Science.gov

Sample records for health organization minimum

  1. Compliance of clinical trial registries with the World Health Organization minimum data set: a survey

    PubMed Central

    Moja, Lorenzo P; Moschetti, Ivan; Nurbhai, Munira; Compagnoni, Anna; Liberati, Alessandro; Grimshaw, Jeremy M; Chan, An-Wen; Dickersin, Kay; Krleza-Jeric, Karmela; Moher, David; Sim, Ida; Volmink, Jimmy

    2009-01-01

    Background Since September 2005 the International Committee of Medical Journal Editors has required that trials be registered in accordance with the World Health Organization (WHO) minimum dataset, in order to be considered for publication. The objective is to evaluate registries' and individual trial records' compliance with the 2006 version of the WHO minimum data set. Methods A retrospective evaluation of 21 online clinical trial registries (international, national, specialty, pharmaceutical industry and local) from April 2005 to February 2007 and a cross-sectional evaluation of a stratified random sample of 610 trial records from the 21 registries. Results Among 11 registries that provided guidelines for registration, the median compliance with the WHO criteria were 14 out of 20 items (range 6 to 20). In the period April 2005–February 2007, six registries increased their compliance by six data items, on average. None of the local registry websites published guidelines on the trial data items required for registration. Slightly more than half (330/610; 54.1%, 95% CI 50.1% – 58.1%) of trial records completed the contact details criteria while 29.7% (181/610, 95% CI 26.1% – 33.5%) completed the key clinical and methodological data fields. Conclusion While the launch of the WHO minimum data set seemed to positively influence registries with better standardisation of approaches, individual registry entries are largely incomplete. Initiatives to ensure quality assurance of registries and trial data should be encouraged. Peer reviewers and editors should scrutinise clinical trial registration records to ensure consistency with WHO's core content requirements when considering trial-related publications. PMID:19624821

  2. The right to a decent minimum of health care.

    PubMed

    Buchanan, Allen E

    1984-01-01

    Buchanan examines, and finds inadequate, several philosophical approaches to justifying and specifying the content of a universal right to a decent minimum of health care: utilitarian arguments, Rawlsian ideal contract arguments, and Norman Daniels' equality of opportunity argument. Also rejecting the libertarian hypothesis that there is no right to a decent minimum of care, he contends that the claim that society should guarantee certain health care services can be supported by a pluralistic approach encompassing special right-claims, harm prevention, prudential arguments emphasizing public health benefits, and beneficence.

  3. EVALUATION OF MINIMUM DATA REQUIREMENTS FOR ACUTE TOXICITY VALUE EXTRAPOLATION WITH AQUATIC ORGANISMS

    EPA Science Inventory

    Buckler, Denny R., Foster L. Mayer, Mark R. Ellersieck and Amha Asfaw. 2003. Evaluation of Minimum Data Requirements for Acute Toxicity Value Extrapolation with Aquatic Organisms. EPA/600/R-03/104. U.S. Environmental Protection Agency, National Health and Environmental Effects Re...

  4. How 'decent' is a decent minimum of health care?

    PubMed

    ter Meulen, Ruud

    2011-12-01

    This article tries to analyze the meaning of a decent minimum of health care, by confronting the idea of decent care with the concept of justice. Following the ideas of Margalith about a decent society, the article argues that a just minimum of care is not necessarily a decent minimum. The way this minimum is provided can still humiliate individuals, even if the end result is the best possible distribution of the goods as seen from the viewpoint of justice. This analysis is combined with an analysis from the perspective of solidarity, particularly of reflective solidarity, as a way to develop decent care, which is care that does not humiliate individuals and maintains their dignity. PMID:22241865

  5. Priority setting in global health: towards a minimum DALY value.

    PubMed

    Drake, Tom

    2014-02-01

    Rational and analytic healthcare decision making employed by many national healthcare-funding bodies could also be expected from global health donors. Cost effectiveness analysis of healthcare investment options presents the effectiveness of a particular action in proportion to the resources required, and cost effectiveness thresholds, while somewhat arbitrary, define the level at which the investment can be considered value for money. Currently, cost effectiveness thresholds reflect the national budget context or willingness-to-pay, which is problematic when making cross-country comparisons. Defining a global minimum monetary value for the disability adjusted life year (DALY) would in effect set a global baseline cost effectiveness threshold. A global minimum DALY value would reflect a universal minimum value on human health, irrespective of a national provider's willingness or ability to pay. A minimum DALY value and associated threshold has both limitations and flaws but is justified on similar grounds to the Millennium Development Goals or the absolute poverty threshold and has the potential to radically improve transparency and efficiency of priority setting in global health. PMID:23576492

  6. 25 CFR 900.45 - What specific minimum requirements shall an Indian tribe or tribal organization's financial...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false What specific minimum requirements shall an Indian tribe or tribal organization's financial management system contain to meet these standards? 900.45 Section 900.45 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  7. The Comparison of the Minimum Data Set for Elderly Health in Selected Countries

    PubMed Central

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

    2015-01-01

    Introduction: Ongoing increase in the elderly population in many developed countries has drawn attention to health of this age group. Recording adequate and relevant data for the elderly is considered as the basis for future planning for this segment of society. So this study was conducted to compare minimum data about elderly health in selected countries. Methods: This review study was conducted through Internet and library studies. Key words were extracted from search engines and data bases including Google, Yahoo, Google Scholar, PubMed, ProQuest and Iranian National Medical Digital Library. Inclusion criteria included English language with no time limits. All articles, research projects, theses, guidelines and progress reports were retrieved from the United States, Sweden, Japan and Iran and reviewed. Also, websites of organizations responsible for elderly health in selected countries were visited and their documents were reviewed. Results from this search were provided narratively and finally were presented within comparison tables. Findings: The findings of this study showed that elderly data in the selected countries are collected around four axis including minimum demographic data, medical histories, health assessment and financial data of elderly health. Discussion and Conclusion: Given the importance of the minimum data set of elderly health for future planning, the use of experiences of leading countries in elderly health seems necessary; however, localization of it according to the country’s needs is inevitable. PMID:26862252

  8. 17 CFR 1.52 - Self-regulatory organization adoption and surveillance of minimum financial requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... requirements; and (2) Of the identity of the designated self-regulatory organization that has been delegated... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Self-regulatory organization... Miscellaneous § 1.52 Self-regulatory organization adoption and surveillance of minimum financial...

  9. 17 CFR 1.52 - Self-regulatory organization adoption and surveillance of minimum financial requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (ii) of the identity of the designated self-regulatory organization which has been delegated... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Self-regulatory organization... Miscellaneous § 1.52 Self-regulatory organization adoption and surveillance of minimum financial...

  10. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... withdrawal of approval of the plan in accordance with 5 CFR 890.204. A health benefits plan shall: (1) Comply... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Minimum standards for health benefits... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans §...

  11. World Health Organization

    MedlinePlus

    ... Advisory Committee Final Report of the Advisory Group Zika virus and complications After a spike in cases of microcephaly and Guillain-Barré syndrome associated with Zika virus, WHO declared a public health emergency. Information ...

  12. Pan American Health Organization

    MedlinePlus

    ... y la enfermedad. Watch video... 60% of infectious human diseases are of animal origin. With the goal of uniting efforts to improve human, animal, and environmental health, the world celebrates the ...

  13. 17 CFR 1.52 - Self-regulatory organization adoption and surveillance of minimum financial requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... financial and related reporting requirements; and (2) Of the identity of the designated self-regulatory... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Self-regulatory organization... Miscellaneous § 1.52 Self-regulatory organization adoption and surveillance of minimum financial...

  14. 17 CFR 1.52 - Self-regulatory organization adoption and surveillance of minimum financial requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... financial and related reporting requirements; and (2) Of the identity of the designated self-regulatory... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Self-regulatory organization... Miscellaneous § 1.52 Self-regulatory organization adoption and surveillance of minimum financial...

  15. Democratizing the world health organization.

    PubMed

    van de Pas, R; van Schaik, L G

    2014-02-01

    A progressive erosion of the democratic space appears as one of the emerging challenges in global health today. Such delimitation of the political interplay has a particularly evident impact on the unique public interest function of the World Health Organization (WHO). This paper aims to identify some obstacles for a truly democratic functioning of the UN specialized agency for health. The development of civil society's engagement with the WHO, including in the current reform proposals, is described. The paper also analyses how today's financing of the WHO--primarily through multi-bi financing mechanisms--risks to choke the agency's role in global health. Democratizing the public debate on global health, and therefore the role of the WHO, requires a debate on its future role and engagement at the country level. This desirable process can only be linked to national debates on public health, and the re-definition of health as a primary political and societal concern.

  16. Democratizing the world health organization.

    PubMed

    van de Pas, R; van Schaik, L G

    2014-02-01

    A progressive erosion of the democratic space appears as one of the emerging challenges in global health today. Such delimitation of the political interplay has a particularly evident impact on the unique public interest function of the World Health Organization (WHO). This paper aims to identify some obstacles for a truly democratic functioning of the UN specialized agency for health. The development of civil society's engagement with the WHO, including in the current reform proposals, is described. The paper also analyses how today's financing of the WHO--primarily through multi-bi financing mechanisms--risks to choke the agency's role in global health. Democratizing the public debate on global health, and therefore the role of the WHO, requires a debate on its future role and engagement at the country level. This desirable process can only be linked to national debates on public health, and the re-definition of health as a primary political and societal concern. PMID:24417900

  17. Do minimum wages improve early life health? Evidence from developing countries.

    PubMed

    Majid, Muhammad Farhan; Mendoza Rodríguez, José M; Harper, Sam; Frank, John; Nandi, Arijit

    2016-06-01

    The impact of legislated minimum wages on the early-life health of children living in low and middle-income countries has not been examined. For our analyses, we used data from the Demographic and Household Surveys (DHS) from 57 countries conducted between 1999 and 2013. Our analyses focus on height-for-age z scores (HAZ) for children under 5 years of age who were surveyed as part of the DHS. To identify the causal effect of minimum wages, we utilized plausibly exogenous variation in the legislated minimum wages during each child's year of birth, the identifying assumption being that mothers do not time their births around changes in the minimum wage. As a sensitivity exercise, we also made within family comparisons (mother fixed effect models). Our final analysis on 49 countries reveal that a 1% increase in minimum wages was associated with 0.1% (95% CI = -0.2, 0) decrease in HAZ scores. Adverse effects of an increase in the minimum wage were observed among girls and for children of fathers who were less than 35 years old, mothers aged 20-29, parents who were married, parents who were less educated, and parents involved in manual work. We also explored heterogeneity by region and GDP per capita at baseline (1999). Adverse effects were concentrated in lower-income countries and were most pronounced in South Asia. By contrast, increases in the minimum wage improved children's HAZ in Latin America, and among children of parents working in a skilled sector. Our findings are inconsistent with the hypothesis that increases in the minimum wage unconditionally improve child health in lower-income countries, and highlight heterogeneity in the impact of minimum wages around the globe. Future work should involve country and occupation specific studies which can explore not only different outcomes such as infant mortality rates, but also explore the role of parental investments in shaping these effects. PMID:27132065

  18. Do minimum wages improve early life health? Evidence from developing countries.

    PubMed

    Majid, Muhammad Farhan; Mendoza Rodríguez, José M; Harper, Sam; Frank, John; Nandi, Arijit

    2016-06-01

    The impact of legislated minimum wages on the early-life health of children living in low and middle-income countries has not been examined. For our analyses, we used data from the Demographic and Household Surveys (DHS) from 57 countries conducted between 1999 and 2013. Our analyses focus on height-for-age z scores (HAZ) for children under 5 years of age who were surveyed as part of the DHS. To identify the causal effect of minimum wages, we utilized plausibly exogenous variation in the legislated minimum wages during each child's year of birth, the identifying assumption being that mothers do not time their births around changes in the minimum wage. As a sensitivity exercise, we also made within family comparisons (mother fixed effect models). Our final analysis on 49 countries reveal that a 1% increase in minimum wages was associated with 0.1% (95% CI = -0.2, 0) decrease in HAZ scores. Adverse effects of an increase in the minimum wage were observed among girls and for children of fathers who were less than 35 years old, mothers aged 20-29, parents who were married, parents who were less educated, and parents involved in manual work. We also explored heterogeneity by region and GDP per capita at baseline (1999). Adverse effects were concentrated in lower-income countries and were most pronounced in South Asia. By contrast, increases in the minimum wage improved children's HAZ in Latin America, and among children of parents working in a skilled sector. Our findings are inconsistent with the hypothesis that increases in the minimum wage unconditionally improve child health in lower-income countries, and highlight heterogeneity in the impact of minimum wages around the globe. Future work should involve country and occupation specific studies which can explore not only different outcomes such as infant mortality rates, but also explore the role of parental investments in shaping these effects.

  19. Minimum Standards for Tribal Child Care: A Health and Safety Guide

    ERIC Educational Resources Information Center

    US Department of Health and Human Services, 2005

    2005-01-01

    The Child Care Bureau is reissuing the minimum standards as a "Health and Safety Guide" for Child Care and Development Fund (CCDF) Tribal Lead Agencies in conjunction with the 2005 Tribal Cluster Trainings, "Supporting the Physical, Social, and Emotional Wellness of Our Tribal Children." These voluntary guidelines represent the baseline from which…

  20. Composition of organic matter in sediments of the oxygen minimum zone of the Northeastern Mexican Pacific

    NASA Astrophysics Data System (ADS)

    Juarez, M.; Sanchez, A.; Aguiñiga-García, S.; Lara-Mendoza, A.

    2013-05-01

    Total organic carbon (TOC) content, total nitrogen (TN) content, elemental (C and N), and isotopic (δ13C-TOC) composition of organic matter derived from both marine and terrestrial sources constrain the relative contributions from marine productivity, the mangroves, and the continental wind erosion of 36 carbonate-free surface sediments along the southwestern coast of the Baja California Peninsula. In general, the spatial patterns of TOC, TN, C:N ratio and δ13C-TOC are similar. The maximum content of TOC (14.5%) and TN (1.6%) were measured inside the oxygen minimum zone (OMZ). The stable carbon isotopic compositions were enriched in 12C in surface sediments at suboxic sites within the OMZ. The C:N ratio and δ13C-TOC values indicated that the organic sediment material is predominantly of marine origin, with a minor contribution from the terrestrial source or mangroves. In the stations near to the coast, the high values of the C:N ratio and the depleted 13C values suggest a proportionally greater accumulation of terrestrial organic matter. The terrestrial-derived organic carbon content is <10% at the continental margin and >40% at the stations near to the coast, based on a Mixing Model of End Members. Keywords: Total organic carbon, total nitrogen, carbon stable isotopes, oxygen minimum zone, northeastern Pacific.

  1. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... withdrawal of approval of the plan in accordance with 5 CFR 890.204. A health benefits plan shall: (1) Comply... the enrollment, in accordance with this part, and without regard to age, race, sex, health status, or... the organization on account of the prohibited factors (age, race, sex, health status, or...

  2. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... withdrawal of approval of the plan in accordance with 5 CFR 890.204. A health benefits plan shall: (1) Comply... the enrollment, in accordance with this part, and without regard to age, race, sex, health status, or... the organization on account of the prohibited factors (age, race, sex, health status, or...

  3. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... withdrawal of approval of the plan in accordance with 5 CFR 890.204. A health benefits plan shall: (1) Comply... the enrollment, in accordance with this part, and without regard to age, race, sex, health status, or... the organization on account of the prohibited factors (age, race, sex, health status, or...

  4. Minimum data set for mass-gathering health research and evaluation: a discussion paper.

    PubMed

    Ranse, Jamie; Hutton, Alison

    2012-12-01

    This paper discusses the need for consistency in mass-gathering data collection and biomedical reporting. Mass gatherings occur frequently throughout the world, and having an understanding of the complexities of mass gatherings is important to inform health services about the possible required health resources. Factors within the environmental, psychosocial and biomedical domains influence the usage of health services at mass gatherings. The biomedical domain includes the categorization of presenting injury or illness, and rates such as patient presentation rate, transferred to hospital rate and referred to hospital rate. These rates provide insight into the usage of onsite health services, prehospital ambulance services. and hospital emergency department services. Within the literature, these rates are reported in a manner that is varied, haphazard and author dependent. This paper proposes moving away from an author-dependent practice of collection and reporting of data. An expert consensus approach is proposed as a means of further developing mass-gathering theory and moving beyond the current situation of reporting on individual case studies. To achieve this, a minimum data set with a data dictionary is proposed in an effort to generate conversation about a possible agreed minimum amount and type of information that should be collected consistently for research and evaluation at mass gatherings. Finally, this paper outlines future opportunities that will emerge from the consistent collection and reporting of mass-gathering data, including the possibility for meta-analysis, comparison of events across societies and modeling of various rates to inform health services. PMID:23174040

  5. The cultural moral right to a basic minimum of accessible health care.

    PubMed

    Menzel, Paul T

    2011-03-01

    (1) The conception of a cultural moral right is useful in capturing the social-moral realities that underlie debate about universal health care. In asserting such rights, individuals make claims above and beyond their legal rights, but those claims are based on the society's existing commitments and moral culture. In the United States such a right to accessible basic health care is generated by various empirical social facts, primarily the conjunction of the legal requirement of access to emergency care with widely held principles about unfair free riding and just sharing of costs between well and ill. The right can get expressed in social policy through either single-payer or mandated insurance. (2) The same elements that generate this right provide modest assistance in determining its content, the structure and scope of a basic minimum of care. They justify limits on patient cost sharing, require comparative effectiveness, and make cost considerations relevant. They shed light on the status of expensive, marginally life extending, last-chance therapies, as well as life support for PVS patients. They are of less assistance in settling contentious debates about screening for breast and prostate cancer and treatments for infertility and erectile dysfunction, but even there they establish a useful framework for discussion. Scarcity of resources need not be a leading conceptual consideration in discerning a basic minimum. More important are the societal elements that generate the cultural moral right to a basic minimum. PMID:21598847

  6. 17 CFR 31.28 - Self-regulatory organization adoption and surveillance of minimum financial, cover, segregation...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... reporting requirements; and (2) Of the identity of the designated self-regulatory organization which has... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Self-regulatory organization... TRANSACTIONS § 31.28 Self-regulatory organization adoption and surveillance of minimum financial,...

  7. 17 CFR 31.28 - Self-regulatory organization adoption and surveillance of minimum financial, cover, segregation...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... reporting requirements; and (2) Of the identity of the designated self-regulatory organization which has... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Self-regulatory organization... TRANSACTIONS § 31.28 Self-regulatory organization adoption and surveillance of minimum financial,...

  8. 17 CFR 31.28 - Self-regulatory organization adoption and surveillance of minimum financial, cover, segregation...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... reporting requirements; and (2) Of the identity of the designated self-regulatory organization which has... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Self-regulatory organization... TRANSACTIONS § 31.28 Self-regulatory organization adoption and surveillance of minimum financial,...

  9. 17 CFR 31.28 - Self-regulatory organization adoption and surveillance of minimum financial, cover, segregation...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... reporting requirements; and (2) Of the identity of the designated self-regulatory organization which has... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Self-regulatory organization... TRANSACTIONS § 31.28 Self-regulatory organization adoption and surveillance of minimum financial,...

  10. Using matrix organization to manage health care delivery organizations.

    PubMed

    Allcorn, S

    1990-01-01

    Matrix organization can provide health care organization managers enhanced information processing, faster response times, and more flexibility to cope with greater organization complexity and rapidly changing operating environments. A review of the literature informed by work experience reveals that the use of matrix organization creates hard-to-manage ambiguity and balances of power in addition to providing positive benefits for health care organization managers. Solutions to matrix operating problems generally rely on the use of superior information and decision support systems and extensive staff training to develop attitudes and behavior consistent with the more collegial matrix organization culture. Further improvement in understanding the suitability of matrix organization for managing health care delivery organizations will involve appreciating the impact of partial implementation of matrix organization, temporary versus permanent uses of matrix organization, and the impact of the ambiguity created by dual lines of authority upon the exercise of power and authority.

  11. Capitated contracting of integrated health provider organizations.

    PubMed

    Bazzoli, G J; Dynan, L; Burns, L R

    This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on health plan risk contracting with health providers. PMID:10711318

  12. Capitated contracting of integrated health provider organizations.

    PubMed

    Bazzoli, G J; Dynan, L; Burns, L R

    This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on health plan risk contracting with health providers.

  13. Job satisfaction in health-care organizations

    PubMed Central

    Bhatnagar, Kavita; Srivastava, Kalpana

    2012-01-01

    Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations. PMID:23766585

  14. 25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... or tribal organization financial management systems when carrying out a self-determination contract... Financial Management Systems § 900.44 What minimum general standards apply to all Indian tribe or tribal organization financial management systems when carrying out a self-determination contract? The fiscal...

  15. 25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... or tribal organization financial management systems when carrying out a self-determination contract... Financial Management Systems § 900.44 What minimum general standards apply to all Indian tribe or tribal organization financial management systems when carrying out a self-determination contract? The fiscal...

  16. 25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... or tribal organization financial management systems when carrying out a self-determination contract... Financial Management Systems § 900.44 What minimum general standards apply to all Indian tribe or tribal organization financial management systems when carrying out a self-determination contract? The fiscal...

  17. 25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... or tribal organization financial management systems when carrying out a self-determination contract... Financial Management Systems § 900.44 What minimum general standards apply to all Indian tribe or tribal organization financial management systems when carrying out a self-determination contract? The fiscal...

  18. 25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... or tribal organization financial management systems when carrying out a self-determination contract... Financial Management Systems § 900.44 What minimum general standards apply to all Indian tribe or tribal organization financial management systems when carrying out a self-determination contract? The fiscal...

  19. 25 CFR 900.45 - What specific minimum requirements shall an Indian tribe or tribal organization's financial...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... or tribal organization's financial management system contain to meet these standards? 900.45 Section... ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Standards for Financial Management Systems § 900.45 What specific minimum requirements shall an Indian tribe or tribal...

  20. 25 CFR 900.45 - What specific minimum requirements shall an Indian tribe or tribal organization's financial...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... or tribal organization's financial management system contain to meet these standards? 900.45 Section... ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Standards for Financial Management Systems § 900.45 What specific minimum requirements shall an Indian tribe or tribal...

  1. 25 CFR 900.45 - What specific minimum requirements shall an Indian tribe or tribal organization's financial...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... or tribal organization's financial management system contain to meet these standards? 900.45 Section... ASSISTANCE ACT Standards for Tribal or Tribal Organization Management Systems Standards for Financial Management Systems § 900.45 What specific minimum requirements shall an Indian tribe or tribal...

  2. Health Maintenance Organization (HMO) Plan

    MedlinePlus

    ... up/change plans About Medicare health plans Medicare Advantage Plans + Share widget - Select to show Subcategories Getting ... plan? About Medicare health plans , current subcategory Medicare Advantage Plans , current page Medicare Medical Savings Account (MSA) ...

  3. Managing mechanistic and organic structure in health care organizations.

    PubMed

    Olden, Peter C

    2012-01-01

    Managers at all levels in a health care organization must organize work to achieve the organization's mission and goals. This requires managers to decide the organization structure, which involves dividing the work among jobs and departments and then coordinating them all toward the common purpose. Organization structure, which is reflected in an organization chart, may range on a continuum from very mechanistic to very organic. Managers must decide how mechanistic versus how organic to make the entire organization and each of its departments. To do this, managers should carefully consider 5 factors for the organization and for each individual department: external environment, goals, work production, size, and culture. Some factors may push toward more mechanistic structure, whereas others may push in the opposite direction toward more organic structure. Practical advice can help managers at all levels design appropriate structure for their departments and organization.

  4. Achieving population health in accountable care organizations.

    PubMed

    Hacker, Karen; Walker, Deborah Klein

    2013-07-01

    Although "population health" is one of the Institute for Healthcare Improvement's Triple Aim goals, its relationship to accountable care organizations (ACOs) remains ill-defined and lacks clarity as to how the clinical delivery system intersects with the public health system. Although defining population health as "panel" management seems to be the default definition, we called for a broader "community health" definition that could improve relationships between clinical delivery and public health systems and health outcomes for communities. We discussed this broader definition and offered recommendations for linking ACOs with the public health system toward improving health for patients and their communities.

  5. Organizational health in health organizations: towards a conceptualization.

    PubMed

    Orvik, Arne; Axelsson, Runo

    2012-12-01

    This article is introducing a new concept of organizational health and discussing its possible implications for health organizations and health management. The concept is developed against the background of New Public Management, which has coincided with increasing workplace health problems in health organizations. It is based on research mainly in health promotion and health management. Organizational health is defined in terms of how an organization is able to deal with the tensions of diverse and competing values. This requires a dialectical perspective, integration as well as disintegration, and a tricultural approach to value tensions. The concept of organizational health is pointing towards an inverse value pyramid and a hybrid- and value-based form of management in health organizations. An application of this concept may clarify competing values and help managers to deal with the value tensions underlying workplace health problems on an organizational as well as an individual and group level. More empirical research is required, however, to link more closely the different aspects of organizational health in health organizations.

  6. World Health Organization and disease surveillance: Jeopardizing global public health?

    PubMed

    Blouin Genest, Gabriel

    2015-11-01

    Health issues now evolve in a global context. Real-time global surveillance, global disease mapping and global risk management characterize what have been termed 'global public health'. It has generated many programmes and policies, notably through the work of the World Health Organization. This globalized form of public health raises, however, some important issues left unchallenged, including its effectiveness, objectivity and legitimacy. The general objective of this article is to underline the impacts of WHO disease surveillance on the practice and theorization of global public health. By using the surveillance structure established by the World Health Organization and reinforced by the 2005 International Health Regulations as a case study, we argue that the policing of 'circulating risks' emerged as a dramatic paradox for global public health policy. This situation severely affects the rationale of health interventions as well as the lives of millions around the world, while travestying the meaning of health, disease and risks. To do so, we use health surveillance data collected by the WHO Disease Outbreak News System in order to map the impacts of global health surveillance on health policy rationale and theory.

  7. A new weapon for the interstellar complex organic molecule hunt: the minimum energy principle

    NASA Astrophysics Data System (ADS)

    Lattelais, M.; Pauzat, F.; Ellinger, Y.; Ceccarelli, C.

    2010-09-01

    Context. The hunt for the interstellar complex organic molecules (COMs) supposed to be the building blocks of the molecules at the origin of life is a challenging but very expensive task. It starts with laboratory experiments, associated with theoretical calculations, that give the line frequencies and strengths of the relevant molecules to be identified and finishes with observations at the telescopes. Aims: The present study aims to suggest possible guidelines to optimize this hunt. Levering on the minimum energy principle (MEP) presented in a previous study, we discuss the link between thermodynamic stability and detectability of a number of structures in the important families of amides, sugars and aminonitriles. Methods: The question of the relative stability of these different species is addressed by means of quantum density functional theory simulations. The hybrid B3LYP formalism was used throughout. All 72 molecules part of this survey were treated on an equal footing. Each structure, fully optimized, was verified to be a stationary point by vibrational analysis. Results: A comprehensive screening of 72 isomers of CH3NO, C2H5NO, C3H7NO, C2H4O2, C3H6O3 and C2H4N2 chemical formula has been carried out. We found that formamide, acetamide and propanamide (the first two identified in the Inter-Stellar Medium) are the most stable compounds in their families demonstrating at the same time that the peptide bond >N-C=O at the origin of life is the most stable bond that can be formed. Dihydroxyacetone, whose detection awaits for confirmation, is far from being the most stable isomer of its family while aminoacetonitrile, that has been recently identified, is effectively the most stable species. Conclusions: The MEP appears to be a useful tool for optimizing the hunt for new species by identifying the potentially more abundant isomers of a given chemical formula.

  8. Health care organization drug testing.

    PubMed

    Brooks, J P; Dempsey, J

    1992-09-01

    Health care managers are being required to respond to the growing concerns of the public about alcohol and drug use in the health care workplace. To this end, the following recommendations are offered. A drug testing policy should be developed with input from and support of employees and unions. "For cause" testing should be used because it results in more definitive results and better employee acceptance. Unless there are compelling reasons for random testing, "for cause" testing is the preferable method. All levels of employees and the medical staff should be subject to the drug-testing policy. Rehabilitation rather than punishment should be emphasized in dealing with employees with alcohol and drug problems.

  9. A marketing matrix for health care organizations.

    PubMed

    Weaver, F J; Gombeski, W R; Fay, G W; Eversman, J J; Cowan-Gascoigne, C

    1986-06-01

    Irrespective of the formal marketing structure successful marketing for health care organizations requires the input on many people. Detailed here is the Marketing Matrix used at the Cleveland Clinic Foundation in Cleveland, Ohio. This Matrix is both a philosophy and a tool for clarifying and focusing the organization's marketing activities.

  10. Marketing home health care to health maintenance organizations.

    PubMed

    Shalowitz, J

    1987-01-01

    Home health care is a rapidly growing industry whose continued success depends upon expansion into new markets. One target market a successful company will need to reach is health maintenance organizations. The following article summarizes basic marketing strategies a home care company needs to follow in order to access such contracts.

  11. Driving population health through accountable care organizations.

    PubMed

    Devore, Susan; Champion, R Wesley

    2011-01-01

    Accountable care organizations, scheduled to become part of the Medicare program under the Affordable Care Act, have been promoted as a way to improve health care quality, reduce growth in costs, and increase patients' satisfaction. It is unclear how these organizations will develop. Yet in principle they will have to meet quality metrics, adopt improved care processes, assume risk, and provide incentives for population health and wellness. These capabilities represent a radical departure from today's health delivery system. In May 2010 the Premier healthcare alliance formed the Accountable Care Implementation Collaborative, which consists of health systems that seek to pursue accountability by forming partnerships with private payers to evolve from fee-for-service payment models to new, value-driven models. This article describes how participants in the collaborative are building models and developing best practices that can inform the implementation of accountable care organizations as well as public policies.

  12. Minimum Initial Service Package (MISP) for reproductive health during emergencies: time for a new paradigm?

    PubMed

    Onyango, Monica Adhiambo; Hixson, Bretta Lynne; McNally, Siobhan

    2013-01-01

    Reproductive health (RH) has historically received low priority in the hierarchy of humanitarian response. Awareness of RH needs in emergencies began in the mid-1990s and led to the formation of the Inter-Agency Working Group (IAWG) for RH. Subsequently, the Minimum Initial Service Package (MISP), a set of guidelines for RH service delivery in crisis settings, was created. The objectives of the MISP are to facilitate the coordination of RH services, prevent and manage the consequences of sexual violence, reduce HIV transmission, minimize maternal and neonatal morbidity and mortality, and plan for comprehensive RH services in the post-crisis phase. Available documentation on MISP implementation is minimal, and reveals mixed success. Challenges include low MISP awareness, inadequate RH training among humanitarian actors, logistical difficulties and poor coordination. Continued emphasis on advocacy and capacity building, a stronger focus on logistics and coordination and a greater commitment to monitoring and evaluation are essential for improving the MISP's effectiveness in the field. PMID:23394618

  13. Organic foods for children: health or hype.

    PubMed

    Batra, Prerna; Sharma, Nisha; Gupta, Piyush

    2014-05-01

    Organic foods are promoted as superior and safer options for today's health-conscious consumer. Manufacturers of organic food claim it to be pesticide-free and better in terms of micronutrients. Consumers have to pay heavily for these products--and they are willing to--provided they are assured of the claimed advantages. Scientific data proving the health benefits of organic foods, especially in children, are lacking. Indian Government has developed strict guidelines and certification procedures to keep a check on manufacturers in this financially attractive market. American Academy of Pediatrics, in its recently issued guidelines, did not recommend organic foods over conventional food for children. Indian Academy of Pediatrics has not opined on this issue till date. In this perspective, we present a critical review of production and marketing of organic foods, and scientific evidence pertaining to their merits and demerits, with special reference to pediatric population.

  14. The World Health Organization and Global Health Governance: post-1990.

    PubMed

    Lidén, J

    2014-02-01

    This article takes a historical perspective on the changing position of WHO in the global health architecture over the past two decades. From the early 1990s a number of weaknesses within the structure and governance of the World Health Organization were becoming apparent, as a rapidly changing post Cold War world placed more complex demands on the international organizations generally, but significantly so in the field of global health. Towards the end of that decade and during the first half of the next, WHO revitalized and played a crucial role in setting global health priorities. However, over the past decade, the organization has to some extent been bypassed for funding, and it lost some of its authority and its ability to set a global health agenda. The reasons for this decline are complex and multifaceted. Some of the main factors include WHO's inability to reform its core structure, the growing influence of non-governmental actors, a lack of coherence in the positions, priorities and funding decisions between the health ministries and the ministries overseeing development assistance in several donor member states, and the lack of strong leadership of the organization. PMID:24388640

  15. The World Health Organization and Global Health Governance: post-1990.

    PubMed

    Lidén, J

    2014-02-01

    This article takes a historical perspective on the changing position of WHO in the global health architecture over the past two decades. From the early 1990s a number of weaknesses within the structure and governance of the World Health Organization were becoming apparent, as a rapidly changing post Cold War world placed more complex demands on the international organizations generally, but significantly so in the field of global health. Towards the end of that decade and during the first half of the next, WHO revitalized and played a crucial role in setting global health priorities. However, over the past decade, the organization has to some extent been bypassed for funding, and it lost some of its authority and its ability to set a global health agenda. The reasons for this decline are complex and multifaceted. Some of the main factors include WHO's inability to reform its core structure, the growing influence of non-governmental actors, a lack of coherence in the positions, priorities and funding decisions between the health ministries and the ministries overseeing development assistance in several donor member states, and the lack of strong leadership of the organization.

  16. [Ethical dilemmas in public health care organizations].

    PubMed

    Pereda Vicandi, M

    2014-01-01

    Today you can ask if you can apply ethics to organizations because much of the greater overall impact decisions are not made by private individuals, are decided by organizations. Any organization is legitimate because it satisfies a need of society and this legitimacy depends if the organization does with quality. To offer a good service, quality service, organizations know they need to do well, but seem to forget that should do well not only instrumental level, must also make good on the ethical level. Public health care organizations claim to promote attitudes and actions based on ethics, level of their internal functioning and level of achievement of its goals, but increased awareness and analysis of its inner workings can question it. Such entities, for its structure and procedures, may make it difficult for ethical standards actually govern its operation, also can have negative ethical consequences at the population level. A healthcare organization must not be organized, either structurally or functionally, like any other organization that offers services. In addition, members of the organization can not simply be passive actors. It is necessary that operators and users have more pro-ethical behaviors. Operators from the professionalism and users from liability.

  17. Can health care organizations improve health behavior and treatment adherence?

    PubMed

    Bender, Bruce G

    2014-04-01

    Many Americans are failing to engage in both the behaviors that prevent and those that effectively manage chronic health conditions, including pulmonary disorders, cardiovascular conditions, diabetes, and cancer. Expectations that health care providers are responsible for changing patients' health behaviors often do not stand up against the realities of clinical care that include large patient loads, limited time, increasing co-pays, and restricted access. Organizations and systems that might share a stake in changing health behavior include employers, insurance payers, health care delivery systems, and public sector programs. However, although the costs of unhealthy behaviors are evident, financial resources to address the problem are not readily available. For most health care organizations, the return on investment for developing behavior change programs appears highest when addressing treatment adherence and disease self-management, and lowest when promoting healthy lifestyles. Organizational strategies to improve adherence are identified in 4 categories: patient access, provider training and support, incentives, and information technology. Strategies in all 4 categories are currently under investigation in ongoing studies and have the potential to improve self-management of many chronic health conditions.

  18. Recommendations by health organizations for pulse consumption.

    PubMed

    Leterme, Pascal

    2002-12-01

    The present paper aims to study why and how health organizations recommend the consumption of pulses such as beans, chickpeas or lentils. Although it is recognized that frequent pulse consumption may reduce serum cholesterol levels and helps reduce risks of coronary heart disease and diabetes, these advantages are scarcely mentioned by health-promoting associations, i.e. vegetarians and organizations helping people to reduce the risks for chronic diseases. Pulses, especially common beans, are rather considered as whole grains that provide plenty of proteins, starch, dietary fibres, minerals and vitamins. Many organizations refer to the food guide pyramid to advise their members, and place beans either in the third part, together with meat, in the second one with fruits and vegetables, or in the bottom part with starchy foods. Whatever their place, they have acquired the status of staple food for anyone who wants to eat a healthy diet. PMID:12498622

  19. Organ Procurement Organizations and the Electronic Health Record.

    PubMed

    Howard, R J; Cochran, L D; Cornell, D L

    2015-10-01

    The adoption of electronic health records (EHRs) has adversely affected the ability of organ procurement organizations (OPOs) to perform their federally mandated function of honoring the donation decisions of families and donors who have signed the registry. The difficulties gaining access to potential donor medical record has meant that assessment, evaluation, and management of brain dead organ donors has become much more difficult. Delays can occur that can lead to potential recipients not receiving life-saving organs. For over 40 years, OPO personnel have had ready access to paper medical records. But the widespread adoption of EHRs has greatly limited the ability of OPO coordinators to readily gain access to patient medical records and to manage brain dead donors. Proposed solutions include the following: (1) hospitals could provide limited access to OPO personnel so that they could see only the potential donor's medical record; (2) OPOs could join with other transplant organizations to inform regulators of the problem; and (3) hospital organizations could be approached to work with Center for Medicare and Medicaid Services (CMS) to revise the Hospital Conditions of Participation to require OPOs be given access to donor medical records.

  20. Communicating with Public Health Organizations: Technical Solution

    NASA Astrophysics Data System (ADS)

    Mihai, Alexandru; Catalan, Daniel; Kurapkiene, Skaidra; Felfly, Wadih

    By working with experts throughout Europe, ECDC pools Europe's health knowledge, so as to develop authoritative scientific opinions about the risks posed by current and emerging infectious diseases. Difficulties rose in the management of competent bodies' lists and the information was duplicated several times across the organization. ECDC started implementing a CRM system to organize the information in a structured data model, track the history of communication, provide contact information to application in house and support the nomination process and the user identity management for these applications.

  1. Understandings of health. How individual perceptions of health affect health promotion needs in organizations.

    PubMed

    Ness, P

    1997-07-01

    The purpose of the study was to discover what the concept of health means to the participants and to determine how an organization can assist its members in developing and maintaining their notion of health. The participants for this study were drawn from the employees at a post secondary educational institution. Tape recorded interviews were transcribed by the researcher, and the transcripts were analyzed for common topics and predominant themes. Imbedded in the data were four themes that provided an over arching conceptual framework from which to view health and health promoting activities: well being as a broad definition of health; the concept of balance as a prime contributor to health; the notion of self efficacy in determining one's health, and the value of caring as a significant determinant of health. Findings of the study have significance for individual health, organizations and health, health promoters, and further research. PMID:9250025

  2. The Raising of Minimum Alcohol Prices in Saskatchewan, Canada: Impacts on Consumption and Implications for Public Health

    PubMed Central

    Zhao, Jinhui; Giesbrecht, Norman; Macdonald, Scott; Thomas, Gerald; Wettlaufer, Ashley

    2012-01-01

    Objectives. We report impacts on alcohol consumption following new and increased minimum alcohol prices in Saskatchewan, Canada. Methods. We conducted autoregressive integrated moving average time series analyses of alcohol sales and price data from the Saskatchewan government alcohol monopoly for 26 periods before and 26 periods after the intervention. Results. A 10% increase in minimum prices significantly reduced consumption of beer by 10.06%, spirits by 5.87%, wine by 4.58%, and all beverages combined by 8.43%. Consumption of coolers decreased significantly by 13.2%, cocktails by 21.3%, and liqueurs by 5.3%. There were larger effects for purely off-premise sales (e.g., liquor stores) than for primarily on-premise sales (e.g., bars, restaurants). Consumption of higher strength beer and wine declined the most. A 10% increase in minimum price was associated with a 22.0% decrease in consumption of higher strength beer (> 6.5% alcohol/volume) versus 8.17% for lower strength beers. The neighboring province of Alberta showed no change in per capita alcohol consumption before and after the intervention. Conclusions. Minimum pricing is a promising strategy for reducing the public health burden associated with hazardous alcohol consumption. Pricing to reflect percentage alcohol content of drinks can shift consumption toward lower alcohol content beverage types. PMID:23078488

  3. Occupational health experience with organic additives.

    PubMed

    Thiess, A M; Wellenreuther, G

    1984-12-01

    For many decades, interest in occupational medicine has been focused on the wide variety of organic additives, which includes a large number of substances, for example, dyestuffs, pigments, and auxiliaries for the textile, leather, and paper industries. The reason is that, if the recommended precautions are not observed, there is a risk of exposure to most of these substances during both production and use. Moreover, over the years, some additives have caused concern and aroused suspicion regarding adverse effects on health. In order to deal with health problems in this field, it is important to be aware of how, what, and where occupational diseases or accidents arise. Much knowledge has been gained about these, and it would be an impossible task to give a systematic survey of the data that have accumulated, especially since it is necessary to take account of the problem of exposure to more than one substance. Thus an attempt is made to report on occupational health experience in general, and to demonstrate how an industrial hygienist may approach the many and various problems. Some epidemiological studies on organic additives (auramine, anthraquinone dyestuffs, organic dyes, etc.) are discussed.

  4. The World Health Organization Health and Work Performance Questionnaire (HPQ).

    PubMed

    Kessler, Ronald C; Barber, Catherine; Beck, Arne; Berglund, Patricia; Cleary, Paul D; McKenas, David; Pronk, Nico; Simon, Gregory; Stang, Paul; Ustun, T Bedirhan; Wang, Phillip

    2003-02-01

    This report describes the World Health Organization Health and Work Performance Questionnaire (HPQ), a self-report instrument designed to estimate the workplace costs of health problems in terms of reduced job performance, sickness absence, and work-related accidents-injuries. Calibration data are presented on the relationship between individual-level HPQ reports and archival measures of work performance and absenteeism obtained from employer archives in four groups: airline reservation agents (n = 441), customer service representatives (n = 505), automobile company executives (n = 554), and railroad engineers (n = 850). Good concordance is found between the HPQ and the archival measures in all four occupations. The paper closes with a brief discussion of the calibration methodology used to monetize HPQ reports and of future directions in substantive research based on the HPQ. PMID:12625231

  5. 48 CFR 1609.7001 - Minimum standards for health benefits carriers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... accordance with 5 CFR 890.204. (1) It must be lawfully engaged in the business of supplying health benefits... business practice in the management or administration of a health benefits plan is cause for OPM's... health benefits carriers. 1609.7001 Section 1609.7001 Federal Acquisition Regulations System OFFICE...

  6. 48 CFR 1609.7001 - Minimum standards for health benefits carriers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... accordance with 5 CFR 890.204. (1) It must be lawfully engaged in the business of supplying health benefits... health benefits carriers. 1609.7001 Section 1609.7001 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION ACQUISITION...

  7. 48 CFR 1609.7001 - Minimum standards for health benefits carriers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... accordance with 5 CFR 890.204. (1) It must be lawfully engaged in the business of supplying health benefits... instructions and directives. (2) Legal and ethical business and health care practices. (3) Compliance with the... chargeable to the contract; (2) Using fraudulent or unethical business or health care practices or...

  8. 78 FR 27001 - Horse Protection Act; Requiring Horse Industry Organizations To Assess and Enforce Minimum...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... published in the Federal Register on June 7, 2012 (77 FR 33607-33619, Docket No. APHIS-2011-0030), and... Inspection Service 9 CFR Part 11 RIN 0579-AD43 Horse Protection Act; Requiring Horse Industry Organizations... Federal Register on June 7, 2012, and effective on July 9, 2012, we amended the horse...

  9. What could a strengthened right to health bring to the post-2015 health development agenda?: interrogating the role of the minimum core concept in advancing essential global health needs

    PubMed Central

    2013-01-01

    Background Global health institutions increasingly recognize that the right to health should guide the formulation of replacement goals for the Millennium Development Goals, which expire in 2015. However, the right to health’s contribution is undercut by the principle of progressive realization, which links provision of health services to available resources, permitting states to deny even basic levels of health coverage domestically and allowing international assistance for health to remain entirely discretionary. Discussion To prevent progressive realization from undermining both domestic and international responsibilities towards health, international human rights law institutions developed the idea of non-derogable “minimum core” obligations to provide essential health services. While minimum core obligations have enjoyed some uptake in human rights practice and scholarship, their definition in international law fails to specify which health services should fall within their scope, or to specify wealthy country obligations to assist poorer countries. These definitional gaps undercut the capacity of minimum core obligations to protect essential health needs against inaction, austerity and illegitimate trade-offs in both domestic and global action. If the right to health is to effectively advance essential global health needs in these contexts, weaknesses within the minimum core concept must be resolved through innovative research on social, political and legal conceptualizations of essential health needs. Summary We believe that if the minimum core concept is strengthened in these ways, it will produce a more feasible and grounded conception of legally prioritized health needs that could assist in advancing health equity, including by providing a framework rooted in legal obligations to guide the formulation of new health development goals, providing a baseline of essential health services to be protected as a matter of right against governmental claims of

  10. Tweeting as Health Communication: Health Organizations' Use of Twitter for Health Promotion and Public Engagement.

    PubMed

    Park, Hyojung; Reber, Bryan H; Chon, Myoung-Gi

    2016-01-01

    This study examined how major health organizations use Twitter for disseminating health information, building relationships, and encouraging actions to improve health. The sampled organizations were the American Heart Association, American Cancer Society, and American Diabetes Association. A content analysis was conducted on 1,583 tweets to examine these organizations' use of Twitter's interactive features and to understand the message functions and topics of their tweets. The numbers of retweets and favorites were also measured as engagement indicators and compared by different message functions. The results revealed that all of the organizations posted original tweets most, but they differed in the degree to which they used the retweet and reply functions. Hashtags and hyperlinks were the most frequently used interactive tools. The majority of the tweets were about organization-related topics, whereas personal health-related tweets represented a relatively small portion of the sample. Followers were most likely to like and retweet personal health action-based messages.

  11. Tweeting as Health Communication: Health Organizations' Use of Twitter for Health Promotion and Public Engagement.

    PubMed

    Park, Hyojung; Reber, Bryan H; Chon, Myoung-Gi

    2016-01-01

    This study examined how major health organizations use Twitter for disseminating health information, building relationships, and encouraging actions to improve health. The sampled organizations were the American Heart Association, American Cancer Society, and American Diabetes Association. A content analysis was conducted on 1,583 tweets to examine these organizations' use of Twitter's interactive features and to understand the message functions and topics of their tweets. The numbers of retweets and favorites were also measured as engagement indicators and compared by different message functions. The results revealed that all of the organizations posted original tweets most, but they differed in the degree to which they used the retweet and reply functions. Hashtags and hyperlinks were the most frequently used interactive tools. The majority of the tweets were about organization-related topics, whereas personal health-related tweets represented a relatively small portion of the sample. Followers were most likely to like and retweet personal health action-based messages. PMID:26716546

  12. 42 CFR 422.382 - Minimum net worth amount.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Minimum net worth amount. 422.382 Section 422.382... net worth amount. (a) At the time an organization applies to contract with CMS as a PSO under this part, the organization must have a minimum net worth amount, as determined under paragraph (c) of...

