 70%, for RC in 70% and to dentin for RMGIC in 81%, for RC in 56%. No significant differences were seen between the experimental groups. At the cervical margins, RMGIC showed significantly better adaptation to enamel than RC, 74% and 42%, respectively. In conclusion, the investigated restorations showed a high percentage of gap-free interfacial adaptation in vivo. Interfacial adaptation to dentin and to cervical enamel was significantly better for RMGIC than for RC.

  2. Evaluation of Laser Stabilization and Imaging Systems for LCLS-II - Final Paper

    SciTech Connect

    Barry, Matthew

    2015-08-20

    By combining the top performing commercial laser beam stabilization system with the most ideal optical imaging configuration, the beamline for the Linear Accelerator Coherent Light Source II (LCLS-II) will deliver the highest quality and most stable beam to the cathode. To determine the optimal combination, LCLS-II beamline conditions were replicated and the systems tested with a He-Ne laser. The Guidestar-II and MRC active laser beam stabilization systems were evaluated for their ideal positioning and stability. Both a two and four lens optical imaging configuration was then evaluated for beam imaging quality, magnification properties, and natural stability. In their best performances when tested over fifteen hours, Guidestar-II kept the beam stable over approximately 70-110um while the MRC system kept it stable over approximately 90-100um. During short periods of time, Guidestar-II kept the beam stable between 10-20um, but was more susceptible to drift over time, while the MRC system maintained the beam between 30-50um with less overall drift. The best optical imaging configuration proved to be a four lens system that images to the iris located in the cathode room and from there, imaged to the cathode. The magnification from the iris to the cathode was 2:1, within an acceptable tolerance to the expected 2.1:1 magnification. The two lens configuration was slightly more stable in small periods of time (less than 10 minutes) without the assistance of a stability system, approximately 55um compared to approximately 70um, but the four lens configurations beam image had a significantly flatter intensity distribution compared to the two lens configuration which had a Gaussian distribution. A final test still needs to be run with both stability systems running at the same time through the four lens system. With this data, the optimal laser beam stabilization system can be determined for the beamline of LCLS-II.

  3. [Pragmatism and realism for public health intervention evaluation].

    PubMed

    Ridde, V; Haddad, S

    2013-06-01

    Forty years ago, Schwartz and Lellouch invented pragmatic clinical trials. Their proposal has not yet been fully espoused. This appears to be the case today also in the domain of public health interventions evaluation, where some still insist on the superiority of experimental methods. Yet evaluations of complex public health interventions are fraught with pitfalls for researchers. Most such interventions take place in natural experimental contexts, where they have no control over the context or the factors that modify implementation and influence the effects. Experimental approaches are, in these cases, not very appropriate, and yet decision makers want to be able to take decisions to improve them. This article presents our experience over the past 5years with evaluative research in two public health interventions. We wish to show how we conduct evaluations in practice using a pragmatic approach. The article is focused on elements that have not, to date, received much attention in the francophone literature: the evaluability assesment and intervention logic, research strategies reinforced particularly by mixed methods and time series, and the analysis of implementation fidelity and mechanisms that foster effectiveness. Because the pragmatic approach to evaluative research stresses the need for good understanding of context and uses reinforced methodological strategies, it allows for rigorous responses to evaluation questions raised by those implementing complex public health interventions. Thus, experimental approaches are not necessarily required to analyze the effectiveness of interventions.

  4. Health economic evaluation in Japan: a case study of one aspect of health technology assessment.

    PubMed

    Oliver, Adam

    2003-02-01

    There is a burgeoning literature in health economic evaluation, with this form of analysis becoming increasingly influential at the health policy making level in a number of countries. However, a search of the literature reveals that in Japan, the world's second largest health care market, very little health economic evaluation has been undertaken. The main reason for the lack of interest in economic evaluation is that the fee-for-service and strict price regulation that characterises the system of health care financing in Japan is not conducive to this form of analysis. Moreover, the government and many researchers are satisfied that the current organisation of health care has given long life and low infant mortality at low cost. Even if it is accepted that low health care costs and good health prevail in Japan, slower economic growth rates, an ageing population and the development of new medical technologies will place increasing pressure on health care resources and will necessitate a more rational use of these resources. Good economic evaluation, by weighing benefits against costs, has an important role to play.

  5. Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

    PubMed

    Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

    2017-08-14

    To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

  6. MDPHnet: Secure, Distributed Sharing of Electronic Health Record Data for Public Health Surveillance, Evaluation, and Planning

    PubMed Central

    Vogel, Joshua; Brown, Jeffrey S.; Land, Thomas; Platt, Richard

    2014-01-01

    Electronic health record systems contain clinically detailed data from large populations of patients that could significantly enrich public health surveillance. Clinical practices’ security, privacy, and proprietary concerns, however, have limited their willingness to share these data with public health agencies. We describe a novel distributed network for public health surveillance called MDPHnet. The system allows the Massachusetts Department of Public Health (MDPH) to initiate custom queries against participating practices’ electronic health records while the data remain behind each practice’s firewall. Practices can review proposed queries before execution and approve query results before releasing them to the health department. MDPH is using the system for routine surveillance for priority conditions and to evaluate the impact of public health interventions. PMID:25322301

  7. MDPHnet: secure, distributed sharing of electronic health record data for public health surveillance, evaluation, and planning.

    PubMed

    Vogel, Joshua; Brown, Jeffrey S; Land, Thomas; Platt, Richard; Klompas, Michael

    2014-12-01

    Electronic health record systems contain clinically detailed data from large populations of patients that could significantly enrich public health surveillance. Clinical practices' security, privacy, and proprietary concerns, however, have limited their willingness to share these data with public health agencies. We describe a novel distributed network for public health surveillance called MDPHnet. The system allows the Massachusetts Department of Public Health (MDPH) to initiate custom queries against participating practices' electronic health records while the data remain behind each practice's firewall. Practices can review proposed queries before execution and approve query results before releasing them to the health department. MDPH is using the system for routine surveillance for priority conditions and to evaluate the impact of public health interventions.

  8. Systematic overview of economic evaluations of health-related rehabilitation.

    PubMed

    Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

    2016-01-01

    Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Mental health, citizenship, and the memory of World War II in the Netherlands (1945-85).

    PubMed

    Oosterhuis, Harry

    2014-03-01

    After World War II, Dutch psychiatrists and other mental health care professionals articulated ideals of democratic citizenship. Framed in terms of self-development, citizenship took on a broad meaning, not just in terms of political rights and obligations, but also in the context of material, social, psychological and moral conditions that individuals should meet in order to develop themselves and be able to act according to those rights and obligations in a responsible way. In the post-war period of reconstruction (1945-65), as well as between 1965 and 1985, the link between mental health and ideals of citizenship was coloured by the public memory of World War II and the German occupation, albeit in completely different, even opposite ways. The memory of the war, and especially the public consideration of its victims, changed drastically in the mid-1960s, and the mental health sector played a crucial role in bringing this change about. The widespread attention to the mental effects of the war that surfaced in the late 1960s after a period of 20 years of public silence should be seen against the backdrop of the combination of democratization and the emancipation of emotions.

  10. Evaluation of SAGE II and Balloon-Borne Stratospheric Aerosol Measurements

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Under funding from this proposal we evaluated measurements of stratospheric sulfate aerosols from three platforms. Two were satellite platforms providing solar extinction measurements, the Stratospheric Aerosol and Gas Experiment (SAGE) II using wavelengths from 0.386 - 1.02 microns, and the Halogen Occultation Experiment (HALOE) using wavelengths from 2.45 to 5.26 microns. The third set of measurements was from in situ sampling by balloonborne optical particle counters (OPCs). The goal was to determine the consistency among these data sets. This was accomplished through analysis of the existing measurement records, and through additional balloonborne OPC flights coinciding with new SAGE II observations over Laramie, Wyoming. All analyses used the SAGE II v 6.0 data. This project supported two balloon flights per year over Laramie dedicated to SAGE II coincidence. Because logistical factors, such as poor surface weather or unfavorable payload impact location, can make it difficult to routinely obtain close coincidences with SAGE II, we attempt to conduct nearly every Laramie flight (roughly one per month) in conjunction with a SAGE II overpass. The Laramie flight frequency has varied over the years depending on field commitments and funding sources. Current support for the Laramie measurements is from the National Science Foundation in addition to support from this NASA grant. We have also completed a variety of comparisons using aerosol measurements from SAGE II, OPCs, and HALOE. The instruments were compared for their various estimates of aerosol extinction at the SAGE II wavelengths and for aerosol surface area. Additional results, such as illustrated here, can be found in a recently accepted manuscript describing comparisons between SAGE II, HALOE, and OPCs for the period 1982 - 2000. While overall, the impression from these results is encouraging, the agreement of the measurements changes with latitude, altitude, time, and parameter. In the broadest sense

  11. Evaluation of SAGE II and Balloon-Borne Stratospheric Aerosol Measurements

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Under funding from this proposal we evaluated measurements of stratospheric sulfate aerosols from three platforms. Two were satellite platforms providing solar extinction measurements, the Stratospheric Aerosol and Gas Experiment (SAGE) II using wavelengths from 0.386 - 1.02 microns, and the Halogen Occultation Experiment (HALOE) using wavelengths from 2.45 to 5.26 microns. The third set of measurements was from in situ sampling by balloonborne optical particle counters (OPCs). The goal was to determine the consistency among these data sets. This was accomplished through analysis of the existing measurement records, and through additional balloonborne OPC flights coinciding with new SAGE II observations over Laramie, Wyoming. All analyses used the SAGE II v 6.0 data. This project supported two balloon flights per year over Laramie dedicated to SAGE II coincidence. Because logistical factors, such as poor surface weather or unfavorable payload impact location, can make it difficult to routinely obtain close coincidences with SAGE II, we attempt to conduct nearly every Laramie flight (roughly one per month) in conjunction with a SAGE II overpass. The Laramie flight frequency has varied over the years depending on field commitments and funding sources. Current support for the Laramie measurements is from the National Science Foundation in addition to support from this NASA grant. We have also completed a variety of comparisons using aerosol measurements from SAGE II, OPCs, and HALOE. The instruments were compared for their various estimates of aerosol extinction at the SAGE II wavelengths and for aerosol surface area. Additional results, such as illustrated here, can be found in a recently accepted manuscript describing comparisons between SAGE II, HALOE, and OPCs for the period 1982 - 2000. While overall, the impression from these results is encouraging, the agreement of the measurements changes with latitude, altitude, time, and parameter. In the broadest sense

  12. Evaluation on equality and efficiency of health resources allocation and health services utilization in China.

    PubMed

    Sun, Jian; Luo, Hongye

    2017-07-14

    China is faced with a daunting challenge to equality and efficiency in health resources allocation and health services utilization in the context of rapid economic growth. This study sought to evaluate the equality and efficiency of health resources allocation and health services utilization in China. Demographic, economic, and geographic area data was sourced from China Statistical Yearbook 2012-2016. Data related to health resources and health services was obtained from China Health Statistics Yearbook 2012-2016. Furthermore, we evaluated the equality of health resources allocation based on Gini coefficient. Concentration index was used to measure the equality in utilization of health services. Data envelopment analysis (DEA) was employed to assess the efficiency of health resources allocation. From 2011 to 2015, the Gini coefficients for health resources by population ranged between 0.0644 and 0.1879, while the Gini coefficients for the resources by geographic area ranged from 0.6136 to 0.6568. Meanwhile, the concentration index values for health services utilization ranged from -0.0392 to 0.2110. Moreover, in 2015, 10 provinces (32.26%) were relatively efficient in terms of health resources allocation, while 7 provinces (22.58%) and 14 provinces (45.16%) were weakly efficient and inefficient, respectively. There exist distinct regional disparities in the distribution of health resources in China, which are mainly reflected in the geographic distribution of health resources. Furthermore, the people living in the eastern developed areas are more likely to use outpatient care, while the people living in western underdeveloped areas are more likely to use inpatient care. Moreover, the efficiency of health resources allocation in 21 provinces (67.74%) of China was low and needs to be improved. Thus, the government should pay more attention to the equality based on geographic area, guide patients to choose medical treatment rationally, and optimize the resource

  13. Acute mental health care according to recent mental health legislation Part II. Activity-based costing.

    PubMed

    Janse van Rensburg, A B; Jassat, W

    2011-03-01

    This is the second of three reports on the follow-up review of mental health care at Helen Joseph Hospital (HJH). Objectives for the review were to provide realistic estimates of cost for unit activities and to establish a quality assurance cycle that may facilitate cost centre management. The study described and used activity-based costing (ABC) as an approach to analyse the recurrent cost of acute in-patient care for the financial year 2007-08. Fixed (e.g. goods and services, staff salaries) and variable recurrent costs (including laboratory' 'pharmacy') were calculated. Cost per day, per user and per diagnostic group was calculated. While the unit accounted for 4.6% of the hospital's total clinical activity (patient days), the cost of R8.12 million incurred represented only 2.4% of the total hospital expenditure (R341.36 million). Fixed costs constituted 90% of the total cost. For the total number of 520 users that stayed on average 15.4 days, the average cost was R1,023.00 per day and R15748.00 per user. Users with schizophrenia accounted for the most (35%) of the cost, while the care of users with dementia was the most expensive (R23,360.68 per user). Costing of the application of World Health Organization norms for acute care staffing for the unit, projected an average increase of 103% in recurrent costs (R5.1 million), with the bulk (a 267% increase) for nursing. In the absence of other guidelines, aligning clinical activity with the proportion of the hospital's total budget may be an approach to determine what amount should be afforded to acute mental health in-patient care activities in a general regional hospital such as HJH. Despite the potential benefits of ABC, its continued application will require time, infrastructure and staff investment to establish the capacity to maintain routine annual cost analyses for different cost centres.

  14. Health and Fitness Evaluations for Long Duration Microgravity Exposure

    NASA Technical Reports Server (NTRS)

    Roden, Sean Kevin; Ewert, Patricia

    2006-01-01

    The current health maintenance program for ISS is adequate; however the future of medical care and research in space requires a change where crew time efficiency and autonomy are emphasized. NASA s medical personnel are currently refining their ability to monitor and provide remote health care in such a manner. The proposed plan would evaluate health and fitness of the on orbit crew to; perform on orbit operations, and readiness to return to a terrestrial environment. A two tiered approach will utilize exercise and medical equipment, as well as periodic medical conferences with the flight surgeon, to provide a quantitative and clinical picture of the crew s health and fitness. Any off nominal health and fitness issues that could arise will be evaluated by providing an "armamentarium" of devices both medical and exercise specific to the on orbit crew to use. The ability for the crew to provide autonomous health care, with decreasing earth support, will become increasingly more important for exploration missions. This new plan of health care and maintenance will allow us to, development such efforts while continuing to monitor and provide the best possible health, care and medical research through the microgravity environment on board ISS.

  15. Evolution of a multilevel framework for health program evaluation.

    PubMed

    Masso, Malcolm; Quinsey, Karen; Fildes, Dave

    2016-06-16

    A well-conceived evaluation framework increases understanding of a program's goals and objectives, facilitates the identification of outcomes and can be used as a planning tool during program development. Herein we describe the origins and development of an evaluation framework that recognises that implementation is influenced by the setting in which it takes place, the individuals involved and the processes by which implementation is accomplished. The framework includes an evaluation hierarchy that focuses on outcomes for consumers, providers and the care delivery system, and is structured according to six domains: program delivery, impact, sustainability, capacity building, generalisability and dissemination. These components of the evaluation framework fit into a matrix structure, and cells within the matrix are supported by relevant evaluation tools. The development of the framework has been influenced by feedback from various stakeholders, existing knowledge of the evaluators and the literature on health promotion and implementation science. Over the years, the framework has matured and is generic enough to be useful in a wide variety of circumstances, yet specific enough to focus data collection, data analysis and the presentation of findings.What is known about the topic? Evaluation in healthcare typically investigates the implementation of complex innovations in uncontrolled 'real world' settings. This presents many challenges for evaluators and those wanting to commission evaluations.What does this paper add? Herein we describe the origins and development of an evaluation framework that is structured in terms of three levels and six domains. The framework has stood the test of time and been used to evaluate a variety of innovations in the delivery of health and aged care. Novel aspects of the framework include the concepts of levels, capacity building and sustainability.What are the implications for practitioners? The structure of the evaluation framework

  16. Economic evaluation of four angiotensin II receptor blockers in the treatment of hypertension.

    PubMed

    Miller, Lesley-Ann; Wade, Rolin; Dai, Dingwei; Cziraky, Mark J; Ramaswamy, Krishnan; Panjabi, Sumeet

    2010-06-01

    To evaluate the cost effectiveness of achieving JNC 7 blood pressure goals with angiotensin II receptor blockers (ARBs). Cost effectiveness of olmesartan, losartan, valsartan, and irbesartan was compared with real world patient chart and claims data from a large US health plan. Patients 18 and older with >or=2 claims for an ARB between May 1, 2002 and December 31, 2005 were identified from the claims database. Patients with a diagnosis of hypertension in the 6-month baseline period before the first (index) ARB claim and ARB-free during baseline were included. Medical charts were randomly sampled from the cohort of identified patients; effectiveness data were obtained from charts and linked to healthcare claims and costs. These data were used to populate the decision analytic model. All-cause and hypertension-attributable costs to achieve JNC 7 goals were measured. Comparisons were made within low and high-dose strata and pooled across ARB doses. 121 472 patients were identified, and charts were randomly abstracted for 1600. Of these, 1293 patients were hypertensive at index. Baseline patient characteristics for the chart group were modestly different from the larger cohort. More patients treated with olmesartan (77.8%) than with losartan (66.5%), valasartan (68.8%), or irbesartan (68.8%) achieved JNC 7 BP goals. In pooled-dose comparisons, cost per patient reaching BP goal was $8964 (all-cause) and $2704 (hypertension-attributable) for olmesartan; compared with $10 848 and $3291 for losartan; $10 557 and $3577 for valsartan; and $13395 and $4325 for irbesartan, respectively. The trend was similar for the dose stratification analysis, except in the comparison between high-dose losartan and olmesartan, where losartan had a lower cost-effectiveness ratio. Overall olmesartan was the most effective and cost-saving treatment option compared to losartan, valsartan, and irbesartan for the achievement of JNC 7 BP goals in this managed-care population.

  17. Transdisciplinary research and evaluation for community health initiatives.

    PubMed

    Harper, Gary W; Neubauer, Leah C; Bangi, Audrey K; Francisco, Vincent T

    2008-10-01

    Transdisciplinary research and evaluation projects provide valuable opportunities to collaborate on interventions to improve the health and well-being of individuals and communities. Given team members' diverse backgrounds and roles or responsibilities in such projects, members' perspectives are significant in strengthening a project's infrastructure and improving its organizational functioning. This article presents an evaluation mechanism that allows team members to express the successes and challenges incurred throughout their involvement in a multisite transdisciplinary research project. Furthermore, their feedback is used to promote future sustainability and growth. Guided by a framework known as organizational development, the evaluative process was conducted by a neutral entity, the Quality Assurance Team. A mixed-methods approach was utilized to garner feedback and clarify how the research project goals could be achieved more effectively and efficiently. The multiple benefits gained by those involved in this evaluation and implications for utilizing transdisciplinary research and evaluation teams for health initiatives are detailed.

  18. The Cradle Coast personally controlled electronic health record evaluation research.

    PubMed

    Cummings, Elizabeth; Cheek, Colleen; Van Der Ploeg, Winifred; Orpin, Peter; Behrens, Heidi; Condon, Sharon; Jaffray, Linda; Ellis, Isabelle; Ringeisen Arnold, Barbara; Brogan, Robyn; Skinner, Timothy

    2012-01-01

    In 2010 the Federal Government announced funding over two years to create a Personally Controlled Electronic Health Record (PCEHR) for Australians. One of the wave 2 implementation sites is the Cradle Coast in Tasmania. A PCEHR Program Benefits and Evaluation Partner (BEP) has been appointed to undertake evaluation activities with the e-health lead implementation sites. In addition to this implementation a comprehensive research plan has been developed and commenced through the Rural Clinical School at the University of Tasmania. The overarching aim of the research agenda is to evaluate the outcomes of various elements of the 4C project as it evolves and is implemented, from multiple perspectives. The research agenda is important as it expands upon the NEHTA mandated evaluation and provides an holistic overview of the PCEHR implementation process and outcomes for clinicians, patients and family members. This paper will detail the planned evaluation and its progress to date.

  19. Transdisciplinary Research and Evaluation for Community Health Initiatives

    PubMed Central

    Harper, Gary W.; Neubauer, Leah C.; Bangi, Audrey K.; Francisco, Vincent T.

    2010-01-01

    Transdisciplinary research and evaluation projects provide valuable opportunities to collaborate on interventions to improve the health and well-being of individuals and communities. Given team members’ diverse backgrounds and roles or responsibilities in such projects, members’ perspectives are significant in strengthening a project’s infrastructure and improving its organizational functioning. This article presents an evaluation mechanism that allows team members to express the successes and challenges incurred throughout their involvement in a multisite transdisciplinary research project. Furthermore, their feedback is used to promote future sustainability and growth. Guided by a framework known as organizational development, the evaluative process was conducted by a neutral entity, the Quality Assurance Team. A mixed-methods approach was utilized to garner feedback and clarify how the research project goals could be achieved more effectively and efficiently. The multiple benefits gained by those involved in this evaluation and implications for utilizing transdisciplinary research and evaluation teams for health initiatives are detailed. PMID:18936267

  20. Consumer Health: Does Advertising Work on You? and Evaluating a Product's Health Claims.

    ERIC Educational Resources Information Center

    Cox, Carolyn C.

