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Sample records for health organization recommended

  1. 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.

  2. The World Health Organization Guidelines on Hand Hygiene in Health Care and their consensus recommendations.

    PubMed

    Pittet, Didier; Allegranzi, Benedetta; Boyce, John

    2009-07-01

    The World Health Organization's Guidelines on Hand Hygiene in Health Care have been issued by WHO Patient Safety on 5 May 2009 on the occasion of the launch of the Save Lives: Clean Your Hands initiative. The Guidelines represent the contribution of more than 100 international experts and provide a comprehensive overview of essential aspects of hand hygiene in health care, evidence- and consensus-based recommendations, and lessons learned from testing their Advanced Draft and related implementation tools.

  3. World Health Organization Guidelines on Postexposure Prophylaxis for HIV: Recommendations for a Public Health Approach.

    PubMed

    Ford, Nathan; Mayer, Kenneth H

    2015-06-01

    The 2014 World Health Organization (WHO) guidelines for postexposure prophylaxis (PEP) developed recommendations for PEP irrespective of exposure source in recognition of the need to simplify eligibility assessment and prescribing practices. Traditionally, separate PEP guidelines have been developed according to exposure type, with difference guidelines for occupational exposure, nonoccupational exposure, and sexual assault. Recognizing the need to improve uptake and completion rates for PEP, the WHO 2014 guideline does not differentiate between exposure sources, but rather provides recommendations across all exposures. Recommendations for simplifying prescribing approaches and supporting adherence are also provided. In translating this guidance into national PEP guidelines, countries are encouraged to consider the need to provide PEP in a way that maximizes uptake and completion rates.

  4. Seasonal influenza vaccine policies, recommendations and use in the World Health Organization's Western Pacific Region.

    PubMed

    Dwyer, Dominic; Barr, Ian; Hurt, Aeron; Kelso, Anne; Reading, Patrick; Sullivan, Sheena; Buchy, Philippe; Yu, Hongjie; Zheng, Jiandong; Shu, Yuelong; Wang, Dayan; Lam; Aguon, Annette; Oliva, Rita Q; Odagiri, Takato; Tashiro, Masato; Verasahib, Khebir; Yusof, Mohd Apandi; Nymadawa, Pagbajabyn; Alexander, Burmaa; Gourinat, Anne-Claire; Grangeon, Jean-Paul; Jennings, Lance; Huang, Sue; Horwood, Paul; Lucero, Marilla; Roque, Vito; Lee Suy, Lyndon; Cardon, Peter; Tandoc, Amado; Olveda, Remigio M; Kang, Chun; Young-Joon, Park; Cutter, Jeffery; Lin, Raymond; Low, Constance; Mai, Le Thi Quynh; Balish, Amanda; Kile, James; Mei, Shang; Mcfarland, Jeffrey; Moen, Ann; Olsen, Sonja; Samaan, Gina; Xiyan, Xu; Chea, Nora; Diorditsa, Sergey; Feldon, Keith; Fox, Kimberley; Jamsran, Mendsaikhan; Konings, Frank; Lewis, Hannah Catherine; McPherson, Michelle; Nilles, Eric; Olowokure, Babatunde; Partridge, Jeffrey

    2013-01-01

    Vaccination is the most effective way to prevent seasonal influenza and its severe outcomes. The objective of our study was to synthesize information on seasonal influenza vaccination policies, recommendations and practices in place in 2011 for all countries and areas in the Western Pacific Region of the World Health Organization (WHO). Data were collected via a questionnaire on seasonal influenza vaccination policies, recommendations and practices in place in 2011. Thirty-six of the 37 countries and areas (97%) responded to the survey. Eighteen (50%) reported having established seasonal influenza vaccination policies, an additional seven (19%) reported having recommendations for risk groups for seasonal influenza vaccination only and 11 (30%) reported having no policies or recommendations in place. Of the 25 countries and areas with policies or recommendations, health-care workers and the elderly were most frequently recommended for vaccination; 24 (96%) countries and areas recommended vaccinating these groups, followed by pregnant women (19 [76%]), people with chronic illness (18 [72%]) and children (15 [60%]). Twenty-six (72%) countries and areas reported having seasonal influenza vaccines available through public funding, private market purchase or both. Most of these countries and areas purchased only enough vaccine to cover 25% or less of their populations. In light of the new WHO position paper on influenza vaccines published in 2012 and the increasing availability of country-specific data, countries and areas should consider reviewing or developing their seasonal influenza vaccination policies to reduce morbidity and mortality associated with annual epidemics and as part of ongoing efforts for pandemic preparedness.

  5. [Recommendations of the World Health Organization Tobacco Control Research Team regarding electronic nicotine delivery devices].

    PubMed

    Kaleta, Dorota

    2010-01-01

    Negative health, social and economic consequences of smoking tobacco are widely known. Recent years have seen the emergence of many commercially sold appliances for inducing nicotine into the airways, including products such as "e-cigarette", "E-cigar" and "green cigarette". These products are often promoted as potential alternatives to nicotine replacement therapy. It transpires, however, that there is a lack of conclusive evidence concerning the health effects of long-term use of chemical substances applied via those electronic nicotine inhalers. Reliable data on the exact chemical composition of the cartridges used in the inhalers is also missing. The objective was to present the main conclusions and recommendations of the World Health Organization Tobacco Control Research Team regarding electronic nicotine delivery devices, which were formulated against the principles of the WHO Framework Convention on Tobacco Control (FCTC). Based on several analyses, WHO recommends a ban on disseminating information that suggest that electronic nicotine vaporisers are safer than cigarettes, or that they are an effective way of combating nicotine addition, until appropriate evidence can be provided. According to the WHO recommendations, references to efficacy of electronic vaporisers for quitting smoking or to their health effects must be backed by reliable pharmacokinetics studies, safety and efficacy tests and appropriate certification from regulatory bodies.

  6. Improving Laboratory Efficiency in the Caribbean to Attain the World Health Organization HIV Treat All Recommendations.

    PubMed

    Alemnji, George A; Chase, Martine; Branch, Songee; Guevara, Giselle; Nkengasong, John N; Albalak, Rachel

    2017-10-01

    Scientific evidence showing the benefits of early initiation of antiretroviral therapy (ART) prompted World Health organization (WHO) to recommend that all persons diagnosed HIV-positive should commence ART irrespective of CD4 count and disease progression. Based on this recommendation, countries should adopt and implement the HIV "Treat All" policy to achieve the UNAIDS 90-90-90 targets and ultimately reach epidemic control. Attaining this goal along the HIV treatment cascade depends on the laboratory to monitor progress and measure impact. The laboratory plays an important role in HIV diagnosis to attain the first 90 and in viral load (VL) and HIV drug resistance testing to reinforce adherence, improve viral suppression, and measure the third 90. Countries in the Caribbean region have endorsed the WHO HIV "Treat all" recommendation; however, they are faced with diminishing financial resources to support laboratory testing, seen as a rate-limiting factor to achieving this goal. To improve laboratory coverage with fewer resources in the Caribbean there is the need to optimise laboratory operations to ensure the implementation of high quality, less expensive, evidence-based approaches that will result in more efficient and effective service delivery. Suggested practical and innovative approaches to achieve this include: 1) targeted testing within HIV hotspots; 2) strengthening sample referral systems for VL; 3) better laboratory data collection systems; and 4) use of treatment cascade data for programmatic decision making. Furthermore, strengthening quality improvement and procurement systems will minimize diagnostic errors and guarantee a continuum of uninterrupted testing which is critical for routine monitoring of patients to meet the stated goal.

  7. Influence of measurement uncertainty on the world health organization recommended regulation for mainstream cigarette smoke constituents.

    PubMed

    Deng, Huimin; Li, Zhonghao; Bian, Zhaoyang; Yang, Fei; Liu, Shanshan; Fan, Ziyan; Wang, Ying; Tang, Gangling

    2017-03-12

    The World Health Organization Study Group on Tobacco Product Regulation (WHO TobReg) proposed mandated ceilings on 9 prioritized mainstream cigarette smoke constituents determined from the market-specific median of nicotine-normalized yield distributions. Considering the requirements for assessing and reporting of compliance with ceilings, it is of great importance to estimate the measurement uncertainty. To have a better understanding of influence of measurement uncertainty on the WHO recommended regulation for cigarette smoke constituents, in the present study, the measurement uncertainties were evaluated systematically based on series of collaborative studies reported by three different authorities over the years from 2012 to 2016, according to the approaches guided in ISO/TS 21748. Furthermore, the compliance assessment of 20 representative cigarette samples with proposed ceilings was conducted by taking measurement uncertainty into account. This work demonstrated that measurement uncertainty had great influence on the implementation of the regulated mandated lowering of toxic smoke constituents, both on the setting of ceilings and the compliance assessment as well.

  8. Implications of the 2015 World Health Organization isoniazid preventive therapy recommendations on tuberculosis prevention efforts in Namibia.

    PubMed

    Oloo, Stella Anne

    2016-07-01

    The World Health Organization recently released guidelines recommending 36-month use of isoniazid preventive therapy in adults and adolescents living with HIV in resource-limited settings. Namibia continues to grapple with one of the highest incidences of tuberculosis (TB) worldwide. Implementation of these guidelines requires considerations of TB epidemiology, health infrastructure, programmatic priorities and patient adherence. This article explores the challenges Namibia currently faces in its fight against TB and the implications of the new guidelines on Namibian TB prevention efforts.

  9. 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.

  10. [Maternal discharge: conditions and organization for mothers and newborns returning home. The French National Authority for Health recommendations update].

    PubMed

    Hascoët, J-M; Petitprez, K

    2014-09-01

    In light of changes in both medical practices and the organization of medical care, the French National Authority for Health (Haute Autorité de santé, HAS) proposed new recommendations on the discharge of mothers and newborns, updating its 2004 recommendations on early discharge of mothers and newborns. This decision in turn made it necessary to define optimal discharge conditions and accompanying measures for mothers and infants returning home. The problem was approached by adopting the usual HAS methodology for drafting good practice recommendations. This involved establishing a working group bringing together representatives of all medical and care fields related to perinatology as well as patient representatives. This working group submitted draft recommendations, based on updated published references, to a committee. The committee then proposed amendments to the recommendations, which the working group was free to accept or reject. The updated recommendations that emerged from this process apply four essential principles : first, preparing for discharge as early as the prenatal period, ideally during the third trimester of pregnancy, in particular by providing expectant mothers with information on how the discharge will be organized and anticipating problems that might arise; second, ensuring care continuity between hospitalization, discharge to home, and follow-up; third, ensuring optimal conditions for discharge after a maternity stay of 72-96 h for normal delivery or 96-120 h in case of caesarean section (this hospital stay duration allows for neonatal screening); and fourth, defining how mothers and children are to be accompanied during the first postnatal month. In conclusion, these recommendations resulted in an increase in the duration of as well as an improvement in routine newborn surveillance, whether in hospital or after discharge, in what is a critical phase of infant development. They encourage ambulatory postnatal monitoring. The new

  11. Ensuring the Ethical Implementation of the New World Health Organization Pre-Exposure Prophylaxis Recommendations for Men Who Have Sex with Men.

    PubMed

    Arora, Kavita Shah; Streed, Carl G

    2015-03-01

    The World Health Organization's (WHO) new recommendation to encourage pre-exposure prophylaxis in men who have sex with men (MSM) is an important step towards eradicating the HIV epidemic. However, the ethical issues of stigma, privacy and confidentiality, and access must be addressed in order to ensure the optimal implementation of this important recommendation.

  12. Recommendations for the organization of mental health services for children and adolescents in Belgium: use of the soft systems methodology.

    PubMed

    Vandenbroeck, Philippe; Dechenne, Rachel; Becher, Kim; Eyssen, Marijke; Van den Heede, Koen

    2014-02-01

    The prevalence of mental health problems among children and adolescents in Western countries is high. Belgium, like many other Western countries, struggles with the set-up of a coherent and effective strategy for dealing with this complex societal problem. This paper describes the development of a policy scenario for the organization of child and adolescent mental health care services (CAMHS) in Belgium. The development process relied on Soft Systems Methodology including a participatory process with 66 stakeholders and a review of the existing (inter-)national evidence. A diagnostic analysis illustrated that the Belgian CAMHS is a system in serious trouble characterized by fragmentation and compartmentalization. A set of 10 strategic recommendations was formulated to lay down the contours of a future, more effective CAMHS system. They focus on mastering the demands made on scarce and expensive specialized mental health services; strengthening the range of services - in particular for those with serious, complex and multiple mental health problems - and strengthening the adaptive capacity of and the ethical guidance within the future CAMHS system.

  13. Fortification of staple cereal flours with iron and other micronutrients: cost implications of following World Health Organization-endorsed recommendations.

    PubMed

    Aaron, Grant J; Laillou, Arnaud; Wolfson, Julian; Moench-Pfanner, Regina

    2012-12-01

    Wheat and maize flours are widely used delivery vehicles for mass fortification. In lower-income countries, most, if not all, national-level cereal flour fortification programs routinely fortify with iron; however, cofortification with other micronutrients is common. Little information is available on the cost implications programs face when considering current fortification practices versus what the World Health Organization (WHO) interim consensus statement recommends. The objectives of the present paper are to provide information on the costs of adding different chemical forms of iron and/or other micronutrients to premix formulations, and to discuss some of the issues that should be considered regarding which micronutrients to include in the premix. Nine countries in Latin America, Africa, and Asia (three countries per region) that currently cofortify with multiple micronutrients including iron were selected based on low (< 75 g/day), medium (75 to 149 g/day), and high (> or = 150 g/day) mean population flour consumption levels. Premix costs per metric ton of flour produced were estimated for improving iron formulations and for following WHO recommendations for other micronutrients. For the selected programs to maintain current premix formulations and improve iron compounds, premix costs would increase by between 155% and 343% when the iron compound was switched from electrolytic iron to sodium iron ethylenediaminetetraacetate (NaFeEDTA), by 6% to 50% when it was switched from electrolytic iron to ferrous sulfate, and by 4% to 13 when iron addition rates were adjusted without switching the compound. To meet WHO recommendations for other micronutrients, premix costs would increase the most when the amounts of vitamins B12 and A were increased. For programs that currently cofortify with iron and additional micronutrients, the quality of the iron fortificant should not be overlooked simply to be able to afford to add more micronutrients to the premix

  14. Testing of the World Health Organization-recommended formulations for surgical hand preparation and proposals for increased efficacy.

    PubMed

    Suchomel, M; Kundi, M; Allegranzi, B; Pittet, D; Rotter, M L

    2011-10-01

    The 2009 World Health Organization (WHO) Guidelines on hand hygiene in health care recommend alcohol-based hand rubs for both hygienic and pre-surgical hand treatment. Two formulations based on ethanol 80% v/v and 2-propanol 75% v/v are proposed for local preparation in healthcare settings where commercial products are not available or too expensive. Both formulations and our suggested modifications (using mass rather than volume percent concentrations) were evaluated for their conformity with the efficacy requirements of the forthcoming amendment of the European Norm (EN) 12791, i.e. non-inferiority of a product when compared with a reference procedure (1-propanol 60% v/v for 3 min) immediately and 3 h after antisepsis. In this study, the WHO-recommended formulations were tested for 3 min and 5 min. Neither formulation met the efficacy requirements of EN 12791 with 3 min application. Increasing the respective concentrations to 80 w/w (85% v/v) and 75 w/w (80% v/v), together with a prolonged application of 5 min, rendered the immediate effect of both formulations non-inferior to the reference antisepsis procedure. This was not the case with the 3h effect, which remained significantly inferior to the reference. Although the original formulations do not meet the efficacy requirements of EN 12791, the clinical significance of this finding deserves further clinical trials. To comply with the requirement of EN 12791, an amendment to the formulations is possible by increasing the alcohol concentrations through changing volume into mass percent and prolonging the duration of application from 3 min to 5 min.

  15. Testing of the World Health Organization recommended formulations in their application as hygienic hand rubs and proposals for increased efficacy.

    PubMed

    Suchomel, Miranda; Kundi, Michael; Pittet, Didier; Weinlich, Martina; Rotter, Manfred L

    2012-05-01

    In Central Europe, alcohol-based hand rubs have been the preferred choice for hand hygiene, whereas, in other countries, other preparations have been used that are based on other active agents. Recently, a move towards alcohol-based hand rubs has begun, but they may be costly and unaffordable to some. Therefore, the World Health Organization (WHO) has recommended 2 hand rub formulations (WHO I and WHO II) for local production in health care settings where commercial products are not available or are too expensive. WHO I, based on ethanol 80% (vol/vol), and WHO II, based on isopropanol 75% (vol/vol), were investigated for their bactericidal efficacy in their application as hygienic hand rubs. The investigation took place at the Institute for Hygiene and Applied Immunology, Medical University Vienna, Austria, as a prospective, randomized, in vivo laboratory study, comparative in crossover design. Both formulations were tested according to the European Standard EN 1500 in 2 applications (1 × 3 mL/30 seconds or 2 × 3 mL/2 × 30 seconds). Additionally, modifications with increased alcohol concentrations (weight instead of volume percent) were tested in the short application. Bactericidal efficacies were compared with those of the respective reference procedure "R," ie, rubbing 2 × 3 mL 60% vol/vol isopropanol for 2 × 30 seconds onto hands artificially contaminated with Escherichia coli K12. The short application of either WHO formulation resulted in bacterial reductions significantly inferior to the respective ones of R. However, prolonging the contact time to 60 seconds or increasing the alcohol content produced reductions similar to those of R. Both WHO-recommended formulations meet the efficacy requirements of EN 1500 within 60 seconds but not within 30 seconds. Increasing the respective alcohol concentrations from 80% vol/vol to 80% wt/wt and 75% vol/vol to 75% wt/wt renders the formulations sufficiently active to conform to the norm also within 30 sections

  16. Introduction on health recommender systems.

    PubMed

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described.

  17. Folate and folic acid in the periconceptional period: recommendations from official health organizations in thirty-six countries worldwide and WHO.

    PubMed

    Gomes, Sandra; Lopes, Carla; Pinto, Elisabete

    2016-01-01

    To summarize the recommendations on folate intake and folic acid supplementation and fortification in the periconceptional period, aimed at prevention of neural tube defects (NTD), provided by official health organizations in different countries worldwide and WHO. Information on recommendations for folate and folic acid intake in the periconceptional period was gathered from the websites of official national health organizations of several countries worldwide and from the WHO website. WHO, selected developed countries and emerging economies, totalling thirty-six countries worldwide (some European, BRICS, G8, Asian Tiger/Asian Dragon and Australia). Recommendations differ between countries, although the majority (69·4 %) recommend a healthy diet plus a folic acid supplement of 400 µg/d from preconception (4-12 weeks) until the end of the first trimester of pregnancy (8-12 weeks). The same recommendation is issued by the WHO. Dosages for women at high risk of NTD are up to 4-5 mg/d (for 41·7 % of studied countries). The recommended intake for folate is in the range of 300-400 µg/d for women of childbearing age and 500-600 µg/d for pregnant women in different countries and WHO. Five countries emphasize the importance of a healthy diet rendering supplementation needless. By contrast, five others advise a healthy diet and supplementation plus mandatory fortification. Only one mentions the importance of ensuring an adequate folate status and refers to checking with a health-care provider on the need for supplements. Different recommendations regarding folate and folic acid, seeking NTD prevention, are available worldwide; however, most countries and WHO focus on a healthy diet and folic acid supplementation of 400 µg/d periconceptionally.

  18. Pilot mental health: expert working group recommendations.

    PubMed

    2012-12-01

    Following a March 27, 2012, incident in which a pilot of a major commercial airline experienced a serious disturbance in his mental health, the Aerospace Medical Association formed an Ad Hoc Working Group on Pilot Mental Health. The working group met several times and analyzed current medical standards for evaluating pilot mental health. The result of the working group was a letter sent to the FAA and other organizations worldwide interested in medical standards. The Committee found that it is neither productive nor cost effective to perform extensive psychiatric evaluations as part of the routine pilot aeromedical assessment. However it did recommend greater attention be given to mental health issues by aeromedical examiners, especially to the more common and detectable mental health conditions and life stressors that can affect pilots and flight performance. They encouraged this through increased education and global recognition of the importance of mental health in aviation safety.

  19. Medicinal plants recommended by the world health organization: DNA barcode identification associated with chemical analyses guarantees their quality.

    PubMed

    Palhares, Rafael Melo; Gonçalves Drummond, Marcela; Dos Santos Alves Figueiredo Brasil, Bruno; Pereira Cosenza, Gustavo; das Graças Lins Brandão, Maria; Oliveira, Guilherme

    2015-01-01

    Medicinal plants are used throughout the world, and the regulations defining their proper use, such as identification of the correct species and verification of the presence, purity and concentration of the required chemical compounds, are widely recognized. Herbal medicines are made from vegetal drugs, the processed products of medicinal species. These processed materials present a number of challenges in terms of botanical identification, and according to the World Health Organization (WHO), the use of incorrect species is a threat to consumer safety. The samples used in this study consisted of the dried leaves, flowers and roots of 257 samples from 8 distinct species approved by the WHO for the production of medicinal herbs and sold in Brazilian markets. Identification of the samples in this study using DNA barcoding (matK, rbcL and ITS2 regions) revealed that the level of substitutions may be as high as 71%. Using qualitative and quantitative chemical analyses, this study identified situations in which the correct species was being sold, but the chemical compounds were not present. Even more troubling, some samples identified as substitutions using DNA barcoding contained the chemical compounds from the correct species at the minimum required concentration. This last situation may lead to the use of unknown species or species whose safety for human consumption remains unknown. This study concludes that DNA barcoding should be used in a complementary manner for species identification with chemical analyses to detect and quantify the required chemical compounds, thus improving the quality of this class of medicines.

  20. Medicinal Plants Recommended by the World Health Organization: DNA Barcode Identification Associated with Chemical Analyses Guarantees Their Quality

    PubMed Central

    Palhares, Rafael Melo; Gonçalves Drummond, Marcela; dos Santos Alves Figueiredo Brasil, Bruno; Pereira Cosenza, Gustavo; das Graças Lins Brandão, Maria; Oliveira, Guilherme

    2015-01-01

    Medicinal plants are used throughout the world, and the regulations defining their proper use, such as identification of the correct species and verification of the presence, purity and concentration of the required chemical compounds, are widely recognized. Herbal medicines are made from vegetal drugs, the processed products of medicinal species. These processed materials present a number of challenges in terms of botanical identification, and according to the World Health Organization (WHO), the use of incorrect species is a threat to consumer safety. The samples used in this study consisted of the dried leaves, flowers and roots of 257 samples from 8 distinct species approved by the WHO for the production of medicinal herbs and sold in Brazilian markets. Identification of the samples in this study using DNA barcoding (matK, rbcL and ITS2 regions) revealed that the level of substitutions may be as high as 71%. Using qualitative and quantitative chemical analyses, this study identified situations in which the correct species was being sold, but the chemical compounds were not present. Even more troubling, some samples identified as substitutions using DNA barcoding contained the chemical compounds from the correct species at the minimum required concentration. This last situation may lead to the use of unknown species or species whose safety for human consumption remains unknown. This study concludes that DNA barcoding should be used in a complementary manner for species identification with chemical analyses to detect and quantify the required chemical compounds, thus improving the quality of this class of medicines. PMID:25978064

  1. Prioritizing Sleep Health: Public Health Policy Recommendations.

    PubMed

    Barnes, Christopher M; Drake, Christopher L

    2015-11-01

    The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a public health issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders.

  2. Global recommendations on physical activity for health

    MedlinePlus

    ... English Français Русский Español Global Strategy on Diet, Physical Activity and Health Menu Diet, Physical Activity & Health Global ... obesity Documents & publications Related links Global recommendations on physical activity for health WHO developed the "Global Recommendations on ...

  3. Rabies postexposure prophylaxis in routine practice in view of the new Centers for Disease Control and Prevention and World Health Organization recommendations.

    PubMed

    Uwanyiligira, Mediatrice; Landry, Pierre; Genton, Blaise; de Valliere, Serge

    2012-07-01

    New recommendations for rabies postexposure prophylaxis (PEP) were published by the Centers for Disease Control and Prevention and the World Health Organization in 2010. In view of these new recommendations, we investigated the adequacy of rabies PEP among patients consulting our travel clinic. A retrospective analysis of the files of all patients who consulted for rabies PEP at the Travel Clinic of the University Hospital in Lausanne, Switzerland, between January 2005 and August 2011 was conducted. A total of 110 patients who received rabies PEP were identified. The median age of the patients was 34 years (range, 2-79 years), and 53% were women. Ninety subjects were potentially exposed to rabies while travelling abroad. Shortcomings in the management of these patients were (1) late initiation of rabies PEP in travelers who waited to seek medical care until returning to Switzerland, (2) administration of human rabies immunoglobulin (HRIG) to only 7 of 50 travelers (14%) who sought care abroad and for whom HRIG was indicated, and (3) antibody levels <0.5 IU/mL in 6 of 90 patients (6.7%) after 4 doses of vaccine. Patients do not always receive optimal rabies PEP under real-life conditions. A significant proportion of patients did not develop adequate antibody levels after 4 doses of vaccine. These data indicate that the measurement of antibody levels on day 21 of the Essen PEP regimen is useful in order to verify an adequate immune response.

  4. [Recommendation for the collection and analysis of data on participation and disability from the perspective of the World Health Organization].

    PubMed

    Coenen, Michaela; Sabariego, Carla; Cieza, Alarcos

    2016-09-01

    The Convention on the Rights of Persons with Disabilities (UNCRPD) demands actions to improve participation of people with disability and to remove barriers that hinder participation in society on an equal basis with others. Policymaking in this area requires reliable and detailed data on all aspects of disability. Up to now, there has been no standardized tool for collecting data on disability and participation in the general population. In November 2011, WHO, in collaboration with the World Bank, started the development of the Model Disability Survey (MDS). The MDS addresses WHO's conceptualization of disability as an outcome of interactions between a person with a health condition and contextual factors. Presentation of the development and implementation of the MDS and the guidelines for standardized data analysis. The development of the MDS was performed in three phases: (1) situation analysis and drafting an alpha version, (2) testing and piloting the alpha version and (3) implementation. The MDS is consequently designed as a survey for the general population without using filters. It has a modular structure and consists of two parts (household questionnaire and individual questionnaire with eight modules). This format allows for its use as a stand alone survey as well as its integration in other (national) surveys. The MDS has been cognitive tested, piloted and implemented in several countries. The MDS is the first general population survey that provides standardized, detailed and nuanced information on disability and participation of the general population to monitor the implementation of the UNCRPD.

  5. Expert Recommender: Designing for a Network Organization

    NASA Astrophysics Data System (ADS)

    Reichling, Tim; Veith, Michael; Wulf, Volker

    Recent knowledge management initiatives focus on expertise sharing within formal organizational units and informal communities of practice. Expert recommender systems seem to be a promising tool in support of these initiatives. This paper presents experiences in designing an expert recommender system for a knowledge- intensive organization, namely the National Industry Association (NIA). Field study results provide a set of specific design requirements. Based on these requirements, we have designed an expert recommender system which is integrated into the specific software infrastructure of the organizational setting. The organizational setting is, as we will show, specific for historical, political, and economic reasons. These particularities influence the employees’ organizational and (inter-)personal needs within this setting. The paper connects empirical findings of a long-term case study with design experiences of an expertise recommender system.

  6. Monitoring HIV Drug Resistance Early Warning Indicators in Cameroon: A Study Following the Revised World Health Organization Recommendations

    PubMed Central

    Fokam, Joseph; Elat, Jean-Bosco N.; Billong, Serge C.; Kembou, Etienne; Nkwescheu, Armand S.; Obam, Nicolas M.; Essiane, André; Torimiro, Judith N.; Ekanmian, Gatien K.; Ndjolo, Alexis; Shiro, Koulla S.; Bissek, Anne C. Z-K.

    2015-01-01

    Background The majority (>95%) of new HIV infection occurs in resource-limited settings, and Cameroon is still experiencing a generalized epidemic with ~122,638 patients receiving antiretroviral therapy (ART). A detrimental outcome in scaling-up ART is the emergence HIV drug resistance (HIVDR), suggesting the need for pragmatic approaches in sustaining a successful ART performance. Methods A survey was conducted in 15 ART sites of the Centre and Littoral regions of Cameroon in 2013 (10 urban versus 05 rural settings; 8 at tertiary/secondary versus 7 at primary healthcare levels), evaluating HIVDR-early warning indicators (EWIs) as-per the 2012 revised World Health Organization’s guidelines: EWI1 (on-time pill pick-up), EWI2 (retention in care), EWI3 (no pharmacy stock-outs), EWI4 (dispensing practices), EWI5 (virological suppression). Poor performance was interpreted as potential HIVDR. Results Only 33.3% (4/12) of sites reached the desirable performance for “on-time pill pick-up” (57.1% urban versus 0% rural; p<0.0001) besides 25% (3/12) with fair performance. 69.2% (9/13) reached the desirable performance for “retention in care” (77.8% urban versus 50% rural; p=0.01) beside 7.7% (1/13) with fair performance. Only 14.4% (2/13) reached the desirable performance of “no pharmacy stock-outs” (11.1% urban versus 25% rural; p=0.02). All 15 sites reached the desirable performance of 0% “dispensing mono- or dual-therapy”. Data were unavailable to evaluate “virological suppression” due to limited access to viral load testing (min-max: <1%-15%). Potential HIVDR was higher in rural (57.9%) compared to urban (27.8%) settings, p=0.02; and at primary (57.9%) compared to secondary/tertiary (33.3%) healthcare levels, p=0.09. Conclusions Delayed pill pick-up and pharmacy stock-outs are major factors favoring HIVDR emergence, with higher risks in rural settings and at primary healthcare. Retention in care appears acceptable in general while ART dispensing

  7. World Health Organization-recommended hand-rub formulations do not meet European efficacy requirements for surgical hand disinfection in five minutes.

    PubMed

    Kampf, G; Ostermeyer, C

    2011-06-01

    The World Health Organization (WHO) has recommended two hand-rub formulations for local production based on 80% ethanol or 75% isopropanol (both v/v). We have looked at their efficacy according to EN 12791. Twenty-six subjects treated their hands with the reference procedure (n-propanol, 60%) for 3 min or with one of the two formulations for 1.5, 3 or 5 min (Latin square design). Post-values (immediate effect) were taken from one hand, the other hand was gloved for 3 h. After the glove had been taken off, the second post-value was taken (3 h effect). The mean log(10) reduction of each hand rub at all three application times was compared to Hodges and Lehmann's reference procedure for non-inferiority. In the first block the reference procedure reduced bacterial load by 2.43 log(10) (immediate effect) and 2.22 log(10) (3 h effect). The efficacy of the ethanol-based formulation (e.g. immediate efficacy of 1.41 log(10) at 5 min) was inferior to the reference procedure at all application times [lower 95% confidence interval (CI): less than -0.75]. In the second block the reference procedure reduced bacterial load by 2.72 log(10) (immediate effect) and 2.26 log(10) (3 h effect). The efficacy of the isopropanol-based formulation (e.g. immediate efficacy of 2.05 log(10) at 5 min) was also inferior to the reference procedure at all application times (lower 95% CI: less than -0.75). Both WHO-recommended hand-rub formulations failed to meet the EN 12791 efficacy requirements for surgical hand disinfection within 5 min. A higher concentration of the active ingredients may improve the efficacy.

  8. Pharmacokinetics of isoniazid, rifampin, and pyrazinamide in children younger than two years of age with tuberculosis: evidence for implementation of revised World Health Organization recommendations.

    PubMed

    Thee, S; Seddon, J A; Donald, P R; Seifart, H I; Werely, C J; Hesseling, A C; Rosenkranz, B; Roll, S; Magdorf, K; Schaaf, H S

    2011-12-01

    The World Health Organization (WHO) recently issued revised first-line antituberculosis (anti-TB) drug dosage recommendations for children. No pharmacokinetic studies for these revised dosages are available for children <2 years. The aim of the study was to document the pharmacokinetics of the first-line anti-TB agents in children <2 years of age comparing previous and revised WHO dosages of isoniazid (INH; 5 versus 10 mg/kg/day), rifampin (RMP; 10 versus 15 mg/kg/day), and pyrazinamide (PZA; 25 versus 35 mg/kg/day) and to investigate the effects of clinical covariates, including HIV coinfection, nutritional status, age, gender, and type of tuberculosis (TB), and the effect of NAT2 acetylator status. Serum INH, PZA, and RMP levels were prospectively assessed in 20 children <2 years of age treated for TB following the previous and the revised WHO dosage recommendations. Samples were taken prior to dosing and at 0.5, 1.5, 3, and 5 h following dosing. The maximum drug concentration in serum (C(max)), the time to C(max) (t(max)), and the area under the concentration-time curve (AUC) were calculated. Eleven children had pulmonary and 9 had extrapulmonary TB. Five were HIV infected. The mean C(max) (μg/ml) following the administration of previous/revised dosages were as follows: INH, 3.19/8.11; RMP, 6.36/11.69; PZA, 29.94/47.11. The mean AUC (μg·h/ml) were as follows: INH, 8.09/20.36; RMP, 17.78/36.95; PZA, 118.0/175.2. The mean C(max) and AUC differed significantly between doses. There was no difference in the t(max) values achieved. Children less than 2 years of age achieve target concentrations of first-line anti-TB agents using revised WHO dosage recommendations. Our data provided supportive evidence for the implementation of the revised WHO guidelines for first-line anti-TB therapy in young children.

  9. Recommendations for Undergraduate Public Health Education

    ERIC Educational Resources Information Center

    Riegelman, Richard K.; Albertine, Susan

    2008-01-01

    This curriculum guide serves to assist faculty who are developing undergraduate courses in public health as well as educational administrators and faculty curriculum committees who are designing undergraduate public health curricula. The approach outlined in these recommendations focuses on the development of three core courses, each of which is…

  10. Efficacy of the World Health Organization-recommended handwashing technique and a modified washing technique to remove Clostridium difficile from hands.

    PubMed

    Deschênes, Philippe; Chano, Frédéric; Dionne, Léa-Laurence; Pittet, Didier; Longtin, Yves

    2017-08-01

    The efficacy of the World Health Organization (WHO)-recommended handwashing technique against Clostridium difficile is uncertain, and whether it could be improved remains unknown. Also, the benefit of using a structured technique instead of an unstructured technique remains unclear. This study was a prospective comparison of 3 techniques (unstructured, WHO, and a novel technique dubbed WHO shortened repeated [WHO-SR] technique) to remove C difficile. Ten participants were enrolled and performed each technique. Hands were contaminated with 3 × 10(6) colony forming units (CFU) of a nontoxigenic strain containing 90% spores. Efficacy was assessed using the whole-hand method. The relative efficacy of each technique and of a structured (either WHO or WHO-SR) vs an unstructured technique were assessed by Mann-Whitney U test and Wilcoxon signed-rank test. The median effectiveness of the unstructured, WHO, and WHO-SR techniques in log10 CFU reduction was 1.30 (interquartile range [IQR], 1.27-1.43), 1.71 (IQR, 1.34-1.91), and 1.70 (IQR, 1.54-2.42), respectively. The WHO-SR technique was significantly more efficacious than the unstructured technique (P = .01). Washing hands with a structured technique was more effective than washing with an unstructured technique (median, 1.70 vs 1.30 log10 CFU reduction, respectively; P = .007). A structured washing technique is more effective than an unstructured technique against C difficile. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  11. [Benchmarking in health care: conclusions and recommendations].

    PubMed

    Geraedts, Max; Selbmann, Hans-Konrad

    2011-01-01

    The German Health Ministry funded 10 demonstration projects and accompanying research of benchmarking in health care. The accompanying research work aimed to infer generalisable findings and recommendations. We performed a meta-evaluation of the demonstration projects and analysed national and international approaches to benchmarking in health care. It was found that the typical benchmarking sequence is hardly ever realised. Most projects lack a detailed analysis of structures and processes of the best performers as a starting point for the process of learning from and adopting best practice. To tap the full potential of benchmarking in health care, participation in voluntary benchmarking projects should be promoted that have been demonstrated to follow all the typical steps of a benchmarking process. Copyright © 2011. Published by Elsevier GmbH.

  12. Recommendations for European health data protection legislation.

    PubMed

    Callens, S; Nys, H

    1996-01-01

    In year 1 of the SEISMED project, the Katholieke Universiteit Leuven coordinated the inventory and analysis of medical personal data protection legislation in Europe. A report on legal issues of medical data protection legislation in Europe was written by the Vrije Universiteit Amsterdam, the Centre National pour la Recherche Scientifique (Paris) and the University College Dublin. This report served as a basis for a second important legal deliverable, i.e. the Health Informatics Deontology Code. In this third and final report, we take into account the results of the other two legal reports and we formulate recommendations for the national and European legislator. This report analyses critically the upcoming privacy directive. We propose several recommendations which should be taken into account by the European and national legislator. We focused quite extensively on the use of medical data for research purposes. We had several reasons to do this. One of them is the fact that the use of medical data for research purposes is very popular, in particular now the health care sector is becoming more and more 'standardized' by using computers, networksystems and telematics. Legislation is therefore needed. Moreover, the use of medical data for research purposes involves the transfer of data from one Member State to another. Therefore, a harmonized legislation is really needed. We hope that the recommendations we propose, will be taken into consideration by the European legislator.

  13. Impact on hand hygiene compliance following migration to a new hospital with improved resources and the sequential introduction of World Health Organization recommendations.

    PubMed

    Abela, Noel; Borg, Michael A

    2012-10-01

    One commonly cited reason for inadequate hand hygiene (HH) in health care facilities is lack of handwashing sinks and alcohol hand rub (AHR). Using the World Health Organization (WHO) direct observation method, we studied HH compliance after migration from an old hospital having 1 HH station (sink and AHR) per 6 beds to a new institution with 1 per 0.85 beds. We then introduced the other WHO strategy components in a sequential manner-posters, active education, and performance feedback-and assessed the impact of the various elements over time. Migration from the old to the new hospital was actually accompanied by a reduction in HH from 27.3% to 14.5% (P < .01), with a 52% decline in handwashing (P = .01) after patient contact. Small group interactive teaching improved HH compliance but only reached a maximum of 33.1%. No change was seen where only posters and leaflets (without educational sessions) were adopted. Significant improvement was only obtained after a performance feedback campaign coupled with increased staff accountability, reaching an overall average of 63% (P < .001). Our results suggest that, on their own, better resources do not offer any guarantees of improved HH practices. However, once in place, audit and feedback-coupled with genuine administrative support and fostering of individual accountability-appear to be effective change tools to increase HH compliance. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  14. The World Health Organization Recommendations for Trachoma Surveillance, Experience in Nepal and Added Benefit of Testing for Antibodies to Chlamydia trachomatis pgp3 Protein: NESTS Study

    PubMed Central

    Zambrano, Andrea I.; Sharma, Shekhar; Crowley, Kathryn; Dize, Laura; Muñoz, Beatriz E.; Mishra, Sailesh K.; Rotondo, Lisa A.; Gaydos, Charlotte A.; West, Sheila K.

    2016-01-01

    Background The World Health Organization (WHO) now requires a second surveillance survey for trachoma after an impact assessment has found follicular trachoma (TF) <5% to determine if re-emergence has occurred. Using new WHO guidelines, we undertook surveillance surveys, and determined the prevalence of infection and antibody positivity, in two districts in Nepal. Methods 20 clusters were randomly selected within each district, 15 were randomly selected for antibody testing. In each cluster, we randomly selected 50 children ages 1–9 years and 100 adults ≥15 years. TF and trachomatous trichiasis (TT) were evaluated. Conjunctival swabs to test for chlamydial infection using GenXpert platform were obtained, and dried blood spots were collected to test for antibodies to Chlamydia Trachomatis pgp3 using the Luminex platform. Findings 3 cases of TF were found in the two districts, and one case of infection. Pgp3 antibody positivity was 2·4% (95% confidence interval: 1·4%, 3·7%), and did not increase with age (P = 0.24). No clustering of antibody positivity within communities was found. TT prevalence was <1/1,000 population. Interpretation The surveillance surveys, as proposed by WHO, showed no evidence for re-emergence of trachoma in two districts of Nepal. The low level and no significant increase by age in seroprevalence of antibodies to C trachomatis pgp3 antigen deserve further investigation as a marker of interruption of transmission. PMID:27654497

  15. Brief Report: Appraising Viral Load Thresholds and Adherence Support Recommendations in the World Health Organization Guidelines for Detection and Management of Virologic Failure.