  13. 42 CFR 422.382 - Minimum net worth amount.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Minimum net worth amount. 422.382 Section 422.382... net worth amount. (a) At the time an organization applies to contract with CMS as a PSO under this part, the organization must have a minimum net worth amount, as determined under paragraph (c) of...

  14. Health maintenance organizations; Midwest Health Plan--Health Resources and Services Administration.

    PubMed

    1983-04-26

    On January 21, 1983, the Office of Health Maintenance Organizations (OHMO) notified Midwest Health Plan (MHP), 3415 Bridgeland Drive, Bridgeton, Missouri 63044, a federally qualified health maintenance organization (HMO), that MHP had successfully reestablished compliance with its assurances to the Secretary that it would (1) maintain a fiscally sound operation, and (2) maintain satisfactory administrative and managerial arrangements. This determination took effect on January 1, 1983. PMID:10324428

  15. Lack of enhanced preservation of organic matter in sediments under the oxygen minimum on the Oman Margin

    SciTech Connect

    Pedersen, T.F. ); Shimmield, G.B.; Price, N.B. )

    1992-01-01

    The impingement of oxygen minima on continental margins is widely thought to promote the accumulation of sedimentary facies enriched in well-preserved organic matter. It is shown here, however, that such a relationship does not clearly apply to the productive Oman Margin in the Arabian Sea, which hosts one of the most severe oxygen minima in the oceans. Measurements made on the 0-1 cm depth interval from fourteen box cores collected from the outer shelf-upper continental slope area off Oman show that (1) deposited organic matter is overwhelmingly of marine origin, (2) there is no significant correlation between the abundance of sedimentary organic carbon (C{sub org}) and the bottom-water O{sub 2} concentration, (3) there is no relation between the sedimentary C{sub org}:N ratio and bottom-water O{sub 2}, and (4) there is no correlation between the hydrogen index (HI) of the organic matter and bottom water oxygen. There are, however, significant correlations between the C{sub org}:N ratio and the I:C{sub org}, Cr:Al, and Zr:Al ratios, as well as between the C{sub org}:N ratio and the hydrogen index. Overall, these data suggest that the bottom water oxygen concentration has little effect in governing either the distribution of the degree of preservation of organic matter on this margin. Thus, the generally high but spatially variable C{sub org} content of the sediments on the Oman Margin may not reflect the occurrence of an oxygen minimum but instead be the result of a high settling flux of organic matter, supported by monsoon-driven upwelling, and post-depositional redistribution of the organic material by hydrodynamic influences.

  16. 48 CFR 1609.7001 - Minimum standards for health benefits carriers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... accordance with 5 CFR 890.204. (1) It must be lawfully engaged in the business of supplying health benefits... instructions and directives. (2) Legal and ethical business and health care practices. (3) Compliance with the... (EHB) Fund less amounts set aside for the administrative and contingency reserves prescribed in 5...

  17. Influencing Organizations to Promote Health: Applying Stakeholder Theory

    ERIC Educational Resources Information Center

    Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H.; Zijlstra, Fred R. H.

    2015-01-01

    Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more…

  18. Sedimentary pigments and nature of organic matter within the oxygen minimum zone (OMZ) of the Eastern Arabian Sea (Indian margin)

    NASA Astrophysics Data System (ADS)

    Rasiq, K. T.; Kurian, S.; Karapurkar, S. G.; Naqvi, S. W. A.

    2016-07-01

    Sedimentary pigments, carbon and nitrogen content and their stable isotopes were studied in three short cores collected from the oxygen minimum zone (OMZ) of the Eastern Arabian Sea (EAS). Nine pigments including chlorophyll a and their degradation products were quantified using High Performance Liquid Chromatography (HPLC). Astaxanthin followed by canthaxanthin and zeaxanthin were the major carotenoids detected in these cores. The total pigment concentration was high in the core collected from 500 m water depth (6.5 μgg-1) followed by 800 m (1.7 μgg-1) and 1100 m (1.1 μgg-1) depths respectively. The organic carbon did not have considerable control on sedimentary pigments preservation. Pigment degradation was comparatively high in the core collected from the 800 m site which depended not only the bottom dissolved oxygen levels, but also on the faunal activity. As reported earlier, the bottom water dissolved oxygen and presence of fauna have good control on the organic carbon accumulation and preservation at Indian margin OMZ sediments. The C/N ratios and δ13C values for all the cores conclude the marine origin of organic matter and δ15N profiles revealed signature of upwelling associated denitrification within the water column.

  19. Exploiting geo-distributed clouds for a e-health monitoring system with minimum service delay and privacy preservation.

    PubMed

    Shen, Qinghua; Liang, Xiaohui; Shen, Xuemin; Lin, Xiaodong; Luo, Henry Y

    2014-03-01

    In this paper, we propose an e-health monitoring system with minimum service delay and privacy preservation by exploiting geo-distributed clouds. In the system, the resource allocation scheme enables the distributed cloud servers to cooperatively assign the servers to the requested users under the load balance condition. Thus, the service delay for users is minimized. In addition, a traffic-shaping algorithm is proposed. The traffic-shaping algorithm converts the user health data traffic to the nonhealth data traffic such that the capability of traffic analysis attacks is largely reduced. Through the numerical analysis, we show the efficiency of the proposed traffic-shaping algorithm in terms of service delay and privacy preservation. Furthermore, through the simulations, we demonstrate that the proposed resource allocation scheme significantly reduces the service delay compared to two other alternatives using jointly the short queue and distributed control law.

  20. Creating High Reliability in Health Care Organizations

    PubMed Central

    Pronovost, Peter J; Berenholtz, Sean M; Goeschel, Christine A; Needham, Dale M; Sexton, J Bryan; Thompson, David A; Lubomski, Lisa H; Marsteller, Jill A; Makary, Martin A; Hunt, Elizabeth

    2006-01-01

    Objective The objective of this paper was to present a comprehensive approach to help health care organizations reliably deliver effective interventions. Context Reliability in healthcare translates into using valid rate-based measures. Yet high reliability organizations have proven that the context in which care is delivered, called organizational culture, also has important influences on patient safety. Model for Improvement Our model to improve reliability, which also includes interventions to improve culture, focuses on valid rate-based measures. This model includes (1) identifying evidence-based interventions that improve the outcome, (2) selecting interventions with the most impact on outcomes and converting to behaviors, (3) developing measures to evaluate reliability, (4) measuring baseline performance, and (5) ensuring patients receive the evidence-based interventions. The comprehensive unit-based safety program (CUSP) is used to improve culture and guide organizations in learning from mistakes that are important, but cannot be measured as rates. Conclusions We present how this model was used in over 100 intensive care units in Michigan to improve culture and eliminate catheter-related blood stream infections—both were accomplished. Our model differs from existing models in that it incorporates efforts to improve a vital component for system redesign—culture, it targets 3 important groups—senior leaders, team leaders, and front line staff, and facilitates change management—engage, educate, execute, and evaluate for planned interventions. PMID:16898981

  1. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... withdrawal of approval of the plan in accordance with 5 CFR 890.204. A health benefits plan shall: (1) Comply... conversion, the carrier must permit conversion at any time before 31 days after the date of notice or 91 days... effective as of the day following the last day of the temporary extension, and the enrollee or...

  2. 48 CFR 1609.7001 - Minimum standards for health benefits carriers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... accordance with 5 CFR 890.204. (1) It must be lawfully engaged in the business of supplying health benefits... (EHB) Fund less amounts set aside for the administrative and contingency reserves prescribed in 5 CFR... eligible survivor annuitants, former spouses continuing coverage with the carrier under 5 CFR...

  3. Representations of minimum unit pricing for alcohol in UK newspapers: a case study of a public health policy debate

    PubMed Central

    Patterson, Chris; Katikireddi, Srinivasa Vittal; Wood, Karen; Hilton, Shona

    2015-01-01

    Background Mass media influence public acceptability, and hence feasibility, of public health interventions. This study investigates newsprint constructions of the alcohol problem and minimum unit pricing (MUP). Methods Quantitative content analysis of 901 articles about MUP published in 10 UK and Scottish newspapers between 2005 and 2012. Results MUP was a high-profile issue, particularly in Scottish publications. Reporting increased steadily between 2008 and 2012, matching the growing status of the debate. The alcohol problem was widely acknowledged, often associated with youths, and portrayed as driven by cheap alcohol, supermarkets and drinking culture. Over-consumption was presented as a threat to health and social order. Appraisals of MUP were neutral, with supportiveness increasing slightly over time. Arguments focused on health impacts more frequently than more emotive perspectives or business interests. Health charities and the NHS were cited slightly more frequently than alcohol industry representatives. Conclusion Emphases on efficacy, evidence and experts are positive signs for evidence-based policymaking. The high profile of MUP, along with growing support within articles, could reflect growing appetite for action on the alcohol problem. Representations of the problem as structurally driven might engender support for legislative solutions, although cultural explanations remain common. PMID:25312002

  4. Health Human Resources Guidelines: Minimum Staffing Standards and Role Descriptions for Canadian Cystic Fibrosis Healthcare Teams.

    PubMed

    McIntosh, Ian D

    2016-01-01

    In cystic fibrosis clinics across Canada, the most common barrier that healthcare workers face when providing care to their patients is having too little time. The Health Human Resources Guidelines were developed to define specifically what amounts of time should be allocated for each discipline of cystic fibrosis clinical care and to provide a description of all the roles involved, reinforcing how these work together to provide comprehensive multidisciplinary care. With involvement from all cystic fibrosis clinics in Canada, through the use of a tailored survey, the Health Human Resources Guidelines are an exclusively Canadian document that has been developed for implementation across the country. The guidelines have been incorporated into a national Accreditation Site Visit program for use in evaluating and improving care across the country and have been distributed to all Canadian cystic fibrosis clinics. The guidelines provide hospital administrators with clear benchmarks for allocating personnel resources to the cystic fibrosis clinics hosted within their institutions. PMID:27445556

  5. Health Human Resources Guidelines: Minimum Staffing Standards and Role Descriptions for Canadian Cystic Fibrosis Healthcare Teams

    PubMed Central

    2016-01-01

    In cystic fibrosis clinics across Canada, the most common barrier that healthcare workers face when providing care to their patients is having too little time. The Health Human Resources Guidelines were developed to define specifically what amounts of time should be allocated for each discipline of cystic fibrosis clinical care and to provide a description of all the roles involved, reinforcing how these work together to provide comprehensive multidisciplinary care. With involvement from all cystic fibrosis clinics in Canada, through the use of a tailored survey, the Health Human Resources Guidelines are an exclusively Canadian document that has been developed for implementation across the country. The guidelines have been incorporated into a national Accreditation Site Visit program for use in evaluating and improving care across the country and have been distributed to all Canadian cystic fibrosis clinics. The guidelines provide hospital administrators with clear benchmarks for allocating personnel resources to the cystic fibrosis clinics hosted within their institutions. PMID:27445556

  6. Health Human Resources Guidelines: Minimum Staffing Standards and Role Descriptions for Canadian Cystic Fibrosis Healthcare Teams.

    PubMed

    McIntosh, Ian D

    2016-01-01

    In cystic fibrosis clinics across Canada, the most common barrier that healthcare workers face when providing care to their patients is having too little time. The Health Human Resources Guidelines were developed to define specifically what amounts of time should be allocated for each discipline of cystic fibrosis clinical care and to provide a description of all the roles involved, reinforcing how these work together to provide comprehensive multidisciplinary care. With involvement from all cystic fibrosis clinics in Canada, through the use of a tailored survey, the Health Human Resources Guidelines are an exclusively Canadian document that has been developed for implementation across the country. The guidelines have been incorporated into a national Accreditation Site Visit program for use in evaluating and improving care across the country and have been distributed to all Canadian cystic fibrosis clinics. The guidelines provide hospital administrators with clear benchmarks for allocating personnel resources to the cystic fibrosis clinics hosted within their institutions.

  7. The effect of riverine dissolved organic matter and other nitrogen forms on the growth and physiology of the dinoflagellate Prorocentrum minimum (Pavillard) Schiller

    NASA Astrophysics Data System (ADS)

    Ou, Linjian; Lundgren, Veronica; Lu, Songhui; Granéli, Edna

    2014-01-01

    The effect of various nitrogen (N) sources, including riverine dissolved organic matter (DOM), nitrate, ammonium, and urea, on the growth and physiology of the dinoflagellate Prorocentrum minimum was compared in a batch culture experiment. P. minimum grew equally well in the presence of identical amounts of nitrate, ammonium, and urea. Approximately 18 to 20% of organic N bound to the DOM was bioavailable. Although the available N added in the DOM treatment was only 1/3 of the amount of any other N sources, the cell densities of P. minimum in the DOM treatment increased to 61 ~ 65% of those in the nitrate, ammonium or urea treatment. The maximum specific growth rates did not differ significantly between the treatments with the highest in the ammonium treatment (0.55 ± 0.13 d- 1) and the lowest in the urea treatment (0.39 ± 0.04 d- 1). P. minimum assimilated the available DOM-bound N in a short period (fewer than 5 days), which was faster than utilizing urea. The increase in the cellular N:P ratios of P. minimum showed the alleviation of N stress in all the treatments after the addition of various N forms. The densities and cellular compositions of P. minimum stabilizing in all the treatments for the whole stationary phase indicated that P. minimum has adaptive physiology under sub-optimal conditions and is a competitive bloom species. We suggest that P. minimum cells utilize DOM-bound N for their growth, and the efficiency in utilizing the available DOM-bound N for growth is comparable to when P. minimum utilizes nitrate, ammonium or urea.

  8. Health systems organization for emergency care.

    PubMed

    Pedroto, Isabel; Amaro, Pedro; Romãozinho, José Manuel

    2013-10-01

    The increasing number of acute and severe digestive diseases presenting to hospital emergency departments, mainly related with an ageing population, demands an appropriate answer from health systems organization, taking into account the escalating pressure on cost reduction. However, patients expect and deserve a response that is appropriate, effective, efficient and safe. The huge variety of variables which can influence the evolution of such cases warranting intensive monitoring, and the coordination and optimization of a range of human and technical resources involved in the care of these high-risk patients, requires their admission in hospital units with conveniently equipped facilities, as is done for heart attack and stroke patients. Little information of gastroenterology emergencies as a function of structure, processes and outcome is available at the organizational level. Surveys that have been conducted in different countries just assess local treatment outcome and question the organizational structure and existing resources but its impact on the outcome is not clear. Most studies address the problem of upper gastrointestinal bleeding and the out-of-hours endoscopy services in the hospital setting. The demands placed on emergency (part of the overall continuum of care) are obvious, as are the needs for the efficient use of resources and processes to improve the quality of care, meaning data must cover the full care cycle. Gastrointestinal emergencies, namely gastrointestinal bleeding, must be incorporated into the overall emergency response as is done for heart attack and stroke. This chapter aims to provide a review of current literature/evidence on organizational health system models towards a better management of gastroenterology emergencies and proposes a research agenda.

  9. Health systems organization for emergency care.

    PubMed

    Pedroto, Isabel; Amaro, Pedro; Romãozinho, José Manuel

    2013-10-01

    The increasing number of acute and severe digestive diseases presenting to hospital emergency departments, mainly related with an ageing population, demands an appropriate answer from health systems organization, taking into account the escalating pressure on cost reduction. However, patients expect and deserve a response that is appropriate, effective, efficient and safe. The huge variety of variables which can influence the evolution of such cases warranting intensive monitoring, and the coordination and optimization of a range of human and technical resources involved in the care of these high-risk patients, requires their admission in hospital units with conveniently equipped facilities, as is done for heart attack and stroke patients. Little information of gastroenterology emergencies as a function of structure, processes and outcome is available at the organizational level. Surveys that have been conducted in different countries just assess local treatment outcome and question the organizational structure and existing resources but its impact on the outcome is not clear. Most studies address the problem of upper gastrointestinal bleeding and the out-of-hours endoscopy services in the hospital setting. The demands placed on emergency (part of the overall continuum of care) are obvious, as are the needs for the efficient use of resources and processes to improve the quality of care, meaning data must cover the full care cycle. Gastrointestinal emergencies, namely gastrointestinal bleeding, must be incorporated into the overall emergency response as is done for heart attack and stroke. This chapter aims to provide a review of current literature/evidence on organizational health system models towards a better management of gastroenterology emergencies and proposes a research agenda. PMID:24160936

  10. Uses of ambulatory health/mental health utilization data in organized health care settings.

    PubMed

    Burns, B J; Goldberg, I D; Hankin, J; Hoeper, E W; Jacobson, A M; Regier, D A

    1982-01-01

    A follow-up assessing uses of findings from NIMH-supported research on health and mental health services utilization in organized health care settings revealed a range of applications across the study sites. The research, conducted primarily for national policy purposes, had an impact on study sites in the following areas: clinician perceptions and attitudes about mental health services provided; program directions; fiscal policy; and further related research. Research team composition and dissemination of study findings are discussed in relation to the applications made. PMID:10260970

  11. Nonbibliographic Databases in a Corporate Health, Safety, and Environment Organization.

    ERIC Educational Resources Information Center

    Cubillas, Mary M.

    1981-01-01

    Summarizes the characteristics of TOXIN, CHEMFILE, and the Product Profile Information System (PPIS), nonbibliographic databases used by Shell Oil Company's Health, Safety, and Environment Organization. (FM)

  12. Public health departments and accountable care organizations: finding common ground in population health.

    PubMed

    Ingram, Richard; Scutchfield, F Douglas; Costich, Julia F

    2015-05-01

    We examined areas of potential collaboration between accountable care organizations and public health agencies, as well as perceived barriers and facilitators. We interviewed 9 key informants on 4 topics: advantages of public health agency involvement in accountable care organizations; services public health agencies could provide; practical, cultural, and legal barriers to accountable care organization-public health agency involvement; and business models that facilitate accountable care organization-public health agency collaboration. Public health agencies could help accountable care organizations partner with community organizations and reach vulnerable patients, provide population-based services and surveillance data, and promote policies that improve member health. Barriers include accountable care organizations' need for short-term financial yield, limited public health agency technical and financial capacity, and the absence of a financial model.

  13. Volatile Organic Compunds (Environmental Health Student Portal)

    MedlinePlus

    ... Gases Impact on Weather Health Effects Take Action Water Pollution Water Pollution Home Chemicals and Pollutants Natural Disasters Drinking Water ... Gases Impact on Weather Health Effects Take Action Water Pollution Water Pollution Home Chemicals and Pollutants Natural Disasters ...

  14. Competition between health maintenance organizations and nonintegrated health insurance companies in health insurance markets.

    PubMed

    Baranes, Edmond; Bardey, David

    2015-12-01

    This article examines a model of competition between two types of health insurer: Health Maintenance Organizations (HMOs) and nonintegrated insurers. HMOs vertically integrate health care providers and pay them at a competitive price, while nonintegrated health insurers work as indemnity plans and pay the health care providers freely chosen by policyholders at a wholesale price. Such difference is referred to as an input price effect which, at first glance, favors HMOs. Moreover, we assume that policyholders place a positive value on the provider diversity supplied by their health insurance plan and that this value increases with the probability of disease. Due to the restricted choice of health care providers in HMOs a risk segmentation occurs: policyholders who choose nonintegrated health insurers are characterized by higher risk, which also tends to favor HMOs. Our equilibrium analysis reveals that the equilibrium allocation only depends on the number of HMOs in the case of exclusivity contracts between HMOs and providers. Surprisingly, our model shows that the interplay between risk segmentation and input price effects may generate ambiguous results. More precisely, we reveal that vertical integration in health insurance markets may decrease health insurers' premiums.

  15. Communicating in Multicultural Health Care Organizations.

    ERIC Educational Resources Information Center

    Kreps, Gary L.; Kunimoto, Elizabeth

    This paper investigates the multicultural demands of health care delivery by examining the role of organizational communication in promoting effective multicultural relations in modern health care systems. The paper describes the multicultural make-up of modern health care systems--noting, for example that providers from different professional…

  16. Mystery shopping as a quality adjunct in public health organizations.

    PubMed

    Hartley, R

    1995-12-01

    Public health in Australia is undergoing unprecedented emphasis on meeting customers' needs, wants and expectations. Mystery shopping, common in the commercial world, has much to offer health organizations in their push towards quality. This paper describes this inexpensive technique and reports on its use in North West Health Service, a large rural health provider. The potential exists for its widescale adoption in health to better meet customer focus objectives. PMID:8719059

  17. "Virtual" health care organizations and the challenges of improving quality.

    PubMed

    Page, Stephen

    2003-01-01

    This article examines the challenges of improving health care quality continuously within and across "virtual" provider organizations such as independent practice associations and physician-hospital organizations. It draws on recent research and theory about interorganizational networks in other fields to develop recommendations for securing physicians' commitment to quality improvement strategies in today's health care environment.

  18. Influencing organizations to promote health: applying stakeholder theory.

    PubMed

    Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H; Zijlstra, Fred R H

    2015-04-01

    Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more central in the network, the stronger the influence. As stakeholders, health promoters may use communicative, compromise, deinstitutionalization, or coercive methods through an ally or a coalition. A hypothetical case study, involving adolescent use of harmful legal products, illustrates the process of applying stakeholder theory to strategic decision making.

  19. Influencing organizations to promote health: applying stakeholder theory.

    PubMed

    Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H; Zijlstra, Fred R H

    2015-04-01

    Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more central in the network, the stronger the influence. As stakeholders, health promoters may use communicative, compromise, deinstitutionalization, or coercive methods through an ally or a coalition. A hypothetical case study, involving adolescent use of harmful legal products, illustrates the process of applying stakeholder theory to strategic decision making. PMID:25829111

  20. The organization of health services for Indian people.

    PubMed Central

    Rhoades, E R; Reyes, L L; Buzzard, G D

    1987-01-01

    The Indian Health Service (IHS) is a bureau of the Health Resources and Services Administration, an agency of the Public Health Service. It was formed in 1955 by a transfer of health services from the Bureau of Indian Affairs, Department of the Interior. Since that time, IHS has grown larger and more complicated and has become a truly complex national organization that is responsible for direct and contract health care services to approximately 1 million Indian people. The historical background of the Service, its present organization, and the services that it provides through a variety of organizational structures are outlined in this report. PMID:3112842

  1. Organic foods: health and environmental advantages and disadvantages.

    PubMed

    Forman, Joel; Silverstein, Janet

    2012-11-01

    The US market for organic foods has grown from $3.5 billion in 1996 to $28.6 billion in 2010, according to the Organic Trade Association. Organic products are now sold in specialty stores and conventional supermarkets. Organic products contain numerous marketing claims and terms, only some of which are standardized and regulated. In terms of health advantages, organic diets have been convincingly demonstrated to expose consumers to fewer pesticides associated with human disease. Organic farming has been demonstrated to have less environmental impact than conventional approaches. However, current evidence does not support any meaningful nutritional benefits or deficits from eating organic compared with conventionally grown foods, and there are no well-powered human studies that directly demonstrate health benefits or disease protection as a result of consuming an organic diet. Studies also have not demonstrated any detrimental or disease-promoting effects from an organic diet. Although organic foods regularly command a significant price premium, well-designed farming studies demonstrate that costs can be competitive and yields comparable to those of conventional farming techniques. Pediatricians should incorporate this evidence when discussing the health and environmental impact of organic foods and organic farming while continuing to encourage all patients and their families to attain optimal nutrition and dietary variety consistent with the US Department of Agriculture's MyPlate recommendations. This clinical report reviews the health and environmental issues related to organic food production and consumption. It defines the term "organic," reviews organic food-labeling standards, describes organic and conventional farming practices, and explores the cost and environmental implications of organic production techniques. It examines the evidence available on nutritional quality and production contaminants in conventionally produced and organic foods. Finally, this

  2. Retrenchment in health care organizations: theory and practice.

    PubMed

    Fottler, M D; Smith, H L; Muller, H J

    1986-01-01

    This paper analyzes retrenchment in health care organizations in terms of prescriptions in the literature and the actual responses of health care executives to retrenchment. Case studies of five organizations indicate that the range of coping strategies is much more limited than the range of possibilities suggested in the literature. Constraints within the culture of the organization are suggested as an explanation for this disparity.

  3. Civil Society Organizations and the Functions of Global Health Governance: What Role within Intergovernmental Organizations?

    PubMed Central

    Lee, Kelley

    2016-01-01

    Amid discussion of how global health governance should and could be strengthened, the potential role of civil society organizations has been frequently raised. This paper considers the role of Civil Society Organizations (CSOs) in four health governance instruments under the auspices of the World Health Organization – the International Code on the Marketing of Breastmilk Substitutes, Framework Convention on Tobacco Control, International Health Regulations and Codex Alimentarius - and maps the functions they have contributed to. The paper draws conclusions about the opportunities and limitations CSOs represent for strengthening global health governance (GHG). PMID:27274776

  4. Quantifying the linkages among soil health, organic farming, and food

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Organic farming systems utilize organic amendments, diverse crop rotations and cover crops to promote soil fertility and enhance soil health. These practices increase biologically available forms of soil organic matter, and increase the activities of beneficial soil microbes and invertebrates. Physi...

  5. The Organic Puppet Theatre. Health Activities Book.

    ERIC Educational Resources Information Center

    Schultz, Terry Louis; Sorenson, Linda M.

    The Organic Puppet Theatre is a creative medium for the classroom, home, day care center, hospital, community center, and clinic. It is designed for children in the early elementary years. The objective of the activity is to acquaint children with the functions of the various organs of the body, how they interact, and how they are affected by poor…

  6. Evaluation of Learning in Health Care Organizations.

    ERIC Educational Resources Information Center

    Barnes, Barbara E.

    1999-01-01

    Health care providers now have collective responsibility for clinical outcomes, so professional continuing education should emphasize collaborative generation and application of knowledge. Continuing education professionals should act as performance consultants implementing the principles of organizational learning that, combined with individual…

  7. Core competencies of the entrepreneurial leader in health care organizations.

    PubMed

    Guo, Kristina L

    2009-01-01

    The purpose of this article is to discuss core competencies that entrepreneurial health care leaders should acquire to ensure the survival and growth of US health care organizations. Three overlapping areas of core competencies are described: (1) health care system and environment competencies, (2) organization competencies, and (3) interpersonal competencies. This study offers insight into the relationship between leaders and entrepreneurship in health care organizations and establishes the foundation for more in-depth studies on leadership competencies in health care settings. The approach for identifying core competencies and designing a competency model is useful for practitioners in leadership positions in complex health care organizations, so that through the understanding and practice of these 3 areas of core competencies, they can enhance their entrepreneurial leadership skills to become more effective health care entrepreneurial leaders. This study can also be used as a tool by health care organizations to better understand leadership performance, and competencies can be used to further the organization's strategic vision and for individual improvement purposes. PMID:19225332

  8. Core competencies of the entrepreneurial leader in health care organizations.

    PubMed

    Guo, Kristina L

    2009-01-01

    The purpose of this article is to discuss core competencies that entrepreneurial health care leaders should acquire to ensure the survival and growth of US health care organizations. Three overlapping areas of core competencies are described: (1) health care system and environment competencies, (2) organization competencies, and (3) interpersonal competencies. This study offers insight into the relationship between leaders and entrepreneurship in health care organizations and establishes the foundation for more in-depth studies on leadership competencies in health care settings. The approach for identifying core competencies and designing a competency model is useful for practitioners in leadership positions in complex health care organizations, so that through the understanding and practice of these 3 areas of core competencies, they can enhance their entrepreneurial leadership skills to become more effective health care entrepreneurial leaders. This study can also be used as a tool by health care organizations to better understand leadership performance, and competencies can be used to further the organization's strategic vision and for individual improvement purposes.

  9. Ethnographic approach to community organization and health empowerment.

    PubMed

    Braithwaite, R L; Bianchi, C; Taylor, S E

    1994-01-01

    The purpose of this article is to address pertinent issues relative to the association between community organization and health empowerment methods in ethnic communities of colour. It seeks to address these issues by utilizing ethnographic procedures for documenting community health concerns and by advocating for empowerment for people of colour and their participation in coalition partnerships. Increasingly the importance of citizen participation in the planning, assessment, and implementation of community-based health initiatives has been identified as essential for effective health promotion and disease prevention programs. This article argues for the utility of a community organization approach for achieving health empowerment, and subsequently decreasing the excess deaths in communities of colour. The interface of ethnographic procedures, community organization, and development of community-owned action plans for programming health interventions is discussed.

  10. Making customer-service a priority in health care organizations.

    PubMed

    O'Hagan, Joshua; Persaud, David

    2008-01-01

    Improving customer-service in health care organizations has been linked to better patient care, satisfied staff, a reduction in preventable medical errors, fewer malpractice lawsuits and improved revenue. However, it has been observed that there is sometimes a gap between the level of customer-service provided by health care organizations and their clients' expectations. This paper integrates, synthesizes and extends theory and practice from existing literature to provide health care organizations with strategies for closing this gap. Methods are also outlined for creating, implementing and evaluating an organizational plan for improving customer-service.

  11. [The Argentine Health System: organization and financial features].

    PubMed

    Arce, Hugo E

    2012-01-01

    The Argentine health system is defined by the following features: a) federal country organization; b) coexistence of public and private services with either outpatients or inpatients; c) fragmented entities of social security, most of these originated outside of the state organization. Components of the system are described and weighed; making decisions strength between national and provincial health authorities is analyzed and the Argentine system is compared with that of other countries. Statistical data on distribution of health expenditures and coverage of health services are presented as well as financial flow among diverse funding sources, insurers, providers and users of each sector. PMID:23089118

  12. Organizing the health sector for response to disasters.

    PubMed

    Shoaf, Kimberley

    2014-09-01

    Each year millions of people around the world are affected by natural and manmade disasters. The consequences of natural disasters in terms of health are complex. Disasters directly impact the health of the population resulting in physical trauma, acute disease, and emotional trauma. Furthermore, disasters may increase the morbidity and mortality associated with chronic and infectious diseases due to the impact on the health system. The health sector must be organized for adequate preparedness, mitigation, response and recuperation from a plethora of potential disasters. This paper examines the various potential impacts of disasters on health, the components of the health sector and their roles in emergency medical care and disaster situations, as well as the coordination and organization necessary within the system to best meet the health needs of a population in the aftermath of a disaster.

  13. Organizing the public health-clinical health interface: theoretical bases.

    PubMed

    St-Pierre, Michèle; Reinharz, Daniel; Gauthier, Jacques-Bernard

    2006-01-01

    This article addresses the issue of the interface between public health and clinical health within the context of the search for networking approaches geared to a more integrated delivery of health services. The articulation of an operative interface is complicated by the fact that the definition of networking modalities involves complex intra- and interdisciplinary and intra- and interorganizational systems across which a new transversal dynamics of intervention practices and exchanges between service structures must be established. A better understanding of the situation is reached by shedding light on the rationale underlying the organizational methods that form the bases of the interface between these two sectors of activity. The Quebec experience demonstrates that neither the structural-functionalist approach, which emphasizes remodelling establishment structures and functions as determinants of integration, nor the structural-constructivist approach, which prioritizes distinct fields of practice in public health and clinical health, adequately serves the purpose of networking and integration. Consequently, a theoretical reframing is imperative. In this regard, structuration theory, which fosters the simultaneous study of methods of inter-structure coordination and inter-actor cooperation, paves the way for a better understanding of the situation and, in turn, to the emergence of new integration possibilities.

  14. A closer look at the World Health Organization's prescribing indicators

    PubMed Central

    Ofori-Asenso, Richard

    2016-01-01

    This communication focuses on the World Health Organization's prescribing indicators. It describes the methods for computing the indicators and highlights their applicability as well as limitations in evaluating the patterns of medicines usage. PMID:27127400

  15. Contribution of Organically Grown Crops to Human Health

    PubMed Central

    Johansson, Eva; Hussain, Abrar; Kuktaite, Ramune; Andersson, Staffan C.; Olsson, Marie E.

    2014-01-01

    An increasing interest in organic agriculture for food production is seen throughout the world and one key reason for this interest is the assumption that organic food consumption is beneficial to public health. The present paper focuses on the background of organic agriculture, important public health related compounds from crop food and variations in the amount of health related compounds in crops. In addition, influence of organic farming on health related compounds, on pesticide residues and heavy metals in crops, and relations between organic food and health biomarkers as well as in vitro studies are also the focus of the present paper. Nutritionally beneficial compounds of highest relevance for public health were micronutrients, especially Fe and Zn, and bioactive compounds such as carotenoids (including pro-vitamin A compounds), tocopherols (including vitamin E) and phenolic compounds. Extremely large variations in the contents of these compounds were seen, depending on genotype, climate, environment, farming conditions, harvest time, and part of the crop. Highest amounts seen were related to the choice of genotype and were also increased by genetic modification of the crop. Organic cultivation did not influence the content of most of the nutritional beneficial compounds, except the phenolic compounds that were increased with the amounts of pathogens. However, higher amounts of pesticide residues and in many cases also of heavy metals were seen in the conventionally produced crops compared to the organic ones. Animal studies as well as in vitro studies showed a clear indication of a beneficial effect of organic food/extracts as compared to conventional ones. Thus, consumption of organic food seems to be positive from a public health point of view, although the reasons are unclear, and synergistic effects between various constituents within the food are likely. PMID:24717360

  16. Contribution of organically grown crops to human health.

    PubMed

    Johansson, Eva; Hussain, Abrar; Kuktaite, Ramune; Andersson, Staffan C; Olsson, Marie E

    2014-04-01

    An increasing interest in organic agriculture for food production is seen throughout the world and one key reason for this interest is the assumption that organic food consumption is beneficial to public health. The present paper focuses on the background of organic agriculture, important public health related compounds from crop food and variations in the amount of health related compounds in crops. In addition, influence of organic farming on health related compounds, on pesticide residues and heavy metals in crops, and relations between organic food and health biomarkers as well as in vitro studies are also the focus of the present paper. Nutritionally beneficial compounds of highest relevance for public health were micronutrients, especially Fe and Zn, and bioactive compounds such as carotenoids (including pro-vitamin A compounds), tocopherols (including vitamin E) and phenolic compounds. Extremely large variations in the contents of these compounds were seen, depending on genotype, climate, environment, farming conditions, harvest time, and part of the crop. Highest amounts seen were related to the choice of genotype and were also increased by genetic modification of the crop. Organic cultivation did not influence the content of most of the nutritional beneficial compounds, except the phenolic compounds that were increased with the amounts of pathogens. However, higher amounts of pesticide residues and in many cases also of heavy metals were seen in the conventionally produced crops compared to the organic ones. Animal studies as well as in vitro studies showed a clear indication of a beneficial effect of organic food/extracts as compared to conventional ones. Thus, consumption of organic food seems to be positive from a public health point of view, although the reasons are unclear, and synergistic effects between various constituents within the food are likely. PMID:24717360

  17. Behavioral Groups as Preventive Care in a Health Maintenance Organization.

    ERIC Educational Resources Information Center

    Shapiro, Joan; And Others

    This paper describes the use of a particular therapeutic modality--behavioral groups--in a relatively new delivery system called a Health Maintenance Organization. The program described, run under the George Washington University Health Plan, offers short-term structured groups designed to aid people at particularly difficult or vulnerable…

  18. Engaging Student Health Organizations in Reducing Health Disparities in Underserved Communities through Volunteerism: Developing a Student Health Corps

    PubMed Central

    Mays, Vickie M.; Ly, Lichin; Allen, Erica; Young, Sophia

    2013-01-01

    One underutilized method for reducing health disparities and training culturally competent health care workers is the engagement of undergraduate student health organizations in conducting health screenings, promotion, and health education outreach activities in in underserved racial/ethnic communities. We conducted a needs assessment of 14 predominantly racial/ethnic minority undergraduate student-run health organizations. The 14 organizations annually served approximately 12,425 people (67% Hispanic, 25% African American, 6.33% Asian Pacific Islander), predominantly at health fairs within Los Angeles County (averaging 138 attendees). Student organizations provided screenings on general health conditions and diseases, with less emphasis on behavioral risk factors (e.g., drinking, smoking). Organizations indicated a need for increased and affordable trainings in preventive health screenings and help in understanding target populations’ needs. Universities are in an excellent position to train, supervise, and organize volunteer health corps in order to engage students in reducing health disparities and to train culturally competent health care providers. PMID:19648716

  19. Are Public Health Organizations Tweeting to the Choir? Understanding Local Health Department Twitter Followership

    PubMed Central

    Choucair, Bechara; Maier, Ryan C; Jolani, Nina; Bernhardt, Jay M

    2014-01-01

    Background One of the essential services provided by the US local health departments is informing and educating constituents about health. Communication with constituents about public health issues and health risks is among the standards required of local health departments for accreditation. Past research found that only 61% of local health departments met standards for informing and educating constituents, suggesting a considerable gap between current practices and best practice. Objective Social media platforms, such as Twitter, may aid local health departments in informing and educating their constituents by reaching large numbers of people with real-time messages at relatively low cost. Little is known about the followers of local health departments on Twitter. The aim of this study was to examine characteristics of local health department Twitter followers and the relationship between local health department characteristics and follower characteristics. Methods In 2013, we collected (using NodeXL) and analyzed a sample of 4779 Twitter followers from 59 randomly selected local health departments in the United States with Twitter accounts. We coded each Twitter follower for type (individual, organization), location, health focus, and industry (eg, media, government). Local health department characteristics were adopted from the 2010 National Association of City and County Health Officials Profile Study data. Results Local health department Twitter accounts were followed by more organizations than individual users. Organizations tended to be health-focused, located outside the state from the local health department being followed, and from the education, government, and non-profit sectors. Individuals were likely to be local and not health-focused. Having a public information officer on staff, serving a larger population, and “tweeting” more frequently were associated with having a higher percentage of local followers. Conclusions Social media has the

  20. Barriers to the routine collection of health outcome data in an Australian community care organization

    PubMed Central

    Nancarrow, Susan A

    2013-01-01

    For over a decade, organizations have attempted to include the measurement and reporting of health outcome data in contractual agreements between funders and health service providers, but few have succeeded. This research explores the utility of collecting health outcomes data that could be included in funding contracts for an Australian Community Care Organisation (CCO). An action-research methodology was used to trial the implementation of outcome measurement in six diverse projects within the CCO using a taxonomy of interventions based on the International Classification of Function. The findings from the six projects are presented as vignettes to illustrate the issues around the routine collection of health outcomes in each case. Data collection and analyses were structured around Donabedian’s structure–process–outcome triad. Health outcomes are commonly defined as a change in health status that is attributable to an intervention. This definition assumes that a change in health status can be defined and measured objectively; the intervention can be defined; the change in health status is attributable to the intervention; and that the health outcomes data are accessible. This study found flaws with all of these assumptions that seriously undermine the ability of community-based organizations to introduce routine health outcome measurement. Challenges were identified across all stages of the Donabedian triad, including poor adherence to minimum dataset requirements; difficulties standardizing processes or defining interventions; low rates of use of outcome tools; lack of value of the tools to the service provider; difficulties defining or identifying the end point of an intervention; technical and ethical barriers to accessing data; a lack of standardized processes; and time lags for the collection of data. In no case was the use of outcome measures sustained by any of the teams, although some quality-assurance measures were introduced as a result of the

  1. The normative authority of the World Health Organization.

    PubMed

    Gostin, L O; Sridhar, D; Hougendobler, D

    2015-07-01

    The World Health Organization (WHO) was born after the devastation of World War II, as a normative agency endowed with unprecedented constitutional powers. But even as it has achieved stunning successes, such as the eradication of smallpox, it has failed to live up to the exalted expectations of the postwar health and human rights movement - exemplified most recently by its inadequate response to the Ebola epidemic. Our aim is to offer innovative ideas for restoring the Organization to its leadership position by exercising its normative authority, even as it faces a crowded and often chaotic global health architecture. Before doing so, it will be helpful to summarize the main tensions the Organization faces in today's global health landscape. PMID:26100341

  2. Towards a Healthy District: Organizing and Managing District Health Systems Based on Primary Health Care.

    ERIC Educational Resources Information Center

    Tarimo, E.

    This book is concerned with orienting health care workers in district health systems in developing countries to ways and means of overcoming problems, and describes briefly how district health systems can be improved. The book is organized around nine issues in nine chapters, each of which is an integral part of a district planning cycle. The…

  3. The health maintenance organization strategy: a corporate takeover of health services delivery.

    PubMed

    Salmon, J W

    1975-01-01

    This paper presents a political economic framework for viewing the social organization of the delivery of health care servies and predicting a qualitatively different institutional configuration involving the health maintenance organization. The principal forces impacting American capitalism today are leading to a fundamental restructuring for increased social efficiency of the entire social welfare sector, including the health services industry. The method to achieve this restructuring involves health policy directed at raising the contribution to the social surplus from the delivery of health care services and eventual corporate domination. The health maintenance organization conceptualization is examined with suggestions as to how the HMO strategy promoted by the state leads to this corporate takeover. The mechanism and extent of the present corporate involvement are examined and implications of health services as a social control mechanism are presented.

  4. Health politics meets post-modernism: its meaning and implications for community health organizing.

    PubMed

    Rosenau, P V

    1994-01-01

    In this article, post-modern theory is described and applied to health politics with examples from community health organizing, social movements, and health promotion. Post-modernism questions conventional assumptions about concepts such as representation, participation, empowerment, community, identity, causality, accountability, responsibility, authority, and roles in community health promotion (those of expert, leader, and organizer). I compare post-modern social movements with their modern counterparts: the organizational forms, leadership styles, and substantive intellectual orientations of the two differ. I explain the social planning, community development, and social action models of community health organizing, comparing them with the priorities of post-modern social movements, and show the similarities and differences between them as to structural preferences, process, and strategies. Finally, and most importantly, I present the implicit lessons that post-modernism offers to health politics and outline the strengths and weaknesses of this approach to health politics.

  5. Basic principles of information technology organization in health care institutions.

    PubMed

    Mitchell, J A

    1997-01-01

    This paper focuses on the basic principles of information technology (IT) organization within health sciences centers. The paper considers the placement of the leader of the IT effort within the health sciences administrative structure and the organization of the IT unit. A case study of the University of Missouri-Columbia Health Sciences Center demonstrates how a role-based organizational model for IT support can be effective for determining the boundary between centralized and decentralized organizations. The conclusions are that the IT leader needs to be positioned with other institutional leaders who are making strategic decisions, and that the internal IT structure needs to be a role-based hybrid of centralized and decentralized units. The IT leader needs to understand the mission of the organization and actively use change-management techniques.

  6. Solar Minimum

    NASA Astrophysics Data System (ADS)

    Lopresto, James C.; Mathews, John; Manross, Kevin

    1995-12-01

    Calcium K plage, H alpha plage and sunspot area have been monitored daily on the INTERNET since November of 1992. The plage and sunspot area have been measured by image processing. The purpose of the project is to investigate the degree of correlation between plage area and solar irradiance. The plage variation shows the expected variation produced by solar rotation and the longer secular changes produced by the solar cycle. The H alpha and sunspot plage area reached a minimum in about late 1994 or early 1995. This is in agreement with the K2 spectral index obtained daily from Sacramento Peak Observatory. The Calcium K plage area minimum seems delayed with respect to the others mentioned above. The minimum of the K line plage area is projected to come within the last few months of 1995.

  7. Advancing organizational health literacy in health care organizations serving high-needs populations: a case study.

    PubMed

    Weaver, Nancy L; Wray, Ricardo J; Zellin, Stacie; Gautam, Kanak; Jupka, Keri

    2012-01-01

    Health care organizations, well positioned to address health literacy, are beginning to shift their systems and policies to support health literacy efforts. Organizations can identify barriers, emphasize and leverage their strengths, and initiate activities that promote health literacy-related practices. The current project employed an open-ended approach to conduct a needs assessment of rural federally qualified health center clinics. Using customized assessment tools, the collaborators were then able to determine priorities for changing organizational structures and policies in order to support continued health literacy efforts. Six domains of organizational health literacy were measured with three methods: environmental assessments, patient interviews, and key informant interviews with staff and providers. Subsequent strategic planning was conducted by collaborators from the academic and clinic teams and resulted in a focused, context-appropriate action plan. The needs assessment revealed several gaps in organizational health literacy practices, such as low awareness of health literacy within the organization and variation in perceived values of protocols, interstaff communication, and patient communication. Facilitators included high employee morale and patient satisfaction. The resulting targeted action plan considered the organization's culture as revealed in the interviews, informing a collaborative process well suited to improving organizational structures and systems to support health literacy best practices. The customized needs assessment contributed to an ongoing collaborative process to implement organizational changes that aided in addressing health literacy needs.

  8. Associations between state minimum wage policy and health care access: a multi-level analysis of the 2004 Behavioral Risk Factor survey.

    PubMed

    McCarrier, Kelly P; Martin, Diane P; Ralston, James D; Zimmerman, Frederick J

    2010-05-01

    Minimum wage policies have been advanced as mechanisms to improve the economic conditions of the working poor. Both positive and negative effects of such policies on health care access have been hypothesized, but associations have yet to be thoroughly tested. To examine whether the presence of minimum wage policies in excess of the federal standard of $5.15 per hour was associated with health care access indicators among low-skilled adults of working age, a cross-sectional analysis of 2004 Behavioral Risk Factor Surveillance System data was conducted. Self-reported health insurance status and experience with cost-related barriers to needed medical care were adjusted in multi-level logistic regression models to control for potential confounding at the state, county, and individual levels. State-level wage policy was not found to be associated with insurance status or unmet medical need in the models, providing early evidence that increased minimum wage rates may neither strengthen nor weaken access to care as previously predicted.

  9. Let's dance: Organization studies, medical sociology and health policy.

    PubMed

    Currie, Graeme; Dingwall, Robert; Kitchener, Martin; Waring, Justin

    2012-02-01

    This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a 'generative dance', between organization studies (OS), and two of the journal's traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine. PMID:22218227

  10. Let's dance: Organization studies, medical sociology and health policy.

    PubMed

    Currie, Graeme; Dingwall, Robert; Kitchener, Martin; Waring, Justin

    2012-02-01

    This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a 'generative dance', between organization studies (OS), and two of the journal's traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine.

  11. Modification of Treatment of Certain Health Organizations. Final regulations.

    PubMed

    2016-06-22

    This document contains final regulations that provide guidance to Blue Cross and Blue Shield organizations, and certain other organizations, on computing and applying the medical loss ratio and the consequences for not meeting the medical loss ratio threshold. The final regulations reflect the enactment of a technical correction to section 833(c)(5) of the Internal Revenue Code by the Consolidated and Further Continuing Appropriations Act of 2015. The final regulations affect Blue Cross and Blue Shield organizations, and certain other organizations involved in providing health insurance. PMID:27373011

  12. 25 CFR 900.45 - What specific minimum requirements shall an Indian tribe or tribal organization's financial...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... circular A-122, “Cost Principles for Non-Profit Organizations.” Tribal educational institution A-21, “Cost..., Local and Indian Tribal Governments.” Tribal private non-profit other than: (1) an institution of higher... or tribal organization's financial management system contain to meet these standards? 900.45...