    This paper describes lessons for teaching middle and high school students how to determine if they are influenced by the power of advertising and how to evaluate a product's health claims. To determine the influence of advertising, teachers have high school students discuss what their latest health product/service purchase was, why they bought it,…

  1. Synthesis, characterization, thermal study and biological evaluation of Cu(II), Co(II), Ni(II) and Zn(II) complexes of Schiff base ligand containing thiazole moiety

    NASA Astrophysics Data System (ADS)

    Nagesh, G. Y.; Mahendra Raj, K.; Mruthyunjayaswamy, B. H. M.

    2015-01-01

    The novel Schiff base ligand 2-(4-(dimethylamino)benzylidene)-N-(4-phenylthiazol-2-yl)hydrazinecarboxamide (L) obtained by the condensation of N-(4-phenylthiazol-2-yl)hydrazinecarboxamide with 4-dimethylaminobenzaldehyde and its newly synthesized Cu(II), Co(II), Ni(II) and Zn(II) complexes have been characterized by microanalysis, magnetic susceptibility, molar conductance, thermal analysis, FT-IR, 1H NMR, ESI mass, UV-Visible, ESR spectroscopy and powder X-ray diffraction data. The newly synthesized ligand behaves as a bidentate ON donor. The IR results confirmed the bidentate binding of the ligand involving oxygen atom of amide carbonyl and azomethine nitrogen. 1H NMR spectral data of the ligand (L) and its Zn(II) complex agreed well with the proposed structures. In order to evaluate the effect of antimicrobial activity of metal ions upon chelation, the newly synthesized ligand and its metal complexes were screened for their antibacterial and antifungal activities by minimum inhibitory concentration (MIC) method. The DNA cleavage activities were studied using plasmid DNA pBR322 as a target molecule by agarose gel electrophoresis method. The brine shrimp bioassay was also carried out to study the in vitro cytotoxicity properties of all the compounds against Artemia salina. Furthermore, the antioxidant activity of the ligand (L) and its metal complexes were determined in vitro by reduction of 1,1-diphenyl-2-picryl hydrazyl (DPPH), the ligand exhibited potent in vitro - antioxidant activity than its metal complexes.

  2. A multicentre evaluation of the new Beckman Coulter anti-Mullerian hormone immunoassay (AMH Gen II).

    PubMed

    Wallace, A M; Faye, S A; Fleming, R; Nelson, S M

    2011-07-01

    The measurement of anti-Müllerian hormone (AMH) has been by two commercial enzyme-linked immunosorbent (ELISA) assays: Diagnostics Systems Laboratory (DSL 10-14400) and Immunotech (A11893 IVD EU only). Beckman Coulter has developed a new assay for AMH (AMH Gen II A79765), which uses the DSL antibodies but is standardized to the Immunotech calibration. As a result, comparative data are urgently required between the old DSL assay and its replacement AMH Gen II. An evaluation of the AMH Gen II assay was performed at three sites, each with extensive experience of measuring circulating AMH in the adult female. Results were compared with the original DSL ELISA assay. The analysis was performed on a total of 271 patients' samples, approximately 90 at each site. Performance characteristics were evaluated for the AMHGen II assay. Linearity was acceptable with observed values close to the expected (mean recovery 106.3%). The functional sensitivity (20% coefficient of variation), calculated from precision profile data, was 1.5 pmol/L. Within- and between-batch imprecision, assessed over the concentration range of 5-70 pmol/L, were 5.3-11.4% and 3.8-17.3%, respectively. There was good agreement between assays with a Bablok-Passing regression equation AMH Gen II = 1.40 DSL-0.62 pmol/L, r = 0.96, n = 271. Our results demonstrate that similar precision and excellent between-assay agreement should be obtained when laboratories change from the DSL to the AMH Gen II ELISA and they should expect an increase in AMH values of approximately 40%.

  3. Evaluation of health care system reform in Hubei Province, China.

    PubMed

    Sang, Shuping; Wang, Zhenkun; Yu, Chuanhua

    2014-02-21

    This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the "Result Chain" logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally.

  4. Evaluation of Health Care System Reform in Hubei Province, China

    PubMed Central

    Sang, Shuping; Wang, Zhenkun; Yu, Chuanhua

    2014-01-01

    This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the “Result Chain” logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally. PMID:24566052

  5. Evaluating Digital Health Interventions: Key Questions and Approaches.

    PubMed

    Murray, Elizabeth; Hekler, Eric B; Andersson, Gerhard; Collins, Linda M; Doherty, Aiden; Hollis, Chris; Rivera, Daniel E; West, Robert; Wyatt, Jeremy C

    2016-11-01

    Digital health interventions have enormous potential as scalable tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety, and personalization. Achieving these improvements requires a cumulative knowledge base to inform development and deployment of digital health interventions. However, evaluations of digital health interventions present special challenges. This paper aims to examine these challenges and outline an evaluation strategy in terms of the research questions needed to appraise such interventions. As they are at the intersection of biomedical, behavioral, computing, and engineering research, methods drawn from all of these disciplines are required. Relevant research questions include defining the problem and the likely benefit of the digital health intervention, which in turn requires establishing the likely reach and uptake of the intervention, the causal model describing how the intervention will achieve its intended benefit, key components, and how they interact with one another, and estimating overall benefit in terms of effectiveness, cost effectiveness, and harms. Although RCTs are important for evaluation of effectiveness and cost effectiveness, they are best undertaken only when: (1) the intervention and its delivery package are stable; (2) these can be implemented with high fidelity; and (3) there is a reasonable likelihood that the overall benefits will be clinically meaningful (improved outcomes or equivalent outcomes at lower cost). Broadening the portfolio of research questions and evaluation methods will help with developing the necessary knowledge base to inform decisions on policy, practice, and research. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Evaluating success of mobile health projects in the developing world.

    PubMed

    Ginige, J Anupama; Maeder, Anthony J; Long, Vanessa

    2014-01-01

    Many mobile health (mHealth) projects, typically deploying pilot or small scale implementations, have been undertaken in developing world settings and reported with a widely varying range of claims being made on their effectiveness and benefits. As a result, there is little evidence for which aspects of such projects lead to successful outcomes. This paper describes a literature review of papers from PubMed undertaken to identify strong contributions to execution and evaluation of mHealth projects in developing world settings, and suggests a template for classifying the main success factors to assist with collating evidence in the future.

  7. Health information systems evaluation frameworks: A systematic review.

    PubMed

    Eslami Andargoli, Amirhossein; Scheepers, Helana; Rajendran, Diana; Sohal, Amrik

    2017-01-01

    Evaluation of health information systems (HISs) is complicated because of the complex nature of the health care domain. Various studies have proposed different frameworks to reduce the complexity in the assessment of these systems. The aim of these frameworks is to provide a set of guidelines for the evaluation of the adequacy of health care information systems. This paper aims to analyse studies on the evaluation of HISs by applying a content, context and process (CCP) framework to address the 'who', 'what', 'how', 'when', and 'why' of the evaluation processes used. This will allow for a better understanding of the relative strengths and weaknesses of various HISs evaluation frameworks, and will pave the way for developing a more complete framework for HISs. A systematic literature review on HIS evaluation studies was undertaken to identify the currently available HIS evaluation frameworks. Five academic databases were selected to conduct this systematic literature review. Most of the studies only address some, but not all, of the five main questions, i.e. the who, what, how, when, why, and that there was a lack of consensus in the way these questions were addressed. The critical role of context was also largely neglected in these studies. Evaluation of HISs is complex. The health care domain is highly context sensitive and in order to have a complete assessment of HISs, consideration of contextual factors is necessary. Specifically, to have the right set of criteria to measure the 'what', the answer to the 'who' of the evaluation is necessary. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Iterative Evaluation of a Web-Based Health Information Resource

    PubMed Central

    ROSENFELD, LINDSAY; SHEPHERD, AMY; AGUNWAMBA, AMENAH A.; McCRAY, ALEXA T.

    2013-01-01

    This paper presents the research process and methods used to evaluate and improve a web-based health information resource intended for the public. The resource is called Community Connect to Research (CC2R) (www.connecttoresearch.org). The research process was an iterative one that involved collaboration with many partners. Two formal evaluations were conducted in 2009 and 2010 using key informant interviews, usability interviews, focus groups, an online survey, and readability and suitability assessment tools. These methods provided us with users’ perspective on the overall design, content, and literacy demands of the web site as well as valuable feedback on their interaction with the web site. We subsequently redesigned CC2R, making significant improvements based on what we learned from the evaluation. The second evaluation revealed that the redesign addressed many issues found in the first evaluation and identified additional areas of possible improvement. Overall, both evaluations suggested that participants believed that the web site was useful and valuable, indicating that CC2R is indeed a health information resource that provides patients and families with accessible, relevant, and high-quality information. Our experience suggests that regular formal evaluation is an essential tool for effective ongoing enhancement of health information resources meant for the public. PMID:23577665

  9. Iterative evaluation of a web-based health information resource.

    PubMed

    Rosenfeld, Lindsay; Shepherd, Amy; Agunwamba, Amenah A; McCray, Alexa T

    2013-08-01

    This article presents the research process and methods used to evaluate and improve a web-based health information resource, called "Community Connect to Research," intended for the public. The research process was iterative and involved collaboration with many partners. Two formal evaluations were conducted in 2009 and 2010 using key informant interviews, usability interviews, focus groups, an online survey, and readability and suitability assessment tools. These methods provided users' perspectives on the overall design, content, and literacy demands of the website as well as valuable feedback on their interaction with the website. The authors subsequently redesigned Community Connect to Research, making significant improvements on the basis of what they learned from the evaluation. The second evaluation revealed that the redesign addressed many issues found in the first evaluation and identified additional areas of possible improvement. Overall, both evaluations suggested that participants believed that the website was useful and valuable, indicating that Community Connect to Research is a health information resource that provides patients and families with accessible, relevant, and high-quality information. Regular formal evaluation is an essential tool for effective ongoing enhancement of health information resources meant for the public.

  10. Evaluation of Pharyngeal Space in Different Combinations of Class II Skeletal Malocclusion

    PubMed Central

    Soni, Jay; Shyagali, Tarulatha R.; Bhayya, Deepak P.; Shah, Romil

    2015-01-01

    Objectives: The study was aimed to evaluate the pharyngeal airway linear measurements of untreated skeletal class II subjects with normal facial vertical pattern in prognathic maxilla with orthognathic mandible and orthognathic maxilla with retrognathic mandible. Materials and method: the sample comprised of lateral Cephalograms of two groups (30 each) of class II malocclusion variants. Group 1 comprised of class II malocclusion with prognathic maxilla and orthognathic mandible, whereas group 2 comprised of class II malocclusion with orthognathic maxilla and retrognathic mandible. Each group was traced for the linear measurements of the pharyngeal airway like the oropharynx, nasopharynx and soft palate. The obtained data was subjected to independent t test and the Mann Whitney test to check the difference between the two groups and within the groups respectively. Results: there was significant difference between all the linear measurements at the soft palate region and the distance between the tip of soft palate to its counter point on the pharyngeal wall in oropharynx region (p-ppm). Conclusion: the pharyngeal airway for class II malocclusion with various combination in an average growth pattern adult showed significant difference. The present results suggested, that the pharyngeal airway space might be the etiological factor for different sagittal growth pattern of the jaws and probable usage of different growth modification appliance can influence the pharyngeal airway. PMID:26635436

  11. Design, Synthesis of Novel Platinum(II) Glycoconjugates, and Evaluation of Their Antitumor Effects.

    PubMed

    Han, Jianbin; Gao, Xiangqian; Liu, Ran; Yang, Jinna; Zhang, Menghua; Mi, Yi; Shi, Ying; Gao, Qingzhi

    2016-06-01

    A new series of sugar-conjugated (trans-R, R-cyclohexane-1, 2-diamine)-2-halo-malonato-platinum(II) complexes were designed and synthesized to target tumor-specific glucose transporters (GLUTs). The water solubility of the sugar-conjugated platinum (II) complexes was greatly improved by average of 570-fold, 33-fold, and 94-fold, respectively, compared to cisplatin (1.0 mg/mL), carboplatin (17.1 mg/mL), and the newest generation of clinical drug oxaliplatin (6.0 mg/mL). Despite the high water solubility, the platinum(II) glycoconjugates exhibited a notable increase in cytotoxicity by a margin of 1.5- to 6.0-fold in six different human cancer cell lines with respect to oxaliplatin. The potential GLUT1 transportability of the complexes was investigated through a molecular docking study and was confirmed with GLUT1 inhibitor-mediated cytotoxicity dependency evaluation. The results showed that the sugar-conjugated platinum(II) complexes can be recognized by the glucose recognition binding site of GLUT1 and their cell killing effect depends highly on the GLUT1 inhibitor, quercetin. The research presenting a prospective concept for targeted therapy anticancer drug design, and with the analysis of the synthesis, water solubility, antitumor activity, and the transportability of the platinum(II) glycoconjugates, this study provides fundamental data supporting the inherent potential of these designed conjugates as lead compounds for GLUT-mediated tumor targeting.

  12. Evaluation of Coronal Shock Wave Velocities from the II Type Radio Bursts Parameters

    NASA Astrophysics Data System (ADS)

    Galanin, V. V.; Isaeva, E. A.; Kravetz, R. O.

    The work presents the results of research of connection between the coronal shock waves and the parameters of type II (mII) meter-decameter bursts in 25-180 MHz band for 66 solar proton events. The velocities of coronal shock waves for this two cases where determined. In the first case the velocities of the shock waves was evaluated according to the Newkirck model and in the second case - directly from the type II radio burst parameters. The calculated values of shock waves velocity was compared with the same velocity values that is published on NGDC site. The comparative analysis showed that precision of coronal shock waves velocity estimation which gets directly from type II radio bursts parameters was higher than the same one which used the Newkirck model. Research showed that there is exist the sufficiently strong connection between the shock wave velocity and the delay of type II burst intensity maximum on the second harmonica. Correlation coefficient between the studied parameters was equal to ≍ 0.65.

  13. Health Literacy Training for Public Health Nurses in Fukushima: A Multi-site Program Evaluation.

    PubMed

    Goto, Aya; Lai, Alden Yuanhong; Rudd, Rima E

    2015-09-01

    Public health nurses (PHNs) are community residents' access points to health information and services in Japan. After the Fukushima nuclear accident, they were challenged to communicate radiation-related health information to best meet community needs. We previously developed and evaluated the outcome of a single-site health literacy training program to augment PHNs' ability to improve community residents' access to written health information. This paper presents an evaluation of an identical training program using data combined from multiple sites, and further included proximal and distal evaluations to document the impact of health literacy training in a post-disaster setting. A total of 64 participants, primarily experienced PHNs, attended one of three multi-session health literacy workshops conducted in multiple sites across Fukushima. Quantitative and qualitative data on PHNs' training satisfaction, self-evaluation of achievements regarding training goals, and application of learned skills were collected and analyzed. Each workshop consisted of two 2-hour sessions introducing health literacy and assessment tools and developing skills to improve written materials, followed by a one-month follow-up assessment on PHNs' application of the gained skills in the field. Post-training evaluations on the appropriateness and usefulness of the workshop were highly positive. At the end of the one-month follow-up, 45% of participants had gained confidence in assessing and revising written materials and had applied the skills they had gained to develop and communicate health information in various settings and modes. This increase in confidence was associated with further application of the learned skills at the municipal level. However, participants reported difficulties in explaining risks, and the need to learn more about plain language to be able to paraphrase professional terms. This paper highlighs the positive outcomes of health literacy training among PHNs. Practical

  14. In vivo and in vitro evaluation of marginal fit of class II ceromer inlays.

    PubMed

    Gemalmaz, D; Kükrer, D

    2006-06-01

    The aim of this study was to evaluate the marginal adaptation of class II ceromer (Targis, Vivadent) indirect inlay restorations under both in vivo and in vitro conditions. Twenty Targis inlays were produced for class II inlay cavities (13 mandibular and seven maxillary teeth) in 20 patients. The in vivo adaptation of the inlay to the tooth cavity was evaluated by means of silicone replica technique. For in vitro evaluation, 20 mesio-occluso-distal (MOD) Targis inlays were made in extracted upper molars. Half of the inlays were cemented with Variolink high-viscosity resin cement while the other half was cemented with Variolink Ultra. The replica specimens and in vitro samples were sectioned buccolingually and mesiodistally, and marginal adaptation was evaluated at both proximal and occlusal margins at 200x magnification under a light microscope. The data was analyzed with anova (P < 0.05). The in vivo mean film thickness values for occlusal and proximal locations were recorded as 73 and 132 microm respectively. In vitro mean marginal fit values were observed as 48 and 67 microm for occlusal and proximal margins of inlays luted with Variolink II high viscosity. The marginal fit values recorded under in vivo conditions were higher in magnitude than the measurements obtained under in vitro conditions. The use of a highly filled resin luting agent with an ultrasonic insertion technique did not cause an increase in marginal gap width of the inlay.

  15. The role of technology in reducing health care costs. Phase II and phase III.

    SciTech Connect

    Cilke, John F.; Parks, Raymond C.; Funkhouser, Donald Ray; Tebo, Michael A.; Murphy, Martin D.; Hightower, Marion Michael; Gallagher, Linda K.; Craft, Richard Layne, II; Garcia, Rudy John

    2004-04-01

    In Phase I of this project, reported in SAND97-1922, Sandia National Laboratories applied a systems approach to identifying innovative biomedical technologies with the potential to reduce U.S. health care delivery costs while maintaining care quality. The effort provided roadmaps for the development and integration of technology to meet perceived care delivery requirements and an economic analysis model for development of care pathway costs for two conditions: coronary artery disease (CAD) and benign prostatic hypertrophy (BPH). Phases II and III of this project, which are presented in this report, were directed at detailing the parameters of telemedicine that influence care delivery costs and quality. These results were used to identify and field test the communication, interoperability, and security capabilities needed for cost-effective, secure, and reliable health care via telemedicine.

  16. A case study in translation methodology using the Health-Promotion Lifestyle Profile II.

    PubMed

    Carlson, E D

    2000-01-01

    Although Hispanics constitute the most rapidly growing segment of the population in the United States, they have received relatively little attention regarding factors affecting their health behaviors and influences. One such factor is the scarcity of reliable and valid Spanish-language instruments for research with this population. Researchers who attempt to translate an existing instrument into Spanish need to recognize the methodological issues involved in the translation process and psychometric testing. The purpose of this article is to describe the advantages and disadvantages of various translation methodologies, to identify statistical issues in cross-cultural research, and to provide a case study of the translation process and statistical analysis of a translated instrument. Specifically, this study looks at the development and pilot testing of a Spanish-language version of the Health-Promoting Lifestyle Profile II using a randomized convenience sample of 60 bilingual Hispanic individuals.

  17. Building a partnership to evaluate school-linked health services: the Cincinnati School Health Demonstration Project.

    PubMed

    Rose, Barbara L; Mansour, Mona; Kohake, Kelli

    2005-12-01

    The Cincinnati School Health Demonstration Project was a 3-year collaboration that evaluated school-linked health services in 6 urban elementary (kindergarten to eighth grade) schools. Partners from the Cincinnati Health Department, Cincinnati Public Schools, Cincinnati Children's Hospital Medical Center, and The Health Foundation of Greater Cincinnati wanted to determine if levels of school-linked care made a difference in student quality of life, school connectedness, attendance, emergency department use, and volume of referrals to health care specialists. School nurses, principals and school staff, parents and students, upper-level managers, and health service researchers worked together over a 2.5-year period to learn about and use new technology to collect information on student health, well-being, and outcome measures. Varying levels of school health care intervention models were instituted and evaluated. A standard model of care was compared with 2 models of enhanced care and service. The information collected from students, parents, nurses, and the school system provided a rich database on the health of urban children. School facilities, staffing, and computer technology, relationship building among stakeholders, extensive communication, and high student mobility were factors that influenced success and findings of the project. Funding for district-wide computerization and addition of school health staff was not secured by the end of the demonstration project; however, relationships among the partners endured and paved the way for future collaborations designed to better serve urban school children in Cincinnati.

  18. The need to evaluate public health reforms: Australian perinatal mental health initiatives.

    PubMed

    Austin, Marie-Paule; Reilly, Nicole; Sullivan, Elizabeth

    2012-06-01

    To describe the Australian perinatal mental health reforms and explore ways of improving surveillance of maternal mental health morbidity and mortality in this context. We reviewed the Australian perinatal (defined as conception to one year postpartum) mental health reforms, in association with an appraisal of the population health methods that could be used for their evaluation. Despite the increasing focus of public health reforms on maternal mental health in the perinatal period, there is currently no national data available to evaluate these reforms or to provide an evidence base for improved health outcomes. National data development and linkage of relevant datasets would go a long way towards enabling such an endeavour. Inclusion of key mental health items in the Perinatal National Minimum Dataset and use of data linkage techniques will allow for monitoring of trends in maternal mental health morbidity and mortality in response to the Australian reforms. Once this is implemented, cost-benefit analyses can be undertaken. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

  19. Evaluating community-based public health leadership training.

    PubMed

    Ceraso, Marion; Gruebling, Kirsten; Layde, Peter; Remington, Patrick; Hill, Barbara; Morzinski, Jeffrey; Ore, Peggy

    2011-01-01

    Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

  20. Evaluation of health promotion training for the Western Australian Aboriginal maternal and child health sector.

    PubMed

    Wilkins, Alexa; Lobo, Roanna C; Griffin, Denese M; Woods, Heather A

    2015-04-01

    The evaluation of health promotion training for the Western Australian (WA) Aboriginal maternal and child health (MCH) sector. Fifty-one MCH professionals from five regions in WA who attended one of three health promotion short courses in 2012-2013 were invited to complete an online survey or a telephone interview, between 4 to 17 months post-course. Respondents were asked how they had utilised the information and resources from the training and to identify the enabling factors or barriers to integrating health promotion into their work practices subsequently. Overall response rate was 33% (n=17); 94% of respondents reported they had utilised the information and resources from the course and 76% had undertaken health promotion activities since attending the course. Building contacts with other MCH providers and access to planning tools were identified as valuable components of the course. Barriers to translating knowledge into practice included financial constraints and lack of organisational support for health promotion activity. Health promotion training provides participants with the skills and confidence to deliver health promotion strategies in their communities. The training presents an opportunity to build health professionals' capacity to address some determinants of poor health outcomes among pregnant Aboriginal women and their babies. SO WHAT?: Training would be enhanced if accompanied by ongoing support for participants to integrate health promotion into their work practice, organisational development including health promotion training for senior management, establishing stronger referral pathways among partner organisations to support continuity of care and embedding training into MCH workforce curricula.