    PubMed

    McCluskey, Suzanne M; Boum, Yap; Musinguzi, Nicholas; Haberer, Jessica E; Martin, Jeffrey N; Hunt, Peter W; Marconi, Vincent C; Bangsberg, David R; Siedner, Mark J

    2017-10-01

    The World Health Organization defines HIV virologic failure as 2 consecutive viral loads >1000 copies/mL, measured 3-6 months apart, with interval adherence support. We sought to empirically evaluate these guidelines using data from an observational cohort. The Uganda AIDS Rural Treatment Outcomes study observed adults with HIV in southwestern Uganda from the time of antiretroviral therapy (ART) initiation and monitored adherence with electronic pill bottles. We included participants on ART with a detectable HIV RNA viral load and who remained on the same regimen until the subsequent measurement. We fit logistic regression models with viral resuppression as the outcome of interest and both initial viral load level and average adherence as predictors of interest. We analyzed 139 events. Median ART duration was 0.92 years, and 100% were on a nonnucleoside reverse-transcriptase inhibitor-based regimen. Viral resuppression occurred in 88% of those with initial HIV RNA <1000 copies/mL and 42% if HIV RNA was >1000 copies/mL (P <0.001). Adherence after detectable viremia predicted viral resuppression for those with HIV RNA <1000 copies/mL (P = 0.011) but was not associated with resuppression for those with HIV RNA >1000 copies/mL (P = 0.894; interaction term P = 0.077). Among patients on ART with detectable HIV RNA >1000 copies/mL who remain on the same regimen, only 42% resuppressed at next measurement, and there was no association between interval adherence and viral resuppression. These data support consideration of resistance testing to help guide management of virologic failure in resource-limited settings.

  16. One-step disposable chambers for sperm concentration and motility assessment: how do they compare with the World Health Organization's recommended methods?

    PubMed

    Tomlinson, M; Turner, J; Powell, G; Sakkas, D

    2001-01-01

    The World Health Organization suggests that 'one-step' type disposable chambers lack the accuracy and precision of the haemocytometer method for assessing sperm concentration. The purpose of this particular study was to compare sperm concentration measurements and motility using the Neubauer((R)) haemocytometer with those obtained using three 'one-step' methods: the Microcell((R)) slide, Leja((R)) slide and a plain glass slide with a 22x22 mm coverslip. A total of 200 sperm concentration measurements and 100 motility assessments were performed on all chambers. Paired comparisons showed enormous discrepancies between the counts, particularly between the Neubauer((R)) and other chambers (P < 0.0001). This discrepancy was less pronounced in oligozoospermic samples, and samples with low (<30% progression) motility but more pronounced in normozoospermic samples and those with good motility (>50% progression). In addition, concentration assessments from a fresh undiluted and unfixed semen sample on the Microcell((R)) slide were found to be significantly lower than both fixed counts on the same slide (P = 0.011) and the initial laboratory reading on the Neubauer((R)) chamber (P = 0.009). No differences were observed in progressive motility between the different chambers and a plain glass slide. There appears to be little comparison between the haemocytometer and either re-useable or disposable one-step chambers. The unfortunate consequence of this is that diagnostic semen analysis and guidelines for allocation of patients to appropriate treatment groups will vary from centre to centre, depending on the method used and may, on occasion, be erroneous.

  17. Codex recommendations on the scientific basis of health claims.

    PubMed

    Grossklaus, Rolf

    2009-12-01

    Within the framework of Codex Alimentarius, attempts are being made at international level to establish guidelines for use of nutrition and health claims. An important issue that has to be addressed is the process of scientific substantiating of claims on foods. To provide an insight into the current step procedure of the proposed draft recommendations on the scientific basis of health claims. These Codex recommendations are intended to facilitate governments' own evaluation of health claims made by the industry. Review of comments of governments, observers and non-governmental organizations (NGOs) and relevant references to the proposed draft recommendations of the last sessions of the Codex Committee on Nutrition and Food for Special Dietary Uses (CCNFSDU). A literature search was performed using the PubMed database. Several proposed draft recommendations on the scientific substantiation of health claims have been considered and amended by the CCNFSDU in recent years but the work is not yet complete. The current work draws on the work of FUFOSE and PASSCLAIM and also on that of WHO and FDA. Given the important role of Codex in food safety, the draft recommendations emphasize circumstances where additional evaluation of safety or nutritional safety needs to be considered. High quality human intervention studies are the prime evidence needed to substantiate claims but there is recognition that, in some cases, only observational studies may be available. Animal and in vitro studies will also be evaluated as part of the totality of the evidence. It has been suggested that the recommendations should include re-evaluation of claims after a certain time period, or if new evidence calls into question the scientific validity underpinning the claims. Setting out a common approach for the substantiation of health claims is an important step in the use of health claims around the world. There is a need to reflect emerging as well as consensus science. The substantiating

  18. Evaluation of Military Field-Water Quality. Volume 5. Infectious Organisms of Military Concern Associated with Consumption: Assessment of Health Risks, and Recommendations for Establishing Related Standards

    DTIC Science & Technology

    1986-02-01

    S .......’ ’DT C AD-A241 524 AD..- r. ~ iiiUCRL 1-21003 Vol. 5 ",",iI• flll •i" Approved for publM elease Distribution unlimited Evaluation of...Recommendations for Establishing Related Standards R. C. Cooper A. W. Olivieri R. E. Danielson P. G. Badger R. C. Spear S . Selvin February 1986 Supported by U.S...Energy by Lawrence Livermore National Laboratory under Contract W-7440-EnS4S. UNCLASSIFIED SECUA~ITy CrASSiXCAr75N Of’ S ’JAU REPORT DOCUMENTATION PAGE OZ

  19. Total Health Organization.

    PubMed

    1993-01-01

    Total Health Organization is a holistic care an humanitarian relief agency with special emphasis on Africa and Third World countries. It was founded in 1987 with a focus on hunger relief, health assistance, handicap, habitat and human rights of destitutes, socially disadvantaged persons and communities which it has adopted as the socially forgotten people (SFP). Total Health Organization is a non-political, non-profit, and international non-governmental organization, having official relations with several national, regional and world bodies. Some of the project activities include: free mobile clinics to rural destitutes, AIDS and related health education, an information and research library, and an NGO Development Center. For more information, please contact: Dr. Obi Osisiogu, Founder and President, Total Health International Center, 147 Ikot-Ekpene Road, P.O. Box 1726, Aba, Abia State Nigeria, Tel: 082-222279, Telex: 63311 ANYA NG, Fax: 234-82-227512.

  20. Policy Recommendations for Health Professions Education. Item #7.

    ERIC Educational Resources Information Center

    Illinois State Board of Higher Education, Springfield.

    This report presents recommendations for Illinois' Board of Higher Education's approval in the areas of: (1) general policies for health professions education, (2) the adoption of immediate program priorities to implement the general policy directions in health education programs, and (3) specific recommendations for adjustments in Health Services…

  1. Estimating age-based antiretroviral therapy costs for HIV-infected children in resource-limited settings based on World Health Organization weight-based dosing recommendations

    PubMed Central

    2014-01-01

    Background Pediatric antiretroviral therapy (ART) has been shown to substantially reduce morbidity and mortality in HIV-infected infants and children. To accurately project program costs, analysts need accurate estimations of antiretroviral drug (ARV) costs for children. However, the costing of pediatric antiretroviral therapy is complicated by weight-based dosing recommendations which change as children grow. Methods We developed a step-by-step methodology for estimating the cost of pediatric ARV regimens for children ages 0–13 years old. The costing approach incorporates weight-based dosing recommendations to provide estimated ARV doses throughout childhood development. Published unit drug costs are then used to calculate average monthly drug costs. We compared our derived monthly ARV costs to published estimates to assess the accuracy of our methodology. Results The estimates of monthly ARV costs are provided for six commonly used first-line pediatric ARV regimens, considering three possible care scenarios. The costs derived in our analysis for children were fairly comparable to or slightly higher than available published ARV drug or regimen estimates. Conclusions The methodology described here can be used to provide an accurate estimation of pediatric ARV regimen costs for cost-effectiveness analysts to project the optimum packages of care for HIV-infected children, as well as for program administrators and budget analysts who wish to assess the feasibility of increasing pediatric ART availability in constrained budget environments. PMID:24885453

  2. Estimating age-based antiretroviral therapy costs for HIV-infected children in resource-limited settings based on World Health Organization weight-based dosing recommendations.

    PubMed

    Doherty, Kathleen; Essajee, Shaffiq; Penazzato, Martina; Holmes, Charles; Resch, Stephen; Ciaranello, Andrea

    2014-05-02

    Pediatric antiretroviral therapy (ART) has been shown to substantially reduce morbidity and mortality in HIV-infected infants and children. To accurately project program costs, analysts need accurate estimations of antiretroviral drug (ARV) costs for children. However, the costing of pediatric antiretroviral therapy is complicated by weight-based dosing recommendations which change as children grow. We developed a step-by-step methodology for estimating the cost of pediatric ARV regimens for children ages 0-13 years old. The costing approach incorporates weight-based dosing recommendations to provide estimated ARV doses throughout childhood development. Published unit drug costs are then used to calculate average monthly drug costs. We compared our derived monthly ARV costs to published estimates to assess the accuracy of our methodology. The estimates of monthly ARV costs are provided for six commonly used first-line pediatric ARV regimens, considering three possible care scenarios. The costs derived in our analysis for children were fairly comparable to or slightly higher than available published ARV drug or regimen estimates. The methodology described here can be used to provide an accurate estimation of pediatric ARV regimen costs for cost-effectiveness analysts to project the optimum packages of care for HIV-infected children, as well as for program administrators and budget analysts who wish to assess the feasibility of increasing pediatric ART availability in constrained budget environments.

  3. Evaluation of military field-water quality: Volume 6, Infectious organisms of military concern associated with nonconsumptive exposure: Assessment of health risks and recommendations for establishing related standards

    SciTech Connect

    Cooper, R.C.; Olivieri, A.W.; Danielson, R.E.; Badger, P.G.

    1986-02-01

    This study is an assessment of the risk of illness due to exposure to water-related (i.e., water-based, water-washed) infectious organisms. The organisms under consideration are Aeromonas spp., Leptospira spp., Pseudomonas spp., Staphylococcus spp., non-cholerae Vibrio spp., Acanthamoeba spp., Balantidium coli, Naegleria spp., Ascaris lumbricoides, Dracunculus medinesis, Schistosoma spp., and the agents responsible for cercarial dermatitis (i.e., Trichobilharzia, Gigantobilharzia, and Austrobilharzia). Evaluation of the risk to disease associated with the above pathogens requires information in specific areas such as dose response, concentration of agents in the environment, and environmental persistence. The existing body of knowledge concerning these agents ranges from speculation to established fact. Unfortunately, areas of information critical to risk assessment are frequently unavailable. Because of this lack of data, the risk assessment presented is semiquantitative and limited to the presentation of an environmental classification scheme. 14 refs., 2 figs., 57 tabs.

  4. [Health care levels and minimum recommendations for neonatal care].

    PubMed

    Rite Gracia, S; Fernández Lorenzo, J R; Echániz Urcelay, I; Botet Mussons, F; Herranz Carrillo, G; Moreno Hernando, J; Salguero García, E; Sánchez Luna, M

    2013-07-01

    A policy statement on the levels of care and minimum recommendations for neonatal healthcare was first proposed by the Standards Committee and the Board of the Spanish Society of Neonatology in 2004. This allowed us to define the level of care of each center in our country, as well as the health and technical requirements by levels of care to be defined. This review takes into account changes in neonatal care in the last few years and to optimize the location of resources. Facilities that provide care for newborn infants should be organized within a regionalized system of perinatal care. The functional capabilities of each level of care should be defined clearly and uniformly, including requirements for equipment, facilities, personnel, ancillary services, training, and the organization of services (including transport) needed to cover each level of care.

  5. Evaluation of military field-water quality: Volume 5, Infectious organisms of military concern associated with consumption: Assessment of health risks, and recommendations for establishing related standards

    SciTech Connect

    Cooper, R.C.; Olivieri, A.W.; Danielson, R.E.; Badger, P.G.; Spear, R.C.; Selvin, S.

    1986-02-01

    Considerable interest exists in establishing realistic standards for water quality as related to the transmission of infectious disease. The development of such standards is a complicated task that consciously, and frequently subconsciously, involves the concept of risk assessment. In the context of our study, risk assessment involves the relationship between the concentration of a pathogen in water and the likelihood of disease occurring in individuals who drink the water. A mathematical model was developed to take into account the variability of the pathogen concentration in water, and hence the dose, as well as the biological variability inherent in the dose-response relationship. An interactive computer program was developed that allows the user to select the organism of interest, the amount of water consumed, the treatment-alternative removal rate, the pathogen concentration, the dose-response model, and the number of susceptible individuals. Based on the users' selections, a computer-generated risk curve is produced. 67 refs., 27 figs., 109 tabs.

  6. Following the World Health Organization's Recommendation of Exclusive Breastfeeding to 6 Months of Age Does Not Impact the Growth of Rural Gambian Infants.

    PubMed

    Eriksen, Kamilla G; Johnson, William; Sonko, Bakary; Prentice, Andrew M; Darboe, Momodou K; Moore, Sophie E

    2017-02-01

    The WHO recommends exclusive breastfeeding (EBF) for the first 6 mo of life. The objective of this study was to assess the benefit of EBF to age 6 mo on growth in a large sample of rural Gambian infants at high risk of undernutrition. Infants with growth monitoring from birth to 2 y of age (n = 756) from the ENID (Early Nutrition and Immune Development) trial were categorized as exclusively breastfed if only breast milk and no other liquids or foods were given. EBF status was entered into confounder-adjusted multilevel models to test associations with growth trajectories by using >11,000 weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) z score observations. Thirty-two percent of infants were exclusively breastfed to age 6 mo. The mean age of discontinuation of EBF was 5.2 mo, and growth faltering started at ∼3.5 mo of age. Some evidence for a difference in WAZ and WHZ was found between infants who were exclusively breastfed to age 6 mo (EBF-6) and those who were not (nEBF-6), at 6 and 12 mo of age, with EBF-6 children having a higher mean z score. The differences in z scores between the 2 groups were small in magnitude (at 6 mo of age: 0.147 WAZ; 95% CI: -0.001, 0.293 WAZ; 0.189 WHZ; 95% CI: 0.038, 0.341 WHZ). No evidence for a difference between EBF-6 and nEBF-6 infants was observed for LAZ at any time point (6, 12, and 24 mo of age). Furthermore, a higher mean WLZ at 3 mo of age was associated with a subsequent higher mean age at discontinuation of EBF, which implied reverse causality in this setting (coefficient: 0.060; 95% CI: 0.008, 0.120). This study suggests that EBF to age 6 mo has limited benefit to the growth of rural Gambian infants. This trial was registered at http://www.isrctn.com as ISRCTN49285450.

  7. Recommendations of the National Advisory Council on Migrant Health, 1993.

    ERIC Educational Resources Information Center

    National Migrant Resource Program, Inc., Austin, TX.

    The 1993 recommendations to the Secretary of Health and Human Services on migrant health emphasize that all available federal and state public service programs be mobilized to also serve farmworkers, and that coordination of efforts among federal agencies and departments take place. The following recommendations offer approaches to secure…

  8. Health Care Reform: Recommendations and Analysis.

    ERIC Educational Resources Information Center

    Lewit, Eugene M.; And Others

    1993-01-01

    Health care reform needs to assure coverage to all children regardless of income level or illnesses; address benefits, financing, administration, and delivery systems; provide substantial subsidies to low-income families; be equitable for all people; provide better monitoring of child health; protect and strengthen health providers who assist…

  9. Periodontal and general health: clinical recommendations.

    PubMed

    Bowen, Denise M

    2014-04-01

    The purpose of Linking Research to Clinical Practice is to present evidence based information to clinical dental hygienists so that they can make informed decisions regarding patient treatment and recommendations. Each issue will feature a different topic area of importance to clinical dental hygienists with A BOTTOM LINE to translate the research findings into clinical application.

  10. Wildlife health investigations: needs, challenges and recommendations

    PubMed Central

    2013-01-01

    In a fast changing world with growing concerns about biodiversity loss and an increasing number of animal and human diseases emerging from wildlife, the need for effective wildlife health investigations including both surveillance and research is now widely recognized. However, procedures applicable to and knowledge acquired from studies related to domestic animal and human health can be on partly extrapolated to wildlife. This article identifies requirements and challenges inherent in wildlife health investigations, reviews important definitions and novel health investigation methods, and proposes tools and strategies for effective wildlife health surveillance programs. Impediments to wildlife health investigations are largely related to zoological, behavioral and ecological characteristics of wildlife populations and to limited access to investigation materials. These concerns should not be viewed as insurmountable but it is imperative that they are considered in study design, data analysis and result interpretation. It is particularly crucial to remember that health surveillance does not begin in the laboratory but in the fields. In this context, participatory approaches and mutual respect are essential. Furthermore, interdisciplinarity and open minds are necessary because a wide range of tools and knowledge from different fields need to be integrated in wildlife health surveillance and research. The identification of factors contributing to disease emergence requires the comparison of health and ecological data over time and among geographical regions. Finally, there is a need for the development and validation of diagnostic tests for wildlife species and for data on free-ranging population densities. Training of health professionals in wildlife diseases should also be improved. Overall, the article particularly emphasizes five needs of wildlife health investigations: communication and collaboration; use of synergies and triangulation approaches; investments

  11. Visualization and exploration for recommender systems in enterprise organization

    NASA Astrophysics Data System (ADS)

    Karni, Z.; Shapira, L.

    2013-03-01

    Recommender systems seek to predict the interest a user would find in an item, person or social element they had not yet considered, based upon the properties of the item, the user's past experience and similar users. However, recommended items are often presented to the user with no context and no ability to influence the results. We present a novel visualization technique for recommender systems in which, a user can see the items recommended for him, and understand why they were recommended. Focusing on a user, we render a planar visualization listing a set of recommended items. The items are organized such that similar items reside nearby on the screen, centered around realtime generated categories. We use a combination of iconography, text and tag clouds, with maximal use of screen real estate, and keep items from overlapping to produce our results. We apply our visualization to expert relevance maps in the enterprise and a book recommendation system for consumers. The latter is based on Shelfari, a social network for reading and books.

  12. Advancing human health risk assessment: integrating recent advisory committee recommendations.

    PubMed

    Dourson, Michael; Becker, Richard A; Haber, Lynne T; Pottenger, Lynn H; Bredfeldt, Tiffany; Fenner-Crisp, Penelope A

    2013-07-01

    Over the last dozen years, many national and international expert groups have considered specific improvements to risk assessment. Many of their stated recommendations are mutually supportive, but others appear conflicting, at least in an initial assessment. This review identifies areas of consensus and difference and recommends a practical, biology-centric course forward, which includes: (1) incorporating a clear problem formulation at the outset of the assessment with a level of complexity that is appropriate for informing the relevant risk management decision; (2) using toxicokinetics and toxicodynamic information to develop Chemical Specific Adjustment Factors (CSAF); (3) using mode of action (MOA) information and an understanding of the relevant biology as the key, central organizing principle for the risk assessment; (4) integrating MOA information into dose-response assessments using existing guidelines for non-cancer and cancer assessments; (5) using a tiered, iterative approach developed by the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) as a scientifically robust, fit-for-purpose approach for risk assessment of combined exposures (chemical mixtures); and (6) applying all of this knowledge to enable interpretation of human biomonitoring data in a risk context. While scientifically based defaults will remain important and useful when data on CSAF or MOA to refine an assessment are absent or insufficient, assessments should always strive to use these data. The use of available 21st century knowledge of biological processes, clinical findings, chemical interactions, and dose-response at the molecular, cellular, organ and organism levels will minimize the need for extrapolation and reliance on default approaches.

  13. Advancing human health risk assessment: Integrating recent advisory committee recommendations

    PubMed Central

    Becker, Richard A.; Haber, Lynne T.; Pottenger, Lynn H.; Bredfeldt, Tiffany; Fenner-Crisp, Penelope A.

    2013-01-01

    Over the last dozen years, many national and international expert groups have considered specific improvements to risk assessment. Many of their stated recommendations are mutually supportive, but others appear conflicting, at least in an initial assessment. This review identifies areas of consensus and difference and recommends a practical, biology-centric course forward, which includes: (1) incorporating a clear problem formulation at the outset of the assessment with a level of complexity that is appropriate for informing the relevant risk management decision; (2) using toxicokinetics and toxicodynamic information to develop Chemical Specific Adjustment Factors (CSAF); (3) using mode of action (MOA) information and an understanding of the relevant biology as the key, central organizing principle for the risk assessment; (4) integrating MOA information into dose–response assessments using existing guidelines for non-cancer and cancer assessments; (5) using a tiered, iterative approach developed by the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) as a scientifically robust, fit-for-purpose approach for risk assessment of combined exposures (chemical mixtures); and (6) applying all of this knowledge to enable interpretation of human biomonitoring data in a risk context. While scientifically based defaults will remain important and useful when data on CSAF or MOA to refine an assessment are absent or insufficient, assessments should always strive to use these data. The use of available 21st century knowledge of biological processes, clinical findings, chemical interactions, and dose–response at the molecular, cellular, organ and organism levels will minimize the need for extrapolation and reliance on default approaches. PMID:23844697

  14. Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations

    PubMed Central

    Greenhalgh, Trisha; Robert, Glenn; Macfarlane, Fraser; Bate, Paul; Kyriakidou, Olivia

    2004-01-01

    This article summarizes an extensive literature review addressing the question, How can we spread and sustain innovations in health service delivery and organization? It considers both content (defining and measuring the diffusion of innovation in organizations) and process (reviewing the literature in a systematic and reproducible way). This article discusses (1) a parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, (2) clear knowledge gaps where further research should be focused, and (3) a robust and transferable methodology for systematically reviewing health service policy and management. Both the model and the method should be tested more widely in a range of contexts. PMID:15595944

  15. Achieving Population Health in Accountable Care Organizations

    PubMed Central

    Walker, Deborah Klein

    2013-01-01

    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. PMID:23678910

  16. Recommendations for health information technology implementation in rural hospitals.

    PubMed

    Huang, Yuan-Han; Gramopadhye, Anand K

    2016-05-09

    Purpose - The purpose of this paper is to investigate violations against work standards associated with using a new health information technology (HIT) system. Relevant recommendations for implementing HIT in rural hospitals are provided and discussed to achieve meaningful use. Design/methodology/approach - An observational study is conducted to map medication administration process while using a HIT system in a rural hospital. Follow-up focus groups are held to determine and verify potential adverse factors related to using the HIT system while passing drugs to patients. Findings - A detailed task analysis demonstrated several violations, such as only relying on the barcode scanning system to match up with patient and drugs could potentially result in the medical staff forgetting to provide drug information verbally before administering drugs. There was also a lack of regulated and clear work procedure in using the new HIT system. In addition, the computer system controls and displays could not be adjusted so as to satisfy the users' expectations. Nurses prepared medications and documentation in an environment that was prone to interruptions. Originality/value - Recommendations for implementing a HIT system in rural healthcare facilities can be categorized into five areas: people, tasks, tools, environment, and organization. Detailed remedial measures are provided for achieving continuous process improvements at resource-limited healthcare facilities in rural areas.

  17. The organization of colposcopy services in Ontario: recommended framework

    PubMed Central

    Murphy, J.; Varela, N.P.; Elit, L.; Lytwyn, A.; Yudin, M.; Shier, M.; Wu, V.; El-Khatib, S.

    2015-01-01

    Objective The purpose of this guideline is to help ensure the provision of high-quality colposcopy practices in the province of Ontario, including those conducted as diagnostic procedures in follow-up to an abnormal cervical screening test. Methods This document updates the recommendations published in the 2008 colposcopy guideline from Cancer Care Ontario, The Optimum Organization for the Delivery of Colposcopy Service in Ontario. A systematic review of guidelines was conducted to evaluate the existing evidence and recommendations concerning these key aspects of colposcopy: □ Training, qualification, accreditation, and maintenance of competence□ Practice setting requirements□ Operational practice□ Quality indicators and outcomes Results This guideline provides recommendations on training and maintenance of competence for colposcopists in the practice settings in which colposcopic evaluation and treatments are conducted. It also provides recommendations on operational issues and quality indicators for colposcopy. Conclusions This updated guideline is intended to support quality improvement for colposcopy for all indications, including the follow-up of an abnormal cervical screening test and work-up for lower genital tract lesions that are not clearly malignant. The recommendations contained in this document are intended for clinicians and institutions performing colposcopy in Ontario, and for policymakers and program planners involved in the delivery of colposcopy services. PMID:26300667

  18. A national study of eHealth standardization in Finland--goals and recommendations.

    PubMed

    Mykkänen, Juha; Korhonen, Maritta; Porrasmaa, Jari; Tuomainen, Tuula; Ensio, Antero

    2007-01-01

    The role of standards is constantly increasing in health services, electronic health records, and eHealth applications. There are many areas of standardization which affect the healthcare work and health information systems. On a national level, the organization of the development and support for standardization should be a key priority. This paper summarizes a national study in Finland which reviewed the current status of eHealth standardization and made recommendations for the national standardization and the use of standards. The recommendations are related to the organization model and balanced participation, international and cross-domain collaboration and quality assurance of standards-related activities. In addition, education and support services and support for introductions and pilots are recommended to improve the know-how of standards in system acquisitions.

  19. Overview of human health in the Arctic: conclusions and recommendations

    PubMed Central

    Donaldson, Shawn; Adlard, Bryan; Odland, Jon Øyvind

    2016-01-01

    This article is intended to provide an overview of the key conclusions, knowledge gaps and key recommendations based on the recent 2015 Arctic human health assessment under the Arctic Monitoring and Assessment Program. This assessment was based primarily on data from human health monitoring and research studies and peer-reviewed literature published since the last assessment in 2009. PMID:27974138

  20. Health Recommender Systems: Concepts, Requirements, Technical Basics and Challenges

    PubMed Central

    Wiesner, Martin; Pfeifer, Daniel

    2014-01-01

    During the last decades huge amounts of data have been collected in clinical databases representing patients' health states (e.g., as laboratory results, treatment plans, medical reports). Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS) are meant to centralize an individual's health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS). In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed. PMID:24595212

  1. Changing Population Health Policy: A Model for Identifying Health Needs and Recommendations to Improve Health Status.

    PubMed

    Schroeder, Shawnda M

    2016-06-01

    In the spring of 2014, the North Dakota Center for Rural Health (CRH) was tasked with completing an objective assessment of the state oral health environment. This included an assessment of oral health status, review of workforce needs, evaluation of current oral health programs, and policy recommendations to ameliorate identified oral health needs. The report was prepared for the North Dakota Legislative Health Services Interim Committee. This article highlights a research method developed and employed to identify current population health status and policy recommendations through statewide collaboration, transparent process, and objective analyses, regardless of the health specialty of focus. Evidenced-based decision making in health policy requires more than presentation of data. It requires input from the population or community utilizing or struggling to gain access to the given health service. It is now understood that health services researchers must employ a variety of research methods, include end users in the research process, tailor presentation of the findings for the appropriate audience, and include the population of study in the research, allowing them to provide recommended solutions when possible. Although the effort to be described focused specifically on oral health in North Dakota, the methodologies used to answer the research questions could, and are encouraged to, be employed in other states with regard to other specialty health disciplines and population health studies. The study sought to answer 3 questions: (1) What is the population health need?; (2) What is already being done?; and (3) What are the recommendations to improve population health? (Population Health Management 2016;19:216-223).

  2. Early implementation of WHO recommendations for the retention of health workers in remote and rural areas.

    PubMed

    Buchan, James; Couper, Ian D; Tangcharoensathien, Viroj; Thepannya, Khampasong; Jaskiewicz, Wanda; Perfilieva, Galina; Dolea, Carmen

    2013-11-01

    The maldistribution of health workers between urban and rural areas is a policy concern in virtually all countries. It prevents equitable access to health services, can contribute to increased health-care costs and underutilization of health professional skills in urban areas, and is a barrier to universal health coverage. To address this long-standing concern, the World Health Organization (WHO) has issued global recommendations to improve the rural recruitment and retention of the health workforce. This paper presents experiences with local and regional adaptation and adoption of WHO recommendations. It highlights challenges and lessons learnt in implementation in two countries - the Lao People's Democratic Republic and South Africa - and provides a broader perspective in two regions - Asia and Europe. At country level, the use of the recommendations facilitated a more structured and focused policy dialogue, which resulted in the development and adoption of more relevant and evidence-based policies. At regional level, the recommendations sparked a more sustained effort for cross-country policy assessment and joint learning. There is a need for impact assessment and evaluation that focus on the links between the rural availability of health workers and universal health coverage. The effects of any health-financing reforms on incentive structures for health workers will also have to be assessed if the central role of more equitably distributed health workers in achieving universal health coverage is to be supported.

  3. Early implementation of WHO recommendations for the retention of health workers in remote and rural areas

    PubMed Central

    Buchan, James; Couper, Ian D; Tangcharoensathien, Viroj; Thepannya, Khampasong; Jaskiewicz, Wanda; Perfilieva, Galina

    2013-01-01

    Abstract The maldistribution of health workers between urban and rural areas is a policy concern in virtually all countries. It prevents equitable access to health services, can contribute to increased health-care costs and underutilization of health professional skills in urban areas, and is a barrier to universal health coverage. To address this long-standing concern, the World Health Organization (WHO) has issued global recommendations to improve the rural recruitment and retention of the health workforce. This paper presents experiences with local and regional adaptation and adoption of WHO recommendations. It highlights challenges and lessons learnt in implementation in two countries – the Lao People's Democratic Republic and South Africa – and provides a broader perspective in two regions – Asia and Europe. At country level, the use of the recommendations facilitated a more structured and focused policy dialogue, which resulted in the development and adoption of more relevant and evidence-based policies. At regional level, the recommendations sparked a more sustained effort for cross-country policy assessment and joint learning. There is a need for impact assessment and evaluation that focus on the links between the rural availability of health workers and universal health coverage. The effects of any health-financing reforms on incentive structures for health workers will also have to be assessed if the central role of more equitably distributed health workers in achieving universal health coverage is to be supported. PMID:24347707

  4. From recommendation to action: psychosocial factors influencing physician intention to use Health Technology Assessment (HTA) recommendations

    PubMed Central

    Gagnon, Marie-Pierre; Sánchez, Emília; Pons, Joan MV

    2006-01-01

    Background Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy-makers. Using a psychosocial theoretical framework, this study aimed at exploring the factors affecting physician intention to adopt HTA recommendations. The selected recommendations were prioritisation systems for patients on waiting lists for two surgical procedures: hip and knee replacement and cataract surgery. Methods Determinants of physician intention to use HTA recommendations for patient prioritisation were assessed by a questionnaire based upon the Theory of Interpersonal Behaviour. A total of 96 physicians from two medical specialties (ophthalmology and orthopaedic surgery) responded to the questionnaire (response rate 44.2%). A multiple analysis of variance (MANOVA) was performed to assess differences between medical specialties on the set of theoretical variables. Given the main effect difference between specialties, two regression models were tested separately to assess the psychosocial determinants of physician intention to use HTA recommendations for the prioritisation of patients on waiting lists for surgical procedures. Results Factors influencing physician intention to use HTA recommendations differ between groups of specialists. Intention to use the prioritisation system for patients on waiting lists for cataract surgery among ophthalmologists was related to attitude towards the behaviour, social norms, as well as personal normative beliefs. Intention to use HTA recommendations for patient prioritisation for hip and knee replacement among orthopaedic surgeons was explained by: perception of conditions that facilitated the realisation of the behaviour, personal normative beliefs, and habit of using HTA recommendations in clinical work. Conclusion This study offers a model to assess factors influencing the intention to adopt recommendations from health technology assessment into

  5. Mobile health apps in Sweden: what do physicians recommend?

    PubMed

    Zhang, Yiping; Koch, Sabine

    2015-01-01

    Currently over 50,000 mobile health apps are available worldwide. In general, they are considered as innovations potentially delivering benefits to patients. Physicians are considered as potential channels to disseminate these innovations to patients. However, physicians' behavior in this regard has not been studied. To capture physicians' attitudes towards recommending health apps to patients and to describe factors influencing physicians' behavior, taking the specifics of an early adopter country, Sweden, into account. Diffusion of Innovation theory, the Health App Maturity Model and the Six Hurdles Model were used to construct a web-based survey that was answered by 44 Swedish physicians. Survey results were followed up with 2 individual interviews. Descriptive statistics were used for quantitative data analysis and recursive abstraction for qualitative data analysis. Only a small group of physicians currently recommend mobile health apps to their patients. However, most physicians have a positive attitude and perceive improvement of patients' self-management ability as main benefit of health apps. Main perceived weaknesses include the lack of evidence-based content and lack of multi-language support. Regulation of health apps under the Medical Device Directive is asked for to assure quality and patient safety. Innovators and early adopters play an important role in the diffusion of mobile health apps. Interpersonal communication is seen as the most effective way for physicians gaining information and also motivates them to recommend mobile health apps to their patients. Physicians' knowledge about certified websites to ensure quality is however low.

  6. The organization's mission statement: give up hope or resuscitate? A search for evidence-based recommendations.

    PubMed

    Desmidt, Sebastian; Prinzie, Anita A

    2011-01-01

    The increasing complexity and dynamicity of their environment compels health-care managers to search relentlessly for effective management instruments. One strategic tool that both academics and practitioners have deemed critical to the success of any health-care organization is the development of a meaningful mission statement. However, despite the seemingly omnipresence of the concept, studies indicate that creating an effective mission statement seems to be extremely difficult, if not downright frustrating for a lot of health-care managers. This inability to create an effective mission statement roots for the greater part in the fact that the previous literature has provided little practical guidance on how health-care administrators should formulate and deploy mission statements. Given the increasing pressure on health-care organizations to develop an effective mission statement, this chapter (1) provides a detailed analysis of the mission statement concept based on a thorough literature analysis and (b) offers empirically based recommendations on how to successfully formulate and implement a mission statement within a health-care organization based on a systematic analysis of relevant empirical research. These analyses and the derived evidence-based recommendations will help health-care managers to revive their mission statement and make it more than a piece of paper.

  7. [Organ transplants in HIV infected patients. Update and recommendations].

    PubMed

    Barcan, Laura; Gadano, Adrian; Casetti, Isabel; Villamil, Federico

    2011-01-01

    Until few years ago, HIV infection was an absolute contraindication to consider organ transplants. Since HAART introduction, patient survival increased dramatically, but high mortality due to liver and kidney diseases became evident. For these reasons, this group of patients is now reconsidered for organ transplantation. In 2008, the Argentine Society of Transplants (SAT) and the Argentine Infectious Diseases Society (SADI), encouraged by the increasing published experience on kidney and liver transplants in this population, decided to form a Working Group, to prepare an update on this issue and elaborate practical recommendations for the better management of these patients. The first meeting was held on December 4th 2008. The most important conclusion was that HIV infection did not contraindicate a solid organ transplant. Later on, taking into account the accumulated experience and the available literature, the current document was prepared. HIV infected patients must fulfill certain clinical, immunological, virological and psychosocial criteria to be considered for solid organ transplants. HIV infected recipients of kidney and liver transplants currently show similar short and middle term survival to non HIV infected patients. There is not yet enough data on intrathoracic transplants in these patients in order to include them on a waiting list for these organs-transplants. Interactions between immunosupressors and antiretroviral drugs (specially protease inhibitors) are very important, and require a strict monitoring of immunosupressor levels.

  8. Dental health professional recommendation and consumer habits in denture cleansing.

    PubMed

    Axe, Alyson S; Varghese, Roshan; Bosma, MaryLynn; Kitson, Nicola; Bradshaw, David J

    2016-02-01

    Regular cleaning of dentures is essential to the oral and general health of denture wearers. Only limited systematic data are available on the recommendations that dental health care professionals (DHCPs) make to patients for denture cleaning. Data on denture wearers' cleaning regimens are also lacking. The purpose of this study was to provide data on recommendations that DHCPs make to patients for denture cleaning and on the cleaning regimens of denture wearers. DHCPs (n=613), including dentists and hygienists, were surveyed in developed (Japan, USA, Italy) and developing (Brazil, India) countries. A questionnaire assessing a range of denture cleaning recommendations was used. The questions addressed products, frequency, how to use remedies, the suggested dilution and duration of cleansing treatment, the location of dentures while cleaning, and the reasoning behind the recommendation of particular products or modes of treatment. Denture cleansing methods and the routine of denture wearers in developed and developing countries were also surveyed with a questionnaire (n=2862) and a 1-week diary (n=1462). An average of more than 2 treatments was recommended by DHCPs. Specialist denture cleanser tablets, "regular" toothpaste, mouthwash, soap and water, denture paste, foam or liquid denture cleanser, and dishwashing detergents were most commonly recommended; other product recommendations included baking soda, vinegar, salt water, and bleach. More than 10% of DHCPs made no primary recommendation on cleaning. Denture tablets were more commonly recommended in developed countries, whereas toothpaste was the most common recommendation in developing countries. Denture wearers used products and methods similar to those recommended by DHCPs. Toothpaste, water, and mouthwash were used more frequently than denture tablets. More than 75% of denture wearers reported using denture cleanser tablets for more than 5 minutes, whereas soap and toothpaste were typically used for less

  9. Older adults in health education research: some recommendations.

    PubMed

    Connell, C M

    1999-06-01

    A review of articles published in two health education journals is provided to examine the extent to which older adults were included in published research. The review suggests that older adults were included in about 15% of the research articles published in Health Education and Behavior and Health Education Research. Of the articles that include older adults, age differences in study processes and outcomes are rarely examined, and very few studies advance specific hypotheses based on a theoretical or conceptual model of aging or older adulthood. Several recommendations for health education research are suggested.

  10. Probiotics and prebiotics: prospects for public health and nutritional recommendations.

    PubMed

    Sanders, Mary Ellen; Lenoir-Wijnkoop, Irene; Salminen, Seppo; Merenstein, Daniel J; Gibson, Glenn R; Petschow, Bryon W; Nieuwdorp, Max; Tancredi, Daniel J; Cifelli, Christopher J; Jacques, Paul; Pot, Bruno

    2014-02-01

    Probiotics and prebiotics are useful interventions for improving human health through direct or indirect effects on the colonizing microbiota. However, translation of these research findings into nutritional recommendations and public health policy endorsements has not been achieved in a manner consistent with the strength of the evidence. More progress has been made with clinical recommendations. Conclusions include that beneficial cultures, including probiotics and live cultures in fermented foods, can contribute towards the health of the general population; prebiotics, in part due to their function as a special type of soluble fiber, can contribute to the health of the general population; and a number of challenges must be addressed in order to fully realize probiotic and prebiotic benefits, including the need for greater awareness of the accumulated evidence on probiotics and prebiotics among policy makers, strategies to cope with regulatory roadblocks to research, and high-quality human trials that address outstanding research questions in the field.

  11. Recent revisions to and recommendations for national health expenditures accounting

    PubMed Central

    Haber, Susan G.; Newhouse, Joseph P.

    1991-01-01

    The Health Care Financing Administration (HCFA) has importantly revised the methodology for estimating annual national health expenditures. Among other changes, the revisions estimated out-of-pocket spending directly, disaggregated expenditures to a greater degree, and reduced undercounting and double counting. Estimates of total spending and out-of-pocket spending changed. This article summarizes a meeting of a technical advisory panel, convened by HCFA, that reviewed the modifications adopted and made recommendations for future revisions. PMID:10114932

  12. Third Year Trends in Compliance with Recommended Health Seeking Behaviors.

    ERIC Educational Resources Information Center

    Bausell, R. Barker; Soeken, Karen L.

    Beginning in 1983, a national poll has been conducted annually to assess the extent to which the American public engaged in a core of 21 recommended health seeking behaviors. For the third consecutive year a national sample of approximately 1250 adults were interviewed concerning their self-reported compliance with a basic core of 21 health…

  13. Policy statement--recommendation for mandatory influenza immunization of all health care personnel.

    PubMed

    Bernstein, Henry H; Starke, Jeffrey R

    2010-10-01

    The purpose of this statement is to recommend implementation of a mandatory influenza immunization policy for all health care personnel. Immunization of health care personnel is a critically important step to substantially reduce health care-associated influenza infections. Despite the efforts of many organizations to improve influenza immunization rates with the use of voluntary campaigns, influenza coverage among health care personnel remains unacceptably low. Mandatory influenza immunization for all health care personnel is ethically justified, necessary, and long overdue to ensure patient safety.