  13. Maternal health-seeking behavior: the role of financing and organization of health services in Ghana.

    PubMed

    Aboagye, Emmanuel; Agyemang, Otuo Serebour

    2013-05-30

    This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's health system has shaped maternal health-seeking behavior of women in the district. The paper employs a qualitative case study technique to build a complex and holistic picture, and report detailed views of the women in their natural setting. A purposeful sampling technique is applied to select 16 women in the district for this study. Through face-to-face interviews and group discussions with the selected women, comprehensive and in-depth information on health- seeking behavior and health outcomes are elicited for the analysis. The study highlights that characteristics embedded in decentralization and provision of free maternal health care influence health-seeking behavior. Particularly, the use of antenatal care has increased after the delivery exemption policy in Ghana. Interestingly, the study also reveals certain social structures, which influence women's attitude towards their decisions and choices of health facilities.

  14. The Global Role of the World Health Organization.

    PubMed

    Ruger, Jennifer Prah; Yach, Derek

    2009-04-01

    The 21(st) century global health landscape requires effective global action in the face of globalization of trade, travel, information, human rights, ideas, and disease. The new global health era is more plural, comprising a number of key actors, and requiring more coordination of effort, priorities and investments. The World Health Organization (WHO) plays an essential role in the global governance of health and disease; due to its core global functions of establishing, monitoring and enforcing international norms and standards, and coordinating multiple actors toward common goals. Global health governance requires WHO leadership and effective implementation of WHO's core global functions to ensure better effectiveness of all health actors, but achieving this global mission could be hampered by narrowing activities and budget reallocations from core global functions. PMID:24729827

  15. Determination of Minimum Data Set (MSD) in Echocardiography Reporting System to Exchange with Iran’s Electronic Health Record (EHR) System

    PubMed Central

    Mahmoudvand, Zahra; Kamkar, Mehran; Shahmoradi, Leila; Nejad, Ahmadreza Farzaneh

    2016-01-01

    Background: Determination of minimum data set (MDS) in echocardiography reports is necessary for documentation and putting information in a standard way, and leads to the enhancement of electrocardiographic studies through having access to precise and perfect reports and also to the development of a standard database for electrocardiographic reports. Aim: to determine the minimum data set of echocardiography reporting system to exchange with Iran’s electronic health record (EHR) system. Methods: First, a list of minimum data set was prepared after reviewing texts and studying cardiac patients’ records. Then, to determine the content validity of the prepared MDS, the expert views of 10 cardiologists and 10 health information management (HIM) specialists were obtained; to estimate the reliability of the set, test-retest method was employed. Finally, the data were analyzed using SPSS software. Results: The highest degree of consensus was found for the following MDSs: patient’s name and family name (5), accepting doctor’s name and family name, familial death records due to cardiac disorders, the image identification code, mitral valve, aortic valve, tricuspid valve, pulmonary valve, left ventricle, hole, atrium valve, Doppler examination of ventricular and atrial movement models and diagnoses with an average of. Conclusions: To prepare a model of echocardiography reporting system to exchange with EHR system, creation a standard data set is the vital point. Therefore, based on the research findings, the minimum reporting system data to exchange with Iran’s electronic health record system include information on entity, management, medical record, carried-out acts, and the main content of the echocardiography report, which the planners of reporting system should consider. PMID:27147803

  16. The World Health Organization and the transition from "international" to "global" public health.

    PubMed

    Brown, Theodore M; Cueto, Marcos; Fee, Elizabeth

    2006-01-01

    The term "global health" is rapidly replacing the older terminology of "international health." We describe the role of the World Health Organization (WHO) in both international and global health and in the transition from one to the other. We suggest that the term "global health" emerged as part of larger political and historical processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances. Between 1948 and 1998, WHO moved from being the unquestioned leader of international health to being an organization in crisis, facing budget shortfalls and diminished status, especially given the growing influence of new and powerful players. We argue that WHO began to refashion itself as the coordinator, strategic planner, and leader of global health initiatives as a strategy of survival in response to this transformed international political context. PMID:16322464

  17. Frailty and Organization of Health and Social Care.

    PubMed

    Clegg, Andrew; Young, John

    2015-01-01

    In this chapter, we consider how health and social care can best be organized for older people with frailty. We will consider the merits of routine frailty identification, including risk stratification methods, to inform the provision of evidence-based treatment and holistic, goal-oriented care. We will also consider how best to place older people with frailty at the heart of health and social care systems so that the complex challenges associated with this vulnerable group are addressed. PMID:26301988

  18. The Pan American Health Organization and international health: a history of training, conceptualization, and collective development.

    PubMed

    Auer, Annella; Guerrero Espinel, Juan Eduardo

    2011-08-01

    A constantly changing and increasingly complex global environment requires leaders with special competencies to respond effectively to this scenario. Within this context, the Pan American Health Organization (PAHO) goes beyond traditional leadership training models both in terms of its design as well as its conceptual approach to international health. As an intergovernmental, centenary organization in health, PAHO allows participants a unique vantage point from which to conceptualize, share experiences and develop projects relevant to international health. Derived from over two decades of experience (1985-2006) training professionals through its predessor Training Program in International Health, the Leaders in International Health Program "Edmundo Granda Ugalde" (LIHP) utilizes an innovative design, virtual and practical learning activities, and a problem-based approach to analyze the main concepts, theories, actors, forces, and processes relevant to international health. In collaboration with PAHO/WHO Representative Offices and national institutions, participants develop country projects based on priority health issues, many of which are integrated into the Organization's technical cooperation and/or implemented by relevant ministries and other entities in their respective countries/subregions. A total of 185 participants representing 31 countries have participated in the LIHP since its inception in 2008, building upon the 187 trained through its predecessor. These initiatives have contributed to the development of health professionals in the Region of the Americas devoted to international health, as well as provided important input towards a conceptual understanding of international health by fostering debate on this issue.

  19. The price of a drink: the potential of alcohol minimum unit pricing as a public health measure in the UK.

    PubMed

    Rice, Peter; Drummond, Colin

    2012-09-01

    The UK has seen a dramatic increase in alcohol consumption and alcohol-related harm over the past 30 years. Alcohol taxation has long been considered a key method of controlling alcohol-related harm but a combination of factors has recently led to consideration of methods which affect the price of the cheapest alcohol as a means of improved targeting of alcohol control measures to curb the consumption of the heaviest drinkers. Although much of the evidence in favour of setting a minimum price of a unit of alcohol is based on complex econometric models rather than empirical data, all jurisdictions within the UK now intend to make selling alcohol below a set price illegal, which will provide a naturalistic experiment allowing assessment of the impact of minimum pricing.

  20. Social networks of professionals in health care organizations: a review.

    PubMed

    Tasselli, Stefano

    2014-12-01

    In this article, we provide an overview of social network research in health care, with a focus on social interactions between professionals in organizations. We begin by introducing key concepts defining the social network approach, including network density, centrality, and brokerage. We then review past and current research on the antecedents of health care professionals' social networks-including demographic attributes, professional groups, and organizational arrangements-and their consequences-including satisfaction at work, leadership, behaviors, knowledge transfer, diffusion of innovation, and performance. Finally, we examine future directions for social network research in health care, focusing on micro-macro linkages and network dynamics.

  1. 78 FR 25909 - Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-03

    ... Other Rules Regarding the Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS... relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care... coverage under a qualified health plan through an Affordable Insurance Exchange may receive a premium...

  2. Health care delivery system reform: accountable care organizations.

    PubMed

    Dove, James T; Weaver, W Douglas; Lewin, Jack

    2009-09-01

    Health care reform is moving forward at a frantic pace. There have been 3 documents released from the Senate Finance Committee and proposed legislation from the Senate HELP Committee and the House of Representatives Tri-Committee on Health Reform. The push for legislative action has not been sidetracked by the economic conditions. Integrated health care delivery is the current favored approach to aligning resource use and cost. Accountable care organizations (ACOs), a concept included in health care reform legislation before both the House and Senate, propose to translate the efficiencies and lessons learned from large integrated systems and apply them to nonintegrated practices. The ACO design could be real or virtual integration of local delivery providers. This new structure is complicated, and clinicians, patients, and payers should have input regarding the design and function of it. Because most of health care is delivered in the ambulatory setting, it remains to be determined whether the ACOs are best developed in parallel among physician practices and hospitals or as partnerships between hospitals and physicians. Many are concerned that hospital-led ACOs will force physician employment by hospitals with possible unintended negative consequences for physicians, hospitals, and patients. Patients, physicians, other providers, and payers are in a better position to guide the redesign of the health care delivery system than government agencies, policy organizations, or elected officials, no matter how well intended. We strongly believe-and ACC has proclaimed-that change in health care delivery must be accomplished with patients and physicians at the table.

  3. Mental Snapshots: Creating an Organized Plan for Health Assessment.

    PubMed

    Fosbrook, Susan Curro

    2015-01-01

    Beginning nursing students enter a rapidly moving and changing health care climate. Multiple stimulations can frighten and overwhelm the student's ability to find order of essential patient information. Students need to know how to collect, process, and manage important health data accurately and efficiently in the clinical setting. An integrative method for teaching nursing students to walk into the patient's room and construct a patterned sequence of focused assessments assists students in creating an organized plan for health assessment. The Mental Snapshots Method includes three components for health assessment: (a) sequential assessment steps of the patient; (b) color-coded visual images of the patient representing a bodily condition; and (c) focused assessment questions of primary health complaint(s) with a plan for nursing care. This mental snapshots strategy employs an information processing model of sensory, memory, and motor functioning, which enable students to maintain patient quality and safety. PMID:26428347

  4. The ethics of selectively marketing the health maintenance organization.

    PubMed

    Waymack, M H

    1990-12-01

    Health Maintenance Organization (HMO) administrators have been accused of engaging in 'selective marketing'. That is, through such strategies as tailoring the benefits package of the program or advertising in styles or in media that do not appeal to certain 'undesirable' audiences, the administrator can minimize the percentage of persons in the HMO who are heavy users of health care services. By means of analyzing what 'insurance' is (philosophically) and what it means for something to be a free market commodity, the author argues that, as long as American society chooses to regard health insurance as a commodity or service of the free market. the use of such strategies is within the moral rights of health administrators. The author concludes by noting some morally undesirable results of treating health insurance as a market commodity.

  5. Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit. Final regulations.

    PubMed

    2015-12-18

    This document contains final regulations on the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the Medicare and Medicaid Extenders Act of 2010, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, and the Department of Defense and Full-Year Continuing Appropriations Act, 2011. These final regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges, sometimes called Marketplaces) and claim the health insurance premium tax credit, and Exchanges that make qualified health plans available to individuals and employers. PMID:26685369

  6. Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit. Final regulations.

    PubMed

    2015-12-18

    This document contains final regulations on the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the Medicare and Medicaid Extenders Act of 2010, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, and the Department of Defense and Full-Year Continuing Appropriations Act, 2011. These final regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges, sometimes called Marketplaces) and claim the health insurance premium tax credit, and Exchanges that make qualified health plans available to individuals and employers.

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

    A long-standing scientific discourse on the use of health research evidence to inform policy has come to produce multiple implementation theories, frameworks, models, and strategies. It is from this extensive body of research that the authors extract and present essential components of an implementation process in the health domain, gaining valuable guidance on how to successfully meet the challenges of implementation. Furthermore, this article describes how implementation content can be analyzed and reorganized, with a special focus on implementation at different policy, systems and services, and individual levels using existing frameworks and tools. In doing so, the authors aim to contribute to the establishment and testing of an implementation framework for reports such as the World Health Organization World Report on Disability, the World Health Organization International Perspectives on Spinal Cord Injury, and other health policy reports or technical health guidelines. PMID:24356078

  9. Community Organization and Mental Health; The Woodlawn Experience.

    ERIC Educational Resources Information Center

    Lewis, Michael D.; Lewis, Judith A.

    A paraprofessional training program designed to provide community controlled mental health services to the Woodlawn community of Chicago, Illinois, is described in this monograph. The neighborhood and The Woodlawn Organization (T.W.O.A), a self help project formed in early 1960, are described from an historical perspective. Some of the areas…

  10. [Organization of health services and tuberculosis care management].

    PubMed

    Barrêto, Anne Jaquelyne Roque; de Sá, Lenilde Duarte; Nogueira, Jordana de Almeida; Palha, Pedro Fredemir; Pinheiro, Patrícia Geórgia de Oliveira Diniz; de Farias, Nilma Maria Porto; Rodrigues, Débora Cezar de Souza; Villa, Tereza Cristina Scatena

    2012-07-01

    The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of João Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda.

  11. Health Maintenance Organizations and Medical Education: Breaking the Barriers.

    ERIC Educational Resources Information Center

    Moore, Gordon T.

    1990-01-01

    Health maintenance organizations (HMOs) medical directors and academics (N=450) explored the barriers to and incentives for cooperation between academic medical centers (AMCs) and HMOs in clinical education. AMCs need to be prepared to offer meaningful academic and financial inducements to attract HMOs to participate in teaching. (Author/MLW)

  12. Professionalism: good for patients and health care organizations.

    PubMed

    Brennan, Michael D; Monson, Verna

    2014-05-01

    Professionalism is an indispensable element in the compact between the medical profession and society that is based on trust and putting the needs of patients above all other considerations. The resurgence of interest in professionalism dates back to the 1980s when health maintenance organizations were formed and proprietary influences in health care increased. Since then, a rich and comprehensive literature has emerged in defining professionalism, including desirable individual attributes and behaviors and how they may be taught, promoted, and assessed. More recently, scholarship has shifted from individual to organizational professionalism. This literature addresses the role that health care organizations can play to establish environments that are conducive to the consistent expression of professionalism by individuals and health care teams. We reviewed interdisciplinary empirical studies from health care effectiveness and outcomes, organizational sciences, positive psychology, and social psychology, finding evidence that organizational and individual professionalism is associated with a wide range of benefits to patients and the organization. We identify actionable organizational strategies and approaches that, if adopted, can foster and promote combined organizational and individual professionalism. In doing so, trust in the medical profession and its institutions can be enhanced, which in turn will reconfirm a commitment to the social compact. PMID:24797645

  13. Professionalism: good for patients and health care organizations.

    PubMed

    Brennan, Michael D; Monson, Verna

    2014-05-01

    Professionalism is an indispensable element in the compact between the medical profession and society that is based on trust and putting the needs of patients above all other considerations. The resurgence of interest in professionalism dates back to the 1980s when health maintenance organizations were formed and proprietary influences in health care increased. Since then, a rich and comprehensive literature has emerged in defining professionalism, including desirable individual attributes and behaviors and how they may be taught, promoted, and assessed. More recently, scholarship has shifted from individual to organizational professionalism. This literature addresses the role that health care organizations can play to establish environments that are conducive to the consistent expression of professionalism by individuals and health care teams. We reviewed interdisciplinary empirical studies from health care effectiveness and outcomes, organizational sciences, positive psychology, and social psychology, finding evidence that organizational and individual professionalism is associated with a wide range of benefits to patients and the organization. We identify actionable organizational strategies and approaches that, if adopted, can foster and promote combined organizational and individual professionalism. In doing so, trust in the medical profession and its institutions can be enhanced, which in turn will reconfirm a commitment to the social compact.

  14. A framework for describing health care delivery organizations and systems.

    PubMed

    Piña, Ileana L; Cohen, Perry D; Larson, David B; Marion, Lucy N; Sills, Marion R; Solberg, Leif I; Zerzan, Judy

    2015-04-01

    Describing, evaluating, and conducting research on the questions raised by comparative effectiveness research and characterizing care delivery organizations of all kinds, from independent individual provider units to large integrated health systems, has become imperative. Recognizing this challenge, the Delivery Systems Committee, a subgroup of the Agency for Healthcare Research and Quality's Effective Health Care Stakeholders Group, which represents a wide diversity of perspectives on health care, created a draft framework with domains and elements that may be useful in characterizing various sizes and types of care delivery organizations and may contribute to key outcomes of interest. The framework may serve as the door to further studies in areas in which clear definitions and descriptions are lacking.

  15. New systems of work organization and workers' health.

    PubMed

    Kompier, Michiel A J

    2006-12-01

    This paper aims at identifying major changes in and around work organizations, their effects upon job characteristics and the health and well-being of today's employees, and related research challenges. Increased internationalization and competition, increased utilization of information and communication technology, the changing workforce configuration, and flexibility and new organizational practices are considered. As work has changed from physical to mental in nature, job characteristics have changed significantly. Meanwhile work and family life have blended. New systems of work organization have become more prevalent, but they do not represent a radical change across the whole economy. New practices may have an adverse impact upon job characteristics, but their effects depend on their design, implementation, and management. Research recommendations include improved monitoring of changes in work organization and studies into their health and safety consequences, intervention studies, studies into the motivating potential of modern work practices, studies of marginalized workers and workers in less developed countries, and "mechanism studies".

  16. Regional health information organizations: a vehicle for transforming health care delivery?

    PubMed

    Solomon, Michael R

    2007-02-01

    Information technology (IT) has the potential to be a significant enabler in transforming the health care delivery system. New types of organizations are needed to guide the change. Regional Health Information Organizations (RHIOs) hold promise as agents for transformation. This essay discusses the results from a case study on how RHIOs are advancing IT adoption in the health care community. Results indicate that the RHIO model is early in its evolution. To be a catalyst of change, the RHIO must overcome privacy barriers, actively engage purchasers of care, and create compelling incentives for clinicians to adopt the RHIOs' services.

  17. Diffuse Spectral Reflectance Records from the Northeast Pacific Oxygen Minimum Zone: Evidence for Rapid Shifts in Carbonate and Organic Carbon throughout the Holocene

    NASA Astrophysics Data System (ADS)

    Delvisico, J. G.; OConnell, S.; Ortiz, J. D.

    2002-05-01

    Sediment cores collected within the Oxygen Minimum Zone (O2 < 5 μ m/kg; 400-1300 m depth) from off the coast of Baja California at 25oN during a 1999 R/V Melville cruise present the most southerly evidence of centennial to decadal scale climate instability yet observed on the open Northeast Pacific margin. The development of high resolution proxies through statistical analysis of extensive Diffuse Spectral Reflectance (DSR) data sets provides the framework for gauging rapid shifts in carbonate and organic carbon within the spatial/temporal bounds of the Oxygen Minimum Zone from the last deglaciation to the Holocene (15 to 0 Ka). These shifts are potentially controlled by changes in local primary production or sub-surface water mass ventilation, however the relative importance of each process over this time scale is not well understood. This study focuses on five 10 to 14 m piston cores (MV 01 PC12-16) collected within the Soledad Basin, desirable for its high sedimentation rates (100-120cm/kyr) and its 200 m sill depth. We maintain the hypothesis that variations in carbonate and organic carbon seen through the Diffuse Spectral Reflectance (DSR) will preferentially show the effects of local production on the spatial/temporal extent of the Oxygen Minimum Zone due to the circulation restrictions imposed on the basin by its shallow sill depth. The summer's work involved compiling a composite proxy record of variations in organic carbon through R-mode factor analysis of the Diffuse Spectral Reflectance signal, which was then further constrained through coulometry to provide confidence points for reflectance-derived proxy values. Through the compilation of the five piston core records, a continuous, high frequency climatic proxy record of changes in productivity was constructed over the past 15 Ka. Organic carbon shifts within the Soledad record also contain a periodicity within the time scale bounds of the present day Pacific Decadal Oscillation (20-50 year quasi

  18. Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

    PubMed

    Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

    2014-02-01

    Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role.

  19. The World Health Organization European Health in Prisons Project After 10 Years: Persistent Barriers and Achievements

    PubMed Central

    Gatherer, Alex; Moller, Lars; Hayton, Paul

    2005-01-01

    The recognition that good prison health is important to general public health has led 28 countries in the European Region of the World Health Organization (WHO) to join a WHO network dedicated to improving health within prisons. Within the 10 years since that time, vital actions have been taken and important policy documents have been produced. A key factor in making progress is breaking down the isolation of prison health services and bringing them into closer collaboration with the country’s public health services. However, barriers to progress remain. A continuing challenge is how best to move from policy recommendations to implementation, so that the network’s fundamental aim of noticeable improvements in the health and care of prisoners is further achieved. PMID:16186449

  20. Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

    PubMed Central

    Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan

    2012-01-01

    Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools – accountability measures and payment designs – to improve access to and quality of care for patients with behavioral health needs. PMID:23188486

  1. Health maintenance organization environments in the 1980s and beyond

    PubMed Central

    Morrison, Ellen M.; Luft, Harold S.

    1990-01-01

    Throughout the past decade, health maintenance organizations (HMOs) were buffeted by dramatic regulatory and competitive changes. In this article, literature of the 1980s is reviewed to update our knowledge on the HMO industry and to suggest future research. The influence of intensified competition on these organizations and the determinants of market entry, expansion, and exit are examined. These organizations are now beginning to require copayments and deductibles and to offer point-of-service choice, while indemnity plans are developing sophisticated utilization management techniques. Given these significant structural changes, past distinctions among HMO, preferred provider organization and fee-for-service medicine must be replaced with a distinction between degree of provider choice and level of benefits. PMID:10113465

  2. Building IT capability in health-care organizations.

    PubMed

    Khatri, Naresh

    2006-05-01

    While computer technology has revolutionized industries such as banking and airlines, it has done little for health care so far. Most of the health-care organizations continue the early-computer-era practice of buying the latest technology without knowing how it might effectively be employed in achieving business goals. By investing merely in information technology (IT) rather than in IT capabilities they acquire IT components--primarily hardware, software, and vendor-provided services--which they do not understand and, as a result, are not capable of fully utilizing for achieving organizational objectives. In the absence of internal IT capabilities, health-care organizations have relied heavily on the fragmented IT vendor market in which vendors do not offer an open architecture, and are unwilling to offer electronic interfaces that would make their 'closed' systems compatible with those of other vendors. They are hamstrung as a result because they have implemented so many different technologies and databases that information stays in silos. Health systems can meet this challenge by developing internal IT capabilities that would allow them to seamlessly integrate clinical and business IT systems and develop innovative uses of IT. This paper develops a comprehensive conception of IT capability grounded in the resource-based theory of the firm as a remedy to the woes of IT investments in health care. PMID:16643706

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

    PubMed Central

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

    1992-01-01

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

  4. The minimum knowledge base for predicting organ-at-risk dose-volume levels and plan-related complications in IMRT planning

    NASA Astrophysics Data System (ADS)

    Zhang, Hao H.; Meyer, Robert R.; Shi, Leyuan; D'Souza, Warren D.

    2010-04-01

    IMRT treatment planning requires consideration of two competing objectives: achieving the required amount of radiation for the planning target volume and minimizing the amount of radiation delivered to all other tissues. It is important for planners to understand the tradeoff between competing factors so that the time-consuming human interaction loop (plan-evaluate-modify) can be eliminated. Treatment-plan-surface models have been proposed as a decision support tool to aid treatment planners and clinicians in choosing between rival treatment plans in a multi-plan environment. In this paper, an empirical approach is introduced to determine the minimum number of treatment plans (minimum knowledge base) required to build accurate representations of the IMRT plan surface in order to predict organ-at-risk (OAR) dose-volume (DV) levels and complications as a function of input DV constraint settings corresponding to all involved OARs in the plan. We have tested our approach on five head and neck patients and five whole pelvis/prostate patients. Our results suggest that approximately 30 plans were sufficient to predict DV levels with less than 3% relative error in both head and neck and whole pelvis/prostate cases. In addition, approximately 30-60 plans were sufficient to predict saliva flow rate with less than 2% relative error and to classify rectal bleeding with an accuracy of 90%.

  5. Work organization and the health of bank employees.

    PubMed

    Silva, Juliana Lemos; Navarro, Vera Lucia

    2012-01-01

    The Brazilian banking sector has undergone an intense restructuring process and taken a leading position in the incorporation of new technologies and organizational innovations. Computerization in the industry, in association with forms of work organization, has resulted in changes that reflect on the workers' health. Based on the theoretical and methodological frameworks of historical and dialectical materialism, this qualitative study investigates the work conditions of bank employees in order to identify the extent to which changes in work organization interfere with these workers' health. Data were collected through interviews held with 11 bank employees. In addition to physical sickening due to occupational diseases directly related to work intensification, the results also show an increased incidence of mental suffering and a feeling of loss of professional identity. Work-related frustration, instability and concerns related to psychological pressure resulting from the need to achieve goals predominated in the reports. PMID:22699722

  6. Work organization and the health of bank employees.

    PubMed

    Silva, Juliana Lemos; Navarro, Vera Lucia

    2012-01-01

    The Brazilian banking sector has undergone an intense restructuring process and taken a leading position in the incorporation of new technologies and organizational innovations. Computerization in the industry, in association with forms of work organization, has resulted in changes that reflect on the workers' health. Based on the theoretical and methodological frameworks of historical and dialectical materialism, this qualitative study investigates the work conditions of bank employees in order to identify the extent to which changes in work organization interfere with these workers' health. Data were collected through interviews held with 11 bank employees. In addition to physical sickening due to occupational diseases directly related to work intensification, the results also show an increased incidence of mental suffering and a feeling of loss of professional identity. Work-related frustration, instability and concerns related to psychological pressure resulting from the need to achieve goals predominated in the reports.

  7. Adoption of Clinical Information Systems in Health Services Organizations

    PubMed Central

    Austin, Charles J.; Holland, Gloria J.

    1988-01-01

    This paper presents a conceptual model of factors which influence organizational decisions to invest in the installation of clinical information systems. Using results of previous research as a framework, the relative influence of clinical, fiscal, and strategic-institutional decision structures are examined. These adoption decisions are important in health services organizations because clinical information is essential for managing demand and allocating resources, managing quality of care, and controlling costs.

  8. Hispanic Medical Organizations' Support for LGBT Health Issues.

    PubMed

    Sánchez, John Paul; Sola, Orlando; Ramallo, Jorge; Sánchez, Nelson Felix; Dominguez, Kenneth; Romero-Leggott, Valerie

    2014-09-01

    Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally.

  9. Hispanic Medical Organizations' Support for LGBT Health Issues.

    PubMed

    Sánchez, John Paul; Sola, Orlando; Ramallo, Jorge; Sánchez, Nelson Felix; Dominguez, Kenneth; Romero-Leggott, Valerie

    2014-09-01

    Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally. PMID:26789708

  10. The representation of health professionals on governing boards of health care organizations in New York City.

    PubMed

    Mason, Diana J; Keepnews, David; Holmberg, Jessica; Murray, Ellen

    2013-10-01

    The Representation of Health Professionals on Governing Boards of Health Care Organizations in New York City. The heightened importance of processes and outcomes of care-including their impact on health care organizations' (HCOs) financial health-translate into greater accountability for clinical performance on the part of HCO leaders, including their boards, during an era of health care reform. Quality and safety of care are now fiduciary responsibilities of HCO board members. The participation of health professionals on HCO governing bodies may be an asset to HCO governing boards because of their deep knowledge of clinical problems, best practices, quality indicators, and other issues related to the safety and quality of care. And yet, the sparse data that exist indicate that physicians comprise more than 20 % of the governing board members of hospitals while less than 5 % are nurses and no data exist on other health professionals. The purpose of this two-phased study is to examine health professionals' representations on HCOs-specifically hospitals, home care agencies, nursing homes, and federally qualified health centers-in New York City. Through a survey of these organizations, phase 1 of the study found that 93 % of hospitals had physicians on their governing boards, compared with 26 % with nurses, 7 % with dentists, and 4 % with social workers or psychologists. The overrepresentation of physicians declined with the other HCOs. Only 38 % of home care agencies had physicians on their governing boards, 29 % had nurses, and 24 % had social workers. Phase 2 focused on the barriers to the appointment of health professionals to governing boards of HCOs and the strategies to address these barriers. Sixteen health care leaders in the region were interviewed in this qualitative study. Barriers included invisibility of health professionals other than physicians; concerns about "special interests"; lack of financial resources for donations to the organization

  11. Managing corporate governance risks in a nonprofit health care organization.

    PubMed

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J

    2005-01-01

    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves.

  12. Managing corporate governance risks in a nonprofit health care organization.

    PubMed

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J

    2005-01-01

    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves. PMID:20200865

  13. 42 CFR 475.105 - Prohibition against contracting with health care facilities, affiliates, and payor organizations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Prohibition against contracting with health care... contracting with health care facilities, affiliates, and payor organizations. (a) Basic rule. Except as... health care facility in the QIO area. (2) A health care facility affiliate; that is, an organization...

  14. Improving Coordination of Addiction Health Services Organizations with Mental Health and Public Health Services.

    PubMed

    Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick

    2016-01-01

    In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform.

  15. Information technology and knowledge exchange in health-care organizations.

    PubMed Central

    Vimarlund, V.; Timpka, T.; Patel, V. L.

    1999-01-01

    Despite the increasing global interest in information technology among health care institutions, little has been discussed about its importance for the effectiveness of knowledge management. In this study, economic theories are used to analyze and describe a theoretical framework for the use of information technology in the exchange of knowledge. The analyses show that health care institutions would benefit from developing global problem-solving collaboration, which allows practitioners to exchange knowledge unrestricted by time and geographical barriers. The use of information technology for vertical integration of health-care institutions would reduce knowledge transaction costs, i.e. decrease costs for negotiating and creating communication channels, and facilitating the determination of what, when, and how to produce knowledge. A global network would allow organizations to increase existing knowledge, and thus total productivity, while also supporting an environment where the generation of new ideas is unrestricted. Using all the intellectual potential of market actors and thereby releasing economic resources can reduce today's global budget conflicts in the public sector, i.e. the necessity to choose between health care services and, for instance, schools and support for the elderly. In conclusion, global collaboration and coordination would reduce the transaction costs inherent in knowledge administration and allow a more effective total use of scarce health-care resources. PMID:10566436

  16. Implementing nutrition diagnosis at a multisite health care organization.

    PubMed

    Van Heukelom, Holly; Fraser, Valli; Koh, Jiak-Chin; McQueen, Kay; Vogt, Kara; Johnson, Frances

    2011-01-01

    The American Dietetic Association Nutrition Care Process (NCP) is designed to improve patient care and interdisciplinary communication through the consistent use of standardized nutrition language. Supported by Dietitians of Canada, the NCP has been gaining prominence across Canada. In spring 2009, registered dietitians at Providence Health Care, an academic, multisite health care organization in Vancouver, British Columbia, began using the NCP with a focus on nutrition diagnosis. The success of nutrition diagnosis at Providence Health Care has depended on support from the Clinical Nutrition Department leadership, commitment from the NCP champions, regularly scheduled lunch-and-learn sessions, revised nutrition assessment forms with a section for nutrition diagnosis statements, and the Pocket Guide for International Dietetics & Nutrition Terminology (IDNT) Reference Manual. Audit results from June through August 2010 showed a 92% nutrition diagnosis completion rate for acute-care and long-term care sites within Providence Health Care. Ongoing audits will be used to evaluate the accuracy and quality of nutrition diagnosis statements. This evaluation will allow Providence Health Care dietitians to move forward with nutrition intervention.

  17. The Effects of Organic Pollutants in Soil on Human Health

    NASA Astrophysics Data System (ADS)

    Burgess, Lynn

    2013-04-01

    The soil has always been depository of the organic chemicals produced naturally or anthropogenically. Soil contamination is a serious human and environmental problem. A large body of evidence has shown the risks of adverse health effects with the exposure to contaminated soil due to the large quantities of organic chemicals used in agriculture and urban areas that have a legacy of environmental pollution linked to industrial activities, coal burning, motor vehicle emissions, waste incineration and waste dumping. In agricultural areas, because of the effort to provide adequate quantities of agricultural products, farmers have been using an increasing amount of organic chemicals, but the resulting pollution has enormous potential for environmental damage. The types of organic pollutants commonly found in soils are polychlorinated biphenyls, polybrominated biphenyls, polychlorinated dibenzofurans, polycyclic aromatic hydrocarbons, organophosphorus and carbamate insecticides, herbicides and organic fuels, especially gasoline and diesel. Another source of soil pollution is the complex mixture of organic chemicals, metals and microorganisms in the effluent from septic systems, animal wastes and other sources of biowaste. The soils of the world are a vast mixture of chemicals and although conditions are such that an individual is rarely exposed to a single compound, the great majority of people are exposed to a vast chemical mixture of organics, their metabolites, and other compounds at low concentrations Human exposure to organic pollutants in the soil is an area of toxicology that is very difficult to study due to the low concentration of the pollutants. The toxicological studies of single organic pollutants found in soils are limited and research on the metabolites and of chemical mixtures is very limited. The majority of toxicological studies are conducted at relatively high doses and for short periods of exposure. This makes the application of this data to exposure

  18. New ways of financing and organizing health care in Sweden.

    PubMed

    Håkansson, S

    1994-01-01

    The health care system in Sweden has been undergoing radical change since 1991. The mainly public financed (90%) system with 26 autonomous counties spent 8.5% of its gross domestic product on health care in 1991. The main features of the 'paradigm shift' are: separation of production and financing; resource allocation to health districts in relation to the needs of the population; and introduction of public competition between health districts (purchasers) and hospitals (providers). The health district boards are responsible for the health care of the population in their district hospitals financed by their activities (e.g. through diagnosis-related groups (DRGs)) and quality aspects monitored by central authorities. A parliamentary committee (HSU 2000) is investigating how Sweden's health care system can be organized and financed in the future. Three models are analyzed: a reformed county council court model, a primary care-managed model, and a compulsory insurance model. Each model must be consistent with equity and public financing. From 1992 in the Stockholm county, five surgical specialties were paid for their activities according to DRGs for inpatient care and another system for outpatient care. The number of treated patients during 1992 increased by 8% in inpatient care, 50% in day surgery and by 15% in outpatient care. Taken together, the activities increased by 11%, which is slightly more than the expected 10% increase in productivity. (There was a 10% decrease in DRG prices from 1 January 1992.) The total costs decreased by 1% due to fewer personnel. Nothing has been reported concerning the quality of care, neither before nor after the model was introduced. From 1993, all somatic acute specialties are paid by DRGs and the equivalent outpatient classification systems. The results from 1993 will be presented in the autumn of 1994.

  19. Changing Policy Framing as a Deliberate Strategy for Public Health Advocacy: A Qualitative Policy Case Study of Minimum Unit Pricing of Alcohol

    PubMed Central

    Katikireddi, Srinivasa Vittal; Bond, Lyndal; Hilton, Shona

    2014-01-01

    Context Scotland is the first country in the world to pass legislation introducing a minimum unit price (MUP) for alcohol in an attempt to reduce consumption and associated harms by increasing the price of the cheapest alcohol. We investigated the competing ways in which policy stakeholders presented the debate. We then established whether a change in framing helped explain the policy's emergence. Methods We conducted a detailed policy case study through analysis of evidence submitted to the Scottish parliament, and in-depth, one-to-one interviews (n = 36) with politicians, civil servants, advocates, researchers, and industry representatives. Findings Public- and voluntary-sector stakeholders tended to support MUP, while industry representatives were more divided. Two markedly different ways of presenting alcohol as a policy problem were evident. Critics of MUP (all of whom were related to industry) emphasized social disorder issues, particularly among young people, and hence argued for targeted approaches. In contrast, advocates for MUP (with the exception of those in industry) focused on alcohol as a health issue arising from overconsumption at a population level, thus suggesting that population-based interventions were necessary. Industry stakeholders favoring MUP adopted a hybrid framing, maintaining several aspects of the critical framing. Our interview data showed that public health advocates worked hard to redefine the policy issue by deliberately presenting a consistent alternative framing. Conclusions Framing alcohol policy as a broad, multisectoral, public health issue that requires a whole-population approach has been crucial to enabling policymakers to seriously consider MUP, and public health advocates intentionally presented alcohol policy in this way. This reframing helped prioritize public health considerations in the policy debate and represents a deliberate strategy for consideration by those advocating for policy change around the world and in

  20. Reproductive health services for Syrian refugees in Zaatri Camp and Irbid City, Hashemite Kingdom of Jordan: an evaluation of the Minimum Initial Services Package

    PubMed Central

    2015-01-01

    Background The Minimum Initial Services Package (MISP) for reproductive health, a standard of care in humanitarian emergencies, is a coordinated set of priority activities developed to prevent excess morbidity and mortality, particularly among women and girls, which should be implemented at the onset of an emergency. The purpose of the evaluation was to determine the status of MISP implementation for Syrian refugees in Jordan as part of a global evaluation of reproductive health in crises. Methods In March 2013, applying a formative evaluation approach 11 key informant interviews, 13 health facility assessments, and focus group discussions (14 groups; 159 participants) were conducted in two Syrian refugee sites in Jordan, Zaatri Camp, and Irbid City, respectively. Information was coded, themes were identified, and relationships between data explored. Results Lead health agencies addressed the MISP by securing funding and supplies and establishing reproductive health focal points, services and coordination mechanisms. However, Irbid City was less likely to be included in coordination activities and health facilities reported challenges in human resource capacity. Access to clinical management of rape survivors was limited, and both women and service provider’s knowledge about availability of these services was low. Activities to reduce the transmission of HIV and to prevent excess maternal and newborn morbidity and mortality were available, although some interventions needed strengthening. Some planning for comprehensive reproductive health services, including health indicator collection, was delayed. Contraceptives were available to meet demand. Syndromic treatment of sexually transmitted infections and antiretrovirals for continuing users were not available. In general refugee women and adolescent girls perceived clinical services negatively and complained about the lack of basic necessities. Conclusions MISP services and key elements to support implementation

  1. The Pan American Health Organization and the mainstreaming of human rights in regional health governance.

    PubMed

    Meier, Benjamin Mason; Ayala, Ana S

    2014-01-01

    In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau (PASB), and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes. PMID:25264093

  2. The Pan American Health Organization and the mainstreaming of human rights in regional health governance.

    PubMed

    Meier, Benjamin Mason; Ayala, Ana S

    2014-01-01

    In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau (PASB), and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes.

  3. 76 FR 58466 - Request for Comments on World Health Organization Pandemic Influenza Preparedness Framework

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... influenza preparedness via the Federal Register on September 14, 2010; 75 FR 55776-55777. The Department of... International Trade Administration Request for Comments on World Health Organization Pandemic Influenza... the World Health Organization Pandemic Influenza Preparedness Framework (...

  4. International infectious disease law: revision of the World Health Organization's International Health Regulations.

    PubMed

    Gostin, Lawrence O

    2004-06-01

    The International Health Regulations (IHR), the only global regulations for infectious disease control, have not been significantly changed since they were first issued in 1951. The World Health Organization (WHO) is currently engaged in a process to modernize the IHR. This article reviews WHO's draft revised IHR and recommends new reforms to improve global health, which include (1) a robust mission, emphasizing the WHO's core public health purposes, functions, and essential services; (2) broad scope, flexibly covering diverse health threats; (3) global surveillance, developing informational networks of official and unofficial data sources; (4) national public health systems, setting performance criteria, measuring outcomes, and holding states accountable; (5) human rights protection, setting science-based standards and fair procedures; and (6) good governance, adopting the principles of fairness, objectivity, and transparency. The WHO should ensure state compliance with health norms and generous economic and technical assistance to poorer countries. An important issue for the international community is how sovereign countries can join together to make global health work for everyone, the poor and the wealthy alike. PMID:15173154

  5. Demoralization in mental health organizations: leadership and social support help.

    PubMed

    Gabel, Stewart

    2012-12-01

    Demoralization is a commonly observed feeling state that is characterized by a sense of loss of or threat to one's personal values or goals and a perceived inability to overcome obstacles toward achieving these goals. Demoralization has features in common with burnout and may precede or accompany it. Psychiatrists working in many mental health care organizational settings, be they in the public or private sectors, may be at particular risk for demoralization. This is due partly to stressors that threaten their own professional values because of factors such as programmatic cut backs, budgetary reductions and changing social emphases on the value of mental health treatments. They also may be at risk for demoralization because of the effects on them of the governance styles of the agencies in which they are employed. The leadership or governance style in large organizational settings often is authoritarian, hierarchical and bureaucratic, approaches that are antithetical to the more participative leadership styles favored by many mental health professionals in their clinical activities. Clinical leaders in mental health organizations must exhibit various competencies to successfully address demoralization in clinical staff and to provide a counterbalance to the effects of the governance style of many agencies in which they are employed. Appropriate leadership skills, sometimes too simplistically termed "social support", have been found to reduce burnout in various populations and are likely to lessen demoralization as well. This paper reviews these important leadership issues and the relationship of social support to recognized leadership competencies.

  6. [Epidemiological intelligence as a model of organization in health].

    PubMed

    Rodrigues-Júnior, Antonio Luiz

    2012-03-01

    The concept of epidemiological intelligence, as a construction of information societies, goes beyond monitoring a list of diseases and the ability to elicit rapid responses. The concept should consider the complexity of the definition of epidemiology in the identification of this object of study without being limited to a set of actions in a single government sector. The activities of epidemiological intelligence include risk assessment, strategies for prevention and protection, subsystems of information, crisis management rooms, geographical analysis, etc. This concept contributes to the understanding of policies in health, in multisectorial and geopolitical dimensions, as regards the organization of services around public health emergencies, primary healthcare, as well as disasters. The activities of epidemiological intelligence should not be restricted to scientific research, but the researchers must beware of threats to public health. Lalonde's model enabled consideration of epidemiological intelligence as a way to restructure policies and share resources by creating communities of intelligence, whose purpose is primarily to deal with public health emergencies and disasters.

  7. Demoralization in mental health organizations: leadership and social support help.

    PubMed

    Gabel, Stewart

    2012-12-01

    Demoralization is a commonly observed feeling state that is characterized by a sense of loss of or threat to one's personal values or goals and a perceived inability to overcome obstacles toward achieving these goals. Demoralization has features in common with burnout and may precede or accompany it. Psychiatrists working in many mental health care organizational settings, be they in the public or private sectors, may be at particular risk for demoralization. This is due partly to stressors that threaten their own professional values because of factors such as programmatic cut backs, budgetary reductions and changing social emphases on the value of mental health treatments. They also may be at risk for demoralization because of the effects on them of the governance styles of the agencies in which they are employed. The leadership or governance style in large organizational settings often is authoritarian, hierarchical and bureaucratic, approaches that are antithetical to the more participative leadership styles favored by many mental health professionals in their clinical activities. Clinical leaders in mental health organizations must exhibit various competencies to successfully address demoralization in clinical staff and to provide a counterbalance to the effects of the governance style of many agencies in which they are employed. Appropriate leadership skills, sometimes too simplistically termed "social support", have been found to reduce burnout in various populations and are likely to lessen demoralization as well. This paper reviews these important leadership issues and the relationship of social support to recognized leadership competencies. PMID:22415227

  8. Nursing Minimum Data Set Based on EHR Archetypes Approach.

    PubMed

    Spigolon, Dandara N; Moro, Cláudia M C

    2012-01-01

    The establishment of a Nursing Minimum Data Set (NMDS) can facilitate the use of health information systems. The adoption of these sets and represent them based on archetypes are a way of developing and support health systems. The objective of this paper is to describe the definition of a minimum data set for nursing in endometriosis represent with archetypes. The study was divided into two steps: Defining the Nursing Minimum Data Set to endometriosis, and Development archetypes related to the NMDS. The nursing data set to endometriosis was represented in the form of archetype, using the whole perception of the evaluation item, organs and senses. This form of representation is an important tool for semantic interoperability and knowledge representation for health information systems. PMID:24199126

  9. An exploratory study of organization design configurations in health care delivery organizations.

    PubMed

    Sheppeck, Mick; Militello, Jack

    2014-01-01

    Organizations are configurations of variables that support each other to achieve customer satisfaction. Based on Treacy and Wiersema (1995), we predicted the emergence of two configurations, one supporting a product leadership stance and one predicting the customer intimate approach from a set of 73 for profit health care clinics. In addition, we predicted the emergence of a configuration where the scores on most variables were near the mean for each variable. Using cluster analysis and discriminant function analysis, we identified three configurations: one a "master of two" strategy, one "stuck-in-the-middle," and one showing scores well below the mean on most variables. The implications for organization design and manager actions in the health care industry are discussed. PMID:25004706

  10. An exploratory study of organization design configurations in health care delivery organizations.

    PubMed

    Sheppeck, Mick; Militello, Jack

    2014-01-01

    Organizations are configurations of variables that support each other to achieve customer satisfaction. Based on Treacy and Wiersema (1995), we predicted the emergence of two configurations, one supporting a product leadership stance and one predicting the customer intimate approach from a set of 73 for profit health care clinics. In addition, we predicted the emergence of a configuration where the scores on most variables were near the mean for each variable. Using cluster analysis and discriminant function analysis, we identified three configurations: one a "master of two" strategy, one "stuck-in-the-middle," and one showing scores well below the mean on most variables. The implications for organization design and manager actions in the health care industry are discussed.

  11. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program. PMID:9335724

  12. Assessing the performance of health technology assessment organizations: a framework.

    PubMed

    Lafortune, Louise; Farand, Lambert; Mondou, Isabelle; Sicotte, Claude; Battista, Renaldo

    2008-01-01

    In light of growing demands for public accountability, the broadening scope of health technology assessment organizations (HTAOs) activities and their increasing role in decision-making underscore the importance for them to demonstrate their performance. Based on Parson's social action theory, we propose a conceptual model that includes four functions an organization needs to balance to perform well: (i) goal attainment, (ii) production, (iii) adaptation to the environment, and (iv) culture and values maintenance. From a review of the HTA literature, we identify specific dimensions pertaining to the four functions and show how they relate to performance. We compare our model with evaluations reported in the scientific and gray literature to confirm its capacity to accommodate various evaluation designs, contexts of evaluation, and organizational models and perspectives. Our findings reveal the dimensions of performance most often assessed and other important ones that, hitherto, remain unexplored. The model provides a flexible and theoretically grounded tool to assess the performance of HTAOs.

  13. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

  14. Effect of Mergers on Health Maintenance Organization Premiums

    PubMed Central

    Feldman, Roger; Wholey, Douglas; Christianson, Jon

    1996-01-01

    This study estimated the effect of mergers on health maintenance organization (HMO) premiums, using data on all operational non-Medicaid HMOs in the United States from 1985 to 1993. Two critical issues were examined: whether HMO mergers increase or decrease premiums; and whether the effects of mergers differ according to the degree of competition among HMOs in local markets. The only significant merger effect was found in the most competitive markets, where premiums increased, but only for 1 year after the merger. Our research does not support the argument that consolidation of HMOs in local markets will benefit consumers through lower premiums. PMID:10158729

  15. Scale and scope economies among health maintenance organizations.

    PubMed

    Wholey, D; Feldman, R; Christianson, J B; Engberg, J

    1996-12-01

    We examine scale and scope economics among Group and IPA Health Maintenance Organizations (HMOs) over the period 1988 to 1991 using a national sample of HMOs. We allow for the multiproduct nature of HMO production by estimating the cost of producing a member month of non-Medicare and Medicare coverage, and we examine the effect of HMO market structure on costs. We find that HMOs benefit from scale economies. There are scope diseconomies associated with providing both non-Medicare and Medicare products. Group HMOs in more competitive markets have lower costs but IPA costs are not affected by competition.