  1. Towards a Framework for Evaluating Mobile Mental Health Apps.

    PubMed

    Chan, Steven; Torous, John; Hinton, Ladson; Yellowlees, Peter

    2015-12-01

    Mobile phones are ubiquitous in society and owned by a majority of psychiatric patients, including those with severe mental illness. Their versatility as a platform can extend mental health services in the areas of communication, self-monitoring, self-management, diagnosis, and treatment. However, the efficacy and reliability of publicly available applications (apps) have yet to be demonstrated. Numerous articles have noted the need for rigorous evaluation of the efficacy and clinical utility of smartphone apps, which are largely unregulated. Professional clinical organizations do not provide guidelines for evaluating mobile apps. Guidelines and frameworks are needed to evaluate medical apps. Numerous frameworks and evaluation criteria exist from the engineering and informatics literature, as well as interdisciplinary organizations in similar fields such as telemedicine and healthcare informatics. We propose criteria for both patients and providers to use in assessing not just smartphone apps, but also wearable devices and smartwatch apps for mental health. Apps can be evaluated by their usefulness, usability, and integration and infrastructure. Apps can be categorized by their usability in one or more stages of a mental health provider's workflow. Ultimately, leadership is needed to develop a framework for describing apps, and guidelines are needed for both patients and mental health providers.

  2. Systematic review of guidelines for management of intermediate hepatocellular carcinoma using the Appraisal of Guidelines Research and Evaluation II instrument.

    PubMed

    Holvoet, Tom; Raevens, Sarah; Vandewynckel, Yves-Paul; Van Biesen, Wim; Geboes, Karen; Van Vlierberghe, Hans

    2015-10-01

    Hepatocellular carcinoma is the second leading cause of cancer-related mortality worldwide. Multiple guidelines have been developed to assist clinicians in its management. We aimed to explore methodological quality of these guidelines focusing on treatment of intermediate hepatocellular carcinoma by transarterial chemoembolization. A systematic search was performed for Clinical Practice Guidelines and Consensus statements for hepatocellular carcinoma management. Guideline quality was appraised using the Appraisal of Guidelines Research and Evaluation II instrument, which rates guideline development processes across 6 domains: 'Scope and purpose', 'Stakeholder involvement', 'Rigour of development', 'Clarity of presentation', 'Applicability' and 'Editorial independence'. Thematic analysis of guidelines was performed to map differences in recommendations. Quality of 21 included guidelines varied widely, but was overall poor with only one guideline passing the 50% mark on all domains. Key recommendations as (contra)indications and technical aspects were inconsistent between guidelines. Aspects on side effects and health economics were mainly neglected. Methodological quality of guidelines on transarterial chemoembolization in hepatocellular carcinoma management is poor. This results in important discrepancies between guideline recommendations, creating confusion in clinical practice. Incorporation of the Appraisal of Guidelines Research and Evaluation II instrument in guideline development may improve quality of future guidelines by increasing focus on methodological aspects. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Guidelines in cardiac clinical practice: evaluation of their methodological quality using the AGREE II instrument

    PubMed Central

    Sabharwal, Sanjeeve; Patel, Vanash; Nijjer, Sukhjinder S; Kirresh, Ali; Darzi, Ara; Chambers, John C; Malik, Iqbal; Kooner, Jaspal S; Athanasiou, Thanos

    2013-01-01

    Although clinical guidelines have an influential role in healthcare practice, their development process and the evidence they cite has been subject to criticism. This study evaluates the quality of guidelines in cardiac clinical practice by examining how they adhere to validated methodological standards in guideline development. A structured review of cardiac clinical practice guidelines published in seven cardiovascular journals between January 2001 and May 2011 was performed. The AGREE II assessment tool was used by two researchers to evaluate guideline quality. A total of 101 guidelines were identified. Assessment of guidelines using AGREE II found methodological quality to be highly variable (median score, 58.70%; range, 45.34–76.40%). ‘Scope and purpose’ (median score, 86.1%) and ‘clarity of development’ (median score, 83.3 %) were the two domains within AGREE II that received the highest scores. Applicability (median score, 20.80%; range, 4.20–54.20%) and editorial independence (median score, 33.30%; range, 0–62.50%) had the lowest scores. There is considerable variability in the quality of cardiac clinical practice guidelines and this has not improved over the last 10 years. Incorporating validated guideline assessment tools, such as AGREE II, may improve the quality of guidelines. PMID:23759888

  4. Evaluation of machine learning classifiers in keratoconus detection from orbscan II examinations

    PubMed Central

    Souza, Murilo Barreto; Medeiros, Fabricio Witzel; Souza, Danilo Barreto; Garcia, Renato; Alves, Milton Ruiz

    2010-01-01

    PURPOSE: To evaluate the performance of support vector machine, multi‐layer perceptron and radial basis function neural network as auxiliary tools to identify keratoconus from Orbscan II maps. METHODS: A total of 318 maps were selected and classified into four categories: normal (n = 172), astigmatism (n = 89), keratoconus (n = 46) and photorefractive keratectomy (n = 11). For each map, 11 attributes were obtained or calculated from data provided by the Orbscan II. Ten‐fold cross‐validation was used to train and test the classifiers. Besides accuracy, sensitivity and specificity, receiver operating characteristic (ROC) curves for each classifier were generated, and the areas under the curves were calculated. RESULTS: The three selected classifiers provided a good performance, and there were no differences between their performances. The area under the ROC curve of the support vector machine, multi‐layer perceptron and radial basis function neural network were significantly larger than those for all individual Orbscan II attributes evaluated (p<0.05). CONCLUSION: Overall, the results suggest that using a support vector machine, multi‐layer perceptron classifiers and radial basis function neural network, these classifiers, trained on Orbscan II data, could represent useful techniques for keratoconus detection. PMID:21340208

  5. Involvement of users and relatives in mental health service evaluation.

    PubMed

    Barbato, Angelo; D'Avanzo, Barbara; D'Anza, Vito; Montorfano, Emanuele; Savio, Monica; Corbascio, Caterina G

    2014-06-01

    Although Italian mental health (MH) services are community based, user and relative participation in service evaluation lagged behind until lately. We here review three recent studies involving stakeholder participation in service evaluation: two were quantitative studies, one on 204 users in an MH service in Pistoia (Central Italy) and the other on 2259 relatives, conducted with the National Union of Associations for Mental Health. The third (supported by The Centro per il Controllo delle Malattie, the ministerial Center for Disease Control) was a qualitative study in seven MH services, involving users, relatives, and professionals together, which collected interviews from 136 users, 119 relatives, and 79 professionals. In the quantitative studies, positive evaluations outnumbered negative ones. The qualitative study explored negative aspects in greater depth. Common findings were insufficient information, underinvolvement of users-relatives in planning, no choice of clinician, psychiatrist domination, and limited helpfulness of interventions. With stakeholder participation in service evaluation, the present medical framework will need reshaping.

  6. The Public Health Responsibility Deal: how should such a complex public health policy be evaluated?

    PubMed

    Petticrew, Mark; Eastmure, Elizabeth; Mays, Nicholas; Knai, Cecile; Durand, Mary Alison; Nolte, Ellen

    2013-12-01

    The Public Health Responsibility Deal (RD) in England was launched in 2011 as a public-private partnership which aims to 'tap into the potential for businesses and other influential organisations to make a significant contribution to improving public health by helping us to create this environment'. It has come under criticism from public health advocates and others, who have suggested that it will be ineffective or perhaps even harmful. Like many public health policies, there have also been demands to know whether it 'works'. We conducted a scoping review and used this, supplemented with interviews with stakeholders, to develop a detailed logic model of the RD (presented here) to help understand its likely outcomes and the pathways by which these may be achieved as a basis for planning an evaluation. Evaluations of complex interventions require not just assessment of effects (including outcomes), but also a clear conceptualization of the intervention and its processes. The way the RD and the pledges made by participant organizations has been presented makes it difficult at this stage to evaluate whether the RD 'works' in terms of improving health. Instead, any evaluation needs to put together a jigsaw of evidence about processes, mechanisms and potential future health and non-health impacts, in part using the current scientific evidence. This task is ongoing.

  7. ECMWF MACC-II evaluation of performances with MPLNET Lidar network at NASA Goddard Flight Center

    NASA Astrophysics Data System (ADS)

    Lolli, Simone; Welton, Ellsworth J.; Benedetti, Angela; Lewis, Jasper

    2016-04-01

    Aerosol vertical distribution is a critical parameter for most of the common aerosol forecast models. In this study are evaluated the performances of the MACC-II ECMWF aerosol model in forecasting aerosol extinction profiles and planetary boundary layer height versus the new V3 measured MPLNET Lidar extinction retrievals taken as reference at continuous operational site Goddard Space Flight Center, MD, USA. The model is evaluated at different assimilation stages: no assimilation, MODIS Aerosol Optical Depth (AOD) assimilation and MODIS AOD plus lidar CALIPSO assimilation. The sensitivity study of the model is also investigated respect to the assimilation process..Assessing the model performances it is the first step for future near-real time lidar data assimilation into MACC-II aerosol model forecast.

  8. Comparative therapeutic efficacy and safety of type-II collagen (UC-II), glucosamine and chondroitin in arthritic dogs: pain evaluation by ground force plate.

    PubMed

    Gupta, R C; Canerdy, T D; Lindley, J; Konemann, M; Minniear, J; Carroll, B A; Hendrick, C; Goad, J T; Rohde, K; Doss, R; Bagchi, M; Bagchi, D

    2012-10-01

    The investigation was conducted on client-owned moderately arthritic dogs with two objectives: (i) to evaluate therapeutic efficacy of type-II collagen (UC-II) alone or in combination with glucosamine hydrochloride (GLU) and chondroitin sulphate (CHO), and (ii) to determine their tolerability and safety. Dogs in four groups (n = 7-10), were treated daily for a period of 150 days with placebo (Group-I), 10 mg active UC-II (Group-II), 2000 mg GLU + 1600 mg CHO (Group-III), and UC-II + GLU + CHO (Group-IV). On a monthly basis, dogs were evaluated for observational pain (overall pain, pain upon limb manipulation, and pain after physical exertion) using different numeric scales. Pain level was also measured objectively using piezoelectric sensor-based GFP for peak vertical force and impulse area. Dogs were also examined every month for physical, hepatic (ALP, ALT and bilirubin) and renal (BUN and creatinine) functions. Based on observations, significant (p < 0.05) reduction in pain was noted in Group-II, III, and IV dogs. Using GFP, significant increases in peak vertical force (N/kg body wt) and impulse area (N s/kg body wt), indicative of a decrease in arthritis associated pain, were observed in Group-II dogs only. None of the dogs in any group showed changes in physical, hepatic or renal functions. In conclusion, based on GFP data, moderately arthritic dogs treated with UC-II (10 mg) showed a marked reduction in arthritic pain with maximum improvement by day 150. UC-II, GLU and CHO operate through different mechanisms of action, and were well tolerated over a period of 150 days.

  9. Evaluations of organizational effectiveness in mental health programs.

    PubMed

    Scheid, T L; Greenley, J R

    1997-12-01

    We present a conceptual framework derived from organizational theory for understanding the evaluation of the effectiveness of mental health services. We postulate that organizations are deemed "successful" by their constituents when they conform to institutional demands and expectations that are both internally and externally generated. We empirically assess institutional conformity by examining evaluations of effectiveness by 269 mental health providers in 29 different mental health programs. Specialist programs responded to institutional demands by targeting services to those considered most in need: clients with severe mental illnesses. The formal structure and program philosophy of these programs clearly reflected this emphasis; consequently, levels of goal incongruence were low and evaluations of effectiveness were high. Generalist programs continued to provide care to diverse client groups, had more professionals, offered traditional services (such as psychotherapy), and exhibited higher levels of goal incongruence; these factors resulted in lower evaluations of effectiveness. This research is important because it demonstrates that organizational processes of institutional conformity (program objectives meet the demands of external constituents) and goal congruence (program objectives meet with expectations of internal constituents) are critical to positive evaluations of effectiveness. With the current institutional demand for effective, efficient services, it is critical that researchers have a conceptual framework for analyzing those factors which influence evaluations of effectiveness.

  10. [Empirical standard costs for health economic evaluation in Germany -- a proposal by the working group methods in health economic evaluation].

    PubMed

    Krauth, C; Hessel, F; Hansmeier, T; Wasem, J; Seitz, R; Schweikert, B

    2005-10-01

    Measurement of health care costs is a crucial task in health economic evaluation. Various guidelines with different amount of details have been set up for costing methods in economic evaluation which, however, do not precisely stipulate how to value resource consumption. In this article we present a proposal for the standardisation of the monetary valuation of health care utilisation occurring in the follow up period after the actual intervention to be evaluated. From a societal perspective the primary direct and indirect cost components are considered, such as outpatient medical care, pharmaceuticals, non-physician health services, inpatient care, days of sick leave and early retirement due to sickness. The standard costs are based on administrative charges and rates or on official statistics. They are based on the most current data sources which are mainly from 2002 and 2003. This system of standard costs aims at an average valuation of resource consumption. This makes for the comparability of different health economic studies. Most standard costs are not based on market prices but on administratively specified charges and rates. This implies that institutional changes which are quite common in the health care system, may also affect the valuation rates, for example the introduction of DRGs. This should be taken into account when updating the system of standard costs.

  11. The National Home Start Evaluation Interim Report II: Summative Evaluation Results.

    ERIC Educational Resources Information Center

    DeLoria, Dennis; And Others

    Summative evaluation data from nine of the fifteen Home Start sites is presented. The purposes of this pilot summative evaluation were to assess the Fall 1972 measurement battery and field data collection procedures, to identify entering population characteristics so minimum useable sample sizes could be computed for the Fall 1973 data collection…

  12. Observations and lessons learnt from non health professionals evaluating a health search engine.

    PubMed

    Pletneva, Natalia; Uresova, Zdenka; Altman, Jean-Jacques; Postel Vinay, Nicolas; Degoulet, Patrice; Hajic, Jan; Boyer, Celia

    2014-01-01

    This article presents the results of one of the stages of the user-centered evaluation conducted in a framework of the EU project Khresmoi. In a controlled environment, users were asked to perform health-related tasks using a search engine specifically developed for trustworthy online health information. Twenty seven participants from largely the Czech Republic and France took part in the evaluation. All reported overall a positive experience, while some features caused some criticism. Learning points are summed up regarding running such types of evaluations with the general public and specifically with patients.

  13. Evaluation of the association of mercury(II) with some dicysteinyl tripeptides

    PubMed Central

    Lin, Xiuli; Brooks, Jeremy; Bronson, Matthew; Ngu-Schwemlein, Maria

    2012-01-01

    The present study was undertaken to gain insight into the associations of mercury(II) with dicysteinyl tripeptides in buffered media at pH 7.4. We investigated the effects of increasing the distance between cysteinyl residues on mercury(II) associations and complex formations. The peptide–mercury(II) formation constants and their associated thermodynamic parameters in 3-(N-morpholino)propanesulfonic acid (MOPS) buffered solutions were evaluated by isothermal titration calorimetry. Complexes formed in different relative ratios of mercury(II) to cysteinyl peptides in ammonium formate buffered solutions were characterized by LTQ Orbitrap mass spectrometry. The results from these studies show that n-alkyl dicysteinyl peptides (CP 1–4), and an aryl dicysteinyl peptide (CP 5) can serve as effective “double anchors” to accommodate the coordination sites of mercury(II) to form predominantly one-to-one Hg(peptide) complexes. The aryl dicysteinyl peptide (CP 5) also forms the two-to-two Hg2(peptide)2 complex. In the presence of excess peptide, Hg(peptide)2 complexes are also detected. Notably, increasing the distance between the ligating groups or “anchor points” in CP 1–5 does not significantly affect their affinity for mercury(II). However, the enthalpy change (ΔH) values (ΔH1 ~ −91 kJ mol−1 and ΔH2 ~ −66 kJ mol−1) for complex formation between CP 4 and 5 with mercury(II) are about one and a half times larger than the related values for CP 1, 2 and 3 (ΔH1 ~ −66 kJ mol−1 and ΔH2 ~ −46 kJ mol−1). The corresponding entropy change (ΔS) values (ΔS1 ~ −129 J K−1 mol−1 and ΔS2 ~ −116 J K−1 mol−1) of the structurally larger dicysteinyl peptides CP 4 and 5 are less entropically favorable than for CP 1, 2 and 3 (ΔS1 ~ −48 J K−1 mol−1 and ΔS2 ~ −44 J K−1 mol−1). Generally, these associations result in a decrease in entropy, indicating that these peptide–mercury complexes potentially form highly ordered structures. The

  14. Evaluating health literacy of Kerman Medical University, School of Public Health students about recycling solid waste

    PubMed Central

    Hashemi, Majid; Khanjani, Narges; Saber, Maryam; Fard, Narges Kargar

    2012-01-01

    Background: The increasing trend in waste production and its improper disposal in the environment have led to mismanagement of national resources and hazards to the natural environment. Therefore, the recycling of solid waste can help prevent economic and bio-environmental disasters. The aim of this study was to evaluate the health literacy of the students of the Kerman Public Health School about the management and recycling of solid waste. Materials and Methods: This was a cross-sectional study and the target population was all of the students of the Kerman Public Health School (421 students) in five fields. A questionnaire including demographic and health literacy questions was distributed among the students. Results: The male students answered the questions significantly more than female students (P<0.001). The Environmental Health students acquired a higher score than all other students and health literacy significantly increased as the student's studying degree promoted (P<0.001). Also, as the number of trimesters increased, health literacy significantly increased (P<0.001). The parents’ education, the family income, and number of people in the family had no significant effect on health literacy. All students believed recycling is important and more than 50% had acquired their knowledge from their academics. Conclusion: This survey showed that although students in health-related fields confirm the necessity of recycling solid waste, they still need more education in health literacy as they are supposed to be the promoters of public health in the society in the near future. PMID:23555126

  15. Evaluating health literacy of Kerman Medical University, School of Public Health students about recycling solid waste.

    PubMed

    Hashemi, Majid; Khanjani, Narges; Saber, Maryam; Fard, Narges Kargar

    2012-01-01

    The increasing trend in waste production and its improper disposal in the environment have led to mismanagement of national resources and hazards to the natural environment. Therefore, the recycling of solid waste can help prevent economic and bio-environmental disasters. The aim of this study was to evaluate the health literacy of the students of the Kerman Public Health School about the management and recycling of solid waste. This was a cross-sectional study and the target population was all of the students of the Kerman Public Health School (421 students) in five fields. A questionnaire including demographic and health literacy questions was distributed among the students. The male students answered the questions significantly more than female students (P<0.001). The Environmental Health students acquired a higher score than all other students and health literacy significantly increased as the student's studying degree promoted (P<0.001). Also, as the number of trimesters increased, health literacy significantly increased (P<0.001). The parents' education, the family income, and number of people in the family had no significant effect on health literacy. All students believed recycling is important and more than 50% had acquired their knowledge from their academics. This survey showed that although students in health-related fields confirm the necessity of recycling solid waste, they still need more education in health literacy as they are supposed to be the promoters of public health in the society in the near future.

  16. Evaluating public health resources: what happens when funding disappears?

    PubMed

    Freedman, Ariela M; Kuester, Sarah A; Jernigan, Jan

    2013-11-14

    Although various factors affect the sustainability of public health programs, funding levels can influence many aspects of program continuity. Program evaluation in public health typically does not assess the progress of initiatives after discontinuation of funding. The objective of this study was to describe the effect of funding loss following expiration of a 5-year federal grant awarded to state health departments for development of statewide obesity prevention partnerships. The study used qualitative methods involving semistructured key informant interviews with state health departments. Data were analyzed using thematic analysis for effect of funding loss on staffing, programs, partnerships, and implementation of state plans. Many of the programs that continued to run after the grant expired operated at reduced capacity, either reaching fewer people or conducting fewer program activities for the same population. Although many states were able to leverage funding from other sources, this shift in funding source often resulted in priorities changing to meet new funding requirements. Evaluation capacity suffered in all states. Nearly all states reported losing infrastructure and capacity to communicate widely with partners. All states reported a severe or complete loss of their ability to provide training and technical assistance to partners. Despite these reduced capacities, states reported several key resources that facilitated continued work on the state plan. Decisions regarding continuation of funding are often dependent on budget constraints, evidence of success, and perceived ability to succeed in the future. Evaluating public health funding decisions may help guide development of best practice strategies for supporting long-term program success.