  14. Protection of Human Beings Trafficked for the Purpose of Organ Removal: Recommendations

    PubMed Central

    Pascalev, Assya; Van Assche, Kristof; Sándor, Judit; Codreanu, Natalia; Naqvi, Anwar; Gunnarson, Martin; Frunza, Mihaela; Yankov, Jordan

    2016-01-01

    Abstract This report presents a comprehensive set of recommendations for protection of human beings who are trafficked for the purpose of organ removal or are targeted for such trafficking. Developed by an interdisciplinary group of international experts under the auspices of the project Trafficking in Human Beings for the Purpose of Organ Removal (also known as the HOTT project), these recommendations are grounded in the view that an individual who parts with an organ for money within an illegal scheme is ipso facto a victim and that the crime of trafficking in human beings for the purpose of organ removal (THBOR) intersects with the crime of trafficking in organs. Consequently, the protection of victims should be a priority for all actors involved in antitrafficking activities: those combating organ-related crimes, such as health organizations and survivor support services, and those combating trafficking in human beings, such as the criminal justice sectors. Taking into account the special characteristics of THBOR, the authors identify 5 key stakeholders in the protection of human beings trafficked for organ removal or targeted for such trafficking: states, law enforcement agencies and judiciary, nongovernmental organizations working in the areas of human rights and antitrafficking, transplant centers and health professionals involved in transplant medicine, and oversight bodies. For each stakeholder, the authors identify key areas of concern and concrete measures to identify and protect the victims of THBOR. The aim of the recommendations is to contribute to the development of a nonlegislative response to THBOR, to promote the exchange of knowledge and best practices in the area of victim protection, and to facilitate the development of a policy-driven action plan for the protection of THBOR victims in the European Union and worldwide. PMID:27500252

  15. Protection of Human Beings Trafficked for the Purpose of Organ Removal: Recommendations.

    PubMed

    Pascalev, Assya; Van Assche, Kristof; Sándor, Judit; Codreanu, Natalia; Naqvi, Anwar; Gunnarson, Martin; Frunza, Mihaela; Yankov, Jordan

    2016-02-01

    This report presents a comprehensive set of recommendations for protection of human beings who are trafficked for the purpose of organ removal or are targeted for such trafficking. Developed by an interdisciplinary group of international experts under the auspices of the project Trafficking in Human Beings for the Purpose of Organ Removal (also known as the HOTT project), these recommendations are grounded in the view that an individual who parts with an organ for money within an illegal scheme is ipso facto a victim and that the crime of trafficking in human beings for the purpose of organ removal (THBOR) intersects with the crime of trafficking in organs. Consequently, the protection of victims should be a priority for all actors involved in antitrafficking activities: those combating organ-related crimes, such as health organizations and survivor support services, and those combating trafficking in human beings, such as the criminal justice sectors. Taking into account the special characteristics of THBOR, the authors identify 5 key stakeholders in the protection of human beings trafficked for organ removal or targeted for such trafficking: states, law enforcement agencies and judiciary, nongovernmental organizations working in the areas of human rights and antitrafficking, transplant centers and health professionals involved in transplant medicine, and oversight bodies. For each stakeholder, the authors identify key areas of concern and concrete measures to identify and protect the victims of THBOR. The aim of the recommendations is to contribute to the development of a nonlegislative response to THBOR, to promote the exchange of knowledge and best practices in the area of victim protection, and to facilitate the development of a policy-driven action plan for the protection of THBOR victims in the European Union and worldwide.

  16. 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.

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

    PubMed

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

    2004-01-01

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

  18. Integrating Community Health Workers (CHWs) into Health Care Organizations.

    PubMed

    Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

    2017-04-08

    Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

  19. Reflections on Physical Activity and Health: What Should We Recommend?

    PubMed

    Warburton, Darren E R; Bredin, Shannon S D

    2016-04-01

    The health benefits of regular physical activity are irrefutable; virtually everyone can benefit from being active. The evidence is overwhelming with risk reductions of at least 20%-30% for more than 25 chronic medical conditions and premature mortality. Even higher risk reductions (ie, ≥ 50%) are observed when objective measures of physical fitness are taken. International physical activity guidelines generally recommend 150 minutes per week of moderate- to vigorous-intensity physical activity. A critical review of the literature indicates that half of this volume of physical activity might lead to marked health benefits. There is compelling evidence to support health promotion strategies that emphasize that health benefits can be accrued at a lower volume and/or intensity of physical activity. Public health policies are needed that reduce the barriers to physical activity participation such that everyone can reap the benefits of physical activity. It is also important to highlight that sedentary time (particularly sitting time) carries independent health risks. The simple message of "move more and sit less" likely is more understandable by contemporary society and is formed on the basis of a strong body of evidence. For practitioners who work directly with clients, it is recommended that an individualized prescription (dosage) that takes into consideration the unique characteristics and needs of the client is provided. Physical activity or exercise promotion should not be done in isolation; it should be part of an integrated approach to enhance healthy lifestyle behaviours.

  20. Recommendations

    ERIC Educational Resources Information Center

    Brazelton, G. Blue; Renn, Kristen A.; Stewart, Dafina-Lazarus

    2015-01-01

    In this chapter, the editors provide a summary of the information shared in this sourcebook about the success of students who have minoritized identities of sexuality or gender and offer recommendations for policy, practice, and further research.

  1. Recommendations

    ERIC Educational Resources Information Center

    Brazelton, G. Blue; Renn, Kristen A.; Stewart, Dafina-Lazarus

    2015-01-01

    In this chapter, the editors provide a summary of the information shared in this sourcebook about the success of students who have minoritized identities of sexuality or gender and offer recommendations for policy, practice, and further research.

  2. Public health emergencies: nurses' recommendations for effective actions.

    PubMed

    O'Boyle, Carol; Robertson, Cheryl; Secor-Turner, Molly

    2006-08-01

    During a public health emergency such as an influenza pandemic or a bioterrorism attack, nurses may be at risk for exposure to lethal infectious diseases when caring for victims. The aim of this study was to identify interventions nurses believe will support their ability to cope during public health emergencies. A qualitative research design was used with 33 nurses from designated bioterrorism-receiving hospitals. Nurses recommended adequate protective equipment, education, drills, accessible information and available content experts, and available administrators. Other recommendations included increased security to protect nurses, emotional and physical support, communication with nurses' families, and commitment from institutions to care for ill or injured nurses. Preparations for emergencies should include assessments of nurses' and other stakeholders' concerns. These nurses proposed specific measures to improve safety, reduce anxiety, increase trust in hospitals, and provide physical and emotional support.

  3. Recommendations for mental health professionals in the NICU

    PubMed Central

    Hynan, M T; Steinberg, Z; Baker, L; Cicco, R; Geller, P A; Lassen, S; Milford, C; Mounts, K O; Patterson, C; Saxton, S; Segre, L; Stuebe, A

    2015-01-01

    This article describes recommended activities of social workers, psychologists and psychiatric staff within the neonatal intensive care unit (NICU). NICU mental health professionals (NMHPs) should interact with all NICU parents in providing emotional support, screening, education, psychotherapy and teleservices for families. NMHPs should also offer educational and emotional support for the NICU health-care staff. NMHPs should function at all levels of layered care delivered to NICU parents. Methods of screening for emotional distress are described, as well as evidence for the benefits of peer-to-peer support and psychotherapy delivered in the NICU. In the ideal NICU, care for the emotional and educational needs of NICU parents are outcomes equal in importance to the health and development of their babies. Whenever possible, NMHPs should be involved with parents from the antepartum period through after discharge. PMID:26597800

  4. World Health Organization

    MedlinePlus

    ... mental health in the workplace More top stories » Outbreaks and emergencies Emergencies » Cholera » Food insecurity and famine » Nigeria » South Sudan » Syrian Arab Republic » Yemen » Director-General "I envision a world in which ...

  5. Pan American Health Organization

    MedlinePlus

    ... About PAHO Help and Services Integrity and Conflict Management System (ICMS) Doing Business with PAHO Employment Internships Privacy Policy Events Contacts Resources  PAHO/WHO Collaborating Centers IRIS Institutional Repository for Information Sharing Virtual Campus for Public Health Complete news ...

  6. Geographic information system for improving maternal and newborn health: recommendations for policy and programs.

    PubMed

    Molla, Yordanos B; Rawlins, Barbara; Makanga, Prestige Tatenda; Cunningham, Marc; Ávila, Juan Eugenio Hernández; Ruktanonchai, Corrine Warren; Singh, Kavita; Alford, Sylvia; Thompson, Mira; Dwivedi, Vikas; Moran, Allisyn C; Matthews, Zoe

    2017-01-11

    This correspondence argues and offers recommendations for how Geographic Information System (GIS) applied to maternal and newborn health data could potentially be used as part of the broader efforts for ending preventable maternal and newborn mortality. These recommendations were generated from a technical consultation on reporting and mapping maternal deaths that was held in Washington, DC from January 12 to 13, 2015 and hosted by the United States Agency for International Development's (USAID) global Maternal and Child Survival Program (MCSP). Approximately 72 participants from over 25 global health organizations, government agencies, donors, universities, and other groups participated in the meeting.The meeting placed emphases on how improved use of mapping could contribute to the post-2015 United Nation's Sustainable Development Goals (SDGs), agenda in general and to contribute to better maternal and neonatal health outcomes in particular. Researchers and policy makers have been calling for more equitable improvement in Maternal and Newborn Health (MNH), specifically addressing hard-to-reach populations at sub-national levels. Data visualization using mapping and geospatial analyses play a significant role in addressing the emerging need for improved spatial investigation at subnational scale. This correspondence identifies key challenges and recommendations so GIS may be better applied to maternal health programs in resource poor settings. The challenges and recommendations are broadly grouped into three categories: ancillary geospatial and MNH data sources, technical and human resources needs and community participation.

  7. 76 FR 10598 - Office of the National Coordinator for Health Information Technology; Recommendations Received...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-25

    ... HUMAN SERVICES Office of the National Coordinator for Health Information Technology; Recommendations... the Public Health Service Act, as amended by the Health Information Technology for Economic and Clinical Health (HITECH) Act, requires the National Coordinator for Health Information Technology...

  8. [Monitoring system on prison health: feasibility and recommendations].

    PubMed

    Develay, Aude-Emmanuelle; Verdot, Charlotte; Grémy, Isabelle

    2015-01-01

    This article presents the results of two studies designed to define the feasibility and framework of the future prison health monitoring system in France. The objective of the first study was to obtain the points of view of professionals involved in prison health and the second study was designed to assess the feasibility of using prisoner's medical files for epidemiological purposes. The point of view of various professionals was collected by questionnaire sent to 43 randomly selected prison physicians and by 22 semi-directive interviews. The feasibility study was based on analysis of the medical files of 330 randomly selected prisoners in eleven prisons chosen in order to reflect the diversity of correctional settings and prison populations. Additional interviews were conducted with the medical staff of these prison facilities. There is a consensus on the need to monitor prison health, but there are contrasting views on data collection methods (surveys or routinely collected data]. The feasibility study also showed that the implementation of a prison health monitoring system based on routinely collected data from prisoner's medical records was not feasible at the present time in France. In the light of these findings, it is recommended to initially develop a monitoring system based on regular nationwide surveys, while pursuing computerization and standardization of health data in prison.

  9. Personalising exercise recommendations for brain health: considerations and future directions.

    PubMed

    Barha, Cindy K; Galea, Liisa A; Nagamatsu, Lindsay S; Erickson, Kirk I; Liu-Ambrose, Teresa

    2017-04-01

    The societal value of strategies that delay the onset and progression of dementia cannot be overstated. Physical activity-unstructured and structured-is a promising, cost-effective strategy for the promotion of brain health. However, a large degree of variation exists in its efficacy. Therefore, to increase its utility as 'medication' for healthy cognitive ageing, it is imperative to identify key moderators and mediators of the positive effects of targeted exercise training on brain health. In this commentary, we focus on the type of targeted exercise training, the determinants of individual variation, including biological sex and genotypic factors, and the mechanisms by which exercise exerts its influence on the brain. We argue that a better understanding of these factors will allow for evidence-based, personalised, tailored exercise recommendations that go beyond the one-size-fits-all approach to successfully combat dementia.

  10. Patient Accessible Electronic Health Records: Exploring Recommendations for Successful Implementation Strategies

    PubMed Central

    Urowitz, Sara; Apatu, Emma; DeLenardo, Claudette; Eysenbach, Gunther; Harth, Tamara; Pai, Howard; Leonard, Kevin J

    2008-01-01

    Background Providing patients with access to their electronic health records offers great promise to improve patient health and satisfaction with their care, as well to improve professional and organizational approaches to health care. Although many benefits have been identified, there are many questions about best practices for the implementation of patient accessible Electronic Health Records (EHRs). Objectives To develop recommendations to assist health care organizations in providing patients with access to EHRs in a meaningful, responsible, and responsive manner. Methods A Patient Accessible Electronic Health Record (PAEHR) Workshop was held with nationally and internationally renowned experts to explore issues related to providing patient access to the EHR and managing institutional change. Results The PAEHR Workshop was attended by 45 participants who discussed recommendations for the implementation of patient accessible EHRs. Recommendations were discussed under four subject domains: (1) providing patient access to the EHR, (2) maintaining privacy and confidentiality related to the PAEHR, (3) patient education and navigation of the PAEHR, and (4) strategies for managing institutional change. The discussion focused on the need for national infrastructure, clear definitions for privacy, security and confidentiality, flexible, interoperable solutions, and patient and professional education. In addition, there was a strong call for research into all domains of patient accessible EHRs to ensure the adoption of evidence-based practices. Conclusions Patient access to personal health information is a fundamental issue for patient engagement and empowerment. Health care professionals and organizations should consider the potential benefits and risks of patient access when developing EHR strategies. Flexible, standardized, and interoperable solutions must be integrated with outcomes-based research to activate effectively patients as partners in their health care

  11. 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.

  12. The DECIDE evidence to recommendation framework adapted to the public health field in Sweden.

    PubMed

    Guldbrandsson, Karin; Stenström, Nils; Winzer, Regina

    2016-12-01

    Organizations worldwide compile results from scientific studies, and grade the evidence of interventions, in order to assist policy makers. However, quality of evidence alone is seldom sufficient to make a recommendation. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) framework aims to facilitate decision making and to improve dissemination and implementation of recommendations in the healthcare and public health sector. The aim of this study was to investigate whether the DECIDE framework is applicable in the public health field in Sweden. The DECIDE framework was presented and discussed in interviews with stakeholders and governmental organizations and tested in panels. Content analyses were performed. In general, the informants were positive to the DECIDE framework. However, two questions, the first regarding individual autonomy and the second regarding method sustainability, were by the stakeholders felt to be missing in the framework. The importance of the composition of the DECIDE stakeholder panel was lifted by the informants, as was the significant role of the chair. Further, the informants raised concerns about the general lack of research evidence based on RCT design regarding universal methods in the public health sector. Finally, the local, regional and national levels' responsibility for dissemination and implementation of recommendations were lifted by the informants. The DECIDE framework might be useful as a tool for dissemination and implementation of recommendations in the public health field in Sweden. Important questions for further research are whether these findings are suitable for other public health topics and in other public health settings. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Underinsurance for recently recommended vaccines in private health plans.

    PubMed

    Singer, Dianne C; Davis, Matthew M; Gebremariam, Achamyeleh; Clark, Sarah J

    2012-12-01

    Underinsurance for vaccines presents financial barriers to vaccination. Preventive services coverage is of interest in national healthcare reform. To assess vaccine benefits coverage in private health plans. Private health insurance carriers were surveyed December 2008-June 2009 on policies regarding vaccine coverage in fully insured plans. Carriers were identified as multi-state, state-specific Blue Cross or local-independent carriers. Plan types included HMO, PPO, POS and 'other.' Full benefits coverage was defined as having benefits without a copay or coinsurance for a recommended vaccine. Analyses were conducted to examine associations between carrier type, plan type, and full benefits coverage. Fifty-one carriers (response rate = 56 %) provided data for 78 unique plans, reflecting over 47 million private plan enrollees. Full benefits coverage was highest for combined tetanus/diphtheria/acellular pertussis (74 %) and lower for pneumococcal conjugate (72 %), rotavirus (72 %), human papillomavirus (71 %), hepatitis A (68 %), meningococcal conjugate (67 %), inactivated influenza (67 %), live attenuated influenza (63 %) and zoster (57 %) vaccines. Compared with plans offered by state-specific Blue Cross carriers, significantly higher proportions of multi-state carriers and local independent carriers had plans with full benefits coverage for vaccines (p < 0.05). Compared with PPO and "other" plans, significantly higher proportions of HMO and POS plans had full benefits coverage for vaccines (p < 0.05). In this national study, levels of underinsurance for immunization leave room for improvement. State-specific Blue Cross plans and indemnity or high-deductible plans are least likely to offer full coverage for recently recommended vaccines, and may face changes with incorporation of "essential health benefits" requirements.

  14. Whither the World Health Organization?

    PubMed

    Reid, Michael A; Pearse, E Jim

    2003-01-06

    The outgoing Director-General of the World Health Organization, Gro Harlem Brundtland, has successfully returned health issues to the international arena. The new Director-General will have to cope with reduced control over funding, debate over WHO's mandate, and the relationships between WHO and other organisations. Despite the broad role described in WHO's constitution, many groups see WHO's mandate as narrowly directed at disease eradication. The method of choice for funding health programs has become public-private partnerships. These have the advantages of bringing private money, management expertise and research knowledge to bear on health problems, but rarely consider the health system as a whole, focusing instead on specific diseases. This has the potential to distort resource allocation and priorities. The international community needs to work to strengthen WHO and maintain its broad mandate to achieve the highest possible level of health for all people.

  15. How could health information be improved? Recommended actions from the Victorian Consultation on Health Literacy.

    PubMed

    Hill, Sophie J; Sofra, Tanya A

    2017-03-07

    Objective Health literacy is on the policy agenda. Accessible, high-quality health information is a major component of health literacy. Health information materials include print, electronic or other media-based information enabling people to understand health and make health-related decisions. The aim of the present study was to present the findings and recommended actions as they relate to health information of the Victorian Consultation on Health Literacy.Methods Notes and submissions from the 2014 Victorian Consultation workshops and submissions were analysed thematically and a report prepared with input from an advisory committee.Results Health information needs to improve and recommendations are grouped into two overarching themes. First, the quality of information needs to be increased and this can be done by developing a principle-based framework to inform updating guidance for information production, formulating standards to raise quality and improving the systems for delivering information to people. Second, there needs to be a focus on users of health information. Recommendation actions were for information that promoted active participation in health encounters, resources to encourage critical users of health information and increased availability of information tailored to population diversity.Conclusion A framework to improve health information would underpin the efforts to meet literacy needs in a more consistent way, improving standards and ultimately increasing the participation by consumers and carers in health decision making and self-management.What is known about the topic? Health information is a critical component of the concept of health literacy. Poorer health literacy is associated with poorer health outcomes across a range of measures. Improving access to and the use of quality sources of health information is an important strategy for meeting the health literacy needs of the population. In recent years, health services and governments

  16. Vietnamese Health Care Providers' Preferences Regarding Recommendation of HPV Vaccines.

    PubMed

    Asiedu, Gladys B; Breitkopf, Carmen Radecki; Kremers, Walter K; Ngo, Quang V; Nguyen, Nguyen V; Barenberg, Benjamin J; Tran, Vinh D; Dinh, Tri A

    2015-01-01

    Physician recommendation is an important predictor of HPV vaccine acceptance; however, physician willingness and preferences regarding HPV vaccination may be influenced by factors including patient age, vaccine type, and cost. A cross-sectional survey was administered to a convenience sample of health care providers in Da Nang, Vietnam, to evaluate awareness, perceptions about HPV and HPV vaccines, and willingness to vaccinate a female patient. Willingness to vaccinate was evaluated using a full-factorial presentation of scenarios featuring the following factors: vaccine cost (free vs 1,000,000 VND), patient age (12, 16, or 22 years), and HPV vaccine type (bivalent vs quadrivalent). Responses from 244 providers were analyzed; providers had a mean age of 34±11.9 years; a majority were female, married, and had children of their own. Thirty-six percent specialized in obstetrics/gynecology and 24% were providers in family medicine. Of the three factors considered in conjoint analysis, vaccine cost was the most important factor in willingness to vaccinate, followed by patient age, and vaccine type. The most favorable scenario for vaccinating a female patient was when the vaccine was free, the patient was 22 years of age, and the HPV4 vaccine was described. In multivariable analysis, older age, being a physician, being married, and having children were all associated with increased willingness to recommend HPV vaccination (p<0.05). Provider willingness is an important aspect of successful HPV vaccination programs; identifying preferences and biases in recommendation patterns will highlight potential areas for education and intervention.

  17. TEAC-Health--research-based recommendations for European certification of health telematics services.

    PubMed

    Forsström, J; Rigby, M

    2000-01-01

    Health Telematics services are now a major part of health care delivery, and of citizens' health behaviour, and will rapidly develop further in scope and significance. However, despite their pivotal position in care and treatment, they are unregulated--unlike all other aspects of health care services. This anomaly is potentially putting the citizen at risk, and also underpinning good clinical practice as clinicians are uncertain of the integrity of specific health telematics tools. The TEAC-Health project, funded by the European Commission, has studied the issues, and produced evidence-based recommendations.

  18. Recommendations to improve the National Development Plan for Health.

    PubMed

    de Jager, Pieter; Hofman, Karen; Khan, Taskeen; Volmink, Heinrich; Jina, Ruxana

    2012-09-07

    In November 2011, a draft National Development Plan (NDP) was released that addresses two of South Africa's major challenges: poverty and inequity. Health and economic development are interdependent, presenting an important opportunity through the NDP to integrate health within goals of broader socio-economic development. Reviewing the NDP identified gaps based on evidence and the epidemiological risk profile of South Africa. Recommendations to improve the NDP and to deal with poverty and inequity should focus on prevention and addressing the social determinants of health, including: (i) a multisectoral approach to establish a comprehensive early childhood development programme; (ii) fiscal and legislative policies to bolster efforts to reduce the burden of non-communicable diseases; (iii) promoting and maintaining a healthy workforce; (iv) and promoting a culture of evidence-based priority setting. Achieving the goal of 'a long and healthy life for all South Africans' will require healthy public policies, well functioning institutional and physical infrastructure, social solidarity, and an active and conscientious civil society.

  19. Using the Grade Approach to Support the Development of Recommendations for Public Health Interventions in Radiation Emergencies.

    PubMed

    Carr, Z; Clarke, M; Akl, E A; Schneider, R; Murith, C; Li, C; Parrish-Sprowl, J; Stenke, L; Cui-Ping, L; Bertrand, S; Miller, C

    2016-09-01

    The World Health Organization (WHO) guideline development policy requires that WHO guidelines be developed in a manner that is transparent and based on all available evidences, which must be synthesised and formally assessed for quality. To fulfil this requirement, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach of rating quality of evidence and grading strength of recommendations was applied when developing the WHO recommendations on public health interventions in radiation emergencies. The guideline development group (GDG) formulated 10 PICO (P: population; I: intervention; C: comparator; O: outcomes) questions to guide the development of recommendations on response interventions during the early/intermediate and late emergency phases and on risk communications for mitigating psycho-social impact of radiation emergencies. For each PICO question, an extensive evidence search and systematic review was conducted. The GDG then formulated the recommendations using the evidence to recommendation (E-2-R) decision-making matrix and evaluated the strength of each recommendation. © World Health Organisation 2016. All rights reserved. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.

  20. 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.

  1. The scientific rationale for the World Organisation for Animal Health standards and recommendations on avian influenza.

    PubMed

    Pasick, J; Kahn, S

    2014-12-01

    The World Organisation for Animal Health (OIE) prescribes standards for the diagnosis and control of avian influenza, as well as health measures for safe trade in birds and avian products, which are based on up-to-date scientific information and risk management principles, consistent with the role of the OIE as a reference standard-setting body for the World Trade Organization (WTO). These standards and recommendations continue to evolve, reflecting advances in technology and scientific understanding of this important zoonotic disease. The avian influenza viruses form part of the natural ecosystem by virtue of their ubiquitous presence in wild aquatic birds, a fact that human intervention cannot change. For the purposes of the Terrestrial Animal Health Code (Terrestrial Code), avian influenza is defined as an infection of poultry. However, the scope of the OIE standards and recommendations is not restricted to poultry, covering the diagnosis, early detection and management of avian influenza, including sanitary measures for trade in birds and avian products. The best way to manage avian influenza-associated risks to human and animal health is for countries to conduct surveillance using recommended methods, to report results in a consistent and transparent manner, and to applythe sanitary measures described in the Terrestrial Code. Surveillance for and timely reporting of avian influenza in accordance with OIE standards enable the distribution of relevant, up-to-date information to the global community.

  2. [Recommendations for the prevention of organic foreign bodies aspiration].

    PubMed

    Rodríguez, Hugo; Cuestas, Giselle; Gregori, Darío; Lorenzoni, Giulia; Tortosa, Susana; Rodríguez D'Aquila, Máximo; Rodríguez D'Aquila, Juan A; Carrera, Sandra; Passali, Desiderio

    2017-10-01

    Foreign body aspiration remains a common and potentially serious pediatric problem. Most aspirated foreign bodies are food. The education of parents and caregivers about choking hazards and how to avoid them is critical to reduce the incidence of these events. The pediatricians play a key role in promoting injury prevention. We indicate the main characteristics of hazardous food and we present recommendations on age-appropriate meals, adequate forms of food preparation and behavioral rules at mealtimes in order to reduce food choking. Sociedad Argentina de Pediatría.

  3. A tag based recommendation engine to suggest information resources in an online community for health promotion.

    PubMed

    Khan, Sharib A; Cohall, Alwyn; Kukafka, Rita

    2008-11-06

    WEB 2.0 or the "social web" has created a new paradigm of collaborative information creation, organization and consumption. Among these, the social process of "tagging" has emerged as a bottom-up user-driven method to index content. We describe the use of tags as a way to connect users to resources in an online community that we are developing which utilizes social content creation and collaboration to promote health. Such connections are the basis of a recommendation engine that will suggest users a) other users who have similar health profiles, b) relevant information resources such as articles or blogs on health promotion and c) community resources such as local health facilities.

  4. Adherence to Physician Recommendations for Surveillance in Opportunistic Colorectal Cancer Screening: The Necessity of Organized Surveillance

    PubMed Central

    Stock, Christian; Holleczek, Bernd; Hoffmeister, Michael; Stolz, Thomas; Stegmaier, Christa; Brenner, Hermann

    2013-01-01

    Background Limited evidence exists on the utilization of surveillance colonoscopy in colorectal cancer (CRC) screening programs. We assessed adherence to physician recommendations for surveillance in opportunistic CRC screening in Germany. Methods A follow-up study of screening colonoscopy participants in 2007-2009 in Saarland, Germany, was conducted using health insurance claims data. Utilization of additional colonoscopies through to 2011 was ascertained. Adherence to surveillance intervals of 3, 6, 12 and 36 months, defined as having had colonoscopy at 2.5 to 4, 5 to 8, 10.5 to 16 and 33 to 48 months, respectively (i.e., tolerating a delay of 33% of each interval) was assessed. Potential predictors of non-adherence were investigated using logistic regression analysis. Results A total of 20,058 screening colonoscopy participants were included in the study. Of those with recommended surveillance intervals of 3, 6, 12 and 36 months, 46.5% (95%-confidence interval [CI]: 37.3-55.7%), 38.5% (95%-CI: 29.6-47.3%), 25.4% (95%-CI: 21.2-29.6%) and 28.0% (95%-CI: 25.5-30.5%), respectively, had a subsequent colonoscopy within the specified margins. Old age, longer recommended surveillance interval, not having had polypectomy at screening and negative colonoscopy were statistically significant predictors of non-adherence. Conclusion This study suggests frequent non-adherence to physician recommendations for surveillance colonoscopy in community practice. Increased efforts to improve adherence, including introduction of more elements of an organized screening program, seem necessary to assure a high-quality CRC screening process. PMID:24324821

  5. Health-related quality-of-life scales in Parkinson's disease: critique and recommendations.

    PubMed

    Martinez-Martin, Pablo; Jeukens-Visser, Martine; Lyons, Kelly E; Rodriguez-Blazquez, C; Selai, Caroline; Siderowf, Andrew; Welsh, Mickie; Poewe, Werner; Rascol, Oliver; Sampaio, Cristina; Stebbins, Glenn T; Goetz, Christopher G; Schrag, Anette

    2011-11-01

    Health-related quality of life is an important patient-reported outcome used in intervention trials and for monitoring the consequences of health status on physical, mental, and social domains. Parkinson's disease is a complex disorder that strongly affects patients' quality of life. Several health-related quality of life tools have been used in Parkinson's disease. A Movement Disorder Society Task Force was commissioned to rate the psychometric quality of available health-related quality of life scales as applied to Parkinson's disease. Following the methodology adopted by previous work of the Movement Disorder Society Task Force, a review of generic and specific health-related quality of life scales applied in studies on Parkinson's disease was completed. Considering the scales from 3 perspectives-use in Parkinson's disease, use by multiple research groups, and clinimetric properties-a final classification as "recommended," "suggested," or "listed" was applied to each reviewed instrument. Four generic scales (EuroQoL, Nottingham Health Profile, 36-Item Short-Form Health Survey, and Sickness Impact Profile) and 5 specific scales (39-Item Parkinson's Disease Questionnaire, Parkinson's Disease Questionnaire Short Form, Parkinson's Disease Quality of Life Questionnaire, Parkinson's Impact Scale, and Scales for Outcomes in Parkinson's Disease-Psychosocial) reached the level of "recommended." The 39-item Parkinson's Disease Questionnaire is the most thoroughly tested and applied questionnaire. Three other generic measures (Quality of Life Questionnaire 15D, Schedule for the Evaluation of Individual Quality of Life-Direct Weighting, and World Health Organization Quality of Life Assessment Short Version) and the specific Parkinson's Disease Quality of Life Scale are "suggested." With a little additional effort in completing the stipulated requirements, they could reach the "recommended" level. At present there is a wide variety of health-related quality of life measures

  6. Despite awareness of recommendations, why do health care workers not immunize pregnant women?

    PubMed

    Gesser-Edelsburg, Anat; Shir-Raz, Yaffa; Hayek, Samah; Aassaraf, Sharon; Lowenstein, Lior

    2017-01-04

    Studies indicate uncertainty surrounding vaccination safety and efficacy for pregnant women, causing a central problem for health authorities. In this study, approximately 26% of participants do not recommend the tetanus, diphtheria, and acellular pertussis and influenza vaccines to their patients, although being aware of the health ministry recommendations. We found significant statistical discrepancies between the knowledge about the recommendations and their actual implementation, revealing the concerns of health care workers regarding vaccine safety.

  7. Improving the health status of Caribbean people: recommendations from the Triangulating on Health Equity summit.

    PubMed

    Sastre, Francisco; Rojas, Patria; Cyrus, Elena; De La Rosa, Mario; Khoury, Aysha H

    2014-09-01

    In 2011, Morehouse School of Medicine convened a summit in San Juan, Puerto Rico, to discuss issues related to the health status of people and communities in the Caribbean region. The summit provided a forum for transparent dialog among researchers, policymakers, and advocates from the Caribbean region and the United States. The summit's theme-improving the region's health outcomes through the adoption of effective practices linking health promotion and primary care, within the context of social and cultural determinants-called for a comprehensive and integrative model or a triangulation of methodologies to improve health outcomes. This article summarizes the recommendations of two workgroup sessions examining the challenges to improving health outcomes in the region and the opportunities to meet those challenges. The recommendations seek to develop action-oriented agendas that integrate research, practice, and policy. Outcomes of the summit highlight the importance of (a) community participation in planning interventions, (b) policymakers' commitment to prioritizing health, and (c) Caribbean governments' commitment to addressing the underlying social factors responsible for poor health outcomes.

  8. [Current dietary exposure to mercury during pregnancy and childhood, and public health recommendations].

    PubMed

    Llop, Sabrina; Ibarlucea, Jesús; Sunyer, Jordi; Ballester, Ferran

    2013-01-01

    Exposure to high levels of mercury during vulnerable periods (such as pregnancy and childhood) may have serious consequences for cognitive development, as observed after acute poisoning episodes in Japan and Irak. The main source of mercury exposure in the general population is consumption of certain types of fish. There is growing concern about the possible neurotoxic effects of mercury, especially in younger children in populations where fish intake is moderate to high. The scientific evidence to date is inconclusive. In Spain, the Childhood and Environment (Infancia y Medio Ambiente [INMA]) project has provided information on levels of prenatal exposure to mercury among 1800 newborns from Valencia, Sabadell, Asturias and Guipúzcoa. In general, levels were high, being above the World Health Organization's recommended dose in 24% of children and above the recommended levels of the U.S. Environmental Protection Agency in 64%. However, the results did not indicate a significant association between prenatal mercury exposure and delayed cognitive development during the second year of life. Various agencies have developed recommendations on fish consumption for pregnant women and children, due to the presence of mercury. These recommendations should be strengthened, since there is general consensus among all regional and national public administrations that fish is an essential source of nutrients for development in the early stages of life.

  9. Developing Health Promotion Interventions on Social Networking Sites: Recommendations from The FaceSpace Project

    PubMed Central

    Pedrana, Alisa E; Stoove, Mark A; Chang, Shanton; Howard, Steve; Asselin, Jason; Ilic, Olivia; Batrouney, Colin; Hellard, Margaret E

    2012-01-01

    Online social networking sites offer a novel setting for the delivery of health promotion interventions due to their potential to reach a large population and the possibility for two-way engagement. However, few have attempted to host interventions on these sites, or to use the range of interactive functions available to enhance the delivery of health-related messages. This paper presents lessons learnt from “The FaceSpace Project”, a sexual health promotion intervention using social networking sites targeting two key at-risk groups. Based on our experience, we make recommendations for developing and implementing health promotion interventions on these sites. Elements crucial for developing interventions include establishing a multidisciplinary team, allowing adequate time for obtaining approvals, securing sufficient resources for building and maintaining an online presence, and developing an integrated process and impact evaluation framework. With two-way interaction an important and novel feature of health promotion interventions in this medium, we also present strategies trialled to generate interest and engagement in our intervention. Social networking sites are now an established part of the online environment; our experience in developing and implementing a health promotion intervention using this medium are of direct relevance and utility for all health organizations creating a presence in this new environment. PMID:22374589

  10. Developing health promotion interventions on social networking sites: recommendations from The FaceSpace Project.

    PubMed

    Gold, Judy; Pedrana, Alisa E; Stoove, Mark A; Chang, Shanton; Howard, Steve; Asselin, Jason; Ilic, Olivia; Batrouney, Colin; Hellard, Margaret E

    2012-02-28

    Online social networking sites offer a novel setting for the delivery of health promotion interventions due to their potential to reach a large population and the possibility for two-way engagement. However, few have attempted to host interventions on these sites, or to use the range of interactive functions available to enhance the delivery of health-related messages. This paper presents lessons learnt from "The FaceSpace Project", a sexual health promotion intervention using social networking sites targeting two key at-risk groups. Based on our experience, we make recommendations for developing and implementing health promotion interventions on these sites. Elements crucial for developing interventions include establishing a multidisciplinary team, allowing adequate time for obtaining approvals, securing sufficient resources for building and maintaining an online presence, and developing an integrated process and impact evaluation framework. With two-way interaction an important and novel feature of health promotion interventions in this medium, we also present strategies trialled to generate interest and engagement in our intervention. Social networking sites are now an established part of the online environment; our experience in developing and implementing a health promotion intervention using this medium are of direct relevance and utility for all health organizations creating a presence in this new environment.

  11. Ground-based facilities for simulation of microgravity: organism-specific recommendations for their use, and recommended terminology.

    PubMed

    Herranz, Raul; Anken, Ralf; Boonstra, Johannes; Braun, Markus; Christianen, Peter C M; de Geest, Maarten; Hauslage, Jens; Hilbig, Reinhard; Hill, Richard J A; Lebert, Michael; Medina, F Javier; Vagt, Nicole; Ullrich, Oliver; van Loon, Jack J W A; Hemmersbach, Ruth

    2013-01-01

    Research in microgravity is indispensable to disclose the impact of gravity on biological processes and organisms. However, research in the near-Earth orbit is severely constrained by the limited number of flight opportunities. Ground-based simulators of microgravity are valuable tools for preparing spaceflight experiments, but they also facilitate stand-alone studies and thus provide additional and cost-efficient platforms for gravitational research. The various microgravity simulators that are frequently used by gravitational biologists are based on different physical principles. This comparative study gives an overview of the most frequently used microgravity simulators and demonstrates their individual capacities and limitations. The range of applicability of the various ground-based microgravity simulators for biological specimens was carefully evaluated by using organisms that have been studied extensively under the conditions of real microgravity in space. In addition, current heterogeneous terminology is discussed critically, and recommendations are given for appropriate selection of adequate simulators and consistent use of nomenclature.

  12. Transnational tobacco companies and health in underdeveloped countries: recommendations for avoiding a smoking epidemic.

    PubMed

    Stebbins, K R

    1990-01-01

    This paper examines the impact of transnational tobacco companies on health in underdeveloped countries and makes recommendations for avoiding a coming smoking epidemic. Although tobacco is generally seen as primarily a health problem, tobacco's future in the Third World depends upon a number of nonhealth related considerations, especially political and economic factors. Unfortunately, there is very little relationship between what the World Health Organization and others have recommended, and what most Third World countries are doing today. Although the controversy concerning cigarette smoking and health has only become a 'burning issue' in recent decades, tobacco products have been used around the world for hundreds of years. The public outcry against cigarette smoking has become increasingly widespread since the 1964 U.S. Surgeon General's report on smoking and health. The ill effects of cigarette smoking are now widely considered collectively as the number one preventable health problem in the world, responsible for an estimated 2.5 million deaths per year. In response to declining sales in developed countries, the tobacco transnational corporations have begun focusing their attention on Third World markets, where tobacco consumption has increased dramatically in recent years. Cigarettes not only take precious limited resources away from desperately needed basic human needs, but they also inflict future health problems on vast numbers of Third World people who have only a vague understanding of the risks involved in cigarette smoking. Until Third World governments address the long-term consequences of their short-term lust for cash, the probabilities of a smoking epidemic in the Third World grow increasingly likely.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Guidelines and Recommendations for Developing Interactive eHealth Apps for Complex Messaging in Health Promotion

    PubMed Central

    Heffernan, Kayla Joanne; Maclean, Skye Tamara; Callegari, Emma Teresa; Garland, Suzanne Marie; Reavley, Nicola Jane; Varigos, George Andrew; Wark, John Dennis

    2016-01-01

    Background The now ubiquitous catchphrase, “There’s an app for that,” rings true owing to the growing number of mobile phone apps. In excess of 97,000 eHealth apps are available in major app stores. Yet the effectiveness of these apps varies greatly. While a minority of apps are developed grounded in theory and in conjunction with health care experts, the vast majority are not. This is concerning given the Hippocratic notion of “do no harm.” There is currently no unified formal theory for developing interactive eHealth apps, and development is especially difficult when complex messaging is required, such as in health promotion and prevention. Objective This paper aims to provide insight into the creation of interactive eHealth apps for complex messaging, by leveraging the Safe-D case study, which involved complex messaging required to guide safe but sufficient UV exposure for vitamin D synthesis in users. We aim to create recommendations for developing interactive eHealth apps for complex messages based on the lessons learned during Safe-D app development. Methods For this case study we developed an Apple and Android app, both named Safe-D, to safely improve vitamin D status in young women through encouraging safe ultraviolet radiation exposure. The app was developed through participatory action research involving medical and human computer interaction researchers, subject matter expert clinicians, external developers, and target users. The recommendations for development were created from analysis of the development process. Results By working with clinicians and implementing disparate design examples from the literature, we developed the Safe-D app. From this development process, recommendations for developing interactive eHealth apps for complex messaging were created: (1) involve a multidisciplinary team in the development process, (2) manage complex messages to engage users, and (3) design for interactivity (tailor recommendations, remove barriers to

  14. Guidelines and Recommendations for Developing Interactive eHealth Apps for Complex Messaging in Health Promotion.

    PubMed

    Heffernan, Kayla Joanne; Chang, Shanton; Maclean, Skye Tamara; Callegari, Emma Teresa; Garland, Suzanne Marie; Reavley, Nicola Jane; Varigos, George Andrew; Wark, John Dennis

    2016-02-09

    The now ubiquitous catchphrase, "There's an app for that," rings true owing to the growing number of mobile phone apps. In excess of 97,000 eHealth apps are available in major app stores. Yet the effectiveness of these apps varies greatly. While a minority of apps are developed grounded in theory and in conjunction with health care experts, the vast majority are not. This is concerning given the Hippocratic notion of "do no harm." There is currently no unified formal theory for developing interactive eHealth apps, and development is especially difficult when complex messaging is required, such as in health promotion and prevention. This paper aims to provide insight into the creation of interactive eHealth apps for complex messaging, by leveraging the Safe-D case study, which involved complex messaging required to guide safe but sufficient UV exposure for vitamin D synthesis in users. We aim to create recommendations for developing interactive eHealth apps for complex messages based on the lessons learned during Safe-D app development. For this case study we developed an Apple and Android app, both named Safe-D, to safely improve vitamin D status in young women through encouraging safe ultraviolet radiation exposure. The app was developed through participatory action research involving medical and human computer interaction researchers, subject matter expert clinicians, external developers, and target users. The recommendations for development were created from analysis of the development process. By working with clinicians and implementing disparate design examples from the literature, we developed the Safe-D app. From this development process, recommendations for developing interactive eHealth apps for complex messaging were created: (1) involve a multidisciplinary team in the development process, (2) manage complex messages to engage users, and (3) design for interactivity (tailor recommendations, remove barriers to use, design for simplicity). This research has

  15. Recommendations for Evaluating Temporal Trends of Persistent Organic Pollutants in Breast Milk.

    PubMed

    Gyalpo, Tenzing; Scheringer, Martin; Hungerbühler, Konrad

    2016-07-01

    Biomonitoring data of persistent organic pollutants (POPs) in breast milk are increasingly collected and available for quantitative analysis of levels and time trends. A common approach is to apply log-linear regression to calculate doubling and halving times of the POP concentrations based on the temporal trend observed in breast milk. However, there are different, sometimes conflicting interpretations of these doubling and halving times. We provide a mechanistic understanding of doubling and halving times where possible. Five recommendations are proposed for dealing with POP concentration trends in breast milk during three distinct periods (pre-ban, transition, post-ban period). Using temporal trends of BDE-47 and PCB-153 in breast milk data, we show which information can be gained from the time-trend data. To this end, we analyzed time trends of hypothetical POPs for different periods with time-variant exposure and different intrinsic elimination half-lives, using a dynamic population-based pharmacokinetic model. Different pieces of information can be extracted from time-trend data from different periods. The analysis of trends of short-lived POPs is rather straightforward and facilitates extraction of the intrinsic elimination half-lives from the breast milk data. However, trends of slowly eliminated POPs only provide indications for the exposure time trend. Time-trend data of rapidly eliminated POPs provide information on exposure time trends and elimination half-lives. Temporal trends of slowly eliminated POPs are more complicated to interpret, and the extraction of exposure time trends and elimination half-lives require data sets covering several decades. Gyalpo T, Scheringer M, Hungerbühler K. 2016. Recommendations for evaluating temporal trends of persistent organic pollutants in breast milk. Environ Health Perspect 124:881-885; http://dx.doi.org/10.1289/ehp.1510219.