  16. Trends in Medicare Health Maintenance Organization Enrollment: 1986-93

    PubMed Central

    McMillan, Alma

    1993-01-01

    This study examines Medicare health maintenance organization (HMO) enrollment under the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 (Public Law 97-248) from 1986 to 1993. It shows that there was moderate growth in the number of Medicare beneficiaries participating in the TEFRA risk program, reaching 1 in 20 beneficiaries in 1993. Medicare HMO enrollment is heavily concentrated in a few large plans, resulting in heavy concentrations geographically. California and Florida accounted for over one-third of Medicare HMO enrollees. One-half of the States have no Medicare HMO enrollment and one-fifth of the States have fewer than 15,000 Medicare HMO enrollees. PMID:10133705

  17. Alternative geographic configurations for Medicare payments to health maintenance organizations.

    PubMed

    Porell, F W; Tompkins, C P; Turner, W M

    1990-01-01

    Under prevailing legislation, Medicare payments to health maintenance organizations (HMOs) are based upon projected fee-for-service reimbursement levels for enrollees' county of residence. These rates have been criticized in light of substantial variations in rates among neighboring counties and large fluctuations in rates over time. In this study, the use of nine alternative configurations and the county itself were evaluated on the basis of payment-area homogeneity, payment rate stability, and policy criteria, including the fiscal impacts of reconfiguration on HMOs. The results revealed rather modest differences among most alternative configurations and do not lend strong support for payment area reconfiguration at this time. PMID:10113270

  18. 75 FR 55582 - National Institutes of Health Statement of Organization, Functions, and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-13

    ... Delegations of Authority for the Department of Health and Human Services (40 FR 22859, May 27, 1975, as... and Health Disparities (NCMHD) as the National Institute on Minority Health and Health Disparities..., Organization and Functions, under the heading National Center on Minority Health and Health Disparities...

  19. Exploring Business Strategy in Health Information Exchange Organizations.

    PubMed

    Langabeer, James R; Champagne, Tiffany

    2016-01-01

    Unlike consumer goods industries, healthcare has been slow to implement technolo gies that support exchange of data in patients' health records. This results in avoid able medication errors, avoidable hospital readmissions, unnecessary duplicate testing, and other inefficient or wasteful practices. Community-based regional health information exchange (HIE) organizations have evolved in response to federal aims to encourage interoperability, yet little is known about their strategic approach. We use the lens of institutional and strategic management theories to empirically explore the differences in business strategies deployed in HIEs that are, to date, financially sustainable versus those that are not. We developed a 20-question survey targeted to CEOs to assess HIE business strategies. Our sample consisted of 60 community-based exchanges distributed throughout the United States, and we achieved a 58% response rate. Questions centered on competitive strategy and financial sustainability. We relied on logistic regression methods to explore relationships between variables. Our regression identified characteristics common to sustainable organizations. We defined sustainability as revenues exceeding operational costs. Seventeen of the 35 organizations (49%) defined themselves as currently sustainable. Focus and cost leadership strategies were significantly associated with sustainability. Growth strate gies, which were much more common than other strategies, were not associated with sustainability. We saw little evidence of a differentiation strategy (i.e., the basis of competition whereby the attributes of a product or service are unmatched by rivals). Most CEOs had a relatively optimistic outlook, with 60% stating they were confident of surviving over the next 5 years; however, nearly 9% of the organizations were in some phase of divestiture or exit from the market. HIEs are evolving differently based on local leadership decisions, yet their strategic approach is

  20. Exploring Business Strategy in Health Information Exchange Organizations.

    PubMed

    Langabeer, James R; Champagne, Tiffany

    2016-01-01

    Unlike consumer goods industries, healthcare has been slow to implement technolo gies that support exchange of data in patients' health records. This results in avoid able medication errors, avoidable hospital readmissions, unnecessary duplicate testing, and other inefficient or wasteful practices. Community-based regional health information exchange (HIE) organizations have evolved in response to federal aims to encourage interoperability, yet little is known about their strategic approach. We use the lens of institutional and strategic management theories to empirically explore the differences in business strategies deployed in HIEs that are, to date, financially sustainable versus those that are not. We developed a 20-question survey targeted to CEOs to assess HIE business strategies. Our sample consisted of 60 community-based exchanges distributed throughout the United States, and we achieved a 58% response rate. Questions centered on competitive strategy and financial sustainability. We relied on logistic regression methods to explore relationships between variables. Our regression identified characteristics common to sustainable organizations. We defined sustainability as revenues exceeding operational costs. Seventeen of the 35 organizations (49%) defined themselves as currently sustainable. Focus and cost leadership strategies were significantly associated with sustainability. Growth strate gies, which were much more common than other strategies, were not associated with sustainability. We saw little evidence of a differentiation strategy (i.e., the basis of competition whereby the attributes of a product or service are unmatched by rivals). Most CEOs had a relatively optimistic outlook, with 60% stating they were confident of surviving over the next 5 years; however, nearly 9% of the organizations were in some phase of divestiture or exit from the market. HIEs are evolving differently based on local leadership decisions, yet their strategic approach is

  1. Implications for alcohol minimum unit pricing advocacy: what can we learn for public health from UK newsprint coverage of key claim-makers in the policy debate?

    PubMed

    Hilton, Shona; Wood, Karen; Patterson, Chris; Katikireddi, Srinivasa Vittal

    2014-02-01

    On May 24th 2012, Scotland passed the Alcohol (Minimum Pricing) Bill. Minimum unit pricing (MUP) is an intervention that raises the price of the cheapest alcohol to reduce alcohol consumption and related harms. There is a growing literature on industry's influence in policymaking and media representations of policies, but relatively little about frames used by key claim-makers in the public MUP policy debate. This study elucidates the dynamic interplay between key claim-makers to identify lessons for policy advocacy in the media in the UK and internationally. Content analysis was conducted on 262 articles from seven UK and three Scottish national newspapers between 1st May 2011 and 31st May 2012, retrieved from electronic databases. Advocates' and critics' constructions of the alcohol problem and MUP were examined. Advocates depicted the problem as primarily driven by cheap alcohol and marketing, while critics' constructions focused on youth binge drinkers and dependent drinkers. Advocates justified support by citing the intervention's targeted design, but critics denounced the policy as illegal, likely to encourage illicit trade, unsupported by evidence and likely to be ineffective, while harming the responsible majority, low-income consumers and businesses. Critics' arguments were consistent over time, and single statements often encompassed multiple rationales. This study presents advocates with several important lessons for promoting policies in the media. Firstly, it may be useful to shift focus away from young binge drinkers and heavy drinkers, towards population-level over-consumption. Secondly, advocates might focus on presenting the policy as part of a wider package of alcohol policies. Thirdly, emphasis on the success of recent public health policies could help portray the UK and Scotland as world leaders in tackling culturally embedded health and social problems through policy; highlighting past successes when presenting future policies may be a valuable

  2. Implications for alcohol minimum unit pricing advocacy: what can we learn for public health from UK newsprint coverage of key claim-makers in the policy debate?

    PubMed

    Hilton, Shona; Wood, Karen; Patterson, Chris; Katikireddi, Srinivasa Vittal

    2014-02-01

    On May 24th 2012, Scotland passed the Alcohol (Minimum Pricing) Bill. Minimum unit pricing (MUP) is an intervention that raises the price of the cheapest alcohol to reduce alcohol consumption and related harms. There is a growing literature on industry's influence in policymaking and media representations of policies, but relatively little about frames used by key claim-makers in the public MUP policy debate. This study elucidates the dynamic interplay between key claim-makers to identify lessons for policy advocacy in the media in the UK and internationally. Content analysis was conducted on 262 articles from seven UK and three Scottish national newspapers between 1st May 2011 and 31st May 2012, retrieved from electronic databases. Advocates' and critics' constructions of the alcohol problem and MUP were examined. Advocates depicted the problem as primarily driven by cheap alcohol and marketing, while critics' constructions focused on youth binge drinkers and dependent drinkers. Advocates justified support by citing the intervention's targeted design, but critics denounced the policy as illegal, likely to encourage illicit trade, unsupported by evidence and likely to be ineffective, while harming the responsible majority, low-income consumers and businesses. Critics' arguments were consistent over time, and single statements often encompassed multiple rationales. This study presents advocates with several important lessons for promoting policies in the media. Firstly, it may be useful to shift focus away from young binge drinkers and heavy drinkers, towards population-level over-consumption. Secondly, advocates might focus on presenting the policy as part of a wider package of alcohol policies. Thirdly, emphasis on the success of recent public health policies could help portray the UK and Scotland as world leaders in tackling culturally embedded health and social problems through policy; highlighting past successes when presenting future policies may be a valuable

  3. Implications for alcohol minimum unit pricing advocacy: What can we learn for public health from UK newsprint coverage of key claim-makers in the policy debate?

    PubMed Central

    Hilton, Shona; Wood, Karen; Patterson, Chris; Katikireddi, Srinivasa Vittal

    2014-01-01

    On May 24th 2012, Scotland passed the Alcohol (Minimum Pricing) Bill. Minimum unit pricing (MUP) is an intervention that raises the price of the cheapest alcohol to reduce alcohol consumption and related harms. There is a growing literature on industry's influence in policymaking and media representations of policies, but relatively little about frames used by key claim-makers in the public MUP policy debate. This study elucidates the dynamic interplay between key claim-makers to identify lessons for policy advocacy in the media in the UK and internationally. Content analysis was conducted on 262 articles from seven UK and three Scottish national newspapers between 1st May 2011 and 31st May 2012, retrieved from electronic databases. Advocates' and critics' constructions of the alcohol problem and MUP were examined. Advocates depicted the problem as primarily driven by cheap alcohol and marketing, while critics' constructions focused on youth binge drinkers and dependent drinkers. Advocates justified support by citing the intervention's targeted design, but critics denounced the policy as illegal, likely to encourage illicit trade, unsupported by evidence and likely to be ineffective, while harming the responsible majority, low-income consumers and businesses. Critics' arguments were consistent over time, and single statements often encompassed multiple rationales. This study presents advocates with several important lessons for promoting policies in the media. Firstly, it may be useful to shift focus away from young binge drinkers and heavy drinkers, towards population-level over-consumption. Secondly, advocates might focus on presenting the policy as part of a wider package of alcohol policies. Thirdly, emphasis on the success of recent public health policies could help portray the UK and Scotland as world leaders in tackling culturally embedded health and social problems through policy; highlighting past successes when presenting future policies may be a valuable

  4. Transforming health sectors: new logics of organizing in the New Zealand health system.

    PubMed

    Fougere, G

    2001-04-01

    This paper develops a relational analysis (drawing on the insights of historical institutionalism and economic sociology) of the ongoing process of radical health sector restructuring in New Zealand. The original 'reforms', based on a 'purchaser provider' split, are outlined so as to emphasize their politically consequential ambiguity: was restructuring about revitalizing an essentially public health system or about creating the basis for an eventually private health system with a residual state role? The actual process of restructuring is then traced, emphasizing the responses it has evoked from differently situated actors within the health sector as this is entwined with the political system. The focus is on explaining the largely unintended consequences that have resulted, including the abandonment or significant modification of most of the originally enacted forms of organization together with the emergence of new organizational forms, initiated by providers, and largely unanticipated by the restructurers.

  5. 78 FR 49756 - Notification of a Cooperative Agreement Award to the World Health Organization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-15

    ... HUMAN SERVICES Notification of a Cooperative Agreement Award to the World Health Organization AGENCY... Agreement Award to the World Health Organization for a grant titled: ``Smallpox Research Oversight... of smallpox detected by a member state requires notification to World Health Organization (WHO)...

  6. The case for the World Health Organization's Commission on Social Determinants of Health to address gender identity.

    PubMed

    Pega, Frank; Veale, Jaimie F

    2015-03-01

    We analyzed the case of the World Health Organization's Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments, as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH. PMID:25602894

  7. The case for the World Health Organization's Commission on Social Determinants of Health to address gender identity.

    PubMed

    Pega, Frank; Veale, Jaimie F

    2015-03-01

    We analyzed the case of the World Health Organization's Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments, as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH.

  8. Is organic farming safer to farmers’ health? A comparison between organic and traditional farming

    PubMed Central

    Costa, Carla; García-Lestón, Julia; Costa, Solange; Coelho, Patrícia; Silva, Susana; Valdiglesias, Vanessa; Mattei, Francesca; Dall’Armi, Valentina; Bonassi, Stefano; Laffon, Blanca; Snawder, John; Teixeira, João Paulo

    2015-01-01

    Background Exposure to pesticides is a major public health concern, because of the widespread distribution of these compounds and their possible long term effects. Recently, organic farming has been introduced as a consumer and environmental friendly agricultural system, although little is known about the effects on workers’ health. Objectives To evaluate genetic damage and immunological alterations in workers of both traditional and organic farming. Methods Eighty-five farmers exposed to several pesticides, thirty–six organic farmers and sixty-one controls took part in the study. Biomarkers of exposure (pyrethroids, organophosphates, carbamates, and thioethers in urine and butyrylcholinesterase activity in plasma), early effect (micronuclei in lymphocytes and reticulocytes, T-cell receptor mutation assay, chromosomal aberrations, comet assay and lymphocytes subpopulations) and susceptibility (genetic polymorphisms related to metabolism - EPHX1, GSTM1, GSTT1 and GSTP1 - and DNA repair – XRCC1 and XRCC2) were evaluated. Results When compared to controls and organic farmers, pesticide farmers presented a significant increase of micronuclei in lymphocytes (frequency ratio, FR=2.80) and reticulocytes (FR=1.89), chromosomal aberrations (FR=2.19), DNA damage assessed by comet assay (mean ratio, MR=1.71), and a significant decrease in the proportion of B lymphocytes (MR=0.88). Overall, organic farmers presented similar levels of genetic damage as controls, in some cases modulated by GSTT1 and GSTM1, GSTP1 105Ile/Ile and XRCC1 399Gln/Gln genotypes. Conclusions Results confirmed the increased presence of DNA damage in farmers exposed to pesticides, and showed as exposure conditions and genetic background influence observed effects. Findings from this study indicate that no evident genetic or immunologic damage can be observed in organic farmers. PMID:24576785

  9. A theory for classification of health care organizations in the new economy.

    PubMed

    Vimarlund, Vivian; Sjöberg, Cecilia; Timpka, Toomas

    2003-10-01

    Most of the available studies into information technology (IT) have been limited to investigating specific issues, such as how IT can support decision makers distributing the information throughout health care organization, or how technology impacts organizational performance. In this study, for use in the planning of information system development projects, a theoretical model for the classification of health care organizations is proposed. We try to reflect the development in the contemporary digital economy by theoretically classifying health care organizations into three types, namely traditional, developing, and flexible. We describe traditional health care organizations as organizations with a centralized system for management and control. In developing health care organizations, IT is spread over the horizontal dimension and is used for coordinating the different parties throughout the organization. Finally, flexible health care organizations are those which work actively with the design of new health care organizational structure while they are designing the information system.

  10. Microsporidiosis Acquired Through Solid Organ Transplantation: A Public Health Investigation

    PubMed Central

    Hocevar, Susan N.; Paddock, Christopher D.; Spak, Cedric W.; Rosenblatt, Randall; Diaz-Luna, Hector; Castillo, Isabel; Luna, Sergio; Friedman, Glen C.; Antony, Suresh; Stoddard, Robyn A.; Tiller, Rebekah V.; Peterson, Tammie; Blau, Dianna M.; Sriram, Rama R.; da Silva, Alexandre; de Almeida, Marcos; Benedict, Theresa; Goldsmith, Cynthia S.; Zaki, Sherif R.; Visvesvara, Govinda S.; Kuehnert, Matthew J.

    2015-01-01

    Background Encephalitozoon cuniculi, a microsporidial species most commonly recognized as a cause of renal, respiratory, and central nervous system infections in immunosuppressed patients, was identified as the cause of a temporally associated cluster of febrile illness among 3 solid organ transplant recipients from a common donor. Objective To confirm the source of the illness, assess donor and recipient risk factors, and provide therapy recommendations for ill recipients. Design Public health investigation. Setting Two transplant hospitals and community interview with the deceased donor’s family. Patients Three transplant recipients and the organ donor. Measurements Specimens were tested for microsporidia by using culture, immunofluorescent antibody, polymerase chain reaction, immunohistochemistry, and electron microscopy. Donor medical records were reviewed and a questionnaire was developed to assess for microsporidial infection. Results Kidneys and lungs were procured from the deceased donor and transplanted to 3 recipients who became ill with fever 7 to 10 weeks after the transplant. Results of urine culture, serologic, and polymerase chain reaction testing were positive for Encephalitozoon cuniculi of genotype III in each recipient; the organism was also identified in biopsy or autopsy specimens in all recipients. The donor had positive serologic test results for Encephalitozoon cuniculi. Surviving recipients received albendazole. Donor assessment did not identify factors for suspected Encephalitozoon cuniculi infection. Limitation Inability to detect organism by culture or polymerase chain reaction in donor due to lack of autopsy specimens. Conclusion Transmission of microsporidiosis through organ transplantation is described. Microsporidiosis is now recognized as an emerging transplant-associated disease and should be considered in febrile transplant recipients when tests for routinely encountered agents are unrevealing. Donor-derived disease is critical

  11. Global policy for improvement of oral health in the 21st century--implications to oral health research of World Health Assembly 2007, World Health Organization.

    PubMed

    Petersen, Poul Erik

    2009-02-01

    The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past 5 years to increase the awareness of oral health worldwide as oral health is important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and necessary actions to the continuous improvement of oral health. The strategy is that oral disease prevention and the promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years oral health was subject to discussion by those bodies in 2007. At the EB120 and WHA60, the Member States agreed on an action plan for oral health and integrated disease prevention, thereby confirming the approach of the Oral Health Programme. The policy forms the basis for future development or adjustment of oral health programmes at national level. Clinical and public health research has shown that a number of individual, professional and community preventive measures are effective in preventing most oral diseases. However, advances in oral health science have not yet benefited the poor and disadvantaged populations worldwide. The major challenges of the future will be to translate knowledge and experiences in oral disease prevention and health promotion into action programmes. The WHO Global Oral Health Programme invites the international oral health research community to engage further in research capacity building in developing countries, and in strengthening the work so that research is recognized as the foundation of oral heath policy at global level.

  12. The world health organization multicountry survey on maternal and newborn health: study protocol

    PubMed Central

    2011-01-01

    Background Effective interventions to reduce mortality and morbidity in maternal and newborn health already exist. Information about quality and performance of care and the use of critical interventions are useful for shaping improvements in health care and strengthening the contribution of health systems towards the Millennium Development Goals 4 and 5. The near-miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in maternal and newborn health care. This paper presents the methods of the World Health Organization Multicountry Study in Maternal and Newborn Health. The main objectives of this study are to determine the prevalence of maternal near-miss cases in a worldwide network of health facilities, evaluate the quality of care using the maternal near-miss concept and the criterion-based clinical audit, and develop the near-miss concept in neonatal health. Methods/Design This is a large cross-sectional study being implemented in a worldwide network of health facilities. A total of 370 health facilities from 29 countries will take part in this study and produce nearly 275,000 observations. All women giving birth, all maternal near-miss cases regardless of the gestational age and delivery status and all maternal deaths during the study period comprise the study population. In each health facility, medical records of all eligible women will be reviewed during a data collection period that ranges from two to three months according to the annual number of deliveries. Discussion Implementing the systematic identification of near-miss cases, mapping the use of critical evidence-based interventions and analysing the corresponding indicators are just the initial steps for using the maternal near-miss concept as a tool to improve maternal and newborn health. The findings of projects using approaches similar to those described in this manuscript will be a good starter for a more comprehensive dialogue with

  13. World Health Organization approaches for surveys of health behaviour among schoolchildren and for health-promoting schools.

    PubMed

    Honkala, Sisko

    2014-01-01

    Adolescents make up about one-sixth of the world's population. Most of the healthy and detrimental habits are adopted during childhood and adolescence. In the mid 1980s, a cross-national Health Behaviour in School-Aged Children (HBSC) survey was created to increase information about the well-being, health behaviours and social context of young people by using standard school-based questionnaires adopted by the World Health Organization (WHO) European office. The European Network of Health-Promoting Schools (HPS) was commenced in 1992, followed by the establishment of the WHO Global School Health Initiative in 1995. The initiative aims to improve the health of students, school personnel, families and other members of the community through schools by mobilizing and strengthening health promotion and educational activities at local, national, regional and global levels. The HBSC and HPS programmes have been accepted as activity areas for the WHO Collaborating Centre for Primary Oral Health Care in Kuwait. This article describes the HBSC and the HPS programmes and discusses the importance of establishing these programmes in Kuwait.

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

    PubMed

    Newcomer, R; Harrington, C; Friedlob, A

    1990-08-01

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

  15. Is organic farming safer to farmers' health? A comparison between organic and traditional farming.

    PubMed

    Costa, Carla; García-Lestón, Julia; Costa, Solange; Coelho, Patrícia; Silva, Susana; Pingarilho, Marta; Valdiglesias, Vanessa; Mattei, Francesca; Dall'Armi, Valentina; Bonassi, Stefano; Laffon, Blanca; Snawder, John; Teixeira, João Paulo

    2014-10-15

    Exposure to pesticides is a major public health concern, because of the widespread distribution of these compounds and their possible long term effects. Recently, organic farming has been introduced as a consumer and environmental friendly agricultural system, although little is known about the effects on workers' health. The aim of this work was to evaluate genetic damage and immunological alterations in workers of both traditional and organic farming. Eighty-five farmers exposed to several pesticides, thirty-six organic farmers and sixty-one controls took part in the study. Biomarkers of exposure (pyrethroids, organophosphates, carbamates, and thioethers in urine and butyrylcholinesterase activity in plasma), early effect (micronuclei in lymphocytes and reticulocytes, T-cell receptor mutation assay, chromosomal aberrations, comet assay and lymphocytes subpopulations) and susceptibility (genetic polymorphisms related to metabolism - EPHX1, GSTM1, GSTT1 and GSTP1 - and DNA repair-XRCC1 and XRCC2) were evaluated. When compared to controls and organic farmers, pesticide farmers presented a significant increase of micronuclei in lymphocytes (frequency ratio, FR=2.80) and reticulocytes (FR=1.89), chromosomal aberrations (FR=2.19), DNA damage assessed by comet assay (mean ratio, MR=1.71), and a significant decrease in the proportion of B lymphocytes (MR=0.88). Results were not consistent for organic farmers when compared to controls, with a 48% increase of micronuclei in lumphocytes frequency (p=0.016) contrasted by the significant decreases of TCR-Mf (p=0.001) and %T (p=0.001). Our data confirm the increased presence of DNA damage in farmers exposed to pesticides, and show as exposure conditions may influence observed effects. These results must be interpreted with caution due to the small size of the sample and the unbalanced distribution of individuals in the three study groups.

  16. The role of health professional organizations in improving maternal and newborn health: The FIGO LOGIC experience.

    PubMed

    Taylor, David J

    2015-10-01

    The FIGO Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health improved the internal and external capacity of eight national professional organizations of obstetrics and gynecology in six African and two Asian countries. The initiative was funded by a grant from the Bill and Melinda Gates Foundation and had three key objectives: to support the eight FIGO member associations to strengthen their capacity to work effectively; to influence national policies on maternal and newborn health; and to work toward improving clinical practice in this area. Through improved capacity, and underpinned by Memoranda of Understanding with their governments, the associations influenced national policy in maternal and newborn health, impacted clinical care through the development of over forty national clinical guidelines, delivered national curricula, trained clinical and management staff, and led the development of national maternal death and near-miss review programs.

  17. The World Health Organization Library (Geneva) and Health Literature Services Programme.

    PubMed Central

    Ruff, B

    1988-01-01

    The origins and functions of the World Health Organization (WHO) Library and the global, regional, and national objectives of the WHO Health Literature Services Program (HLSP) are reviewed. WHO is an aggregate of nations and not a supra-national body. With limited resources and unlimited needs, HLSP is involved in surveys, training, regional medical libraries, national and regional networks, bibliographic services and document delivery, promotion, coordination, and communication. The basic concept of HLSP eschews internationally-conceived, self-contained technical projects in favor of broad programs based on national planning. Small rural centers receive more attention than large urban hospitals, and preventive medicine together with health education and community involvement are of more immediate concern than curative medicine. National self-reliance implies national initiative but not necessarily national self-sufficiency. Recent planning and implementation of HLSP activities are described. PMID:3370376

  18. Food protection activities of the Pan American Health Organization.

    PubMed

    1994-03-01

    One of the most widespread health problems in the Caribbean and Latin America is contaminated food and foodborne illness. The Pan American Health Organization (PAHO) has been a major force in activities to strengthen food protection. The program within the regional Program of Technical Cooperation is administered by the Veterinary Public Health program and under the guidance of the Pan American Institute for Food protection and Zoonoses in Buenos Aires, Argentina. A food action plan for 1986-90 was established at the 1986 Pan American Sanitary Conference, and extended to cover 1991-95. Program activities during the 1990s covered cholera, epidemiologic surveillance, street food vendors, shellfish poisoning, meat, national programs, information systems, air catering, food irradiation, and tourism. The action plan for 1991-95 promoted greater political support and cooperation within and between related sectors and institutions, management, and education. The aims were to organize national integrated programs, to strengthen laboratory services, to strengthen inspection services, to establish epidemiologic surveillance systems, and to promote food protection through community participation. Program activities included the initiatives of the Veterinary Public Health Program in 1991 to distribute literature on the transmission of cholera by foods. Studies were conducted in Bolivia, Colombia, and Peru on food contamination. Microbiologists received training on standard methods for detecting Vibrio cholerae in foods. A working group of experts from 10 countries examined the issues and produced a guide for investigating the incidence of foodborne disease. PAHO has contributed to the formation of an Inter-American Network for Epidemiologic Surveillance of Foodborne Diseases. PAHO has worked to improve hygienic practices among street food vendors. Seminars on paralytic shellfish poisoning were conducted in 1990; the outcome was a network working to strengthen national

  19. Development of Health Equity Indicators in Primary Health Care Organizations Using a Modified Delphi

    PubMed Central

    Wong, Sabrina T.; Browne, Annette J.; Varcoe, Colleen; Lavoie, Josée; Fridkin, Alycia; Smye, Victoria; Godwin, Olive; Tu, David

    2014-01-01

    Objective The purpose of this study was to develop a core set of indicators that could be used for measuring and monitoring the performance of primary health care organizations' capacity and strategies for enhancing equity-oriented care. Methods Indicators were constructed based on a review of the literature and a thematic analysis of interview data with patients and staff (n = 114) using procedures for qualitatively derived data. We used a modified Delphi process where the indicators were circulated to staff at the Health Centers who served as participants (n = 63) over two rounds. Indicators were considered part of a priority set of health equity indicators if they received an overall importance rating of>8.0, on a scale of 1–9, where a higher score meant more importance. Results Seventeen indicators make up the priority set. Items were eliminated because they were rated as low importance (<8.0) in both rounds and were either redundant or more than one participant commented that taking action on the indicator was highly unlikely. In order to achieve health care equity, performance at the organizational level is as important as assessing the performance of staff. Two of the highest rated “treatment” or processes of care indicators reflects the need for culturally safe and trauma and violence-informed care. There are four indicators that can be used to measure outcomes which can be directly attributable to equity responsive primary health care. Discussion These indicators and subsequent development of items can be used to measure equity in the domains of treatment and outcomes. These areas represent targets for higher performance in relation to equity for organizations (e.g., funding allocations to ongoing training in equity-oriented care provision) and providers (e.g., reflexive practice, skill in working with the health effects of trauma). PMID:25478914

  20. Alternative geographic adjustments in Medicare payment to health maintenance organizations

    PubMed Central

    Welch, W. Pete

    1992-01-01

    The payment received by a health maintenance organization (HMO) for its Medicare enrollees is proportionate to the average cost of Medicare beneficiaries in that county. However, HMO market share in an area appears to decrease costs in the fee-for-service sector, so that HMOs are paid less. For this and other reasons, alternative payment formulas may be desirable and several are developed in this article. The conceptually simplest location factor would be an input price index. An alternative strategy would also recognize systematic variation in utilization. Utilization rate is regressed on variables such as county population density and physicians per 1,000 persons. The predicted utilization rate times an input price index could serve as a location factor. The value of alternative location factors are presented for specific counties. PMID:10120186

  1. Managing facility risk: external threats and health care organizations.

    PubMed

    Reid, Daniel J; Reid, William H

    2014-01-01

    Clinicians and clinical administrators should have a basic understanding of physical and financial risk to mental health facilities related to external physical threat, including actions usually viewed as "terrorism" and much more common sources of violence. This article refers to threats from mentally ill persons and those acting out of bizarre or misguided "revenge," extortionists and other outright criminals, and perpetrators usually identified as domestic or international terrorists. The principles apply both to relatively small and contained acts (such as a patient or ex-patient attacking a staff member) and to much larger events (such as bombings and armed attack), and are relevant to facilities both within and outside the U.S. Patient care and accessibility to mental health services rest not only on clinical skills, but also on a place to practice them and an organized system supported by staff, physical facilities, and funding. Clinicians who have some familiarity with the non-clinical requirements for care are in a position to support non-clinical staff in preventing care from being interrupted by external threats or events such as terrorist activity, and/or to serve at the interface of facility operations and direct clinical care. Readers should note that this article is an introduction to the topic and cannot address all local, state and national standards for hospital safety, or insurance providers' individual facility requirements. PMID:24733720

  2. Surgical Safety Training of World Health Organization Initiatives.

    PubMed

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

    2014-01-01

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

  3. Mental health care in the accountable care organization.

    PubMed

    Maust, Donovan T; Oslin, David W; Marcus, Steven C

    2013-09-01

    The Centers for Medicare and Medicaid Services (CMS) is promoting formation of accountable care organizations (ACOs). In these population-based models, CMS aligns a Medicare beneficiary population to an ACO with associated expenditure and quality targets, transitioning away from purely volume-based revenue of fee-for-service Medicare. Patients with mental illness are among high-cost Medicare beneficiaries, but this population has received little attention in ACO implementation. Although the ACO goals of providing chronic and preventive care in a coordinated, patient-centered manner are consistent with what some mental health providers have long advocated, the population-based orientation may be unfamiliar. In addressing the needs of high-cost, high-risk patients to meet quality and expenditure targets, an ACO should examine the quality of mental health care it provides as well as medical quality for patients with mental illness. In addition, federal agencies should invest to ensure understanding of the impact of population-based initiatives on patients with mental illness.

  4. The quality of ambulatory care in Medicare health maintenance organizations.

    PubMed

    Retchin, S M; Brown, B

    1990-04-01

    The quality of ambulatory care received by Medicare recipients who enrolled in health maintenance organizations (HMOs) was compared to the care received by fee-for-service (FFS) Medicare recipients, in a quasi-experimental, non-randomized design. Both samples were drawn from the four major geographic areas in the country, and included two types of HMO practices: staff/group models, and independent practice associations (IPAs). A panel of expert physicians developed criteria for evaluating ambulatory care, and medical record abstractions using these criteria were performed on 1,590 outpatient records: 777 FFS and 813 HMO (441 staff/group, 372 IPA). While individual items of medical histories and physical examinations were performed most often for staff/group HMO patients and least often in FFS patients, odds ratios (OR) for performance in staff/group HMO patients were particularly large for health maintenance items: tonometry (OR = 8.4), mammography (OR = 2.7), pelvic examination (OR = 5.3), rectal examination (OR = 2.9), fecal occult blood test (OR = 3.3). The results suggest that recommended elements of routine and preventive care are more likely to be performed for Medicare enrollees in staff/group HMOs than in FFS settings.

  5. Financial risk sharing with providers in health maintenance organizations, 1999.

    PubMed

    Gold, Marsha R; Lake, Timothy; Hurley, Robert; Sinclair, Michael

    2002-01-01

    The transfer of financial risk from health maintenance organizations (HMOs) to providers is controversial. To provide timely national data on these practices, we conducted a telephone survey in 1999 of a multi-staged probability sample of HMOs in 20 of the nation's 60 largest markets, accounting for 86% of all HMO enrollees nationally. Among those sampled, 82% responded. We found that HMOs' provider networks with physicians, hospitals, skilled nursing homes, and home health agencies are complex and multi-tiered Seventy-six percent of HMOs in our study use contracts for their HMO products that involve global, professional services, or hospital risk capitation to intermediate entities. These arrangements account for between 24.5 million and 27.4 million of the 55.9 million commercial and Medicare HMO enrollees in the 60 largest markets. While capitation arrangements are particularly common in California, they are more common elsewhere than many assume. The complex layering of risk sharing and delegation of care management responsibility raise questions about accountability and administrative costs in managed care. Do complex structures provide a way to involve providers more directly in managed care, or do they diffuse authority and add to administrative costs? PMID:12067073

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

    PubMed

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

    2012-12-01

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

  7. Privacy policy analysis for health information networks and regional health information organizations.

    PubMed

    Noblin, Alice M

    2007-01-01

    Regional Health Information Organizations (RHIOs) are forming in response to President George W. Bush's 2004 mandate that medical information be made available electronically to facilitate continuity of care. Privacy concerns are a deterrent to widespread acceptance of RHIOs. The Health Information Portability and Accountability Act of 1996 provides some guidelines for privacy protection. However, most states have stricter guidelines, causing difficulty when RHIOs form across these jurisdictions. This article compares several RHIOs including their privacy policies where available. In addition, studies were reviewed considering privacy concerns of people in the United States and elsewhere. Surveys reveal that Americans are concerned about the privacy of their personal health information and ultimately feel it is the role of the government to provide protection. The purpose of this article is to look at the privacy issues and recommend a policy that may help to resolve some of the concerns of both providers and patients. Policy research and action are needed to move the National Health Information Network toward reality. Efforts to provide consistency in privacy laws are a necessary early step to facilitate the construction and maintenance of RHIOs and the National Health Information Network.

  8. Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

    PubMed

    Silva, Vanessa Costa E; Barbosa, Pedro Ribeiro; Hortale, Virgínia Alonso

    2016-05-01

    This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants. This management model facilitated the expansion of access to primary healthcare through the Family Health Strategy in Rio - where the population covered increased from 7.2% of the population in 2008 to 45.5% in 2015. The results showthat some practices in the contractual logic need to be improved, including negotiation and accountability with autonomywith the service suppliers. Evaluation and control has focus on processes, not results, and there has not been an increase in transparency and social control. The system of performance incentives has been reported as inducing improvements in the work process of the health teams. It is concluded that the regulatory capacity of the municipal management would need to be improved. On the other hand, there is an important and significant process of learning in progress. PMID:27166887

  9. Self-organizing wireless sensor networks for structural health monitoring

    NASA Astrophysics Data System (ADS)

    Basheer, Mohammed R.; Rao, Vittal S.; Derriso, Mark M.

    2003-07-01

    A smart sensor node has been developed which has (a) the ability to sense strain of the structure under observation, (b) process this raw sensor data in cooperation with its neighbors and (c) transmit the information to the end user. This network is designed to be self organizing in the sense of establishing and maintaining the inter node connectivity without the need for human intervention. For the envisioned application of structural health monitoring, wireless communication is the most practical solution for node interconnectivity not only because they eliminate interconnecting cables but also for their ability to establish communication links even in inaccessible regions. But wireless nework brings with it a number of issues such as interference, fault tolerant self organizing, multi-hop communication, energy effieiciency, routing and finally reliable operation in spite of massive complexity of the sysetm. This paper addresses the issue of fault tolerant self organiing in wireless sensor networks. We propose a new architecture called the Redundant Tree Network (RTN). RTN is a hierarchical network which exploits redundant links between nodes to provide reliability.

  10. Organ Donation Among Tiers of Health Workers: Expanding Resources to Optimize Organ Availability in a Developing Country

    PubMed Central

    Oluyombo, Rotimi; Fawale, Bimbo Michael; Busari, Olusegun Adesola; Ogunmola, Jeffery Olarinde; Olanrewaju, Timothy Olusegun; Akinleye, Callistus Adewale; Ojewola, Rufus Wale; Yusuf, Musah; Obajolowo, Omotola; Soje, Michael; Gbadegesin, Babajide

    2016-01-01

    The global increase in end organ failure but disproportional shortage of organ donation calls for attention. Expanding the organ pool by assessing and improving health workers' attitude at all levels of care may be a worthwhile initiative. Methods A questionnaire-based cross sectional study involving tertiary, secondary, and primary health institutions in Southwestern Nigeria was conducted. Results Age range was 18 to 62 (36.7 ± 9.2) years. Only 13.5%, 11.7%, and 11.2% from primary, secondary, and tertiary health centers, respectively, would definitely donate despite high level of awareness (>90%) at each level of care. Participants from primary health care are of low income (P < 0.05), and this cohort is less likely to be aware of organ donation (P < 0.05). At each level of care, permission by religion to donate organs influenced positive attitudes (willingness to donate, readiness to counsel families of potential donors, and signing of organ donation cards) toward organ donation. Good knowledge of organ donation only significantly influenced readiness to counsel donors (P < 0.05) and not willingness to donate (P > 0.05). At each level of health care, young health care workers (P < 0.05) and women (P > 0.05) would be willing to donate, whereas men show positive attitude in signing of organ donor cards (P < 0.05) and counseling of families of potential donors (P > 0.05). Conclusions Knowledge and willingness to donate organs among health care levels were not different. Considering the potential advantage of community placement of other tiers of health care (primary and secondary) in Nigeria, integrating them would be strategically beneficial to organ donation. PMID:27500245

  11. The World Health Organization and public health research and practice in tuberculosis in India.

    PubMed

    Banerji, Debabar

    2012-01-01

    Two major research studies carried out in India fundamentally affected tuberculosis treatment practices worldwide. One study demonstrated that home treatment of the disease is as efficacious as sanatorium treatment. The other showed that BCG vaccination is of little protective value from a public health viewpoint. India had brought together an interdisciplinary team at the National Tuberculosis Institute (NTI) with a mandate to formulate a nationally applicable, socially acceptable, and epidemiologically sound National Tuberculosis Programme (NTP). Work at the NTI laid the foundation for developing an operational research approach to dealing with tuberculosis as a public health problem. The starting point for this was not operational research as enunciated by experts in this field; rather, the NTI achieved operational research by starting from the people. This approach was enthusiastically welcomed by the World Health Organization's Expert Committee on Tuberculosis of 1964. The NTP was designed to "sink or sail with the general health services of the country." The program was dealt a major blow when, starting in 1967, a virtual hysteria was worked up to mobilize most of the health services for imposing birth control on the people. Another blow to the general health services occurred when the WHO joined the rich countries in instituting a number of vertical programs called "Global Initiatives". An ill-conceived, ill-designed, and ill-managed Global Programme for Tuberculosis was one outcome. The WHO has shown rank public health incompetence in taking a very casual approach to operational research and has been downright quixotic in its thinking on controlling tuberculosis worldwide.

  12. New Summary Measures of Population Health and Well-Being for Implementation by Health Plans and Accountable Care Organizations.

    PubMed

    Kottke, Thomas E; Gallagher, Jason M; Rauri, Sachin; Tillema, Juliana O; Pronk, Nicolaas P; Knudson, Susan M

    2016-01-01

    Health plans and accountable care organizations measure many indicators of patient health, with standard metrics that track factors such as patient experience and cost. They lack, however, a summary measure of the third leg of the Triple Aim, population health. In response, HealthPartners has developed summary measures that align with the recommendations of the For the Public's Health series of reports from the Institute of Medicine. (The series comprises the following 3 reports: For the Public's Health: Investing in a Healthier Future, For the Public's Health: Revitalizing Law and Policy to Meet New Challenges, and For the Public's Health: The Role of Measurement in Action and Accountability.) The summary measures comprise 3 components: current health, sustainability of health, and well-being. The measure of current health is disability-adjusted life years (DALYs) calculated from health care claims and death records. The sustainability of health measure comprises member reporting of 6 behaviors associated with health plus a clinical preventive services index that indicates adherence to evidence-based preventive care guidelines. Life satisfaction represents the summary measure of subjective well-being. HealthPartners will use the summary measures to identify and address conditions and factors that have the greatest impact on the health and well-being of its patients, members, and community. The method could easily be implemented by other institutions and organizations in the United States, helping to address a persistent need in population health measurement for improvement. PMID:27390075

  13. New Summary Measures of Population Health and Well-Being for Implementation by Health Plans and Accountable Care Organizations

    PubMed Central

    Gallagher, Jason M.; Rauri, Sachin; Tillema, Juliana O.; Pronk, Nicolaas P.; Knudson, Susan M.

    2016-01-01

    Health plans and accountable care organizations measure many indicators of patient health, with standard metrics that track factors such as patient experience and cost. They lack, however, a summary measure of the third leg of the Triple Aim, population health. In response, HealthPartners has developed summary measures that align with the recommendations of the For the Public’s Health series of reports from the Institute of Medicine. (The series comprises the following 3 reports: For the Public’s Health: Investing in a Healthier Future, For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges, and For the Public’s Health: The Role of Measurement in Action and Accountability.) The summary measures comprise 3 components: current health, sustainability of health, and well-being. The measure of current health is disability-adjusted life years (DALYs) calculated from health care claims and death records. The sustainability of health measure comprises member reporting of 6 behaviors associated with health plus a clinical preventive services index that indicates adherence to evidence-based preventive care guidelines. Life satisfaction represents the summary measure of subjective well-being. HealthPartners will use the summary measures to identify and address conditions and factors that have the greatest impact on the health and well-being of its patients, members, and community. The method could easily be implemented by other institutions and organizations in the United States, helping to address a persistent need in population health measurement for improvement. PMID:27390075

  14. 76 FR 37817 - Cooperative Agreement With the World Health Organization Department of Food Safety and Zoonoses...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Cooperative Agreement With the World Health Organization... source cooperative agreement with the World Health Organization (WHO). The goal of the Food and...

  15. 76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Child Health Patient Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Child Health Patient Safety Organization, Inc. AGENCY: Agency for Healthcare Research and... relinquishment from Child Health Patient Safety Organization, Inc. of its status as a Patient Safety...

  16. 77 FR 11120 - Patient Safety Organizations: Voluntary Relinquishment From UAB Health System Patient Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From UAB Health System Patient Safety Organization AGENCY: Agency for Healthcare Research and... relinquishment from the UAB Health System Patient Safety Organization of its status as a Patient...

  17. Hybrids do it better: Lessons from websites of hybrid organizations in modern health movements.

    PubMed

    Striley, Katie Margavio; Field-Springer, Kimberly

    2016-01-01

    Hybrid organizations in modern health movements adopt multiple organizational logistics, allowing them to more effectively achieve social change. We conducted an analysis of 152 probreastfeeding organization websites categorized as institutionalized organizations, grassroots organizations, or hybrid organizations. Through a series of ANOVA analyses, we found that hybrid's websites provide significantly more useful health care information, better maintained dialogue with members, more efficiently mobilized members, commoditized health care issues less, and created member identity while maintaining institutional ties. Ultimately, hybrids tended to incorporate the positive elements from both grassroots and institutional organizations, while rejecting many of the negative elements. PMID:26950536

  18. [Health maintenance organizations: starting point of a market economical reform of health care].

    PubMed

    Hauser, H

    1981-05-01

    The present work was based on the observations that, as regards health care costs, the major problem in most present systems is that those who are responsible for the treatment decision (physician and patient) do not bear a direct financial responsibility for it, and that the overall system is very fragmented, which leads to numerous externalities. In accordance with this diagnosis, a reform strategy should particularly aim at creating units which are responsible for the provision and the financial coverage of comprehensive health services to a given population. Health Maintenance Organizations (HMOs) are a private economy oriented solution in this direction. They have proved to be a real possibility in the USA over years, at least for part of the population, and show interesting performances as regards costs. They were able to develop and evolve in the largely open US institutional framework. In Switzerland, we have more strongly structured systems, which appear to stand in relative contradiction to the HMO solution. A potential adaptation of the concept to our country would therefore require a preliminary in depth discussion about the meaning of the present collective (insurance) contract structure, the position of hospitals in a private economy health care system as well as about the conditions of the sought for competition in the HMO model. PMID:7303928

  19. Health organizations providing and seeking social support: a Twitter-based content analysis.

    PubMed

    Rui, Jian Raymond; Chen, Yixin; Damiano, Amanda

    2013-09-01

    Providing and seeking social support are important aspects of social exchange. New communication technologies, especially social network sites (SNSs), facilitate the process of support exchange. An increasing number of health organizations are using SNSs. However, how they provide and seek social support via SNSs has yet to garner academic attention. This study examined the types of social support provided and sought by health organizations on Twitter. A content analysis was conducted on 1,500 tweets sent by a random sample of 58 health organizations within 2 months. Findings indicate that providing informational and emotional support, as well as seeking instrumental support, were the main types of social support exchanged by health organizations through Twitter. This study provides a typology for studying social support exchanges by health organizations, and recommends strategies for health organizations regarding the effective use of Twitter.

  20. Health-related quality of life and perceived need for mental health services in adolescent solid organ transplant recipients.

    PubMed

    Reed-Knight, Bonney; Loiselle, Kristin A; Devine, Katie A; Simons, Laura E; Mee, Laura L; Blount, Ronald L

    2013-03-01

    The purpose of the current investigation was to assess interest in mental health services among parents of adolescent solid organ transplant recipients and the relationship between parent perceived need for mental health services and patient health-related quality of life (HRQOL). Sixty-three parents rated interest in receiving 10 mental health services, and patient HRQOL ratings were gathered from adolescent transplant recipients and their parents. Ninety-four percent of parents expressed some level of interest in at least one of the proposed services, with over 40 % indicating maximum interest. Parents' perceived need for mental health services was inversely related to adolescent and parent reports of HRQOL on the behavior, mental health, family cohesion, and parental impact-emotional domains. Results suggest that parents of adolescent solid organ transplant recipients are interested in receiving mental health services for their families. Assessment of need for mental health services and HRQOL may inform the medical team of families requiring intervention.

  1. Cost-effectiveness analysis of computerized ECG interpretation system in an ambulatory health care organization.

    PubMed

    Carel, R S

    1982-04-01

    The cost-effectiveness of a computerized ECG interpretation system in an ambulatory health care organization has been evaluated in comparison with a conventional (manual) system. The automated system was shown to be more cost-effective at a minimum load of 2,500 patients/month. At larger monthly loads an even greater cost-effectiveness was found, the average cost/ECG being about $2. In the manual system the cost/unit is practically independent of patient load. This is primarily due to the fact that 87% of the cost/ECG is attributable to wages and fees of highly trained personnel. In the automated system, on the other hand, the cost/ECG is heavily dependent on examinee load. This is due to the relatively large impact of equipment depreciation on fixed (and total) cost. Utilization of a computer-assisted system leads to marked reduction in cardiologists' interpretation time, substantially shorter turnaround time (of unconfirmed reports), and potential provision of simultaneous service at several remotely located "heart stations."