  17. Chrysotile asbestos and health in Zimbabwe: II. Health status survey of active miners and millers

    SciTech Connect

    Cullen, M.R.; Lopez-Carrillo, L.; Alli, B.; Pace, P.E.; Shalat, S.L.; Baloyi, R.S. )

    1991-02-01

    As part of the effort to establish industrial practice and public policy regarding asbestos in Zimbabwe, we have conducted a cross-sectional study of the chrysotile mines and mills. A stratified random sample of workers with greater than 10 years of exposure has been evaluated by spirometry, chest radiographs, and employment history. The latter was converted to quantitative estimates of exposure dose, using a matrix based on measured and reconstructed fiber levels for each job and facility during the years of work. Based on these data, a clear dose-response between asbestos exposure and functional loss has been demonstrated, with mean losses from predicted of about 400-600 cc in vital capacity in the 10% of the population with heaviest exposures. Low-grade parenchymal radiographic abnormalities (ILO grade greater than or equal to 1/0) were evident in 8.7% of the total study group and were almost 10 times more common in those with more than 100 fibers/cc.years cumulative exposure than in those with 16 fibers/cc.years or less. Pleural disease was relatively rare, occurring in just under 10% of the study group, and was unrelated to exposure dose. Overall, these findings are compatible with results of similar studies in Quebec and Swaziland and suggest that similar control strategies are probably indicated.

  18. [Health economic evaluation in a local level government health care system].

    PubMed

    Sancho, Leyla Gomes; Vargens, José Muniz Costa

    2009-10-01

    This work aims to contribute to the discussion about the possibility of applying health economic evaluations at local level government healthcare system, and consequently use the results of this study into decision making. In order to subside this reflexion, it was analyzed the SAMU/192 Program costs evaluation in the city of Belo Horizonte, as well as data concerning effectiveness of the program and a review on electronic databases (SciELO and Medline) about the application of studies in decision making. The analysis showed that even for a simple evaluation on expenditure, there are still unsolved problems of data availability as well as of data effectiveness on information systems definition and association. It showed that decision makers do not use the result of studies for decision making either. So, we conclude that there is no possibility to apply a health economic evaluation research and have the results used in a local level government health care system.

  19. [Quality evaluation of health care service for adolescents].

    PubMed

    Costa, M C; Formigli, V L

    2001-04-01

    To evaluate the technical and scientific quality of care provided adolescents, pregnant adolescents and their offspring by the Emaús community's health service in Belém, state of Pará, Brazil, between 1994 and 1996. Data for population and health care assessment were collected from medical records and compared with the PAHO/WHO and Brazilian Ministry of Health guidelines. The following features were satisfactory: anthropometric measurements and sexual maturity in adolescent health care program; visits scheduling, weight and blood pressure recording and proceedings in the event of medical problem in prenatal care; early registration in the health program, completing of the immunization schedule, weight and motor development recording and adequacy of medical visits in children care. Other aspects were less satisfactory, such as poor recording of clinical procedures and high level of inadequate or partially adequate procedures for the adolescent group; late admission to prenatal care and low recording of pregnant anti-tetanus immunization in prenatal care; high prevalence of early weaning and poor recording of children's height. This easy-to-perform assessment allowed to evaluate the quality of care provided and made it possible to reallocate services and medical procedures to offer health care service better organized and of better quality to meet the population needs.

  20. Two-year clinical evaluation of IPS Empress II ceramic onlays/inlays.

    PubMed

    Tagtekin, D A; Ozyöney, G; Yanikoglu, F

    2009-01-01

    The stronger the ceramic material, the longer the restoration stays in the mouth. The current study evaluated the two-year clinical performance of a strong ceramic system, IPS Empress II, with increased strength on onlay/inlay restorations of molars. Teeth from 35 patients, including three premolars and 32 molars, were prepared for 28 onlay and seven inlay restorations with IPS Empress II ceramics. The restorations were cemented with a highly viscous, dual-curing luting composite cement (Bifix) and evaluated by two examiners using USPHS criteria at baseline (one week following insertion), six months, one year and two years. The baseline scores and recalls were assessed by Wilcoxon signed rank test. Statistically significant marginal discoloration at the Bravo level was found at the 12- and 24-month recalls (p=0.046). One debonding was statistically insignificant. No changes were observed with respect to anamnesis, such as any symptom from the TMJ or masticatory muscles. No restorations were replaced due to hypersensitivity or were missing at the two-year evaluation. Any wear on the restoration, antagonist tooth or any changes of proximal contacts were not observed. IPS Empress II Ceramics were found to be appropriate as onlay/inlay restorations for clinical use under the conditions of the current study.

  1. Evaluation of Beam Loss and Energy Depositions for a Possible Phase II Design for LHC Collimation

    SciTech Connect

    Lari, L.; Assmann, R.; Bracco, C.; Brugger, M.; Cerutti, F.; Doyle, E.; Ferrari, A.; Keller, L.; Lundgren, S.; Markiewicz, Thomas W.; Mauri, M.; Redaelli, S.; Sarchiapone, L.; Smith, J.; Vlachoudis, V.; Weiler, T.; /CERN

    2011-11-07

    The LHC beams are designed to have high stability and to be stored for many hours. The nominal beam intensity lifetime is expected to be of the order of 20h. The Phase II collimation system has to be able to handle particle losses in stable physics conditions at 7 TeV in order to avoid beam aborts and to allow correction of parameters and restoration to nominal conditions. Monte Carlo simulations are needed in order to evaluate the behavior of metallic high-Z collimators during operation scenarios using a realistic distribution of losses, which is a mix of the three limiting halo cases. Moreover, the consequences in the IR7 insertion of the worst (case) abnormal beam loss are evaluated. The case refers to a spontaneous trigger of the horizontal extraction kicker at top energy, when Phase II collimators are used. These studies are an important input for engineering design of the collimation Phase II system and for the evaluation of their effect on adjacent components. The goal is to build collimators that can survive the expected conditions during LHC stable physics runs, in order to avoid quenches of the SC magnets and to protect other LHC equipments.

  2. Evaluation of Beam Losses And Energy Deposition for a Possible Phase II Design for LHC Collimation

    SciTech Connect

    Lari, L.; Assmann, R.W.; Bracco, C.; Brugger, M.; Cerutti, F.; Ferrari, A.; Mauri, M.; Redaelli, S.; Sarchiapone, L.; Vlachoudis, Vasilis; Weiler, Th.; Doyle, J.E.; Keller, L.; Lundgren, S.A.; Markiewicz, Thomas W.; Smith, J.C.; Lari, L.; /LPHE, Lausanne

    2011-11-01

    The Large Hadron Collider (LHC) beams are designed to have high stability and to be stored for many hours. The nominal beam intensity lifetime is expected to be of the order of 20h. The Phase II collimation system has to be able to handle particle losses in stable physics conditions at 7 TeV in order to avoid beam aborts and to allow correction of parameters and restoration to nominal conditions. Monte Carlo simulations are needed in order to evaluate the behavior of metallic high-Z collimators during operation scenarios using a realistic distribution of losses, which is a mix of the three limiting halo cases. Moreover, the consequences in the IR7 insertion of the worst (case) abnormal beam loss are evaluated. The case refers to a spontaneous trigger of the horizontal extraction kicker at top energy, when Phase II collimators are used. These studies are an important input for engineering design of the collimation Phase II system and for the evaluation of their effect on adjacent components. The goal is to build collimators that can survive the expected conditions during LHC stable physics runs, in order to avoid quenches of the SC magnets and to protect other LHC equipments.

  3. Evaluation criteria for district health management information systems: lessons from the Ministry of Health, Kenya.

    PubMed

    Odhiambo-Otieno, George W

    2005-01-01

    There has been no comprehensive evaluation of the district health management information systems (DHMISs) since the establishment of these systems by the Ministry of Health (MoH), in Kenya. This is partly due to lack of defined criteria for evaluating the systems. The objective of this study is to design evaluation criteria for assessing the viability, sustainability and ultimate contribution of DHMIS in the management of the district health system (DHS) in Kenya. This descriptive cross-sectional study was undertaken in three DHSs in Kenya. Empirical evidence was collected through interviews, complemented by a comprehensive review of relevant literature, reports and operational manuals of various health information systems in Kenya. A set of evaluation criteria for DHMISs in Kenya was designed for each of the three phases of implementation: phase one-pre-implementation evaluation criteria (categorized as policy and objectives, technical feasibility, financial viability, political viability and administrative operability) to be applied at the design stage; phase two-concurrent (operational) implementation evaluation criteria to be applied during implementation of the new system; phase three-post-implementation evaluation criteria (classified as internal-quality of information; external-resources and managerial support; ultimate-systems impact) to be applied after operating the implemented system for at least 3 years. In designing a DHMIS model there is need to have built-in these three sets of evaluation criteria which should be used in a phased manner. Pre-implementation evaluation criteria should be used to evaluate the system's viability before more resources are committed to its implementation; concurrent (operational) implementation evaluation criteria should be used to ascertain the status of the on-going implementation with the view to either fine-tune or abandon it altogether before more resources are used on it; and post-implementation evaluation criteria

  4. Evaluation of Health Educator Consults in Primary Care

    ERIC Educational Resources Information Center

    Maher, Stacia; Lopez, Patricia; McKee, M. Diane; Deen, Darwin; Fornari, Alice; Fletcher, Jason; Blank, Arthur

    2010-01-01

    Purpose: The paper aims to evaluate a primary care obesity prevention intervention, targeting low-income minority parents in the USA. The first objective is to describe the barriers to behavior change experienced by families. The second objective is to understand the types of strategies that were used by the health educator to empower families to…

  5. A Formative Model to Evaluate Health Services Research.

    ERIC Educational Resources Information Center

    Marconi, Katherine M.; Rudzinski, Karen A.

    1995-01-01

    A formative evaluation model is proposed for use by administrators of large health services research grant programs. The model assists in assessing the purpose, methodology, and level of analysis of funded research. It is illustrated through a discussion of HIV/AIDS care. (SLD)

  6. Evaluation of a Health Education Programme about Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Garcia, Jane Mertz; Sellers, Debra M.; Hilgendorf, Amy E.; Burnett, Debra L.

    2014-01-01

    Objective: Our aim was to evaluate a health education programme (TBIoptions: Promoting Knowledge) designed to increase public awareness and understanding about traumatic brain injury (TBI) through in-person (classroom) and computer-based (electronic) learning environments. Design: We used a pre-post survey design with randomization of participants…

  7. Evaluation of Health Educator Consults in Primary Care

    ERIC Educational Resources Information Center

    Maher, Stacia; Lopez, Patricia; McKee, M. Diane; Deen, Darwin; Fornari, Alice; Fletcher, Jason; Blank, Arthur

    2010-01-01

    Purpose: The paper aims to evaluate a primary care obesity prevention intervention, targeting low-income minority parents in the USA. The first objective is to describe the barriers to behavior change experienced by families. The second objective is to understand the types of strategies that were used by the health educator to empower families to…

  8. Evaluation of a Health Education Programme about Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Garcia, Jane Mertz; Sellers, Debra M.; Hilgendorf, Amy E.; Burnett, Debra L.

    2014-01-01

    Objective: Our aim was to evaluate a health education programme (TBIoptions: Promoting Knowledge) designed to increase public awareness and understanding about traumatic brain injury (TBI) through in-person (classroom) and computer-based (electronic) learning environments. Design: We used a pre-post survey design with randomization of participants…

  9. Evaluation of Web Accessibility of Consumer Health Information Websites

    PubMed Central

    Zeng, Xiaoming; Parmanto, Bambang

    2003-01-01

    The objectives of the study are to construct a comprehensive framework for web accessibility evaluation, to evaluate the current status of web accessibility of consumer health information websites and to investigate the relationship between web accessibility and property of the websites. We selected 108 consumer health information websites from the directory service of a Web search engine. We used Web accessibility specifications to construct a framework for the measurement of Web Accessibility Barriers (WAB) of website. We found that none of the websites is completely accessible to people with disabilities, but governmental and educational health information websites exhibit better performance on web accessibility than other categories of websites. We also found that the correlation between the WAB score and the popularity of a website is statistically significant. PMID:14728272

  10. Longitudinal evaluation of dental arch asymmetry in Class II subdivision malocclusion with 3-dimensional digital models.

    PubMed

    Veli, Ilknur; Yuksel, Burcin; Uysal, Tancan

    2014-06-01

    Class II subdivision malocclusions with their asymmetric occlusal relationships often pose treatment difficulties. The aim of this study was to evaluate the longitudinal changes of dental arch asymmetry in untreated subjects with Class II subdivision malocclusion. From 706 files from the University of Michigan Growth Study, longitudinal records of 17 untreated subjects with Class II subdivision malocclusion were included this study. Dental arch changes at 3 consecutive longitudinal intervals, defined by the cervical vertebral maturation method, were analyzed on digital dental models. The average ages of the subjects were 12.4, 15.1, and 19.1 years at the 3 time periods, respectively. Maxillary and mandibular reference lines were constructed and used for the intra-arch asymmetry measurements. The Friedman test and analysis of variance with repeated measures were used to determine dental arch asymmetries at the P <0.05 level. All subjects were found to have a type 1 Class II subdivision malocclusion characterized by distal positioning of the mandibular first molar on the Class II side. No statistically significant intra-arch asymmetry changes were found for the maxillary and mandibular dental arches in any time period. Between the baseline and the final follow-up, the data indicated decreases in maxillary and mandibular intercanine arch widths and arch lengths symmetrically. The results of this study indicate that the dental arch asymmetry in patients with Class II subdivision malocclusions did not improve or worsen with growth. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  11. Evaluation of O-POSSUM vs ASA and APACHE II scores in patients undergoing oesophageal surgery.

    PubMed

    Fodor, Raluca; Cioc, Adrian; Grigorescu, Bianca; Lăzescu, Bogdan; Copotoiu, Sanda Maria

    2015-04-01

    Risk and prognostic scores quantify the patient's risk of death or complication according to the severity of his illness. The aim of this study was to evaluate the predictive accuracy of O-POSSUM vs ASA and APACHE II models on patients undergoing oesophageal surgery. In this observational retrospective study 55 patients were enrolled who had undergone surgical interventions of excision and reconstruction of the oesophagus for neoplastic oesophageal stenosis, in the Surgical Clinics (I and II) of the Clinical County Emergency Hospital Mures, between January 2011 and January 2014. By using patients file records after extracting the data we calculated the predictive mortality, according to the prognostic scores O-POSSUM, ASA and APACHE II and we analyzed its correlations with the postoperative evolution. We evaluated the discriminatory power of the three scores using the ROC (receiver-operating characteristic) curves. According to the cut-off value corresponding to each score, we compared the Kaplan Meier survival curves during the hospitalization period. ROC curves analysis revealed that O-POSSUM had a better discriminatory power for mortality compared to the other two scores: AUC = 0.73 for O-POSSUM, AUC = 0.57 for APACHE II and AUC = 0.64 for ASA (p < 0.001). The cut-off value was statistically significant only in case of O-POSSUM, as it derives from the statistical analysis of the survival curves (p = 0.035). O-POSSUM predicts mortality more accurately compared to ASA or APACHE II in patients undergoing oesophageal surgery.

  12. Evaluation of the Quality of Guidelines for Myasthenia Gravis with the AGREE II Instrument

    PubMed Central

    Zhang, Zhenchang; Guo, Jia; Su, Gang; Li, Jiong; Wu, Hua; Xie, Xiaodong

    2014-01-01

    Background Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioners in making decisions about appropriate healthcare in specific clinical circumstances. The methodological quality of CPGs for myasthenia gravis (MG) are unclear. Objective To critically evaluate the methodological quality of CPGs for MG using AGREE II instrument. Method A systematical search strategy on PubMed, EMBASE, DynaMed, the National Guideline Clearinghouse (NGC) and the Chinese Biomedical Literature database (CBM) was performed on September 20th 2013. All guidelines related to MG were evaluated with AGREE II. The software used for analysis was SPSS 17.0. Results A total of 15 CPGs for MG met the inclusion criteria (12 CPGs in English, 3 CPGs in Chinese). The overall agreement among reviews was moderate or high (ICC >0.70). The mean scores (mean ± SD) for al six domains were presented as follows: scope and purpose (60.93% ±16.62%), stakeholder involvement (40.93% ±20.04%), rigor of development (37.22% ±30.46%), clarity of presentation (64.26% ±16.36%), applicability (28.19% ±20.56%) and editorial independence (27.78% ±28.28%). Compared with non-evidence-based CPGs, evidence-based CPGs had statistically significant higher quality scores for all AGREE II domains (P<0.05). All domain scores appear slightly higher for CPGs published after AGREE II instrument development and validation (P>0.05). The quality scores of CPGs developed by NGC/AAN were higher than the quality scores of CPGs developed by other organizations for all domains. The difference was statistically significant for all domains with the exception of clarity of presentation (P = 0.07). Conclusions The qualities of CPGs on MG were generally acceptable with several flaws. The AGREE II instrument should be adopted by guideline developers, particularly in China. PMID:25402504

  13. Adult Spinal Deformity: Epidemiology, Health Impact, Evaluation, and Management.

    PubMed

    Ames, Christopher P; Scheer, Justin K; Lafage, Virginie; Smith, Justin S; Bess, Shay; Berven, Sigurd H; Mundis, Gregory M; Sethi, Rajiv K; Deinlein, Donald A; Coe, Jeffrey D; Hey, Lloyd A; Daubs, Michael D

    2016-07-01

    Spinal deformity in the adult is a common medical disorder with a significant and measurable impact on health-related quality of life. The ability to measure and quantify patient self-reported health status with disease-specific and general health status measures, and to correlate health status with radiographic and clinical measures of spinal deformity, has enabled significant advances in the assessment of the impact of deformity on our population, and in the evaluation and management of spinal deformity using an evidence-based approach. There has been a significant paradigm shift in the evaluation and management of patients with adult deformity. The paradigm shift includes development of validated, disease-specific measures of health status, recognition of deformity in the sagittal plane as a primary determinant of health status, and information on results of operative and medical/interventional management strategies for adults with spinal deformity. Since its inception in 1966, the Scoliosis Research Society (SRS) has been an international catalyst for improving the research and care for patients of all ages with spinal deformity. The SRS Adult Spinal Deformity Committee serves the mission of developing and defining an evidence-based approach to the evaluation and management of adult spinal deformity. The purpose of this overview from the SRS Adult Deformity Committee is to provide current information on the epidemiology and impact of adult deformity, and to provide patients, physicians, and policy makers a guide to the evidence-based evaluation and management of patients with adult deformity. Copyright © 2016 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

  14. Rethinking the evaluation and measurement of Health in all policies.

    PubMed

    Bauman, Adrian E; King, Lesley; Nutbeam, Don

    2014-06-01

    Current international attention to Health in all policies (HiAP) has its origins in a more sophisticated understanding of the impact of public policies on health, and a recognition that policies across government have an impact on the social and environmental determinants of health and related inequalities in health. As an emerging field, there has been limited attention focused on comprehensive approaches to the evaluation of HiAP to date, and the research focus around HiAP has mainly examined the processes of cross-sectoral policy development, rather than their health-related impacts or outcomes. The purpose of this paper is to explore issues in assessing the implementation of HiAP and describe an expanded evaluation framework for assessing the potential intermediate and end-point effects of HiAP actions, using a planning logic model for 'complex programs'. This meets the needs of public sector policy-makers who express an interest in understanding the relationship between HiAP and health-related and social outcomes. The paper proposes applying a contribution analysis method to estimate and model the anticipated impacts of HiAP policies on intermediate and longer term outcomes, in advance of empirical studies of these outcomes, and as an innovative input into HiAP and evaluation planning. A broader long-term evaluation framework will enhance the political saliency of HiAP initiatives, especially from governments considering HiAP approaches in financially constrained environments. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. How health economic evaluation (HEE) contributes to decision-making in public health care: the case of Brazil.

    PubMed

    Elias, Flávia Tavares Silva; Araújo, Denizar Vianna

    2014-01-01

    The universal access to a health care system for the Brazilian population was established in 1990. Brazil is a country with no tradition in the production and use of health economic evaluation (HEE) to guide decision making in the public health system. It is only within the last two decades that HEEs using a microeconomic approach have appeared in the academic field. On a national level, HEE and Health Technology Assessment (HTA), in a wider sense, were first taken into account in 2003. Two policies deserve to be mentioned - (i) the regulation of medicines in the Brazilian market, and (ii) science, technology and innovation policy. The latter required the fostering of applied research to encourage the application of methods which employ systematic reviews and economic analyses of cost-effectiveness to guide the incorporation of technologies in the Brazilian health care system. The Ministry of Health has initiated the process of incorporating these new technologies on a federal level during the last ten years. In spite of the improvement of HEE methods at Brazilian universities and research institutes, these technologies have not yet reached the governmental bodies. In Brazil, the main challenge lies in the production, interpretation and application of HEE to all technologies within the access scheme(s), and there is limited capacity building. Setting priorities can be the solution for Brazil to be able to perform HEE for relevant technologies within the access scheme(s) while the universal coverage system struggles with a triple burden of disease. Copyright © 2014. Published by Elsevier GmbH.