  16. Recommendations for Evaluating Temporal Trends of Persistent Organic Pollutants in Breast Milk

    PubMed Central

    Gyalpo, Tenzing; Scheringer, Martin; Hungerbühler, Konrad

    2015-01-01

    Background: Biomonitoring data of persistent organic pollutants (POPs) in breast milk are increasingly collected and available for quantitative analysis of levels and time trends. A common approach is to apply log-linear regression to calculate doubling and halving times of the POP concentrations based on the temporal trend observed in breast milk. However, there are different, sometimes conflicting interpretations of these doubling and halving times. Objectives: We provide a mechanistic understanding of doubling and halving times where possible. Five recommendations are proposed for dealing with POP concentration trends in breast milk during three distinct periods (pre-ban, transition, post-ban period). Discussion: Using temporal trends of BDE-47 and PCB-153 in breast milk data, we show which information can be gained from the time-trend data. To this end, we analyzed time trends of hypothetical POPs for different periods with time-variant exposure and different intrinsic elimination half-lives, using a dynamic population-based pharmacokinetic model. Different pieces of information can be extracted from time-trend data from different periods. The analysis of trends of short-lived POPs is rather straightforward and facilitates extraction of the intrinsic elimination half-lives from the breast milk data. However, trends of slowly eliminated POPs only provide indications for the exposure time trend. Conclusions: Time-trend data of rapidly eliminated POPs provide information on exposure time trends and elimination half-lives. Temporal trends of slowly eliminated POPs are more complicated to interpret, and the extraction of exposure time trends and elimination half-lives require data sets covering several decades. Citation: Gyalpo T, Scheringer M, Hungerbühler K. 2016. Recommendations for evaluating temporal trends of persistent organic pollutants in breast milk. Environ Health Perspect 124:881–885; http://dx.doi.org/10.1289/ehp.1510219 PMID:26672061

  17. The Hague Recommendations: Improving Nonlegislative Responses to Trafficking in Human Beings for the Purpose of Organ Removal.

    PubMed

    Ambagtsheer, Frederike; Weimar, Willem

    2016-02-01

    Over the years, the trade in human organs has become an object of international concern. Since the 1980s, antiorgan trade initiatives have mainly involved the strengthening of legislative responses. Little attention however is given to nonlegislative responses by law enforcement authorities. The HOTT project is a European Union-funded research project titled "trafficking in human beings for the purpose of organ removal." Its objectives are to increase knowledge, raise awareness, and improve the nonlegislative response to the crime. Its consortium organized a "Writers' Conference" in The Hague, The Netherlands at Europol's Headquarters where a group of 40 experts, consisting of transplant professionals, law enforcement officials, and policy makers, formulated recommendations to improve nonlegislative responses. These recommendations, presented hereafter, address the ethical and legal obligations of health care providers, the protection of persons trafficked for the purpose of organ removal, strengthening cross-border collaboration in criminal cases, and stimulating partnerships between transplant professionals and law enforcement. These recommendations offer ways in which transplant professionals can contribute to improving the nonlegislative response to trafficking in human beings for the purpose of organ removal.

  18. The Hague Recommendations: Improving Nonlegislative Responses to Trafficking in Human Beings for the Purpose of Organ Removal

    PubMed Central

    Ambagtsheer, Frederike; Weimar, Willem

    2016-01-01

    Abstract Over the years, the trade in human organs has become an object of international concern. Since the 1980s, antiorgan trade initiatives have mainly involved the strengthening of legislative responses. Little attention however is given to nonlegislative responses by law enforcement authorities. The HOTT project is a European Union-funded research project titled “trafficking in human beings for the purpose of organ removal.” Its objectives are to increase knowledge, raise awareness, and improve the nonlegislative response to the crime. Its consortium organized a “Writers' Conference” in The Hague, The Netherlands at Europol's Headquarters where a group of 40 experts, consisting of transplant professionals, law enforcement officials, and policy makers, formulated recommendations to improve nonlegislative responses. These recommendations, presented hereafter, address the ethical and legal obligations of health care providers, the protection of persons trafficked for the purpose of organ removal, strengthening cross-border collaboration in criminal cases, and stimulating partnerships between transplant professionals and law enforcement. These recommendations offer ways in which transplant professionals can contribute to improving the nonlegislative response to trafficking in human beings for the purpose of organ removal. PMID:27500254

  19. An aging population: science, business, and public policy. Recommendations from the World Health Forum 2003.

    PubMed

    Suther, Mary

    2003-10-01

    At the 2003 World Health Forum conference, experts from around the world gathered to examine the issues surrounding global aging trends and to develop recommendations for the economic, health, and policy consequences of an aging population. The recommendations address a wide range of issues, but acknowledge the importance of community-based care, including long-term home care.

  20. 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

  1. Public health and the anticorporate movement: rationale and recommendations.

    PubMed

    Wiist, William H

    2006-08-01

    Institutions and informal networks have formed a movement that is challenging the growing power and pervasive influence of large corporations. The movement's analyses show that the historical development and current function of the corporate entity requires production of a profit regardless of consequences to health, society, or the environment. As a result, public health professionals frequently address health problems related to products, services, or practices of corporations. There are possibilities for links between public health and the anticorporate movement. Public health research and the professional preparation curriculum should focus on the corporate entity as a social structural determinant of disease.

  2. Public Health and the Anticorporate Movement: Rationale and Recommendations

    PubMed Central

    Wiist, William H.

    2006-01-01

    Institutions and informal networks have formed a movement that is challenging the growing power and pervasive influence of large corporations. The movement’s analyses show that the historical development and current function of the corporate entity requires production of a profit regardless of consequences to health, society, or the environment. As a result, public health professionals frequently address health problems related to products, services, or practices of corporations. There are possibilities for links between public health and the anticorporate movement. Public health research and the professional preparation curriculum should focus on the corporate entity as a social structural determinant of disease. PMID:16809584

  3. Analyzing health organizations' use of Twitter for promoting health literacy.

    PubMed

    Park, Hyojung; Rodgers, Shelly; Stemmle, Jon

    2013-01-01

    This study explored health-related organizations' use of Twitter in delivering health literacy messages. A content analysis of 571 tweets from health-related organizations revealed that the organizations' tweets were often quoted or retweeted by other Twitter users. Nonprofit organizations and community groups had more tweets about health literacy than did other types of health-related organizations examined, including health business corporations, educational institutions, and government agencies. Tweets on health literacy topics focused predominantly on using simple language rather than complicated language. The results suggest that health organizations need a more strategic approach to managing positive organizational self-presentations in order to create an optimal level of exposure on social networking sites.

  4. 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.

  5. Urban Forest Health Needs Assessment Survey: Results and Recommendations

    Treesearch

    Jill D. Pokorny

    1998-01-01

    The survey was designed to query urban forestry professionals in the 20 northeastern and Midwest States and the District of Columbia, which are served by the Northeastern Area, to learn about their attitudes toward the general issue of urban forest health, identify specific training and information needs in the area of urban tree health management, and discover...

  6. Ground-Based Facilities for Simulation of Microgravity: Organism-Specific Recommendations for Their Use, and Recommended Terminology

    PubMed Central

    Anken, Ralf; Boonstra, Johannes; Braun, Markus; Christianen, Peter C.M.; de Geest, Maarten; Hauslage, Jens; Hilbig, Reinhard; Hill, Richard J.A.; Lebert, Michael; Medina, F. Javier; Vagt, Nicole; Ullrich, Oliver

    2013-01-01

    Abstract Research in microgravity is indispensable to disclose the impact of gravity on biological processes and organisms. However, research in the near-Earth orbit is severely constrained by the limited number of flight opportunities. Ground-based simulators of microgravity are valuable tools for preparing spaceflight experiments, but they also facilitate stand-alone studies and thus provide additional and cost-efficient platforms for gravitational research. The various microgravity simulators that are frequently used by gravitational biologists are based on different physical principles. This comparative study gives an overview of the most frequently used microgravity simulators and demonstrates their individual capacities and limitations. The range of applicability of the various ground-based microgravity simulators for biological specimens was carefully evaluated by using organisms that have been studied extensively under the conditions of real microgravity in space. In addition, current heterogeneous terminology is discussed critically, and recommendations are given for appropriate selection of adequate simulators and consistent use of nomenclature. Key Words: 2-D clinostat—3-D clinostat—Gravity—Magnetic levitation—Random positioning machine—Simulated microgravity—Space biology. Astrobiology 13, 1–17. PMID:23252378

  7. Health plan implementation of U.S. Preventive Services Task Force A and B recommendations--Colorado, 2010.

    PubMed

    2011-10-07

    The Patient Protection and Affordable Care Act (PPACA) is aimed at expanding access to health care and lowering cost barriers to seeking and receiving care, particularly high-value preventive care. The legislation requires Medicare and all qualified commercial health plans (except grandfathered individual and employer-sponsored plans) to cover routine preventive services graded A and B by the U.S. Preventive Services Task Force (USPSTF) at no cost to the consumer, along with recommended immunizations and additional preventive care and screenings for women. In 2009, Colorado passed a law with similar USPTF A and B service coverage requirements. To determine how Colorado health plans had interpreted the state and federal law, the Colorado Department of Public Health and Environment (CDPHE) interviewed representatives of commercial health plans serving Colorado residents. The results of those interviews indicated that different health plans interpreted certain USPSTF recommendations differently, including tobacco screening and pharmacotherapy, colorectal cancer screening, and obesity screening and counseling. One health plan communicated the scope, eligibility criteria, and content of the new preventive services coverage to its members or providers. The differences in interpretation of the USPSTF recommendations and limited communication to consumers or health-care providers in Colorado might be repeated in other states. To ensure optimal consumer and health-care provider utilization of preventive service benefits, the preventive services supported by USPSTF A and B recommendations should be clearly defined in health plan benefit language, with processes put in place for consistent implementation and eligibility criteria communicated to both consumers and providers. The experience in Colorado shows that public health organizations can play a key role in successfully implementing PPACA prevention services provisions.

  8. Tuberculosis-a World Health Organization Perspective.

    PubMed

    Sotgiu, Giovanni; Sulis, Giorgia; Matteelli, Alberto

    2017-01-01

    Tuberculosis (TB) is an important cause of morbidity and mortality worldwide. The World Health Organization (WHO) has implemented and scaled-up three important global public health strategies (i.e., DOTS, Stop TB, and End TB) to improve the international scenario. Their epidemiological impact was relevant, as they decreased the number of potential new cases of disease and death. However, the emergence and spread of TB/HIV coinfection and multidrug-resistant TB have hindered the progress towards the elimination of TB by 2050. More efforts are required to increase the global annual decline of the TB incidence rate. Political commitment is necessary, with global and national strategies oriented to the adoption and adaptation of the international, evidence-based recommendations on diagnosis, treatment, and prevention. Research and development activities should be planned to improve the current tools adopted to fight the disease. New rapid diagnostics, an updated and effective therapeutic armamentarium, and an effective preventive vaccine could represent the solution to address the current epidemiological threats.

  9. 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.

  10. Overview to Health Professions Education: Health Education Commission Recommendations for Use in Developing the Illinois Master Plan--Phase IV.

    ERIC Educational Resources Information Center

    McGill, J. T.

    Recommendations for the preparation of health professionals in Illinois are made in order to: (1) ensure that an adequate number of health professionals are educated to meet the needs of Illinois citizens; (2) improve the distribution of available health manpower within the State; (3) enhance the access to health professions education programs for…

  11. [Overweight and obesity; recommendations from the National Health Council].

    PubMed

    Meinders, A E; Fogteloo, J

    2003-09-20

    The Health Council of the Netherlands has issued a report on overweight and obesity. These are considered major threats to personal health, the public health care services and economic welfare. Overweight and obesity are no longer considered variations of the norm, but as a disease. As genetically predisposing factors cannot be influenced, major initiatives to contain further deterioration of the problem must be on environmental factors i.e. on macronutrient intake and physical exercise. Special target groups (young people, people of low socioeconomic status and immigrants) need to be defined. Government, health care organisations, industry and the general public should work together to combat overweight and obesity. The chances of success are not predictable but are certainly big enough to justify action.

  12. Health IT success and failure: recommendations from literature and an AMIA workshop.

    PubMed

    Kaplan, Bonnie; Harris-Salamone, Kimberly D

    2009-01-01

    With the United States joining other countries in national efforts to reap the many benefits that use of health information technology can bring for health care quality and savings, sobering reports recall the complexity and difficulties of implementing even smaller-scale systems. Despite best practice research that identified success factors for health information technology projects, a majority, in some sense, still fail. Similar problems plague a variety of different kinds of applications, and have done so for many years. Ten AMIA working groups sponsored a workshop at the AMIA Fall 2006 Symposium. It was entitled "Avoiding The F-Word: IT Project Morbidity, Mortality, and Immortality" and focused on this under-addressed problem. PARTICIPANTS discussed communication, workflow, and quality; the complexity of information technology undertakings; the need to integrate all aspects of projects, work environments, and regulatory and policy requirements; and the difficulty of getting all the parts and participants in harmony. While recognizing that there still are technical issues related to functionality and interoperability, discussion affirmed the emerging consensus that problems are due to sociological, cultural, and financial issues, and hence are more managerial than technical. Participants drew on lessons from experience and research in identifying important issues, action items, and recommendations to address the following: what "success" and "failure" mean, what contributes to making successful or unsuccessful systems, how to use failure as an enhanced learning opportunity for continued improvement, how system successes or failures should be studied, and what AMIA should do to enhance opportunities for successes. The workshop laid out a research agenda and recommended action items, reflecting the conviction that AMIA members and AMIA as an organization can take a leadership role to make projects more practical and likely to succeed in health care settings.

  13. Recommendations from the Exploring Accreditation for State and Local Health Departments: do we have the political will?

    PubMed

    Bender, Kaye

    2007-01-01

    Acting upon several years of related work from a variety of public health practice arenas, 4 leading public health organizations received funding to conduct a study of the desirability and feasibility of establishing a national voluntary public health accreditation system. The study was conducted by a 25-member Steering Committee, with representatives from public health organizations at the local, state, and federal levels. The study was advised by input from additional numbers of public health experts participating in workgroups, as consultants, or in public comment groups. Public health nursing was represented by 3 members of the Steering Committee, including the chair, and by 7 other nurses who served on work groups or as staff to the process. The report of the study committee, released in the fall of 2006, contained answers to 2 questions related to the desirability and feasibility of such a program. Additionally, the report contained recommendations regarding the program's initial implementation. This article summarizes those recommendations and discusses the policy implications for their implementation, with a special emphasis on the role of the public health nursing community in the establishment of a national voluntary public health accreditation system.

  14. Commentary: preparing for health care reform: ten recommendations for academic health centers.

    PubMed

    Shomaker, T Samuel

    2011-05-01

    Health care reform, the subject of intense national debate and discussion during the presidential campaign and the first year of the Obama presidency, is now reality. The Patient Protection and Affordable Care Act of 2010 (PPACA) became law in March 2010. Despite efforts by the new Republican majority in the House of Representatives of the 112th Congress to repeal the bill, some aspects of PPACA have already taken effect, and the majority of the remainder are scheduled to be implemented by 2014. PPACA will change the U.S. health care system in fundamental ways. Perhaps more than other entities in the U.S. health care system, academic health centers (AHCs) will bear the impact of the struggle to care for 32 million new, primarily low-income insurance beneficiaries. A large influx of new patients trying to access the health care system through AHCs will coincide with major changes in the financing of health care, the training of health professions students, and the conduct of biomedical research. Although many of the sweeping changes coming through PPACA will not happen until later in this decade, AHCs must begin planning for the future now if they are to prosper, or even survive, in the brave new world of health care reform. The author of this commentary first briefly analyzes some of the most important effects PPACA will have on AHCs and then makes recommendations for how AHCs can prepare to take advantage of the opportunities and mitigate the challenges inherent in implementing PPACA. Copyright © by the Association of American medical Colleges.

  15. [The role of the mental health community in an evolving mental health system. State of knowledge and recommendations].

    PubMed

    Grenier, Guy; Fleury, Marie-Josée

    2014-01-01

    ; and 5) rootedness of the organization within the community. MCHO are grouped at the provincial level according to their functions, their ideological affinity, and or their particular mandate, but there is no national classification of community organizations as yet. The financing of community organizations remains a principal source of discontent. The MSSS has indicated that the overall financing of MCHO should correspond to at least 10% of global expenditures for mental health programming, whereas the actual budget is equivalent to only 8.8%. This underfunding obliges community organizations to reduce services despite demands for increased financial assistance, which runs the risk of provoking increased "revolving door" situations, and the utilization of emergency services in cases of service users transferred from hospitals to the Health Social Services Centers, who are in difficulty after losing contact with their service providers who would otherwise have provided follow-up. As well, MCHO fear the loss of their autonomy and of being reduced to the role of secondary services in signing these service agreements. The current reform would represent a step backward for MHCO in terms of recognition of their expertise. The former consultation structures have been dispossessed of any real power, decision making now being in the hands of the regional agency and directors of institutions. Numerous relocations of personnel have also lead to breaks in contact between MCHO and the public system, as these relationships were usually informal. A number of recommendations emanate from these findings that may permit MHCO to respond more adequately to the needs of the population served without calling into question their autonomy: 1) offer more adequate financing, particularly for self-help groups and organizations offering psychosocial rehabilitation, access to education and work reintegration; 2) allocate specific services exclusively to the community-based system in order to

  16. Navigating barriers: two-year follow up on recommendations to improve the use of maternal health guidelines in Kosovo.

    PubMed

    Moore, Julia E; Uka, Sami; Vogel, Joshua P; Timmings, Caitlyn; Rashid, Shusmita; Gülmezoglu, A Metin; Straus, Sharon E

    2016-09-15

    Although there are a growing number of initiatives aimed at supporting guideline implementation in resource-constrained settings, few studies assess progress on achieving next steps and goals after the initial activities are completed and the initial funding period has ended. The aim of the current study was to conduct a qualitative process evaluation of progress, barriers, facilitators, and proposed solutions to operationalize nine recommendations to prepare Kosovo to implement the 2012 World Health Organization (WHO) prevention and treatment of postpartum haemorrhage guideline. In 2012, we co-created nine recommendations designed to support implementing the WHO's guideline on the prevention and treatment of postpartum haemorrhage in Kosovo. The current study uses a realist evaluation approach to assess activities and progress two years after the recommendations were developed. The study involved conducting qualitative focus groups and one-on-one interviews with participants from the first meeting to evaluate the activities and progress on the nine recommendations. Forty-three participants provided insights into the barriers and opportunities experienced to date and proposed future directions. Although progress has been made towards implementation of a number of the recommendations, scaling up has been limited by barriers, such as lack of awareness, limited resources, and evaluation challenges. Participants proposed addressing these barriers by building within- and between-country partnerships to facilitate guideline implementation. In addition, participants reported less progress on implementing recommendations related to broader cultural changes, which indicates a need for specific and actionable recommendations to operationalize implementation efforts. In the two years since the initial meeting, there has been mixed progress on the recommendations. Based on participant feedback, we refined the recommendations so that they can be operationalized by health care

  17. Health literacy and communication quality in health care organizations.

    PubMed

    Wynia, Matthew K; Osborn, Chandra Y

    2010-01-01

    The relationship between limited health literacy and poor health may be due, in part, to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28% to 79% less likely than those with adequate health literacy to report their health care organization "always" provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers.

  18. Health Literacy and Communication Quality in Health Care Organizations

    PubMed Central

    Wynia, Matthew K.; Osborn, Chandra Y.

    2011-01-01

    The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197

  19. DOE organization and management approach in responding to recommendation 94-2 - The implementation plan

    SciTech Connect

    Widmayer, D.

    1995-12-31

    In March, the Department of Energy (DOE) submitted the Implementation Plan in response to the Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 94-2, {open_quotes}Conformance with Safety Standards at Department of Energy Low-Level Nuclear Waste and Disposal Sites.{close_quotes} This paper discusses the management organization and interactions established to accomplish the tasks developed to respond to the DNFSB Recommendation. The organization of the tasks into six technical areas and the interfaces and connections between the tasks are briefly described. A summary of how each significant part of the DNFSB Recommendation is being addressed is presented. This paper provides a brief introduction to the remaining presentations in this session.

  20. Meeting "Valuing People" Health Targets: Recommendations from a Research Workshop

    ERIC Educational Resources Information Center

    Mir, Ghazala

    2007-01-01

    Research at the University of Leeds has evaluated how well changes to healthcare proposed in the Government White Paper "Valuing People" (Department of Health 2001) were being implemented in one locality and their impact on people with learning disabilities. The project had a developmental aspect and incorporated two workshops over the…

  1. Forensic mental health assessment in France: recommendations for quality improvement.

    PubMed

    Combalbert, Nicolas; Andronikof, Anne; Armand, Marine; Robin, Cécile; Bazex, Hélène

    2014-01-01

    The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called "experts" in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.

  2. World Health Organization guideline development: an evaluation.

    PubMed

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

    2013-01-01

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

  3. Health Maintenance Organization (HMO) Plan

    MedlinePlus

    ... Plans in your area . Can I get my health care from any doctor, other health care provider, or hospital? In HMO Plans, you generally ... get your care and services from doctors, other health care providers, or hospitals in the plan's network, except: ...

  4. Improving Health (Majority Recommendations.) Next Steps for Children and Families. Implementation Guide Series.

    ERIC Educational Resources Information Center

    National Commission on Children, Washington, DC.

    Based on the assumption that all American children deserve an opportunity to be born healthy and to grow up healthy, this guide presents the recommendations approved by the majority of the National Commission on Children for improving the health of the nation's pregnant women and children. The Commission's five recommendations are: (1) provide…

  5. Fact Sheet: Revised National Recommended Water Quality Criteria for the Protection of Human Health

    EPA Pesticide Factsheets

    2003 Revised National Recommended Ambient Water Quality Criteria for the Protection of Human Health. 15 Pollutants revised criteria will be published including, chlorobenzene, cyanide, endrin, ethylbenzene, lindane, thallium, toluene, and more.

  6. Cell phones and health concerns: impact of knowledge and voluntary precautionary recommendations.

    PubMed

    Cousin, Marie-Eve; Siegrist, Michael

    2011-02-01

    The article explores how voluntary precautionary recommendations for cell phone usage influence people's health concerns and behavior. An experimental study using a sample of Swiss citizens (N=408) was conducted. Three different versions of a newly developed booklet, which focused on common misconceptions in regard to mobile communication, and an existing booklet were tested. The experimental design addressed questions of the potential effects of knowledge, precautionary recommendations, and sender identity on health concerns and transfer of the proposed recommendations. Participants' perceptions were measured three times: immediately before and after reading the booklet, and two weeks later. The reading of the booklets increased participants' knowledge considerably and led to perceptual changes. In regard to cell phones, health concerns increased after the reading and stayed at a higher level even after two weeks. The negative perception of base stations, in contrast, tended to decrease. Neither the identity of the sender nor the omission of precautionary recommendations had significant effects on health concerns. Provision of specific recommendations enhanced readers' behavioral changes. Confrontation with information per se, and not precautionary recommendations, influenced the public's health concerns. These changes should not prevent the provision of precautionary recommendations because, in the face of scientific uncertainty, these are the only means through which to enable users to make informed decisions.

  7. Testing public health ethics: why the CDC's HIV screening recommendations may violate the least infringement principle.

    PubMed

    Pierce, Matthew W; Maman, Suzanne; Groves, Allison K; King, Elizabeth J; Wyckoff, Sarah C

    2011-01-01

    The CDC's HIV screening recommendations for health care settings advocate abandoning two important autonomy protections: (1) pretest counseling and (2) the requirement that providers obtain affirmative agreement from patients prior to testing. The recommendations may violate the least infringement principle because there is insufficient evidence to conclude that abandoning pretest counseling or affirmative agreement requirements will further the CDC's stated public health goals. © 2011 American Society of Law, Medicine & Ethics, Inc.

  8. 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. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  9. Building HR capability in health care organizations.

    PubMed

    Khatri, Naresh

    2006-01-01

    The current human resource (HR) management practices in health care are consistent with the industrial model of management. However, health care organizations are not factories. They are highly knowledge-intensive and service-oriented entities and thus require a different set of HR practices and systems to support them. Drawing from the resource-based theory, I argue that HRs are a potent weapon of competitive advantage for health care organizations and propose a five-dimensional conception of HR capability for harnessing HRs in health care organizations. The significant complementarities that exist between HRs and information technologies for delivering safer and better quality of patient care are also discussed.

  10. Recommendations: Health Professions Education. A Report to the Southern Regional Education Board by Its Commission on Health and Human Services.

    ERIC Educational Resources Information Center

    Southern Regional Education Board, Atlanta, GA.

    Problems facing health professions schools and academic health centers that can damage health were identified by the Southern Regional Education Board, along with recommendations for action within the states. Nine problems for these schools and centers concern: declining applications and enrollments for dental schools and many schools of pharmacy,…

  11. Review of institute of medicine and national research council recommendations for one health initiative.

    PubMed

    Rubin, Carol; Myers, Tanya; Stokes, William; Dunham, Bernadette; Harris, Stic; Lautner, Beth; Annelli, Joseph

    2013-12-01

    Human health is inextricably linked to the health of animals and the viability of ecosystems; this is a concept commonly known as One Health. Over the last 2 decades, the Institute of Medicine (IOM) and the National Research Council (NRC) have published consensus reports and workshop summaries addressing a variety of threats to animal, human, and ecosystem health. We reviewed a selection of these publications and identified recommendations from NRC and IOM/NRC consensus reports and from opinions expressed in workshop summaries that are relevant to implementation of the One Health paradigm shift. We grouped these recommendations and opinions into thematic categories to determine if sufficient attention has been given to various aspects of One Health. We conclude that although One Health themes have been included throughout numerous IOM and NRC publications, identified gaps remain that may warrant targeted studies related to the One Health approach.

  12. Review of Institute of Medicine and National Research Council Recommendations for One Health Initiative

    PubMed Central

    Myers, Tanya; Stokes, William; Dunham, Bernadette; Harris, Stic; Lautner, Beth; Annelli, Joseph

    2013-01-01

    Human health is inextricably linked to the health of animals and the viability of ecosystems; this is a concept commonly known as One Health. Over the last 2 decades, the Institute of Medicine (IOM) and the National Research Council (NRC) have published consensus reports and workshop summaries addressing a variety of threats to animal, human, and ecosystem health. We reviewed a selection of these publications and identified recommendations from NRC and IOM/NRC consensus reports and from opinions expressed in workshop summaries that are relevant to implementation of the One Health paradigm shift. We grouped these recommendations and opinions into thematic categories to determine if sufficient attention has been given to various aspects of One Health. We conclude that although One Health themes have been included throughout numerous IOM and NRC publications, identified gaps remain that may warrant targeted studies related to the One Health approach. PMID:24274461

  13. 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.

  14. Consumers' intention to use health recommendation systems to receive personalized nutrition advice.

    PubMed

    Wendel, Sonja; Dellaert, Benedict G C; Ronteltap, Amber; van Trijp, Hans C M

    2013-04-04

    Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to rely on endorsement by the medical sector

  15. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    PubMed Central

    2013-01-01

    Background Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. Methods 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. Results We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. Conclusions We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to

  16. Consistency and sources of divergence in recommendations on screening with questionnaires for presently experienced health problems or symptoms: a comparison of recommendations from the Canadian Task Force on Preventive Health Care, UK National Screening Committee, and US Preventive Services Task Force.

    PubMed

    Thombs, Brett D; Saadat, Nazanin; Riehm, Kira E; Karter, Justin Michael; Vaswani, Akansha; Andrews, Bonnie K; Simons, Peter; Cosgrove, Lisa

    2017-08-09

    Recently, health screening recommendations have gone beyond screening for early-stage, asymptomatic disease to include "screening" for presently experienced health problems and symptoms using self-report questionnaires. We examined recommendations from three major national guideline organizations to determine the consistency of recommendations, identify sources of divergent recommendations, and determine if guideline organizations have identified any direct randomized controlled trial (RCT) evidence for the effectiveness of questionnaire-based screening. We reviewed recommendation statements listed by the Canadian Task Force on Preventive Health Care (CTFPHC), the United Kingdom National Screening Committee (UKNSC), and the United States Preventive Services Task Force (USPSTF) as of 5 September 2016. Eligible recommendations focused on using self-report questionnaires to identify patients with presently experienced health problems or symptoms. Within each recommendation and accompanying evidence review we identified screening RCTs. We identified 22 separate recommendations on questionnaire-based screening, including three CTFPHC recommendations against screening, eight UKNSC recommendations against screening, four USPSTF recommendations in favor of screening (alcohol misuse, adolescent depression, adult depression, intimate partner violence), and seven USPSTF recommendations that did not recommend for or against screening. In the four cases where the USPSTF recommended screening, either the CTFPHC, the UKNSC, or both recommended against. When recommendations diverged, the USPSTF expressed confidence in benefits based on indirect evidence, evaluated potential harms as minimal, and did not consider cost or resource use. CTFPHC and UKNSC recommendations against screening, on the other hand, focused on the lack of direct evidence of benefit and raised concerns about harms to patients and resource use. Of six RCTs that directly evaluated screening interventions, five

  17. Guidelines for potential multiple organ donors (adult). Part III: organ-specific recommendations.

    PubMed

    Westphal, Glauco Adrieno; Caldeira Filho, Milton; Vieira, Kalinca Daberkow; Zaclikevis, Viviane Renata; Bartz, Miriam Cristine Machado; Wanzuita, Raquel; Réa-Neto, Alvaro; Teixeira, Cassiano; Franke, Cristiano; Machado, Fernando Osni; Andrade, Joel de; Matos, Jorge Dias de; Gerent, Karine Becker; Fiorelli, Alfredo; Gonçalves, Anderson Ricardo Roman; Ferraz Neto, Ben-Hur; Dias, Fernando Suparregui; Carvalho, Frederico Bruzzi de; Costa, Gerson; Camargo, José Jesus; Teles, José Mário Meira; Maia, Marcelo; Nogara, Marcelo; Coelho, Maria Emília; Mazzali, Marilda; Youssef, Nazah Cherif Mohamad; Duarte, Péricles; Souza, Rafael Lisboa de; Fernandes, Rogério; Camargo, Spencer; Garcia, Valter Duro

    2011-12-01

    Brain death (BD) alters the pathophysiology of patients and may damage the kidneys, the lungs, the heart and the liver. To obtain better quality transplant organs, intensive care physicians in charge of the maintenance of deceased donors should attentively monitor these organs. Careful hemodynamic, ventilatory and bronchial clearance management minimizes the loss of kidneys and lungs. The evaluation of cardiac function and morphology supports the transplant viability assessment of the heart. The monitoring of liver function, the management of the patient's metabolic status and the evaluation of viral serology are fundamental for organ selection by the transplant teams and for the care of the transplant recipient.

  18. Health care reform in the USA: Recommendations from USA and non-USA radiologists.

    PubMed

    Burke, Lauren Mb; Martin, Diego R; Bader, Till; Semelka, Richard C

    2012-02-28

    To compare the opinions and recommendations of imaging specialists from United States (USA) and non-USA developed nations for USA health care reform. A survey was emailed out to 18 imaging specialists from 17 non-USA developed nation countries and 14 radiologists within the USA regarding health care reform. The questionnaire contained the following questions: what are the strengths of your health care system, what problems are present in your nation's health care system, and what recommendations do you have for health care reform in the USA. USA and non-USA radiologists received the same questionnaire. Strengths of the USA health care system include high quality care, autonomy, and access to timely care. Twelve of 14 (86%) USA radiologists identified medicolegal action as a major problem in their health care system and felt that medicolegal reform was a critical aspect of health care reform. None of the non-USA radiologists identified medicolegal aspects as a problem in their own country nor identified it as a subject for USA health care reform. Eleven of 14 (79%) USA radiologists and 16/18 (89%) non-USA radiologists identified universal health care coverage as an important recommendation for reform. Without full universal coverage, meaningful health care reform will likely require medicolegal reform as an early and important aspect of improved and efficient health care.

  19. Towards Collaborative Filtering Recommender Systems for Tailored Health Communications

    PubMed Central

    Marlin, Benjamin M.; Adams, Roy J.; Sadasivam, Rajani; Houston, Thomas K.

    2013-01-01

    The goal of computer tailored health communications (CTHC) is to promote healthy behaviors by sending messages tailored to individual patients. Current CTHC systems collect baseline patient “profiles” and then use expert-written, rule-based systems to target messages to subsets of patients. Our main interest in this work is the study of collaborative filtering-based CTHC systems that can learn to tailor future message selections to individual patients based explicit feedback about past message selections. This paper reports the results of a study designed to collect explicit feedback (ratings) regarding four aspects of messages from 100 subjects in the smoking cessation support domain. Our results show that most users have positive opinions of most messages and that the ratings for all four aspects of the messages are highly correlated with each other. Finally, we conduct a range of rating prediction experiments comparing several different model variations. Our results show that predicting future ratings based on each user’s past ratings contributes the most to predictive accuracy. PMID:24551430

  20. Towards collaborative filtering recommender systems for tailored health communications.

    PubMed

    Marlin, Benjamin M; Adams, Roy J; Sadasivam, Rajani; Houston, Thomas K

    2013-01-01

    The goal of computer tailored health communications (CTHC) is to promote healthy behaviors by sending messages tailored to individual patients. Current CTHC systems collect baseline patient "profiles" and then use expert-written, rule-based systems to target messages to subsets of patients. Our main interest in this work is the study of collaborative filtering-based CTHC systems that can learn to tailor future message selections to individual patients based explicit feedback about past message selections. This paper reports the results of a study designed to collect explicit feedback (ratings) regarding four aspects of messages from 100 subjects in the smoking cessation support domain. Our results show that most users have positive opinions of most messages and that the ratings for all four aspects of the messages are highly correlated with each other. Finally, we conduct a range of rating prediction experiments comparing several different model variations. Our results show that predicting future ratings based on each user's past ratings contributes the most to predictive accuracy.

  1. Accountable Care Organizations and Oral Health Accountability.

    PubMed

    Mayberry, Melanie E

    2017-05-01

    Accountable care organizations agree to be accountable for the cost and outcomes of an attributed population. However, in many, no provisions have been made to account for oral health. There are several social, medical, and financial implications for health care provider and payer systems and health care outcomes when oral health is not accounted for in patient management. How can an organization strive to improve population health without including the oral health system? Total systemic health for a population must include oral health. Accountable care organizations are positioned to change the course of oral health in the United States and close the disparities that exist among vulnerable populations, including seniors. Such efforts will reduce health care costs. Opportunities abound to expand points of entry into the health care system via dental or medical care. Closing the great divide between 2 historically isolated professions will position the United States to make gains in true population health. I provide evidence of the need to mandate access to oral health care services for all Americans-specifically adults, because legislation currently exists for pediatric dental coverage.

  2. Identifying male college students' perceived health needs, barriers to seeking help, and recommendations to help men adopt healthier lifestyles.

    PubMed

    Davies, J; McCrae, B P; Frank, J; Dochnahl, A; Pickering, T; Harrison, B; Zakrzewski, M; Wilson, K

    2000-05-01

    Seven focus groups at a university campus were formed to identify college men's health concerns, barriers to seeking help, and recommendations to help college men adopt healthier lifestyles. Content analysis was used to identify and organize primary patterns in the focus-group data. Results of the study revealed that the college men were aware that they had important health needs but took little action to address them. The participants identified both physical and emotional health concerns. Alcohol and substance abuse were rated as the most important issues for men. The greatest barrier to seeking services was the men's socialization to be independent and conceal vulnerability. The most frequently mentioned suggestions for helping men adopt healthier lifestyles were offering health classes, providing health information call-in service, and developing a men's center. Implications of the results are discussed.

  3. World Trade Organization activity for health services.

    PubMed

    Gros, Clémence

    2012-01-01

    Since the establishment of a multilateral trading system and the increasing mobility of professionals and consumers of health services, it seems strongly necessary that the World Trade Organization (WTO) undertakes negotiations within the General Agreement on Trade in Services (GATS), and that WTO's members attempt to reach commitments for health-related trade in services. How important is the GATS for health policy and how does the GATS refer to health services? What are the current negotiations and member's commitments?

  4. A large-scale, rapid public health response to rabies in an organ recipient and the previously undiagnosed organ donor.

    PubMed

    Wallace, R M; Stanek, D; Griese, S; Krulak, D; Vora, N M; Pacha, L; Kan, V; Said, M; Williams, C; Burgess, T H; Clausen, S S; Austin, C; Gabel, J; Lehman, M; Finelli, L N; Selvaggi, G; Joyce, P; Gordin, F; Benator, D; Bettano, A; Cersovsky, S; Blackmore, C; Jones, S V; Buchanan, B D; Fernandez, A I; Dinelli, D; Agnes, K; Clark, A; Gill, J; Irmler, M; Blythe, D; Mitchell, K; Whitman, T J; Zapor, M J; Zorich, S; Witkop, C; Jenkins, P; Mora, P; Droller, D; Turner, S; Dunn, L; Williams, P; Richards, C; Ewing, G; Chapman, K; Corbitt, C; Girimont, T; Franka, R; Recuenco, S; Blanton, J D; Feldman, K A

    2014-12-01

    This article describes and contrasts the public health response to two human rabies cases: one organ recipient diagnosed within days of symptom onset and the transplant donor who was diagnosed 18 months post-symptom onset. In response to an organ-transplant-related rabies case diagnosed in 2013, organ donor and recipient investigations were conducted by multiple public health agencies. Persons with potential exposure to infectious patient materials were assessed for rabies virus exposure. An exposure investigation was conducted to determine the source of the organ donor's infection. Over 100 persons from more than 20 agencies spent over 2700 h conducting contact investigations in healthcare, military and community settings. The 564 persons assessed include 417 healthcare workers [5.8% recommended for post-exposure prophylaxis (PEP)], 96 community contacts (15.6% recommended for PEP), 30 autopsy personnel (50% recommended for PEP), and 21 other persons (4.8% recommended for PEP). Donor contacts represented 188 assessed with 20.2% recommended for PEP, compared with 5.6% of 306 recipient contacts recommended for PEP. Human rabies cases result in substantial use of public health and medical resources, especially when diagnosis is delayed. Although rare, clinicians should consider rabies in cases of encephalitis of unexplained aetiology, particularly for cases that may result in organ donation.