  2. Global Health Security Demands a Strong International Health Regulations Treaty and Leadership From a Highly Resourced World Health Organization.

    PubMed

    Burkle, Frederick M

    2015-10-01

    If the Ebola tragedy of West Africa has taught us anything, it should be that the 2005 International Health Regulations (IHR) Treaty, which gave unprecedented authority to the World Health Organization (WHO) to provide global public health security during public health emergencies of international concern, has fallen severely short of its original goal. After encouraging successes with the 2003 severe acute respiratory syndrome (SARS) pandemic, the intent of the legally binding Treaty to improve the capacity of all countries to detect, assess, notify, and respond to public health threats has shamefully lapsed. Despite the granting of 2-year extensions in 2012 to countries to meet core surveillance and response requirements, less than 20% of countries have complied. Today it is not realistic to expect that these gaps will be solved or narrowed in the foreseeable future by the IHR or the WHO alone under current provisions. The unfortunate failures that culminated in an inadequate response to the Ebola epidemic in West Africa are multifactorial, including funding, staffing, and poor leadership decisions, but all are reversible. A rush by the Global Health Security Agenda partners to fill critical gaps in administrative and operational areas has been crucial in the short term, but questions remain as to the real priorities of the G20 as time elapses and critical gaps in public health protections and infrastructure take precedence over the economic and security needs of the developed world. The response from the Global Outbreak Alert and Response Network and foreign medical teams to Ebola proved indispensable to global health security, but both deserve stronger strategic capacity support and institutional status under the WHO leadership granted by the IHR Treaty. Treaties are the most successful means the world has in preventing, preparing for, and controlling epidemics in an increasingly globalized world. Other options are not sustainable. Given the gravity of ongoing

  3. Global Health Security Demands a Strong International Health Regulations Treaty and Leadership From a Highly Resourced World Health Organization.

    PubMed

    Burkle, Frederick M

    2015-10-01

    If the Ebola tragedy of West Africa has taught us anything, it should be that the 2005 International Health Regulations (IHR) Treaty, which gave unprecedented authority to the World Health Organization (WHO) to provide global public health security during public health emergencies of international concern, has fallen severely short of its original goal. After encouraging successes with the 2003 severe acute respiratory syndrome (SARS) pandemic, the intent of the legally binding Treaty to improve the capacity of all countries to detect, assess, notify, and respond to public health threats has shamefully lapsed. Despite the granting of 2-year extensions in 2012 to countries to meet core surveillance and response requirements, less than 20% of countries have complied. Today it is not realistic to expect that these gaps will be solved or narrowed in the foreseeable future by the IHR or the WHO alone under current provisions. The unfortunate failures that culminated in an inadequate response to the Ebola epidemic in West Africa are multifactorial, including funding, staffing, and poor leadership decisions, but all are reversible. A rush by the Global Health Security Agenda partners to fill critical gaps in administrative and operational areas has been crucial in the short term, but questions remain as to the real priorities of the G20 as time elapses and critical gaps in public health protections and infrastructure take precedence over the economic and security needs of the developed world. The response from the Global Outbreak Alert and Response Network and foreign medical teams to Ebola proved indispensable to global health security, but both deserve stronger strategic capacity support and institutional status under the WHO leadership granted by the IHR Treaty. Treaties are the most successful means the world has in preventing, preparing for, and controlling epidemics in an increasingly globalized world. Other options are not sustainable. Given the gravity of ongoing

  4. The case for the World Health Organization's Commission on the Social Determinants of Health to address sexual orientation.

    PubMed

    Logie, Carmen

    2012-07-01

    The World Health Organization's (WHO's) social determinants of health discussion underscores the need for health equity and social justice. Yet sexual orientation was not addressed within the WHO Commission on the Social Determinants of Health final report Closing the Gap in a Generation. This omission of sexual orientation as a social determinant of health stands in stark contrast with a body of evidence that demonstrates that sexual minorities are disproportionately affected by health problems associated with stigma and discrimination, such as mental health disorders. I propose strategies to integrate sexual orientation into the WHO's social determinants of health dialogue. Recognizing sexual orientation as a social determinant of health is an important first step toward health equity for sexual minorities.

  5. Grafting Perspective into Health Law: Organ Transplantation as a Tool for Teaching.

    ERIC Educational Resources Information Center

    Bovbjerg, Randall R.

    1988-01-01

    The topic of organ transplantation adds interest and perspective to the basic health law curriculum. It can be used well to integrate a variety of topics by focusing on the policy and law of organ rationing. (MSE)

  6. Advancing the right to health through global organizations: The potential role of a Framework Convention on Global Health.

    PubMed

    Friedman, Eric A; Gostin, Lawrence O; Buse, Kent

    2013-06-14

    Organizations, partnerships, and alliances form the building blocks of global governance. Global health organizations thus have the potential to play a formative role in determining the extent to which people are able to realize their right to health. This article examines how major global health organizations, such as WHO, the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, and GAVI approach human rights concerns, including equality, accountability, and inclusive participation. We argue that organizational support for the right to health must transition from ad hoc and partial to permanent and comprehensive. Drawing on the literature and our knowledge of global health organizations, we offer good practices that point to ways in which such agencies can advance the right to health, covering nine areas: 1) participation and representation in governance processes; 2) leadership and organizational ethos; 3) internal policies; 4) norm-setting and promotion; 5) organizational leadership through advocacy and communication; 6) monitoring and accountability; 7) capacity building; 8) funding policies; and 9) partnerships and engagement. In each of these areas, we offer elements of a proposed Framework Convention on Global Health (FCGH), which would commit state parties to support these standards through their board membership and other interactions with these agencies. We also explain how the FCGH could incorporate these organizations into its overall financing framework, initiate a new forum where they collaborate with each other, as well as organizations in other regimes, to advance the right to health, and ensure sufficient funding for right to health capacity building. We urge major global health organizations to follow the leadership of the UN Secretary-General and UNAIDS to champion the FCGH. It is only through a rights-based approach, enshrined in a new Convention, that we can expect to achieve health for all in our lifetimes.

  7. Organization of ambulatory care provision: a critical determinant of health system performance in developing countries.

    PubMed Central

    Berman, P.

    2000-01-01

    Success in the provision of ambulatory personal health services, i.e. providing individuals with treatment for acute illness and preventive health care on an ambulatory basis, is the most significant contributor to the health care system's performance in most developing countries. Ambulatory personal health care has the potential to contribute the largest immediate gains in health status in populations, especially for the poor. At present, such health care accounts for the largest share of the total health expenditure in most lower income countries. It frequently comprises the largest share of the financial burden on households associated with health care consumption, which is typically regressively distributed. The "organization" of ambulatory personal health services is a critical determinant of the health system's performance which, at present, is poorly understood and insufficiently considered in policies and programmes for reforming health care systems. This article begins with a brief analysis of the importance of ambulatory care in the overall health system performance and this is followed by a summary of the inadequate global data on ambulatory care organization. It then defines the concept of "macro organization of health care" at a system level. Outlined also is a framework for analysing the organization of health care services and the major pathways through which the organization of ambulatory personal health care services can affect system performance. Examples of recent policy interventions to influence primary care organization--both government and nongovernmental providers and market structure--are reviewed. It is argued that the characteristics of health care markets in developing countries and of most primary care goods result in relatively diverse and competitive environments for ambulatory care services, compared with other types of health care. Therefore, governments will be required to use a variety of approaches beyond direct public provision

  8. Public health safety and transplant with increased-risk organs: striking the balance.

    PubMed

    Batra, Ramesh; Katariya, Nitin; Hewitt, Winston; Mathur, Amit; Reddy, Sudhakar; Moss, Adyr; Segev, Dorry; Singer, Andrew

    2015-04-01

    There is significant variability amongst transplant centers, Organ Procurement Organizations (OPO), members of public, and patients about organs from Public Health Service increased risk donors. This has therefore required regulatory bodies like Centers for Disease Control and Prevention to formulate policies for transplant centers and OPOs to minimize risk of infectious transmission to recipients of solid-organ transplants from such donors.

  9. Closing the health equity gap: evidence-based strategies for primary health care organizations

    PubMed Central

    2012-01-01

    Introduction International evidence shows that enhancement of primary health care (PHC) services for disadvantaged populations is essential to reducing health and health care inequities. However, little is known about how to enhance equity at the organizational level within the PHC sector. Drawing on research conducted at two PHC Centres in Canada whose explicit mandates are to provide services to marginalized populations, the purpose of this paper is to discuss (a) the key dimensions of equity-oriented services to guide PHC organizations, and (b) strategies for operationalizing equity-oriented PHC services, particularly for marginalized populations. Methods The PHC Centres are located in two cities within urban neighborhoods recognized as among the poorest in Canada. Using a mixed methods ethnographic design, data were collected through intensive immersion in the Centres, and included: (a) in-depth interviews with a total of 114 participants (73 patients; 41 staff), (b) over 900 hours of participant observation, and (c) an analysis of key organizational documents, which shed light on the policy and funding environments. Results Through our analysis, we identified four key dimensions of equity-oriented PHC services: inequity-responsive care; trauma- and violence-informed care; contextually-tailored care; and culturally-competent care. The operationalization of these key dimensions are identified as 10 strategies that intersect to optimize the effectiveness of PHC services, particularly through improvements in the quality of care, an improved 'fit' between people's needs and services, enhanced trust and engagement by patients, and a shift from crisis-oriented care to continuity of care. Using illustrative examples from the data, these strategies are discussed to illuminate their relevance at three inter-related levels: organizational, clinical programming, and patient-provider interactions. Conclusions These evidence- and theoretically-informed key dimensions and

  10. Organization of health care in small plants in the USA

    PubMed Central

    Miller, Seward E.

    1955-01-01

    In the USA, the concept of an occupational health programme has grown steadily, and now embraces the total health of the worker. Elements of basic in-plant health programmes have been identified and patterns developed for successful operation. Today, health services in small plants still fall far short of optimal requirements. No more than 5% of workers in small plants enjoy the benefit of occupational health services. The main reason for the arrested development of these programmes is the lack of organizational and administrative techniques for providing health services in small plants. Recently, however, several projects have demonstrated that these difficulties can be overcome, and the future development of such programmes in small plants thus looks hopeful. Other recent developments hold promise of strengthening the health services available to workers. Union health centres, now being established in increasing numbers, offer the workers varying services, ranging from diagnostic and preventive procedures to complete medical care. Further benefits to both the worker and his family are being provided under collective bargaining agreements by voluntary health-insurance schemes. In addition to making services available to large numbers of workers previously not covered, the development of both union health centres and the prepaid health-insurance schemes offer future possibilities for integration of these programmes into the preventive and diagnostic services offered in the plant. Finally, governmental occupational health agencies, in addition to their industrial hygiene activities, are taking an increasing interest in the establishment and development of in-plant health programmes. PMID:13276820

  11. Latina Workers in North Carolina: Work Organization, Domestic Responsibilities, Health, and Family Life.

    PubMed

    Rodriguez, Guadalupe; Trejo, Grisel; Schiemann, Elizabeth; Quandt, Sara A; Daniel, Stephanie S; Sandberg, Joanne C; Arcury, Thomas A

    2016-06-01

    This analysis describes the work organization and domestic work experienced by migrant Latinas, and explores the linkage between work and health. Twenty Latina workers in North Carolina with at least one child under age 12 completed in-depth interviews focused on their work organization, domestic responsibilities, work-family conflict, health, and family health. Using a systematic qualitative analysis, these women described a demanding work organization that is contingent and exploitative, with little control or support. They also described demanding domestic roles, with gendered and unequal division of household work. The resulting work-family conflict affects their mental and physical health, and has negative effects on the care and health of their families. The findings from this study highlight that work stressors from an unfavorable work organization create work-family conflict, and that work-family conflict in this population has a negative influence on workers' health and health behaviors.

  12. Mobile Health Applications for the Most Prevalent Conditions by the World Health Organization: Review and Analysis

    PubMed Central

    2013-01-01

    Background New possibilities for mHealth have arisen by means of the latest advances in mobile communications and technologies. With more than 1 billion smartphones and 100 million tablets around the world, these devices can be a valuable tool in health care management. Every aid for health care is welcome and necessary as shown by the more than 50 million estimated deaths caused by illnesses or health conditions in 2008. Some of these conditions have additional importance depending on their prevalence. Objective To study the existing applications for mobile devices exclusively dedicated to the eight most prevalent health conditions by the latest update (2004) of the Global Burden of Disease (GBD) of the World Health Organization (WHO): iron-deficiency anemia, hearing loss, migraine, low vision, asthma, diabetes mellitus, osteoarthritis (OA), and unipolar depressive disorders. Methods Two reviews have been carried out. The first one is a review of mobile applications in published articles retrieved from the following systems: IEEE Xplore, Scopus, ScienceDirect, Web of Knowledge, and PubMed. The second review is carried out by searching the most important commercial app stores: Google play, iTunes, BlackBerry World, Windows Phone Apps+Games, and Nokia's Ovi store. Finally, two applications for each condition, one for each review, were selected for an in-depth analysis. Results Search queries up to April 2013 located 247 papers and more than 3673 apps related to the most prevalent conditions. The conditions in descending order by the number of applications found in literature are diabetes, asthma, depression, hearing loss, low vision, OA, anemia, and migraine. However when ordered by the number of commercial apps found, the list is diabetes, depression, migraine, asthma, low vision, hearing loss, OA, and anemia. Excluding OA from the former list, the four most prevalent conditions have fewer apps and research than the final four. Several results are extracted from

  13. Report a Complaint (about a Health Care Organization)

    MedlinePlus

    ... What Is Accreditation? Become Accredited Download the Gold Seal Find Accredited Organizations Newsletters Publicity Kits State Recognition ... What Is Certification? Become Certified Download the Gold Seal Find Certified Organizations Newsletters Publicity Kit State Recognition ...

  14. Minimum Principles in Motor Control.

    PubMed

    Engelbrecht, Sascha E.

    2001-06-01

    Minimum (or minimal) principles are mathematical laws that were first used in physics: Hamilton's principle and Fermat's principle of least time are two famous example. In the past decade, a number of motor control theories have been proposed that are formally of the same kind as the minimum principles of physics, and some of these have been quite successful at predicting motor performance in a variety of tasks. The present paper provides a comprehensive review of this work. Particular attention is given to the relation between minimum theories in motor control and those used in other disciplines. Other issues around which the review is organized include: (1) the relation between minimum principles and structural models of motor planning and motor control, (2) the empirically-driven development of minimum principles and the danger of circular theorizing, and (3) the design of critical tests for minimum theories. Some perspectives for future research are discussed in the concluding section of the paper. Copyright 2001 Academic Press. PMID:11401453

  15. Improving capacity to monitor and support sustainability of mental health peer-run organizations.

    PubMed

    Ostrow, Laysha; Leaf, Philip J

    2014-02-01

    Peer-run mental health organizations are managed and staffed by people with lived experience of the mental health system. These understudied organizations are increasingly recognized as an important component of the behavioral health care and social support systems. This Open Forum describes the National Survey of Peer-Run Organizations, which was conducted in 2012 to gather information about peer-run organizations and programs, organizational operations, policy perspectives, and service systems. A total of 895 entities were identified and contacted as potential peer-run organizations. Information was obtained for 715 (80%) entities, and 380 of the 715 responding entities met the criteria for a peer-run organization. Implementation of the Affordable Care Act may entail benefits and unintended consequences for peer-run organizations. It is essential that we understand this population of organizations and continue to monitor changes associated with policies intended to provide better access to care that promotes wellness and recovery.

  16. 75 FR 48691 - Single Source Cooperative Agreement Award for the World Health Organization (WHO) To Continue...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... HUMAN SERVICES Single Source Cooperative Agreement Award for the World Health Organization (WHO) To... Authority ACTION: Notice. SUMMARY: Notification of Single Source Cooperative Agreement Award for the World... 2010, BARDA plans to provide a Single Source Continuation Award to the World Health Organization...

  17. 77 FR 57567 - Single Source Cooperative Agreement Award for World Health Organization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-18

    ... HUMAN SERVICES Single Source Cooperative Agreement Award for World Health Organization AGENCY...). ACTION: Notification of Single Source Cooperative Agreement Award for World Health Organization for a... Regulations (IHR) (2005). A case of smallpox detected by a member state requires notification to World...

  18. The World Health Organization's mechanisms for increasing the health sector budget: The South African context.

    PubMed

    Venter, Fouche Hendrik Johannes; Wolfaardt, Jaqueline Elizabeth

    2016-07-04

    South Africa (SA) has limited scope for raising income taxes, and the proposed National Health Insurance (NHI) scheme will necessitate growth in the health sector budget. The NHI White Paper suggests five funding scenarios to meet the expected shortfall. These scenarios are a mixture of a surcharge on taxable income, an increase in value-added tax and a payroll tax. Five alternative options, suggested by the World Health Organization, are interrogated as ways to decrease the general taxation proposed in the White Paper. The five mechanisms (corporate tax, financial transaction levy, and taxes on tobacco, alcohol and unhealthy foods) were chosen based on their fund-raising potential and their mandatory element. A literature review provides the information for a discussion of the potential costs of each mechanism. Within specific assumptions, potential budgetary contribution is compared with the requirement. First, raising corporate tax rates could raise enough funds, but the losses due to capital flight might be too much for the local economy to bear. Second, a levy on currency transactions is unlikely to raise the required resources, even without a probable decrease in the number of transactions. Third, the increase in the tax on tobacco and alcohol would need to be very large, even assuming that consumption patterns would remain unchanged. Lastly, a tax on unhealthy food products is a new idea and could be explored as an option - especially as the SA Treasury has announced its future implementation. Implementing only one of the mechanisms is unlikely to increase available funding sufficiently, but if they are implemented together the welfare-maximising tax rate for each mechanism may be high enough to fulfil the NHI scheme's budgetary requirement, moderating the increases in the tax burden of the SA population.

  19. The World Health Organization's mechanisms for increasing the health sector budget: The South African context.

    PubMed

    Venter, Fouche Hendrik Johannes; Wolfaardt, Jaqueline Elizabeth

    2016-08-01

    South Africa (SA) has limited scope for raising income taxes, and the proposed National Health Insurance (NHI) scheme will necessitate growth in the health sector budget. The NHI White Paper suggests five funding scenarios to meet the expected shortfall. These scenarios are a mixture of a surcharge on taxable income, an increase in value-added tax and a payroll tax. Five alternative options, suggested by the World Health Organization, are interrogated as ways to decrease the general taxation proposed in the White Paper. The five mechanisms (corporate tax, financial transaction levy, and taxes on tobacco, alcohol and unhealthy foods) were chosen based on their fund-raising potential and their mandatory element. A literature review provides the information for a discussion of the potential costs of each mechanism. Within specific assumptions, potential budgetary contribution is compared with the requirement. First, raising corporate tax rates could raise enough funds, but the losses due to capital flight might be too much for the local economy to bear. Second, a levy on currency transactions is unlikely to raise the required resources, even without a probable decrease in the number of transactions. Third, the increase in the tax on tobacco and alcohol would need to be very large, even assuming that consumption patterns would remain unchanged. Lastly, a tax on unhealthy food products is a new idea and could be explored as an option - especially as the SA Treasury has announced its future implementation. Implementing only one of the mechanisms is unlikely to increase available funding sufficiently, but if they are implemented together the welfare-maximising tax rate for each mechanism may be high enough to fulfil the NHI scheme's budgetary requirement, moderating the increases in the tax burden of the SA population. PMID:27499398

  20. 75 FR 53304 - Office of the Assistant Secretary for Health; Statement of Organization, Functions, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Office of the Assistant Secretary for Health; Statement of... Organizations, Functions and Delegations of Authority for the Department of Health and Human Services (HHS)...

  1. Managing professional work: three models of control for health organizations.

    PubMed Central

    Scott, W R

    1982-01-01

    Three arrangements for structuring the work of professional participants in professional organizations are described, contrasted and evaluated. Arguments are illustrated by application to the organization of physicians within hospitals. The primary rationale, the support structures that have fostered its development, the key structural features and the advantages and disadvantages of each arrangement are described. The effect on these arrangements of structures and forces external to any particular professional organization is emphasized. PMID:6749761

  2. Organic farming, soil health, and food quality: considering possible links

    Technology Transfer Automated Retrieval System (TEKTRAN)

    That the health of soils, plants, animals and people are linked is an ancient idea that still resonates. It is well known that soil nutrient deficiencies and toxicities can adversely impact plant and animal health. Growing evidence also supports the idea of positive links between farm management, so...

  3. Services Shared by Health Care Organizations: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Hospital Research and Educational Trust, Chicago, IL.

    This bibliography is designed to assist planners in the field of institutional health and health support services in gaining access to knowledge that will enhance their efforts to achieve new or expanded arrangements of service sharing. Entries are cross-referenced to as many categories as the material warrants. Case studies that are not annotated…

  4. The Community Mental Health Center as a Matrix Organization.

    ERIC Educational Resources Information Center

    White, Stephen L.

    1978-01-01

    This article briefly reviews the literature on matrix organizational designs and discusses the ways in which the matrix design might be applied to the special features of a community mental health center. The phases of one community mental health center's experience in adopting a matrix organizational structure are described. (Author)

  5. Biochemistry in Undergraduate Health Courses: Structure and Organization

    ERIC Educational Resources Information Center

    Silva, Irani F.; Batista, Nildo A.

    2003-01-01

    This article describes the following aspects of teaching biochemistry in undergraduate health courses: objectives, number of hours, time in which the subject is studied, selection of content, teaching strategies, and evaluation methodologies used. Fifty-three courses distributed in 13 areas within the health field and offered by 12 institutions…

  6. Design of high reliability organizations in health care.

    PubMed

    Carroll, J S; Rudolph, J W

    2006-12-01

    To improve safety performance, many healthcare organizations have sought to emulate high reliability organizations from industries such as nuclear power, chemical processing, and military operations. We outline high reliability design principles for healthcare organizations including both the formal structures and the informal practices that complement those structures. A stage model of organizational structures and practices, moving from local autonomy to formal controls to open inquiry to deep self-understanding, is used to illustrate typical challenges and design possibilities at each stage. We suggest how organizations can use the concepts and examples presented to increase their capacity to self-design for safety and reliability.

  7. The New Left and Public Health The Health Policy Advisory Center, Community Organizing, and the Big Business of Health, 1967–1975

    PubMed Central

    2011-01-01

    Soon after its founding in the politically tumultuous late 1960s, the Health Policy Advisory Center (Health/PAC) and its Health/PAC Bulletin became the strategic hub of an intense urban social movement around health care equality in New York City. I discuss its early formation, its intellectual influences, and the analytical framework that it devised to interpret power relations in municipal health care. I also describe Health/PAC's interpretation of health activism, focusing in particular on a protracted struggle regarding Lincoln Hospital in the South Bronx. Over the years, the organization's stance toward community-oriented health politics evolved considerably, from enthusiastically promoting its potential to later confronting its limits. I conclude with a discussion of Health/PAC's major theoretical contributions, often taken for granted today, and its book American Health Empire. PMID:21228287

  8. Health Organization in Republic of Macedonia-the place of preventive health care in the medical health system: advantages and disadvantages.

    PubMed

    Kamcev, Nikola; Angelovska, Bistra; Kamceva, Gordana; Richter, Kneginja

    2010-12-01

    The health system in Macedonia is organized by public or private property health institutions divided on three levels: primary, secondary and tertiary health care. According to the legal regulations and their acts, regulatory authorities for preventive care are the health institutions of primary health care (whether they have private or public character), heath care establishments and some of the hospitals. In the period of transition starting from 1991 up to this day, numerous health system modifications have been made concerning health reforms: common alterations in health legislation change in property of health institutions, realignment of authorities etc. The adjustment of the system to the new circumstances and constant changes has provoked partial disruption in the established system for preventive health care activity. PMID:23199112

  9. Healthcare organization-education partnerships and career ladder programs for health care workers.

    PubMed

    Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

    2014-12-01

    Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization. PMID:25441318

  10. Healthcare organization-education partnerships and career ladder programs for health care workers.

    PubMed

    Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

    2014-12-01

    Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization.

  11. [Toward a new organization of public health services in Spain. 2008 SESPAS Report].

    PubMed

    Artundo Purroy, Carlos; Rivadeneyra Sicilia, Ana

    2008-04-01

    Public health in Spain shows significant weaknesses. Spanish public health services respond reasonably well in crisis situations but tend to be invisible and occupy a marginal position in political agendas and in relation to health services. The organization of the public health subsystem is clearly out of date in terms of its ability to promote and protect community health, to prevent diseases, and to cope effectively with the new public health threats and challenges related to the physical and social environment in today's globalized world. Consequently, there is broad consensus on the need to rethink functions, strategies and the organization of public health in Spain, in line with European and international trends. Thus, public health reform is currently a pending challenge and a strategic priority. Indeed, some Autonomous Communities have initiated a process of modernization and change. Empowerment of public health in the political agendas and in relation to the health services is strongly recommended by promoting intersectorial approaches, the Health in All Policies strategy and Health Impact Assessment. There is also a need for a specific law that would update public health functions, organization and structures, allocate competencies by facilitating alliances and partnership, and regulate coordination and intersectorial intervention. The following key elements related to this reform are described: 1) a participatory leadership in public health; 2) the generation of intelligence and evidence in public health; 3) improvement of professional education and development; 4) the importance of transparent, independent and competent performance and communication, and 5) new and flexible organization coherent with the new strategies and close to the local level and primary health care services. Coordination between the State and the Autonomous Communities should involved a functional and intelligent relationship by building up common spaces, alliances, networks and

  12. Organic farming: Impacts on soil, food, and human health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The importance of responsible stewardship in managing soil is a central tenet of organic farming. Organic farmers believe that practices which stimulate biology and overall quality of soil enhance production of healthy and nutritious crops. Few involved in agriculture would argue this point. Neverth...

  13. The evolution of human rights in World Health Organization policy and the future of human rights through global health governance.

    PubMed

    Meier, B M; Onzivu, W

    2014-02-01

    The World Health Organization (WHO) was intended to serve at the forefront of efforts to realize human rights to advance global health, and yet this promise of a rights-based approach to health has long been threatened by political constraints in international relations, organizational resistance to legal discourses, and medical ambivalence toward human rights. Through legal research on international treaty obligations, historical research in the WHO organizational archives, and interview research with global health stakeholders, this research examines WHO's contributions to (and, in many cases, negligence of) the rights-based approach to health. Based upon such research, this article analyzes the evolving role of WHO in the development and implementation of human rights for global health, reviews the current state of human rights leadership in the WHO Secretariat, and looks to future institutions to reclaim the mantle of human rights as a normative framework for global health governance.

  14. Trucking organization and mental health disorders of truck drivers.

    PubMed

    Shattell, Mona; Apostolopoulos, Yorghos; Collins, Chad; Sönmez, Sevil; Fehrenbacher, Caitlin

    2012-07-01

    There are over 3 million truck drivers employed in the commercial transportation and material moving occupations, one of the largest occupational groups in the United States. Workers in this large and growing occupational segment are at risk for a range of occupational health-induced conditions, including mental health and psychiatric disorders due to high occupational stress, low access and use of health care, and limited social support. The purpose of this study was to explore male truck drivers' mental health risks and associated comorbidities, using a cross-sectional and quantitative design. Data were collected from a random sample of 316 male truckers between the ages of 23 and 76 at a large truck stop located within a 100-mile radius of Greensboro, North Carolina, USA, using a self-administered 82-item questionnaire. Surveyed truckers were found to have significant issues affecting their mental health, such as loneliness (27.9%), depression (26.9%), chronic sleep disturbances (20.6%), anxiety (14.5%), and other emotional problems (13%). Findings have potential to help researchers develop interventions to improve the emotional and occupational health of truck drivers, a highly underserved population. Mental health promotion, assessment, and treatment must become a priority to improve the overall trucking environment for truckers, the transportation industry, and safety on US highways. PMID:22757596

  15. [Youth mental health at the cross roads of service organization].

    PubMed

    Rousseau, Cécile; Nadeau, Lucie; Pontbriand, Annie; Johnson-Lafleur, Janique; Measham, Toby; Broadhurst, Joanna

    2014-01-01

    The importance of children and youth mental health is increasingly recognized. This rapidly developing field cannot be conceptualized as an extension of adult services to a younger age group and its developmental and organizational specificities are the object of debate. Reviewing recent literature in this domain and some preliminary information about the Quebec Mental Health Plan implementation, this paper addresses some of the questions which structure this debate in Quebec.Quebec mental health plan has put at the forefront collaboration among disciplines and partnership among institutions. In spite of having produced significant improvement in the field, discontinuities in services, which interfere with an ecosystemic model of care, persist. Recent studies suggest that the organisational climate which surrounds youth mental health services has a direct impact on the quality of services and on youth health outcomes. A flexible management structure, which engages clinicians and health workers, favors empowerment, minimizes work stress and facilitates partnership, is needed to foster successful interdisciplinary and intersectorial collaboration. This collaboration is the cornerstone of youth mental health services.

  16. Trucking organization and mental health disorders of truck drivers.

    PubMed

    Shattell, Mona; Apostolopoulos, Yorghos; Collins, Chad; Sönmez, Sevil; Fehrenbacher, Caitlin

    2012-07-01

    There are over 3 million truck drivers employed in the commercial transportation and material moving occupations, one of the largest occupational groups in the United States. Workers in this large and growing occupational segment are at risk for a range of occupational health-induced conditions, including mental health and psychiatric disorders due to high occupational stress, low access and use of health care, and limited social support. The purpose of this study was to explore male truck drivers' mental health risks and associated comorbidities, using a cross-sectional and quantitative design. Data were collected from a random sample of 316 male truckers between the ages of 23 and 76 at a large truck stop located within a 100-mile radius of Greensboro, North Carolina, USA, using a self-administered 82-item questionnaire. Surveyed truckers were found to have significant issues affecting their mental health, such as loneliness (27.9%), depression (26.9%), chronic sleep disturbances (20.6%), anxiety (14.5%), and other emotional problems (13%). Findings have potential to help researchers develop interventions to improve the emotional and occupational health of truck drivers, a highly underserved population. Mental health promotion, assessment, and treatment must become a priority to improve the overall trucking environment for truckers, the transportation industry, and safety on US highways.

  17. Institutionalizing HIPAA compliance: organizations and competing logics in U.S. health care.

    PubMed

    Anthony, Denise L; Appari, Ajit; Johnson, M Eric

    2014-03-01

    Health care in the United States is highly regulated, yet compliance with regulations is variable. For example, compliance with two rules for securing electronic health information in the 1996 Health Insurance Portability and Accountability Act took longer than expected and was highly uneven across U.S. hospitals. We analyzed 3,321 medium and large hospitals using data from the 2003 Health Information and Management Systems Society Analytics Database. We find that organizational strategies and institutional environments influence hospital compliance, and further that institutional logics moderate the effect of some strategies, indicating the interplay of regulation, institutions, and organizations that contribute to the extensive variation that characterizes the U.S. health care system. Understanding whether and how health care organizations like hospitals respond to new regulation has important implications both for creating desired health care reform and for medical sociologists interested in the changing organizational structure of health care.

  18. The World Health Organization and the Transition From “International” to “Global” Public Health

    PubMed Central

    Brown, Theodore M.; Cueto, Marcos; Fee, Elizabeth

    2006-01-01

    The term “global health” is rapidly replacing the older terminology of “international health.” We describe the role of the World Health Organization (WHO) in both international and global health and in the transition from one to the other. We suggest that the term “global health” emerged as part of larger political and historical processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances. Between 1948 and 1998, WHO moved from being the unquestioned leader of international health to being an organization in crisis, facing budget shortfalls and diminished status, especially given the growing influence of new and powerful players. We argue that WHO began to refashion itself as the coordinator, strategic planner, and leader of global health initiatives as a strategy of survival in response to this transformed international political context. PMID:16322464

  19. Prevalence and factors associated with resistant hypertension in a large health maintenance organization in Israel.

    PubMed

    Weitzman, Dahlia; Chodick, Gabriel; Shalev, Varda; Grossman, Chagai; Grossman, Ehud

    2014-09-01

    Previous assessments of the prevalence of resistant hypertension (RH) in uncontrolled blood pressure (BP) have ranged from 3% to 30%. Using real-world data, our aim was to estimate the prevalence of RH in patients belonging to the Maccabi Healthcare Services, a 2-million-member health organization in Israel. From 2010 to 2011, all hypertensive patients with ≥2 recorded BP measurements during a minimum period of 6 months were identified. Patients were considered uncontrolled if their most recent BP during the study period and their mean systolic BP or diastolic BP during a preceding period of ≥6months were systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg, or systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg in chronic kidney disease or diabetes mellitus. Uncontrolled patients taking diuretics and ≥2 antihypertensive therapy classes at their maximal recommended dose were regarded as resistant hypertensives. A total of 172 432 patients were eligible for the study. Uncontrolled BP was found in 35.9% (n=65 710). Overall, 2.2% of the uncontrolled patients (n=1487) were resistant hypertensives. Patients with RH were characterized by a significantly (P<0.01) older age, higher body mass index, and multicomorbidity (including dyslipidemia, diabetes mellitus, and impaired renal function) compared with patients with controlled hypertension receiving equivalent treatment. The results of this large population-based study indicate a substantially lower prevalence of RH than previously reported. Most patients with uncontrolled BP took less than the maximal recommended antihypertensive treatment.

  20. Consumer-directed health care: implications for health care organizations and managers.

    PubMed

    Guo, Kristina L

    2010-01-01

    This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality. PMID:20436329

  1. Consumer-directed health care: implications for health care organizations and managers.

    PubMed

    Guo, Kristina L

    2010-01-01

    This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality.

  2. e-business means survival for health care organizations in 2010.

    PubMed

    Lutz, S

    2000-01-01

    Within the next five years, most health care organizations will communicate with suppliers, other providers, payers, regulators, and patients through the Internet. The Internet will recalibrate expectations of speed and service for patients and providers, but it also will increase accountability in which digitalized information is tracked and analyzed. The rate at which health care organizations are developing Web-based solutions is neck-snapping in the United States. As individual product lines, departments, and subsidiaries grow their own e-health businesses, organizations must decide which initiatives they must fund, which are essential to survival, and which could be financial black holes.

  3. [Significance of organic crops in health prevention illustrated by the example of organic paprika (Capsicumannuum)].

    PubMed

    Hallmann, Ewelina; Rembiałkowska, Ewa; Szafirowska, Anna; Grudzień, Konstanty

    2007-01-01

    The paprika fruits are perfect source of bioactive compounds as carotenoids (beta-carotene and lutein), flavonoids and vitamin C. The aim of work was to determine the content of bioactive compounds in paprika fruits from organic and conventional cultivation. Organic and conventional paprika fruits were chemically analyzed. The results obtained showed that organic paprika contained more total and reducing sugars, vitamin C and flavonoids than conventional one. Additionally organic paprika fruits had slightly higher acidity than conventional fruits.

  4. Health in the news: an analysis of magazines coverage of health issues in veterans and military service organizations.

    PubMed

    Jitnarin, Nattinee; Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara

    2015-05-01

    The purpose of this study was to conduct a content analysis of Veterans and Military Service Organizations (VMSOs) magazines to determine what health-related topics VMSOs target and how they inform their constituencies about health issues. Health-related topics in 288 VMSOs' magazines from 21 VMSOs published in 2011 and 2012 were coded by trained raters using a standardized manual. The top three most addressed health topics were Health Services (Health care, Insurance), Disability and Disability benefits, and post-traumatic stress disorder. Topics least frequently covered were Tobacco and Smoking cessation, Illegal drugs, Alcohol, Gulf War Syndrome, and Weight and Body composition. VMSOs are concerned about the health and well-being of their members given the considerable amount of content devoted to certain health topics such as health insurance concerns, disability, and post-traumatic stress disorder. However, other health concerns that affect a considerable number of both current military personnel and veterans and cost both the Department of Veterans Affairs and the Department of Defense millions annually, such as drug and alcohol problems, and tobacco use and smoking cessation, are infrequently covered. The results of this study improve our understanding of the health-related information that reaches the military and veteran populations through this important media outlet.

  5. 42 CFR 84.72 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Breathing tubes; minimum requirements. 84.72 Section 84.72 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL...-Contained Breathing Apparatus § 84.72 Breathing tubes; minimum requirements. Flexible breathing tubes...

  6. 42 CFR 84.72 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Breathing tubes; minimum requirements. 84.72 Section 84.72 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL...-Contained Breathing Apparatus § 84.72 Breathing tubes; minimum requirements. Flexible breathing tubes...

  7. 42 CFR 84.115 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Breathing tubes; minimum requirements. 84.115 Section 84.115 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... § 84.115 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction with...

  8. 42 CFR 84.132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Breathing tubes; minimum requirements. 84.132 Section 84.132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Respirators § 84.132 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction...

  9. 42 CFR 84.195 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Breathing tubes; minimum requirements. 84.195 Section 84.195 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Cartridge Respirators § 84.195 Breathing tubes; minimum requirements. Flexible breathing tubes used...

  10. 42 CFR 84.1132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Breathing tubes; minimum requirements. 84.1132 Section 84.1132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Gas Masks § 84.1132 Breathing tubes; minimum requirements. (a) Flexible breathing tubes used...

  11. 42 CFR 84.115 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Breathing tubes; minimum requirements. 84.115 Section 84.115 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... § 84.115 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction with...

  12. 42 CFR 84.195 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing tubes; minimum requirements. 84.195 Section 84.195 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Cartridge Respirators § 84.195 Breathing tubes; minimum requirements. Flexible breathing tubes used...

  13. 42 CFR 84.1132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Breathing tubes; minimum requirements. 84.1132 Section 84.1132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Gas Masks § 84.1132 Breathing tubes; minimum requirements. (a) Flexible breathing tubes used...

  14. 42 CFR 84.195 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Breathing tubes; minimum requirements. 84.195 Section 84.195 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Cartridge Respirators § 84.195 Breathing tubes; minimum requirements. Flexible breathing tubes used...

  15. 42 CFR 84.1132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing tubes; minimum requirements. 84.1132 Section 84.1132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Gas Masks § 84.1132 Breathing tubes; minimum requirements. (a) Flexible breathing tubes used...

  16. 42 CFR 84.72 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Breathing tubes; minimum requirements. 84.72 Section 84.72 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL...-Contained Breathing Apparatus § 84.72 Breathing tubes; minimum requirements. Flexible breathing tubes...

  17. 42 CFR 84.195 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Breathing tubes; minimum requirements. 84.195 Section 84.195 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Cartridge Respirators § 84.195 Breathing tubes; minimum requirements. Flexible breathing tubes used...

  18. 42 CFR 84.1132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Breathing tubes; minimum requirements. 84.1132 Section 84.1132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Gas Masks § 84.1132 Breathing tubes; minimum requirements. (a) Flexible breathing tubes used...

  19. 42 CFR 84.72 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing tubes; minimum requirements. 84.72 Section 84.72 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL...-Contained Breathing Apparatus § 84.72 Breathing tubes; minimum requirements. Flexible breathing tubes...

  20. 42 CFR 84.132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing tubes; minimum requirements. 84.132 Section 84.132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Respirators § 84.132 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction...

  1. 42 CFR 84.115 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Breathing tubes; minimum requirements. 84.115 Section 84.115 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... § 84.115 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction with...

  2. 42 CFR 84.132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Breathing tubes; minimum requirements. 84.132 Section 84.132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Respirators § 84.132 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction...

  3. 42 CFR 84.132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Breathing tubes; minimum requirements. 84.132 Section 84.132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Respirators § 84.132 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction...

  4. 42 CFR 84.72 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Breathing tubes; minimum requirements. 84.72 Section 84.72 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL...-Contained Breathing Apparatus § 84.72 Breathing tubes; minimum requirements. Flexible breathing tubes...

  5. 42 CFR 84.132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Breathing tubes; minimum requirements. 84.132 Section 84.132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Respirators § 84.132 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction...

  6. 42 CFR 84.115 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Breathing tubes; minimum requirements. 84.115 Section 84.115 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... § 84.115 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction with...

  7. 42 CFR 84.115 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing tubes; minimum requirements. 84.115 Section 84.115 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... § 84.115 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction with...

  8. 42 CFR 84.1132 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Breathing tubes; minimum requirements. 84.1132 Section 84.1132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Gas Masks § 84.1132 Breathing tubes; minimum requirements. (a) Flexible breathing tubes used...

  9. 42 CFR 84.195 - Breathing tubes; minimum requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Breathing tubes; minimum requirements. 84.195 Section 84.195 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... Cartridge Respirators § 84.195 Breathing tubes; minimum requirements. Flexible breathing tubes used...

  10. Transforming Health Care Coalitions From Hospitals to Whole of Community: Lessons Learned From Two Large Health Care Organizations.

    PubMed

    Cormier, Scott; Wargo, Michael; Winslow, Walter

    2015-12-01

    A health care emergency preparedness coalition (coalition) is a group of health care organizations, public safety agencies, and public health partners that join forces for the common cause of making their communities safer, healthier, and more resilient. Coalitions have been characterized as being focused on hospital systems instead of the health care of the community as a whole. We discuss 2 examples of coalition partners that use a more inclusive approach to planning, response, and recovery. The first is a large health care system spread across 23 states, and the other is a public safety agency in northeast Pennsylvania that took the lead to address the preparedness and response toward a large influx of burn patients and grew to encompass all aspects of community health care.

  11. How to create a health care organization that can succeed in an unpredictable future.

    PubMed

    Olden, Peter C; Haynos, Jessika

    2013-01-01

    For those who manage organizations, it has been said that success does not come from predicting the future but instead comes from creating an organization that can succeed in an unpredictable future. Managers are responsible for creating such an organization. To do that, managers can apply management-related principles and methods. This article explains selected principles of organization structure, human resources, culture, decision making, and change management and how to apply them to health care organizations. If done well, that will help such organizations succeed in an unpredictable future.

  12. The illusion of control and the importance of community in health care organizations.

    PubMed

    Pitts, T

    1993-01-01

    The complexity of our health care environment and organizations requires a management style that moves beyond control to empowerment. Even though this complexity minimizes our ability to control events, many organizations are still preoccupied with the illusion of control. This restrains the performance of our health care organizations. Some of the contributing factors supporting this illusion are bureaucracy, scientific methodology, individualism, and our confusion of management with leadership. The concept of "community" is discussed from an organizational perspective. It is suggested that we can improve the performance of our organizations by rediscovering the values of community.

  13. The Philadelphia Health Insurance Organization: the results of managed health care for 96,000 medical assistance recipients.

    PubMed

    Temple, P C; Kron, S

    On March 1, 1986, an innovative Medicaid program serving 96,000 recipients began operation in Philadelphia, Pennsylvania. Known as the HealthPASS program, it changed the previous fee for service Medicaid program into a capitated, managed care "gatekeeper" system. The plan was administered through a Health Insurance Organization (HIO) designed cooperatively by the Pennsylvania Department of Welfare and a for-profit health maintenance organization. In its first year, the program enrolled over 500 physician case managers, saved the Commonwealth of Pennsylvania $20 million, instituted a quality assurance program with on-site audit of primary care physician office facilities and medical records, provided a 24-hour hotline, made available central case management for mental health care, and began to compile a comprehensive database to support medical case management.

  14. The Australian experiment: how primary health care organizations supported the evolution of a primary health care system.

    PubMed

    Nicholson, Caroline; Jackson, Claire L; Marley, John E; Wells, Robert

    2012-03-01

    Primary health care in Australia has undergone 2 decades of change. Starting with a vision for a national health strategy with general practice at its core, Australia established local meso-level primary health care organizations--Divisions of General Practice--moving from focus on individual practitioners to a professional collective local voice. The article identifies how these meso-level organizations have helped the Australian primary health care system evolve by supporting the roll-out of initiatives including national practice accreditation, a focus on quality improvement, expansion of multidisciplinary teams into general practice, regional integration, information technology adoption, and improved access to care. Nevertheless, there are still challenges to ensuring equitable access and the supply and distribution of a primary care workforce, addressing the increasing rates of chronic disease and obesity, and overcoming the fragmentation of funding and accountability in the Australian system.

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

    PubMed

    Shale, Suzanne

    2008-03-01

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

  16. Offering-level strategy formulation in health service organizations.

    PubMed

    Pointer, D D

    1990-01-01

    One of six different strategies must be selected for a health service offering to provide consumers with distinctive value and achieve sustainable competitive advantage in a market or market segment. Decisions must be made regarding objectives sought, market segmentation, market scope, and the customer-value proposition that will be pursued.

  17. Offering-level strategy formulation in health service organizations.

    PubMed

    Pointer, D D

    1990-01-01

    One of six different strategies must be selected for a health service offering to provide consumers with distinctive value and achieve sustainable competitive advantage in a market or market segment. Decisions must be made regarding objectives sought, market segmentation, market scope, and the customer-value proposition that will be pursued. PMID:2118882

  18. Armenia: Influences and Organization of Mental Health Services

    ERIC Educational Resources Information Center

    McCarthy, John; Harutyunyan, Hasmik; Smbatyan, Meri; Cressley, Heidi

    2013-01-01

    Relatively little has been published on mental health care and counseling as they pertain to Armenia, a country of approximately three million residents that gained independence in 1991 from the former Soviet Union. Various influences, such as its history, economy, religious and family systems, and a major natural disaster in 1988, have affected…

  19. Algae as promising organisms for environment and health

    PubMed Central

    2011-01-01

    Algae, like other plants, produce a variety of remarkable compounds collectively referred to as secondary metabolites. They are synthesized by these organisms at the end of the growth phase and/or due to metabolic alterations induced by environmental stress conditions. Carotenoids, phenolic compounds, phycobiliprotein pigments, polysaccharides and unsaturated fatty acids are same of the algal natural products, which were reported to have variable biological activities, including antioxidant activity, anticancer activity, antimicroabial activity against bacteria-virus-algae-fungi, organic fertilizer and bioremediation potentials. PMID:21862867

  20. Studies in Ambulatory Care Quality Assessment in the Indian Health Service. Volume III: Comparison of Rural Private Practice, Health Maintenance Organizations, and the Indian Health Service.

    ERIC Educational Resources Information Center

    Nutting, Paul A.; And Others

    Utilizing a quality assessment methodology for ambulatory patient care currently under development by the Indian Health Service's (IHS) Office of Research and Development, comparisons were made between results derived from a pilot test in IHS service units, 2 metropolitan Health Maintenance Organizations (HMO), and 3 rural private practices.…

  1. Characteristics of community health organizations and decision-makers considering the adoption of motivational interviewing.