  16. An evaluation of the hemiplegic subject based on the Bobath approach. Part II: The evaluation protocol.

    PubMed

    Corriveau, H; Guarna, F; Dutil, E; Riley, E; Arsenault, A B; Drouin, G

    1988-01-01

    A protocol of evaluation of the hemiplegic patient based on the Bobath approach to treatment is presented. Six parameters are evaluated: sensorium, muscle tone, reflex activity, active movement, postural reactions and pain. The first and last of these are included because of their possible effects on the motor recovery process of the hemiplegic patient. The other four are directly borrowed from the Bobath modality of treatment. For each of these parameters, the procedures are given for its evaluation along with its respective rating scales. These scales are of an ordinal nature ranging from 0 to 3. It is suggested that this new evaluation protocol is fully compatible with the therapeutic modality developed by Bobath and as well is adequate to quantify patient progress in the principle aspects treated by this well used rehabilitation approach.

  17. Oral health promotion in the community pharmacy: an evaluation of a pilot oral health promotion intervention.

    PubMed

    Sturrock, A; Cussons, H; Jones, C; Woodcock, C; Bird, L

    2017-09-15

    Introduction Poor oral health is a significant public health concern, costing the NHS in England £3.4 billion annually. Community pharmacies are easily accessible, frequently visited by patients and the community pharmacy contractual framework requires pharmacies to provide healthy living advice to patients - therefore offering a little explored avenue for the delivery of oral health interventions.Methodology A pilot oral health promotion intervention was introduced in five pharmacies in deprived areas of County Durham between September and December 2016. A mixed methods approach to the evaluation was performed, utilising a patient evaluation questionnaire and semi-structured qualitative interviews with pharmacy staff.Results One thousand and eighty-nine participants received the intervention. Following the intervention 72% of participants perceived their knowledge of oral health as much better, 66% definitely intended to change their oral health habits and 64% definitely thought a pharmacy was the right place to receive advice about oral health. Three themes emerged from the qualitative data: (1) intervention feedback, (2) knowledge gap and (3) service development.Discussion The data demonstrated the acceptability of patients to a community pharmacy based oral health intervention, with most patients reporting intentions to change their oral healthcare habits after receiving the intervention. Previous literature has identified a willingness of pharmacy staff to become involved with oral health; this study provides evidence that patients are also receptive to such services being delivered in the community pharmacy setting. Further work is required to assess the benefits of a community pharmacy based oral health intervention and the potential for further growth of this role.Conclusion A community pharmacy is perceived by patients as an acceptable provider of oral health interventions and has the potential to provide positive changes to the oral health of the

  18. CMS Innovation Center Health Care Innovation Awards: Evaluation Plan.

    PubMed

    Berry, Sandra H; Concannon, Thomas W; Morganti, Kristy Gonzalez; Auerbach, David I; Beckett, Megan K; Chen, Peggy G; Farley, Donna O; Han, Bing; Harris, Katherine M; Jones, Spencer S; Liu, Hangsheng; Lovejoy, Susan L; Marsh, Terry; Martsolf, Grant R; Nelson, Christopher; Okeke, Edward N; Pearson, Marjorie L; Pillemer, Francesca; Sorbero, Melony E; Towe, Vivian; Weinick, Robin M

    2013-01-01

    The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards, funded through the Affordable Care Act, for applicants who proposed compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children's Health Insurance Program enrollees. CMS is also interested in learning how new models would affect subpopulations of beneficiaries (e.g., those eligible for Medicare and Medicaid and complex patients) who have unique characteristics or health care needs that could be related to poor outcomes. In addition, the initiative seeks to identify new models of workforce development and deployment, as well as models that can be rapidly deployed and have the promise of sustainability. This article describes a strategy for evaluating the results. The goal for the evaluation design process is to create standardized approaches for answering key questions that can be customized to similar groups of awardees and that allow for rapid and comparable assessment across awardees. The evaluation plan envisions that data collection and analysis will be carried out on three levels: at the level of the individual awardee, at the level of the awardee grouping, and as a summary evaluation that includes all awardees. Key dimensions for the evaluation framework include implementation effectiveness, program effectiveness, workforce issues, impact on priority populations, and context. The ultimate goal is to identify strategies that can be employed widely to lower cost while improving care.

  19. A system dynamics evaluation model: implementation of health information exchange for public health reporting.

    PubMed

    Merrill, Jacqueline A; Deegan, Michael; Wilson, Rosalind V; Kaushal, Rainu; Fredericks, Kimberly

    2013-06-01

    To evaluate the complex dynamics involved in implementing electronic health information exchange (HIE) for public health reporting at a state health department, and to identify policy implications to inform similar implementations. Qualitative data were collected over 8 months from seven experts at New York State Department of Health who implemented web services and protocols for querying, receipt, and validation of electronic data supplied by regional health information organizations. Extensive project documentation was also collected. During group meetings experts described the implementation process and created reference modes and causal diagrams that the evaluation team used to build a preliminary model. System dynamics modeling techniques were applied iteratively to build causal loop diagrams representing the implementation. The diagrams were validated iteratively by individual experts followed by group review online, and through confirmatory review of documents and artifacts. Three casual loop diagrams captured well-recognized system dynamics: Sliding Goals, Project Rework, and Maturity of Resources. The findings were associated with specific policies that address funding, leadership, ensuring expertise, planning for rework, communication, and timeline management. This evaluation illustrates the value of a qualitative approach to system dynamics modeling. As a tool for strategic thinking on complicated and intense processes, qualitative models can be produced with fewer resources than a full simulation, yet still provide insights that are timely and relevant. System dynamics techniques clarified endogenous and exogenous factors at play in a highly complex technology implementation, which may inform other states engaged in implementing HIE supported by federal Health Information Technology for Economic and Clinical Health (HITECH) legislation.

  20. Board self-evaluation: the Bayside Health experience.

    PubMed

    Duncan-Marr, Alison; Duckett, Stephen J

    2005-08-01

    Board evaluation is a critical component of good governance in any organisation. This paper describes the board self-evaluation process used by Bayside Health, a public health service in Melbourne. The question of how governing boards can assess their performance has received increasing attention over the past decade. In particular, the increasing demand for accountability to shareholders and regulators experienced by corporate sector Boards has resulted in greater scrutiny of board performance, with the market and the balance sheet providing some basis for assessment. Performance evaluation of governing boards in the public sector has been more challenging. Performance evaluation is complex in a sector that is not simply driven by the bottom line, where the stakeholders involve both government and the broader community, and where access to, and the quality and safety of the services provided, are often the major public criteria by which performance may be judged. While some practices from the corporate sector can be applied successfully in the public sector, this is not always the case, and public sector boards such as the Board of Directors of Bayside Health have been developing ways to evaluate and improve their performance.

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

    PubMed

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

    2014-06-01

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

  2. The AME2016 atomic mass evaluation (II). Tables, graphs and references

    NASA Astrophysics Data System (ADS)

    Wang, Meng; Audi, G.; Kondev, F. G.; Huang, W. J.; Naimi, S.; Xu, Xing

    2017-03-01

    This paper is the second part of the new evaluation of atomic masses, AME2016. Using least-squares adjustments to all evaluated and accepted experimental data, described in Part I, we derive tables with numerical values and graphs to replace those given in AME2012. The first table lists the recommended atomic mass values and their uncertainties. It is followed by a table of the influences of data on primary nuclides, a table of various reaction and decay energies, and finally, a series of graphs of separation and decay energies. The last section of this paper lists all references of the input data used in the AME2016 and the NUBASE2016 evaluations (first paper in this issue). AMDC: http://amdc.impcas.ac.cn/ Contents The AME2016 atomic mass evaluation (II). Tables, graphs and referencesAcrobat PDF (293 KB) Table I. The 2016 Atomic mass tableAcrobat PDF (273 KB) Table II. Influences on primary nuclidesAcrobat PDF (160 KB) Table III. Nuclear-reaction and separation energiesAcrobat PDF (517 KB) Graphs of separation and decay energiesAcrobat PDF (589 KB) References used in the AME2016 and the NUBASE2016 evaluationsAcrobat PDF (722 KB)

  3. Training evaluation: a case study of training Iranian health managers

    PubMed Central

    Omar, Maye; Gerein, Nancy; Tarin, Ehsanullah; Butcher, Christopher; Pearson, Stephen; Heidari, Gholamreza

    2009-01-01

    Background The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. Methods The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Results Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least useful areas were those that dealt

  4. Trial-Based Economic Evaluations in Occupational Health

    PubMed Central

    van Wier, Marieke F.; Tompa, Emile; Bongers, Paulien M.; van der Beek, Allard J.; van Tulder, Maurits W.; Bosmans, Judith E.

    2014-01-01

    To allocate available resources as efficiently as possible, decision makers need information on the relative economic merits of occupational health and safety (OHS) interventions. Economic evaluations can provide this information by comparing the costs and consequences of alternatives. Nevertheless, only a few of the studies that consider the effectiveness of OHS interventions take the extra step of considering their resource implications. Moreover, the methodological quality of those that do is generally poor. Therefore, this study aims to help occupational health researchers conduct high-quality trial-based economic evaluations by discussing the theory and methodology that underlie them, and by providing recommendations for good practice regarding their design, analysis, and reporting. This study also helps consumers of this literature with understanding and critically appraising trial-based economic evaluations of OHS interventions. PMID:24854249

  5. Evaluation of a mental health outreach service for homeless families

    PubMed Central

    Tischler, V; Vostanis, P; Bellerby, T; Cumella, S

    2002-01-01

    Aims: To describe the characteristics of homeless children and families seen by the mental health outreach service (MHOS), to evaluate the impact of this service on the short term psychosocial functioning of children and parents, and to establish perceptions of, and satisfaction with, the service. Methods: Twenty seven children from 23 families who were in receipt of the MHOS and 27 children from 23 families residing in other hostels where no such service was available were studied. The MHOS was delivered by a clinical nurse specialist with expertise in child mental health, who offered the following interventions: assessment and brief treatment of mental health disorders in children; liaison with agencies; and training of homeless centre staff. Results: Children in the experimental group had a significantly higher decrease in Strengths and Difficulties Questionnaire (SDQ) total scores. Having received the intervention was the strongest predictor of improvement in SDQ total scores. There was no significant impact on parental mental health (General Health Questionnaire) scores. Homeless families and staff expressed high satisfaction with the MHOS. Conclusion: This MHOS for homeless families is an innovative intervention which meets the complex and multiple needs of a vulnerable population unable to access mainstream mental health services. The primary objective of the service was to improve child mental health problems; however, the service developed in a responsive way by meeting social and practical needs of families in addition to its clinical role. PMID:11861229

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

    PubMed

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

    2008-03-01

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

  7. Evaluating the public health impact of health promotion interventions: the RE-AIM framework.

    PubMed Central

    Glasgow, R E; Vogt, T M; Boles, S M

    1999-01-01

    Progress in public health and community-based interventions has been hampered by the lack of a comprehensive evaluation framework appropriate to such programs. Multilevel interventions that incorporate policy, environmental, and individual components should be evaluated with measurements suited to their settings, goals, and purpose. In this commentary, the authors propose a model (termed the RE-AIM model) for evaluating public health interventions that assesses 5 dimensions: reach, efficacy, adoption, implementation, and maintenance. These dimensions occur at multiple levels (e.g., individual, clinic or organization, community) and interact to determine the public health or population-based impact of a program or policy. The authors discuss issues in evaluating each of these dimensions and combining them to determine overall public health impact. Failure to adequately evaluate programs on all 5 dimensions can lead to a waste of resources, discontinuities between stages of research, and failure to improve public health to the limits of our capacity. The authors summarize strengths and limitations of the RE-AIM model and recommend areas for future research and application. PMID:10474547

  8. A systematic review of economic evaluations of health and health-related interventions in Bangladesh

    PubMed Central

    2011-01-01

    Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER). Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis of knowledge in the area. The

  9. Synthesis and evaluation of 18F-labeled ATP competitive inhibitors of topoisomerase II as probes for imaging topoisomerase II expression

    PubMed Central

    Daumar, Pierre; Zeglis, Brian M.; Ramos, Nicholas; Divilov, Vadim; Sevak, Kuntal Kumar; Pillarsetty, NagaVaraKishore; Lewis, Jason S.

    2015-01-01

    Type II topoisomerase (Topo-II) is an ATP-dependent enzyme that is essential in the transcription, replication, and chromosome segregation processes and, as such, represents an attractive target for cancer therapy. Numerous studies indicate that the response to treatment with Topo-II inhibitors is highly dependent on both the levels and the activity of the enzyme. Consequently, a non-invasive assay to measure tumoral Topo-II levels has the potential to differentiate responders from non-responders. With the ultimate goal of developing a radiofluorinated tracer for positron emission tomography (PET) imaging, we have designed, synthesized, and evaluated a set of fluorinated compounds based on the structure of the ATP-competitive Topo-II inhibitor QAP1. Compounds 18 and 19b showed inhibition of Topo-II in in vitro assays and exhibited moderate, Topo-II level dependent cytotoxicity in SK-BR-3 and MCF-7 cell lines. Based on these results, 18F-labeled analogs of these two compounds were synthesized and evaluated as PET probes for imaging Topo-II overexpression in mice bearing SK-BR-3 xenografts. [18F]-18 and [18F]-19b were synthesized from their corresponding protected tosylated derivatives by fluorination and subsequent deprotection. Small animal PET imaging studies indicated that both compounds do not accumulate in tumors and exhibit poor pharmacokinetics, clearing from the blood pool very rapidly and getting metabolized over. The insights gained from the current study will surely aid in the design and construction of future generations of PET agents for the non-invasive delineation of Topo-II expression. PMID:25240701

  10. Evaluating the Accuracy of Health News Publications in a Drug Literature Evaluation Course

    PubMed Central

    Timpe, Erin M.; Eichner, Samantha F.

    2006-01-01

    Objectives To design an assignment for second-professional year pharmacy students to assess the accuracy and quality of health information published in the news. Design Students in a literature evaluation course were assigned a health-related news publication to review and find the original published research article. They then critically evaluated the quality and accuracy of the news publication based on the original research. All students wrote a critique focusing on the quality and accuracy of the news article and potential responses the lay public might have. Assessment Eighty-four percent of students agreed the writing assignment reinforced critical literature evaluation skills, while 90% agreed the assignment contributed to completion of course objectives. Conclusions A writing assignment requiring comparison of a news publication to the original research reinforces critical literature evaluation and communication skills, as well as stimulates thought about the accuracy, quality, and public responses to health information published in the news. PMID:17136202

  11. Evaluating sexual health planning for the London 2012 Olympics.

    PubMed

    Lorenc, Ava; Robinson, Nicola

    2015-09-01

    The public health impact of mass gatherings should not be underestimated, requiring careful planning. This evaluation identified the successes and failures of a programme targeted to mitigate against potential increases in sexual ill health during the London 2012 Olympics. Programme planning was evaluated using documentary analysis. Stakeholders' experiences were explored using an online survey. Finally, selected stakeholders were interviewed in depth. Over 100 documents were analysed, 36 survey responses received and 12 interviews conducted. Most respondents felt aims were appropriate, potentially overambitious. 'Business as usual', with no disruption or increased demand, was reported in sexual health services. Some interviewees felt evidence for increased demand was limited, although contingency planning was needed. Signposting service users and providing 'residual risk responses' appeared successful. Planned service transformation was not fully achieved and perhaps inappropriate, although new service collaborations emerged. Over 2000 individuals participated; wider public engagement was seen as inappropriate. A 'Sex Factor 2012' competition was particularly successful. Legacy opportunities included planning work, groundwork for transformation, relationship building and continuing the resilience changes. The Games allowed sexual health services to explore new ways of working, engage with stakeholders and develop new relationships, although in reality demand for services did not increase. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Discover Health Services Near You! The North Dakota Story: Part II

    PubMed Central

    Safratowich, Michael; Markland, Mary J.; Rieke, Judith L.

    2010-01-01

    Since the 2003 launch of NC Health Info, the National Library of Medicine has encouraged the development of Go Local databases. A team of Go Local enthusiasts at North Dakota’s only medical school library wanted to obtain NLM funding and build a resource for their rural state. Although short on staff, money, and time, the team found a way to realize a Go Local database that serves the state’s residents and helps them “Discover Health Services Near You!” A team approach and collaboration with health providers and organizations worked well in this small rural state. North Dakota’s Go Local project offers a low-cost model that stresses collaboration, teamwork and technology. Part I which appeared in the last issue describes the rural setting, explains how the project was conceived, and the processes necessary to begin building the database. Part II which appears in this issue details how records were created including developing the input style guide and indexing decisions, the NLM testing and review process, the maintenance and auditing process, and publicity and promotion of the project. PMID:20436944

  13. A rational model for assessing and evaluating complex interventions in health care

    PubMed Central

    May, Carl

    2006-01-01

    Background Understanding how new clinical techniques, technologies and other complex interventions become normalized in practice is important to researchers, clinicians, health service managers and policy-makers. This paper presents a model of the normalization of complex interventions. Methods Between 1995 and 2005 multiple qualitative studies were undertaken. These examined: professional-patient relationships; changing patterns of care; the development, evaluation and implementation of telemedicine and related informatics systems; and the production and utilization of evidence for practice. Data from these studies were subjected to (i) formative re-analysis, leading to sets of analytic propositions; and to (ii) a summative analysis that aimed to build a robust conceptual model of the normalization of complex interventions in health care. Results A normalization process model that enables analysis of the conditions necessary to support the introduction of complex interventions is presented. The model is defined by four constructs: interactional workability; relational integration; skill set workability and contextual integration. This model can be used to understand the normalization potential of new techniques and technologies in healthcare settings Conclusion The normalization process model has face validity in (i) assessing the potential for complex interventions to become routinely embedded in everyday clinical work, and (ii) evaluating the factors that promote or inhibit their success and failure in practice. PMID:16827928

  14. TEST & EVALUATION REPORT FOR THE HEDGEHOG-II PACKAGING SYSTEMS DOT-7A TYPE A CONTAINER

    SciTech Connect

    KELLY, D.L.

    2003-12-29

    This report documents the US. Department of Transportation Specification 7A (DOT-7A) Type A compliance test and evaluation results for the Hedgehog-II packaging systems. The approved Hedgehog-II packaging configurations provide primary and secondary containment. The approved packaging configurations described within this report are designed to ship Type A quantities of radioactive materials, normal form. Contents may be in solid or liquid form. Liquids transported in the approved 1 L glass bottle assembly shall have a specific gravity of less than or equal to 1.6. Liquids transported in all other approved configurations shall have a specific gravity of less than or equal to 2.0. The solid contents, including packaging, are limited in weight to the gross weight of the as-tested liquids and bottles. The approved Hedgehog-II packaging configurations described in this report may be transported by air, and have been evaluated as meeting the applicable International Air Transport Association/International Civil Aviation Organization (IATA/ICAO) Dangerous Goods Regulations in addition to the DOT requirements.

  15. Status of calibration and data evaluation of AMSR on board ADEOS-II

    NASA Astrophysics Data System (ADS)

    Imaoka, Keiji; Fujimoto, Yasuhiro; Kachi, Misako; Takeshima, Toshiaki; Igarashi, Tamotsu; Kawanishi, Toneo; Shibata, Akira

    2004-02-01

    The Advanced Microwave Scanning Radiometer (AMSR) is the multi-frequency, passive microwave radiometer on board the Advanced Earth Observing Satellite-II (ADEOS-II), currently called Midori-II. The instrument has eight-frequency channels with dual polarization (except 50-GHz band) covering frequencies between 6.925 and 89.0 GHz. Measurement of 50-GHz channels is the first attempt by this kind of conically scanning microwave radiometers. Basic concept of the instrument including hardware configuration and calibration method is almost the same as that of ASMR for EOS (AMSR-E), the modified version of AMSR. Its swath width of 1,600 km is wider than that of AMSR-E. In parallel with the calibration and data evaluation of AMSR-E instrument, almost identical calibration activities have been made for AMSR instrument. After finished the initial checkout phase, the instrument has been continuously obtaining the data in global basis. Time series of radiometer sensitivities and automatic gain control telemetry indicate the stable instrument performance. For the radiometric calibration, we are now trying to apply the same procedure that is being used for AMSR-E. This paper provides an overview of the instrument characteristics, instrument status, and preliminary results of calibration and data evaluation activities.

  16. Quality evaluation of the Finasteride polymorphic forms I and II in capsules.

    PubMed

    da Silva, Lucélia Magalhães; Montanari, Cristina Martiniano; Santos, Olimpia Maria Martins; Cazedey, Edith Cristina Laignier; Ângelo, Marilene Lopes; de Araújo, Magali Benjamin

    2015-02-01

    Finasteride (FNS) is a specific competitive inhibitor of steroid type-II 5α-reductase and is widely used for the treatment of benign prostatic hyperplasia, prostate cancer, and androgenetic alopecia. FNS has two polymorphic forms identified as Form I and Form II. It is known that polymorphism can cause significant differences in the physicochemical properties of a compound such as melting point, density, morphology, solubility, and color. Thus, proper qualitative and quantitative monitoring of the solid-state forms is crucial to ensure high-quality products. There are no published papers studying the influence of the FNS polymorphs on the physicochemical quality of capsules. Furthermore, the available analytical methods are time-consuming, expensive, use buffer or do not demonstrate stability-indicating capacity. The aim of this work was to validate a rapid high-performance liquid chromatography (HPLC) method to evaluate FNS in capsules and to study the physicochemical properties of polymorphic forms, evaluating their possible influence in the dissolution profile and stability of FNS in capsules. Capsules containing Forms I and II of FNS were prepared and subjected to quality control studies, dissolution profiles and a stability study at 50°C. A significant effect of polymorphism on the FNS solubility and dissolution properties was observed. These results suggest that changes in the effects of FNS can occur if a suitable control study is not performed on the raw material used to produce the capsules.