  5. Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments

    PubMed Central

    Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

    2016-01-01

    Background The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. Objective To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. Methods A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Results Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Conclusions Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems. PMID:26932350

  6. An informatics agenda for public health: summarized recommendations from the 2011 AMIA PHI Conference.

    PubMed

    Massoudi, Barbara L; Goodman, Kenneth W; Gotham, Ivan J; Holmes, John H; Lang, Lisa; Miner, Kathleen; Potenziani, David D; Richards, Janise; Turner, Anne M; Fu, Paul C

    2012-01-01

    The AMIA Public Health Informatics 2011 Conference brought together members of the public health and health informatics communities to revisit the national agenda developed at the AMIA Spring Congress in 2001, assess the progress that has been made in the past decade, and develop recommendations to further guide the field. Participants met in five discussion tracks: technical framework; research and evaluation; ethics; education, professional training, and workforce development; and sustainability. Participants identified 62 recommendations, which clustered into three key themes related to the need to (1) enhance communication and information sharing within the public health informatics community, (2) improve the consistency of public health informatics through common public health terminologies, rigorous evaluation methodologies, and competency-based training, and (3) promote effective coordination and leadership that will champion and drive the field forward. The agenda and recommendations from the meeting will be disseminated and discussed throughout the public health and informatics communities. Both communities stand to gain much by working together to use these recommendations to further advance the application of information technology to improve health.

  7. An informatics agenda for public health: summarized recommendations from the 2011 AMIA PHI Conference

    PubMed Central

    Goodman, Kenneth W; Gotham, Ivan J; Holmes, John H; Lang, Lisa; Miner, Kathleen; Potenziani, David D; Richards, Janise; Turner, Anne M; Fu, Paul C

    2012-01-01

    The AMIA Public Health Informatics 2011 Conference brought together members of the public health and health informatics communities to revisit the national agenda developed at the AMIA Spring Congress in 2001, assess the progress that has been made in the past decade, and develop recommendations to further guide the field. Participants met in five discussion tracks: technical framework; research and evaluation; ethics; education, professional training, and workforce development; and sustainability. Participants identified 62 recommendations, which clustered into three key themes related to the need to (1) enhance communication and information sharing within the public health informatics community, (2) improve the consistency of public health informatics through common public health terminologies, rigorous evaluation methodologies, and competency-based training, and (3) promote effective coordination and leadership that will champion and drive the field forward. The agenda and recommendations from the meeting will be disseminated and discussed throughout the public health and informatics communities. Both communities stand to gain much by working together to use these recommendations to further advance the application of information technology to improve health. PMID:22395299

  8. A Health Informatics Curriculum Congruent with IS 2010 and IMIA Recommendations for an Undergraduate Degree

    ERIC Educational Resources Information Center

    Longenecker, Herbert E., Jr.; Campbell, S. Matt; Landry, Jeffrey P.; Pardue, Harold; Daigle, Roy J.

    2012-01-01

    In addition to being a relevant program for health information technology workers, a recently proposed Health Informatics program was designed with additional objectives in mind: that the program is compatible with the IS 2010 Model Curriculum and that it satisfies the International Medical Informatics Association recommendation for undergraduate…

  9. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy.

    PubMed

    Baber, R J; Panay, N; Fenton, A

    2016-04-01

    The International Menopause Society (IMS) has produced these new 2016 recommendations on women's midlife health and menopause hormone therapy (MHT) to help guide health-care professionals in optimizing their management of women in the menopause transition and beyond. The term MHT has been used to cover therapies including estrogens, progestogens and combined regimens. For the first time, the 2016 IMS recommendations now include grades of recommendations, levels of evidence and 'good practice points', in addition to section-specific references. Where possible, the recommendations are based on and linked to the evidence that supports them, unless good-quality evidence is absent. Particular attention has been paid to published evidence from 2013 onwards, the last time the IMS recommendations were updated. Databases have been extensively searched for relevant publications using key terms specific to each specialist area within menopause physiology and medicine. Information has also been drawn from international consensus statements published by bodies such as the IMS, the European Menopause and Andropause Society and the North American Menopause Society. The recommendations have been produced by experts derived mainly from the IMS, with the assistance of key collaborators where deemed advantageous. In preparing these international recommendations, experts have taken into account geographical variations in medical care, prevalence of diseases, and country-specific attitudes of the public, medical community and health authorities towards menopause management. The variation in availability and licensing of MHT and other products has also been considered.

  10. Health information use in home care: brainstorming barriers, facilitators, and recommendations.

    PubMed

    Stolee, Paul; Steeves, Brandie; Manderson, Brooke L; Toscan, Justine L; Glenny, Christine; Berg, Katherine

    2010-01-01

    There is growing recognition of the importance of sharing health information in home care; however, limited research exists to identify appropriate strategies, especially with home care providers. We engaged home care stakeholders from three locations in Ontario to determine facilitators, barriers, and recommendations for using health information in home care. The results suggest that health professionals recognize the potential of these systems to enhance communication through several emergent themes; however, there was a lack of agreement on the current facilitators, barriers, and recommendations for future interventions. More research is needed to achieve consensus before strategies for improvement can be initiated.

  11. Seasonal influenza vaccine policies, recommendations and use in the World Health Organization’s Western Pacific Region

    PubMed Central

    System, Response

    2013-01-01

    Objective Vaccination is the most effective way to prevent seasonal influenza and its severe outcomes. The objective of our study was to synthesize information on seasonal influenza vaccination policies, recommendations and practices in place in 2011 for all countries and areas in the Western Pacific Region of the World Health Organization (WHO). Methods Data were collected via a questionnaire on seasonal influenza vaccination policies, recommendations and practices in place in 2011. Results Thirty-six of the 37 countries and areas (97%) responded to the survey. Eighteen (50%) reported having established seasonal influenza vaccination policies, an additional seven (19%) reported having recommendations for risk groups for seasonal influenza vaccination only and 11 (30%) reported having no policies or recommendations in place. Of the 25 countries and areas with policies or recommendations, health-care workers and the elderly were most frequently recommended for vaccination; 24 (96%) countries and areas recommended vaccinating these groups, followed by pregnant women (19 [76%]), people with chronic illness (18 [72%]) and children (15 [60%]). Twenty-six (72%) countries and areas reported having seasonal influenza vaccines available through public funding, private market purchase or both. Most of these countries and areas purchased only enough vaccine to cover 25% or less of their populations. Discussion In light of the new WHO position paper on influenza vaccines published in 2012 and the increasing availability of country-specific data, countries and areas should consider reviewing or developing their seasonal influenza vaccination policies to reduce morbidity and mortality associated with annual epidemics and as part of ongoing efforts for pandemic preparedness. PMID:24319615

  12. Commentary Considerations for Recommending Extended Use and Limited Reuse of Filtering Facepiece Respirators in Health Care Settings

    PubMed Central

    Fisher, Edward M.; Shaffer, Ronald E.

    2015-01-01

    Public health organizations, such as the Centers for Disease Control and Prevention (CDC), are increasingly recommending the use of N95 filtering facepiece respirators (FFRs) in health care settings. For infection control purposes, the usual practice is to discard FFRs after close contact with a patient (“single use”). However, in some situations, such as during contact with tuberculosis patients, limited FFR reuse (i.e., repeated donning and doffing of the same FFR by the same person) is practiced. A related practice, extended use, involves wearing the same FFR for multiple patient encounters without doffing. Extended use and limited FFR reuse have been recommended during infectious disease outbreaks and pandemics to conserve FFR supplies. This commentary examines CDC recommendations related to FFR extended use and limited reuse and analyzes available data from the literature to provide a relative estimate of the risks of these practices compared to single use. Analysis of the available data and the use of disease transmission models indicate that decisions regarding whether FFR extended use or reuse should be recommended should continue to be pathogen- and event-specific. Factors to be included in developing the recommendations are the potential for the pathogen to spread via contact transmission, the potential that the event could result in or is currently causing a FFR shortage, the protection provided by FFR use, human factors, potential for self-inoculation, the potential for secondary exposures, and government policies and regulations. While recent findings largely support the previous recommendations for extended use and limited reuse in certain situations, some new cautions and limitations should be considered before issuing recommendations in the future. In general, extended use of FFRs is preferred over limited FFR reuse. Limited FFR reuse would allow the user a brief respite from extended wear times, but increases the risk of self-inoculation and

  13. 78 FR 9397 - International Drug Scheduling; Convention on Psychotropic Substances; World Health Organization...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-08

    ... Substances; World Health Organization Scheduling Recommendations for Gamma-hydroxybutyric Acid AGENCY: Food...), has notified the Secretary-General that it is of the opinion that Gamma- hydroxybutyric acid (GHB... control of y-hydroxybutyric acid (GHB). The recommendation is that GHB be rescheduled from Schedule IV to...

  14. 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".

  15. [Improving prevention: Integrative model and recommendations intended for public health professionals].

    PubMed

    Broc, G; Edjolo, A

    2017-04-01

    Public health policies aim to diminish people's exposure to negative factors, behaviors or determinants of health. Despite awareness-raising campaigns, health recommendations are still not sufficiently followed. First, the article wondered the reasons behind this observation. In order to do this, we present a theoretical model incorporating: (a) the motivational theories of communication processing; (b) the theories of motivation and volition; (c) self-regulation and self-determination theories. In a second part, the paper describes five principles for improving communication.

  16. Monitoring and assessment in maternal and child health: recommendations for action at the state level.

    PubMed

    Peoples, M D; Miller, C A

    1983-01-01

    Recent administration-sponsored changes in federal health policy and funding may harbor adverse effects for the health of mothers and children, and for the capabilities of state-level programs to serve them appropriately. Careful monitoring is required to assess the nature, extent, and impact of those changes. This paper examines several monitoring efforts in maternal and child health and recommends additional action at the state level to meet urgent information requirements.

  17. 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

  18. The World Health Organization European Health in Prisons Project after 10 years: persistent barriers and achievements.

    PubMed

    Gatherer, Alex; Moller, Lars; Hayton, Paul

    2005-10-01

    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.

  19. Mental health consumer parents' recommendations for designing psychoeducation interventions for their minor children.

    PubMed

    Riebschleger, Joanne; Onaga, Esther; Tableman, Betty; Bybee, Deborah

    2014-09-01

    This research explores consumer parents' recommendations for developing psychoeducation programs for their minor children. Data were drawn from a purposive sample of 3 focus groups of parent consumers of a community mental health agency. The research question was: "What do consumer parents recommend for developing psychoeducation programs for their minor children?" Parents recommended content foci of mental illness, recovery, heritability, stigma, and coping. The next step is youth psychoeducation intervention development and evaluation. Parents, youth, and professionals should be included in the program planning. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  20. A national agenda for public health informatics: summarized recommendations from the 2001 AMIA Spring Congress.

    PubMed

    Yasnoff, W A; Overhage, J M; Humphreys, B L; LaVenture, M

    2001-01-01

    The AMIA 2001 Spring Congress brought together members of the the public health and informatics communities to develop a national agenda for public health informatics. Discussions of funding and governance; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; and training and workforce resulted in 74 recommendations with two key themes-that all stakeholders need to be engaged in coordinated activities related to public health information architecture, standards, confidentiality, best practices, and research; and that informatics training is needed throughout the public health workforce. Implementation of this consensus agenda will help promote progress in the application of information technology to improve public health.

  1. 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.

  2. Ethics Guide Recommendations for Organ-Donation-Focused Physicians: Endorsed by the Canadian Medical Association.

    PubMed

    Shemie, Sam D; Simpson, Christy; Blackmer, Jeff; MacDonald, Shavaun; Dhanani, Sonny; Torrance, Sylvia; Byrne, Paul

    2017-05-01

    Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services. In anticipation of actual, potential or perceived ethical challenges with the role, Canadian Blood Services in partnership with the Canadian Medical Association organized the development of an evidence-informed consensus process of donation experts and bioethicists to produce an ethics guide. This guide includes overarching principles and benefits of the DP role, and recommendations in regard to communication with families, role disclosure, consent discussions, interprofessional conflicts, conscientious objection, death determination, donation specific clinical practices in neurological determination of death and donation after circulatory death, end-of-life care, performance metrics, resources and remuneration. Although this report is intended to inform donation physician practices, it is recognized that the recommendations may have applicability to other professionals (eg, physicians in intensive care, emergency medicine, neurology, neurosurgery, pulmonology) who may also participate in the end-of-life care of potential donors in various clinical settings. It is hoped that this guidance will assist practitioners and their sponsoring organizations in preserving their duty of care, protecting the interests of dying patients, and fulfilling best practices for organ and tissue donation.

  3. The Future of Public Health Informatics: Alternative Scenarios and Recommended Strategies

    PubMed Central

    Edmunds, Margo; Thorpe, Lorna; Sepulveda, Martin; Bezold, Clem; Ross, David A.

    2014-01-01

    Background: In October 2013, the Public Health Informatics Institute (PHII) and Institute for Alternative Futures (IAF) convened a multidisciplinary group of experts to evaluate forces shaping public health informatics (PHI) in the United States, with the aim of identifying upcoming challenges and opportunities. The PHI workshop was funded by the Robert Wood Johnson Foundation as part of its larger strategic planning process for public health and primary care. Workshop Context: During the two-day workshop, nine experts from the public and private sectors analyzed and discussed the implications of four scenarios regarding the United States economy, health care system, information technology (IT) sector, and their potential impacts on public health in the next 10 years, by 2023. Workshop participants considered the potential role of the public health sector in addressing population health challenges in each scenario, and then identified specific informatics goals and strategies needed for the sector to succeed in this role. Recommendations and Conclusion: Participants developed recommendations for the public health informatics field and for public health overall in the coming decade. These included the need to rely more heavily on intersectoral collaborations across public and private sectors, to improve data infrastructure and workforce capacity at all levels of the public health enterprise, to expand the evidence base regarding effectiveness of informatics-based public health initiatives, and to communicate strategically with elected officials and other key stakeholders regarding the potential for informatics-based solutions to have an impact on population health. PMID:25848630

  4. [Methodological limitations and recommendations in publications on migrant population health in Spain].

    PubMed

    Monge, Susana; Ronda, Elena; Pons-Vigués, Mariona; Vives Cases, Carmen; Malmusi, Davide; Gil-González, Diana

    2015-01-01

    Our objective was to describe the methodological limitations and recommendations identified by authors of original articles on immigration and health in Spain. A literature review was conducted of original articles published in Spanish or English between 1998 and 2012 combining keywords on immigration and health. A total of 311 articles were included; of these, 176 (56.6%) mentioned limitations, and 15 (4.8%) made recommendations. The most frequently mentioned limitations included the following: reduced sample sizes; internal validity and sample representativeness issues, with under- or overrepresentation of specific groups; problems of validity of the collected information and missing data mostly related to measurement tools; and absence of key variables for adjustment or stratification. Based on these results, a series of recommendations are proposed to minimise common limitations and advance the quality of scientific production on immigration and health in our setting. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  5. 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. © The Author(s) 2014.

  6. Expert Panel Recommendations on Lower Urinary Tract Health of Women Across Their Life Span

    PubMed Central

    Losada, Liliana; Amundsen, Cindy L.; Ashton-Miller, James; Chai, Toby; Close, Clare; Damaser, Margot; DiSanto, Michael; Dmochowski, Roger; Fraser, Matthew O.; Kielb, Stephanie J.; Kuchel, George; Mueller, Elizabeth R.; Parker-Autry, Candace; Wolfe, Alan J.

    2016-01-01

    Abstract Urologic and kidney problems are common in women across their life span and affect their daily life, including physical activity, sexual relations, social life, and future health. Urological health in women is still understudied and the underlying mechanisms of female urological dysfunctions are not fully understood. The Society for Women's Health Research (SWHR®) recognized the need to have a roundtable discussion where researchers and clinicians would define the current state of knowledge, gaps, and recommendations for future research directions to transform women's urological health. This report summarizes the discussions, which focused on epidemiology, clinical presentation, basic science, prevention strategies, and efficacy of current therapies. Experts around the table agreed on a set of research, education, and policy recommendations that have the potential to dramatically increase awareness and improve women's urological health at all stages of life. PMID:27285829

  7. Report of recommendations: the Annapolis Coalition Conference on Behavioral Health Work Force Competencies.

    PubMed

    Hoge, Michael A; Morris, John A; Daniels, Allen S; Huey, Leighton Y; Stuart, Gail W; Adams, Neal; Paris, Manuel; Goplerud, Eric; Horgan, Constance M; Kaplan, Linda; Storti, Susan A; Dodge, Joan M

    2005-01-01

    In May 2004, the Annapolis Coalition on Behavioral Health Workforce Education convened a national meeting on the identification and assessment of competencies. The Conference on Behavioral Health Workforce Competencies brought leading consumer and family advocates together with other experts on competencies from diverse disciplines and specialties in the fields of both mental health care and substance use disorders treatment. Aided by experts on competency development in business and medicine, conference participants have generated 10 consensus recommendations to guide the future development of workforce competencies in behavioral health. This article outlines those recommendations. A collaborative effort to identify a set of core or common competencies is envisioned as a key strategy for advancing behavioral health education, training, and other workforce development initiatives.

  8. A comparison of Child Health Programmes recommended for preschool children in selected high-income countries.

    PubMed

    Wood, Rachael; Blair, Mitch

    2014-09-01

    The UK Child Health Programme (CHP) aims to ensure that children attain their development and health potential. It comprises a series of proactive child health reviews incorporating growth and development surveillance and health promotion; routine immunizations; and certain screening tests, and is offered to all children. The evidence underpinning different elements of the CHP varies from robust to sparse, and consequently there is uncertainty about optimal programme design. This study aimed to compare the CHP currently recommended in the UK with that recommended in selected other high-income countries in order to inform ongoing CHP policy development. The CHP recommended for preschool children in the UK was compared with that in Australia; Canada; the USA; and Sweden using a combination of literature review, focused website searches, and consultation with experts in the countries studied. Delivery, content, and uptake of child health reviews, immunizations, and screening were considered. All the countries studied recommend CHP services including child health reviews, immunizations, and screening to their preschool populations. Despite this superficial uniformity, considerable variation exists between countries in the detail of CHP delivery and content. The UK programme is relatively narrow in scope, offering the fewest child health reviews, a relatively restricted immunization programme (although some expansion is planned), and limited newborn bloodspot screening. Internationally comparable data on the uptake/coverage of CHP services are patchy: the available information suggests substantial variation between and within countries in the uptake of child health reviews. In the absence of uncontested evidence on the 'ideal' CHP for preschool children, demonstrating variation between countries in recommended programmes provides valuable contextual information for policy makers. Further work looking at relationships between CHP services and children's outcomes would

  9. A case study of organizational decline: lessons for health care organizations.

    PubMed

    Crow, Stephen M; Hartman, Sandra J

    2003-01-01

    This case study reports on an organizational decline situation involving a historically well-known and respected professional organization outside the health care field, with the intention of pointing to several implications for health care. We begin by discussing the results of a survey that involved both members of the organization and "outsiders." Our primary finding, both in the survey and in presenting the results to the membership, was that while those outside the organization perceived the organization as increasingly irrelevant and in decline, those inside it reacted with defensiveness to "meddling by outsiders." We then reviewed the literature on decline, with emphasis upon important findings by Guy, to further understand our results and to make recommendations. We then turn to the situation in health care organizations and point out why some organizations may be at risk and conclude with a series of recommendations with emphasis on health care.

  10. Provider Perceptions of Parent Health Literacy and Effect on Asthma Treatment Recommendations and Instructions

    PubMed Central

    Haven, Kristen M.; Bailey, William C.; Gerald, Lynn B.

    2013-01-01

    Little is known about how pediatric providers assess parental health literacy, how concordant they are with validated measures of health literacy, and how these perceptions may influence treatment recommendations, how instructions are given or how reliable they perceive parents to be in carrying out instructions. Two hundred and eighty-one parents of 6–12-year-old asthma patients attending a pediatric clinic visit were recruited to a cross-sectional study of health literacy and asthma outcomes. Fourteen pediatric healthcare providers participated. Parents completed surveys that included 2 measures of health literacy: the Test of Function Health Literacy in Adults (TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). Immediately postvisit, pediatric providers completed a brief survey asking their assessment of the parent's health literacy and how it impacted treatment instructions and recommendations. Kappa statistics tested concordance; chi square and logistic regression tested associations among provider ratings, rating concordance, and demographic factors. Six providers were interviewed regarding the bases for their ratings. Providers' perceptions influenced asthma treatment recommendations (p=0.001) and how treatment instructions were given (p=0.001). Providers indicated that their perceptions were shaped by parent's verbal communication skills and patterns of past behavior related to children's asthma management. Data from 277 parents indicated that most had adequate health literacy with a lower percentage scored as adequate by the REALM versus the TOFHLA. Pediatric provider estimates of parental health literacy had low concordance with the validated measures. Providers were more likely to designate whites as adequately health literate. Pediatric asthma providers' perceptions of parents' health literacy can influence treatment recommendations and instructional practices. PMID:23781393

  11. Provider Perceptions of Parent Health Literacy and Effect on Asthma Treatment Recommendations and Instructions.

    PubMed

    Harrington, Kathleen F; Haven, Kristen M; Bailey, William C; Gerald, Lynn B

    2013-06-01

    Little is known about how pediatric providers assess parental health literacy, how concordant they are with validated measures of health literacy, and how these perceptions may influence treatment recommendations, how instructions are given or how reliable they perceive parents to be in carrying out instructions. Two hundred and eighty-one parents of 6-12-year-old asthma patients attending a pediatric clinic visit were recruited to a cross-sectional study of health literacy and asthma outcomes. Fourteen pediatric healthcare providers participated. Parents completed surveys that included 2 measures of health literacy: the Test of Function Health Literacy in Adults (TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). Immediately postvisit, pediatric providers completed a brief survey asking their assessment of the parent's health literacy and how it impacted treatment instructions and recommendations. Kappa statistics tested concordance; chi square and logistic regression tested associations among provider ratings, rating concordance, and demographic factors. Six providers were interviewed regarding the bases for their ratings. Providers' perceptions influenced asthma treatment recommendations (p=0.001) and how treatment instructions were given (p=0.001). Providers indicated that their perceptions were shaped by parent's verbal communication skills and patterns of past behavior related to children's asthma management. Data from 277 parents indicated that most had adequate health literacy with a lower percentage scored as adequate by the REALM versus the TOFHLA. Pediatric provider estimates of parental health literacy had low concordance with the validated measures. Providers were more likely to designate whites as adequately health literate. Pediatric asthma providers' perceptions of parents' health literacy can influence treatment recommendations and instructional practices.

  12. Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.

    PubMed

    Adler-Milstein, Julia; Embi, Peter J; Middleton, Blackford; Sarkar, Indra Neil; Smith, Jeff

    2017-03-15

    While great progress has been made in digitizing the US health care system, today's health information technology (IT) infrastructure remains largely a collection of systems that are not designed to support a transition to value-based care. In addition, the pursuit of value-based care, in which we deliver better care with better outcomes at lower cost, places new demands on the health care system that our IT infrastructure needs to be able to support. Provider organizations pursuing new models of health care delivery and payment are finding that their electronic systems lack the capabilities needed to succeed. The result is a chasm between the current health IT ecosystem and the health IT ecosystem that is desperately needed.In this paper, we identify a set of focal goals and associated near-term achievable actions that are critical to pursue in order to enable the health IT ecosystem to meet the acute needs of modern health care delivery. These ideas emerged from discussions that occurred during the 2015 American Medical Informatics Association Policy Invitational Meeting. To illustrate the chasm and motivate our recommendations, we created a vignette from the multistakeholder perspectives of a patient, his provider, and researchers/innovators. It describes an idealized scenario in which each stakeholder's needs are supported by an integrated health IT environment. We identify the gaps preventing such a reality today and present associated policy recommendations that serve as a blueprint for critical actions that would enable us to cross the current health IT chasm by leveraging systems and information to routinely deliver high-value care.

  13. Institute of Medicine recommends a continuing professional development institute for U.S. health professions.

    PubMed

    Mazmanian, Paul E

    2010-01-01

    A workforce of knowledgeable professionals is critical to the discovery and application of best health care practices; yet, today in the United States, the professional health workforce is not consistently prepared to provide safe, high-quality health care, even as the nation spends more per capita on health care than any other country. The Institute of Medicine recently recommended creation of a continuing professional development institute (CPDI) supported as a public-private initiative. The CPDI would coordinate and guide efforts that align: (a) content and knowledge among health professions; (b) regulation across states and national continuing professional development (CPD) providers; and (c) the financing of CPD, not only for improving professional performance and patient outcomes, but also for strengthening the scientific basis for the practice of CPD. With a strong scientific foundation, the community of health professions educators and regulators may advance the development of health care practitioners, enhance the discipline of CPD, and improve health outcomes for patients.

  14. Reducing Health Inequities in the U.S.: Recommendations From the NHLBI's Health Inequities Think Tank Meeting.

    PubMed

    Sampson, Uchechukwu K A; Kaplan, Robert M; Cooper, Richard S; Diez Roux, Ana V; Marks, James S; Engelgau, Michael M; Peprah, Emmanuel; Mishoe, Helena; Boulware, L Ebony; Felix, Kaytura L; Califf, Robert M; Flack, John M; Cooper, Lisa A; Gracia, J Nadine; Henderson, Jeffrey A; Davidson, Karina W; Krishnan, Jerry A; Lewis, Tené T; Sanchez, Eduardo; Luban, Naomi L; Vaccarino, Viola; Wong, Winston F; Wright, Jackson T; Meyers, David; Ogedegbe, Olugbenga G; Presley-Cantrell, Letitia; Chambers, David A; Belis, Deshirée; Bennett, Glen C; Boyington, Josephine E; Creazzo, Tony L; de Jesus, Janet M; Krishnamurti, Chitra; Lowden, Mia R; Punturieri, Antonello; Shero, Susan T; Young, Neal S; Zou, Shimian; Mensah, George A

    2016-08-02

    The National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. The panel recommended several specific actions, including: 1) embrace broad and inclusive research themes; 2) develop research platforms that optimize the ability to conduct informative and innovative research, and promote systems science approaches; 3) develop networks of collaborators and stakeholders, and launch transformative studies that can serve as benchmarks; 4) optimize the use of new data sources, platforms, and natural experiments; and 5) develop unique transdisciplinary training programs to build research capacity. Confronting health inequities will require engaging multiple disciplines and sectors (including communities), using systems science, and intervening through combinations of individual, family, provider, health system, and community-targeted approaches. Details of the panel's remarks and recommendations are provided in this report.

  15. Respirators, recommendations, and regulations: the controversy surrounding protection of health care workers from tuberculosis.

    PubMed

    Jarvis, W R; Bolyard, E A; Bozzi, C J; Burwen, D R; Dooley, S W; Martin, L S; Mullan, R J; Simone, P M

    1995-01-15

    Recent nosocomial outbreaks of tuberculosis have increased concern about the occupational acquisition of tuberculosis by health care workers. The Centers for Disease Control and Prevention (CDC), Department of Health and Human Services, and the Occupational Safety and Health Administration, Department of Labor, have issued recommendations and regulations in an effort to decrease health care workers' risk for exposure to patients with infectious tuberculosis. Within the CDC, the National Center for Infectious Diseases, the National Center for Prevention Services, and the National Institute for Occupational Safety and Health collaborated to produce the 1994 Guidelines for Preventing the Transmission of Tuberculosis in Health-Care Facilities. As stated in the Draft Guidelines, the major components of health care worker protection from Mycobacterium tuberculosis infection include administration or source controls, engineering controls, and respiratory protective devices. We review the evolution of the seemingly conflicting recommendations for respiratory protective devices made by these Centers of the CDC and explain how the recommendations in the current CDC Guidelines were reached.

  16. Towards a coherent global framework for health financing: recommendations and recent developments.

    PubMed

    Ottersen, Trygve; Elovainio, Riku; Evans, David B; McCoy, David; Mcintyre, Di; Meheus, Filip; Moon, Suerie; Ooms, Gorik; Røttingen, John-Arne

    2017-04-01

    The articles in this special issue have demonstrated how unprecedented transitions have come with both challenges and opportunities for health financing. Against the background of these challenges and opportunities, the Working Group on Health Financing at the Chatham House Centre on Global Health Security laid out, in 2014, a set of policy responses encapsulated in 20 recommendations for how to make progress towards a coherent global framework for health financing. These recommendations pertain to domestic financing of national health systems, global public goods for health, external financing for national health systems and the cross-cutting issues of accountability and agreement on a new global framework. Since the Working Group concluded its work, multiple events have reinforced the group's recommendations. Among these are the agreement on the Addis Ababa Action Agenda, the adoption of the Sustainable Development Goals, the outbreak of Ebola in West Africa and the release of the Panama Papers. These events also represent new stepping stones towards a new global framework.

  17. Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

    PubMed

    Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas

    2016-01-01

    The Affordable Care Act's marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool--plan recommendations--in improving marketplace decisions. Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia. We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended. Primary data were gathered using an online choice experiment and questionnaire. Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made. As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers' decisions.

  18. Biodiversity and health: Lessons and recommendations from an interdisciplinary conference to advise Southeast Asian research, society and policy.

    PubMed

    Walther, Bruno Andreas; Boëte, Christophe; Binot, Aurélie; By, Youlet; Cappelle, Julien; Carrique-Mas, Juan; Chou, Monidarin; Furey, Neil; Kim, Sothea; Lajaunie, Claire; Lek, Sovan; Méral, Philippe; Neang, Malyne; Tan, Boon-Huan; Walton, Catherine; Morand, Serge

    2016-06-01

    Southeast Asia is an economic, biodiverse, cultural and disease hotspot. Due to rapid socio-economic and environmental changes, the role of biodiversity and ecosystems for human health ought to be examined and communicated to decision-makers and the public. We therefore summarized the lessons and recommendations from an interdisciplinary conference convened in Cambodia in 2014 to advise Southeast Asian societies on current research efforts, future research needs, and to provide suggestions for improved education, training and science-policy interactions. First, we reviewed several examples of the important role of ecosystems as 'sentinels' in the sense that potentially harmful developments for human health become first apparent in ecosystem components. Other ecosystem services which also benefit human well-being are briefly summarized. Second, we summarized the recommendations of the conference's roundtable discussions and added recent developments in the science-policy interface. The recommendations were organized along five themes: Ethical and legal considerations; implementation of the One Health approach; education, training, and capacity building; future research priorities; and potential science-policy interactions. While the role of biodiversity for human health needs further research, especially for zoonoses and emerging diseases, many direct and indirect benefits to human health are already apparent, but have yet to filter down to the science-policy interface in order to influence legislation and enforcement. Therefore, efforts to strengthen the interface in Southeast Asia should become a high priority in order to strengthen the health and resilience of Southeast Asian societies. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Knowledge and likelihood to recommend intrauterine devices for adolescents among school-based health center providers.

    PubMed

    Kohn, Julia E; Hacker, Jordan G; Rousselle, Marissa A; Gold, Marji

    2012-10-01

    The American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention recommend intrauterine devices (IUDs) as safe and highly effective contraceptives for adolescents. Nevertheless, many U.S. providers do not recommend or provide IUDs to adolescents-a population at high risk for unintended pregnancy. The purpose of this study was to identify barriers to IUD provision for adolescents. A 36-item self-administered survey of knowledge and attitudes regarding IUDs was completed by 162 staff of New York City school-based health centers, including 69 clinicians (e.g., pediatricians and nurse practitioners) and 93 nonclinicians (e.g., social workers and health educators). Half (55%) of all respondents would be likely to recommend an IUD to a patient under age 20 years. Respondents were less likely to recommend an IUD for patients with history of recent STD (31%), remote pelvic inflammatory disease (37%), and patients not in a monogamous relationship (38%). Whereas 77% of respondents indicated that IUDs are safe for adolescents, 18% of those respondents would be unlikely to recommend an IUD to a patient under age 20 years. While 86% of respondents knew that IUDs can be used in nulliparous women, 25% of those respondents would be unlikely to recommend an IUD to a patient who has never been pregnant. Additionally, 61% believed that counseling patients about IUDs would take more time than other methods. Misinformation about risks associated with IUDs and beliefs about patient eligibility may present barriers to provision. Apparent contradictions between knowledge and likelihood to recommend IUDs warrant further study. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Using Simulations to Improve Electronic Health Record Use, Clinician Training and Patient Safety: Recommendations From A Consensus Conference

    PubMed Central

    Mohan, Vishnu; Woodcock, Deborah; McGrath, Karess; Scholl, Gretchen; Pranaat, Robert; Doberne, Julie W.; Chase, Dian A.; Gold, Jeffrey A.; Ash, Joan S.

    2016-01-01

    A group of informatics experts in simulation, biomedical informatics, patient safety, medical education, and human factors gathered at Corbett, Oregon on April 30 and May 1, 2015. Their objective: to create a consensus statement on best practices for the use of electronic health record (EHR) simulations in education and training, to improve patient safety, and to outline a strategy for future EHR simulation work. A qualitative approach was utilized to analyze data from the conference and generate recommendations in five major categories: (1) Safety, (2) Education and Training, (3) People and Organizations, (4) Usability and Design, and (5) Sociotechnical Aspects. PMID:28269887

  1. Collecting Comparative Data on Farmworker Housing and Health: Recommendations for Collecting Housing and Health Data Across Places and Time.

    PubMed

    Arcury, Thomas A; Gabbard, Susan; Bell, Bryan; Casanova, Vanessa; Flocks, Joan D; Swanberg, Jennifer E; Wiggins, Melinda F

    2015-11-01

    The substandard nature of the housing in which most farmworkers live has detrimental effects on their health, as well as on their children's health and development. However, little research has directly documented associations between farmworker housing and health; existing research is not always comparable due to differences in design and measurement. Comparative data can help determine actual causal links between housing characteristics and farmworker health and help to evaluate the efficacy of current housing policy. The goal of this paper is to provide guidelines promoting comparable research on farmworker housing and the association of this housing with health. This paper reviews general concepts relevant to measuring farmworker housing and health, issues that should be considered in designing farmworker housing and health research, data collection methods, and measures. It concludes with recommendations for a research agenda on farmworker housing and health.

  2. HEALTH OCCUPATIONS SUPPORTIVE TO NURSING, A STATEMENT OF POLICIES AND RECOMMENDATIONS.

    ERIC Educational Resources Information Center

    American Nurses' Association, New York, NY.

    TO SOLVE THE NURSING PERSONNEL SHORTAGE, THE AMERICAN NURSES' ASSOCIATION RECOMMENDED--(1) THE FIRST PRIORITY FOR FEDERAL MONIES FOR TRAINING HEALTH WORKERS FOR NURSING SERVICES SHOULD BE TO PREPARE REGISTERED NURSES FOR TEACHING, SUPERVISION, AND ADMINISTRATION, (2) A CONCERTED EFFORT SHOULD BE MADE TO RECRUIT YOUNG PEOPLE AND TO ATTRACT INACTIVE…

  3. Physical Activity Patterns among Walkers and Compliance with Public Health Recommendations.

    ERIC Educational Resources Information Center

    Rafferty, Ann P.; Reeves, Mathew J.; McGee, Harry B.; Pivarnik, James M.

    2002-01-01

    Assessed data from the 1998 Behavioral Risk Factor Surveillance System to determine the prevalence of walking for physical activity and the proportions of walkers who met current public health physical activity recommendations. Results indicated that in 1998, approximately 38.6 percent of U.S. adults walked for physical activity. Less than 40…

  4. A Systematic Review of Public Health-Aligned Recommendations for Preparing Physical Education Teacher Candidates

    ERIC Educational Resources Information Center

    Webster, Collin A.; Webster, Liana; Russ, Laura; Molina, Sergio; Lee, Heesu; Cribbs, Jason

    2015-01-01

    Purpose: Since Sallis and McKenzie's seminal article in 1991 outlining physical education's role in public health, increased attention has been given to promoting youth physical activity in schools. The present study systematically reviewed the literature from 1991 to 2013 to identify recommendations for the preparation of physical…

  5. A Systematic Review of Public Health-Aligned Recommendations for Preparing Physical Education Teacher Candidates

    ERIC Educational Resources Information Center

    Webster, Collin A.; Webster, Liana; Russ, Laura; Molina, Sergio; Lee, Heesu; Cribbs, Jason

    2015-01-01

    Purpose: Since Sallis and McKenzie's seminal article in 1991 outlining physical education's role in public health, increased attention has been given to promoting youth physical activity in schools. The present study systematically reviewed the literature from 1991 to 2013 to identify recommendations for the preparation of physical…

  6. A Health Website Recommendation from Gold Coast General Practitioners to Their Patients: A Mixed Method Approach

    ERIC Educational Resources Information Center

    Usher, Wayne

    2011-01-01

    Introduction: To identify health website recommendation trends by Gold Coast (Australia) general practitioners (GPs) to their patients. Method: A mixed method approach to data collection and analysis was employed. Quantitative data were collected using a prepaid postal survey, consisting of 17 questions, mailed to 250 (61 per cent) of 410 GPs on…

  7. Recommendations of Community Pharmacists and Health Food Store Employees Regarding Undiagnosed Symptoms of Diabetes

    PubMed Central

    Kavalieratos, Dio; Weinberger, Morris

    2010-01-01

    ABSTRACT BACKGROUND Consumers may seek health advice from health food store employees (HFSEs) and pharmacists. Delays in the diagnosis of time-critical illnesses may increase the likelihood of morbidity, mortality and healthcare expenditures. OBJECTIVE To describe the information provided by HFSEs and pharmacists for symptoms of undiagnosed Type 1 diabetes. DESIGN A standardized actor portrayed a consumer with symptoms of Type 1 diabetes at eight community pharmacies and 12 health food stores (HFSs) in Pittsburgh, Pennsylvania, and Chapel Hill and Durham, North Carolina. He inquired about potential diagnoses, the need to see a physician, and product recommendations. SUBJECTS The subjects included twelve HFSEs and eight licensed pharmacists. RESULTS Four of eight (50%) pharmacists and two of 12 (17%) HFSEs mentioned diabetes as a potential diagnosis. Although six pharmacists recommended urgent physician follow-up, only two HFSEs did so; two HFSEs explicitly advised against a physician visit. One pharmacist recommended a product. Nine HFSEs recommended at least one product (monthly costs, range: $24.70–$209.96). CONCLUSIONS Even when presented with classic symptoms of Type 1 diabetes, under-recognition of diabetes was common among HFSEs and community pharmacists. Delays in treatment present a health risk to consumers. Further research could confirm these results and inform educational interventions to improve diabetes recognition by both groups. PMID:20361270

  8. Women's Health in the Baccalaureate Nursing School Curriculum: Report of a Survey and Recommendations.

    ERIC Educational Resources Information Center

    National Inst. of Nursing Research (NIH), Bethesda, MD.

    This report presents the analytical results of a survey of U.S. baccalaureate nursing schools conducted during 1999 by the American Colleges of Nursing with a description of the extent of women's health content in the curriculum and selected recommendations designed to strengthen this content. Additional resources are included that describe the…

  9. Evaluation of the soil health nutrient tool for corn nitrogen recommendations across the Midwest

    USDA-ARS?s Scientific Manuscript database

    Use and development of soil biological tests for estimating soil N availability and subsequently corn (Zea mays L.) fertilizer N recommendations is garnering considerable interest. The objective of this research was to evaluate relationships between the Soil Health Nutrient Tool (SHNT), also known a...