    PubMed

    Williams, Jessica Roberts; Dusablon, Tracy; Williams, Weston O; Blais, Marissa Puckett; Hennessy, Kevin D

    2014-07-01

    Research related to the adoption of comparative effectiveness research (CER) in mental health practice is limited. This study explores the factors that influence decisions to adopt motivational interviewing (MI)-an evidence-based practice (EBP) grounded in CER-among decision-makers (n = 311) in community health organizations (n = 92). Descriptive analyses focus on organization and decision-maker characteristics and processes that may influence the decision to adopt an EBP, including demographics, structure and operations, readiness, attitudes, barriers, and facilitators. Within-group agreement is examined to determine the degree to which participants within each organization gave similar responses. Results show characteristics differed according to type of organization (community health versus community behavioral health) and position (directors versus staff). Within-group agreement was also influenced by position. These findings indicate different strategies may be needed to best disseminate CER to the two groups.

  2. Reporting intellectual capital in health care organizations: specifics, lessons learned, and future research perspectives.

    PubMed

    Veltri, Stefania; Bronzetti, Giovanni; Sicoli, Graziella

    2011-01-01

    This article analyzes the concept of intellectual capital (IC) in the health sector sphere by studying the case of a major nonprofit research organization in this sector, which has for some time been publishing IC reports. In the last few years, health care organizations have been the object of great attention in the implementation and transfer of managerial models and tools; however, there is still a lack of attention paid to the strategic management of IC as a fundamental resource for supporting and enhancing performance improvement dynamics. The main aim of this article is to examine the IC reporting model used by the Center of Molecular Medicine (CMM), a Swedish health organization which is an outstanding benchmark in reporting its IC. We also consider the specifics of IC reporting for health organizations, the lessons learned by analyzing CMM's IC reporting, and future perspectives for research. PMID:22372033

  3. Salutogenic factors for mental health promotion in work settings and organizations.

    PubMed

    Graeser, Silke

    2011-12-01

    Accompanied by an increasing awareness of companies and organizations for mental health conditions in work settings and organizations, the salutogenic perspective provides a promising approach to identify supportive factors and resources of organizations to promote mental health. Based on the sense of coherence (SOC) - usually treated as an individual and personality trait concept - an organization-based SOC scale was developed to identify potential salutogenic factors of a university as an organization and work place. Based on results of two samples of employees (n = 362, n = 204), factors associated with the organization-based SOC were evaluated. Statistical analysis yielded significant correlations between mental health and the setting-based SOC as well as the three factors of the SOC yielded by factor analysis yielded three factors comprehensibility, manageability and meaningfulness. Significant statistic results of bivariate and multivariate analyses emphasize the significance of aspects such as participation and comprehensibility referring to the organization, social cohesion and social climate on the social level, and recognition on the individual level for an organization-based SOC. Potential approaches for the further development of interventions for work-place health promotion based on salutogenic factors and resources on the individual, social and organization level are elaborated and the transcultural dimensions of these factors discussed.

  4. Environment Health & Safety Research Program. Organization and 1979-1980 Publications

    SciTech Connect

    1981-01-01

    This document was prepared to assist readers in understanding the organization of Pacific Northwest Laboratory, and the organization and functions of the Environment, Health and Safety Research Program Office. Telephone numbers of the principal management staff are provided. Also included is a list of 1979 and 1980 publications reporting on work performed in the Environment, Health and Safety Research Program, as well as a list of papers submitted for publication.

  5. The effect of graphic organizers on subjective and objective comprehension of a health education text.

    PubMed

    Kools, Marieke; van de Wiel, Margaretha W J; Ruiter, Robert A C; Crüts, Anica; Kok, Gerjo

    2006-12-01

    This study examined the effect of graphic organizers on the comprehension of a health education brochure text and compared subjective with objective comprehension measures. Graphic organizers are graphical depictions of relations among concepts in a text. Participants read a brochure text about asthma with and without these organizers, and subjective and objective text comprehension was measured. It was found that graphic organizers had effects on four levels of objective comprehension as indicated by open comprehension questions. However, on the subjective comprehension measure using Likert-type scales, the groups with and without graphic organizers did not differ from each other. It is concluded that health education texts could benefit from relatively simple techniques to increase comprehension. Furthermore, in developing health education materials, comprehension should be measured objectively.

  6. [International cooperation and affirmative action policies: the role of the Pan American Health Organization (PAHO)].

    PubMed

    Maio, Marcos Chor; Pires-Alves, Fernando A; Paiva, Carlos Henrique Assunção; Silva Magalhães, Rodrigo Cesar da

    2010-07-01

    The article analyzes the formulation, legitimation, and implementation of a policy with an ethnic/race approach by the Pan American Health Organization (PAHO). The study includes the emergence of the theme within this international organization, the institutional dynamics related to it, and the proposals focused on the Black population in Latin America. These issues are discussed on the basis of interaction between PAHO and a range of intergovernmental agencies and private organizations working in the international health domain. Participation by PAHO in the ethnic/racial theme provides elements for understanding the dual role played by intergovernmental organizations in the new global scenario, as both social actors and arenas. As an important social actor in the international health field, PAHO has produced and disseminated values and guidelines related to the ethnic/racial theme. As an arena, the organization has proven open to various interests, seeking to work harmoniously with them through its internal administration. PMID:20694349

  7. Oregon's experiment in health care delivery and payment reform: coordinated care organizations replacing managed care.

    PubMed

    Howard, Steven W; Bernell, Stephanie L; Yoon, Jangho; Luck, Jeff; Ranit, Claire M

    2015-02-01

    To control Medicaid costs, improve quality, and drive community engagement, the Oregon Health Authority introduced a new system of coordinated care organizations (CCOs). While CCOs resemble traditional Medicaid managed care, they have differences that have been deliberately designed to improve care coordination, increase accountability, and incorporate greater community governance. Reforms include global budgets integrating medical, behavioral, and oral health care and public health functions; risk-adjusted payments rewarding outcomes and evidence-based practice; increased transparency; and greater community engagement. The CCO model faces several implementation challenges. If successful, it will provide improved health care delivery, better health outcomes, and overall savings.

  8. Consumption of organic and functional food. A matter of well-being and health?

    PubMed

    Goetzke, Beate; Nitzko, Sina; Spiller, Achim

    2014-06-01

    Health is an important motivation for the consumption of both organic and functional foods. The aim of this study was to clarify to what extent the consumption of organic and functional foods are characterized by a healthier lifestyle and a higher level of well-being. Moreover, the influence of social desirability on the respondents' response behavior was of interest and was also analyzed. Well-being and health was measured in a sample of 555 German consumers at two levels: the cognitive-emotional and the behavioral level. The results show that although health is an important aspect for both functional food and organic food consumption, these two forms of consumption were influenced by different understandings of health: organic food consumption is influenced by an overall holistic healthy lifestyle including a healthy diet and sport, while functional food consumption is characterized by small "adjustments" to lifestyle to enhance health and to increase psychological well-being. An overlap between the consumption of organic and functional food was also observed. This study provides information which enables a better characterization of the consumption of functional food and organic food in terms of well-being and health.

  9. The Black church, sexual health, and sexuality: a conceptual framework to promote health through faith-based organizations.

    PubMed

    Stewart, Jennifer M; Sommers, Marilyn S; Brawner, Bridgette M

    2013-01-01

    There is a growing body of literature that documents the unique impact of black churches on social and health-related changes in the black community. Sexual health and sexuality, however, have long been sources of contention within the institution. The purpose of this article was to refine existing theoretical models that undergird sexual health research in faith-based organizations. The proposed conceptual model explores social-level factors (racism, homophobia, and heterosexism) and church organizational-level factors (beliefs, social trust, norms, and social support/influence). We make an argument in favor of illuminating the negative social-level barriers and affirming the internal cultural supports.

  10. Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems

    NASA Astrophysics Data System (ADS)

    Sandifer, P. A.; Trtanj, J.; Collier, T. K.

    2012-12-01

    Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and

  11. [Experience of health personnel at an organ procurement center].

    PubMed

    Romano, P; Romano, H; Mercadal, L

    1990-01-01

    Organs' procurement oblige to take care of a great number of brain death patients. This study concerns the psychological influence of such a situation on teams, nurses and physicians of this specific activity of harvesting. It took place in three organs' procurement intensive care units and interested sixty three men and women. These teams reveal the difficulty to live "the brain death", according to brain death patients themselves and their families, but also to transplantation: to work on brain death patients for the life of other patients. So it seem necessary to give a place at a psychologist in this specific intensive care units not for the patients, they are dead, but for the teams.

  12. Hierarchical Organization of Human Cortical Networks in Health and Schizophrenia

    PubMed Central

    Bassett, Danielle S.; Bullmore, Edward; Verchinski, Beth A.; Mattay, Venkata S.; Weinberger, Daniel R.; Meyer-Lindenberg, Andreas

    2009-01-01

    The complex organization of connectivity in the human brain is incompletely understood. Recently, topological measures based on graph theory have provided a new approach to quantify large-scale cortical networks. These methods have been applied to anatomical connectivity data on non-human species and cortical networks have been shown to have small-world topology, associated with high local and global efficiency of information transfer. Anatomical networks derived from cortical thickness measurements have shown the same organizational properties of the healthy human brain, consistent with similar results reported in functional networks derived from resting state functional MRI and MEG data. Here we show, using anatomical networks derived from analysis of inter-regional covariation of gray matter volume in magnetic resonance imaging (MRI) data on 259 healthy volunteers, that classical divisions of cortex (multimodal, unimodal and transmodal) have some distinct topological attributes. While all cortical divisions shared non-random properties of small-worldness and efficient wiring (short mean Euclidean distance between connected regions), the multimodal network had a hierarchical organization, dominated by frontal hubs with low clustering, whereas the transmodal network was assortative. Moreover, in a sample of 203 people with schizophrenia, multimodal network organization was abnormal, as indicated by reduced hierarchy, the loss of frontal and the emergence of non-frontal hubs, and increased connection distance. We propose that the topological differences between divisions of normal cortex may represent the outcome of different growth processes for multimodal and transmodal networks; and that neurodevelopmental abnormalities in schizophrenia specifically impact multimodal cortical organization. PMID:18784304

  13. 42 CFR 476.72 - Review of the quality of care of risk-basis health maintenance organizations and competitive...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Review of the quality of care of risk-basis health maintenance organizations and competitive medical plans. 476.72 Section 476.72 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND...

  14. Responding to a crisis: a stakeholder analysis of community health organizations.

    PubMed

    Savage, Grant T; Dunkin, Jeri W; Ford, David M

    2004-01-01

    On May 11, 2001, the Bureau of Primary Health Care notified West Alabama Health Services, doing business as Family HealthCare of Alabama, that it was terminating $6 million in grants due to non-compliance and amid allegations of financial mismanagement and fraud. West Alabama Health Services, a not-for-profit organization, operated 19 community health centers that provided preventive and primary care services for 17 counties in Alabama. This disruption of health services engendered considerable stakeholder debate. Within this context, the authors examine how a small, newly established rural health center and a well-established, federally qualified community health center responded to this crisis. The authors use a stakeholder analysis framework to highlight how key relationships with stakeholders may change with the perceived credibility of the organizational leaders and the legitimacy of their actions. PMID:15704640

  15. Ten Ways Community Organizations Can Link Children to Medicaid (and Other Public Health Insurance Programs).

    ERIC Educational Resources Information Center

    Center on Budget and Policy Priorities, Washington, DC.

    Ten ways community organizations, which may include schools, can link children to Medicaid and other public health insurance programs are listed. They are: (1) disseminate information about the availability of health insurance for children in low-income families; (2) incorporate Medicaid income eligibility screening as part of the program's…

  16. Development of a College Student's Mistrust of Health Care Organizations Scale

    ERIC Educational Resources Information Center

    Price, James H.; Kirchofer, Gregg M.; Khubchandani, Jagdish; Kleinfelder, JoAnn; Bryant, Michele

    2013-01-01

    Objective: The purpose of this study was to develop a College Student's Mistrust of Health Care Organizations (CSMHCO) scale and determine the relationship between medical mistrust with the use of a variety of health care services. Methods: A convenience sample of college students (n = 545) at 2 universities in the United States was recruited in…

  17. 76 FR 74788 - Patient Safety Organizations: Voluntary Relinquishment From HealthWatch, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-01

    ... Relinquishment From HealthWatch, Inc. AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION...Watch, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality... the list of federally approved PSOs. AHRQ has accepted a notification from HealthWatch, Inc.,...

  18. Clocking in: The Organization of Work Time and Health in the United States

    ERIC Educational Resources Information Center

    Kleiner, Sibyl; Pavalko, Eliza K.

    2010-01-01

    This article assesses the health implications of emerging patterns in the organization of work time. Using data from the National Longitudinal Survey of Youth 1979, we examine general mental and physical health (SF-12 scores), psychological distress (CESD score), clinical levels of obesity, and the presence of medical conditions, at age 40.…

  19. Describing an Academic and Nonprofit Organization Partnership to Educate At-Risk Adolescents about Cardiovascular Health

    ERIC Educational Resources Information Center

    Palazzo, Steven J.; Skager, Cherie; Kraiger, Anneliese

    2014-01-01

    There is emerging evidence to suggest community-based interventions can change community-wide behaviors and attitudes toward cardiovascular health. This article describes a partnership between an academic institution and a community nonprofit organization to develop and implement a cardiovascular health promotion program targeting at risk high…

  20. Community Organization in a School Health Education Program to Reduce Sodium Consumption.

    ERIC Educational Resources Information Center

    McKay, Ruth B.; And Others

    1985-01-01

    This paper describes the important role of community organization in providing reinforcing factors necessary to enable students to adopt dietary behavior changes recommended in a school health education program for cardiovascular health. The subjects were 55 urban, black, sixth grade students. The pilot program was of two years duration.…

  1. How do urban organized health care delivery systems link with rural providers?

    PubMed

    Christianson, J B; Wellever, A; Radcliff, T; Knutson, D J

    2000-01-01

    Organized delivery systems are becoming an increasingly important component of urban health care markets and are expanding their influence in rural areas as well. They also are developing new linkages with rural providers. This article, based on the experiences of 20 diverse organizations, identifies and describes the strategies being used by urban systems to redefine linkages with rural hospitals and, particularly, physicians. PMID:10937336

  2. Interorganizational collaboration for health care between nongovernmental organizations (NGOs) in Pakistan.

    PubMed

    Gulzar, Laila; Henry, Beverly

    2005-11-01

    The complexity and cost of health systems requires innovative forms of organization to provide accessible health services of an acceptable quality and at an acceptable cost. Interorganizational collaboration (IoC) is an innovation to increase the availability of organizational resources, improve service effectiveness, and improve access to health care. In Pakistan, a weak health system and little collaboration limit access, especially of women and children, to health services. Many nongovernmental organizations (NGOs) provide primary health care to the very poor, and some appear to collaborate to varying degrees; however, this has not been systematically analyzed. The purpose of this qualitative research, the first scientific study of collaboration between NGOs providing health services in Pakistan, was to describe collaboration between three pairs of NGOs providing community-based health services to women in Karachi. A long-term goal is to build a basis for future research linking IoC to access to health care and health outcomes. Findings indicated that collaboration was strongest when there was willingness to cooperate, a need for expertise and funds, and adaptive efficiency. In Pakistan's complex social environment, collaboration tended to be stronger when there was fairly high organizational formalization. Broader IoC appears to be positively associated with women's access to health care. Recommendations are made for future research, education, and management.

  3. Community-based organizations in the health sector: a scoping review.

    PubMed

    Wilson, Michael G; Lavis, John N; Guta, Adrian

    2012-11-21

    Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry.We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks).Given the range of terms used to describe community

  4. Knowledge Regarding Organ Donation and Willingness to Donate among Health Workers in South-West Nigeria

    PubMed Central

    Oluyombo, R.; Fawale, M. B.; Ojewola, R. W.; Busari, O. A.; Ogunmola, O. J.; Olanrewaju, T. O.; Akinleye, C. A.; Oladosu, Y. O.; Olamoyegun, M. A.; Gbadegesin, B. A.; Obajolowo, O. O.; Soje, M. O.; Adelaja, A.; Ayodele, L. M.; Ayodele, O. E.

    2016-01-01

    Background: Organ transplantation program in developing countries is still significantly dwarfed. Health workers are undeniably important in the success of transplantation. Objective: To assess the knowledge and attitude of health workers toward organ donation in South-West Nigeria with a view to explaining reasons for these shortcomings. Methods: In a cross-sectional study conducted on 850 health care workers, self-administered questionnaires were used to obtain information from participants. Results: Of 850 participants, 766 (90.1%) returned their completed questionnaires. The mean±SD age of participants was 36.7±9.2 years. Majority (93.3%) of participants had heard of organ donation; 82.5% had desirable knowledge. Only 29.5% and 39.4% would be willing to donate and counsel potential organ donors, respectively; 36.5% would consider signing organ donation cards. Only 19.4% believed that organ transplantation is often effective and 63.4% believed they were permitted by their religion to donate. Permission by religion (OR 3.5; 95% CI 2.3 to 5.3), good knowledge (OR 2.9; 95% CI 1.4 to 5.7), readiness to sign donation cards (OR 2.6; 95% CI 1.7 to 3.8), discuss organ donation (OR 2.7; 95%CI 8.0 to 63.8), and knowing somebody who had donated (OR 2.9) independently influenced willingness to donate organ. Conclusion: There is disparity in knowledge of organ donation and willingness to donate among health care workers. Efforts should be intensified to give comprehensive and appropriate education to health care workers about organ donation to bridge this gap. PMID:26889370

  5. Implementation of a health data-sharing infrastructure across diverse primary care organizations.

    PubMed

    Cole, Allison M; Stephens, Kari A; Keppel, Gina A; Lin, Ching-Ping; Baldwin, Laura-Mae

    2014-01-01

    Practice-based research networks bring together academic researchers and primary care clinicians to conduct research that improves health outcomes in real-world settings. The Washington, Wyoming, Alaska, Montana, and Idaho region Practice and Research Network implemented a health data-sharing infrastructure across 9 clinics in 3 primary care organizations. Following implementation, we identified challenges and solutions. Challenges included working with diverse primary care organizations, adoption of health information data-sharing technology in a rapidly changing local and national landscape, and limited resources for implementation. Overarching solutions included working with a multidisciplinary academic implementation team, maintaining flexibility, and starting with an established network for primary care organizations. Approaches outlined may generalize to similar initiatives and facilitate adoption of health data sharing in other practice-based research networks. PMID:24594564

  6. Towards an organization with a memory: exploring the organizational generation of adverse events in health care.

    PubMed

    Smith, Denis; Toft, Brian

    2005-05-01

    The role of organizational factors in the generation of adverse events, and the manner in which such factors can also inhibit an organization's abilities to learn, have become important agenda items within health care. The government report 'An organization with a memory' highlighted many of the problems facing health care and suggested changes that need to be made if the sector is to learn effective lessons and prevent adverse events from occurring. This paper seeks to examine some of these organizational factors in more detail and suggests issues that managers need to consider as part of their wider strategies for the prevention and management of risk. The paper sets out five core elements that are held to be importance in shaping the manner in which the potential for risk is incubated within organizations. Although the paper focuses its attention on health care, the points made have validity across the public sector and into private sector organizations.

  7. Suicide and organ donors: spillover effects of mental health insurance mandates.

    PubMed

    Fernandez, Jose; Lang, Matthew

    2015-04-01

    This paper considers the effect of mental health insurance mandates on the supply of cadaveric donors. We find that enacting a mental health mandate decreases the count of organ donors from suicides and results are driven by female donors. Using a number of empirical specifications, we calculate that the mental health parity laws are responsible for an approximately 0.52% decrease in cadaveric donors. Additional regression results show that the mandates are not related to other types of organ donations, ruling out the possibility that the mandates are related to an overall trend in the supply of organ donations. The findings suggest that future policies aimed at reducing suicide in a large and significant way can potentially increase the inefficiency that currently exists in the organ donor market.

  8. Willingness to participate in accountable care organizations: health care managers' perspective.

    PubMed

    Wan, Thomas T H; Demachkie Masri, Maysoun; Ortiz, Judith; Lin, Blossom Y J

    2014-01-01

    This study examines how health care managers responded to the accountable care organization (ACO). The effect of perceived benefits and barriers of the commitment to develop a strategic plan for ACOs and willingness to participate in ACOs is analyzed, using organizational social capital, health information technology uses, health systems integration and size of the health networks, geographic factors, and knowledge about ACOs as predictors. Propensity score matching and analysis are used to adjust the state and regional variations. When the number of perceived benefits is greater than the number of perceived barriers, health care managers are more likely to reveal a stronger commitment to develop a strategic plan for ACO adoption. Health care managers who perceived their organizations as lacking leadership support or commitment, financial incentives, and legal and regulatory support to ACO adoption were less willing to participate in ACOs in the future. Future research should gather more diverse views from a larger sample size of health professionals regarding ACO participation. The perspective of health care managers should be seriously considered in the adoption of an innovative health care delivery system. The transparency on policy formulation should consider multiple views of health care managers.

  9. Are health professionals responsible for the shortage of organs from deceased donors in Malaysia?

    PubMed

    Abidin, Zada L Zainal; Ming, Wee Tong; Loch, Alexander; Hilmi, Ida; Hautmann, Oliver

    2013-02-01

    The rate of organ donations from deceased donors in Malaysia is among the lowest in the world. This may be because of the passivity among health professionals in approaching families of potential donors. A questionnaire-based study was conducted amongst health professionals in two tertiary hospitals in Kuala Lumpur, Malaysia. Four hundred and sixty-two questionnaires were completed. 93.3% of health professionals acknowledged a need for organ transplantation in Malaysia. 47.8% were willing to donate their organs (with ethnic and religious differences). Factors which may be influencing the shortage of organs from deceased donors include: nonrecognition of brainstem death (38.5%), no knowledge on how to contact the Organ Transplant Coordinator (82.3%), and never approaching families of a potential donor (63.9%). There was a general attitude of passivity in approaching families of potential donors and activating transplant teams among many of the health professionals. A misunderstanding of brainstem death and its definition hinder identification of a potential donor. Continuing medical education and highlighting the role of the Organ Transplant Coordinator, as well as increasing awareness of the public through religion and the media were identified as essential in improving the rate of organ donations from deceased donors in Malaysia.

  10. [World Health Organization strategies "Towards Unity for Health" and the social responsibility of medical schools].

    PubMed

    Boelen, C

    2003-04-01

    One may wonder why multiple endeavours conducted worldwide over the last five decades to reform health systems have not achieved their expected outcomes. In light of increasing fragmentation, the current health system must be substituted by a true systems vision along with political will to create a unity of action between the five main stakeholders, namely: policy-makers, health care service managers, professionals and professional associations, academic institutions including medical schools, and civil society. Such synergy can only be established if the partners share the same commitment to core values such as quality, equity, relevance and cost-effectiveness in the health care field. Through its functions of providing education, training, research, and services, the medical school has the potential to induce reflection and stimulate action leading to a more coherent, effective, and equitable health system and policies.

  11. Apostolic faith church organization contexts for health and wellbeing in women and children

    PubMed Central

    Mpofu, Elias; Dune, Tinashe Moira; Hallfors, Denise Dion; Mapfumo, John; Mutepfa, Magen Mhaka; January, James

    2012-01-01

    Objective The study explored contexts for health and wellbeing for women and children influenced by the structural behavior of an Apostolic faith church organization in Zimbabwe. Methods Twenty-three purposively selected members of an African indigenous Apostolic church (males =12; females =11; age range 22 to 95 years) were informants to a focus group discussion session. They provided data on the institutional behaviors that were culturally-historically embedded in the organization’s activities. Data were analyzed thematically and using cultural-historical activity theory (CHAT) to foreground essential themes. Results The church organization provided social capital to support health and wellbeing in members. However, the culturally embedded practices to minimize decision making by women and child members potentially compromised their health and wellbeing. Conclusion The findings suggest that the structural activities of the church for health and wellbeing could also have the paradoxical effect of exposing women and children to health risks from obligatory roles. PMID:21671203

  12. Modes of organising at two health services organizations: a case study approach.

    PubMed

    Rowe, Patricia A; Boyce, Rosalie A; Boyle, Maree V

    2002-08-01

    This paper applies a case study methodology to examine the development of two distinct models of organising allied health professionals within two health service organizations. In particular, it explores options in modes of organising. Case study data reflected that in one case a single stakeholder entity was achieved through the development of quasi-shareholder roles for allied health discipline leaders. In contrast, the second case included multiple small weak stakeholders who had competing visions regarding both identity and resource allocation. The emergence of these two distinct forms of organising within allied health has implications for policy and practice.

  13. A SWOT analysis of the organization and financing of the Danish health care system.

    PubMed

    Christiansen, Terkel

    2002-02-01

    The organization and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of Strengths, Weaknesses, Opportunities and Threats) by a panel of five members with a background in health economics. The present paper describes the methods and materials used for the evaluation: selection of panel members, structure of the evaluation task according to the health care triangle model, selection of background material consisting of documents and literature on the Danish health care system, and a 1-week study visit. PMID:11755992

  14. The facility audit and review method: evaluating institutional ethics in health care organizations.

    PubMed

    Oetjen, Dawn; Oetjen, Reid; Rotarius, Timothy

    2007-01-01

    Auditing processes--such as financial, compliance, and investigative audits-are commonplace in the health care industry. However, an audit to assess institutional ethics in health care facilities is a fairly new concept. The Facility Audit and Review Method is an assessment tool that provides an evaluation scheme to review the organization's policies, procedures, and outcomes using an ethical perspective. This article discusses ethics in the context of health care, the various types of auditing mechanisms used in health care facilities, and how these two--ethics and audits--come together to form the 4-stage Facility Audit and Review Method.

  15. A SWOT analysis of the organization and financing of the Danish health care system.

    PubMed

    Christiansen, Terkel

    2002-02-01

    The organization and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of Strengths, Weaknesses, Opportunities and Threats) by a panel of five members with a background in health economics. The present paper describes the methods and materials used for the evaluation: selection of panel members, structure of the evaluation task according to the health care triangle model, selection of background material consisting of documents and literature on the Danish health care system, and a 1-week study visit.

  16. Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state.

    PubMed

    Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

    2014-02-01

    Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version.

  17. A comparison of the capital structures of nonprofit and proprietary health care organizations.

    PubMed

    Trussel, John

    2012-01-01

    The relative amount of debt used by an organization is an important determination of the organization's likelihood of financial problems and its cost of capital. This study addresses whether or not there are any differences between proprietary and nonprofit health care organizations in terms of capital structure. Controlling for profitability, risk, growth, and size, analysis of covariance is used to determine whether or not proprietary and nonprofit health care organizations use the same amount of leverage in their capital structures. The results indicate that there is no difference in the amount of leverage between the two institutional types. Although nonprofit and proprietary organizations have unique financing mechanisms, these differences do not impact the relative amount of debt and equity in their capital structures.

  18. A comparison of the capital structures of nonprofit and proprietary health care organizations.

    PubMed

    Trussel, John

    2012-01-01

    The relative amount of debt used by an organization is an important determination of the organization's likelihood of financial problems and its cost of capital. This study addresses whether or not there are any differences between proprietary and nonprofit health care organizations in terms of capital structure. Controlling for profitability, risk, growth, and size, analysis of covariance is used to determine whether or not proprietary and nonprofit health care organizations use the same amount of leverage in their capital structures. The results indicate that there is no difference in the amount of leverage between the two institutional types. Although nonprofit and proprietary organizations have unique financing mechanisms, these differences do not impact the relative amount of debt and equity in their capital structures. PMID:23155741

  19. Medicare program; payment to health maintenance organizations and competitive medical plans--HCFA. Proposed rule.

    PubMed

    1984-05-25

    These proposed regulations would implement section 114 of the Tax Equity and Fiscal Responsibility Act of 1982. This provision of the law amended section 1876 of the Social Security Act, which authorizes Medicare reimbursement to eligible organizations on a prospective basis for those organizations that have a risk contract or on a reasonable cost basis for those that have a cost contract. The definition of an eligible organization includes both health maintenance organizations (HMOs) that meet the definition of a qualified HMO under the Public Health Service Act and competitive medical plans (CMPs). The purpose of this proposal is to set forth the requirements that an entity must meet in order to be (1) eligible to enter into a Medicare contract (either risk or reasonable cost) as an eligible organization and (2) reimbursed by Medicare on a capacitation basis (either prospectively or retrospectively) for items and services furnished to Medicare enrollees. PMID:10299521

  20. Family planning and sexual health organizations: management lessons for health system reform.

    PubMed

    Ambegaokar, Maia; Lush, Louisiana

    2004-10-01

    Advocates of health system reform are calling for, among other things, decentralized, autonomous managerial and financial control, use of contracting and incentives, and a greater reliance on market mechanisms in the delivery of health services. The family planning and sexual health (FP&SH) sector already has experience of these. In this paper, we set forth three typical means of service provision within the FP&SH sector since the mid-1900s: independent not-for-profit providers, vertical government programmes and social marketing programmes. In each case, we present the context within which the service delivery mechanism evolved, the management techniques that characterize it and the lessons learned in FP&SH that are applicable to the wider debate about improving health sector management. We conclude that the FP&SH sector can provide both positive and negative lessons in the areas of autonomous management, use of incentives to providers and acceptors, balancing of centralization against decentralization, and employing private sector marketing and distribution techniques for delivering health services. This experience has not been adequately acknowledged in the debates about how to improve the quality and quantity of health services for the poor in developing countries. Health sector reform advocates and FP&SH advocates should collaborate within countries and regions to apply these management lessons.

  1. 2011 Sea Ice Minimum

    NASA Video Gallery

    This video shows Arctic sea ice from March 7, 2011, to Sept. 9, 2011, ending with a comparison of the 30-year average minimum extent, shown in yellow, and the Northwest Passage, in red. (no audio) ...

  2. Achieving the World Health Organization's vision for clinical pharmacology.

    PubMed

    Martin, Jennifer H; Henry, David; Gray, Jean; Day, Richard; Bochner, Felix; Ferro, Albert; Pirmohamed, Munir; Mörike, Klaus; Schwab, Matthias

    2016-02-01

    Clinical pharmacology is a medical specialty whose practitioners teach, undertake research, frame policy, give information and advice about the actions and proper uses of medicines in humans and implement that knowledge in clinical practice. It involves a combination of several activities: drug discovery and development, training safe prescribers, providing objective and evidence-based therapeutic information to ethics, regulatory and pricing bodies, supporting patient care in an increasingly subspecialized arena where co-morbidities, polypharmacy, altered pharmacokinetics and drug interactions are common and developing and contributing to medicines policies for Governments. Clinical pharmacologists must advocate drug quality and they must also advocate for sustainability of the Discipline. However for this they need appropriate clinical service and training support. This Commentary discusses strategies to ensure the Discipline is supported by teaching, training and policy organizations, to communicate the full benefits of clinical pharmacology services, put a monetary value on clinical pharmacology services and to grow the clinical pharmacology workforce to support a growing clinical, academic and regulatory need. PMID:26466826

  3. Peripheral Reproductive Organ Health and Melatonin: Ready for Prime Time

    PubMed Central

    Reiter, Russel J.; Rosales-Corral, Sergio A.; Manchester, Lucien C.; Tan, Dun-Xian

    2013-01-01

    Melatonin has a wide variety of beneficial actions at the level of the gonads and their adnexa. Some actions are mediated via its classic membrane melatonin receptors while others seem to be receptor-independent. This review summarizes many of the published reports which confirm that melatonin, which is produced in the ovary, aids in advancing follicular maturation and preserving the integrity of the ovum prior to and at the time of ovulation. Likewise, when ova are collected for in vitro fertilization-embryo transfer, treating them with melatonin improves implantation and pregnancy rates. Melatonin synthesis as well as its receptors have also been identified in the placenta. In this organ, melatonin seems to be of particular importance for the maintenance of the optimal turnover of cells in the villous trophoblast via its ability to regulate apoptosis. For male gametes, melatonin has also proven useful in protecting them from oxidative damage and preserving their viability. Incubation of ejaculated animal sperm improves their motility and prolongs their viability. For human sperm as well, melatonin is also a valuable agent for protecting them from free radical damage. In general, the direct actions of melatonin on the gonads and adnexa of mammals indicate it is an important agent for maintaining optimal reproductive physiology. PMID:23549263

  4. Interorganizational relationships among family support organizations and child mental health agencies.

    PubMed

    Acri, Mary C; Palinkas, Larry; Hoagwood, Kimberly E; Shen, Sa; Schoonover, Diana; Reutz, Jennifer Rolls; Landsverk, John

    2014-07-01

    This study examined: (1) qualitative aspects of close working relationships between family support organizations and child mental health agencies, including effective and ineffective characteristics of the relationship and aspects that they would change, and (2) the impact of the working relationship upon the family support organization. Semi-structured interviews were conducted with 40 directors of family support organizations characterized as having a close working relationship with a child mental health agency. Three main themes emerged regarding the quality of the working relationship: (a) interactional factors, including shared trust, communication, collaboration and service coordination; (b) aspects of the inner context of the family support organization, mental health agency, or both, including alignment of goals and values and perceptions of mental health services; and (c) outer contextual factors external to the organizations, such as financial and county regulations. Responses to the perceived impact of the relationship was divided into two themes: positive impacts (e.g. gained respect, influence and visibility), and negative impacts (e.g. lack of trust). This study lays the foundation for future research to better understand the mechanisms underlying interorganizational relationships in communities among different types of providers to create a more seamless continuum of services for families of children with mental health conditions.

  5. Enhancing learning, innovation, adaptation, and sustainability in health care organizations: the ELIAS performance management framework.

    PubMed

    Persaud, D David

    2014-01-01

    The development of sustainable health care organizations that provide high-quality accessible care is a topic of intense interest. This article provides a practical performance management framework that can be utilized to develop sustainable health care organizations. It is a cyclical 5-step process that is premised on accountability, performance management, and learning practices that are the foundation for a continuous process of measurement, disconfirmation, contextualization, implementation, and routinization This results in the enhancement of learning, innovation, adaptation, and sustainability (ELIAS). Important considerations such as recognizing that health care organizations are complex adaptive systems and the presence of a dynamic learning culture are necessary contextual factors that maximize the effectiveness of the proposed framework. Importantly, the ELIAS framework utilizes data that are already being collected by health care organizations for accountability, improvement, evaluation, and strategic purposes. Therefore, the benefit of the framework, when used as outlined, would be to enhance the chances of health care organizations achieving the goals of ongoing adaptation and sustainability, by design, rather than by chance.

  6. Perspectives of community- and faith-based organizations about partnering with local health departments for disasters.

    PubMed

    Stajura, Michael; Glik, Deborah; Eisenman, David; Prelip, Michael; Martel, Andrea; Sammartinova, Jitka

    2012-07-01

    Public health emergency planners can better perform their mission if they develop and maintain effective relationships with community- and faith-based organizations in their jurisdictions. This qualitative study presents six themes that emerged from 20 key informant interviews representing a wide range of American community- and faith-based organizations across different types of jurisdictions, organizational types, and missions. This research seeks to provide local health department public health emergency planners with tools to assess and improve their inter-organizational community relationships. The themes identified address the importance of community engagement, leadership, intergroup dynamics and communication, and resources. Community- and faith-based organizations perceive that they are underutilized or untapped resources with respect to public health emergencies and disasters. One key reason for this is that many public health departments limit their engagement with community- and faith-based organizations to a one-way "push" model for information dissemination, rather than engaging them in other ways or improving their capacity. Beyond a reprioritization of staff time, few other resources would be required. From the perspective of community- and faith-based organizations, the quality of relationships seems to matter more than discrete resources provided by such ties. PMID:22851942

  7. European organic dairy farmers' preference for animal health management within the farm management system.

    PubMed

    van Soest, F J S; Mourits, M C M; Hogeveen, H

    2015-11-01

    The expertise and knowledge of veterinary advisors on improving animal health management is key towards a better herd health status. However, veterinary advisors are not always aware of the goals and priorities of dairy farmers. To dairy farmers animal health is only one aspect of farm management and resources may be allocated to other more preferred areas. Veterinary advisors may experience this as non-compliant with their advice. To explore the preferences of European Union (EU) organic dairy farmers for improved animal health management relative to other farm management areas an adaptive conjoint analysis (ACA) was performed. A total of 215 farmers participated originating from organic dairy farms in France (n = 70), Germany (n = 60), Spain (n = 28) and Sweden (n = 57). The management areas udder health and claw health represented animal health management whereas barn, calf and pasture management represented potential conflicting management areas. Results indicate that EU organic dairy farmers differ in their preferences for improved animal health management within the farming system. In general, improved calf management was the most preferred area and improved claw health management was found to be least preferred, the remaining areas were of intermediate interest. Cluster analyses on claw health measures and udder health measures resulted in respectively seven and nine distinct preference profiles. The results indicate a high degree of variation in farmers' preference, which cannot be explained by the typical herd characteristics. With the individual preferences revealed by ACA, a veterinary advisor can now find out whether his intended advice is directed at a favourable or unfavourable management area of the farmer. If the latter is the case the veterinarian should first create awareness of the problem to the farmer. Insights in individual farmers preferences will allow veterinary advisors to better understand why farmers were incompliant with their advice

  8. Leadership, organization and health at work: a case study of a Swedish industrial company.

    PubMed

    Eriksson, Andrea; Jansson, Bjarne; Haglund, Bo J A; Axelsson, Runo

    2008-06-01

    The application of knowledge on organization and leadership is important for the promotion of health at workplace. The purpose of this article is to analyse the leadership and organization, including the organizational culture, of a Swedish industrial company in relation to the health of the employees. The leadership in this company has been oriented towards developing and actively promoting a culture and a structure of organization where the employees have a high degree of control over their work situation. According to the employees, this means extensive possibilities for personal development and responsibility, as well as good companionship, which makes them feel well at work. This is also supported by the low sickness rate of the company. The results indicate that the leadership and organization of this company may have been conducive to the health of the employees interviewed. However, the culture of personal responsibility and the structure of self-managed teams seemed to suit only those who were able to manage the demands of the company and adapt to that kind of organization. Therefore, the findings indicate that the specific context of the technology, the environment and the professional level of the employees need to be taken into consideration when analysing the relation between leadership, organization and health at work.

  9. Animal health organizations: roles to mitigate the impact of ecologic change on animal health in the tropics.

    PubMed

    Acord, Bobby R; Walton, Thomas E

    2004-10-01

    Production of livestock across North and South America is extensive. The opportunities for production, commerce, and thriving economies related to animal agriculture are balanced against the devastating threats of disease. Commitment by livestock and poultry producers in exporting countries to production methods, herd health management, and biosecurity in their operations must be coupled with an animal health and marketing infrastructure that allows the industries to thrive and offers assurances to trading partners that their livestock industries will not be jeopardized. National and international animal health organizations play a key role in providing this infrastructure to the industries that they serve. The incentive for the successful World agricultural production economies to provide direction and support for improving animal health and conveying principles for competitive and safe production to lesser developed nations is the assurance that the expanding economies of these nations offer an eager and hungry market for the products of the other industries of an export-dependent economy. The World Trade Organization (WTO) was established after the Uruguay Round of the General Agreement on Tariffs and Trade (GATT). The WTO provides the permanent international multilateral institutional framework for implementing dispute resolution agreements and the agreement on the application of sanitary and phytosanitary (SPS) measures. The SPS agreements allow for the protection of animal and plant health.

  10. Using Professional Organizations to Prepare the Behavioral Health Workforce to Respond to the Needs of Pediatric Populations Impacted by Health-Related Disasters: Guiding Principles and Challenges.

    PubMed

    Sprang, Ginny; Silman, Miriam

    2015-12-01

    Behavioral health professional organizations are in the unique role of aggregating and disseminating information to their membership before, during, and after health-related disasters to promote the integration of behavioral health services into the public health disaster response plan. This article provides a set of 5 principles to direct this undertaking that are based on the current literature and previous evaluation of the online guidance provided by 6 prominent behavioral health professional organizations. These principles use a strengths-based approach to prioritize resilience; underscore the importance of context, collaboration, and coordination; recognize the unique needs of pediatric populations; and guide ongoing training and content development in the area of biopsychosocial responses to health-related disasters. Recognizing important innovations and strides made by the behavioral health organizations noted in a previous study, this article recommends additional areas in which behavioral health professional organizations can contribute to overall pandemic disaster preparedness and response efforts.

  11. Weight loss goals of patients in a health maintenance organization.

    PubMed

    Dutton, Gareth R; Perri, Michael G; Dancer-Brown, Melissa; Goble, Mary; Van Vessem, Nancy

    2010-04-01

    Individuals seeking weight loss treatment endorse unrealistic expectations regarding their goals for weight loss, although these conclusions are primarily based on research conducted in obesity specialty clinics and/or controlled clinical trials. This study examined the weight loss goals and predictors of these goals among patients participating in obesity treatment in an applied, clinical setting (i.e., managed care organization). Managed care patients enrolled in a behavioral weight loss program (N=143; mean age=46.8 years; mean BMI=36.9 kg/m(2); 89.5% female; 64.5% Caucasian) completed a self-report survey during an initial weight loss session. The survey included items assessing patients' weight loss expectations, including goals for dream, happy, acceptable, and disappointed weights. Participants completed questions regarding contacts with their primary care physician and physician provision of weight loss counseling and/or referrals. They also provided values for current height and weight. BMI's and weight loss associated with dream, happy, acceptable, and disappointed weight goals were 24.8 kg/m(2) (30.9% loss), 27.1 kg/m(2) (25.2% loss), 29.3 kg/m(2) (19.7% loss), and 33.0 kg/m(2) (10.4% loss), respectively. There were significant gender differences in weight loss goals, with women endorsing more unrealistic goals than men for dream and happy weights, ps<0.001. Significant predictors of all four weight loss goals included baseline BMI, gender, ethnicity, and frequency of visits with one's primary care physician, ps<0.01. Consistent with previous research, patients participating in a weight loss program implemented in a managed care setting endorsed unrealistic expectations for weight loss. However, more frequent contact with one's primary care physician was associated with more realistic goals. Future, longitudinal research is needed to document the discrepancy between these goals and actual weight loss achieved in such settings as well as to determine

  12. Health needs and eHealth readiness assessment of health care organizations in Kabul and Bamyan, Afghanistan.

    PubMed

    Durrani, H; Khoja, S; Naseem, A; Scott, R E; Gul, A; Jan, R

    2012-06-01

    This study assessed the need and readiness of health care institutions in Kabul and Bamyan, Afghanistan for successful implementation of information and communication technology in health care (eHealth). A mixed methods design was adopted at 2 institutions in the Aga Khan Development Network in Afghanistan: the French Medical Institute for Children in Kabul and Bamyan Provincial Hospital, Bamyan. Information for the needs assessment was obtained from interviews and focus groups and eHealth readiness was assessed using a validated survey tool. The needs of institutions in the Aga Khan Development Network in Afghanistan were categorized as follows: provision of care needs; learning needs; and information management needs. eHealth readiness on average was lower in Bamyan compared with Kabul in all areas of the readiness assessment. Other institutions in Afghanistan may benefit from adopting the model of needs and readiness assessment used for Aga Khan Development Network institutions. PMID:22888626

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

    PubMed Central

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

    2012-01-01

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

  14. Recommendations from a meeting on health implications of genetically modified organism (GMO).

    PubMed

    Amofah, George

    2014-06-01

    The Ghana Public Health Association organized a scientific seminar to examine the introduction of genetically modified organisms into public use and the health consequences. The seminar was driven by current public debate on the subject. The seminar identified some of the advantages of GMOs and also the health concerns. It is clear that there is the need to enhance local capacity to research the introduction and use of GMOs; to put in place appropriate regulatory mechanisms including particularly the labeling of GMO products and post-marketing surveillance for possible negative health consequences in the long term. Furthermore the appropriate state agency should put in place advocacy strategies to keep the public informed about GMOs. PMID:25667561

  15. Recommendations from a meeting on health implications of genetically modified organism (GMO).

    PubMed

    Amofah, George

    2014-06-01

    The Ghana Public Health Association organized a scientific seminar to examine the introduction of genetically modified organisms into public use and the health consequences. The seminar was driven by current public debate on the subject. The seminar identified some of the advantages of GMOs and also the health concerns. It is clear that there is the need to enhance local capacity to research the introduction and use of GMOs; to put in place appropriate regulatory mechanisms including particularly the labeling of GMO products and post-marketing surveillance for possible negative health consequences in the long term. Furthermore the appropriate state agency should put in place advocacy strategies to keep the public informed about GMOs.

  16. Organizational culture: its impact on employee relations and discipline in health care organizations.

    PubMed

    Crow, Stephen M; Hartman, Sandra J

    2002-12-01

    Organizations need to examine their cultures at the level of the "shop floor"--in health care, the point where health care workers deal with patients--to determine if the culture is consistent with management policies and will permit an effective program of reward and discipline. This article describes a case where organizational culture was a major imperative in the outcome of an arbitration case. Discussed is a shop-floor situation in manufacturing holding implications for health care, a setting in which management, by countenancing counterproductive aspects of the culture, made it impossible to apply discipline as needed. The conclusion is that health care organizations that neglect the detrimental elements of their culture may find themselves not only at risk of poor employee relations, but also unable to apply discipline effectively.

  17. [Governance of primary health-care-based health-care organization].

    PubMed

    Báscolo, Ernesto

    2010-01-01

    An analytical framework was developed for explaining the conditions for the effectiveness of different strategies promoting integrated primary health-care (PHC) service-based systems in Latin-America. Different modes of governance (clan, incentives and hierarchy) were characterised from a political economics viewpoint for representing alternative forms of regulation promoting innovation in health-service-providing organisations. The necessary conditions for guaranteeing the modes of governance's effectiveness are presented, as are their implications in terms of posts in play. The institutional construction of an integrated health system is interpreted as being a product of a social process in which different modes of governance are combined, operating with different ways of resolving normative aspects for regulating service provision (with the hierarchical mode), resource distribution (with the incentives mode) and on the social values legitimising such process (with the clan mode). PMID:20963299

  18. Estimating the Development Assistance for Health Provided to Faith-Based Organizations, 1990–2013

    PubMed Central

    Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L.

    2015-01-01

    Background Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Material and Methods Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. Results In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund’s contributions to NGOs. In 2011, the Gates Foundation’s contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Conclusion Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health. PMID:26042731

  19. An interactive integrative approach to translating knowledge and building a "learning organization" in health services management.

    PubMed Central

    Chunharas, Somsak

    2006-01-01

    This paper proposes a basic approach to ensuring that knowledge from research studies is translated for use in health services management with a view towards building a "learning organization". (A learning organization is one in which the environment is structured in such a way as to facilitate learning as well as the sharing of knowledge among members or employees.) This paper highlights various dimensions that determine the complexity of knowledge translation, using the problem-solving cycle as the backbone for gaining a better understanding of how different types of knowledge interact in health services management. It is essential to use an integrated and interactive approach to ensure that knowledge from research is translated in a way that allows a learning organization to be built and that knowledge is not used merely to influence a single decision in isolation from the overall services and management of an organization. PMID:16917653

  20. An interactive integrative approach to translating knowledge and building a "learning organization" in health services management.