  17. Diabetic silkworms for evaluation of therapeutically effective drugs against type II diabetes

    PubMed Central

    Matsumoto, Yasuhiko; Ishii, Masaki; Hayashi, Yohei; Miyazaki, Shinya; Sugita, Takuya; Sumiya, Eriko; Sekimizu, Kazuhisa

    2015-01-01

    We previously reported that sugar levels in the silkworm hemolymph, i.e., blood, increase immediately (within 1 h) after intake of a high-glucose diet, and that the administration of human insulin decreases elevated hemolymph sugar levels in silkworms. In this hyperglycemic silkworm model, however, administration of pioglitazone or metformin, drugs used clinically for the treatment of type II diabetes, have no effect. Therefore, here we established a silkworm model of type II diabetes for the evaluation of anti-diabetic drugs such as pioglitazone and metformin. Silkworms fed a high-glucose diet over a long time-period (18 h) exhibited a hyperlipidemic phenotype. In these hyperlipidemic silkworms, phosphorylation of JNK, a stress-responsive protein kinase, was enhanced in the fat body, an organ that functionally resembles the mammalian liver and adipose tissue. Fat bodies isolated from hyperlipidemic silkworms exhibited decreased sensitivity to human insulin. The hyperlipidemic silkworms have impaired glucose tolerance, characterized by high fasting hemolymph sugar levels and higher hemolymph sugar levels in a glucose tolerance test. Administration of pioglitazone or metformin improved the glucose tolerance of the hyperlipidemic silkworms. These findings suggest that the hyperlipidemic silkworms are useful for evaluating the hypoglycemic activities of candidate drugs against type II diabetes. PMID:26024298

  18. Diabetic silkworms for evaluation of therapeutically effective drugs against type II diabetes.

    PubMed

    Matsumoto, Yasuhiko; Ishii, Masaki; Hayashi, Yohei; Miyazaki, Shinya; Sugita, Takuya; Sumiya, Eriko; Sekimizu, Kazuhisa

    2015-05-29

    We previously reported that sugar levels in the silkworm hemolymph, i.e., blood, increase immediately (within 1 h) after intake of a high-glucose diet, and that the administration of human insulin decreases elevated hemolymph sugar levels in silkworms. In this hyperglycemic silkworm model, however, administration of pioglitazone or metformin, drugs used clinically for the treatment of type II diabetes, have no effect. Therefore, here we established a silkworm model of type II diabetes for the evaluation of anti-diabetic drugs such as pioglitazone and metformin. Silkworms fed a high-glucose diet over a long time-period (18 h) exhibited a hyperlipidemic phenotype. In these hyperlipidemic silkworms, phosphorylation of JNK, a stress-responsive protein kinase, was enhanced in the fat body, an organ that functionally resembles the mammalian liver and adipose tissue. Fat bodies isolated from hyperlipidemic silkworms exhibited decreased sensitivity to human insulin. The hyperlipidemic silkworms have impaired glucose tolerance, characterized by high fasting hemolymph sugar levels and higher hemolymph sugar levels in a glucose tolerance test. Administration of pioglitazone or metformin improved the glucose tolerance of the hyperlipidemic silkworms. These findings suggest that the hyperlipidemic silkworms are useful for evaluating the hypoglycemic activities of candidate drugs against type II diabetes.

  19. Phase II Evaluation of Magnetic Resonance Imaging Guided Focal Laser Ablation of Prostate Cancer.

    PubMed

    Eggener, Scott E; Yousuf, Ambereen; Watson, Sydeaka; Wang, Shiyang; Oto, Aytekin

    2016-12-01

    Magnetic resonance imaging guided focal laser ablation is an investigational strategy for the treatment of prostate cancer. This phase II evaluation of focal laser ablation included men with stage T1c-T2a, prostate specific antigen less than 15 ng/ml or prostate specific antigen density less than 0.15 ng/ml(3), Gleason 7 or less in 25% or less of biopsies and magnetic resonance imaging with 1 or 2 lesions concordant with biopsy detected cancer. At 3 months all patients underwent magnetic resonance imaging with biopsy of ablation zone(s). At 12 months all underwent magnetic resonance imaging and systematic biopsy. I-PSS (International Prostate Symptom Score) and SHIM (Sexual Health Inventory for Men) scores were collected before focal laser ablation, and at 1, 3 and 12 months. The primary end point was no cancer on the 3-month ablation zone biopsy. Secondary end points were safety, 12-month biopsy, and urinary and sexual function. In the 27 men median age was 62 years and mean prostate specific antigen was 4.4 ng/ml. Biopsy Gleason score was 6 in 23 patients (85%) and Gleason 7 in 4 (15%). Seven men (26%) had low volume Gleason 6 disease outside the intended ablation zone(s). At 3 months 26 patients (96%) had no evidence of cancer on magnetic resonance imaging guided biopsy of the ablation zone. No significant I-PSS changes were observed (each p >0.05). SHIM was lower at 1 month (p = 0.03), marginally lower at 3 months (p = 0.05) and without a significant difference at 12 months (p = 0.38). At 12-month biopsy cancer was identified in 10 patients (37%), including in the ablation zone(s) in 3 (11%) and outside the ablation zone(s) in 8 (30%) with cancer in and outside the ablation zone in 1. In select men with localized prostate cancer and visible magnetic resonance imaging lesions focal laser ablation has an acceptable morbidity profile and is associated with encouraging short-term oncologic outcomes. Significantly longer followup is mandatory to fully assess this

  20. Evaluating covariance in prognostic and system health management applications

    NASA Astrophysics Data System (ADS)

    Menon, Sandeep; Jin, Xiaohang; Chow, Tommy W. S.; Pecht, Michael

    2015-06-01

    Developing a diagnostic and prognostic health management system involves analyzing system parameters monitored during the lifetime of the system. This data analysis may involve multiple steps, including data reduction, feature extraction, clustering and classification, building control charts, identification of anomalies, and modeling and predicting parameter degradation in order to evaluate the state of health for the system under investigation. Evaluating the covariance between the monitored system parameters allows for better understanding of the trends in monitored system data, and therefore it is an integral part of the data analysis. Typically, a sample covariance matrix is used to evaluate the covariance between monitored system parameters. The monitored system data are often sensor data, which are inherently noisy. The noise in sensor data can lead to inaccurate evaluation of the covariance in data using a sample covariance matrix. This paper examines approaches to evaluate covariance, including the minimum volume ellipsoid, the minimum covariance determinant, and the nearest neighbor variance estimation. When the performance of these approaches was evaluated on datasets with increasing percentage of Gaussian noise, it was observed that the nearest neighbor variance estimation exhibited the most stable estimates of covariance. To improve the accuracy of covariance estimates using nearest neighbor-based methodology, a modified approach for the nearest neighbor variance estimation technique is developed in this paper. Case studies based on data analysis steps involved in prognostic solutions are developed in order to compare the performance of the covariance estimation methodologies discussed in the paper.

  1. Reinvigorating performance evaluation: first steps in a local health department.

    PubMed

    Smith, Kathleen N; Gunzenhauser, Jeffrey D; Fielding, Jonathan E

    2010-01-01

    The ability of a local health department to assess and improve employee performance through an effective evaluation process is critical to overall organizational success. A constructive performance evaluation process not only provides meaningful feedback on work performance but also provides opportunities to reinforce work behaviors that support the organization's mission, to recognize exceptional work, and to guide future growth and learning. The Los Angeles County Department of Public Health is creating a new approach to performance evaluation that recognizes 3 distinct components of work performance: standard business practices, competencies, and standards of practice. This multidimensional perspective acknowledges that the expectations of workers are complex and that evaluations of performance are not easily captured with single-dimension assessment tools. This report describes the conceptual relationships of these 3 components and how they integrate to form a single performance evaluation process. Key elements within this structure include a base document of competencies for all workers, expanded competency sets for professional staff, role-specific duty statements for workers who perform similar work, and standards of competent practice related to the mission of units to which individuals are assigned. Key first steps are to define the terminology of performance evaluation and to create role-specific duty statements.

  2. Evaluation in health: participatory methodology and involvement of municipal managers

    PubMed Central

    de Almeida, Cristiane Andrea Locatelli; Tanaka, Oswaldo Yoshimi

    2016-01-01

    ABSTRACT OBJECTIVE To analyze scopes and limits of the use of participatory methodology of evaluation with municipal health managers and administrators. METHODS Qualitative research with health policymakers and managers of the Comissão Intergestores Regional (CIR – Regional Interagency Commission) of a health region of the state of Sao Paulo in Brazil. Representatives from seven member cities participated in seven workshops facilitated by the researchers, with the aim of assessing a specific problem of the care line, which would be used as a tracer of the system integrality. The analysis of the collected empirical material was based on the hermeneutic-dialectic methodology and aimed at the evaluation of the applied participatory methodology, according to its capacity of promoting a process of assessment capable to be used as a support for municipal management. RESULTS With the participatory approach of evaluation, we were able to promote in-depth discussions with the group, especially related to the construction of integral care and to the inclusion of the user’s perspective in decision-making, linked to the search for solution to concrete problems of managers. By joint exploration, the possibility of using data from electronic information systems was opened, as well as information coming directly from the users of the services, to enhance discussions and negotiations between partners. The participants were disbelievers of the replication potential of this type of evaluation without the direct monitoring of the academy, given the difficulty of organizing the process in everyday life, already taken by emergency and political issues. CONCLUSIONS Evaluations of programs and services carried out within the Regional Interagency Commission, starting from the local interest and facilitating the involvement of its members by the use of participatory methodologies, can contribute to the construction of integral care. To the extent that the act of evaluating stay

  3. Operational Test and Evaluation Handbook for Aircrew Training Devices. Volume II. Operational Effectiveness Evaluation

    DTIC Science & Technology

    1982-02-01

    to assess ATD training, capability. Several candidate capa- bility rating scales are provided below: Option A. Option A is a standar d seven-point...human facors engineering study design questionnaires test and evaluation rating scales transfer of training 20. ABSTRACT (Contint&, on roversO aide It...RATING SCALES AND QUESTIONNAIRES ........... ... 57 INTRODUCTION ....... ................................... 57 Advantages of Rating Method

  4. Health evaluation of western arctic King Eiders (Somateria spectabilis)

    USGS Publications Warehouse

    Scott, Cheryl A.; Mazet, Jonna A.K.; Powell, Abby N.

    2010-01-01

    The western arctic population of King Eiders (Somateria spectabilis) has declined by >50% in recent years. A health assessment was conducted for adult King Eiders breeding on the north slope of Alaska, USA, to evaluate body condition (n=90, 2002–2006) and baseline biochemical and hematologic values (n=20–30, 2005–2006). Body condition for males and females was excellent. Total protein, calcium, alkaline phosphatase, amylase, and globulin were significantly higher in females than in males, likely because of differences in reproductive physiology. These baseline health data can be used to promote conservation of King Eiders and other closely related species of concern.

  5. Health technology assessment. Evaluation of biomedical innovative technologies.

    PubMed

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival.

  6. Social anxiety and fear of negative evaluation: construct validity of the BFNE-II.

    PubMed

    Carleton, R Nicholas; Collimore, Kelsey C; Asmundson, Gordon J G

    2007-01-01

    disorder. Psychological Assessment, 17, 179-190]; however [Carleton, R. N., McCreary, D., Norton, P. J., & Asmundson, G. J. G. (in press-a). The Brief Fear of Negative Evaluation Scale, Revised. Depression & Anxiety; Collins, K. A., Westra, H. A., Dozois, D. J. A., & Stewart, S. H. (2005). The validity of the brief version of the fear of negative evaluation scale. Journal of Anxiety Disorders, 19, 345-359] recommend that these items be reworded to maintain scale sensitivity. The present study examined the reliability and validity of the BFNE-II, a version of the BFNE evaluating revisions of the reverse-worded items in a community sample. A unitary model of the BFNE-II resulted in excellent confirmatory factor analysis fit indices. Moderate convergent and discriminant validity were found when BFNE-II items were correlated with additional independent measures of social anxiety [i.e., Social Interaction Anxiety & Social Phobia Scales; Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455-470], and fear [i.e., Anxiety Sensitivity Index; Reiss, S., & McNally, R. J. (1985). The expectancy model of fear. In S. Reiss, R. R. Bootzin (Eds.), Theoretical issues in behaviour therapy (pp. 107--121). New York: Academic Press. and the Illness/Injury Sensitivity Index; Carleton, R. N., Park, I., & Asmundson, G. J. G. (in press-b). The Illness/Injury Sensitivity Index: an examination of construct validity. Depression & Anxiety). These findings support the utility of the revised items and the validity of the BFNE-II as a measure of the fear of negative evaluation. Implications and future research directions are discussed.

  7. Health Behaviours, Socioeconomic Status, and Mortality: Further Analyses of the British Whitehall II and the French GAZEL Prospective Cohorts

    PubMed Central

    Stringhini, Silvia; Dugravot, Aline; Shipley, Martin; Goldberg, Marcel; Zins, Marie; Kivimäki, Mika; Marmot, Michael; Sabia, Séverine; Singh-Manoux, Archana

    2011-01-01

    Background Differences in morbidity and mortality between socioeconomic groups constitute one of the most consistent findings of epidemiologic research. However, research on social inequalities in health has yet to provide a comprehensive understanding of the mechanisms underlying this association. In recent analysis, we showed health behaviours, assessed longitudinally over the follow-up, to explain a major proportion of the association of socioeconomic status (SES) with mortality in the British Whitehall II study. However, whether health behaviours are equally important mediators of the SES-mortality association in different cultural settings remains unknown. In the present paper, we examine this issue in Whitehall II and another prospective European cohort, the French GAZEL study. Methods and Findings We included 9,771 participants from the Whitehall II study and 17,760 from the GAZEL study. Over the follow-up (mean 19.5 y in Whitehall II and 16.5 y in GAZEL), health behaviours (smoking, alcohol consumption, diet, and physical activity), were assessed longitudinally. Occupation (in the main analysis), education, and income (supplementary analysis) were the markers of SES. The socioeconomic gradient in smoking was greater (p<0.001) in Whitehall II (odds ratio [OR]  = 3.68, 95% confidence interval [CI] 3.11–4.36) than in GAZEL (OR  = 1.33, 95% CI 1.18–1.49); this was also true for unhealthy diet (OR  = 7.42, 95% CI 5.19–10.60 in Whitehall II and OR  = 1.31, 95% CI 1.15–1.49 in GAZEL, p<0.001). Socioeconomic differences in mortality were similar in the two cohorts, a hazard ratio of 1.62 (95% CI 1.28–2.05) in Whitehall II and 1.94 in GAZEL (95% CI 1.58–2.39) for lowest versus highest occupational position. Health behaviours attenuated the association of SES with mortality by 75% (95% CI 44%–149%) in Whitehall II but only by 19% (95% CI 13%–29%) in GAZEL. Analysis using education and income yielded similar results. Conclusions Health

  8. Primary Health Care Evaluation: the view of clients and professionals about the Family Health Strategy1

    PubMed Central

    da Silva, Simone Albino; Baitelo, Tamara Cristina; Fracolli, Lislaine Aparecida

    2015-01-01

    Objective: to evaluate the attributes of primary health care as for access; longitudinality; comprehensiveness; coordination; family counseling and community counseling in the Family Health Strategy, triangulating and comparing the views of stakeholders involved in the care process. Method: evaluative research with a quantitative approach and cross-sectional design. Data collected using the Primary Care Assessment Tool for interviews with 527 adult clients, 34 health professionals, and 330 parents of children up to two years old, related to 33 family health teams, in eleven municipalities. Analysis conducted in the Statistical Package for Social Sciences software, with a confidence interval of 95% and error of 0.1. Results: the three groups assessed the first contact access - accessibility with low scores. Professionals evaluated with a high score the other attributes. Clients assigned low score evaluations for the attributes: community counseling; family counseling; comprehensiveness - services rendered; comprehensiveness - available services. Conclusions: the quality of performance self-reported by the professionals of the Family Health Strategy is not perceived or valued by clients, and the actions and services may have been developed inappropriately or insufficiently to be apprehended by the experience of clients. PMID:26487150

  9. [Health promotion effectiveness: testing the German statutory health insurance agencies evaluation system in health promotion, and preliminary findings from 212 health training courses].

    PubMed

    Kliche, T; Schreiner-Kürten, K; Wanek, V; Koch, U

    2011-04-01

    The purpose of this study was to develop a measurement system for the evaluation of health promotion training courses offered by German statutory health insurance companies. In a field test, N=1 671 participants from 212 youth and adult courses for the promotion of either physical activity, coping with stress or nutritional improvement were included. 80% were female. Participants were questioned in a pre-post-design with a three month follow-up. The questionnaires covered health behaviour and health status. Participants' compliance and psychometric quality of the measurement instruments were good. On average, the health insurance companies assigned participants to different interventions adequately according to the participant's individual health problems. The health promotion courses triggered improvements of high effect sizes for health behaviour patterns, of moderate effect sizes for physical complaints, subjective health ratings, and health-related quality of life. Effects decreased after the end of the intervention but remained significantly above the initial values. BMI values continued their improvement after the end of the training courses. Thus, health promotion training courses generated stable health improvements of practically relevant effect sizes. The interventions provided good support and health improvements for all subgroups of participants, regardless of age, gender and educational background. Thus, the health promotion curricula of the health insurance companies offer a ubiquitous and easily accessible but effective intervention for health promotion in Germany, although men are clearly underrepresented among the participants. The trainings may be recommended and used by other health-care suppliers. The evaluation toolkit provides practical and valid instruments for a routine evaluation of health promotion trainings. It should be applied within random sampling designs. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Endocrine actions of pesticides measured in the Flemish environment and health studies (FLEHS I and II).

    PubMed

    Croes, K; Den Hond, E; Bruckers, L; Govarts, E; Schoeters, G; Covaci, A; Loots, I; Morrens, B; Nelen, V; Sioen, I; Van Larebeke, N; Baeyens, W

    2015-10-01

    Within the Flemish Environment and Health studies (FLEHS I, 2002-2006, and FLEHS II, 2007-2012), pesticide exposure, hormone levels and degree of sexual maturation were measured in 14-15-year-old adolescents residing in Flanders (Belgium). In FLEHS II, geometric mean concentrations (with 95 % confidence interval (CI)) of 307 (277-341) and 36.5 ng L(-1) (34.0-39.2) were found for p,p'-dichlorophenyldichloroethylene (p,p'-DDE) and hexachlorobenzene (HCB). These values were respectively 26 and 60 % lower than levels in FLEHS I, 5 years earlier. Metabolites of organophosphorus pesticides (OPPs) and of para-dichlorobenzene were measured for the first time in FLEHS II, yielding concentrations of 11.4, 3.27 and 1.57 μg L(-1) for the sum of dimethyl- and diethyl phosphate metabolites and 2,5-dichlorophenol (2,5-DCP), respectively. Data on internal exposure of HCB showed a positive correlation with sexual maturation, testosterone and the aromatase index for boys and with free thyroxine (fT4) and thyroid stimulating hormone (TSH) (both boys and girls). For both p,p'-DDE and HCB, a negative association with sexual development in girls was found. The OPP metabolites were negatively associated with sex hormone levels in the blood of boys and with sexual maturation (both boys and girls). The pesticide metabolite 2,5-DCP was negatively correlated with free T4, while a positive association with TSH was reported (boys and girls). These results show that even exposure to relatively low concentrations of pesticides can have significant influences on hormone levels and the degree of sexual maturation in 14-15-year-old adolescents.

  11. [Evaluation of health education training in a French region].

    PubMed

    Defebvre, Marguerite-Marie; Pavageau, Marie; Chrétien, Alice; Carron, François; Vanlacken, Vincent

    2007-01-01

    In the context of the National Health Education Plan launched in 2001, the Nord/ Pas-de-Calais Region engaged itself in reflection and debate on how to improve health education practices. The teaching curricula of health education programmes from the regional paramedical, social and teacher training schools were studied. They were then compared with a set of official texts on the subject (including the national report by Sandrin Berthon) which provide regulations and guidance for this type of teacher training. Teachers and trainers from these institutions were interviewed and questioned about their difficulties and needs. Health education is an optional module in these schools, creating heterogeneity in teaching methods. A shared basis for core teaching materials on subjects in health education does not exist, and specifically, evaluation as a practice is under-developed. These difficulties are therefore exposed, and the article demonstrates the need to provide teachers with a common culture to be shared across these different frameworks and models if one aims to teach health education according to the methods advocated by WHO and Sandrin Berthon's report.

  12. Efficacy methods to evaluate health communication and marketing campaigns.

    PubMed

    Evans, W Douglas; Uhrig, Jennifer; Davis, Kevin; McCormack, Lauren

    2009-06-01

    Communication and marketing are growing areas of health research, but relatively few rigorous efficacy studies have been conducted in these fields. In this article, we review recent health communication and marketing efficacy research, present two case studies that illustrate some of the considerations in making efficacy design choices, and advocate for greater emphasis on rigorous health communication and marketing efficacy research and the development of a research agenda. Much of the outcomes research in health communication and marketing, especially mass media, utilizes effectiveness designs conducted in real time, in the media markets or communities in which messages are delivered. Such evaluations may be impractical or impossible, however, imiting opportunities to advance the state of health communication and marketing research and the knowledge base on effective campaign strategies, messages, and channels. Efficacy and effectiveness studies use similar measures of behavior change. Efficacy studies, however, offer greater opportunities for experimental control, message exposure, and testing of health communication and marketing theory. By examining the literature and two in-depth case studies, we identify advantages and limitations to efficacy studies. We also identify considerations for when to adopt efficacy and effectiveness methods, alone or in combination. Finally, we outline a research agenda to investigate issues of internal and external validity, mode of message presentation, differences between marketing and message strategies, and behavioral outcomes.