  10. Strategies and recommendations for addressing forest health issues in the Blue Mountains of Oregon and Washington.

    Treesearch

    J.A. Tanaka; G.L. Starr; T.M. Quigley

    1995-01-01

    The Blue Mountains Natural Resources Institute held three types of meetings to obtain public and scientific input into the development of strategies and recommendations for addressing forest health issues in the Blue Mountains of Oregon and Washington. Seven strategies are proposed: (1) plan and implement management activities on a landscape level; (2) enhance training...

  11. A Health Website Recommendation from Gold Coast General Practitioners to Their Patients: A Mixed Method Approach

    ERIC Educational Resources Information Center

    Usher, Wayne

    2011-01-01

    Introduction: To identify health website recommendation trends by Gold Coast (Australia) general practitioners (GPs) to their patients. Method: A mixed method approach to data collection and analysis was employed. Quantitative data were collected using a prepaid postal survey, consisting of 17 questions, mailed to 250 (61 per cent) of 410 GPs on…

  12. Commentary: Recommendations and remaining questions for health care leadership training programs.

    PubMed

    Stoller, James K

    2013-01-01

    Effective leadership is critical for optimizing cost, access, and quality in health care. Creating a pipeline of effective health care leaders requires developing leadership competencies that differ from the usual criteria of clinical and scientific excellence by which physicians have traditionally been promoted to leadership positions. Specific competencies that differentiate effective leaders from average leaders, especially emotional intelligence and its component abilities, are essential for effective leadership.Adopting a long-standing practice from successful corporations, some health care institutions, medical societies, and business schools now offer leadership programs that address these differentiating leadership competencies. The author draws on experience with such programs through the Cleveland Clinic Academy to provide recommendations for health care leadership training and to identify unanswered questions about such programs.The author recommends that such training should be broadly available to all health care leadership communities (i.e., nurses, administrators, and physicians). A progressive curriculum, starting with foundational concepts and extending to coaching and feedback opportunities through experiential learning, recognizes the challenge of becoming an effective leader and the long time line needed to do so. Linking leadership courses to continuing medical education and to graduate credit opportunities is appealing to participants. Other recommendations focus on the importance of current leaders' involvement in nominating emerging leaders for participation, embedding leadership development discussions in faculty's professional reviews, and blending discussion of frameworks and theory with practical, experiential lessons. The author identifies questions about the benefits of formal health care leadership training that remain to be answered.

  13. Applying the WHO recommendations on health-sector response to violence against women to assess the Spanish health system. A mixed methods approach.

    PubMed

    Goicolea, Isabel; Vives-Cases, Carmen; Minvielle, Fauhn; Briones-Vozmediano, Erica; Ohman, Ann

    2014-01-01

    This methodological note describes the development and application of a mixed-methods protocol to assess the responsiveness of Spanish health systems to violence against women in Spain, based on the World Health Organization (WHO) recommendations. Five areas for exploration were identified based on the WHO recommendations: policy environment, protocols, training, accountability/monitoring, and prevention/promotion. Two data collection instruments were developed to assess the situation of 17 Spanish regional health systems (RHS) with respect to these areas: 1) a set of indicators to guide a systematic review of secondary sources, and 2) an interview guide to be used with 26 key informants at the regional and national levels. We found differences between RHSs in the five areas assessed. The progress of RHSs on the WHO recommendations was notable at the level of policies, moderate in terms of health service delivery, and very limited in terms of preventive actions. Using a mixed-methods approach was useful for triangulation and complementarity during instrument design, data collection and interpretation. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Management of cytomegalovirus infection in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations.

    PubMed

    Torre-Cisneros, J; Aguado, J M; Caston, J J; Almenar, L; Alonso, A; Cantisán, S; Carratalá, J; Cervera, C; Cordero, E; Fariñas, M C; Fernández-Ruiz, M; Fortún, J; Frauca, E; Gavaldá, J; Hernández, D; Herrero, I; Len, O; Lopez-Medrano, F; Manito, N; Marcos, M A; Martín-Dávila, P; Monforte, V; Montejo, M; Moreno, A; Muñoz, P; Navarro, D; Pérez-Romero, P; Rodriguez-Bernot, A; Rumbao, J; San Juan, R; Vaquero, J M; Vidal, E

    2016-07-01

    Cytomegalovirus (CMV) infection remains a major complication of solid organ transplantation. Because of management of CMV is variable among transplant centers, in 2011 the Spanish Transplantation Infection Study Group (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) developed consensus guidelines for the prevention and treatment of CMV infection in solid organ transplant recipients. Since then, new publications have clarified or questioned the aspects covered in the previous document. For that reason, a panel of experts revised the evidence on CMV management, including immunological monitoring, diagnostics, prevention, vaccines, indirect effects, treatment, drug resistance, immunotherapy, investigational drugs, and pediatric issues. This document summarizes the recommendations. Copyright © 2016. Published by Elsevier Inc.

  15. 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.

  16. Policy and science in children's health and environment: recommendations from the PINCHE project.

    PubMed

    van den Hazel, Peter; Zuurbier, Moniek; Bistrup, Marie Louise; Busby, Chris; Fucic, Aleksandra; Koppe, Janna G; Lundqvist, Christofer; Ronchetti, Roberto; ten Tusscher, Gavin

    2006-10-01

    Policy recommendations result from the discussions and analysis of the present situation in environment and health. Such analysis was performed in PINCHE. This led to recommendations based on the scientific literature. In the field of children's environmental health the policy process will follow more or less fixed rules, but this process is still at an early level of development. The link between science and policy still faces many challenges. Scientific assessment of environmental risk must recognize and tackle the problems of data sets, variability of human and environmental systems, the range, spatial and temporal diffusion of potential health effects and many biases and confounding factors. The PINCHE network recommends a general improvement of the supporting scientific fields in environment and health. Assessments from epidemiology or toxicology should play a key role in influencing science-policy decisions in programmes that are intended to inform the public policy process. Scientific committees at a local level could play a role. The relation between health and environment needs to be better incorporated in training and education. There is a need for harmonization of data production and use. The priorities in PINCHE focus on the most important issues. A classification of low, medium or high priority for action was used to describe a range of different environmental stressors. PINCHE provided recommendations to reduce exposure for children. Exposure reduction is not always linked to improved health in the short term, but it will reduce the body burden of accumulating chemicals in children. A strategic choice is reduction of exposure of children to compounds by changing production techniques or by increasing the distance of child specific settings to sources. The contribution of all players in the production, distribution and use of scientific knowledge in the field of children's environmental health is necessary.

  17. 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.

  18. The World Health Organization "Rehabilitation 2030: a call for action".

    PubMed

    Gimigliano, Francesca; Negrini, Stefano

    2017-04-04

    February 6th and 7th of year 2017 might be remembered in the future of rehabilitation. In fact, in these two days the World Health Organization (WHO) has called in the Executive Board Room of WHO headquarters in Geneva, Switzerland, more than 200 people representing the rehabilitation stakeholders. The aims were to a launch "Rehabilitation 2030 - a call for action" and to present the WHO Recommendations on rehabilitation in health systems. These initiatives are meant to draw attention to the increasing needs for rehabilitation in the world; to highlight the role of rehabilitation in achieving the Sustainable Development Goals proposed by the United Nations; to call for coordinated and concerted global action towards strengthening rehabilitation in health systems. The aim of this paper is to present in detail the scientific events of these 2 days that will very likely mark the history of rehabilitation.

  19. Organ donor management: Eight common recommendations and actions that deserve reflection.

    PubMed

    Chamorro-Jambrina, C; Muñoz-Ramírez, M R; Martínez-Melgar, J L; Pérez-Cornejo, M S

    2017-03-16

    Despite major advances in our understanding of the physiopathology of brain death (BD), there are important controversies as to which protocol is the most appropriate for organ donor management. Many recent reviews on this subject offer recommendations that are sometimes contradictory and in some cases are not applied to other critically ill patients. This article offers a review of the publications (many of them recent) with an impact upon these controversial measures and which can help to confirm, refute or open new areas of research into the most appropriate measures for the management of organ donors in BD, and which should contribute to discard certain established recommendations based on preconceived ideas, that lead to actions lacking a physiopathological basis. Aspects such as catecholamine storm management, use of vasoactive drugs, hemodynamic objectives and monitoring, assessment of the heart for donation, and general care of the donor in BD are reviewed. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  20. [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. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  1. 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.…

  2. 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.…

  3. Improving Clinical Workflow in Ambulatory Care: Implemented Recommendations in an Innovation Prototype for the Veteran’s Health Administration

    PubMed Central

    Patterson, Emily S.; Lowry, Svetlana Z.; Ramaiah, Mala; Gibbons, Michael C.; Brick, David; Calco, Robert; Matton, Greg; Miller, Anne; Makar, Ellen; Ferrer, Jorge A.

    2015-01-01

    Introduction: Human factors workflow analyses in healthcare settings prior to technology implemented are recommended to improve workflow in ambulatory care settings. In this paper we describe how insights from a workflow analysis conducted by NIST were implemented in a software prototype developed for a Veteran’s Health Administration (VHA) VAi2 innovation project and associated lessons learned. Methods: We organize the original recommendations and associated stages and steps visualized in process maps from NIST and the VA’s lessons learned from implementing the recommendations in the VAi2 prototype according to four stages: 1) before the patient visit, 2) during the visit, 3) discharge, and 4) visit documentation. NIST recommendations to improve workflow in ambulatory care (outpatient) settings and process map representations were based on reflective statements collected during one-hour discussions with three physicians. The development of the VAi2 prototype was conducted initially independently from the NIST recommendations, but at a midpoint in the process development, all of the implementation elements were compared with the NIST recommendations and lessons learned were documented. Findings: Story-based displays and templates with default preliminary order sets were used to support scheduling, time-critical notifications, drafting medication orders, and supporting a diagnosis-based workflow. These templates enabled customization to the level of diagnostic uncertainty. Functionality was designed to support cooperative work across interdisciplinary team members, including shared documentation sessions with tracking of text modifications, medication lists, and patient education features. Displays were customized to the role and included access for consultants and site-defined educator teams. Discussion: Workflow, usability, and patient safety can be enhanced through clinician-centered design of electronic health records. The lessons learned from implementing

  4. The Use of Social Networking Sites (SNSs) in Health Communication Campaigns: Review and Recommendations.

    PubMed

    Shi, Jingyuan; Poorisat, Thanomwong; Salmon, Charles T

    2016-11-18

    The past decade has witnessed a rapid increase in the use of Social Networking Sites (SNSs) in health communication campaigns seeking to achieve an ambitious range of health-related impacts. This article provides a review of 40 studies and research protocols, with a focus on two key factors that differentiate SNSs from more traditional health communication approaches of the past. The first is the potential dualism between message sender and receiver, in which receivers become receiver-sources who forward and amplify the content and reach of health messages. The second is the potential dualism between message and message impact, in which the act of forwarding and modifying messages by receiver-sources itself becomes a measure of message impact. Each of these dualisms has implications for the design and evaluation of contemporary health communication campaigns. The review concludes with a series of observations and recommendations for future health communication research.

  5. The Science of Eliminating Health Disparities: Summary and Analysis of the NIH Summit Recommendations

    PubMed Central

    Rhee, Kyu B.; Williams, Kester; Sanchez, Idalia; Sy, Francisco S.; Stinson, Nathaniel; Ruffin, John

    2010-01-01

    In December 2008, the National Institutes of Health (NIH) sponsored the first NIH Summit showcasing its investment and contribution to health disparities research and unveiling a framework for moving this important field forward. The Summit, titled “The Science of Eliminating Health Disparities,” drew on extensive experience of experts leading health disparities research transformation in diverse fields. The Summit also provided a historic educational opportunity to contribute to health care reform. The theme, addressing disparities through integration of science, practice, and policy, introduced a paradigm for advancing research through transformational, translational, and transdisciplinary research. Engaging active participation throughout the Summit generated recommendations bridging science, practice, and policy, including action on social determinants of health, community engagement, broad partnerships, capacity-building, and media outreach. PMID:20147660

  6. The science of eliminating health disparities: summary and analysis of the NIH summit recommendations.

    PubMed

    Dankwa-Mullan, Irene; Rhee, Kyu B; Williams, Kester; Sanchez, Idalia; Sy, Francisco S; Stinson, Nathaniel; Ruffin, John

    2010-04-01

    In December 2008, the National Institutes of Health (NIH) sponsored the first NIH Summit showcasing its investment and contribution to health disparities research and unveiling a framework for moving this important field forward. The Summit, titled "The Science of Eliminating Health Disparities," drew on extensive experience of experts leading health disparities research transformation in diverse fields. The Summit also provided a historic educational opportunity to contribute to health care reform. The theme, addressing disparities through integration of science, practice, and policy, introduced a paradigm for advancing research through transformational, translational, and transdisciplinary research. Engaging active participation throughout the Summit generated recommendations bridging science, practice, and policy, including action on social determinants of health, community engagement, broad partnerships, capacity-building, and media outreach.

  7. A systematic review of public health-aligned recommendations for preparing physical education teacher candidates.

    PubMed

    Webster, Collin A; Webster, Liana; Russ, Laura; Molina, Sergio; Lee, Heesu; Cribbs, Jason

    2015-03-01

    Since Sallis and McKenzie's seminal article in 1991 outlining physical education's role in public health, increased attention has been given to promoting youth physical activity in schools. The present study systematically reviewed the literature from 1991 to 2013 to identify recommendations for the preparation of physical education teacher candidates (PETCs) from a public health perspective. Eight online databases (e.g., Educational Resources Information Center, Google Scholar) served as data sources for the study. Multiple combinations of key terms (e.g., physical education teacher education [PETE], public health, health-oriented) were used to identify relevant literature meeting search criteria. A content analysis was used to identify 47 distinct recommendations from 25 included articles and to synthesize these recommendations into major areas of focus. Three major areas of focus were identified: (a) candidate profile (e.g., PETCs should be physically active and fit role models), (b) candidate knowledge (e.g., PETCs should know about behavior change theories), and (c) candidate skills (e.g., PETCs should be able to advocate for school-based physical activity). This review can serve as a blueprint for PETE programs seeking to align professional preparation with public health goals.

  8. A WWW Implementation of National Recommendations for Protecting Electronic Health Information

    PubMed Central

    Halamka, John D.; Szolovits, Peter; Rind, David; Safran, Charles

    1997-01-01

    Abstract In March of 1997, the National Research Council (NRC) of the National Academy of Sciences issued the report, “For the Record: Protecting Electronic Health Information.” Concluding that the current practices at the majority of health care facilities in the United States are insufficient, the Council delineated both technical and organizational approaches to protecting electronic health information. The Beth Israel Deaconess Medical Center recently implemented a proof-of-concept, Web-based, cross-institutional medical record, CareWeb, which incorporates the NRC security and confidentiality recommendations. We report on our WWW implementation of the NRC recommendations and an initial evaluation of the balance between ease of use and confidentiality. PMID:9391933

  9. Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

    PubMed Central

    Barnes, Andrew J.; Hanoch, Yaniv; Rice, Thomas

    2016-01-01

    Objective The Affordable Care Act’s marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool—plan recommendations—in improving marketplace decisions. Study Setting Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia. Study Design We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended. Data Collection Primary data were gathered using an online choice experiment and questionnaire. Principal Findings Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made. Conclusions As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers’ decisions. PMID:27028008

  10. Recommendations for further improvement of the deceased organ donation process in Belgium.

    PubMed

    Hoste, Pieter; Ferdinande, Patrick; Hoste, Eric; Vanhaecht, Kris; Rogiers, Xavier; Eeckloo, Kristof; Van Deynse, Dominique; Ledoux, Didier; Vandewoude, Koenraad; Vogelaers, Dirk

    2016-10-01

    Belgium has achieved high deceased organ donation rates but according to the medical record data in the Donor Action database, deceased potential donors are still missed along the pathway. Between 2010 and 2014, 12.9 ± 3.3% of the potential donors after brain death (DBD) and 24.6 ± 1.8% of the potential donors after circulatory (DCD) death were not identified. Conversion rates of 41.7 ± 2.1% for DBD and 7.9 ± 0.9% for DCD indicate room for further improvement. We identify and discuss different issues in the monitoring of donation activities, practices and outcomes; donor pool; legislation on deceased organ donation; registration; financial reimbursement; educational and training programs; donor detection and practice clinical guidance. The overall aim of this position paper, elaborated by a Belgian expert panel, is to provide recommendations for further improvement of the deceased organ donation process up to organ procurement in Belgium.

  11. Research priorities for public mental health in Europe: recommendations of the ROAMER project.

    PubMed

    Forsman, Anna K; Wahlbeck, Kristian; Aarø, Leif Edvard; Alonso, Jordi; Barry, Margaret M; Brunn, Matthias; Cardoso, Graça; Cattan, Mima; de Girolamo, Giovanni; Eberhard-Gran, Malin; Evans-Lacko, Sara; Fiorillo, Andrea; Hansson, Lars; Haro, Josep Maria; Hazo, Jean-Baptiste; Hegerl, Ulrich; Katschnig, Heinz; Knappe, Susanne; Luciano, Mario; Miret, Marta; Nordentoft, Merete; Obradors-Tarragó, Carla; Pilgrim, David; Ruud, Torleif; Salize, Hans Joachim; Stewart-Brown, Sarah L; Tómasson, Kristinn; van der Feltz-Cornelis, Christina M; Ventus, Daniel B J; Vuori, Jukka; Värnik, Airi

    2015-04-01

    The ROAdmap for MEntal health Research in Europe project aimed to create an integrated European roadmap for mental health research. Leading mental health research experts across Europe have formulated consensus-based recommendations for future research within the public mental health field. Experts were invited to compile and discuss research priorities in a series of topic-based scientific workshops. In addition, a Delphi process was carried out to reach consensus on the list of research priorities and their rank order. Three web-based surveys were conducted. Nearly 60 experts were involved in the priority setting process. Twenty priorities for public mental health research were identified through the consensus process. The research priorities were divided into summary principles-encompassing overall recommendations for future public mental health research in Europe-and thematic research priorities, including area-specific top priorities on research topics and methods. The priorities represent three overarching goals mirroring societal challenges, that is, to identify causes, risk and protective factors for mental health across the lifespan; to advance the implementation of effective public mental health interventions and to reduce disparities in mental health. The importance of strengthening research on the implementation and dissemination of promotion, prevention and service delivery interventions in the mental health field needs to be emphasized. The complexity of mental health and its broader conceptualisation requires complementary research approaches and interdisciplinary collaboration to better serve the needs of the European population. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  12. [Recommendations for the analysis of cumulated data in antimicrobial susceptibility in health institutions].

    PubMed

    2010-04-01

    Due to the great variability in antimicrobial resistance patterns, local reports of cumulative antimicrobial susceptibility data are necessary in every health center. The purpose is to guide clinical decisions and the early detection of patterns that allow preventive measures to avoid dissemination of resistant strains. The main objective of this guide is to provide recommendations for the analysis of antimicrobial susceptibility data and elaboration of a local report. Recommendations provided in this guide are based on the Clinical and Laboratory Standards Institute (CLSI) document "Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data" (3). Key aspects related to information gathering and data processing, analysis and presentation are described.

  13. [Organizing health care: an ethical perspective].

    PubMed

    2013-06-01

    Health care at population level is a complex problem. Having this in mind, the purpose of this paper is to focus on the goods that are ethically relevant in the process of caring for health at this level. We briefly analyze some of the Chilean health statistics that, although they show important improvements along the years, demonstrate that certain conditions are to be deemed as inadequate by both healthcare providers and patients. Ethics is a central component to determine how to structure and organize health care systems and how they should operate. We emphasize human dignity as an ethical corner stone of the health care system, along with other important values such as justice and humanization, under the scope of the ends of medicine, and other components such as technical competence of providers and the financing of the whole process. We conclude that as far as a health care system is organized in a way that medical practice is well ordered, primarily and fundamentally according the ends of medicine and the good of persons, such a health care system is ethically adequate.

  14. The future of nursing: monitoring the progress of recommended change in hospitals, nurse-led clinics, and home health and hospice agencies.

    PubMed

    Pittman, Patricia; Bass, Emily; Hargraves, John; Herrera, Carolina; Thompson, Pamela

    2015-02-01

    The objective of this study was to assess the implementation of recommendations of the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health. In 2010, the IOM made a series of recommendations aimed at transforming the role of nurses in healthcare delivery. We conducted a multiyear survey, in 2011 and 2013, with nurse leaders who were members of the American Organization of Nurse Executives, the National Nursing Centers Consortium, or the Visiting Nurses Association of America. When comparing 2013 to 2011, we find progress in instituting the IOM's recommendations in 3 areas: (1) raising the proportion of employed RNs with at least a bachelor's degree; (2) expanding the proportion of healthcare institutions with nurse residency programs; and (3) offering opportunities for continuing nurse education Our findings suggest that healthcare organizations are transforming to support the recommendations of the IOM.

  15. 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.

  16. Meeting Recommended Levels of Physical Activity in Relation to Preventive Health Behavior and Health Status Among Adults

    PubMed Central

    2017-01-01

    Objectives The purpose of this study was to examine the relationship of meeting the recommended levels of physical activity (PA) with health status and preventive health behavior in adults. Methods A total of 5630 adults 18 years of age or older were included in this study. PA was assessed using a series of questions that categorized activities based on their metabolic equivalent values and then categorized individuals based on the reported frequency and duration of such activities. Participants reporting 150 minutes or more of moderate-intensity PA per week were considered to have met the PA guidelines. Multiple logistic regression was used to model the relationships between meeting PA guidelines and health status and preventive health behavior, while controlling for confounding variables. Results Overall, 53.9% (95% confidence interval [CI], 51.9 to 55.9%) of adults reported meeting the recommended levels of PA. Among adults with good general health, 56.9% (95% CI, 54.7 to 59.1%) reported meeting the recommended levels of PA versus 43.1% (95% CI, 40.9 to 45.3%) who did not. Adults who met the PA guidelines were significantly more likely not to report high cholesterol, diabetes, chronic obstructive pulmonary disease, arthritis, asthma, depression, or overweight. Furthermore, adults meeting the PA guidelines were significantly more likely to report having health insurance, consuming fruits daily, consuming vegetables daily, and not being a current cigarette smoker. Conclusions In this study, we found meeting the current guidelines for PA to have a protective relationship with both health status and health behavior in adults. Health promotion programs should focus on strategies that help individuals meet the current guidelines of at least 150 minutes per week of moderate-intensity PA. PMID:28173688

  17. Travel vaccination recommendations and endemic infection risks in solid organ transplantation recipients.

    PubMed

    Trubiano, Jason A; Johnson, Douglas; Sohail, Asma; Torresi, Joseph

    2016-06-01

    Solid organ transplant (SOT) recipients are often heavily immunosuppressed and consequently at risk of serious illness from vaccine preventable viral and bacterial infections or with endemic fungal and parasitic infections. We review the literature to provide guidance regarding the timing and appropriateness of vaccination and pathogen avoidance related to the immunological status of SOT recipients. A PUBMED search ([Vaccination OR vaccine] AND/OR ["specific vaccine"] AND/OR [immunology OR immune response OR cytokine OR T lymphocyte] AND transplant was performed. A review of the literature was performed in order to develop recommendations on vaccination for SOT recipients travelling to high-risk destinations. Whilst immunological failure of vaccination in SOT is primarily the result of impaired B-cell responses, the role of T-cells in vaccine failure and success remains unknown. Vaccination should be initiated at least 4 weeks prior to SOT or more than 6 months post-SOT. Avoidance of live vaccination is generally recommended, although some live vaccines may be considered in the specific situations (e.g. yellow fever). The practicing physician requires a detailed understanding of region-specific endemic pathogen risks. We provide a vaccination and endemic pathogen guide for physicians and travel clinics involved in the care of SOT recipients. In addition, recommendations based on timing of anticipated immunological recovery and available evidence regarding vaccine immunogenicity in SOT recipients are provided to help guide pre-travel consultations. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  18. 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.

  19. Health-care providers' perceptions, attitudes towards and recommendation practice of cervical cancer screening.

    PubMed

    Hweissa, N Ab; Lim, J N W; Su, T T

    2016-09-01

    In Libya, cervical cancer is ranked third as the most frequent cancer among women with early diagnosis being shown to reduce morbidity and mortality. Health-care providers can influence women's screening behaviours, and their lack of recommendations for screening can be one of the barriers that affect women's participation in screening programmes. This study aims to assess the health-care provider's perception around cervical cancer screening. In-depth, face-to-face interviews were conducted with 16 health-care providers, from both public and private sectors in Az-Zawiya city, Libya, between February and July of 2014. The interviews were recorded and transcribed, then analysed using thematic analysis. Our findings suggest that health-care providers did not provide sufficient information regarding cervical cancer screening for women who attend health-care facilities. The results highlight the role played by health-care professionals in motivating women to attend cervical cancer screening programs, and the need for health education of health-care providers to offer a precious advice regarding the screening. On the other hand, health-care providers highlighted that implementation of reminding system of cervical cancer screening will support them to improve screening attendance. In addition, health-care providers stressed the necessity for educational and awareness campaigns of cervical cancer screening among Libyan women.

  20. Attitudes, Knowledge, Use, and Recommendation of Complementary and Alternative Medicine by Health Professionals in Western Mexico.

    PubMed

    Brambila-Tapia, Aniel Jessica Leticia; Rios-Gonzalez, Blanca Estela; Lopez-Barragan, Liliana; Saldaña-Cruz, Ana Miriam; Rodriguez-Vazquez, Katya

    2016-01-01

    The use of complementary and alternative medicine (CAM) has increased in many countries, and this has altered the knowledge, attitudes, and treatment recommendations of health professionals in regard to CAM. Considering Mexican health professionals׳ lack of knowledge of CAM, in this report we surveyed 100 biomedical researchers and Ph.D. students and 107 specialized physicians and residents of a medical specialty in Guadalajara, México (Western Mexico) with a questionnaire to address their attitudes, knowledge, use, and recommendation of CAM. We observed that significantly more researchers had ever used CAM than physicians (83% vs. 69.2%, P = .023) and that only 36.4% of physicians had ever recommended CAM. Female researchers tended to have ever used CAM more than male researchers, but CAM use did not differ between genders in the physician group or by age in either group. Homeopathy, herbal medicine, and massage therapy were the most commonly used CAMs in both the groups. Physicians more frequently recommended homeopathy, massage therapy, and yoga to their patients than other forms of CAM, and physicians had the highest perception of safety and had taken the most courses in homeopathy. All CAMs were perceived to have high efficacy (>60%) in both the groups. The attitude questionnaire reported favorable attitudes toward CAM in both the groups. We observed a high rate of Mexican health professionals that had ever used CAM, and they had mainly used homeopathy, massage therapy, and herbal medicine. However, the recommendation rate of CAM by Mexican physicians was significantly lower than that in other countries, which is probably due to the lack of CAM training in most Mexican medical schools. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. University Health Center Providers' Beliefs about Discussing and Recommending Sexual Health Prevention to Women College Students

    ERIC Educational Resources Information Center

    Jozkowski, Kristen N.; Geshnizjani, Alireza; Middlestadt, Susan E.

    2013-01-01

    Sexual health concerns such as sexually transmitted infections and unintended pregnancy remain substantial health problems faced by young adults, especially college women. University healthcare providers may be instrumental in increasing female patients' involvement in preventative sexual health behaviors, however little research has examined this…

  2. Contact Precautions for Multidrug-Resistant Organisms (MDROs): Current Recommendations and Actual Practice

    PubMed Central

    Clock, Sarah A.; Cohen, Bevin; Behta, Maryam; Ross, Barbara; Larson, Elaine L.

    2009-01-01

    Background Contact precautions are recommended for interactions with patients colonized/infected with multidrug-resistant organisms; however, rates of contact precautions practice are unknown. Methods Observers recorded the availability of supplies and staff/visitor adherence to contact precautions at rooms of patients indicated for contact precautions. Data were collected at three sites in a New York City hospital network. Results Contact precautions signs were present for 85.4% of indicated patients. The largest proportions were indicated for isolation for vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus cultures. Isolation carts were available outside 93.7-96.7% of rooms displaying signs, and personal protective equipment was available at rates of 49.4-72.1% for gloves (all sizes: small, medium, and large) and 91.7-95.2% for gowns. Overall adherence rates upon room entry and exit, respectively, were 19.4% and 48.4% for hand hygiene, 67.5% and 63.5% for gloves, and 67.9% and 77.1% for gowns. Adherence was significantly better in intensive care units (p<0.05) and by patient-care staff (p<0.05), and patient-care staff compliance with one contact precautions behavior was predictive of adherence to additional behaviors (p<0.001). Conclusions Our findings support the recommendation that methods to monitor contact precautions and identify and correct non-adherent practices should be a standard component of infection prevention and control programs. PMID:19913329

  3. Recommended Correlations for the Surface Tension of Aliphatic, Carboxylic, and Polyfunctional Organic Acids

    NASA Astrophysics Data System (ADS)

    Mulero, A.; Cachadiña, I.; Sanjuán, E. L.

    2016-09-01

    In previous papers, we have proposed specific correlations to reproduce the surface tension values for several sets of fluids and for wide ranges of temperatures. In this paper, we focus our attention on organic fatty (aliphatic, carboxylic, and polyfunctional) acids. We have taken into account the available data and values in the DIPPR and DETHERM databases and also Wohlfarth and Wohlfarth's (1997) book. In some cases we have also considered new data published elsewhere. All the data and values have been carefully filtered and subsequently fitted with the use of the model currently implemented in NIST's REFPROP program, calculating two or four adjustable coefficients for each fluid. As a result, we propose recommended correlations for 99 acids, providing mean absolute percentage deviations below 1.6% in all cases.

  4. Awareness of national physical activity recommendations for health promotion among US adults.

    PubMed

    Bennett, Gary G; Wolin, Kathleen Y; Puleo, Elaine M; Mâsse, Louise C; Atienza, Audie A

    2009-10-01

    To examine whether knowledge of the 1995 Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine (ACSM) national physical activity recommendations varies by sociodemographic, behavioral, and communication-related factors. Cross-sectional analyses of 2381 participants in the 2005 Health Information National Trends Survey, a national probability sample of the US population contacted via random-digit dial. Only a third of respondents were accurately knowledgeable of the CDC/ACSM physical activity recommendations. Recommendation knowledge was higher among women (OR = 1.70; 95% confidence interval (CI) = 1.35-2.14) than men, the employed compared with those not currently working (OR = 0.73; 95% CI = 0.55-0.95), foreign-born individuals (OR = 1.62; 95% CI = 1.15-2.30) compared with the US-born, and those meeting CDC/ACSM recommendations vs those who do not (OR = 0.74; 95% CI = 0.58-0.96). There is not widespread knowledge of the consensus national physical activity recommendations. These findings highlight the need for more effective campaigns to promote physical activity among the American public.

  5. Psychological functioning and adherence to the recommended dose of physical activity in later life: results from a national health survey.

    PubMed

    Netz, Yael; Dunsky, Ayelet; Zach, Sima; Goldsmith, Rebecca; Shimony, Tal; Goldbourt, Uri; Zeev, Aviva

    2012-12-01

    Official health organizations have established the dose of physical activity needed for preserving both physical and psychological health in old age. The objective of this study was to explore whether adherence to the recommended criterion of physical activity accounted for better psychological functioning in older adults in Israel. A random sample of 1,663 (799 men) Israelis reported their physical activity routine, and based on official guidelines were divided into sufficiently active, insufficiently active, and inactive groups. The General Health Questionnaire (GHQ) was used for assessing mental health and the Mini-Mental State Examination (MMSE) for assessing cognitive functioning. Factor analysis performed on the GHQ yielded two factors - positive and negative. Logistic regressions for the GHQ factors and for the MMSE were conducted for explaining their variance, with demographic variables entered first, followed by health and then physical activity. The explained variance in the three steps was Cox and Snell R2 = 0.022, 0.023, 0.039 for the positive factor, 0.066, 0.093, 0.101 for the negative factor, and 0.204, 0.206, 0.209 for the MMSE. Adherence to the recommended dose of physical activity accounted for better psychological functioning beyond demographic and health variables; however, the additional explained variance was small. More specific guidelines of physical activity may elucidate a stronger relationship, but only randomized controlled trials can reveal cause-effect relationship between physical activity and psychological functioning. More studies are needed focusing on the positive factor of psychological functioning.

  6. World Health Organization cardiovascular risk stratification and target organ damage.

    PubMed

    Piskorz, D; Bongarzoni, L; Citta, L; Citta, N; Citta, P; Keller, L; Mata, L; Tommasi, A

    2016-01-01

    Prediction charts allow treatment to be targeted according to simple markers of cardiovascular risk; many algorithms do not recommend screening asymptomatic target organ damage which could change dramatically the assessment. To demonstrate that target organ damage is present in low cardiovascular risk hypertensive patients and it is more frequent and severe as global cardiovascular risk increases. Consecutive hypertensive patients treated at a single Latin American center. Cardiovascular risk stratified according to 2013 WHO/ISH risk prediction chart America B. Left ventricular mass assessed by Devereux method, left ventricular hypertrophy considered >95g/m(2) in women and >115g/m(2) in men. Transmitral diastolic peak early flow velocity to average septal/lateral peak early diastolic relaxation velocity (E/e' ratio) measured cut off value >13. Systolic function assessed by tissue Doppler average interventricular septum/lateral wall mitral annulus rate systolic excursion (s wave). A total of 292 patients were included of whom 159 patients (54.5%) had cardiovascular risk of <10%, 90 (30.8%) had cardiovascular risk of 10-20% and 43 (14.7%) had cardiovascular risk of >20%. Left ventricular hypertrophy was detected in 17.6% low risk patients, 27.8% in medium risk and 23.3% in high risk (p<0.05), abnormal E/e' ratio was found in 13.8%, 31.1% and 27.9%, respectively (p<0.05). Mean s wave was 8.03+8, 8.1+9 and 8.7+1cm/s for low, intermediate and high risk patients, respectively (p<0.025). Target organ damage is more frequent and severe in high risk; one over four subjects was misclassified due to the presence of asymptomatic target organ damage. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

  7. Patterns of sedentary behavior and compliance with public health recommendations in Spanish adolescents: the AFINOS study.

    PubMed

    Martínez Gómez, David; Veiga, Oscar L; Zapatera, Belén; Cabanas-Sánchez, Verónica; Gomez-Martinez, Sonia; Martinez-Hernández, David; Marcos, Ascensión

    2012-12-01

    The aims of the present study were: (i) describe patterns of sedentary behavior in Spanish adolescents; and (ii) determine the proportion of adolescents that do not meet the public health recommendations for sedentary behavior. This study comprised 1,724 Spanish adolescents (882 girls), aged 13 to 16 years. Patterns of sedentary behavior (TV viewing, use of computer games, console games and surfing the Internet) were assessed using the HELENA sedentary behavior questionnaire. The total proportion of adolescents watching TV, using computer and console games, and surfing the internet for more than two hours daily was 24%, 9%, 7%, and 17%, respectively, on weekdays, and 50%, 22%, 16%, and 35%, respectively, on weekends. Over 63% of the adolescents from the study did not meet the recommendation for sedentary behavior (< 2 hours daily screen time) on weekdays and 87% did not comply with this recommendation on weekends. Since sedentary behavior plays a key role in adolescent health, public health interventions in Spain that take these factors into consideration are needed.

  8. The refinement of topics for systematic reviews: lessons and recommendations from the Effective Health Care Program.

    PubMed

    Buckley, David I; Ansari, Mohammed T; Butler, Mary; Soh, Clara; Chang, Christine S

    2014-04-01

    The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program conducts systematic reviews of health-care topics nominated by stakeholders. Topics undergo refinement to ensure relevant questions of appropriate scope and useful reviews. Input from key informants, experts, and a literature scan informs changes in the nominated topic. AHRQ convened a work group to assess approaches and develop recommendations for topic refinement. Work group members experienced in topic refinement generated a list of questions and guiding principles relevant to the refinement process. They discussed each issue and reached agreement on recommendations. Topics should address important health-care questions or dilemmas, consider stakeholder priorities and values, reflect the state of the science, and be consistent with systematic review research methods. Guiding principles of topic refinement are fidelity to the nomination, relevance, research feasibility, responsiveness to stakeholder inputs, reduced investigator bias, transparency, and suitable scope. Suggestions for stakeholder engagement, synthesis of input, and reporting are discussed. Refinement decisions require judgment and balancing guiding principles. Variability in topics precludes a prescriptive approach. Accurate, rigorous, and useful systematic reviews require well-refined topics. These guiding principles and methodological recommendations may help investigators refine topics for reviews. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. The mental health focus in rape crisis services: tensions and recommendations.

    PubMed

    Woody, Jane D; Beldin, Kerry L

    2012-01-01

    In the evolution of rape crisis services, tensions persist between rape crisis service programs and mental health professionals. Changes within these programs and professions have brought the embedded concerns to the surface, but they remain unexamined and unresolved. Recent research on rape trauma and survivors' mental health needs has added to tensions by calling for description and evaluation of rape crisis services and timely psychological treatment for survivors. This article offers a new perspective by discussing the tensions in an open but balanced way so as to promote discussion and solutions. Recommendations and action steps are offered for promoting constructive dialogue and change to improve direct services for survivors.

  10. Privacy and security in mobile health apps: a review and recommendations.

    PubMed

    Martínez-Pérez, Borja; de la Torre-Díez, Isabel; López-Coronado, Miguel

    2015-01-01

    In a world where the industry of mobile applications is continuously expanding and new health care apps and devices are created every day, it is important to take special care of the collection and treatment of users' personal health information. However, the appropriate methods to do this are not usually taken into account by apps designers and insecure applications are released. This paper presents a study of security and privacy in mHealth, focusing on three parts: a study of the existing laws regulating these aspects in the European Union and the United States, a review of the academic literature related to this topic, and a proposal of some recommendations for designers in order to create mobile health applications that satisfy the current security and privacy legislation. This paper will complement other standards and certifications about security and privacy and will suppose a quick guide for apps designers, developers and researchers.

  11. Recommendations for the role of social science research in One Health.

    PubMed

    Lapinski, Maria Knight; Funk, Julie A; Moccia, Lauren T

    2015-03-01

    The social environment has changed rapidly as technology has facilitated communication among individuals and groups in ways not imagined 20 years ago. Communication technology increasingly plays a role in decision-making about health and environmental behaviors and is being leveraged to influence that process. But at its root is the fundamental need to understand human cognition, communication, and behavior. The concept of 'One Health' has emerged as a framework for interdisciplinary work that cuts across human, animal, and ecosystem health in recognition of their interdependence and the value of an integrated perspective. Yet, the science of communication, information studies, social psychology, and other social sciences have remained marginalized in this emergence. Based on an interdisciplinary collaboration, this paper reports on a nascent conceptual framework for the role of social science in 'One Health' issues and identifies a series of recommendations for research directions that bear additional scrutiny and development. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

    PubMed

    Kneale, Laura; Choi, Yong; Demiris, George

    2016-01-01

    Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.

  13. [Nutrition and health--recommendations of the Health Council of the Netherlands regarding energy, proteins, fats and carbohydrates].

    PubMed

    Fernandes, J

    2002-11-23

    The present report of the Health Council of the Netherlands, entitled 'Dietary reference intakes: energy, proteins, fats and digestible carbohydrates' is the second of a series of updated and revised recommendations in which the emphasis has shifted from nutritional deficiencies to the risks for some chronic diseases caused by the affluent nutrition of the 'developed' Western countries. The recommendation for total fat differs between people with an optimum weight and those who are overweight. The range for normal intake, from 20 to 40 energy per cent, has been enlarged due to a higher upper threshold. For persons who are already overweight, the narrower range from 20 to 30/35 energy percent has been maintained. Due attention should be given to the fatty acid composition of the fat and the favourable effects of unsaturated fatty acids on some chronic diseases, particularly coronary heart disease. The adequate intake of alpha-linolenic acid has been raised to 1 energy per cent while maintaining linoleic acid at 2 energy per cent. The benefits of the n-3-polyunsaturated fatty acids from fish are emphasised. Trans fatty acids should be limited to 1 energy per cent. The recommendation of 50 to 40 energy per cent for digestible carbohydrates from birth to old age is lower than in foreign recommendations. The estimate is derived from the production of endogenous glucose. No specific effects on chronic diseases are known. The recommended dietary allowances for protein are lower than those in the previous Dutch recommendation. They are now in line with most recommendations in other countries. With respect to the energy requirement, an abnormal level of physical activity should be reflected in a correction factor on the normal energy consumption.

  14. Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations.