    PubMed

    Chunharas, Somsak

    2006-08-01

    This paper proposes a basic approach to ensuring that knowledge from research studies is translated for use in health services management with a view towards building a "learning organization". (A learning organization is one in which the environment is structured in such a way as to facilitate learning as well as the sharing of knowledge among members or employees.) This paper highlights various dimensions that determine the complexity of knowledge translation, using the problem-solving cycle as the backbone for gaining a better understanding of how different types of knowledge interact in health services management. It is essential to use an integrated and interactive approach to ensure that knowledge from research is translated in a way that allows a learning organization to be built and that knowledge is not used merely to influence a single decision in isolation from the overall services and management of an organization.

  1. Organizational barriers to quality improvement in medical and health care organizations.

    PubMed

    Ziegenfuss, J T

    1991-01-01

    This paper identifies organizational barriers to quality improvement in medical and health care organizations. Quality is now recognized as one of the most challenging issues of the 1990s. The push for quality improvement rests on the significant assumption that large and small medical and health care organizations will engage in quality assessment and assurance. Both researchers and practitioners must consider the organizational barriers the quality movement will encounter, particularly those major impediments to be overcome in the next 5-10 years. This paper organizes the analysis of organizational barriers to quality assessment and assurance according to a five-part systems model of the organization. The barriers are categorized as technical, structural, psychosocial, managerial, and goals and values. Following a mapping of the barriers, education, training, and research and development needs to support quality improvement are identified.

  2. Health-care organizations as "patients": transforming the fundamental od paradigm.

    PubMed

    Rubin, Irwin M

    2011-01-01

    Hidden behind such frequently used phrases as "The system/policy requires...," "The organization has decided..." is one simple fact. Systems/policies don't drop from the sky etched in stone tablets and organizations don't decide anything. People make decisions and design systems and write policies. Embracing this fact increases the likelihood that the provision of health-care emanates from a "care dealership" in contrast to a "car dealership." Ignoring this fact leads to less humane, less effective, and more costly health-care. This chapter will challenge all of us concerned with caring for all of us--from Organizational Development (OD). Practitioners to CEOs to ... to ... all of us at some point in our lives--to step up to the need to transform our most basic paradigms. To remind ourselves that human beings give birth to, nurture, sustain, and care for that which we call an organization. In so doing, we will be able to begin to act from the premise that a health-care organization is itself a living breathing human organism, a "Patient" in need of care. The quality of care we afford this "Patient" directly and inevitably impacts the quality of care we are afforded as patients. Acting from this premise will transform all of health-care, all "care dealerships" ... and potentially "car dealerships" as well. OD professionals, therefore, can propel us all to a fourth dimension of caring for all of us.

  3. Time banking and health: the role of a community currency organization in enhancing well-being.

    PubMed

    Lasker, Judith; Collom, Ed; Bealer, Tara; Niclaus, Erin; Young Keefe, Jessica; Kratzer, Zane; Baldasari, Lauren; Kramer, Ethan; Mandeville, Rachel; Schulman, Julia; Suchow, Danielle; Letcher, Abby; Rogers, Anne; Perlow, Kathy

    2011-01-01

    Time banking is an international movement that seeks to transform traditional asymmetric social service models into social networks in which members both provide and receive services that are assigned equal value. Time banks have been shown to enhance social capital, and there is some evidence for improved health. This article, based on a survey of 160 members of a hospital-affiliated time bank, examines the likelihood and predictors of improvement in physical and mental health as a result of membership. Men, people with lower income, and those who were not working full-time reported highest levels of participation in exchanging services; attachment to the organization was greatest among women, older members, people with less education, and those with the highest participation levels. Multivariate analyses revealed that physical health improvement attributed to membership was significantly predicted by attachment to the organization and living alone; mental health gains were predicted by general health changes, average number of exchanges, and attachment to the organization. We conclude that a sense of belonging, a dimension of social capital, is key to improved well-being and that time banking may be particularly valuable in promoting health and belonging among older and lower-income individuals and those who live alone. PMID:20685912

  4. Does hand therapy literature incorporate the holistic view of health and function promoted by the World Health Organization?

    PubMed

    Winthrop Rose, Barbara; Kasch, Mary C; Aaron, Dorit Haenosh; Stegink-Jansen, Caroline W

    2011-01-01

    The International Classification of Function (ICF), as formulated by the World Health Organization (WHO), is an accepted international standard for categorizing health and disability. We examined the frequency that ICF domains have been included in 788 Journal of Hand Therapy articles and 78 hand therapy articles from other sources using a scoring system based on the WHO ICF definitions. We found emphasis on body functions and body structures, with less emphasis placed on activities, participation, and environmental factors. This trend has remained stable over time despite the emergence of patient-centered disability measures. We recommend that scientists increasingly incorporate all of the WHO ICF domains in their scientific investigations to demonstrate the societal and personal impact of the profession in a language that is understood and appreciated by a wide array of health care users, policy makers, and third-party payers.

  5. The performance of primary health care organizations depends on interdependences with the local environment.

    PubMed

    Lamarche, Paul; Maillet, Lara

    2016-09-19

    Purpose Improving the performance of health care organizations is now perceived as essential in order to better address the needs of the populations and respect their ability to pay for the services. There is no consensus on what is performance. It is increasingly considered as the optimal execution of four functions that every organization must achieve in order to survive and develop: reach goals; adapt to its environment; produce goods or services and maintain values; and a satisfying organizational climate. There is also no consensus on strategies to improve this performance. The paper aims to discuss these issues. Design/methodology/approach This paper intends to analyze the performance of primary health care organizations from the perspective of Kauffman's model. It mainly aims to understand the often contradictory, paradoxical and unexpected results that emerge from studies on this topic. Findings To do so, the first section briefly presents Kauffman's model and lays forward its principal components. The second section presents three studies on the performance of primary organizations and brings out the contradictory, paradoxical and unexpected results they obtained. The third section explains these results in the light of Kauffman's model. Originality/value Kauffman's model helps give meaning to the results of researches on performance of primary health care organizations that were qualified as paradoxical or unexpected. The performance of primary health care organizations then cannot be understood by only taking into account the characteristics of these organizations. The complexity of the environments in which they operate must simultaneously be taken into account. This paper brings original development of an integrated view of the performance of organizations, their own characteristics and those of the local environment in which they operated. PMID:27681020

  6. The performance of primary health care organizations depends on interdependences with the local environment.

    PubMed

    Lamarche, Paul; Maillet, Lara

    2016-09-19

    Purpose Improving the performance of health care organizations is now perceived as essential in order to better address the needs of the populations and respect their ability to pay for the services. There is no consensus on what is performance. It is increasingly considered as the optimal execution of four functions that every organization must achieve in order to survive and develop: reach goals; adapt to its environment; produce goods or services and maintain values; and a satisfying organizational climate. There is also no consensus on strategies to improve this performance. The paper aims to discuss these issues. Design/methodology/approach This paper intends to analyze the performance of primary health care organizations from the perspective of Kauffman's model. It mainly aims to understand the often contradictory, paradoxical and unexpected results that emerge from studies on this topic. Findings To do so, the first section briefly presents Kauffman's model and lays forward its principal components. The second section presents three studies on the performance of primary organizations and brings out the contradictory, paradoxical and unexpected results they obtained. The third section explains these results in the light of Kauffman's model. Originality/value Kauffman's model helps give meaning to the results of researches on performance of primary health care organizations that were qualified as paradoxical or unexpected. The performance of primary health care organizations then cannot be understood by only taking into account the characteristics of these organizations. The complexity of the environments in which they operate must simultaneously be taken into account. This paper brings original development of an integrated view of the performance of organizations, their own characteristics and those of the local environment in which they operated.

  7. School Desegregation With Minimum Busing: A Report to the Assistant Secretary for Planning and Evaluation, U.S. Department of Health, Education, and Welfare.

    ERIC Educational Resources Information Center

    Pugh, George E.; Krasnakevich, John

    This analysis is designed to provide Health, Education and Welfare and local school officials with a more objective and uniform assessment of desegregation problems in specific districts in the United States. To carry out the study, Lambda Corporation designed and implemented an analysis procedure for systematically assigning students to schools.…

  8. A minimum data set of animal health laboratory data to allow for collation and analysis across jurisdictions for the purpose of surveillance.

    PubMed

    Kloeze, H; Berezowski, J; Bergeron, L; de With, N; Duizer, G; Green, C; McNab, B; VanderKop, M

    2012-06-01

    A minimum data set consisting of 15 data elements originating from laboratory submissions and results was formulated by a national committee of epidemiologists in Canada for the purposes of disease reporting, disease detection and analysis. The data set consists of both data that are filled out on the submission form as well as the results of the laboratory testing. The elements in the data set are unique identifier, premises identification, date submitted, geographic location, species, farm type, group type, total population of tested species on the farm, number sick, number dead, test(s) performed, disease agent, test result, disease classification by submitter and final laboratory diagnosis. The data set was designed to be concise while allowing for domestic and international disease reporting, effective analysis, including geographic, temporal and prevalence outputs, and syndromic surveillance to enable disease detection. The selected data elements do not identify the producer as specific geographic and nominal information is not included in the data set. The data elements selected, thus, allow for voluntary collaboration and data sharing by avoiding issues associated with privacy legislation.

  9. Record Sea Ice Minimum

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Arctic sea ice reached a record low in September 2007, below the previous record set in 2005 and substantially below the long-term average. This image shows the Arctic as observed by the Advanced Microwave Scanning Radiometer for EOS (AMSR-E) aboard NASA's Aqua satellite on September 16, 2007. In this image, blue indicates open water, white indicates high sea ice concentration, and turquoise indicates loosely packed sea ice. The black circle at the North Pole results from an absence of data as the satellite does not make observations that far north. Three contour lines appear on this image. The red line is the 2007 minimum, as of September 15, about the same time the record low was reached, and it almost exactly fits the sea ice observed by AMSR-E. The green line indicates the 2005 minimum, the previous record low. The yellow line indicates the median minimum from 1979 to 2000.

  10. An empirical determination of the minimum number of measurements needed to estimate the mean random vitrinite reflectance of disseminated organic matter

    USGS Publications Warehouse

    Barker, C.E.; Pawlewicz, M.J.

    1993-01-01

    In coal samples, published recommendations based on statistical methods suggest 100 measurements are needed to estimate the mean random vitrinite reflectance (Rv-r) to within ??2%. Our survey of published thermal maturation studies indicates that those using dispersed organic matter (DOM) mostly have an objective of acquiring 50 reflectance measurements. This smaller objective size in DOM versus that for coal samples poses a statistical contradiction because the standard deviations of DOM reflectance distributions are typically larger indicating a greater sample size is needed to accurately estimate Rv-r in DOM. However, in studies of thermal maturation using DOM, even 50 measurements can be an unrealistic requirement given the small amount of vitrinite often found in such samples. Furthermore, there is generally a reduced need for assuring precision like that needed for coal applications. Therefore, a key question in thermal maturation studies using DOM is how many measurements of Rv-r are needed to adequately estimate the mean. Our empirical approach to this problem is to compute the reflectance distribution statistics: mean, standard deviation, skewness, and kurtosis in increments of 10 measurements. This study compares these intermediate computations of Rv-r statistics with a final one computed using all measurements for that sample. Vitrinite reflectance was measured on mudstone and sandstone samples taken from borehole M-25 in the Cerro Prieto, Mexico geothermal system which was selected because the rocks have a wide range of thermal maturation and a comparable humic DOM with depth. The results of this study suggest that after only 20-30 measurements the mean Rv-r is generally known to within 5% and always to within 12% of the mean Rv-r calculated using all of the measured particles. Thus, even in the worst case, the precision after measuring only 20-30 particles is in good agreement with the general precision of one decimal place recommended for mean Rv

  11. The World Health Organization's recent work on the lexicography of mental disorders.

    PubMed

    Janca, A; Sartorius, N

    1995-01-01

    Standardization of nomenclature and terminology used in the field of mental health has been one of the main goals of the World Health Organization's (WHO) Mental Health Programme among recent activities undertaken to achieve this goal, is the development of definition and guidelines accompanying the chapter dealing with mental disorders in the tenth revision of the International Classification of Diseases (ICD-10) and of a set of instruments for the assessment of mental disorders. To enhance common understanding and uniformity of usage of the terms embedded in the classification and instruments and to facilitate their use in different cultures and settings, a series of lexica and glossaries has also been produced by WHO. The article describes the basic characteristics of the Lexicon of psychiatric and mental health terms, 2nd edition; Lexicon of alcohol and drug terms; Lexicon of crosscultural terms in mental health; SCAN glossary; and the ICD-10 symptom glossary for mental disorders.

  12. Strategic analysis for health care organizations: the suitability of the SWOT-analysis.

    PubMed

    van Wijngaarden, Jeroen D H; Scholten, Gerard R M; van Wijk, Kees P

    2012-01-01

    Because of the introduction of (regulated) market competition and self-regulation, strategy is becoming an important management field for health care organizations in many European countries. That is why health managers are introducing more and more strategic principles and tools. Especially the SWOT (strengths, weaknesses, opportunities, threats)-analysis seems to be popular. However, hardly any empirical research has been done on the use and suitability of this instrument for the health care sector. In this paper four case studies are presented on the use of the SWOT-analysis in different parts of the health care sector in the Netherlands. By comparing these results with the premises of the SWOT and academic critique, it will be argued that the SWOT in its current form is not suitable as a tool for strategic analysis in health care in many European countries. Based on these findings an alternative SWOT-model is presented, in which expectations and learning of stakeholder are incorporated.

  13. The role of non-governmental organizations in the social and the health system.

    PubMed

    Piotrowicz, Maria; Cianciara, Dorota

    2013-01-01

    The article presents the definitions, objectives, fields and tasks of non-governmental organizations in social life, health system and health policy. In addition, the article addresses the issue of effectiveness and quality of NGOs' activity. The term "NGOs" (Non-governmental Organizations) includes different categories of entities that operate not to obtain financial gain, and also do not belong to the government sector. Non-governmental Organizations' fields of activity were described in the International Classification of Non-Profit Organizations (ICNPO). NGOs are an integral part of a democratic society. Sociological sciences emphasize their importance in enhancing social integration, implementation of the principle of subsidiarity, building civil society, social dialogue and participatory democracy. The main tasks of NGOs in the health system are providing services and health advocacy. Provision of services includes medical, social and psychological services as well as, integration activities, care and nursing, material and financial support, educational and information services and training. Health advocacy is a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or program. An important task carried out by NGOs is participation in the formation of health policy. The increasing role of NGOs in providing social services and the participation in political processes, result in the need to confirm the validity and credibility of their operation. One of the ways could be to introduce the mechanisms to assess quality and efficiency, such as registration as a part of a legal system, self-regulatory activities (card rules, codes of ethics), certification, participation in networks, monitoring and audit. PMID:23745379

  14. The role of non-governmental organizations in the social and the health system.

    PubMed

    Piotrowicz, Maria; Cianciara, Dorota

    2013-01-01

    The article presents the definitions, objectives, fields and tasks of non-governmental organizations in social life, health system and health policy. In addition, the article addresses the issue of effectiveness and quality of NGOs' activity. The term "NGOs" (Non-governmental Organizations) includes different categories of entities that operate not to obtain financial gain, and also do not belong to the government sector. Non-governmental Organizations' fields of activity were described in the International Classification of Non-Profit Organizations (ICNPO). NGOs are an integral part of a democratic society. Sociological sciences emphasize their importance in enhancing social integration, implementation of the principle of subsidiarity, building civil society, social dialogue and participatory democracy. The main tasks of NGOs in the health system are providing services and health advocacy. Provision of services includes medical, social and psychological services as well as, integration activities, care and nursing, material and financial support, educational and information services and training. Health advocacy is a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or program. An important task carried out by NGOs is participation in the formation of health policy. The increasing role of NGOs in providing social services and the participation in political processes, result in the need to confirm the validity and credibility of their operation. One of the ways could be to introduce the mechanisms to assess quality and efficiency, such as registration as a part of a legal system, self-regulatory activities (card rules, codes of ethics), certification, participation in networks, monitoring and audit.

  15. Health maintenance organizations: structure, performance, and current issues for employee health benefits design.

    PubMed

    Gold, M

    1991-03-01

    After summarizing the origins and key principles of HMOs, including the current characteristics of the HMO industry, this article reviews the evidence of HMO performance in the areas of benefits design, utilization and cost effectiveness, quality of care and consumer satisfaction, and selection and overall employer satisfaction. Outstanding issues and concerns, from the perspective of employee health benefits design, include issues such as assuring a fair price for HMO benefits, employer contribution methods, HMO diversification, and cost escalation and the search for value. Results of research studies have been generally positive about HMO performance on benefits, cost effectiveness, quality, and consumer satisfaction, and more mixed on employer satisfaction. As employers address concerns, some changes are likely in the methods used to integrate HMOs into a health benefits strategy. Because the issues involved in these changes are numerous and complex, careful consideration and design are desirable to assure that the net impact of any change is positive and consistent with overall goals. PMID:1903152

  16. Health maintenance organizations: critical issues raised by restructuring delivery for health systems reform.

    PubMed

    Gold, M

    1993-10-01

    In sum, the potential that managed care will grow under health systems reform creates an opportunity for the HMO industry but also serves as a challenge and a threat. Faced with greater scrutiny and growing demands, HMOs increasingly are being forced to demonstrate their potential and live up to their expectation. At the same time, the changing nature of the health care system creates a challenge for HMOs. Cost pressures create needs to review the entire delivery system, including the ambulatory component, with a focus on enhancing cost-effectiveness. Greater visibility also creates demands; growing market penetration argues for the creation of a new paradigm to define an appropriate structure for public accountability and management. Finally, the transformation of an HMO industry into a managed care industry is not without its risks as HMO performance becomes evaluated not only against itself but as part of the performance of the broader managed care industry in which HMOs have become embedded. PMID:10128419

  17. Internal marketing within a health care organization: developing an implementation plan.

    PubMed

    Hallums, A

    1994-05-01

    This paper discusses how the concept of internal marketing can be applied within a health care organization. In order to achieve a market orientation an organization must identify the needs and wants of its customers and how these may change in the future. In order to achieve this, internal marketing is a necessary step to the implementation of the organizations marketing strategy. An outline plan for the introduction of an internal marketing programme within an acute hospital trust is proposed. The plan identifies those individuals and departments who should be involved in the planning and implementation of the programme. The benefits of internal marketing to the Trust are also considered.

  18. Alternative dispute resolution: methods to address workplace conflict in health services organizations.

    PubMed

    DeSouza, J R

    1998-01-01

    As healthcare organizations become increasingly complex, healthcare administrators and human resource managers face the cost and challenges of employment-related disputes. Litigation and legal costs associated with employment disputes are escalating at a significant rate. Additionally, litigation procedures are drawn out and damage the employer-employee relationship. Alternative dispute resolution (ADR) programs such as mediation and arbitration alleviate the burden of litigation and preserve positive employment relationships between the organization and its employees. A proposed ADR program is presented is a guideline for health services organizations considering the adoption of such programs. PMID:10182933

  19. Faculty of Dentistry, Kuwait University, designated as a World Health Organization Collaborating Centre for Primary Oral Health Care.

    PubMed

    Behbehani, J M

    2014-01-01

    The Faculty of Dentistry, Kuwait University, was designated as a World Health Organization (WHO) Collaborating Centre for Primary Oral Health Care (POHC) in 2011. This article aimed to describe the following: (1) the background for this nomination, (2) the WHO Collaborating Centre for POHC, its terms of reference and 5 activities, (3) the primary health care concept as it was established in Alma-Ata, (4) the oral health situation in Kuwait and in the Middle-East region and, finally, (5) how POHC policy should be implemented in Kuwait and this region. It can be concluded that, because the caries experience is very high in Kuwait and in the other countries of the Eastern Mediterranean region, good POHC programmes should be designed and implemented in this region. The Faculty of Dentistry will strengthen its research tradition and as a WHO Collaborating Centre for POHC will try to collect information and experience from POHC in this region and exchange ideas between POHC experts in this region on how these programmes could be further developed. This will happen according to the terms of reference and activity plans of the WHO Collaborating Centre for POHC approved by the WHO Global Oral Health Programme.

  20. Health-promoting organization and organizational effectiveness of health promotion in hospitals: a national cross-sectional survey in Taiwan.

    PubMed

    Lin, Yea-Wen; Lin, Yueh-Ysen

    2011-09-01

    To assess the organizational health-promotion (HP) status and its effect on the organizational effectiveness of HP in a national cross-sectional survey of all hospitals above the local community hospital level in Taiwan's hospitals, questionnaires were sent to 474 hospitals, of which 162 (34.18%) hospitals returned them and were rendered valid. The results of the organizational HP status reveal that the standardized overall score achieved is 76.26, suggesting that there is considerable room for improvement. The results of correlation analysis partially support the proposition of this study, suggesting that the higher the organizational HP status, the better the self-evaluated overall organizational and administrative effectiveness of its HP. When hierarchical multiple regression was performed, support for ownership (private hospitals), hospital accreditation grades (academic medical centers) and overall score of the Organizational Health of Hospital Assessment Scale were significant predicators of self-evaluated overall organizational effectiveness (F = 11.097, p < 0.01, R(2) = 0.369). Moreover, drafted annually, HP policies and plans and the number of staff HP training activities were found to partially mediate the relation between the organizational HP status, hospital characteristics and self-evaluated overall organizational effectiveness. The results contribute to clarify the conception of health-promoting hospital organizations and to identify a number of dimensions of health-promoting organizations related to the organizational effectiveness of HP in hospitals, which could allow hospitals to establish a healthier organization and more effective HP programs. This study also supplies the research field with important data and insights that can be used in future research.

  1. Research-based-decision-making in Canadian health organizations: a behavioural approach.

    PubMed

    Jbilou, Jalila; Amara, Nabil; Landry, Réjean

    2007-06-01

    Decision making in Health sector is affected by a several elements such as economic constraints, political agendas, epidemiologic events, managers' values and environment... These competing elements create a complex environment for decision making. Research-Based-Decision-Making (RBDM) offers an opportunity to reduce the generated uncertainty and to ensure efficacy and efficiency in health administrations. We assume that RBDM is dependant on decision makers' behaviour and the identification of the determinants of this behaviour can help to enhance research results utilization in health sector decision making. This paper explores the determinants of RBDM as a personal behaviour among managers and professionals in health administrations in Canada. From the behavioural theories and the existing literature, we build a model measuring "RBDM" as an index based on five items. These items refer to the steps accomplished by a decision maker while developing a decision which is based on evidence. The determinants of RBDM behaviour are identified using data collected from 942 health care decision makers in Canadian health organizations. Linear regression is used to model the behaviour RBDM. Determinants of this behaviour are derived from Triandis Theory and Bandura's construct "self-efficacy." The results suggest that to improve research use among managers in Canadian governmental health organizations, strategies should focus on enhancing exposition to evidence through facilitating communication networks, partnerships and links between researchers and decision makers, with the key long-term objective of developing a culture that supports and values the contribution that research can make to decision making in governmental health organizations. Nevertheless, depending on the organizational level, determinants of RBDM are different. This difference has to be taken into account if RBDM adoption is desired. Decision makers in Canadian health organizations (CHO) can help to build

  2. Reproducibility of the World Health Organization 2008 criteria for myelodysplastic syndromes

    PubMed Central

    Senent, Leonor; Arenillas, Leonor; Luño, Elisa; Ruiz, Juan C.; Sanz, Guillermo; Florensa, Lourdes

    2013-01-01

    The reproducibility of the World Health Organization 2008 classification for myelodysplastic syndromes is uncertain and its assessment was the major aim of this study. The different peripheral blood and bone marrow variables required for an adequate morphological classification were blindly evaluated by four cytomorphologists in samples from 50 patients with myelodysplastic syndromes. The degree of agreement among observers was calculated using intraclass correlation coefficient and the generalized kappa statistic for multiple raters. The degree of agreement for the percentages of blasts in bone marrow and peripheral blood, ring sideroblasts in bone marrow, and erythroid, granulocytic and megakaryocytic dysplastic cells was strong (P<0.001 in all instances). After stratifying the percentages according to the categories required for the assignment of World Health Organization subtypes, the degree of agreement was not statistically significant for cases with 5-9% blasts in bone marrow (P=0.07), 0.1-1% blasts in peripheral blood (P=0.47), or percentage of erythroid dysplastic cells (P=0.49). Finally, the interobserver concordance for World Health Organization-defined subtypes showed a moderate overall agreement (P<0.001), the reproducibility being lower for cases with refractory anemia with excess of blasts type 1 (P=0.05) and refractory anemia with ring sideroblasts (P=0.09). In conclusion, the reproducibility of the World Health Organization 2008 classification for myelodysplastic syndromes is acceptable but the defining criteria for blast cells and features of erythroid dysplasia need to be refined. PMID:23065505

  3. The Camp Health Manual. An Excellent Reference Written Especially for Organized Camps. Revised.

    ERIC Educational Resources Information Center

    Goldring, David; Middelkamp, J. Neal

    This book is a guide to the diagnosis and care of sick children in organized camping situations. This book presents health care information for the management of medical and surgical problems by the camp counselor, camp director, camp nurse, and camp physician. The chapters are: (1) Camp Standards; (2) The Infirmary; (3) Infirmary Supplies; (4)…

  4. Experiences in Rural Mental Health II: Organizing a Low Budget Program.

    ERIC Educational Resources Information Center

    Hollister, William G.; And Others

    Based on a North Carolina feasibility study (1967-73) which focused on development of a pattern for providing comprehensive mental health services to rural people, this second program guide deals with organization of a low-income program budget. Presenting the basic assumptions utilized in the development of a low-budget program in Franklin and…

  5. Between the Local and the Global: Organized Research Units and International Collaborations in the Health Sciences

    ERIC Educational Resources Information Center

    Sa, Creso M.; Oleksiyenko, Anatoly

    2011-01-01

    Organized research units--also known as centers, institutes, and laboratories--are increasingly prominent in the university. This paper examines how ORUs emerge to promote global agendas and international collaborations in an academic health center in North America. The roles these units play in helping researchers work across institutional and…

  6. Health Care, Heal Thyself! An Exploration of What Drives (and Sustains) High Performance in Organizations Today

    ERIC Educational Resources Information Center

    Wolf, Jason A.

    2008-01-01

    What happens when researching the radical unveils the simplest of solutions? This article tells the story of the 2007 ISPI Annual Conference Encore Presentation, Healthcare, Heal Thyself, sharing the findings of an exploration into high-performance health care facilities and their relevance to all organizations today. It shows how to overcome…

  7. Association between organizational capacity and involvement in chronic disease prevention programming among Canadian public health organizations.

    PubMed

    Hanusaik, Nancy; Sabiston, Catherine M; Kishchuk, Natalie; Maximova, Katerina; O'Loughlin, Jennifer

    2015-04-01

    In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement in core chronic disease prevention practices) and (ii) examined differences in the nature of these relationships among organizations operating in more and less facilitating external environments. OC was conceptualized as skills and resources/supports for chronic disease prevention programming. Data were from a census of 210 Canadian public health organizations with mandates for chronic disease prevention. The hypothesized relationships were tested using structural equation modeling. Overall, the results supported the model. Organizational supports for evaluation accounted for 33% of the variance in skills. Skills and resources/supports were directly and strongly related to involvement. Organizations operating within facilitating external contexts for chronic disease prevention had more effective partnerships, more resources/supports, stronger skills and greater involvement in core chronic disease prevention practices. Results also suggested that organizations functioning in less facilitating environments may not benefit as expected from partnerships. Empirical testing of this conceptual model helps develop a better understanding of public health OC.

  8. Association between organizational capacity and involvement in chronic disease prevention programming among Canadian public health organizations

    PubMed Central

    Hanusaik, Nancy; Sabiston, Catherine M.; Kishchuk, Natalie; Maximova, Katerina; O’Loughlin, Jennifer

    2015-01-01

    In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement in core chronic disease prevention practices) and (ii) examined differences in the nature of these relationships among organizations operating in more and less facilitating external environments. OC was conceptualized as skills and resources/supports for chronic disease prevention programming. Data were from a census of 210 Canadian public health organizations with mandates for chronic disease prevention. The hypothesized relationships were tested using structural equation modeling. Overall, the results supported the model. Organizational supports for evaluation accounted for 33% of the variance in skills. Skills and resources/supports were directly and strongly related to involvement. Organizations operating within facilitating external contexts for chronic disease prevention had more effective partnerships, more resources/supports, stronger skills and greater involvement in core chronic disease prevention practices. Results also suggested that organizations functioning in less facilitating environments may not benefit as expected from partnerships. Empirical testing of this conceptual model helps develop a better understanding of public health OC. PMID:25361958

  9. 77 FR 60996 - Office of the Assistant Secretary for Health, Statement of Organization, Functions, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ..., administration and management functions for the U.S. Public Health Service (PHS) Commissioned Corps in the OASH... following functions, beginning with (13) through (22): 3. Assignments and Career Management Branch (ACM23... Organization, Functions, and Delegations of Authority Part A, Office of the Secretary, Statement...

  10. In Search of Excellence: Practical Strategies for Managing Change in Environmental Health Organizations.

    ERIC Educational Resources Information Center

    Veninga, Robert L.

    1987-01-01

    Describes three methods intended to assist in assessing the attitudes of environmental health organization employees with regard to change. Focuses on ways to bring about orderly organizational change, how to evaluate whether the changes are effective, and how to diminish resistance to new ideas. (Author/TW)

  11. Health-related quality of life in pediatric patients with functional and organic gastrointestinal diseases

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of our study was to compare health-related quality of life (HRQOL) in pediatric patients with functional gastrointestinal disorders (FGIDs) and organic gastrointestinal (GI) diseases with an age-, sex-, and race/ethnicity-matched healthy sample across GI diagnostic groups and with one ...

  12. How to develop a second victim support program: a toolkit for health care organizations.

    PubMed

    Pratt, Stephen; Kenney, Linda; Scott, Susan D; Wu, Albert W

    2012-05-01

    A toolkit was developed to help health care organizations implement support programs for clinicians suffering from the emotional impact of errors and adverse events. Based on the best available evidence related to the second victim experience, the toolkit consists of 10 modules, each with a series of specific action steps, references, and exemplars.

  13. Professional liability insurance for health care organizations--several significant considerations.

    PubMed

    Rotarius, T; Liberman, A

    2000-09-01

    The purchase of professional liability insurance coverage represents one of the more important financial and administrative decisions in terms of managing a health services organization. This manuscript outlines a decision process for evaluating and determining the most viable option(s). Also addressed are some significant caveats in assessing the strengths and weaknesses of various coverage options. PMID:11183654

  14. How Community Organizations Promote Continuity of Care for Young People with Mental Health Problems.

    PubMed

    Polgar, Michael F; Cabassa, Leopoldo J; Morrissey, Joseph P

    2016-04-01

    Young people between the ages of 16 and 25 who experience mental health problems experience transitions and need help from a variety of organizations. Organizations promote continuity of care by assisting young adults with developmental, service, and systemic transitions. Providers offer specific services to help transitions and also form cooperative relationships with other community organizations. Results from a survey of 100 service providers in one community describe organizational attributes and practices which are associated with continuity of care in a regional system for young adults. Data analyses show that full-service organizations which practice cultural competence offer more specific services that foster continuity of care. Larger, full-service organizations are also more likely to have more extensive and collaborative inter-organizational networks that help young adults continue care over time within the regional system of care.

  15. Minimum Critical Values Study

    SciTech Connect

    Fox, P.B.

    2005-07-11

    This report provides minimum critical values for various 30-cm water-reflected uranium and plutonium oxide and nitrate aqueous mixtures as calculated by the SCALE CSAS1X sequence using the 238-group ENDF/B-V neutron cross-section library. The minimum values were determined through parametric searches in one-dimensional geometry. The calculations have been performed to obtain the minimum values: critical volume and mass for spheres, critical radius for cylinders, critical thickness for slabs, and minimum critical concentration (infinite geometry) for the following homogeneous mixtures: (1) UO{sub 2}-H{sub 2}O for 3, 4, 5, 20, and 100 wt % {sup 235}U; (2) UNH for 3, 4, 5, 20, and 100 wt % {sup 235}U; (3) PuO{sub 2}-H{sub 2}O for 100/0/0, 95/5/0, 90/5/5, 80/10/10, and 71/17/11/1 wt % of {sup 239}Pu/{sup 240}Pu/{sup 241}Pu(/{sup 242}Pu); and (4) PuNH for 100/0/0, 95/5/0, 90/5/5, 80/10/10, and 71/17/11/1 wt % of {sup 239}Pu/{sup 240}Pu/{sup 241}Pu(/{sup 242}Pu). All bounding surfaces were fully reflected by 30 cm of H{sub 2}O.

  16. Minimum variance geographic sampling

    NASA Technical Reports Server (NTRS)

    Terrell, G. R. (Principal Investigator)

    1980-01-01

    Resource inventories require samples with geographical scatter, sometimes not as widely spaced as would be hoped. A simple model of correlation over distances is used to create a minimum variance unbiased estimate population means. The fitting procedure is illustrated from data used to estimate Missouri corn acreage.

  17. Organization and Finance of China's Health Sector: Historical Antecedents for Macroeconomic Structural Adjustment.

    PubMed

    Li, Hui; Hilsenrath, Peter

    2016-01-01

    China has exploded onto the world economy over the past few decades and is undergoing rapid transformation toward relatively more services. The health sector is an important part of this transition. This article provides a historical account of the development of health care in China since 1949. It also focuses on health insurance and macroeconomic structural adjustment to less saving and more consumption. In particular, the question of how health insurance impacts precautionary savings is considered. Multivariate analysis using data from 1990 to 2012 is employed. The household savings rate is the dependent variable in 3 models segmented for rural and urban populations. Independent variables include out-of-pocket health expenditures, health insurance payouts, housing expenditure, education expenditure, and consumption as a share of gross domestic product (GDP). Out-of-pocket health expenditures were positively correlated with household savings rates. But health insurance remains weak, and increased payouts by health insurers have not been associated with lower levels of household savings so far. Housing was positively correlated, whereas education had a negative association with savings rates. This latter finding was unexpected. Perhaps education is perceived as investment and a substitute for savings. China's shift toward a more service-oriented economy includes growing dependence on the health sector. Better health insurance is an important part of this evolution. The organization and finance of health care is integrally linked with macroeconomic policy in an environment constrained by prevailing institutional convention. Problems of agency relationships, professional hegemony, and special interest politics feature prominently, as they do elsewhere. China also has a dual approach to medicine relying heavily on providers of traditional Chinese medicine. Both of these segments will take part in China's evolution, adding another layer of complexity to policy.

  18. Organization and Finance of China's Health Sector: Historical Antecedents for Macroeconomic Structural Adjustment.

    PubMed

    Li, Hui; Hilsenrath, Peter

    2016-01-01

    China has exploded onto the world economy over the past few decades and is undergoing rapid transformation toward relatively more services. The health sector is an important part of this transition. This article provides a historical account of the development of health care in China since 1949. It also focuses on health insurance and macroeconomic structural adjustment to less saving and more consumption. In particular, the question of how health insurance impacts precautionary savings is considered. Multivariate analysis using data from 1990 to 2012 is employed. The household savings rate is the dependent variable in 3 models segmented for rural and urban populations. Independent variables include out-of-pocket health expenditures, health insurance payouts, housing expenditure, education expenditure, and consumption as a share of gross domestic product (GDP). Out-of-pocket health expenditures were positively correlated with household savings rates. But health insurance remains weak, and increased payouts by health insurers have not been associated with lower levels of household savings so far. Housing was positively correlated, whereas education had a negative association with savings rates. This latter finding was unexpected. Perhaps education is perceived as investment and a substitute for savings. China's shift toward a more service-oriented economy includes growing dependence on the health sector. Better health insurance is an important part of this evolution. The organization and finance of health care is integrally linked with macroeconomic policy in an environment constrained by prevailing institutional convention. Problems of agency relationships, professional hegemony, and special interest politics feature prominently, as they do elsewhere. China also has a dual approach to medicine relying heavily on providers of traditional Chinese medicine. Both of these segments will take part in China's evolution, adding another layer of complexity to policy. PMID

  19. [Animal health in organic agriculture: new guidelines and perspectives for food animal practitioners].

    PubMed

    Hertzberg, H; Walkenhorst, M; Klocke, P

    2003-11-01

    In the last decade, the organic agriculture in Switzerland has been substantially increased due to the interest of consumer and financial incentives of the federation. Ruminants take directly or indirectly the largest part from grassland used within the organic managed surfaces. As the contacts between veterinary practice and organic agriculture has increased, the potential for veterinary activity in this area has developed considerably. The organic agriculture guidelines stipulate that all the preventive measures should be taken in feeding, keeping and breeding to insure animal health safety. This requires veterinary services for herd management. The organic status of a farm affects veterinary practice also in the form of alternative therapy/drugs administration and measures like dehorning and tail-docking. An important point in organic managed herds requests that treatment of animals should depend on alternative medical preparations or procedures based on veterinarian's experience and also on the therapeutic effect on the animal species concerned as well as on the disease. However, there are no restrictions on the veterinarian to use registered drugs as long as no alternative therapy, according to experience and possible success, is available to treat the animals. The prophylactic administration of allopathic veterinary drugs is not permissible. Further features in organic farms regarding the use of drugs are the keeping of withholding/withdrawal time, the documentation and the treatment frequency tolerated by organic marketing. Despite the above measures, the animal health has a priority regardless of its organic status. Although management of organic farms represent a unique responsibility, there are still obvious deficits in the education of veterinary practitioners for this new situation. However, in the future the extension of veterinary activity to include the alternative medical therapy should be regarded for the practitioner as a challenge and an

  20. A comparative study of production performance and animal health practices in organic and conventional dairy systems.

    PubMed

    Silva, Jenevaldo B; Fagundes, Gisele M; Soares, João P G; Fonseca, Adivaldo H; Muir, James P

    2014-10-01

    Health and production management strategies influence environmental impacts of dairies. The objective of this paper was to measure risk factors on health and production parameters on six organic and conventional bovine, caprine, and ovine dairy herds in southeastern Brazil over six consecutive years (2006-2011). The organic operations had lower milk production per animal (P ≤ 0.05), lower calf mortality (P ≤ 0.05), less incidence of mastitis (P ≤ 0.05), fewer rates of spontaneous abortions (P ≤ 0.05), and reduced ectoparasite loads (P ≤ 0.05) compared to conventional herds and flocks. Organic herds, however, had greater prevalence of internal parasitism (P ≤ 0.05) than conventional herds. In all management systems, calves, kids, and lambs had greater oocyte counts than adults. However, calves in the organic group showed lower prevalence of coccidiosis. In addition, animals in the organic system exhibited lower parasitic resistance to anthelmintics. Herd genetic potential, nutritive value of forage, feed intake, and pasture parasite loads, however, may have influenced productive and health parameters. Thus, although conventional herds showed greater milk production and less disease prevalence, future research might quantify the potential implications of these unreported factors. PMID:25015183

  1. A comparative study of production performance and animal health practices in organic and conventional dairy systems.

    PubMed

    Silva, Jenevaldo B; Fagundes, Gisele M; Soares, João P G; Fonseca, Adivaldo H; Muir, James P

    2014-10-01

    Health and production management strategies influence environmental impacts of dairies. The objective of this paper was to measure risk factors on health and production parameters on six organic and conventional bovine, caprine, and ovine dairy herds in southeastern Brazil over six consecutive years (2006-2011). The organic operations had lower milk production per animal (P ≤ 0.05), lower calf mortality (P ≤ 0.05), less incidence of mastitis (P ≤ 0.05), fewer rates of spontaneous abortions (P ≤ 0.05), and reduced ectoparasite loads (P ≤ 0.05) compared to conventional herds and flocks. Organic herds, however, had greater prevalence of internal parasitism (P ≤ 0.05) than conventional herds. In all management systems, calves, kids, and lambs had greater oocyte counts than adults. However, calves in the organic group showed lower prevalence of coccidiosis. In addition, animals in the organic system exhibited lower parasitic resistance to anthelmintics. Herd genetic potential, nutritive value of forage, feed intake, and pasture parasite loads, however, may have influenced productive and health parameters. Thus, although conventional herds showed greater milk production and less disease prevalence, future research might quantify the potential implications of these unreported factors.

  2. Evaluation of a randomized intervention to increase adoption of comparative effectiveness research by community health organizations.

    PubMed

    Williams, Jessica Roberts; Williams, Weston O; Dusablon, Tracy; Blais, Marissa Puckett; Tregear, Stephen J; Banks, Duren; PhD, Kevin D Hennessy

    2014-07-01

    This randomized controlled trial examined the influence of two strategies (informational packets alone and in conjunction with Webinars) aimed at increasing the adoption of motivational interviewing (MI), a patient-centered behavioral health practice supported by evidence from comparative effectiveness studies, among community health organizations responsible for delivering mental and behavioral health services. Data were obtained from 311 directors and staff across 92 community organizations. Hierarchical linear modeling was used to examine changes in decision to adopt MI. The mediating effects of multiple contextual variables were also examined. Results showed that both strategies positively influenced the decision to adopt. The positive impact on decision to adopt was significantly greater among individuals that received informational packets in conjunction with Webinars. Baseline attitudes toward evidence-based practices and pressures for change appeared to mediate this effect. PMID:24091611

  3. Applying Community Organizing Principles to Assess Health Needs in New Haven, Connecticut.

    PubMed

    Santilli, Alycia; Carroll-Scott, Amy; Ickovics, Jeannette R

    2016-05-01

    The Affordable Care Act added requirements for nonprofit hospitals to conduct community health needs assessments. Guidelines are minimal; however, they require input and representation from the broader community. This call echoes 2 decades of literature on the importance of including community members in all aspects of research design, a tenet of community organizing. We describe a community-engaged research approach to a community health needs assessment in New Haven, Connecticut. We demonstrate that a robust community organizing approach provided unique research benefits: access to residents for data collection, reliable data, leverage for community-driven interventions, and modest improvements in behavioral risk. We make recommendations for future community-engaged efforts and workforce development, which are important for responding to increasing calls for community health needs assessments. PMID:26985599

  4. Applying Community Organizing Principles to Assess Health Needs in New Haven, Connecticut.

    PubMed

    Santilli, Alycia; Carroll-Scott, Amy; Ickovics, Jeannette R

    2016-05-01

    The Affordable Care Act added requirements for nonprofit hospitals to conduct community health needs assessments. Guidelines are minimal; however, they require input and representation from the broader community. This call echoes 2 decades of literature on the importance of including community members in all aspects of research design, a tenet of community organizing. We describe a community-engaged research approach to a community health needs assessment in New Haven, Connecticut. We demonstrate that a robust community organizing approach provided unique research benefits: access to residents for data collection, reliable data, leverage for community-driven interventions, and modest improvements in behavioral risk. We make recommendations for future community-engaged efforts and workforce development, which are important for responding to increasing calls for community health needs assessments.

  5. A resource-based view of partnership strategies in health care organizations.

    PubMed

    Yarbrough, Amy K; Powers, Thomas L

    2006-01-01

    The distribution of management structures in health care has been shifting from independent ownership to interorganizational relationships with other firms. A shortage of resources has been cited as one cause for such collaboration among health care entities. The resource- based view of the firm suggests that organizations differentiate between strategic alliances and acquisition strategies based on a firm's internal resources and the types of resources a potential partner organization possesses. This paper provides a review of the literature using the resource-based theory of the firm to understand what conditions foster different types of health care partnerships. A model of partnership alliances using the resource-based view is presented, strategic linkages are presented, managerial implications are outlined, and directions for future research are given.

  6. Reducing health risk assigned to organic emissions from a chemical weapons incinerator.

    PubMed

    Laman, David M; Weiler, B Douglas; Skeen, Rodney S

    2013-03-01

    Organic emissions from a chemical weapons incinerator have been characterized with an improved set of analytical methods to reduce the human health risk assigned to operations of the facility. A gas chromatography/mass selective detection method with substantially reduced detection limits has been used in conjunction with scanning electron microscopy/energy dispersive X-ray spectrometry and Fourier transform infrared microscopy to improve the speciation of semi-volatile and non-volatile organics emitted from the incinerator. The reduced detection limits have allowed a significant reduction in the assumed polycyclic aromatic hydrocarbon (PAH) and aminobiphenyl (ABP) emission rates used as inputs to the human health risk assessment for the incinerator. A mean factor of 17 decrease in assigned human health risk is realized for six common local exposure scenarios as a result of the reduced PAH and ABP detection limits.

  7. Involving homeless persons in the leadership of a health care organization.

    PubMed

    Buck, David S; Rochon, Donna; Davidson, Harriett; McCurdy, Sheryl

    2004-04-01

    Consumer advisory boards (CABs) are a way of involving patients in their health care. To engage the homeless in the administration of a health care organization for the homeless, a service agency formed such a board comprising homeless and formerly homeless individuals. The purpose was to integrate experiences of homelessness into programmatic design and research efforts of the organization, and to promote participatory research among the homeless. A content analysis and member checking revealed four distinct themes relating to committee goals, identity definition, power, and issues and needs of the homeless. Findings indicate that participatory research provided a useful structure in which the CAB could improve self-sufficiency and self-efficacy, and contribute to the direction of the health care agency. PMID:15068577

  8. Work organization and health issues in long-term care centers.

    PubMed

    Zhang, Yuan; Flum, Marian; Nobrega, Suzanne; Blais, Lara; Qamili, Shpend; Punnett, Laura

    2011-05-01

    This qualitative study explored common and divergent perceptions of caregivers and managers regarding occupational health and safety, work organization, and psychosocial concerns in long-term care centers. Both common and differing issues were identified. Both groups agreed on the importance of ergonomic concerns, the high prevalence of stress, and receptiveness to participatory health promotion programs. However, numerous work organization issues and physical and psychosocial workplace hazards were identified by certified nursing assistants but were not mentioned by managers. The results suggest that different perceptions naturally arise from people's varying positions in the occupational hierarchy and their consequent exposures to health and safety hazards. Improved systems of communication that allow frontline workers to express their concerns would make it possible to create solutions to these problems.

  9. 30 CFR 56.19021 - Minimum rope strength.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Minimum rope strength. 56.19021 Section 56... MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Personnel Hoisting Wire Ropes § 56.19021 Minimum rope strength. At installation, the nominal strength...

  10. 30 CFR 56.19021 - Minimum rope strength.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Minimum rope strength. 56.19021 Section 56... MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Personnel Hoisting Wire Ropes § 56.19021 Minimum rope strength. At installation, the nominal strength...

  11. 30 CFR 56.19021 - Minimum rope strength.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Minimum rope strength. 56.19021 Section 56... MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Personnel Hoisting Wire Ropes § 56.19021 Minimum rope strength. At installation, the nominal strength...

  12. 45 CFR 158.210 - Minimum medical loss ratio.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Minimum medical loss ratio. 158.210 Section 158.210 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS... § 158.210 Minimum medical loss ratio. Subject to the provisions of § 158.211 of this subpart: (a)...