  13. Evaluation of CRISTO II Storage Arrays Benchmark with TRIPOLI-4.2 Criticality Calculations

    NASA Astrophysics Data System (ADS)

    Lee, Y. K.

    The new lattice feature of TRIPOLI-4.2 geometry package was applied to model the CRISTO II storage arrays of PWR fuels with various kinds of neutron absorber plates. The new `Kcoll' collision estimator of TRIPOLI-4.2 code was utilized to evaluate the infinite multiplication factors, Kinf. Comparing with the published ICSBEP benchmark results of CRISTO II experiments and of three different continuousenergy Monte Carlo codes - TRIPOLI-4.1 (JEF2.2), MCNP4B2 (ENDF/B-V) and MCNP4XS (ENDF/B-VI.r4), the present study using cost-effective modeling, JEF2.2 and ENDF/B-VI.r4 libraries obtained satisfactory results.

  14. Evaluation of hydrothermal resources of North Dakota. Phase II. Final technical report

    SciTech Connect

    Harris, K.L.; Howell, F.L.; Winczewski, L.M.; Wartman, B.L.; Umphrey, H.R.; Anderson, S.B.

    1981-06-01

    This evaluation of the hydrothermal resources of North Dakota is based on existing data on file with the North Dakota Geological Survey (NDGS) and other state and federal agencies, and field and laboratory studies conducted. The principal sources of data used during the Phase II study were WELLFILE, the computer library of oil and gas well data developed during the Phase I study, and WATERCAT, a computer library system of water well data assembled during the Phase II study. A field survey of the shallow geothermal gradients present in selected groundwater observation holes was conducted. Laboratory determinations of the thermal conductivity of core samples is being done to facilitate heat-flow calculations on those hole-of-convenience cased.

  15. Synthesis and biological evaluation of naphthoquinone-coumarin conjugates as topoisomerase II inhibitors.

    PubMed

    Hueso-Falcón, Idaira; Amesty, Ángel; Anaissi-Afonso, Laura; Lorenzo-Castrillejo, Isabel; Machín, Félix; Estévez-Braun, Ana

    2017-02-01

    Based on previous Topoisomerase II docking studies of naphthoquinone derivatives, a series of naphthoquinone-coumarin conjugates was synthesized through a multicomponent reaction from aromatic aldehydes, 4-hydroxycoumarin and 2-hydroxynaphthoquinone. The hybrid structures were evaluated against the α isoform of human topoisomerase II (hTopoIIα), Escherichia coli DNA Gyrase and E. coli Topoisomerase I. All tested compounds inhibited the hTopoIIα-mediated relaxation of negatively supercoiled circular DNA in the low micromolar range. This inhibition was specific since neither DNA Gyrase nor Topoisomerase I were affected. Cleavage assays pointed out that naphthoquinone-coumarins act by catalytically inhibiting hTopoIIα. ATPase assays and molecular docking studies further pointed out that the mode of action is related to the hTopoIIα ATP-binding site.

  16. Evaluation of health promotion in schools: a realistic evaluation approach using mixed methods

    PubMed Central

    2010-01-01

    Background Schools are key settings for health promotion (HP) but the development of suitable approaches for evaluating HP in schools is still a major topic of discussion. This article presents a research protocol of a program developed to evaluate HP. After reviewing HP evaluation issues, the various possible approaches are analyzed and the importance of a realistic evaluation framework and a mixed methods (MM) design are demonstrated. Methods/Design The design is based on a systemic approach to evaluation, taking into account the mechanisms, context and outcomes, as defined in realistic evaluation, adjusted to our own French context using an MM approach. The characteristics of the design are illustrated through the evaluation of a nationwide HP program in French primary schools designed to enhance children's social, emotional and physical health by improving teachers' HP practices and promoting a healthy school environment. An embedded MM design is used in which a qualitative data set plays a supportive, secondary role in a study based primarily on a different quantitative data set. The way the qualitative and quantitative approaches are combined through the entire evaluation framework is detailed. Discussion This study is a contribution towards the development of suitable approaches for evaluating HP programs in schools. The systemic approach of the evaluation carried out in this research is appropriate since it takes account of the limitations of traditional evaluation approaches and considers suggestions made by the HP research community. PMID:20109202

  17. Habitat Evaluation Procedures (HEP) Report, Pend Oreille Wetlands Wildlife II Project, Technical Report 2002.

    SciTech Connect

    Holmes, Darren

    2003-06-01

    In 2002, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Pend Oreille Wetlands Wildlife II Project, an acquisition completed by the Kalispel Tribe of Indians in 1997. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, and yellow warbler. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Pend Oreille Wetlands Wildlife II Project provides a total of 313.91 Habitat Units (HUs) for the species evaluated. Open water habitat provides 16.08 HUs for Canada goose and mallard. Shoreline and island habitat provide 7.36 HUs fore Canada goose and mallard. Wet meadow provides 117.62 HUs for Canada goose and mallard. Scrub-shrub wetlands provide 9.78 HUs for yellow warbler, mallard, and white-tailed deer. Deciduous forested wetlands provide 140.47 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Conifer forest provides 22.60 HUs for bald eagle, black-capped chickadee, and white-tailed deer. The objective of using HEP at the Pend Oreille Wetlands Wildlife II Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  18. Health as Submission and Social Responsibilities: Embodied Experiences of Javanese Women With Type II Diabetes.

    PubMed

    Pitaloka, Dyah; Hsieh, Elaine

    2015-08-01

    By examining women's experiences with type II diabetes, we explore how illness can provide resources to construct meanings of everyday life in Javanese culture. We conducted in-depth interviews with 30 female participants in Central Java, Indonesia, and adopted grounded theory for data analysis. We identified four themes that diabetes serves as resources for women in Indonesia to (a) normalize suffering, (b) resist social control, (c) accept fate, and (d) validate faith. We concluded by noting three unique aspects of Javanese women's illness management. First, through the performance of submission, our participants demonstrated spirituality and religiosity as essential elements of health. Second, diabetes empowers individuals in everyday suffering through two divergent processes: embracing submission and resisting control. Finally, diabetes provides opportunities for individuals within a social network to (re)negotiate social responsibilities. In summary, diabetes provides unique resources to empower our participants to obtain voices that they otherwise would not have had.

  19. Evaluation of computerized health management information system for primary health care in rural India

    PubMed Central

    2010-01-01

    Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

  20. Improving occupational health care for construction workers: a process evaluation

    PubMed Central

    2013-01-01

    Background To evaluate the process of a job-specific workers’ health surveillance (WHS) in improving occupational health care for construction workers. Methods From January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service throughout the Netherlands. The intervention aimed at detecting signs of work-related health problems, reduced work capacity and/or reduced work functioning. Measurements were obtained using a recruitment record and questionnaires at baseline and follow-up. The process evaluation included the following: reach (attendance rate), intervention dose delivered (provision of written recommendations and follow-up appointments), intervention dose received (intention to follow-up on advice directly after WHS and remembrance of advice three months later), and fidelity (protocol adherence). The workers scored their increase in knowledge from 0–10 with regard to health status and work ability, their satisfaction with the intervention and the perceived (future) effect of such an intervention. Program implementation was defined as the mean score of reach, fidelity, and intervention dose delivered and received. Results Reach was 9% (77 workers participated), fidelity was 67%, the intervention dose delivered was 92 and 63%, and the intervention dose received was 68 and 49%. The total programme implementation was 58%. The increases in knowledge regarding the health status and work ability of the workers after the WHS were graded as 7.0 and 5.9, respectively. The satisfaction of the workers with the entire intervention was graded as 7.5. The perceived (future) effects on health status were graded as 6.3, and the effects on work ability were graded with a 5.2. The economic recession affected the workers as well as the occupational health service that enacted the implementation. Conclusions Programme implementation was acceptable. Low reach, limited protocol adherence and

  1. [Irritant contact dermatitis. Part II. Evaluation evaluation of skin irritation potential of chemicals].

    PubMed

    Chomiczewska, Dorota; Kieć-Swierczyńska, Marta; Krecisz, Beata

    2009-01-01

    The evaluation of skin irritation potential of chemicals is essential to secure the safety of individuals exposed to several substances designed for industrial, pharmaceutical or cosmetic use. Until recently, preclinical safety assessment of chemicals was largely based on animal experiments. Ethical concerns and the limited value of animal models in evaluating human skin irritation potential resulted in the development of alternative in vitro methods, such as EpiDerm, EPISKIN or SkinEthic, to assess irritation, i.e. cell cultures and human epidermis models. International organizations like the European Centre for the Validation of Alternative Methods (ECVAM) promotes and monitors the development of nonanimal tests. Human patch tests and use tests also provide an opportunity to identify substances with significant skin irritation potential without recourse to the use of animals. These tests are useful to assess skin irritation potential of cosmetics and detergents.

  2. The roundtrip to Fairbanks: the circumpolar health movement comes full circle, part II

    PubMed Central

    Murphy, Neil J.

    2013-01-01

    Objectives Evaluate the course of the International Union for Circumpolar Health (IUCH) and the Proceedings of the International Congress(s) on Circumpolar Health (ICCH) in the context of the concomitant historical events. Make recommendations for future circumpolar health research. Study design Medline search and historical archive search of ICCH Proceedings. Methods Search of all PubMed resources from 1966 concerning the circumpolar health movement. Two University of Alaska, Anchorage Archive Collections were searched: the C. E. Albrecht and Frank Pauls Archive Collections. Results Fourteen sets of Proceedings manuscripts and one set of Proceedings Abstracts were evaluated. There was a trend towards consistent use of the existing journals with indexing in Index Medicus; shorter intervals between the Congress and Proceedings manuscript publication; and increased online availability of either the Table of Contents or Proceedings citations. Recent additions include online publication of full-length manuscripts and 2 instances of full peer-review evaluations of the Proceedings manuscripts. These trends in Proceedings publication are described within the course of significant events in the circumpolar health movement. During this period, the IUCH funds are at an all-time low and show little promise of increasing, unless significant alternative funds strategies are pursued. Conclusions The IUCH has matured politically over these years, but some of the same questions persist over the years. There has been a trend towards more rapid dissemination of scientific content, more analytic documentation of epidemiologic study design and trend towards wider dissemination of scientific content through the Internet. Significant progress in each of those areas is still possible and desirable. In the meantime, the IUCH should encourage alternative funding strategies by developing a foundation to support on-going expenses, for example Hildes awards; explore venues to finance Council

  3. Consequences of captivity: health effects of far East imprisonment in World War II.

    PubMed

    Robson, D; Welch, E; Beeching, N J; Gill, G V

    2009-02-01

    Though medical consequences of war attract attention, the health consequences of the prisoner-of-war (POW) experience are poorly researched and appreciated. The imprisonment of Allied military personnel by the Japanese during the World War II provides an especially dramatic POW scenario in terms of deprivation, malnutrition and exposure to tropical diseases. Though predominantly British, these POWs also included troops from Australia, Holland and North America. Imprisonment took place in various locations in Southeast Asia and the Far East for a 3.5-year period between 1942 and 1945. Nutritional deficiency syndromes, dysentery, malaria, tropical ulcers and cholera were major health problems; and supplies of drugs and medical equipment were scarce. There have been limited mortality studies on ex-Far East prisoners (FEPOWs) since repatriation, but these suggest an early (up to 10 years post-release) excess mortality due to tuberculosis, suicides and cirrhosis (probably related to hepatitis B exposure during imprisonment). In terms of morbidity, the commonest has been a psychiatric syndrome which would now be recognized as post-traumatic stress disorder--present in at least one-third of FEPOWs and frequently presenting decades later. Peptic ulceration, osteoarthritis and hearing impairment also appear to occur more frequently. In addition, certain tropical diseases have persisted in these survivors--notably infections with the nematode worm Strongyloides stercoralis. Studies 30 years or more after release have shown overall infection rates of 15%. Chronic strongyloidiasis of this type frequently causes a linear urticarial 'larva currens' rash, but can potentially lead to fatal hyperinfection if immunity is suppressed. Finally, about 5% of FEPOW survivors have chronic nutritional neuropathic syndromes--usually optic atrophy or sensory peripheral neuropathy (often painful). The World War II FEPOW experience was a unique, though often tragic, accidental experiment into

  4. Beginning Teacher Evaluation Study: Phase II, 1973-74, Final Report: Volume V.3. Historical Data Study.

    ERIC Educational Resources Information Center

    Wheeler, Patricia; Elias, Patricia J.

    The Beginning Teacher Evaluation Study (BTES), Phase II, was a research project on effective teaching behavior--what teachers do that significantly affects what and how pupils learn. The purposes of Phase II were to (1) develop an assessment system for measuring teacher and pupil behaviors and other factors which could influence each of them and…

  5. A Preliminary Investigation of the Utility of the "Behavior Support Plan Quality Evaluation Guide II" for Use in Australia

    ERIC Educational Resources Information Center

    Webber, Lynne S.; McVilly, Keith R.; Fester, Tarryn; Zazelis, Telly

    2011-01-01

    Background: The quality of behaviour support plans (BSPs) can be an important influence on the quality of the support provided to people with disability who show challenging behaviours. The Behavior Support Plan Quality Evaluation Guide II (BSP-QE II) is one tool that may be useful in assessing the quality of behaviour support plans. It has…

  6. [Outcomes evaluation of the school staff health promotion project].

    PubMed

    Woynarowska-Sołdan, Magdalena

    This article presents selected outcomes of a 3-year project "Health promotion of school staff in health-promoting schools," as well as the achievements and difficulties in its implementation. The research was conducted on 644 teachers and 226 members of non-teaching staff in 21 schools. The method involved opinion poll and authored questionnaires. A 2-part model of outcome evaluation was developed. Most participants appreciated the changes that took place within the 3 years of the project implementation. These included the improved level of their knowledge about health, health-conducive behaviors (62-93%) and the physical and social environment of the school (50-92%). Changes were more frequently acknowledged by teachers. About 80% of the participants had a positive attitude to the project, but only 20% assessed their involvement as considerable. About 90% believed that health promotion activities should be continued. According to the project leaders, insufficient support and financial resources, and difficulties in motivating school employees, particularly the nonteaching staff, to undertake health-promotion activities were the major handicaps in the project implementation. The project outcomes can be assessed as satisfying. They revealed that it is posssible to initiate health promotion among school staff. This can be effective on condition that participants are motivated, actively engaged in the project and supported by the head teacher and the local community. Necessarily, school leaders should be prepared to promote health among adults and to gain support from school policy decision makers, school administration, trade unions and universities involved in teacher training. Med Pr 2016;67(2):187-200. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  7. Phase II -- Photovoltaics for Utility Scale Applications (PVUSA): Safety and health action plan

    SciTech Connect

    Berg, K.

    1994-09-01

    To establish guidelines for the implementation and administration of an injury and illness prevention program for PVUSA and to assign specific responsibilities for the execution of the program. To provide a basic Safety and Health Action Plan (hereinafter referred to as Plan) that assists management, supervision, and project personnel in the recognition, evaluation, and control of hazardous activities and/or conditions within their respective areas of responsibility.

  8. Personal Benefits of a Health Evaluation and Enhancement Program

    NASA Technical Reports Server (NTRS)

    Heinzelmann, F.; Durbeck, D. C.

    1970-01-01

    A study was made of the benefits reported by participants in a health evaluation and enhancement program dealing with physical activity. Program benefits were identified and defined in regard to three major areas: program effects on work; program effects on health; and program effects on habits and behavior. A strong positive and consistent relationship was found between reported benefits in each of these areas and measures of improvement in cardiovascular functioning based on treadmill performance. Significant differences in these measures of improvement were also found between participants who reported program benefits and those persons who did not. These findings provide a meaningful profile of the pattern of benefits generated by this kind of health program.

  9. Personal Benefits of a Health Evaluation and Enhancement Program

    NASA Technical Reports Server (NTRS)

    Heinzelmann, F.; Durbeck, D. C.

    1970-01-01

    A study was made of the benefits reported by participants in a health evaluation and enhancement program dealing with physical activity. Program benefits were identified and defined in regard to three major areas: program effects on work; program effects on health; and program effects on habits and behavior. A strong positive and consistent relationship was found between reported benefits in each of these areas and measures of improvement in cardiovascular functioning based on treadmill performance. Significant differences in these measures of improvement were also found between participants who reported program benefits and those persons who did not. These findings provide a meaningful profile of the pattern of benefits generated by this kind of health program.

  10. Evaluating community and campus environmental public health programs.

    PubMed

    Pettibone, Kristianna G; Parras, Juan; Croisant, Sharon Petronella; Drew, Christina H

    2014-01-01

    The National Institute of Environmental Health Sciences' (NIEHS) Partnerships for Environmental Public Health (PEPH) program created the Evaluation Metrics Manual as a tool to help grantees understand how to map out their programs using a logic model, and to identify measures for documenting their achievements in environmental public health research. This article provides an overview of the manual, describing how grantees and community partners contributed to the manual, and how the basic components of a logic model can be used to identify metrics. We illustrate how the approach can be implemented, using a real-world case study from the University of Texas Medical Branch, where researchers worked with community partners to develop a network to address environmental justice issues.

  11. GIS applications to evaluate public health effects of global warming

    SciTech Connect

    Regens, J.L.; Hodges, D.G.

    1996-12-31

    Modeling projections of future climatic conditions suggest changes in temperature and precipitation patterns that might induce direct adverse effects on human health by altering the extent and severity of infectious and vector-borne diseases. The incidence of mosquito-borne diseases, for example, could increase substantially in areas where temperature and relative humidity rise. The application of Geographic Information Systems (GIS) offers new methodologies to evaluate the impact of global warming on changes in the incidence of infectious and vector-borne diseases. This research illustrates the potential analytical and communication uses of GIS for monitoring historical patterns of climate and human health variables and for projecting changes in these health variables with global warming.

  12. Evaluation of two communication strategies to improve udder health management.

    PubMed

    Jansen, J; Renes, R J; Lam, T J G M

    2010-02-01

    Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder health management, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered

  13. Public health surveillance: historical origins, methods and evaluation.

    PubMed Central

    Declich, S.; Carter, A. O.

    1994-01-01

    In the last three decades, disease surveillance has grown into a complete discipline, quite distinct from epidemiology. This expansion into a separate scientific area within public health has not been accompanied by parallel growth in the literature about its principles and methods. The development of the fundamental concepts of surveillance systems provides a basis on which to build a better understanding of the subject. In addition, the concepts have practical value as they can be used in designing new systems as well as understanding or evaluating currently operating systems. This article reviews the principles of surveillance, beginning with a historical survey of the roots and evolution of surveillance, and discusses the goals of public health surveillance. Methods for data collection, data analysis, interpretation, and dissemination are presented, together with proposed procedures for evaluating and improving a surveillance system. Finally, some points to be considered in establishing a new surveillance system are presented. PMID:8205649

  14. Evaluation of the Arizona health care cost-containment system

    PubMed Central

    McCall, Nelda; Henton, Douglas; Crane, Michael; Haber, Susan; Freund, Deborah; Wrightson, William

    1985-01-01

    This article evaluates Arizona's alternative to the acute portion of Medicaid, the Arizona Health Care Cost-Containment System (AHCCCS), during its first 18 months of operation from October 1982 through March 1984. It focuses on the program's implementation and describes and evaluates the program's innovative features. The features of the program outlined in the original AHCCCS legislation included: Competitive bidding, prepaid capitation of providers, capitation of the State by the Health Care Financing Administration, assignment of gatekeepers, beneficiary copayment, private administration, inclusion of private and public employees and county financed long-term care. An assessment of implementation during the second 18 months of the program reporting on more recent developments and is now being prepared by SRI International. PMID:10311438

  15. A Logic Model for Evaluating the Academic Health Department.

    PubMed

    Erwin, Paul Campbell; McNeely, Clea S; Grubaugh, Julie H; Valentine, Jennifer; Miller, Mark D; Buchanan, Martha

    2016-01-01

    Academic Health Departments (AHDs) are collaborative partnerships between academic programs and practice settings. While case studies have informed our understanding of the development and activities of AHDs, there has been no formal published evaluation of AHDs, either singularly or collectively. Developing a framework for evaluating AHDs has potential to further aid our understanding of how these relationships may matter. In this article, we present a general theory of change, in the form of a logic model, for how AHDs impact public health at the community level. We then present a specific example of how the logic model has been customized for a specific AHD. Finally, we end with potential research questions on the AHD based on these concepts. We conclude that logic models are valuable tools, which can be used to assess the value and ultimate impact of the AHD.