    PubMed

    Fernandez, Ana; Gillespie, James A; Smith-Merry, Jennifer; Feng, Xiaoqi; Astell-Burt, Thomas; Maas, Cailin; Salvador-Carulla, Luis

    2016-03-24

    Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence.Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD.Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing.Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care.What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system.What does this paper add? This paper provides a critical analysis of

  15. Meeting the public health challenge of protecting private wells: Proceedings and recommendations from an expert panel workshop.

    PubMed

    Fox, Mary A; Nachman, Keeve E; Anderson, Breeana; Lam, Juleen; Resnick, Beth

    2016-06-01

    Private wells serving fewer than 25 people are federally unregulated, and their users may be exposed to naturally occurring agents of concern such as arsenic and radionuclides, as well as anthropogenic contaminants. The Centers for Disease Control and Prevention's Clean Water for Health Program works to protect private wells and prevent adverse health outcomes for the roughly 15% of Americans who rely on them. To understand current and emerging challenges to the private drinking water supply, an interdisciplinary expert panel workshop on "Future and Emerging Issues for Private Wells" was organized to inform strategic planning for the Clean Water for Health Program. The panel assessed current conditions of ground water as a source for private wells, identified emerging threats, critical gaps in knowledge, and public health needs, and recommended strategies to guide future activities to ensure the safety of private drinking water wells. These strategies addressed topics of broad interest to the environmental public health community including: development of new methods to support citizen science; addressing contaminant mixtures; expanding capacity for well testing; evaluating treatment technologies; building an evidence base on best practices on well owner outreach and stewardship; and research and data needs.

  16. Nursing domain of CI governance: recommendations for health IT adoption and optimization.

    PubMed

    Collins, Sarah A; Alexander, Dana; Moss, Jacqueline

    2015-05-01

    There is a lack of recommended models for clinical informatics (CI) governance that can facilitate successful health information technology implementation. To understand existing CI governance structures and provide a model with recommended roles, partnerships, and councils based on perspectives of nursing informatics leaders. We conducted a cross-sectional study through administering a survey via telephone to facilitate semistructured interviews from June 2012 through November 2012. We interviewed 12 nursing informatics leaders, across the United States, currently serving in executive- or director-level CI roles at integrated health care systems that have pioneered electronic health records implementation projects. We found the following 4 themes emerge: (1) Interprofessional partnerships are essential. (2) Critical role-based levels of practice and competencies need to be defined. (3) Integration into existing clinical infrastructure facilitates success. (4) CI governance is an evolving process. We described specific lessons learned and a model of CI governance with recommended roles, partnerships, and councils from the perspective of nursing informatics leaders. Applied CI work is highly interprofessional with patient safety implications that heighten the need for best practice models for governance structures, adequate resource allocation, and role-based competencies. Overall, there is a notable lack of a centralized CI group comprised of formally trained informaticians to provide expertise and promote adherence to informatics principles within EHR implementation governance structures. Our model of the nursing domain of CI governance with recommended roles, partnerships, and councils provides a starting point that should be further explored and validated. Not only can the model be used to understand, shape, and standardize roles, competencies, and structures within CI practice for nursing, it can be used within other clinical domains and by other informaticians

  17. Research in lower middle income countries - recommendations for a national mental health research agenda in South Africa.

    PubMed

    Chipps, J; Ramlall, S

    2012-11-01

    In the current mental health environment in South Africa, the development of a relevant mental health research agenda poses several challenges. This paper provides a brief overview of the current state of published research in mental health and, using a translation research framework, makes recommendations for five strategic directions to be considered in the development of a national mental health research agenda.

  18. Expanding the evidence base for global recommendations on health systems: strengths and challenges of the OptimizeMNH guidance process.

    PubMed

    Glenton, Claire; Lewin, Simon; Gülmezoglu, Ahmet Metin

    2016-07-18

    In 2012, the World Health Organization (WHO) published recommendations on the use of optimization or "task-shifting" strategies for key, effective maternal and newborn interventions (the OptimizeMNH guidance). When making recommendations about complex health system interventions such as task-shifting, information about the feasibility and acceptability of interventions can be as important as information about their effectiveness. However, these issues are usually not addressed with the same rigour. This paper describes our use of several innovative strategies to broaden the range of evidence used to develop the OptimizeMNH guidance. In this guidance, we systematically included evidence regarding the acceptability and feasibility of relevant task-shifting interventions, primarily using qualitative evidence syntheses and multi-country case study syntheses; we used an approach to assess confidence in findings from qualitative evidence syntheses (the Grading of Recommendations, Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach); we used a structured evidence-to-decision framework for health systems (the DECIDE framework) to help the guidance panel members move from the different types of evidence to recommendations. The systematic inclusion of a broader range of evidence, and the use of new guideline development tools, had a number of impacts. Firstly, this broader range of evidence provided relevant information about the feasibility and acceptability of interventions considered in the guidance as well as information about key implementation considerations. However, inclusion of this evidence required more time, resources and skills. Secondly, the GRADE-CERQual approach provided a method for indicating to panel members how much confidence they should place in the findings from the qualitative evidence syntheses and so helped panel members to use this qualitative evidence appropriately. Thirdly

  19. [Inequality in access to health care services. Policy recommendations aimed at achieving equity].

    PubMed

    Urbanos-Garrido, Rosa

    2016-11-01

    This article reveals the presence of inequalities in access to health care that may be considered unfair and avoidable. These inequalities are related to coverage of clinical needs, to the financial problems faced by families in completing medical treatments, or to disparities in waiting times and the use of services for equal need. A substantial proportion of inequalities appears to have increased as a result of the measures adopted to face the economic crisis. The recommendations aimed at improving equity affect different pillars of the taxpayer-funded health system, including, among others, the definition of the right to public health care coverage, the formulas of cost-sharing, the distribution of powers between primary and specialty care, the reforms of clinical management, and the production and dissemination of information to facilitate the decision-making processes of health authorities, professionals and citizens. Moreover, it is recommended to focus on particularly vulnerable population groups. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Fiber supplements and clinically proven health benefits: How to recognize and recommend an effective fiber therapy

    PubMed Central

    Lambeau, Kellen V.

    2017-01-01

    Abstract Background Only 5% of adults consume the recommended level of dietary fiber. Fiber supplements appear to be a convenient and concentrated source of fiber, but most do not provide the health benefits associated with dietary fiber. Purpose This review will summarize the physical effects of isolated fibers in small and large intestines, which drive clinically meaningful health benefits. Data sources A comprehensive literature review was conducted (Scopus and PubMed) without limits to year of publication (latest date included: October 31, 2016). Conclusions The physical effects of fiber in the small intestine drive metabolic health effects (e.g., cholesterol lowering, improved glycemic control), and efficacy is a function of the viscosity of gel‐forming fibers (e.g., psyllium, β‐glucan). In the large intestine, fiber can provide a laxative effect if (a) it resists fermentation to remain intact throughout the large intestine, and (b) it increases percentage of water content to soften/bulk stool (e.g., wheat bran and psyllium). Implications for practice It is important for nurse practitioners to understand the underlying mechanisms that drive specific fiber‐related health benefits, and which fiber supplements have rigorous clinical data to support a recommendation. Clinical pearl For most fiber‐related beneficial effects, “Fiber needs to gel to keep your patients well.” PMID:28252255

  1. Recommendations for use of marginal donors in heart transplantation: Brazilian Association of Organs Transplantation guideline.

    PubMed

    Fiorelli, A I; Stolf, N A G; Pego-Fernandes, P M; Oliveira Junior, J L; Santos, R H B; Contreras, C A M; Filho, D D L; Dinkhuysen, J J; Moreira, M C V; Mejia, J A C; Castro, M C R

    2011-01-01

    The high prevalence of heart failure has increased the candidate list for heart transplantation; however, there is a shortage of viable donated organs, which is responsible for the high mortality of patients awaiting a transplantation. Because the marginal donor presents additional risk factors, it is not considered to be an ideal donor. The use of a marginal donor is only justified in situations when the risk of patient death due to heart disease is greater than that offered by the donor. These recommendations sought to expand the supply of donors, consequently increasing the transplant rate. We selected articles based on robust evidence to provide a substratum to develop recommendations for donors who exceed the traditional acceptance criteria. Recipient survival in the immediate postoperative period is intimately linked to allograft quality. Primary allograft failure is responsible for 38% to 40% of immediate deaths after heart transplantation: therefore; marginal donor selection must be more rigorous to not increase the surgical risk. The main donor risk factors with the respective evidence levels are: cancer in the donor (B), female donor (B), donor death due to hemorrhagic stroke (B), donor age above 50 years (relative risk [RR] = 1.5) (B), weight mismatch between donor and recipient < 0.8 (RR = 1.3) (B), ischemia > 240 minutes (RR = 1.2) (B), left ventricular dysfunction with ejection fraction below 45% (B), and use of high doses of vasoactive drugs (dopamine > 15 mg/kg·min) (B). Factors that impact recipient mortality are: age over 50 years (RR = 1.5); allograft harvest at a distance; adult recipient weighing more than 20% of the donor; high doses of vasoactive drugs (dopamine greater than 15 mg/kg·min) and ischemic time >4 hours. The use of a marginal donor is only justified when it is able to increase life expectancy compared with clinical treatment, albeit the outcomes are interior to those using an ideal donor.

  2. EU Country Specific Recommendations for health systems in the European Semester process: trends, discourse and predictors.

    PubMed

    Azzopardi-Muscat, Natasha; Clemens, Timo; Stoner, Deborah; Brand, Helmut

    2015-03-01

    In the framework of "Europe 2020", European Union Member States are subject to a new system of economic monitoring and governance known as the European Semester. This paper seeks to analyse the way in which national health systems are being influenced by EU institutions through the European Semester. A content analysis of the Country Specific Recommendations (CSRs) for the years 2011, 2012, 2013 and 2014 was carried out. This confirmed an increasing trend for health systems to feature in CSRs which tend to be framed in the discourse on sustainability of public finances rather than that of social inclusion with a predominant focus on the policy objective of sustainability. The likelihood of obtaining a health CSRs was tested against a series of financial health system performance indicators and general government finance indicators. The odds ratio of obtaining a health CSR increased slightly with the increase in level of general Government debt, with an OR 1.02 (CI: 1.01, 1.03; p=0.007) and decreased with an increased public health expenditure/total health expenditure ratio, with an OR 0.89 (CI: 0.84, 0.96; p=0.001). The European Semester process is a relatively new process that is influencing health systems in the European Union. The effect of this process on health systems merits further attention. Health stakeholders should seek to engage more closely with this process which if steered appropriately could also present opportunities for health system reform. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  3. 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

    2016-07-07

    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.

  4. 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

  5. [Reason for dietary salt reduction and potential effect on population health--WHO recommendation].

    PubMed

    Kaić-Rak, Antoinette; Pucarin-Cvetković, Jasna; Heim, Inge; Skupnjak, Berislav

    2010-05-01

    It is well known that reduction of salt results in lowering blood pressure and cardiovascular incidents. Daily salt is double the recommended daily quantity and mainly comes from processed food. The assessment of daily salt intake for Croatia is 12 g/day (WHO recommendation is <5 g/day). The main source of sodium is processed food and food prepared in restaurants (77%), natural content of sodium in food (12%), added salt at table (6%) and prepared meals at home (5%). Reduction of salt by 50% would save nearly 180,000 lives per year in Europe. It is necessary to establish better collaboration with food manufacturers in order to reduce the content of salt in processed food and to achieve appropriate salt intake per day in accordance with the WHO recommendation. Further, it is necessary to encourage food manufacturers to produce food and meals with low or reduced salt content (shops, catering, changes in recipes, offer salt substitutions). This kind of collaboration is based on bilateral interests that can result in positive health effects. One of the most important public health tasks is to educate consumers and to give them choice when buying food. This can be achieved by effective campaigns and social marketing, by ensuring a declaration of salt content on the product, or specially designed signs for food products with low or reduced salt content.

  6. Should bioactive trace elements not recognized as essential, but with beneficial health effects, have intake recommendations.

    PubMed

    Nielsen, Forrest H

    2014-10-01

    Today, most nutritionists do not consider a trace element essential unless it has a defined biochemical function in higher animals or humans. As a result, even though it has been found that trace elements such as boron and silicon have beneficial bioactivity in higher animals and humans, they generally receive limited attention or mention when dietary guidelines or intake recommendations are formulated. Recently, the possibility of providing dietary intake recommendations such as an adequate intake (AI) for some bioactive food components (e.g., flavonoids) has been discussed. Boron, chromium, nickel, and silicon are bioactive food components that provide beneficial health effects by plausible mechanisms of action in nutritional and supra nutritional amounts, and thus should be included in the discussions. Although the science base may not be considered adequate for establishing AIs, a significant number of findings suggest that statements about these trace elements should be included when dietary intake guidance is formulated. An appropriate recommendation may be that diets should include foods that would provide trace elements not currently recognized as essential in amounts shown to reduce the risk of chronic disease and/or promote health and well-being. Published by Elsevier GmbH.

  7. Compliance with Guidelines-Recommended Processes in Pneumonia: Impact of Health Status and Initial Signs

    PubMed Central

    Menéndez, Rosario; Torres, Antoni; Reyes, Soledad; Zalacain, Rafael; Capelastegui, Alberto; Rajas, Olga; Borderías, Luis; Martín-Villasclaras, Juan J.; Bello, Salvador; Alfageme, Inmaculada; de Castro, Felipe Rodríguez; Rello, Jordi; Molinos, Luis; Ruiz-Manzano, Juan

    2012-01-01

    Initial care has been associated with improved survival of community-acquired pneumonia (CAP). We aimed to investigate patient comorbidities and health status measured by the Charlson index and clinical signs at diagnosis associated with adherence to recommended processes of care in CAP. We studied 3844 patients hospitalized with CAP. The evaluated recommendations were antibiotic adherence to Spanish guidelines, first antibiotic dose <6 hours and oxygen assessment. Antibiotic adherence was 72.6%, first dose <6 h was 73.4% and oxygen assessment was 90.2%. Antibiotic adherence was negatively associated with a high Charlson score (Odds ratio [OR], 0.91), confusion (OR, 0.66) and tachycardia ≥100 bpm (OR, 0.77). Delayed first dose was significantly lower in those with tachycardia (OR, 0.75). Initial oxygen assessment was negatively associated with fever (OR, 0.61), whereas tachypnea ≥30 (OR, 1.58), tachycardia (OR, 1.39), age >65 (OR, 1.51) and COPD (OR, 1.80) were protective factors. The combination of antibiotic adherence and timing <6 hours was negatively associated with confusion (OR, 0.69) and a high Charlson score (OR, 0.92) adjusting for severity and hospital effect, whereas age was not an independent factor. Deficient health status and confusion, rather than age, are associated with lower compliance with antibiotic therapy recommendations and timing, thus identifying a subpopulation more prone to receiving lower quality care. PMID:22629420

  8. The Global Commission on HIV and the Law: recommendations for legal reform to promote sexual and reproductive health and rights.

    PubMed

    El Feki, Shereen; Avafia, Tenu; Fidalgo, Tania Martins; Divan, Vivek; Chauvel, Charles; Dhaliwal, Mandeep; Cortez, Clifton

    2014-11-01

    The Global Commission on HIV and the Law was established in 2010 to identify and analyse the complex framework of international, national, religious and customary law shaping national responses to HIV and the well-being of people living with HIV and key populations. Two years of deliberation, based on an exhaustive review of international public health and human rights scholarship, as well as almost 700 testimonials from individuals and organizations in more than 130 countries, informed the Commission's recommendations on reform to laws and practices that criminalize those living with and vulnerable to HIV, sustain or mitigate violence and discrimination lived by women, facilitate or impede access to HIV-related treatment, and/or pertain to children and young people in the context of HIV. This paper presents the Commission's findings and recommendations as they relate to sexual and reproductive health and rights, and examines how the Commission's work intersects with strategic litigation on forced sterilization of women living with HIV, legal reform on the status of transgender individuals, initiatives to improve police treatment of female sex workers, and equal property rights for women living with HIV in sub-Saharan Africa and Latin America.

  9. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA.

    PubMed

    Middleton, Blackford; Bloomrosen, Meryl; Dente, Mark A; Hashmat, Bill; Koppel, Ross; Overhage, J Marc; Payne, Thomas H; Rosenbloom, S Trent; Weaver, Charlotte; Zhang, Jiajie

    2013-06-01

    In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems. After a careful review of the literature and of vendor experiences with EHR design and implementation, the task force developed 10 recommendations in four areas: (1) human factors health information technology (IT) research, (2) health IT policy, (3) industry recommendations, and (4) recommendations for the clinician end-user of EHR software. These AMIA recommendations are intended to stimulate informed debate, provide a plan to increase understanding of the impact of usability on the effective use of health IT, and lead to safer and higher quality care with the adoption of useful and usable EHR systems.

  10. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA

    PubMed Central

    Middleton, Blackford; Bloomrosen, Meryl; Dente, Mark A; Hashmat, Bill; Koppel, Ross; Overhage, J Marc; Payne, Thomas H; Rosenbloom, S Trent; Weaver, Charlotte; Zhang, Jiajie

    2013-01-01

    In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems. After a careful review of the literature and of vendor experiences with EHR design and implementation, the task force developed 10 recommendations in four areas: (1) human factors health information technology (IT) research, (2) health IT policy, (3) industry recommendations, and (4) recommendations for the clinician end-user of EHR software. These AMIA recommendations are intended to stimulate informed debate, provide a plan to increase understanding of the impact of usability on the effective use of health IT, and lead to safer and higher quality care with the adoption of useful and usable EHR systems. PMID:23355463

  11. Architecture and User-Context Models of CoCare: A Context-Aware Mobile Recommender System for Health Promotion.

    PubMed

    Cerón-Rios, Gineth; López, Diego M; Blobel, Bernd

    2017-01-01

    Recommender systems (RS) are useful tools for filtering and sorting items and information for users. There is a wide diversity of approaches that help creating personalized recommendations. Context-aware recommender systems (CARS) are a kind of RS which provide adaptation capabilities to the user's environment, e.g., by sensing data through wearable devices or other biomedical sensors. In healthcare and wellbeing, CARS can support health promotion and health education, considering that each individual requires tailored intervention programs. Our research aims at proposing a context-aware mobile recommender system for the promotion of healthy habits. The system is adapted to the user's needs, his/her health information, interests, time, location and lifestyles. In this paper, the CARS computational architecture and the user and context models of health promotion are presented, which were used to implement and test a prototype recommender system.

  12. Receipt of Recommended Adolescent Vaccines Among Youth With Special Health Care Needs.

    PubMed

    McRee, Annie-Laurie; Maslow, Gary R; Reiter, Paul L

    2016-07-28

    We examined vaccination coverage among youth with special health care needs (YSHCN) using data from parents of adolescents (11-17 years) who responded to a statewide survey in 2010-2012 (n = 2156). Using a validated screening tool, we identified 29% of adolescents as YSHCN. Weighted multivariable logistic regression assessed associations between special health care needs and receipt of tetanus booster, meningococcal, and human papillomavirus (HPV) vaccines. Only 12% of youth had received all 3 vaccines, with greater coverage for individual vaccines (tetanus booster, 91%; meningococcal, 32%; HPV, 26%). YSHCN had greater odds of HPV vaccination than other youth (33% vs 23%, OR = 1.70, 95% CI = 1.16-2.50) but vaccination coverage was similar (P ≥ .05) for other outcomes. In subgroup analyses, HPV vaccination also differed depending on the number and type of special health care needs identified. Findings highlight low levels of vaccination overall and missed opportunities to administer recommended vaccines among all youth, including YSHCN.

  13. Supporting public health priorities: recommendations for physical education and physical activity promotion in schools.

    PubMed

    Hills, Andrew P; Dengel, Donald R; Lubans, David R

    2015-01-01

    Physical activity (PA) provides numerous physiological and psychosocial benefits. However, lifestyle changes, including reduced PA opportunities in multiple settings, have resulted in an escalation of overweight and obesity and related health problems. Poor physical and mental health, including metabolic and cardiovascular problems is seen in progressively younger ages, and the systematic decline in school PA has contributed to this trend. Of note, the crowded school curriculum with an intense focus on academic achievement, lack of school leadership support, funding and resources, plus poor quality teaching are barriers to PA promotion in schools. The school setting and physical educators in particular, must embrace their role in public health by adopting a comprehensive school PA program. We provide an overview of key issues and challenges in the area plus best bets and recommendations for physical education and PA promotion in the school system moving forward.

  14. Health policy and systems research training: global status and recommendations for action

    PubMed Central

    Tancred, Tara M; Schleiff, Meike; Peters, David H

    2016-01-01

    Abstract Objective To investigate the characteristics of health policy and systems research training globally and to identify recommendations for improvement and expansion. Methods We identified institutions offering health policy and systems research training worldwide. In 2014, we recruited participants from identified institutions for an online survey on the characteristics of the institutions and the courses given. Survey findings were explored during in-depth interviews with selected key informants. Findings The study identified several important gaps in health policy and systems research training. There were few courses in central and eastern Europe, the Middle East, North Africa or Latin America. Most (116/152) courses were instructed in English. Institutional support for courses was often lacking and many institutions lacked the critical mass of trained individuals needed to support doctoral and postdoctoral students. There was little consistency between institutions in definitions of the competencies required for health policy and systems research. Collaboration across disciplines to provide the range of methodological perspectives the subject requires was insufficient. Moreover, the lack of alternatives to on-site teaching may preclude certain student audiences such as policy-makers. Conclusion Training in health policy and systems research is important to improve local capacity to conduct quality research in this field. We provide six recommendations to improve the content, accessibility and reach of training. First, create a repository of information on courses. Second, establish networks to support training. Third, define competencies in health policy and systems research. Fourth, encourage multidisciplinary collaboration. Fifth, expand the geographical and language coverage of courses. Finally, consider alternative teaching formats. PMID:27429488

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

    PubMed

    Gostin, Lawrence O

    2004-06-02

    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.

  16. Dietary Fats and Health: Dietary Recommendations in the Context of Scientific Evidence1

    PubMed Central

    Lawrence, Glen D.

    2013-01-01

    Although early studies showed that saturated fat diets with very low levels of PUFAs increase serum cholesterol, whereas other studies showed high serum cholesterol increased the risk of coronary artery disease (CAD), the evidence of dietary saturated fats increasing CAD or causing premature death was weak. Over the years, data revealed that dietary saturated fatty acids (SFAs) are not associated with CAD and other adverse health effects or at worst are weakly associated in some analyses when other contributing factors may be overlooked. Several recent analyses indicate that SFAs, particularly in dairy products and coconut oil, can improve health. The evidence of ω6 polyunsaturated fatty acids (PUFAs) promoting inflammation and augmenting many diseases continues to grow, whereas ω3 PUFAs seem to counter these adverse effects. The replacement of saturated fats in the diet with carbohydrates, especially sugars, has resulted in increased obesity and its associated health complications. Well-established mechanisms have been proposed for the adverse health effects of some alternative or replacement nutrients, such as simple carbohydrates and PUFAs. The focus on dietary manipulation of serum cholesterol may be moot in view of numerous other factors that increase the risk of heart disease. The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs, which are discussed here. This review calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs, for which mechanisms for adverse health effects are lacking. PMID:23674795

  17. Dietary fats and health: dietary recommendations in the context of scientific evidence.

    PubMed

    Lawrence, Glen D

    2013-05-01

    Although early studies showed that saturated fat diets with very low levels of PUFAs increase serum cholesterol, whereas other studies showed high serum cholesterol increased the risk of coronary artery disease (CAD), the evidence of dietary saturated fats increasing CAD or causing premature death was weak. Over the years, data revealed that dietary saturated fatty acids (SFAs) are not associated with CAD and other adverse health effects or at worst are weakly associated in some analyses when other contributing factors may be overlooked. Several recent analyses indicate that SFAs, particularly in dairy products and coconut oil, can improve health. The evidence of ω6 polyunsaturated fatty acids (PUFAs) promoting inflammation and augmenting many diseases continues to grow, whereas ω3 PUFAs seem to counter these adverse effects. The replacement of saturated fats in the diet with carbohydrates, especially sugars, has resulted in increased obesity and its associated health complications. Well-established mechanisms have been proposed for the adverse health effects of some alternative or replacement nutrients, such as simple carbohydrates and PUFAs. The focus on dietary manipulation of serum cholesterol may be moot in view of numerous other factors that increase the risk of heart disease. The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs, which are discussed here. This review calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs, for which mechanisms for adverse health effects are lacking.

  18. Active Commuting Behaviors in a Nordic Metropolitan Setting in Relation to Modality, Gender, and Health Recommendations

    PubMed Central

    Stigell, Erik; Schantz, Peter

    2015-01-01

    Active commuting between home and place of work or study is often cited as an interesting source of physical activity in a public health perspective. However, knowledge about these behaviors is meager. This was therefore studied in adult active commuters (n = 1872) in Greater Stockholm, Sweden, a Nordic metropolitan setting. They received questionnaires and individually adjusted maps to draw their normal commuting route. Three different modality groups were identified in men and women: single-mode cyclists and pedestrians (those who only cycle or walk, respectively) and dual-mode commuters (those who alternately walk or cycle). Some gender differences were observed in trip distances, frequencies, and velocities. A large majority of the commuting trip durations met the minimum health recommendation of at least 10-minute-long activity bouts. The median single-mode pedestrians and dual-mode commuters met or were close to the recommended weekly physical activity levels of at least 150 minutes most of the year, whereas the single-mode cyclists did so only during spring–mid-fall. A high total number of trips per year (range of medians: 231–389) adds to the value in a health perspective. To fully grasp active commuting behaviors in future studies, both walking and cycling should be assessed over different seasons and ideally over the whole year. PMID:26690193

  19. Recommendations for international gambling harm-minimisation guidelines: comparison with effective public health policy.

    PubMed

    Gainsbury, Sally M; Blankers, Matthijs; Wilkinson, Claire; Schelleman-Offermans, Karen; Cousijn, Janna

    2014-12-01

    Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of basing policy on empirical evidence, international conventions exist for policy on alcohol, tobacco, and illegal substances. This paper examines the evidence of best practice policies to provide recommendations for international guidelines for harm-minimisation policy for gambling, including specific consideration of the specific requirements for policies on Internet gambling. Evidence indicates that many of the public health policies implemented for addictive substances can be adapted to address gambling-related harms. Specifically, a minimum legal age of at least 18 for gambling participation, licensing of gambling venues and activities with responsible gambling and consumer protection strategies mandated, and brief interventions should be available for those at-risk for and experiencing gambling-related problems. However, there is mixed evidence on the effectiveness of limits on opening hours and gambling venue density and increased taxation to minimise harms. Given increases in trade globalisation and particularly the global nature of Internet gambling, it is recommended that jurisdictions take actions to harmonise gambling public health policies.

  20. Metal-Organic Frameworks: Literature Survey and Recommendation of Potential Sorbent Materials

    SciTech Connect

    Baumann, T F

    2010-04-29

    Metal-organic frameworks (MOFs) are a special type of porous material with a number of unique properties, including exceptionally high surface areas, large internal pore volumes (void space) and tunable pore sizes. These materials are prepared through the assembly of molecular building blocks into ordered three-dimensional structures. The bulk properties of the MOF are determined by the nature of the building blocks and, as such, these materials can be designed with special characteristics that cannot be realized in other sorbent materials, like activated carbons. For example, MOFs can be constructed with binding sites or pockets that can exhibit selectivity for specific analytes. Alternatively, the framework can be engineered to undergo reversible dimensional changes (or 'breathing') upon interaction with an analyte, effectively trapping the molecule of interest in the lattice structure. In this report, we have surveyed the 4000 different MOF structures reported in the open literature and provided recommendations for specific MOF materials that should be investigated as sorbents for this project.

  1. The Abrams report--communicable disease control; how do Health Districts measure up to the recommendations?

    PubMed

    Grime, L P; Horsley, S D

    1995-12-01

    The aims of the study were to examine whether Health Districts in the North Western Region complied with the recommendations in the Abrams report regarding the control of communicable disease [incorporated into the Annex to Circular HSG(93)56], and to identify areas that need further attention. The recommendations were extracted and arranged in questionnaire form. Further items were included dealing with the use of Epinet in communicating with the profession. A compliance score was derived from affirmative and qualified affirmative responses. Many recommendations were met by all or most Districts. Compliance was 90 percent or over for 58 percent of the questions where an assessment was appropriate. Of the 16 Districts in consortia, 75 percent did not have a consortium plan. Day-to-day plans were informal in 21 percent of Districts. In 63 percent of Districts the Family Health Services Authority (FHSA) was not involved to the extent that it should be. The Consultant in Communicable Disease Control (CCDC) had insufficient District Health Authority support in 42 percent of Districts and insufficient Local Authority support in 16 percent of Districts. In 58 percent of Districts there was lack of inclusion of matters relating to the control of infectious disease in contractual statements between purchaser and provider. There was a lack of audit in 47 percent of Districts. One plan or a compatible series of plans are required across each District. Informal day-to-day plans should be formalized. The FHSA should be fully involved in infectious disease control plans. Certain Districts require a Community Infection Control Nurse, accountable to the CCDC and/or administrative support to input and scan surveillance data. Contractual statements between purchaser and provider should include appropriate infection control requirements when this is not already the case. Communicable disease control audit should be a regular part of CCDC duties.

  2. The Contribution of the World Health Organization to a New Public Health and Health Promotion

    PubMed Central

    Kickbusch, Ilona

    2003-01-01

    The author traces the development of the concept of health promotion from 1980s policies of the World Health Organization. Two approaches that signify the modernization of public health are outlined in detail: the European Health for All targets and the settings approach. Both aim to reorient health policy priorities from a risk factor approach to strategies that address the determinants of health and empower people to participate in improving the health of their communities. These approaches combine classic public health dictums with “new” strategies, some setting explicit goals to integrate public health with general welfare policy. Health for All, health promotion, and population health have contributed to this reorientation in thinking and strategy, but the focus of health policy remains expenditure rather than investment. PMID:12604477

  3. Improving Indoor Environmental Quality for Public Health: Impediments and Policy Recommendations

    PubMed Central

    Wu, Felicia; Jacobs, David; Mitchell, Clifford; Miller, David; Karol, Meryl H.

    2007-01-01

    Background People in modern societies spend more than 90% of their time indoors. Hence, indoor environmental quality (IEQ) has a significant impact on public health. In this article we describe health risks associated with indoor environments, illuminate barriers to overcoming these risks, and provide policy recommendations to achieve healthier indoor environments. Objectives The weight of evidence suggests that indoor environmental contaminants pose significant public health risks, particularly among children and the poor, and the societal costs of illnesses related to indoor environments are considerable. Despite the evidence of harm to human health, poor indoor environments are generally difficult to regulate and not of sufficient concern to the general public. We discuss several reasons for this lack of concern about IEQ, focusing specifically on home environments. Discussion Economics plays a large role both in political inaction and individual-level indifference. Because little effort has been made to quantify the value of the societal and individual costs of poor housing quality, as well as the benefits achievable by simple interventions, policymakers lack motivation to act on IEQ. Similarly, individual homeowners lack the incentive to remediate homes, as other problems may be more pressing than home environmental quality. Conclusions Although the problem of IEQ involves multiple stakeholders and multiple levels of governance, it is possible to establish economic incentives that would set the wheels in motion for action at all levels to achieve healthy home environments. Also important are education and information dissemination on the public health risks associated with indoor environments. These recommendations are intended for all decision makers who have an influence in developing policy to improve indoor environmental quality. PMID:17589606

  4. Guidelines for preventing health-care--associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee.

    PubMed

    Tablan, Ofelia C; Anderson, Larry J; Besser, Richard; Bridges, Carolyn; Hajjeh, Rana

    2004-03-26

    This report updates, expands, and replaces the previously published CDC "Guideline for Prevention of Nosocomial Pneumonia". The new guidelines are designed to reduce the incidence of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals and in other health-care settings (e.g., ambulatory and long-term care institutions) and other facilities where health care is provided. Among the changes in the recommendations to prevent bacterial pneumonia, especially ventilator-associated pneumonia, are the preferential use of oro-tracheal rather than naso-tracheal tubes in patients who receive mechanically assisted ventilation, the use of noninvasive ventilation to reduce the need for and duration of endotracheal intubation, changing the breathing circuits of ventilators when they malfunction or are visibly contaminated, and (when feasible) the use of an endotracheal tube with a dorsal lumen to allow drainage of respiratory secretions; no recommendations were made about the use of sucralfate, histamine-2 receptor antagonists, or antacids for stress-bleeding prophylaxis. For prevention of health-care--associated Legionnaires disease, the changes include maintaining potable hot water at temperatures not suitable for amplification of Legionella spp., considering routine culturing of water samples from the potable water system of a facility's organ-transplant unit when it is done as part of the facility's comprehensive program to prevent and control health-care--associated Legionnaires disease, and initiating an investigation for the source of Legionella spp. when one definite or one possible case of laboratory-confirmed health-care--associated Legionnaires disease is identified in an inpatient hemopoietic stem-cell transplant (HSCT) recipient or in two or more HSCT recipients who had visited an outpatient HSCT unit during all or part of the 2-10 day period before illness onset. In the section on aspergillosis, the revised recommendations

  5. Predictors for the uptake of recommended vaccinations in Mecca travelers who visited the Public Health Service Amsterdam for mandatory meningitis vaccination.

    PubMed

    Keles, Havva; Sonder, Gerard J B; van den Hoek, Anneke

    2011-01-01

    Hajj, the pilgrimage to Mecca, is one of the obligatory religious duties of Islam. The travel clinic of the Public Health Service (PHS) Amsterdam administers vaccinations, including the required meningitis ACYW135 vaccine, and provides travelers with individual recommendations for all their travels. We extracted all data from the PHS database pertaining to Muslims who visited the clinic before travel to Mecca. From 2001 to 2009, the characteristics are described and trends are analyzed retrospectively. Acceptance of dTP vaccine was used as a proxy for acceptance of recommended vaccinations. For the years 2007 to 2009, predictive factors for the acceptance of advised vaccinations are analyzed. From 2001 to 2009, significantly more women and people older than 50 years of age traveled to Mecca. Since 2007, only 527 of 2,156 (24%) of those who were advised to take vaccines accepted the recommendation. Independent factors for acceptance were being female, of younger age, and being less healthy. Specifically, Mecca travelers with heart disorders and with liver or gastrointestinal disorders accepted recommended vaccinations more often than those without. Only a quarter of Mecca travelers who visit the travel clinic for their mandatory meningitis vaccination also take other, recommended, vaccinations. To improve the acceptance rate, Islamic organizations that inform Mecca travelers in preparation for their travel should be supplied with up-to-date advice, not only about the requirements but also about recommended vaccinations and health precautions. © 2011 International Society of Travel Medicine.

  6. Building service capacity within a regional district mental health service: recommendations from an Indigenous mental health symposium.

    PubMed

    Eley, Diann S; Hunter, Keith

    2006-01-01

    In response to recent developments within the mental health services of south-east Queensland, the Toowoomba District Mental Health Service (TDMHS) has developed a Model of Service Delivery, which outlines the range of services provided for consumers across their lifespan. Indigenous consumers of the TDMHS come from a wide area of communities in the surrounding shires (Rural, remote and metropolitan areas (RRMA) 4-7). It was recognised by the service that Indigenous mental health consumers have unique needs and, because of these needs, this area of service delivery required greater attention and further development. In December 2004, a symposium was organised by the service to bring together a range of speakers and delegates working in the area of Indigenous mental health to discuss issues and work towards developing strategies to enable the service to better meet the needs of Indigenous consumers in this region of south-east Queensland. The symposium program consisted of keynote speakers and invited papers and culminated with an afternoon workshop that collated the symposium's main issues and themes around building service capacity for Indigenous mental health consumers. The objective of the workshop was 'Identifying ways to meet Indigenous mental health needs'. This workshop gave the delegates a chance to reflect, discuss and brainstorm the major issues of concern relating to this question. A group facilitator guided the discussion and organised the delegates into groups to evaluate, debate and propose recommendations for each of the major issues that emerged. The feedback and discussion arising from the workshop is presented. Sixteen major themes emerged from the workshop. Seven of these were voted by the participants as being dominant and in greatest need of discussion: (1) communication; (2) cultural respect; (3) culturally appropriate clinical tools; (4) supportive management; (5) patient compliance; (6) career structure; and (7) empowerment. These seven

  7. The role of public health inspectors in maintaining housing in northern and rural communities: recommendations to support public health practice.

    PubMed

    Lefebvre, Stephanie; Montgomery, Phyllis; Michel, Isabelle; Warren, Claire; Larose, Tricia; Kauppi, Carol

    2012-01-01

    Although there is much evidence about the effects of particular housing conditions on health, less is known about the practices of public health inspectors (PHIs) in relation to minimizing or eliminating potential housing health risks. The purpose of this qualitative study was to illuminate the practices of PHIs in relation to types of biological and physical housing risks. This study used photo vignettes to focus on PHIs' perceptions, options, and resultant interventions with regards to typical housing risks encountered by PHIs in northeastern Ontario. The vignettes represented two general categories of potential housing risks: biological exposures, and physical characteristics of housing. During a semi-structured interview, 34 PHI participants viewed the vignettes, assessed the housing hazard depicted in each, and described the most appropriate intervention. Traditional content analysis methods were used. The assessment of the physical housing hazards was fairly consistent among the PHIs. There seemed to be more variation in their assessment of risk associated with biological factors. Variation in responses was often explained by their different interpretations of the scope of the provincial legislation as well as local public health unit policies and practices. This study demonstrated that PHIs' assessment and responses to potential physical housing hazards were influenced by an interplay between variables related to residents, local service partners, organizational culture, and policy. The recommendations for action also range from specific public health unit protocol to broader research and policy advocacy initiatives. Collectively, the recommendations focus on strategies for optimizing the role of PHIs in reducing housing health risks in mid-size urban or rural areas.

  8. A critique of a World Health Organization-commissioned report and associated paper on electronic cigarettes.

    PubMed

    McNeill, Ann; Etter, Jean-Francois; Farsalinos, Konstantinos; Hajek, Peter; le Houezec, Jacques; McRobbie, Hayden

    2014-12-01

    The World Health Organization (WHO) recently commissioned a report reviewing evidence on electronic cigarettes and making policy recommendations. A version of it was subsequently published as an academic paper. We identify important errors in the description and interpretation of the studies reviewed, and find many of its key conclusions misleading.

  9. Our correspondence with the World Health Organization about the hypertension guidelines.

    PubMed

    1999-12-01

    (1) Following publication of the hypertension guidelines by the World Health Organization (WHO) and the International Society of Hypertension (ISH) we wrote to Dr Brundtland, criticizing the recommendations that markedly conflicted with reliable published data. (2) We were not happy with Dr Brundtland's response to our letter, so we have stopped the process to become a WHO collaborating centre.

  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. Developing longitudinal qualitative designs: lessons learned and recommendations for health services research

    PubMed Central

    2013-01-01

    Background Longitudinal qualitative methods are becoming increasingly used in the health service research, but the method and challenges particular to health care settings are not well described in the literature.We reflect on the strategies used in a longitudinal qualitative study to explore the experience of symptoms in cancer patients and their carers, following participants from diagnosis for twelve months; we highlight ethical, practical, theoretical and methodological issues that need to be considered and addressed from the outset of a longitudinal qualitative study. Results Key considerations in undertaking longitudinal qualitative projects in health research, include the use of theory, utilizing multiple methods of analysis and giving consideration to the practical and ethical issues at an early stage. These can include issues of time and timing; data collection processes; changing the topic guide over time; recruitment considerations; retention of staff; issues around confidentiality; effects of project on staff and patients, and analyzing data within and across time. Conclusions As longitudinal qualitative methods are becoming increasingly used in health services research, the methodological and practical challenges particular to health care settings need more robust approaches and conceptual improvement. We provide recommendations for the use of such designs. We have a particular focus on cancer patients, so this paper will have particular relevance for researchers interested in chronic and life limiting conditions. PMID:23388075

  12. European Organization for Research and Treatment of Cancer and International Society for Cutaneous Lymphoma consensus recommendations for the management of cutaneous B-cell lymphomas.