  13. 45 CFR 158.210 - Minimum medical loss ratio.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Minimum medical loss ratio. 158.210 Section 158.210 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS... § 158.210 Minimum medical loss ratio. Subject to the provisions of § 158.211 of this subpart: (a)...

  14. [Imaginary dimension and intersubjectivity in public health organizations: implications to managerial work and organizational change].

    PubMed

    Azevedo, Creuza da Silva

    2010-06-01

    This paper deals with organization management in a new perspective, stressing the micro-social aspects and the role of individuals in the process of implementing change in public health organizations such as hospitals. Following the paths of French psychosociology, the article approaches the imaginary, intersubjective and collective dimensions of these organizations, highlighting the ways hospitals' directors and employees engage themselves in a struggle for power, affiliation and recognition. An essentially interactive and intersubjective activity, management is examined in the light of psychoanalysis's leadership function. It seems crucial to take into account the directors' potential structuring role in order to understand the organizational changing processes. Nevertheless, the mounting crisis in Rio de Janeiro public health services does not favor change and the building of personal bonds, but disruption, dismantle of institutional affiliations. In this scenario, the management structuring function and the director's social and psychological mediating role lose ground. PMID:20640254

  15. The mouse that roared: a case history of community organization for health practice.

    PubMed

    Winder, A E

    1985-01-01

    This article presents a case study of a health education process, community organization, that deals with an issue of health protection. The issue concerns herbicide spraying along rights-of-way in Leverett, Massachusetts. The intervention team consisted of the author and a graduate class in community organization. The case study provides a description of the community and history of the problem, the nature of the intervention team, the theoretical and conceptual model held by the intervention team, a description of the intervention, assessment of outcomes, and implications for theory and practice. The intervention extended over a period of 6 months. The intervention represented, for the intervention team, an opportunity to learn community organization and community education skills through active participation in the community. Both the nature and the effects of the intervention are described and discussed.

  16. Beyond HMOs: understanding the next wave of change in health-care organization.

    PubMed

    Gottlieb, S; Einhorn, T A

    1998-01-01

    The growing strength of managed care has diminished the financial and clinical autonomy of many orthopaedic surgeons. In part to offset these negative trends, new relationships are being developed to define doctors' methods of contracting with health-maintenance organizations. These include physician practice management companies (PPMs), independent practice associations, management service organizations, and physician-sponsored organizations. Each entity offers distinct advantages and disadvantages. While the PPM is the most popular new vehicle to offset adverse market trends, it carries with it some of the greatest potential pitfalls. In every case, before negotiating to join one of these new entities, it is important for a physician to have a solid understanding of the competing claims made by each entity, as well as insight into the fiscal health of the particular company in question. For some doctors, these arrangements offer a solution to current woes. For others, PPMs interpose another meddlesome intermediary in a market already bloated by layers of bureaucracy.

  17. Improving Asian American, Native Hawaiian, and Pacific Islander Health: National Organizations Leading Community Research Initiatives

    PubMed Central

    Cook, Won Kim; Weir, Rosy Chang; Ro, Margeurite; Ko, Kathy Lim; Panapasa, Sela; Bautista, Roxanna; Asato, Lloyd; Chung, Corina; Cabllero, Jeffery; Islam, Nadia

    2012-01-01

    Background Functionally, many CBPR projects operate through a model of academic partners providing research expertise and community partners playing a supporting role. Objectives To demonstrate how national umbrella organizations deeply rooted in communities, cognizant of community needs, and drawing on the insights and assets of community partners, can lead efforts to address health disparities affecting their constituents through research. Methods Case studies of two Asian American, Native Hawaiian, and Pacific Islander national organizations Results Strategically engaging a diverse range of partners and securing flexible funding mechanisms that support research were important facilitators. Main challenges included limited interest of local community organizations whose primary missions as service or health care providers may deprioritize research. Conclusions Efforts to make research relevant to the work of community partners and to instill the value of research in community partners, as well as flexible funding mechanisms, may help to promote community-driven research. PMID:22643786

  18. Beyond HMOs: understanding the next wave of change in health-care organization.

    PubMed

    Gottlieb, S; Einhorn, T A

    1998-01-01

    The growing strength of managed care has diminished the financial and clinical autonomy of many orthopaedic surgeons. In part to offset these negative trends, new relationships are being developed to define doctors' methods of contracting with health-maintenance organizations. These include physician practice management companies (PPMs), independent practice associations, management service organizations, and physician-sponsored organizations. Each entity offers distinct advantages and disadvantages. While the PPM is the most popular new vehicle to offset adverse market trends, it carries with it some of the greatest potential pitfalls. In every case, before negotiating to join one of these new entities, it is important for a physician to have a solid understanding of the competing claims made by each entity, as well as insight into the fiscal health of the particular company in question. For some doctors, these arrangements offer a solution to current woes. For others, PPMs interpose another meddlesome intermediary in a market already bloated by layers of bureaucracy. PMID:9682069

  19. 42 CFR 84.85 - Breathing bags; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing bags; minimum requirements. 84.85 Section 84.85 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  20. 42 CFR 84.82 - Gas pressure gages; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Gas pressure gages; minimum requirements. 84.82 Section 84.82 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  1. 42 CFR 84.78 - Head harnesses; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Head harnesses; minimum requirements. 84.78 Section 84.78 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  2. 42 CFR 84.76 - Facepieces; eyepieces; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Facepieces; eyepieces; minimum requirements. 84.76 Section 84.76 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  3. 42 CFR 84.124 - Facepiece tests; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Facepiece tests; minimum requirements. 84.124 Section 84.124 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas...

  4. 42 CFR 84.76 - Facepieces; eyepieces; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Facepieces; eyepieces; minimum requirements. 84.76 Section 84.76 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  5. 42 CFR 84.117 - Gas mask containers; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Gas mask containers; minimum requirements. 84.117 Section 84.117 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas...

  6. 42 CFR 84.78 - Head harnesses; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Head harnesses; minimum requirements. 84.78 Section 84.78 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  7. 42 CFR 84.87 - Compressed gas filters; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Compressed gas filters; minimum requirements. 84.87 Section 84.87 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  8. 42 CFR 84.87 - Compressed gas filters; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Compressed gas filters; minimum requirements. 84.87 Section 84.87 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  9. 42 CFR 84.119 - Facepieces; eyepieces; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Facepieces; eyepieces; minimum requirements. 84.119 Section 84.119 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas...

  10. 42 CFR 84.62 - Component parts; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Component parts; minimum requirements. 84.62 Section 84.62 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  11. 42 CFR 84.121 - Head harnesses; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Head harnesses; minimum requirements. 84.121 Section 84.121 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas...

  12. 42 CFR 84.122 - Breathing resistance test; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing resistance test; minimum requirements. 84.122 Section 84.122 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  13. 42 CFR 84.62 - Component parts; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Component parts; minimum requirements. 84.62 Section 84.62 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  14. 42 CFR 84.119 - Facepieces; eyepieces; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Facepieces; eyepieces; minimum requirements. 84.119 Section 84.119 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas...

  15. 42 CFR 84.124 - Facepiece tests; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Facepiece tests; minimum requirements. 84.124 Section 84.124 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas...

  16. 42 CFR 84.121 - Head harnesses; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Head harnesses; minimum requirements. 84.121 Section 84.121 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas...

  17. 42 CFR 84.117 - Gas mask containers; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Gas mask containers; minimum requirements. 84.117 Section 84.117 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas...

  18. 42 CFR 84.85 - Breathing bags; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Breathing bags; minimum requirements. 84.85 Section 84.85 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  19. 42 CFR 84.122 - Breathing resistance test; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Breathing resistance test; minimum requirements. 84.122 Section 84.122 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  20. Marketing the health care experience: eight steps to infuse brand essence into your organization.

    PubMed

    Lofgren, Diane Gage; Rhodes, Sonia; Miller, Todd; Solomon, Jared

    2006-01-01

    One of the most elusive challenges in health care marketing is hitting on a strategy to substantially differentiate your organization in the community and drive profitable business. This article describes how Sharp HealthCare, the largest integrated health care delivery system in San Diego, has proven that focusing first on improving the health care experience for patients, physicians, and employees can provide the impetus for a vital marketing strategy that can lead to increased market share and net revenue. Over the last five years, this nonprofit health system has transformed the health care experience into tangible actions that are making a difference in the lives of all those the system serves. That difference has become Sharp's "brand essence"--a promise to the community that has been made through marketing, public relations, and advertising and then delivered through the dedicated work of Sharp's 14,000 team members. They call this performance improvement strategy The Sharp Experience. This article outlines the eight-step journey that led the organization to this brand essence marketing campaign, a campaign whose centerpiece is an award-winning 30-minute television documentary that use real-time patient stories to demonstrate Sharp's focus on service and patient-centered care against a backdrop of clinical quality and state-of-the-art technology, and documentary-style radio and television commercials. PMID:18681201

  1. Supporting evidence-based health care in crises: what information do humanitarian organizations need?

    PubMed

    Turner, Tari; Green, Sally; Harris, Claire

    2011-03-01

    In crisis situations, there is an enormous burden of disease and very limited resources. To achieve the best possible health outcomes in these situations and ensure that scarce resources are not wasted, knowledge from health research needs to be translated into practice. We investigated what information from health research was needed by humanitarian aid workers in crisis settings and how it could be best provided. Semistructured interviews were conducted by telephone with 19 humanitarian aid workers from a range of organizations around the world and the results analyzed thematically. Participants identified a clear and currently unmet need for access to high-quality health research to support evidence-based practice in crisis situations. They emphasized that research into delivery of health care was potentially more valuable than research into the effectiveness of particular clinical interventions and highlighted the importance of including contextual information to enable the relevance of the research to be assessed. They suggested that providers of health research information and humanitarian aid organizations work together to develop these resources.

  2. Marketing the health care experience: eight steps to infuse brand essence into your organization.

    PubMed

    Lofgren, Diane Gage; Rhodes, Sonia; Miller, Todd; Solomon, Jared

    2006-01-01

    One of the most elusive challenges in health care marketing is hitting on a strategy to substantially differentiate your organization in the community and drive profitable business. This article describes how Sharp HealthCare, the largest integrated health care delivery system in San Diego, has proven that focusing first on improving the health care experience for patients, physicians, and employees can provide the impetus for a vital marketing strategy that can lead to increased market share and net revenue. Over the last five years, this nonprofit health system has transformed the health care experience into tangible actions that are making a difference in the lives of all those the system serves. That difference has become Sharp's "brand essence"--a promise to the community that has been made through marketing, public relations, and advertising and then delivered through the dedicated work of Sharp's 14,000 team members. They call this performance improvement strategy The Sharp Experience. This article outlines the eight-step journey that led the organization to this brand essence marketing campaign, a campaign whose centerpiece is an award-winning 30-minute television documentary that use real-time patient stories to demonstrate Sharp's focus on service and patient-centered care against a backdrop of clinical quality and state-of-the-art technology, and documentary-style radio and television commercials.

  3. World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries.

    PubMed

    Marriott, Bernadette P; White, Alan; Hadden, Louise; Davies, Jayne C; Wallingford, John C

    2012-07-01

    Eight World Health Organization (WHO) feeding indicators (FIs) and Demographic and Health Survey data for children <24 months were used to assess the relationship of child feeding with stunting and underweight in 14 poor countries. Also assessed were the correlations of FI with country gross national income (GNI). Prevalence of underweight and stunting increased with age and ≥ 50% of 12-23-month children were stunted. About 66% of babies received solids by sixth to eighth months; 91% were still breastfeeding through months 12-15. Approximately half of the children were fed with complementary foods at the recommended daily frequency, but <25% met food diversity recommendations. GNI was negatively correlated with a breastfeeding index (P < 0.01) but not with other age-appropriate FI. Regression modelling indicated a significant association between early initiation of breastfeeding and a reduction in risk of underweight (P < 0.05), but a higher risk of underweight for continued breastfeeding at 12-15 months (P < 0.001). For infants 6-8 months, consumption of solid foods was associated with significantly lower risk of both stunting and underweight (P < 0.001), as was meeting WHO guidance for minimum acceptable diet, iron-rich foods (IRF) and dietary diversity (P < 0.001); desired feeding frequency was only associated with lower risk of underweight (P < 0.05). Timely solid food introduction, dietary diversity and IRF were associated with reduced probability of underweight and stunting that was further associated with maternal education (P < 0.001). These results identify FI associated with growth and reinforce maternal education as a variable to reduce risk of underweight and stunting in poor countries. PMID:22171937

  4. The power of servant leadership to transform health care organizations for the 21st-century economy.

    PubMed

    Schwartz, Richard W; Tumblin, Thomas F

    2002-12-01

    Physician leadership is emerging as a vital component in transforming the nation's health care industry. Because few physicians have been introduced to the large body of literature on leadership and organizations, we herein provide a concise review, as this literature relates to competitive health care organizations and the leaders who serve them. Although the US health care industry has transitioned to a dynamic market economy governed by a wide range of internal and external forces, health care organizations continue to be dominated by leaders who practice an outmoded transactional style of leadership and by organizational hierarchies that are inherently stagnant. In contrast, outside the health care sector, service industries have repeatedly demonstrated that transformational, situational, and servant leadership styles are most successful in energizing human resources within organizations. This optimization of intellectual capital is further enhanced by transforming organizations into adaptable learning organizations where traditional institutional hierarchies are flattened and efforts to evoke change are typically team driven and mission oriented.

  5. Faith-based organizations and the Affordable Care Act: Reducing Latino mental health care disparities.

    PubMed

    Villatoro, Alice P; Dixon, Elizabeth; Mays, Vickie M

    2016-02-01

    The Patient Protection and Affordable Care Act (ACA; 2010) is expected to increase access to mental health care through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% of the federal poverty level, subsidizing the purchase of private insurance among individuals not eligible for Medicaid, and requiring employers with 50 or more employees to offer health insurance. An anticipated result of this landmark legislation is improvement in the screening, diagnosis, and treatment of mental disorders in racial/ethnic minorities, particularly for Latinos, who traditionally have had less access to these services. However, these efforts alone may not sufficiently ameliorate mental health care disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental health care of Latinos by increasing help seeking, providing religion-based mental health services, and delivering supportive services that address common access barriers among Latinos. Thus, in determining ways to eliminate Latino mental health care disparities under the ACA, examining pathways into care through the faith-based sector offers unique opportunities to address some of the cultural barriers confronted by this population. We examine how partnerships between FBOs and primary care patient-centered health homes may help reduce the gap of unmet mental health needs among Latinos in this era of health reform. We also describe the challenges FBOs and primary care providers need to overcome to be partners in integrated care efforts.

  6. Faith-based organizations and the Affordable Care Act: Reducing Latino mental health care disparities.

    PubMed

    Villatoro, Alice P; Dixon, Elizabeth; Mays, Vickie M

    2016-02-01

    The Patient Protection and Affordable Care Act (ACA; 2010) is expected to increase access to mental health care through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% of the federal poverty level, subsidizing the purchase of private insurance among individuals not eligible for Medicaid, and requiring employers with 50 or more employees to offer health insurance. An anticipated result of this landmark legislation is improvement in the screening, diagnosis, and treatment of mental disorders in racial/ethnic minorities, particularly for Latinos, who traditionally have had less access to these services. However, these efforts alone may not sufficiently ameliorate mental health care disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental health care of Latinos by increasing help seeking, providing religion-based mental health services, and delivering supportive services that address common access barriers among Latinos. Thus, in determining ways to eliminate Latino mental health care disparities under the ACA, examining pathways into care through the faith-based sector offers unique opportunities to address some of the cultural barriers confronted by this population. We examine how partnerships between FBOs and primary care patient-centered health homes may help reduce the gap of unmet mental health needs among Latinos in this era of health reform. We also describe the challenges FBOs and primary care providers need to overcome to be partners in integrated care efforts. PMID:26845492

  7. Rising above the Minimum Wage.

    ERIC Educational Resources Information Center

    Even, William; Macpherson, David

    An in-depth analysis was made of how quickly most people move up the wage scale from minimum wage, what factors influence their progress, and how minimum wage increases affect wage growth above the minimum. Very few workers remain at the minimum wage over the long run, according to this study of data drawn from the 1977-78 May Current Population…

  8. Assessing communications effectiveness in meeting corporate goals of public health organizations.

    PubMed

    Brown, Gordon D; Bopp, Kenneth D; Boren, Suzanne Austin

    2005-01-01

    Much evaluation of health communications in public health is considered from a program perspective of smoking cessation, weight reduction, education on sexually transmitted diseases, etc. These studies have advanced the knowledge base of communications theory and evaluation and have contributed to program effectiveness. In program-based evaluation the communications process is structured as part of the program itself. This article extends program-based communications evaluation to view communications from the perspective of the consumer and how effectively public health departments respond to consumer expectations. It develops a conceptual model for evaluating elements of communications such as its importance in defining mission and goals within the community, managing strategic constituencies, and enlisting individuals and groups as customers and co-producers of health. It gives a broader perspective on how communications in public heath organizations are managed and a basis for assessing whether they are being managed effectively.

  9. Non-governmental organizations in international health: past successes, future challenges.

    PubMed

    Gellert, G A

    1996-01-01

    Non-governmental organizations, or NGOs, are increasingly instrumental to the implementation of international health programs. Following an overview of current conditions in global health and the problems that could be targeted by NGOs, this article describes the activities and philosophies of several representative approaches in this sector. The attributes of NGOs that increase their potential effectiveness are discussed, including ability to reach areas of severe need, promotion of local involvement, low cost of operations, adaptiveness and innovation, independence, and sustainability. A summary is provided of major future challenges in international health that may be addressed by NGOs, with particular emphasis on tobacco-related disease, communicable diseases and the AIDS epidemic, maternal mortality and women's health, injury prevention and control, and the need to secure durable financial support. PMID:10157062

  10. Strengthening health systems in poor countries: a code of conduct for nongovernmental organizations.

    PubMed

    Pfeiffer, James; Johnson, Wendy; Fort, Meredith; Shakow, Aaron; Hagopian, Amy; Gloyd, Steve; Gimbel-Sherr, Kenneth

    2008-12-01

    The challenges facing efforts in Africa to increase access to antiretroviral HIV treatment underscore the urgent need to strengthen national health systems across the continent. However, donor aid to developing countries continues to be disproportionately channeled to international nongovernmental organizations (NGOs) rather than to ministries of health. The rapid proliferation of NGOs has provoked "brain drain" from the public sector by luring workers away with higher salaries, fragmentation of services, and increased management burdens for local authorities in many countries. Projects by NGOs sometimes can undermine the strengthening of public primary health care systems. We argue for a return to a public focus for donor aid, and for NGOs to adopt a code of conduct that establishes standards and best practices for NGO relationships with public sector health systems.

  11. The demonstration projects: creating the capacity for nursing health human resource planning in Ontario's healthcare organizations.

    PubMed

    Burkoski, Vanessa; Tepper, Joshua

    2010-05-01

    Timely access to healthcare services requires the right number, mix and distribution of appropriately educated nurses, physicians and other healthcare professionals. In Ontario, as in several other jurisdictions, changing demographics, patterns of health service utilization and an aging workforce have created challenges related to the supply of nurses available now and in the future to deliver quality patient care. From 2006 to 2009, the Nursing Secretariat (NS) of Ontario's Ministry of Health and Long-Term Care (the ministry) undertook a progressive and comprehensive approach to address the issue of nursing supply across the province through the introduction of 17 Nursing Health Human Resources Demonstration Projects (demonstration projects). The demonstration projects initiative has led to the creation of a unique collection of best practices, tools and resources aimed at improving organizational planning capacity. Evaluation of the initiative generated recommendations that may guide the ministry toward policy and program development to foster improved nursing health human resource planning capacity in Ontario healthcare organizations.

  12. Non-governmental organizations in international health: past successes, future challenges.

    PubMed

    Gellert, G A

    1996-01-01

    Non-governmental organizations, or NGOs, are increasingly instrumental to the implementation of international health programs. Following an overview of current conditions in global health and the problems that could be targeted by NGOs, this article describes the activities and philosophies of several representative approaches in this sector. The attributes of NGOs that increase their potential effectiveness are discussed, including ability to reach areas of severe need, promotion of local involvement, low cost of operations, adaptiveness and innovation, independence, and sustainability. A summary is provided of major future challenges in international health that may be addressed by NGOs, with particular emphasis on tobacco-related disease, communicable diseases and the AIDS epidemic, maternal mortality and women's health, injury prevention and control, and the need to secure durable financial support.

  13. The management of health and safety hazards in tourist resorts. World Tourism Organization.

    PubMed

    Phillip, R; Hodgkinson, G

    1994-01-01

    The enjoyment of a holiday has to do with landscape, buildings, people, and their activities. For truly sustainable development, these components need to become better integrated. Ways of achieving this were discussed at the IVth World Health Organization International Conference on Tourist Health, Rimini, Italy, in May 1994. It was agreed that attention to the health enhancing aspects of each component in the built environment is essential. Risks to health from man-made hazards in tourist resorts therefore need to be eliminated where possible, or otherwise minimised, contained or controlled. A systematic approach is outlined here in which owners, managers, operators, workers and users all have responsibilities and in which occupational physicians can contribute.

  14. Closing the gap: building the capacity of non-government organizations as advocates for health equity.

    PubMed

    Nathan, Sally; Rotem, Arie; Ritchie, Jan

    2002-03-01

    Seeking achievement of health equity has underpinned national government and global health policies for decades. However, major difficulties and challenges faced in the practice of achieving 'Health for All' has led to a recognition of the need to broaden the focus of efforts to improve health equity. Civil society groups have been identified as key stakeholders in attempts to achieve health equity, and the importance of strengthening their capacity to influence relevant government policy and practice has been highlighted. This paper presents the results of a qualitative study which examined the role of organizations outside government in advocating for health equity, and the capacities and conditions that were related to their success. In-depth, unstructured interviews were conducted with 26 non-government organizations (NGOs) who were active in three important health policy debates in Australia. The grounded theory method was used to direct data collection and analysis, and member checking was employed to ensure soundness and build ownership of the findings. Effective advocacy was found to be a dynamic process characterized by flexibility and opportunism within a framework of longer term goals. Two key ways of working were identified--in partnership and in conflict with government, with shifts in emphasis in response to organizational strengths and a changing environment. A number of domains of capacity, which together are termed 'capacity for advocacy', were also identified. It is clear that NGOs can learn a great deal from each other, but there needs to be investment by governments, international agencies and NGOs themselves if advocacy for health equity is to be strengthened.

  15. Analysis of knowledge of the general population and health professionals on organ donation after cardiac death

    PubMed Central

    Bedenko, Ramon Correa; Nisihara, Renato; Yokoi, Douglas Shun; Candido, Vinícius de Mello; Galina, Ismael; Moriguchi, Rafael Massayuki; Ceulemans, Nico; Salvalaggio, Paolo

    2016-01-01

    Objective To evaluate the knowledge and acceptance of the public and professionals working in intensive care units regarding organ donation after cardiac death. Methods The three hospitals with the most brain death notifications in Curitiba were selected, and two groups of respondents were established for application of the same questionnaire: the general public (i.e., visitors of patients in intensive care units) and health professionals working in the same intensive care unit. The questionnaire contained questions concerning demographics, intention to donate organs and knowledge of current legislation regarding brain death and donation after cardiac death. Results In total, 543 questionnaires were collected, including 442 from family members and 101 from health professionals. There was a predominance of women and Catholics in both groups. More females intended to donate. Health professionals performed better in the knowledge comparison. The intention to donate organs was significantly higher in the health professionals group (p = 0.01). There was no significant difference in the intention to donate in terms of education level or income. There was a greater acceptance of donation after uncontrolled cardiac death among Catholics than among evangelicals (p < 0.001). Conclusion Most of the general population intended to donate, with greater intentions expressed by females. Education and income did not affect the decision. The type of transplant that used a donation after uncontrolled cardiac death was not well accepted in the study population, indicating the need for more clarification for its use in our setting. PMID:27626950

  16. A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care.

    PubMed

    Chin, Marshall H; Clarke, Amanda R; Nocon, Robert S; Casey, Alicia A; Goddu, Anna P; Keesecker, Nicole M; Cook, Scott C

    2012-08-01

    Over the past decade, researchers have shifted their focus from documenting health care disparities to identifying solutions to close the gap in care. Finding Answers: Disparities Research for Change, a national program of the Robert Wood Johnson Foundation, is charged with identifying promising interventions to reduce disparities. Based on our work conducting systematic reviews of the literature, evaluating promising practices, and providing technical assistance to health care organizations, we present a roadmap for reducing racial and ethnic disparities in care. The roadmap outlines a dynamic process in which individual interventions are just one part. It highlights that organizations and providers need to take responsibility for reducing disparities, establish a general infrastructure and culture to improve quality, and integrate targeted disparities interventions into quality improvement efforts. Additionally, we summarize the major lessons learned through the Finding Answers program. We share best practices for implementing disparities interventions and synthesize cross-cutting themes from 12 systematic reviews of the literature. Our research shows that promising interventions frequently are culturally tailored to meet patients' needs, employ multidisciplinary teams of care providers, and target multiple leverage points along a patient's pathway of care. Health education that uses interactive techniques to deliver skills training appears to be more effective than traditional didactic approaches. Furthermore, patient navigation and engaging family and community members in the health care process may improve outcomes for minority patients. We anticipate that the roadmap and best practices will be useful for organizations, policymakers, and researchers striving to provide high-quality equitable care.

  17. Health-related quality of life after solid organ transplantation: the role of sport activity.

    PubMed

    Cicognani, Elvira; Mazzoni, Davide; Totti, Valentina; Roi, Giulio Sergio; Mosconi, Giovanni; Nanni Costa, Alessandro

    2015-01-01

    The aim of the study was to investigate the effects of sport activity on health-related quality of life (HRQoL) of solid organ transplant recipients participating in sports competitions. A group of 168 sportive transplanted patients (STP), a group of 97 nonsportive transplanted patients (NSTP), and a group of 152 sportive healthy controls (SHC) were compared on the eight scales of the SF-36 questionnaire. STP and NSTP reported significantly lower scores than SHC on the physical functioning scale. STP did not differ from SHC in the Role-Physical, General Health, and Vitality scales, while NSTP reported significantly lower scores. STP obtained higher scores than NSTP and SHC on Mental Health. Among STP, the effect of quantity of sport activity was significant on General Health and Role Emotional, with more sport activity associated with higher HRQoL. Organ failure and post-transplant therapies may have negative consequences on HRQoL. Sports activities and participation in sports competitions can reduce this impact, improving general and psychological functioning of solid organ transplant recipients.

  18. Lobbying and advocacy for the public's health: what are the limits for nonprofit organizations?

    PubMed Central

    Vernick, J S

    1999-01-01

    Nonprofit organizations play an important role in advocating for the public's health in the United States. This article describes the rules under US law for lobbying by nonprofit organizations. The 2 most common kinds of non-profits working to improve the public's health are "public charities" and "social welfare organizations." Although social welfare organizations may engage in relatively unlimited lobbying, public charities may not engage in "substantial" lobbying. Lobbying is divided into 2 main categories. Direct lobbying refers to communications with law-makers that take a position on specific legislation, and grassroots lobbying includes attempts to persuade members of the general public to take action regarding legislation. Even public charities may engage in some direct lobbying and a smaller amount of grassroots lobbying. Much public health advocacy, however, is not lobbying, since there are several important exceptions to the lobbying rules. These exceptions include "non-partisan analysis, study, or research" and discussions of broad social problems. Lobbying with federal or earmarked foundation funds is generally prohibited. PMID:10474565

  19. Welfare of organic laying hens kept at different indoor stocking densities in a multi-tier aviary system. II: live weight, health measures and perching.

    PubMed

    Steenfeldt, S; Nielsen, B L

    2015-09-01

    Multi-tier aviary systems, where conveyor belts below the tiers remove the manure at regular intervals, are becoming more common in organic egg production. The area on the tiers can be included in the net area available to the hens (also referred to as usable area) when calculating maximum indoor stocking densities in organic systems within the EU. In this article, results on live weight, health measures and perching are reported for organic laying hens housed in a multi-tier system with permanent access to a veranda and kept at stocking densities (D) of 6, 9 and 12 hens/m2 available floor area, with concomitant increases in the number of hens per trough, drinker, perch and nest space. In a fourth treatment, access to the top tier was blocked reducing vertical, trough, and perch access at the lowest stocking density (D6x). In all other aspects than stocking density, the experiment followed the EU regulations on the keeping of organic laying hens. Hen live weight, mortality and foot health were not affected by the stocking densities used in the present study. Other variables (plumage condition, presence of breast redness and blisters, pecked tail feathers, and perch use) were indirectly affected by the increase in stocking density through the simultaneous reduction in access to other resources, mainly perches and troughs. The welfare of the hens was mostly affected by these associated constraints, despite all of them being within the allowed minimum requirements for organic production in the EU. Although the welfare consequences reported here were assessed to be moderate to minor, it is important to take into account concurrent constraints on access to other resources when higher stocking densities are used in organic production.

  20. Welfare of organic laying hens kept at different indoor stocking densities in a multi-tier aviary system. II: live weight, health measures and perching.

    PubMed

    Steenfeldt, S; Nielsen, B L

    2015-09-01

    Multi-tier aviary systems, where conveyor belts below the tiers remove the manure at regular intervals, are becoming more common in organic egg production. The area on the tiers can be included in the net area available to the hens (also referred to as usable area) when calculating maximum indoor stocking densities in organic systems within the EU. In this article, results on live weight, health measures and perching are reported for organic laying hens housed in a multi-tier system with permanent access to a veranda and kept at stocking densities (D) of 6, 9 and 12 hens/m2 available floor area, with concomitant increases in the number of hens per trough, drinker, perch and nest space. In a fourth treatment, access to the top tier was blocked reducing vertical, trough, and perch access at the lowest stocking density (D6x). In all other aspects than stocking density, the experiment followed the EU regulations on the keeping of organic laying hens. Hen live weight, mortality and foot health were not affected by the stocking densities used in the present study. Other variables (plumage condition, presence of breast redness and blisters, pecked tail feathers, and perch use) were indirectly affected by the increase in stocking density through the simultaneous reduction in access to other resources, mainly perches and troughs. The welfare of the hens was mostly affected by these associated constraints, despite all of them being within the allowed minimum requirements for organic production in the EU. Although the welfare consequences reported here were assessed to be moderate to minor, it is important to take into account concurrent constraints on access to other resources when higher stocking densities are used in organic production. PMID:25990629

  1. Utilization of internal evaluation results by community mental health organizations: Credibility in different forms.

    PubMed

    Yusa, Anna; Hynie, Michaela; Mitchell, Scott

    2016-02-01

    Internal evaluations are numerous but the literature is largely focused on external evaluations. There have been few explorations of the factors affecting the use of findings from internal evaluations that are carried out by program staff in community organizations. This study examined the instrumental use of internal evaluation findings within 19 community mental health organizations in Ontario, Canada. All but one respondent reported instrumental use in their organization, using the evaluation findings to make program-related decisions. For these non-controversial programs, qualities such as the ability of internal evaluators to identify relevant information, their role/expertise within the organization and the consistency of evaluation findings with current understanding appeared to influence use more strongly than evaluator objectivity.

  2. Through Mintzberg's glasses: a fresh look at the organization of ministries of health.

    PubMed Central

    Unger, J. P.; Macq, J.; Bredo, F.; Boelaert, M.

    2000-01-01

    In 1987, district health care policies were officially adopted by a majority of developing countries. Many operational problems constraining implementation of such policies have subsequently been identified, most of which are attributable to well-known characteristics of less developed countries. However, the policy of operational and administrative decentralization has often been critically obstructed by inappropriate organizational structures in ministries of health. By applying Mintzberg's analytical framework to several ministries of health, we identify structural deficiencies that make systems unfit to match their policy environment and yield the expected outcomes of functional and decentralized services. We propose a typology likely to elicit strategies for decentralizing health care administration. Our analysis is based on the following steps: a description of Mintzberg's concepts of organizational structure, generic components (strategic apex, technostructure, supporting structure, middle line, operational core) and functions (horizontal and vertical integration, liaison devices, vertical and horizontal decentralization) applied to health systems; a discussion of divisionalized adhocracy as a suitable configuration for health organizations with a need for a high degree of regional autonomy, community participation, medical staff initiative, action research and operational research, and continuous evaluation; a discussion of the organizational features of a number of health ministry systems and a consideration of strategies for transforming configurations towards divisionalized adhocracy. PMID:10994284

  3. Considerations for Public Health Organizations Attempting to Implement a Social Media Presence: A Qualitative Study

    PubMed Central

    2016-01-01

    Background In the past decade, social media has become an integral part of our everyday lives, but research on how this tool is used by public health workers and organizations is still developing. Budget cuts and staff reduction in county departments have required employees to take on more responsibilities. These reductions have caused a reduction in the time for training or collaborating with others in the field. To make up for the loss, many employees are seeking collaboration through social media sites but are unable to do so because state departments block these Internet sites. Objective This study sought to highlight the key considerations and decision-making process for a public health organization deciding whether to implement a social media presence for their organization. Methods Using 3 structured interviews, 15 stakeholders were questioned on their personal experience with social media, experience within the context of public health, and their thoughts on implementation for their center. Interviews were coded using constant comparative qualitative methods. Results The following themes emerged from the interviews: (1) personal experience with technology and social networking sites, (2) use of social networking sites in public health, (3) use of social networking sites in work environments, (4) social networking sites access, (5) ways the Rural South Public Health Training Center could use social networking sites, and (6) perceived outcomes of social networking site usage for the Rural South Public Health Training Center (positive and negative). Conclusions The collective voice of the center showed a positive perceived perception of social media implementation, with the benefits outweighing the risks. Despite the benefits, there is a cautious skepticism of the importance of social networking site use. PMID:27227160

  4. Community organizing practices in a globalizing era: building power for health equity at the community level.

    PubMed

    Speer, Paul W; Tesdahl, Eric A; Ayers, Jeanne F

    2014-01-01

    In the postindustrial era, global economic processes have constrained the ability of local agencies, service providers, and civic groups to respond to systemic challenges in public health. Community health psychology can benefit by focusing on interventions through mediating structures that develop innovative methods of leveraging power in the context of globalizing economic forces. Promising methods include careful analysis of power within targeted policy domains and developing strategic alliances with others, so as to exercise social power to affect policy change. The case of ISAIAH, an organizing group based in Minnesota, illustrates innovative avenues for intervention in the context of globalization. PMID:24058111

  5. Social health maintenance organizations' service use and costs, 1985-89

    PubMed Central

    Harrington, Charlene; Newcomer, Robert J.

    1991-01-01

    Presented in this article are aggregate utilization and financial data from the four social health maintenance organization (SIHMO) demonstrations that were collected and analyzed as a part of the national evaluation of the SIHMO demonstration project conducted for the Health Care Financing Administration. The S/HMOs, in offering a $6,500 to $12,000 chronic care benefit in addition to the basic HMO benefit package, had higher startup costs and financial losses over the first 5 years than expected, and controlling costs continues to be a challenge to the sites and their sponsors. PMID:10113612

  6. Financial performance in the social health maintenance organization, 1985-88

    PubMed Central

    Leutz, Walter; Malone, Joelyn; Kistner, Marlin; O'Bar, Tim; Ripley, Jeanne M.; Sandhaus, Martin

    1990-01-01

    Since early 1985, four social health maintenance organizations have delivered integrated health and long-term care services to Medicare beneficiaries under congressionally mandated waivers that included shared public-program risk for losses. Three of four sites had substantial losses in the first 3 years, primarily because of slow enrollment and resultant high marketing and administrative costs. After assuming full risk, two of the three showed surpluses in 1988. Service and management costs for expanded long-term care were similar across sites and were affordable within the framework of Medicare and Medicaid reimbursement and private premiums. PMID:10113466

  7. On the Nature and Strategies of Organized Interests in Health Care Policy Making

    PubMed Central

    Contandriopoulos, Damien

    2012-01-01

    Relying on a sweeping review of the literature on interest group influence in health care policy making, we propose a basic definition and a typology of interest groups in provincial health care policy making. Then, using Milbrath’s communication framework, we analyze organized interests’ strategies for influencing policy making. This article is a modest attempt to cross-fertilize the group theory and resource dependency literature. This theoretical framework allows us to explore many of the recurring questions about groups’ origins and strategies from an original standpoint. PMID:23087490

  8. Conflict across organizational boundaries: managed care organizations versus health care providers.

    PubMed

    Callister, R R; Wall, J A

    2001-08-01

    This research examined conflicts that occur across organizational boundaries, specifically between managed care organizations and health care providers. Using boundary spanning theory as a framework, the authors identified 3 factors in the 1st study (30 interviews) that influence this conflict: (a) organizational power, (b) personal status differences of the individuals handling the conflict, and (c) their previous interactions. These factors affected the individuals' behavioral responses or emotions, specifically anger. After developing hypotheses, the authors tested them in a 2nd study using 109 conflict incidents drawn from 9 different managed care organizations. The results revealed that organizational power affects behavioral responses, whereas status differences and previous negative interactions affect emotions.

  9. The state of regional health information organizations: current activities and financing.

    PubMed

    Adler-Milstein, Julia; McAfee, Andrew P; Bates, David W; Jha, Ashish K

    2008-01-01

    Electronic clinical data exchange promises substantial financial and societal benefits, but it is unclear whether and when it will become widespread. In early 2007 we surveyed 145 regional health information organizations (RHIOs), the U.S. entities working to establish data exchange. Nearly one in four was likely defunct. Only twenty efforts were of at least modest size and exchanging clinical data. Most early successes involved the exchange of test results. To support themselves, thirteen RHIOs received regular fees from participating organizations, and eight were heavily dependent on grants. Our findings raise concerns about the ability of the current approach to achieve widespread electronic clinical data exchange.

  10. Measuring a Community-Based Mental Health Organization's Culture and Climate Scores Stability.

    PubMed

    Patterson, David A; Wolf Adelv Unegv Waya, Silver; Maguin, Eugene; Dulmus, Catherine N; Nisbet, Bruce C

    2011-01-01

    This project builds on the work of Glisson et al. (2008) and the knowledge learned from community-based mental health organizations' internal structures (e.g., culture and climate), which possibly impede the implantation and adoption of new technologies. The Organizational Social Context (OSC) Model measurement system is guided by a model of social context that composes both organizational and individual level constructs, including individual and shared perceptions that are believed to mediate the impact of the organization on the individual. Although the OSC has been developed and validated over time, the literature does not provide guidance on test-retest reliability of the scale.

  11. Learning the organization: a model for health system analysis for new nurse administrators.

    PubMed

    Clark, Mary Jo

    2004-01-01

    Health systems are large and complex organizations in which multiple components and processes influence system outcomes. In order to effectively position themselves in such organizations, nurse administrators new to a system must gain a rapid understanding of overall system operation. Such understanding is facilitated by use of a model for system analysis. The model presented here examines the dynamic interrelationships between and among internal and external elements as they affect system performance. External elements to be analyzed include environmental factors and characteristics of system clientele. Internal elements flow from the mission and goals of the system and include system culture, services, resources, and outcomes.

  12. A new mode of organizing in health care? Governmentality and managed networks in cancer services in England.

    PubMed

    Ferlie, Ewan; McGivern, Gerry; Fitzgerald, Louise

    2012-02-01

    We explore the argument that a new mode of health care organizing is emerging which moves beyond the established professional dominance versus New Public Management (NPM) debate. We review Foucault's work on 'governmentality', as applied to health care organizations. We specify two specific Foucauldian themes (the power/knowledge nexus in Evidence Based Medicine (EBM); and the technologies of the clinical managerial self) to analyse organizing in the English cancer services field. We introduce two qualitative case studies of Managed Cancer Networks. We suggest their governance can be fruitfully seen through a 'governmentality' lens. We consider implications for developing Foucauldian analysis of health care organizations.

  13. "The worst of both worlds": the management reform of the World Health Organization.

    PubMed

    Lerer, L; Matzopoulos, R

    2001-01-01

    The governance and management of global health institutions, such as the World Health Organization (WHO), are under increasing critical scrutiny. This management case study explores the first year of transformation at the WHO under Director-General Dr. Gro Harlem Brundtland, focusing on the key stakeholders and the role of complexity in institutional change. This is a story about transition in a difficult, politically fraught, and management-resource-constrained environment. In the search for appropriate management paradigms, organizations such as the WHO may believe that the answers lie in harsh reengineering and the search for high-profile "success stories." Ironically, global business has moved away from such approaches and is far more focused on collaboration, empowerment, and knowledge sharing. PMID:11407175

  14. Promoting Usability in Organizations with a New Health Usability Model: Implications for Nursing Informatics

    PubMed Central

    Staggers, Nancy; Rodney, Melanie

    2012-01-01

    Usability issues with products such as Electronic Health Records (EHRs) are of global interest to nursing informaticists. Although improvements in patient safety, clinical productivity and effectiveness are possible when usability principles and practices are in place, most organizations do not embrace usability. This paper presents a new Health Usability Maturity Model consisting of 5 phases: unrecognized, preliminary, implemented, integrated and strategic. Within each level various aspects are discussed including focus on users, management, education, resources, processes and infrastructure. Nurse informaticists may use this new model as a guide for assessing their organization’s level of usability and transitioning to the next level. Using tactics outlined here, nurse informaticists may also serve as catalysts for change and lead efforts to improve the user experience in organizations across industry, academe and healthcare settings. PMID:24199128

  15. Health Advocacy Organizations and the Pharmaceutical Industry: An Analysis of Disclosure Practices

    PubMed Central

    Raveis, Victoria H.; Friedman, Anne; Rothman, David J.

    2011-01-01

    Health advocacy organizations (HAOs) are influential stakeholders in health policy. Although their advocacy tends to closely correspond with the pharmaceutical industry's marketing aims, the financial relationships between HAOs and the pharmaceutical industry have rarely been analyzed. We used Eli Lilly and Company's grant registry to examine its grant-giving policies. We also examined HAO Web sites to determine their grant-disclosure patterns. Only 25% of HAOs that received Lilly grants acknowledged Lilly's contributions on their Web sites, and only 10% acknowledged Lilly as a grant event sponsor. No HAO disclosed the exact amount of a Lilly grant. As highly trusted organizations, HAOs should disclose all corporate grants, including the purpose and the amount. Absent this disclosure, legislators, regulators, and the public cannot evaluate possible conflicts of interest or biases in HAO advocacy. PMID:21233424

  16. Health advocacy organizations and the pharmaceutical industry: an analysis of disclosure practices.

    PubMed

    Rothman, Sheila M; Raveis, Victoria H; Friedman, Anne; Rothman, David J

    2011-04-01

    Health advocacy organizations (HAOs) are influential stakeholders in health policy. Although their advocacy tends to closely correspond with the pharmaceutical industry's marketing aims, the financial relationships between HAOs and the pharmaceutical industry have rarely been analyzed. We used Eli Lilly and Company's grant registry to examine its grant-giving policies. We also examined HAO Web sites to determine their grant-disclosure patterns. Only 25% of HAOs that received Lilly grants acknowledged Lilly's contributions on their Web sites, and only 10% acknowledged Lilly as a grant event sponsor. No HAO disclosed the exact amount of a Lilly grant. As highly trusted organizations, HAOs should disclose all corporate grants, including the purpose and the amount. Absent this disclosure, legislators, regulators, and the public cannot evaluate possible conflicts of interest or biases in HAO advocacy.

  17. A university and health care organization partnership to prepare nurses for evidence-based practice.

    PubMed

    Missal, Bernita; Schafer, Beth Kaiser; Halm, Margo A; Schaffer, Marjorie A

    2010-08-01

    This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators mentored graduate students in conducting critical appraisals of the literature. Students learned how to search for the evidence, summarize the existing research findings, and translate the findings into practice recommendations. Through presenting and discussing their findings with key stakeholders, students learned how nurses planned to integrate the evidence into practice. Nurses used the evidence-based results to improve their practice in the two partner hospitals. The partnership stimulated action for further inquiry into best practices.

  18. "The worst of both worlds": the management reform of the World Health Organization.

    PubMed

    Lerer, L; Matzopoulos, R

    2001-01-01

    The governance and management of global health institutions, such as the World Health Organization (WHO), are under increasing critical scrutiny. This management case study explores the first year of transformation at the WHO under Director-General Dr. Gro Harlem Brundtland, focusing on the key stakeholders and the role of complexity in institutional change. This is a story about transition in a difficult, politically fraught, and management-resource-constrained environment. In the search for appropriate management paradigms, organizations such as the WHO may believe that the answers lie in harsh reengineering and the search for high-profile "success stories." Ironically, global business has moved away from such approaches and is far more focused on collaboration, empowerment, and knowledge sharing.

  19. An organizational analysis of the World Health Organization: narrowing the gap between promise and performance.

    PubMed

    Peabody, J W

    1995-03-01

    The World Health Organization's (WHO's) nearly half century amelioration of suffering stands as a singular achievement in international cooperation. But after 45 years, the Organization has grown into a complex bureaucracy with an outdated organizational structure. A multidisciplinary framework, which emphasizes organizational theory, yields some insights into these problems. Using this approach, this paper examines the structure, culture, mission, and rules of WHO, and adds a perspective, not otherwise found in the literature, to the growing debate on the future of the Organization. Previous studies of international organizations have explained their behavior as the consequence of the dominant external interests of powerful members. This perspective suggests that organizations like WHO have fewer options and less control of their policies and output. By contrast, there has been very little analysis explaining how international organizations function internally. This paper refutes an exclusively external perspective and shows that the internal organization is also important to understanding WHO. Several conclusions are drawn from this perspective. WHO's organizational myths, as a politically neutral technical agency staffed with uniquely qualified staff, need to be validated and enhanced to attract funding. A new organizational structure, based on an 'open systems' model, is proposed. This strategy would strengthen the WHO Representative Country Offices, redefine staff objectives, close the Regional Offices, and establish open, public elections of the Director General. Traditional WHO culture should only be used for health problems that are well matched to WHO's critical tasks. For more complex social and economic issues, newer, often non-medical, approaches are needed. The internal and external rules, which shape the incentives of WHO staff and leaders, need to be realigned to close the gap between WHO's myths and its day to day work. In the short run it is

  20. What can the World Health Organization learn from EU lessons in civil society engagement and participation for health?

    PubMed

    Battams, Samantha

    2014-01-01

    This article explores challenges for and the development of civil society engagement and stakeholder representation, transparency, and accountability measures in the European Union, with a specific focus on health policy. The stance of the European Union on stakeholder participation within reform debates of the World Health Organization (WHO) is also considered, along with EU lessons for multi-stakeholders at the WHO. The European Commission has developed a number of measures for stakeholder engagement and transparency; however, the European Union has been prone to lobbying interests and has found difficulty in leading and making accountable the private sector when it comes to achieving its own health policy goals. The strong influence of corporate lobbyists on the European Union has come to light, with concerns about a lack of transparency and accountability in decision-making processes. While the WHO could learn from the European Union in terms of its strategies for stakeholder engagement, it could also heed some of the important lessons for the European Union when it comes to working with a broad range of stakeholders.