  16. Economic Evaluation of Environmental Health Interventions to Support Decision Making

    PubMed Central

    Hutton, Guy

    2008-01-01

    Environmental burden of disease represents one quarter of overall disease burden, hence necessitating greater attention from decision makers both inside and outside the health sector. Economic evaluation techniques such as cost-effectiveness analysis and cost-benefit analysis provide key information to health decision makers on the efficiency of environmental health interventions, assisting them in choosing interventions which give the greatest social return on limited public budgets and private resources. The aim of this article is to review economic evaluation studies in three environmental health areas—water, sanitation, hygiene (WSH), vector control, and air pollution—and to critically examine the policy relevance and scientific quality of the studies for selecting and funding public programmers. A keyword search of Medline from 1990–2008 revealed 32 studies, and gathering of articles from other sources revealed a further 18 studies, giving a total of 50 economic evaluation studies (13 WSH interventions, 16 vector control and 21 air pollution). Overall, the economic evidence base on environmental health interventions remains relatively weak—too few studies per intervention, of variable scientific quality and from diverse locations which limits generalisability of findings. Importantly, there still exists a disconnect between economic research, decision making and programmer implementation. This can be explained by the lack of translation of research findings into accessible documentation for policy makers and limited relevance of research findings, and the often low importance of economic evidence in budgeting decisions. These findings underline the importance of involving policy makers in the defining of research agendas and commissioning of research, and improving the awareness of researchers of the policy environment into which their research feeds. PMID:21572840

  17. Methods for the evaluation and analysis of health expenditure.

    PubMed

    Sandier, S

    1983-01-01

    The purpose of health expenditure evaluation is to give an overall picture of the amounts spent for the functions of the health system; it also allows the analysis of the financial flows between the financiers, producers and consumers of the health system. Principles of evaluation include: monetary evaluation (market prices); avoidance of double accounts; quick communication of data; use of all available reliable statistics; use of rough estimates rather than leaving blanks in tables. Information already available can be used. Statistics also should be collected from financing bodies, providers of medical care, sample surveys, and general sources. Many statistics cannot be used directly but must be processed, adjusted, or broken down. In order to analyze information for health services management, one must ask: who is financing the consumption of medical care, and what is the trend of medical expenditure by sector or activity? Over time, summaries should be used to analyze trends. At the macrolevel, structural trends can be compared, such as demographic factors, gross economic product, inflation, price of medical care, volume of medical care, and contribution of prices and volumes to increases in expenditures. Causes of these trends include factors such as changes in collective financing and developments in the health care system. A brief analysis of the trends in final medical consumption expenditure in France shows 3300 francs per person expended in 1979, (7.3% of the GNP in 1979). Tables for France show: type of expenditure; type of financing in 1979; medical expenditure as a % of the gross domestic product, 1950-1980; and type of financing, 1950-1978. Hospitalization has accounted for an increasing proportion of medical expenditure in France, reflecting improvement in quality of services offered by hospitals. Public financing is shown to be increasing in France.

  18. Integrating children's health services: evaluation of a national demonstration project.

    PubMed

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

    1997-12-01

    Increasingly, the public and private sectors are turning to "service integration" efforts to reduce, if not eliminate, barriers to needed care created by categorical programs. In 1991, the Robert Wood Johnson Foundation established a new national demonstration project, called the Child Health Initiative, intended to test the feasibility of developing mechanisms at the community level to coordinate the delivery of health services and to pay for those services through a flexible pool of previously categorical funds. This article presents the findings of an independent evaluation of the Child Health Initiative. The evaluation utilized a combination of qualitative methods to assess and describe the experiences of the communities as they developed and implemented integrated health services. It used a repeated measures design involving two site visits and interim telephone interviews, as well as review of documents. Overall, the demonstration project achieved mixed success. Both care coordination and the production of community health report cards were found to be achievable within the relatively short life of the foundation grant. However, many sites experienced significant delays in the production of report cards and implementing care coordination plans because the sites largely did not benefit from the successful models already in existence. Little clear progress was made in implementing the decategorization component of the project. Sites experienced difficulties due to lack of previous experience with this new undertaking, the inability to secure active cooperation from local, state, and federal agencies, the relatively short duration of the project, and other factors. A number of lessons were learned from this project that may be useful in future decategorization experiments, including (1) a clear understanding of the concept and its applications among all parties is essential, (2) high-level political commitments to the effort are needed between all levels of

  19. Evaluation and diagnosis of the hair loss patient: part II. Trichoscopic and laboratory evaluations.

    PubMed

    Mubki, Thamer; Rudnicka, Lidia; Olszewska, Malgorzata; Shapiro, Jerry

    2014-09-01

    The use of trichoscopy for evaluating a number of hair and scalp disorders is gaining popularity. It is a simple and noninvasive in vivo tool for visualizing hair shafts and the scalp. Recently, alopecias have been classified according to their trichoscopic findings. The second part of this 2-part continuing medical education article reviews recent advances in this field and describes a systematic approach for using the differential diagnostic findings of trichoscopy in alopecia. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  20. An Evaluation of the Navy’s Health Promotion Videotapes

    DTIC Science & Technology

    1990-04-30

    has mainly occurred in hospitals, clinics, and patient education centers. However, as noted by Holm (1983), the broader intent of the patient ...Mitchell, M. (1977). Evaluation of a patient education program for chronic obstructive pulmonary disease. Mayo Clinic Proceedings, 52, 106-111...effectiveness of videotape in patient education on depression. Journal of Biocommunication, 1Q, 19-23. Cull, P. (1988). The production process of health

  1. An Evaluation of the Navy’s Health Promotion Videotapes

    DTIC Science & Technology

    1990-04-30

    Currently, the use of videotape in health education has mainly occurred in hospitals, clinics, and patient education centers. However, as noted by...Holm (1983). the broader intent of the patient education movement is to make healtb information as available as possible to the general public. This...559-584. Black, L., & Mitchell, M. (1977). Evaluation of a patient education program for chronic obstructive pulmonary disease. Mayo Clinic

  2. Equivalent income and fair evaluation of health care.

    PubMed

    Fleurbaey, Marc; Luchini, Stéphane; Muller, Christophe; Schokkaert, Erik

    2013-06-01

    We argue that the economic evaluation of health care (cost-benefit analysis) should respect individual preferences and should incorporate distributional considerations. Relying on individual preferences does not imply subjective welfarism. We propose a particular non-welfarist approach, based on the concept of equivalent income, and show how it helps to define distributional weights. We illustrate the feasibility of our approach with empirical results from a pilot survey. Copyright © 2012 John Wiley & Sons, Ltd.

  3. Evaluation of the Coca-Cola company travel health kit.

    PubMed

    Harper, Lynne A; Bettinger, Julie; Dismukes, Roberta; Kozarsky, Phyllis E

    2002-01-01

    The Coca-Cola travel health kit has been used for about one decade for international travelers and required evaluation to see if the items contained were appropriate for the employees. Two hundred thirty-four travelers were sampled and filled out a voluntary survey including questions about demographic information, travel history, and usage and value of the contents of the travel health kit. One hundred eighty-one surveys were returned; 65% of the respondents were male, and the majority of travelers were between the ages of 36 and 45 years. The most useful items were analgesics and medications used for gastrointestinal problems. In general, the items identified as being the least useful were those requiring specialized use by a medical practitioner, such as needles and syringes. Suggestions of items to be added to the kit included vitamins, cough drops, sleep aids, and eye drops. A surprising result that Coca-Cola employees expressed the desire for brand name rather than generic items. Evaluation of the Coca-Cola Company travel health kit revealed it to be very useful to most corporate travelers. Suggestions that were made will be taken into consideration in designing a new kit, and consideration is being given to whether a basic travel health kit should be provided to which travelers can add other items depending on their personal needs.

  4. Empowerment evaluation in redesigning a public health unit nutrition program.

    PubMed

    Dwyer, John J M; Vavaroutsos, Denise; Lutterman, Ann; Hier, Michelle; Hughes, May; Makarchuk, Mary-Jo

    2006-01-01

    This article illustrates how empowerment evaluation was used in Toronto Public Health's (TPH) nutrition programming redesign to consult with staff about how roles, responsibilities, and organisational structure could be changed to improve how nutrition programs are delivered. One of three moderators facilitated the ten two-hour focus group sessions in TPH. TPH staff, namely 71 front-line staff and 13 managers who were responsible for providing community nutrition services, participated in the study. Focus group participants included Public Health Dietitians, Public Health Nutritionists, Public Health Nurses (PHNs), and paraprofessionals (i.e., community nutrition assistants). Participants' preferred roles, responsibilities, and organisational structure in TPH, which they believe would improve nutrition service delivery in the community, were examined. A constant comparison approach was used to develop themes inductively. It was found that participants wanted Dietitians and Nutritionists to provide current nutrition-related information to them. They felt that nutrition programs should be promoted better and made more accessible to the public. They suggested that Dietitians and Nutritionists and other staff should share information with each other better. They suggested that Dietitians and Nutritionists should provide nutrition services directly to the public and provide support to other staff, mainly PHNs, who deliver nutrition programs. In conclusion, this empowerment evaluation produced results that were used to assist in decision making about nutrition programming.

  5. Health gain from restorative dental treatment evaluated by computer simulation.

    PubMed

    Downer, M C; Moles, D R

    1998-03-01

    To simulate the influence over time of relevant factors on health gain from restorative dental treatment under varying assumptions and to compare outcomes with those resulting under a 'do nothing' scenario. A decision model was used in a computer simulation of the caries process in posterior approximal tooth surfaces. The effect of superimposing restorative treatment, based on bitewing radiology, was incorporated. Input data came from current observational studies and included caries progression rates, notional survival times of restorations, and sensitivity (Sn) and specificity (Sp) of treatment decision making by a high (A) and a low (B) performing dentist. Utility values, on a scale 0-1, for different tooth health states were obtained from questioning 92 adults of appropriate age. By assumption, the primary dental care sector. A hypothetical population, initially 14-15 years old. Class II amalgam restorations. Computed in utility based units (UBUs) as sums of the product of numbers of sound, carious and restored surfaces and their utility values. Health gain (in UBUs) was assessed relative to interim end point UBUs pertaining under 'do nothing'. One thousand approximal surfaces, designated initially as 920 sound, 51 carious and 29 filled were followed in the model over 10 years. The greatest health gain (33.16 UBUs) was from dentist A (Sn = 0.23, Sp = 0.99, 50 per cent restoration survival rate = 10 years, caries rate = 4.4% per annum). The least was from dentist B (Sn = 0.52, Sp = 0.88, 50% survival = 5 years, caries rate = 0.0% per annum) representing a loss of 17.07 UBUs compared with 'do nothing'. Results suggest that caution is advisable when making positive decisions to restore on the basis of bitewing radiographs.

  6. Marine Resiliency Study II

    DTIC Science & Technology

    2016-07-06

    the Army Study of Risk and Resilience (Army STARRS) program, by evaluating the physical , family, social, cognitive and mental health status of...MRS II) is to identify the individual, social. and deployment factors that predict trajectories of mental health response, particularly posttraumatic...with an overarching ob ject ive co develop a platform to provide an early analysis of predictors of mental health outcomes , such as Post Traumatic

  7. Health economic evaluations help inform payers of the best use of scarce health care resources.

    PubMed

    O'Reilly, Daria; Gaebel, Kathryn; Xie, Feng; Tarride, Jean-Eric; Goeree, Ron

    2011-09-01

    The number of new health technologies has risen over the past decade. These new technologies usually are more effective but they also cost more compared to existing ones. In a publicly funded health care system such as Canada, the aim is to maximize the health of the population within the resources available. As a result, it is unavoidable that choices and trade-offs have to be made because there will always be more treatment options than resources will allow (i.e., scarcity of resources) as well as alternative uses for those resources (i.e., opportunity costs). The objective of this paper is to provide an overview of economic evaluations and how these tools can be used to help inform payers of the best use of scarce health care resources. This descriptive paper includes a summary of key consepts and definitions in economic appraisal and draws upon recently published papers as illustrations. Background on the necessity and role of economic evaluations is provided, followed by a description of the approaches for, and types of, economic evaluations. Two illustrative examples are used and some implications for rural, remote and circumpolar communities are discussed. There are 2 main approaches for conducting an economic evaluation (trial- and model-based) and 3 types of evaluations which can be considered to inform payers of the best use of health care resources (cost-effectiveness, cost-utility and cost-benefit analyses). Techniques of economic evaluation are useful tools and an important input into the decision-making process. Although these techniques have universal application, there are issues specific to rural, remote and circumpolar communities which can affect the results of economic appraisals.

  8. The new production theory for health care through clinical reengineering: a study of clinical guidelines--Part II.

    PubMed

    Sharp, J R

    1995-01-01

    In Part I of this two-part article, in the December 1994 issue of the journal, the author discussed the manufacturing theories of Peter Drucker in terms of their applicability for the health care field. He concluded that Drucker's four principles and practices of manufacturing--statistical quality control, manufacturing accounting, modular organization, and systems approach--do have application to the health care system. Clinical guidelines, a variation on the Drucker theory, are a specific example of the manufacturing process in health. The performance to date of some guidelines and their implications for the health care reform debate are discussed in Part II of the article.

  9. Three different methods to evaluate microleakage of packable composites in Class II restorations.

    PubMed

    de Almeida, Janaina Bertoncelo; Platt, Jeffrey A; Oshida, Yoshiki; Moore, B Keith; Cochran, Michael A; Eckert, George J

    2003-01-01

    This in vitro study compared three different methods to evaluate detectable levels of microleakage in Class II restorations placed with five commercially available packable resin composites: Alert, Glacier, Pyramid, Solitaire 2 and SureFil. A flowable resin composite, Flow-It, was used to line all packable composites. The hybrid resin composite Z100 was also included. The adhesive system used with all groups was Scotchbond MultiPurpose Plus. Standard Class II cavities were prepared on the mesial (enamel margins) and distal (dentin margins) sides of the teeth with no communication between them. Based on a power analysis, 180 permanent human molars were randomly assign to each of six groups with 30 specimens per group. All restorative materials were placed following manufacturers' recommendations. Following restoration and thermocycling, the specimens were stored at room temperature in solutions of 45Ca, methylene blue and rhodamine B, sequentially. Microleakage was ordinal scored as 1 (no penetration), 2 (penetration up to one-third of the cervical floor), 3 (penetration beyond one-third of the cervical floor to the axial wall) and 4 (penetration along the axial wall) by two independent evaluators. Analysis of the occlusal surfaces was also accomplished following the same scheme. In this study, tracers/dyes were evaluated for differences in penetration using generalized estimating equation methodology applied to cumulative logistic regression models. The results showed that Rhodamine B detected more microleakage than 45Ca or methylene blue, and 45Ca generally detected more microleakage than methylene blue.

  10. Clinical Evaluation of Restorative Materials in Primary Teeth Class II Lesions.

    PubMed

    Sengul, F; Gurbuz, T

    2015-01-01

    The aim of this study was to evaluate clinical success of primary teeth class II lesions restored with different restorative materials [Hybrid Composite Resin (HCR), Resin Modified Glass Ionomer Cement (RMGIC), compomer, and Giomer Composite Resin (GCR)] followed up for 24 months. This study was carried out on 146 primary molars of 41 children in the age range of 5-7 years. The class II lesions in primary molars of a patient were restored using different restorative materials. Restorations were evaluated according to FDI-criteria and their survival rates were determined. Data were analysed with Pearson chi-square, Kaplan-Meier and Wilcoxon (Breslow) tests (α = 0.05). The failure rates of restorative materials were as follows: compomer 33.3%, RMGIC 28.1%, HCR 22.5% and GCR 21.1%. While the functional failure was the most important factor in restorative material failure, RMGIC was the most successful material in terms of biological evaluation criterion and GCR had the longest survival rate.

  11. Marginal Adaptation Evaluation of Biodentine and MTA Plus in "Open Sandwich" Class II Restorations.

    PubMed

    Aggarwal, Vivek; Singla, Mamta; Yadav, Suman; Yadav, Harish; Ragini

    2015-01-01

    This study aimed at evaluation of two different commercially available calcium silicate materials (Biodentine and mineral trioxide aggregate [MTA] Plus) used as dentin substitute. Sixty Class II cavities were prepared in extracted mandibular third molars, with margins extending 1 mm below the cementum-enamel junction. The samples were divided into three groups on the basis of dentin substitute used: resin modified glass ionomer cement, Biodentine, and MTA Plus. Cavities were restored with composite resins in an "open sandwich" technique. The samples were subjected to alternate aging in phosphate buffered saline and cyclic loading. Marginal adaptation was evaluated in terms of "continuous margin" at the gingival margin, using a low vacuum scanning electron microscope. Statistical analysis was done with two-way analysis of variance with Holm-Sidak's correction for multiple comparisons. The glass ionomer group and Biodentine group presented an overall 83% and 91% of continuous margins, with no difference between them. MTA Plus showed least values of continuous margins. Granular deposits were seen over the surface of Biodentine and MTA Plus. Biodentine and resin-modified glass ionomer cement, when used as a dentin substitute under composite restorations in open sandwich technique, gave satisfactory marginal adaptation values. Contemporary calcium silicate materials can be used as dentin substitute materials in "open sandwich" Class II restorations. This study evaluates the marginal adaptation of Biodentine, MTA Plus, and resin modified glass ionomer cement used as dentin substitutes and reports better adaptation obtained with Biodentine and glass ionomer cement. © 2015 Wiley Periodicals, Inc.

  12. 29 CFR 1960.79 - Self-evaluations of occupational safety and health programs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Self-evaluations of occupational safety and health programs... AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.79 Self-evaluations of occupational safety and health programs. Agency heads shall develop...

  13. 29 CFR 1960.79 - Self-evaluations of occupational safety and health programs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Self-evaluations of occupational safety and health programs... AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.79 Self-evaluations of occupational safety and health programs. Agency heads shall develop...

  14. 29 CFR 1960.79 - Self-evaluations of occupational safety and health programs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Self-evaluations of occupational safety and health programs... AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.79 Self-evaluations of occupational safety and health programs. Agency heads shall develop...

  15. 29 CFR 1960.79 - Self-evaluations of occupational safety and health programs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Self-evaluations of occupational safety and health programs... AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.79 Self-evaluations of occupational safety and health programs. Agency heads shall develop...

  16. 29 CFR 1960.79 - Self-evaluations of occupational safety and health programs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Self-evaluations of occupational safety and health programs... AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.79 Self-evaluations of occupational safety and health programs. Agency heads shall develop...

  17. Health economic evaluations in orthodontics: a systematic review.

    PubMed

    Sollenius, Ola; Petrén, Sofia; Björnsson, Liselotte; Norlund, Anders; Bondemark, Lars

    2016-06-01

    Economic evaluation is assuming increasing importance as an integral component of health services research. To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs. The literature review was conducted in four steps, according to Goodman's model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation). The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment. This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently

  18. The impact of health economic evaluations in Sweden.

    PubMed

    Heintz, Emelie; Arnberg, Karl; Levin, Lars-Åke; Liliemark, Jan; Davidson, Thomas

    2014-01-01

    The responsibility for healthcare in Sweden is shared by the central government, county councils and municipalities. The counties and municipalities are free to make their own prioritizations within the framework of the state healthcare laws. To guide prioritization of healthcare resources in Sweden, there is consensus that cost-effectiveness constitutes one of the three principles. The objective of this paper is to describe how cost-effectiveness, and hence health economic evaluations (HEE), have a role in pricing decisions, reimbursement of pharmaceuticals as well as the overall prioritization and allocation of resources in the Swedish healthcare system. There are various organizations involved in the processes of implementing health technologies in the Swedish healthcare system, several of which consider or produce HEEs when assessing different technologies: the Dental and Pharmaceutical Benefits Agency (TLV), the county councils' group on new drug therapies (NLT), the National Board of Health and Welfare, the Swedish Council on Health Technology Assessment (SBU), regional HTA agencies and the Public Health Agency of Sweden. The only governmental agency that has official and mandatory guidelines for how to perform HEE is TLV (LFNAR 2003:2). Even though HEEs may seem to have a clear and explicit role in the decision-making processes in the Swedish healthcare system, there are various obstacles and challenges in the use and dissemination of the results.

  19. [Evaluation of health information about the influenza vaccine on internet].

    PubMed

    Hernández-García, I; González Celador, R

    2014-01-01

    The quality of health information on internet is a question of concern to governments and users. Our aim was to determine the extent to which information about the influenza vaccine adheres to the gold standard set by the Spanish Health Ministry. Between June and July 2014 information on indications, adverse effects and counter-indications of the vaccine was evaluated to see if it adhered to this gold standard. This information was obtained through Google, using terms provided by medical students. A univariate analysis was performed, where the variable result was getting information that adhered correctly to the standard, and explanatory variables were the type of origin of the information and its country. Using the terms provided by 104 students, we obtained 134 different web links. Adhesion reached 65.7% (88/134) with respect to indication in health workers (HW). Nineteen point four percent provided incorrect information on indication in pregnant women. There was significantly better adherence in the information from official public health bodies (indication in HW (OR: 2.6), pregnant women (OR: 5.4) and immunodepressed patients (OR: 2.2)). Adherence of information on Spanish web links was worse (indication in pregnancy (OR: 0.3) and counter-indication if allergic to eggs (OR: 0.5). Adhesion was improvable. It's necessary to promote that internet users use official public health bodies websites when they search information regarding influenza vaccine on internet.

  20. Implementation and evaluation of an interdisciplinary health professions core curriculum.

    PubMed

    Buck, M M; Tilson, E R; Andersen, J C

    1999-01-01

    An interdisciplinary core curriculum has been implemented in the College of Health Professions at Armstrong Atlantic State University since spring 1996. The curriculum is designed to provide students with the knowledge, skills, and values necessary for interprofessional practice. The courses are taught by interdisciplinary teams and are offered as electives or as part of major requirements in nursing, health science, physical therapy, dental hygiene, medical technology, radiologic sciences, and respiratory therapy. In addition to ongoing evaluation methods, a survey designed to assess the student and faculty perceptions of the experience has been conducted. Both groups agreed that the experience has had a positive impact on the students' professional performances, patient interactions, understanding of the health care delivery system, and health career preparation. Faculty agreed that teaching in an interdisciplinary team was a positive experience. The collaboration among the health professions' faculty has resulted in increased respect for one another and for others' disciplines. Although the experience places an additional burden on their workload, they agreed that the experience is beneficial, their efforts are worthwhile, and they would be willing to continue to teach interdisciplinary courses.