    PubMed

    Senff, Nancy J; Noordijk, Evert M; Kim, Youn H; Bagot, Martine; Berti, Emilio; Cerroni, Lorenzo; Dummer, Reinhard; Duvic, Madeleine; Hoppe, Richard T; Pimpinelli, Nicola; Rosen, Steven T; Vermeer, Maarten H; Whittaker, Sean; Willemze, Rein

    2008-09-01

    Primary cutaneous B-cell lymphomas (CBCL) represent approximately 20% to 25% of all primary cutaneous lymphomas. With the advent of the World Health Organization-European Organization for Research and Treatment of Cancer (EORTC) Consensus Classification for Cutaneous Lymphomas in 2005, uniform terminology and classification for this rare group of neoplasms were introduced. However, staging procedures and treatment strategies still vary between different cutaneous lymphoma centers, which may be because consensus recommendations for the management of CBCL have never been published. Based on an extensive literature search and discussions within the EORTC Cutaneous Lymphoma Group and the International Society for Cutaneous Lymphomas, the present report aims to provide uniform recommendations for the management of the 3 main groups of CBCL. Because no systematic reviews or (randomized) controlled trials were available, these recommendations are mainly based on retrospective studies and small cohort studies. Despite these limitations, there was consensus among the members of the multidisciplinary expert panel that these recommendations reflect the state-of-the-art management as currently practiced in major cutaneous lymphoma centers. They may therefore contribute to uniform staging and treatment and form the basis for future clinical trials in patients with a CBCL.

  13. Assessing readability formula differences with written health information materials: application, results, and recommendations.

    PubMed

    Wang, Lih-Wern; Miller, Michael J; Schmitt, Michael R; Wen, Frances K

    2013-01-01

    Readability formulas are often used to guide the development and evaluation of literacy-sensitive written health information. However, readability formula results may vary considerably as a result of differences in software processing algorithms and how each formula is applied. These variations complicate interpretations of reading grade level estimates, particularly without a uniform guideline for applying and interpreting readability formulas. This research sought to (1) identify commonly used readability formulas reported in the health care literature, (2) demonstrate the use of the most commonly used readability formulas on written health information, (3) compare and contrast the differences when applying common readability formulas to identical selections of written health information, and (4) provide recommendations for choosing an appropriate readability formula for written health-related materials to optimize their use. A literature search was conducted to identify the most commonly used readability formulas in health care literature. Each of the identified formulas was subsequently applied to word samples from 15 unique examples of written health information about the topic of depression and its treatment. Readability estimates from common readability formulas were compared based on text sample size, selection, formatting, software type, and/or hand calculations. Recommendations for their use were provided. The Flesch-Kincaid formula was most commonly used (57.42%). Readability formulas demonstrated variability up to 5 reading grade levels on the same text. The Simple Measure of Gobbledygook (SMOG) readability formula performed most consistently. Depending on the text sample size, selection, formatting, software, and/or hand calculations, the individual readability formula estimated up to 6 reading grade levels of variability. The SMOG formula appears best suited for health care applications because of its consistency of results, higher level of expected

  14. Effects of leather industry on health and recommendations for improving the situation in Pakistan.

    PubMed

    Syed, Madiha; Saleem, Taimur; Shuja-ur-Rehman; Iqbal, Muhammed Asif; Javed, Faisal; Khan, Muhammed Bilal Salman; Sadiq, Kamran

    2010-01-01

    The leather industry and its associated sectors contribute significantly to the Pakistani economy. There are around 600 tanneries in Pakistan that are concentrated in 3 major cities (Kasur, Karachi, Sialkot). Waste discharge from tanneries pollutes the air, soil, and water, causing serious health problems. Exposure to such contaminated environmental milieu has been seen to culminate in a multiple array of disease processes such as asthma, dermatitis, hepatic and neurological disorders, and various malignancies. An overall dearth of research on the occupational hazards of employment in the leather industry as well as its effects on pediatric population was observed during literature review with particular reference to Pakistan. It is recommended that research should be conducted about the health hazards in the leather industry in Pakistan as well as globally to gather data that can be translated into effective prevention programs for both adults as well as pediatric populations.

  15. Trial-based economic evaluations in occupational health: principles, methods, and recommendations.

    PubMed

    van Dongen, Johanna M; van Wier, Marieke F; Tompa, Emile; Bongers, Paulien M; van der Beek, Allard J; van Tulder, Maurits W; Bosmans, Judith E

    2014-06-01

    To allocate available resources as efficiently as possible, decision makers need information on the relative economic merits of occupational health and safety (OHS) interventions. Economic evaluations can provide this information by comparing the costs and consequences of alternatives. Nevertheless, only a few of the studies that consider the effectiveness of OHS interventions take the extra step of considering their resource implications. Moreover, the methodological quality of those that do is generally poor. Therefore, this study aims to help occupational health researchers conduct high-quality trial-based economic evaluations by discussing the theory and methodology that underlie them, and by providing recommendations for good practice regarding their design, analysis, and reporting. This study also helps consumers of this literature with understanding and critically appraising trial-based economic evaluations of OHS interventions.

  16. Funding agencies and disease organizations: resources and recommendations to facilitate ALS clinical research.

    PubMed

    Chad, David A; Bidichandani, Sanjay; Bruijn, Lucie; Capra, J Donald; Dickie, Brian; Ferguson, John; Figlewicz, Denise; Forsythe, Melissa; Kaufmann, Petra; Kirshner, Annette; Monti, William

    2013-05-01

    Ten groups presented their perspectives on facilitating clinical research in ALS including four federal agencies, four disease organizations, one foundation and one advocacy group. The federal agencies (National Institute of Neurological Disorders and Stroke, National Institute of Environmental Health Sciences, Office of Rare Diseases Research, Department of Defense) encourage fostering a team approach between pre-clinical and clinical research investigators, coordinating with patient groups in the early phases of clinical studies, enhancing private and public partnerships, and investigating the interplay between genetic susceptibility and environmental exposure. The disease organizations (Muscular Dystrophy Association, ALS Association, ALS Society of Canada, and the Motor Neurone Disease Association UK) support fellowship training programs to develop ALS clinician scientists, and encourage work on the epidemiology of ALS, on genetic and epigenetic mechanisms that are relevant to ALS pathogenesis, on developing ALS registries and biobanks, and building bridges of collaboration among study groups. The Foundation supports innovative projects, including stem-cell research, and Patient Advocacy is committed to supporting excellence in ALS research and patient care, and believes strongly in enhancing communication between patients and members of the research community.

  17. [Declared dead? Recommendations regarding integrated care from the perspective of German statutory health insurance].

    PubMed

    Amelung, Volker; Wolf, S; Ozegowski, S; Eble, S; Hildebrandt, H; Knieps, F; Lägel, R; Schlenker, R-U; Sjuts, R

    2015-04-01

    The traditional separation of health care into sectors in Germany causes communication problems that hinder continuous, patient-oriented care. This is most evident in the transition from inpatient to outpatient care. That said, there are also breaks in the flow of information, a lack of supply, or even incorrect information flowing within same-sector care. The transition from a division of functions into sectors to a patient-oriented process represents a change in the paradigm of health care that can only be successfully completed with considerable effort. Germany's statutory health insurance (SHI) funds play a key role here, as they are the contracting parties as well as the financiers of integrated care, and are strategically located at the center of the development process.The objective of this article is to explore how Germany's SHI funds view integrated care, what they regard as being the drivers of and barriers to transitioning to such a system, and what recommendations they can provide with regard to the further development of integrated care. For this purpose semi-structured interviews with board members and those responsible for implementing integrated care into the operations of ten SHI funds representing more than half of Germany's SHI-insured population were conducted. According to the interviewees, a better framework for integrated care urgently needs to be developed and rendered more receptive to innovation.Only in this way will the widespread stagnation of the past several years be overcome. The deregulation of § 140a-d SGB V and the establishment of a uniform basis for new forms of care in terms of a new innovation clause are among the central recommendations of this article. The German federal government's innovation fund was met with great hope, but also implied risks. Nonetheless, the new law designed to strengthen health care overall generated high expectations.

  18. Persistent organic pollutants and male reproductive health

    PubMed Central

    Vested, Anne; Giwercman, Aleksander; Bonde, Jens Peter; Toft, Gunnar

    2014-01-01

    Environmental contaminants such as persistent organic pollutants (POPs) are man-made bioaccumulative compounds with long half-lives that are found throughout the world as a result of heavy use in a variety of consumer products during the twentieth century. Wildlife and animal studies have long suggested adverse effects of exposure to these compounds on human reproductive health, which, according to the endocrine disrupter hypothesis, are ascribed to the compounds’ potential to interfere with endocrine signaling, especially when exposure occurs during certain phases of fetal and childhood development. An extensive number of epidemiological studies have addressed the possible effects of exposure to POPs on male reproductive health, but the results are conflicting. Thus far, most studies have focused on investigating exposure and the different reproductive health outcomes during adulthood. Some studies have addressed the potential harmful effects of fetal exposure with respect to malformations at birth and/or reproductive development, whereas only a few studies have been able to evaluate whether intrauterine exposure to POPs has long-term consequences for male reproductive health with measurable effects on semen quality markers and reproductive hormone levels in adulthood. Humans are not exposed to a single compound at a time, but rather, to a variety of different substances with potential divergent hormonal effects. Hence, how to best analyze epidemiological data on combined exposures remains a significant challenge. This review on POPs will focus on current knowledge regarding the potential effects of exposure to POPs during fetal and childhood life and during adulthood on male reproductive health, including a critical revision of the endocrine disruption hypothesis, a comment on pubertal development as part of reproductive development and a comment on how to account for combined exposures in epidemiological research. PMID:24369135

  19. 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…

  20. 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…

  1. [Return on investment for occupational health: review of methods and recommendations].

    PubMed

    Rydlewska-Liszkowska, Izabela

    2010-01-01

    The impact of the population health on the national economy, occupational risk factors and economic consequences of workers' behaviors in the workplace are the subject of health economics studies. Conditions and behaviors at work are recognized as one of the major economic factors. These relations are analyzed and evaluated with use of methods that combine economic consequences of working conditions, management and enterprise finances. The methods of assessing this impact are well known but the ability to implement them in practice is still limited. There are two main types of methods: methods for measuring economic relations between the work environment and enterprise management and methods for the economic analysis of investments in the work environment and occupational health. Methods for assessing economic effectiveness of working conditions limited to measurements of costs of absenteeism at work are also used. One of the methodological options in this regard is return on investment (ROI) for occupational health. ROI has been applied in many firms all over the world. Depending on the analytical assumptions and the scope of research, the ROI value ranged between more than 1 and 13. This means that the increase in return on investment for occupational health has been observed. There are examples that the return on invested resources cannot be always obtained. ROI accounting gives employers an opportunity of increasing effectiveness. Evidence of the real value of health investment enables to provide the platform of discussion among managers and other persons responsible for occupational health management. The results of the studies cannot be overestimated as an element of economic incentives system. Based on the review of the methods and results of their implementation some recommendations can be formulated.

  2. [Environment and health in Taranto, southern Italy: epidemiological studies and public health recommendations].

    PubMed

    Comba, Pietro; Pirastu, Roberta; Conti, Susanna; De Santis, Marco; Iavarone, Ivano; Marsili, Giovanni; Mincuzzi, Antonia; Minelli, Giada; Manno, Valerio; Minerba, Sante; Musmeci, Loredana; Rashid, Ivan; Soggiu, Eleonora; Zona, Amerigo

    2012-01-01

    in Taranto IPS (Italian polluted site, made up of 2 municipalities) the Decree defining site boundaries lists the presence of a refinery, a steel plant, a harbour area and waste landfills together with illegal dumping sites. Previous environmental and epidemiological investigations in the area documented the presence of environmental contamination and increased mortality from respiratory and cardiovascular diseases as well as a number of cancer sites; for these same health outcomes the cohort study of residents showed increased risk both in terms of mortality and morbidity. to describe the health status of residents in Taranto IPS analyzing different health indicators available at municipal level, i.e. mortality (2003-2009), mortality time trend (1980-2008) and cancer incidence (2006-2007). the analyses were carried out for residents in Taranto IPS. Mortality update (SENTIERI Project, 2003-2009) regards 63 single or grouped causes (all ages, both genders); for a selection of causes 0-1 and 0-14 age classes were analyzed (both genders combined). Standardized mortality ratio crude (SMR) and deprivation adjusted together with 90% confidence intervals (90%CI) were computed using regional rates for comparison. Mortality time trend (1980-2008, triennial intervals) were analyzed calculating standardized rates (0-99 years, both genders, per 100,000, Italian population at 2001 Census as reference) and 90%CI. Time trends were computed for all causes, all neoplasms (and lung cancer), cardiovascular diseases (and ischemic heart diseases), respiratory diseases (also acute and chronic) and all causes infant mortality (both genders combined). For cancer incidence (2006-2007) Standardized incidence ratio (SIR) and 90%CI were calculated for both genders; incidence rates of cancer registries of the macroarea South and Islands (2005-2007) and rates of Taranto Province excluding SIN municipalities (2006-2007) were used for comparison. in Taranto IPS mortality among men is in excess in

  3. Health care economics, financing, organization, and delivery.

    PubMed

    Cox, Malcolm; Pacala, James T; Vercellotti, Gregory M; Shea, Judy A

    2004-01-01

    The US health care system is in a state of rapid evolution, with changing payment, organizational, and management structures. To learn how to function optimally in a system in which care is increasingly managed and competitive, today's medical students must understand the structural and economic underpinnings of the system within which they will practice. At the outset of the Undergraduate Medical Education for the 21st Century (UME-21) project, the great majority of medical school curricula were lacking in areas of health care financing and organizational structure. The institutions involved in the UME-21 project sought to address curricular deficiencies in two broad areas: (1) the structure and financing of the US health care system ("health policy") and (2) the manner in which this system is reflected in the organization and activities of health care providers ("care delivery"). This article discusses the development, implementation, and evaluation of the first of the two areas. Data were abstracted from written reports provided by each of the UME-21 schools to the project's Executive Committee and sponsor. In selected cases, additional data were obtained by personal communications with project directors and evaluators. Local UME-21 project leaders verified all data presented. Curricular philosophy and teaching methods varied widely, but health policy curricula were predominantly preclinical and didactic in nature. At the school level, much was achieved in terms of student knowledge, curricula were generally well received by students, attitudes toward managed care generally moved in a positive direction, and behavior may have been positively influenced as well. At the project level, many potentially interesting changes exist within the 18 schools and between the UME-21 and other schools, but it is not clear whether or what parts of the health policy curricula were responsible for these changes. Nonetheless, as measured by changes in health policy-related items

  4. Behavioral Recommendations in Health Research News as Cues to Action: Self-Relevancy and Self-Efficacy Processes.

    PubMed

    Chang, Chingching

    2016-08-01

    This study argues that behavioral recommendations in health news function as cues to action. A proposed self-oriented model seeks to explore the impacts of behavioral recommendations in health research news as cues to action through their influences on self-relevancy and self-efficacy. A content analysis (Study 1) first establishes that health research news commonly features behavioral recommendations. A message experiment (Study 2) then explores the utility of behavioral recommendations as cues to action by demonstrating a self-relevancy effect: Health research news with, as opposed to without, behavioral recommendations increases the self-relevancy of advocated health behaviors, which then improve people's attitudes toward and intentions to adopt those behaviors. A second message experiment (Study 3) tests whether varying presentations of behavioral recommendations alter their effectiveness as cues to action and thus people's behavioral intentions through a dual effect process. In addition to the previously demonstrated self-relevancy effect, this experiment shows that concrete, as opposed to abstract, behavioral recommendations trigger a self-efficacy effect, increasing perceived self-efficacy and further improving behavioral intentions.

  5. Sampling protocol recommendations for measuring soil organic carbon stocks in the tropics

    NASA Astrophysics Data System (ADS)

    van Straaten, Oliver; Veldkamp, Edzo; Corre, Marife D.

    2013-04-01

    In the tropics, there is an urgent need for cost effective sampling approaches to quantify soil organic carbon (SOC) changes associated with land-use change given the lack of reliable data. The tropics are especially important considering the high deforestation rates, the huge belowground carbon pool and the fast soil carbon turnover rates. In the framework of a pan-tropic (Peru, Cameroon and Indonesia) land-use change study, some highly relevant recommendations on the SOC stocks sampling approaches have emerged. In this study, where we focused on deeply weathered mineral soils, we quantified changes in SOC stock following land-use change (deforestation and subsequent establishment of other land-uses). We used a space-for-time substitution sampling approach, measured SOC stocks in the top three meters of soil and compared recently converted land-uses with adjacent reference forest plots. In each respective region we investigated the most predominant land-use trajectories. In total 157 plots were established across the three countries, where soil samples were taken to a depth of three meters from a central soil pit and from the topsoil (to 0.5m) from 12 pooled composite samples. Finding 1 - soil depth: despite the fact that the majority of SOC stock from the three meter profile is found below one meter depth (50 to 60 percent of total SOC stock), the significant changes in SOC were only measured in the top meter of soil, while the subsoil carbon stock remained relatively unchanged by the land-use conversion. The only exception was for older (>50 yrs) cacao plantations in Cameroon where significant decreases were found below one meter. Finding 2 - pooled composite samples taken across the plot provided more spatially representative estimates of SOC stocks than samples taken from the central soil pit.

  6. 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

  7. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association.

    PubMed

    Haskell, William L; Lee, I-Min; Pate, Russell R; Powell, Kenneth E; Blair, Steven N; Franklin, Barry A; Macera, Caroline A; Heath, Gregory W; Thompson, Paul D; Bauman, Adrian

    2007-08-01

    In 1995 the American College of Sports Medicine and the Centers for Disease Control and Prevention published national guidelines on Physical Activity and Public Health. The Committee on Exercise and Cardiac Rehabilitation of the American Heart Association endorsed and supported these recommendations. The purpose of the present report is to update and clarify the 1995 recommendations on the types and amounts of physical activity needed by healthy adults to improve and maintain health. Development of this document was by an expert panel of scientists, including physicians, epidemiologists, exercise scientists, and public health specialists. This panel reviewed advances in pertinent physiologic, epidemiologic, and clinical scientific data, including primary research articles and reviews published since the original recommendation was issued in 1995. Issues considered by the panel included new scientific evidence relating physical activity to health, physical activity recommendations by various organizations in the interim, and communications issues. Key points related to updating the physical activity recommendation were outlined and writing groups were formed. A draft manuscript was prepared and circulated for review to the expert panel as well as to outside experts. Comments were integrated into the final recommendation. To promote and maintain health, all healthy adults aged 18 to 65 yr need moderate-intensity aerobic (endurance) physical activity for a minimum of 30 min on five days each week or vigorous-intensity aerobic physical activity for a minimum of 20 min on three days each week. [I (A)] Combinations of moderate- and vigorous-intensity activity can be performed to meet this recommendation. [IIa (B)] For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates

  8. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association.

    PubMed

    Haskell, William L; Lee, I-Min; Pate, Russell R; Powell, Kenneth E; Blair, Steven N; Franklin, Barry A; Macera, Caroline A; Heath, Gregory W; Thompson, Paul D; Bauman, Adrian

    2007-08-28

    In 1995 the American College of Sports Medicine and the Centers for Disease Control and Prevention published national guidelines on Physical Activity and Public Health. The Committee on Exercise and Cardiac Rehabilitation of the American Heart Association endorsed and supported these recommendations. The purpose of the present report is to update and clarify the 1995 recommendations on the types and amounts of physical activity needed by healthy adults to improve and maintain health. Development of this document was by an expert panel of scientists, including physicians, epidemiologists, exercise scientists, and public health specialists. This panel reviewed advances in pertinent physiologic, epidemiologic, and clinical scientific data, including primary research articles and reviews published since the original recommendation was issued in 1995. Issues considered by the panel included new scientific evidence relating physical activity to health, physical activity recommendations by various organizations in the interim, and communications issues. Key points related to updating the physical activity recommendation were outlined and writing groups were formed. A draft manuscript was prepared and circulated for review to the expert panel as well as to outside experts. Comments were integrated into the final recommendation. To promote and maintain health, all healthy adults aged 18 to 65 yr need moderate-intensity aerobic (endurance) physical activity for a minimum of 30 min on five days each week or vigorous-intensity aerobic physical activity for a minimum of 20 min on three days each week. [I (A)] Combinations of moderate- and vigorous-intensity activity can be performed to meet this recommendation. [IIa (B)] For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates

  9. Improving Human Resources for Health means Retaining Health-Workers: Application of the WHO-Recommendations for the Retention of Health-Workers in Rural Northern-Nigeria.

    PubMed

    Afenyadu, Godwin Y; Adegoke, Adetoro A; Findley, Sally

    2017-01-01

    Nigeria is one of 57 countries with critical shortage of health workers (HWs). Strategies to increase and equitably distribute HWs are critical to the achievement of Health Millennium/Sustainable Development Goals. We describe how three Northern Nigeria states adapted World Health Organisation (WHO)-recommended incentives to attract, recruit, and retain midwives. Secondary analysis of data from two surveys assessing midwife motivation, retention, and attrition in Northern Nigeria; and expert consultations. Midwives highlighted financial and non-financial incentives as key factors in their decisions to renew their contracts. Their perspectives informed the consensus positions of health managers, policymakers and heads of institutions, and led to the adaptation of the WHO recommendations into appropriate state-specific incentive packages. The feedback from midwives combined with an expert consultation approach allowed stakeholders to consider and use available evidence to select appropriate incentive packages that offer the greatest potential for helping to address inadequate numbers of rural midwives.

  10. A guide for health professionals to interpret and use recommendations in guidelines developed with the GRADE approach.

    PubMed

    Neumann, Ignacio; Santesso, Nancy; Akl, Elie A; Rind, David M; Vandvik, Per Olav; Alonso-Coello, Pablo; Agoritsas, Thomas; Mustafa, Reem A; Alexander, Paul Elias; Schünemann, Holger; Guyatt, Gordon H

    2016-04-01

    An increasing number of organizations worldwide are using new and improved standards for developing trustworthy clinical guidelines. One of such approaches, developed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group, offers systematic and transparent guidance in moving from evidence to recommendations. The GRADE strategy concentrates on four factors: the balance between benefits and harms, the certainty of the evidence, values and preferences, and resource considerations. However, it also considers issues around feasibility, equity, and acceptability of recommendations. GRADE distinguishes two types of recommendations: strong and weak. Strong recommendations reflect a clear preference for one alternative and should apply to all or almost all patients, obviating the need for a careful review of the evidence with each patient. Weak recommendations are appropriate when there is a close balance between desirable and undesirable consequences of alternative management strategies, uncertainty regarding the effects of the alternatives, uncertainty or variability in patients' values and preferences, or questionable cost-effectiveness. Weak recommendations usually require accessing the underlying evidence and a shared decision-making approach. Clinicians using GRADE recommendations should understand the meaning of the strength of the recommendation, be able to critically appraise the recommendation, and apply trustworthy recommendations according to their strength.

  11. [Recommendations from parents of obese children in treatment to the health-care team: qualitative study].

    PubMed

    García, Andrea; Aspillaga, Carolina; Cruzat-Mandich, Claudia; Barja, S

    2017-01-01

    The family plays an essential role in the adherence and effectiveness in the treatment of childhood obesity. Caregivers’ experience is fundamental for proper guidance. To describe the recommendations for the health-care team made by parents of children that are being treated for obesity. Cross-sectional and descriptive study with a qualitative approach and purposeful sampling. In the first semester of 2015, interviews were conducted with nine parents of children from 4 to 10 years old that were being treated for obesity ad who had at least three medical appointments in the previous year. The data analysis was based on the Grounded Theory Approach through open coding. The study was ethically approved and informed parental consent was obtained. The results were grouped in the following main categories: a) Health-care team-caregiver relationship, b) Health-care team-child relationship, c) Encouraging family participation, d) Encouraging therapeutic adherence in the child and e) Frequency of medical appointments. From the perspective of this group of parents of obese children, the health-care team should establish a close therapeutic bond with the children and their parents during the treatment process, in addition to encouraging family participation. The importance of developing therapeutic interventions that consider the perspective of the patient’s system is emphasized.

  12. Military Youth and the Deployment Cycle: Emotional Health Consequences and Recommendations for Intervention

    PubMed Central

    Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M.; Bodzy, Mary; Swenson, Rebecca R.; Spirito, Anthony

    2011-01-01

    The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and re-integration periods. Despite widespread acknowledgement of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically-based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle. PMID:21707172

  13. Military youth and the deployment cycle: emotional health consequences and recommendations for intervention.

    PubMed

    Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M; Bodzy, Mary; Swenson, Rebecca R; Spirito, Anthony

    2011-08-01

    The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and reintegration periods. Despite widespread acknowledgment of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle.

  14. Emergency preparedness in high school-based athletics: a review of the literature and recommendations for sport health professionals.

    PubMed

    Olympia, Robert P; Brady, Jodi

    2013-05-01

    Approximately 7.6 million high school students in the United States participate in sports. Although most sport-related injuries in adolescents are considered minor emergencies, life-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus and exercise-induced asthma, catastrophic brain injuries, cervical spine injuries, heat- and cold-related illness, blunt chest/abdominal injuries, and extremity fractures resulting in compartment syndrome. Emergency preparedness in athletics involves the identification of and planning for medical services to promote the safety of the athlete, to limit injury, and to provide medical care at the site of practice or competition. Several national organizations have published guidelines for emergency preparedness in school-based athletics. Our article reviews guidelines for emergency preparedness put forth by the Sideline Preparedness collaboration (comprised of 6 major professional associations, including the American Academy of Family Physicians, American Academy of Orthopedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine), the National Athletic Trainers' Association, the American Academy of Pediatrics' Committee on School Health, and the American Heart Association. Additionally, we review published data examining compliance of US high schools with these recommendations for emergency preparedness in school-based athletics, determine deficiencies, and provide recommendations for improvement based on these deficiencies.

  15. [Health-related strength and power training in seniors: Purpose and recommendations].

    PubMed

    Donath, Lars; Faude, Oliver; Bopp, Micha; Zahner, Lukas

    2015-05-01

    The proportion of older people in western societies rapidly increases. Aging-induced disease conditions accompanied with declines in cardiocirculatory and neuromuscular performance constitute a major individual and economic health burden. Besides decreasing vascular and cardiac function during the process of aging, a loss of skeletal muscle mass, muscle structure and function seem to mainly account for decreasing maximal strength, strength development and strength endurance. These findings adversely interfer with static and dynamic postural control and may lead to an increased risk of falling with impairments of autonomy and quality of life. Traditional strength training recommendations basing on health-related exercise prescriptions for elderly people have been proven to counteract or at least attenuate aging-induced declines of neuromuscular muscular function. Multimodal and combined strength and balance training deliver additional improvements of neuromuscular capacity. Recent evidence additionally underpin the need of trunk muscle training and claimed for regimes considering explosive and high-velocity strength training in seniors. High quality RCTs revealed notable strength training effects on mobility, autonomy, quality of life and the reduction of the risk of falling (up to 50%). Available evidence also indicates that various strength training regimes elicit preventive and therapeutic effects on osteoporosis, diabetes type 2 and other chronic diseases, with effect sizes comparable to medication intake. Thus, health care providers, health insurances, Employers' Liability Insurance Associations and politicians should promote infrastructural developments that enable feasible and cost-effective access to health-related fitness centers or other sport facilities (e. g. sport clubs). These environmental requirements should be embedded in multi-centric education programs and campaigns that might enable regularly conducted strength and endurance training perceived as

  16. Using existing health care systems to respond to the AIDS epidemic: research and recommendations for Chile.

    PubMed

    Aiken, L H; Smith, H L; Lake, E T

    1997-01-01

    Chile is a country with a relatively low prevalence of HIV infection, where successful prevention has the potential to change the future course of the epidemic. A controversial national prevention strategy based upon public education has emerged in response to characterizations of the epidemic as well-dispersed with a growing involvement of heterosexuals. This characterization is not consistent with the observed facts. There is a comparatively well-organized health care system in Santiago that is doing a good job of detecting HIV infection and already has in place the elements of a targeted intervention scheme. Chile should place priority on the use of the existing health care infrastructure for implementing both the traditional public health interventions for sexually transmitted diseases (contact tracing and partner notification) and the AIDS-necessitated strategy of focused counseling and education.

  17. The First Physical Therapy Summit on Global Health: implications and recommendations for the 21st century.

    PubMed

    Dean, Elizabeth; Al-Obaidi, Saud; De Andrade, Armele Dornelas; Gosselink, Rik; Umerah, Gloria; Al-Abdelwahab, Sami; Anthony, Joseph; Bhise, Anjali R; Bruno, Selma; Butcher, Scotty; Fagevik-Olsén, Monika; Frownfelter, Donna; Gappmaier, Eduard; Gylfadóttir, Sif; Habibi, Mehrdad; Hanekom, Susan; Hasson, Scott; Jones, Alice; LaPier, Tanya; Lomi, Constantina; Mackay, Liz; Mathur, Sunita; O'Donoghue, Grainne; Playford, Kristen; Ravindra, Savita; Sangroula, Kanchan; Scherer, Susan; Skinner, Margot; Wong, Wai Pong

    2011-11-01

    The First Physical Therapy Summit on Global Health was convened at the 2007 World Confederation for Physical Therapy (WCPT) Congress to vision practice in the 21st century and, in turn, entry-level education and research, as informed by epidemiological indicators, and consistent with evidence-based noninvasive interventions, the hallmark of physical therapy. The Summit and its findings were informed by WHO data and validated through national databases of the countries of the five WCPT regions. The health priorities based on mortality were examined in relation to proportions of physical therapists practicing in the areas of regional priorities and of the curricula in entry-level programs. As a validation check and to contextualize the findings, input from members of the 800 Summit participants was integrated and international consultants refined the recommendations. Lifestyle-related conditions (ischemic heart disease, smoking-related conditions, hypertension, stroke, cancer, and diabetes) were leading causes of premature death across regions. Contemporary definitions of physical therapy support that the profession has a leading role in preventing, reversing, as well as managing lifestyle-related conditions. The proportions of practitioners practicing primarily in these priority areas and of the entry-level curricula based on these priorities were low. The proportions of practitioners in priority areas and entry-level curricula devoted to lifestyle-related conditions warrant being better aligned with the prevalence of these conditions across regions in the 21st century. A focus on clinical competencies associated with effective health education and health behavior change formulates the basis for The Second Physical Therapy Summit on Global Health.

  18. The World Health Organization's role and future plans in laboratory standardization.

    PubMed

    Heuck, C C

    1993-01-01

    WHO is monitoring health care and the status of health of the population in each of its member states. The statistics provides valuable information for the comparison of the effectiveness of different health systems. As part of its global responsibility on health WHO issues international reference materials (IRMs), assigns international nonproprietary names for therapeutics (INNs), publishes guidelines for good manufacturing practice (GMP) and good laboratory practice (GLP) and, in collaboration with international professional organizations, makes recommendations towards achieving global harmonization of clinical laboratory investigations.

  19. Diagnostic Accuracy of Two Food Insecurity Screeners Recommended for Use in Health Care Settings.

    PubMed

    Makelarski, Jennifer A; Abramsohn, Emily; Benjamin, Jasmine H; Du, Senxi; Lindau, Stacy Tessler

    2017-09-21

    To test the diagnostic accuracy of the American Academy of Pediatrics (AAP) recommended food insecurity screener. We conducted prospective diagnostic accuracy studies between July and November 2016 in Chicago, Illinois. We recruited convenience samples of adults from adult and pediatric emergency departments (12-month recall study: n = 188; 30-day recall study: n = 154). A self-administered survey included the 6-item Household Food Security Screen (gold standard), the validated 2-item Hunger Vital Sign (HVS; often, sometimes, never response categories), and the 2-item AAP tool (yes-or-no response categories). Food insecurity was prevalent (12-month recall group: 46%; 30-day group: 39%). Sensitivity of the AAP tool using 12-month and 30-day recall was, respectively, 76% (95% confidence interval [CI] = 65%, 85%) and 72% (95% CI = 57%, 84%). The HVS sensitivity was significantly higher than the AAP tool (12-month: 94% [95% CI = 86%, 98%; P = .002]; 30-day: 92% [95% CI = 79%, 98%; P = .02]). The AAP tool missed nearly a quarter of food-insecure adults screened in the hospital; the HVS screening tool was more sensitive. Public health implications. Health care systems adopting food insecurity screening should optimize ease of administration and sensitivity of the screening tool. (Am J Public Health. Published online ahead of print September 21, 2017: e1-e6. doi:10.2105/AJPH.2017.304033).

  20. Long term preservation of electronic health records. Recommendations in a large teaching hospital in Belgium.

    PubMed

    France, F H; Beguin, C; van Breugel, R; Piret, C

    2000-01-01

    Health records should be readily accessed by authorised persons for diagnosis, treatment and legal security purposes during patient's lifetime and thereafter for research and training purposes. Technology makes difficult the preservation of digital material, because of rapid changes in information media, hardware and software evolution, and because of the multiplicity of its location as well as the complexity of its environment. A committee in a large teaching hospital in Belgium, recommends two complementary approaches: (1) After a patient departure, all his health information should be managed by a unique organisation that would update regularly accesses to all data bases concerned by this patient. Health archives should be formatted using XML (Extensible Mark up Language) software family, and set on supports such as DVD-ROM, to be upgraded or updated when needed. This archive media is fast but not safe. (2) Computer output microfilm (COM) and scanners for non electronic data to be preserved appears to be also needed, as it is storage safe for at least 250 years and readable directly by eye. This archive media is safe but not fast.

  1. Consumers' perceptions of the dietary supplement health and education act: implications and recommendations.

    PubMed

    Dodge, Tonya

    2016-01-01

    In 1994, the United States Congress passed the Dietary Supplement Health and Education Act (DSHEA). The regulatory framework for dietary supplements created by DSHEA has led to significant misperceptions regarding consumers' understanding of the safety and efficacy of supplements. Research shows that consumers erroneously believe that: (1) supplements are approved by the government, (2) supplements have been tested for safety and effectiveness, (3) the content of supplements is analyzed, and (4) manufacturers are required to disclose known adverse effects to consumers. Furthermore, labelling requirements that are intended to provide transparency to consumers are relatively ineffective. The following four recommendations are offered for reforming DSHEA: (1) only allow structure-function claims that are supported by research evidence, (2) require manufacturers to list known adverse effects on the labels of dietary supplements, (3) require that the Food and Drug Administration analyzes the content of dietary supplements and (4) restrict the definition of dietary ingredients. These recommendations would bring DSHEA to more closely align with consumer expectations regarding the regulation of dietary supplements and would likely provide a safer landscape for the use of supplements. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Lack of a recommended dietary allowance for copper may be hazardous to your health.

    PubMed

    Klevay, L M

    1998-08-01

    The 10th edition of Recommended Dietary Allowances (RDA) did not include an RDA for copper; rather a safe and adequate daily intake was suggested. Criteria, history and uses of RDAs were summarized along with data on dietary intakes, balance and depletion experiments, low (fats and oils, skim milk and yogurt) and high (legumes, mushrooms, nuts and seeds) copper foods and hazards of zinc supplements. Bone disease and cardiovascular disease from diets-low in copper have been studied in animals for decades. Men and women fed diets close to 1 mg of copper per day, amounts quite frequent in the US, responded similarly to deficient animals with reversible, potentially harmful changes in blood pressure control, cholesterol and glucose metabolism, and electrocardiograms. Women supplemented with trace elements including copper experienced beneficial effects on bone density. These data exceed similar data on magnesium, selenium and zinc and are sufficient for establishing an RDA. Ischemic heart disease and osteoporosis are likely consequences of diets low in copper. Numerous anatomical, chemical and physiological similarities between animals deficient in copper and people with ischemic heart disease have been noticed. Association between osteoporosis and low copper status deserves further inquiry. Augmenting low copper diets with high copper foods may be beneficial. Committees that establish RDAs should return to the traditions of the first nine editions and make recommendations that promote health and nutritional welfare, meet functional needs, prevent disease and promote public welfare.

  3. Extracting insights from electronic health records: case studies, a visual analytics process model, and design recommendations.

    PubMed

    Wang, Taowei David; Wongsuphasawat, Krist; Plaisant, Catherine; Shneiderman, Ben

    2011-10-01

    Current electronic health record (EHR) systems facilitate the storage, retrieval, persistence, and sharing of patient data. However, the way physicians interact with EHRs has not changed much. More specifically, support for temporal analysis of a large number of EHRs has been lacking. A number of information visualization techniques have been proposed to alleviate this problem. Unfortunately, due to their limited application to a single case study, the results are often difficult to generalize across medical scenarios. We present the usage data of Lifelines2 (Wang et al. 2008), our information visualization system, and user comments, both collected over eight different medical case studies. We generalize our experience into a visual analytics process model for multiple EHRs. Based on our analysis, we make seven design recommendations to information visualization tools to explore EHR systems.

  4. Recommendations for Internet-Based Qualitative Health Research With Hard-to-Reach Populations

    PubMed Central

    Wilkerson, J. Michael; Iantaffi, Alex; Grey, Jeremy A.; Bockting, Walter O.; Simon Rosser, B. R.

    2014-01-01

    Researchers new to online qualitative health research frequently have questions about how to transfer knowledge of offline data collection to an online environment. In this article, we present best-practice guidelines derived from the literature and our experience to help researchers determine if an online qualitative study design is appropriate for their research project and, if so, when to begin data collection with a hard-to-reach population. Researchers should reflect on administrative, population, and data collection considerations when deciding between online and offline data collection. Decisions must be made regarding whether to conduct interviews or focus groups, to collect data using asynchronous or synchronous methods, and to use only text or incorporate visual media. Researchers should also reflect on human subjects, recruitment, research instrumentation, additional data collection, and public relations considerations when writing protocols to guide the research team’s response to various situations. Our recommendations direct researchers’ reflection on these considerations. PMID:24623662

  5. Recommendations for internet-based qualitative health research with hard-to-reach populations.

    PubMed

    Wilkerson, J Michael; Iantaffi, Alex; Grey, Jeremy A; Bockting, Walter O; Rosser, B R Simon

    2014-04-01

    Researchers new to online qualitative health research frequently have questions about how to transfer knowledge of offline data collection to an online environment. In this article, we present best-practice guidelines derived from the literature and our experience to help researchers determine if an online qualitative study design is appropriate for their research project and, if so, when to begin data collection with a hard-to-reach population. Researchers should reflect on administrative, population, and data collection considerations when deciding between online and offline data collection. Decisions must be made regarding whether to conduct interviews or focus groups, to collect data using asynchronous or synchronous methods, and to use only text or to incorporate visual media. Researchers should also reflect on human subjects, recruitment, research instrumentation, additional data collection, and public relations considerations when writing protocols to guide the research team's response to various situations. Our recommendations direct researchers' reflection on these considerations.

  6. Interactive preventive health record to enhance delivery of recommended care: a randomized trial.

    PubMed

    Krist, Alex H; Woolf, Steven H; Rothemich, Stephen F; Johnson, Robert E; Peele, J Eric; Cunningham, Tina D; Longo, Daniel R; Bello, Ghalib A; Matzke, Gary R

    2012-01-01

    Americans receive only one-half of recommended preventive services. Information technologies have been advocated to engage patients. We tested the effectiveness of an interactive preventive health record (IPHR) that links patients to their clinician's record, explains information in lay language, displays tailored recommendations and educational resources, and generates reminders. This randomized controlled trial involved 8 primary care practices. Four thousand five hundred patients were randomly selected to receive a mailed invitation to use the IPHR or usual care. Outcomes were measured using patient surveys and electronic medical record data and included IPHR use and service delivery. Comparisons were made between invited and usual-care patients and between users and nonusers among those invited to use the IPHR. At 4 and 16 months, 229 (10.2%) and 378 (16.8%) of invited patients used the IPHR. The proportion of patients up-to-date with all services increased between baseline and 16 months by 3.8% among intervention patients (from 11.4% to 15.2%, P <.001) and by 1.5% among control patients (from 11.1% to 12.6%, P = .07), a difference of 2.3% (P = .05). Greater increases were observed among patients who used the IPHR. At 16 months, 25.1% of users were up-to-date with all services, double the rate among nonusers. At 4 months, delivery of colorectal, breast, and cervical cancer screening increased by 19%, 15%, and 13%, respectively, among users. Information systems that feature patient-centered functionality, such as the IPHR, have potential to increase preventive service delivery. Engaging more patients to use systems could have important public health benefits.

  7. Interactive Preventive Health Record to Enhance Delivery of Recommended Care: A Randomized Trial

    PubMed Central

    Krist, Alex H.; Woolf, Steven H.; Rothemich, Stephen F.; Johnson, Robert E.; Peele, J. Eric; Cunningham, Tina D.; Longo, Daniel R.; Bello, Ghalib A.; Matzke, Gary R.

    2012-01-01

    PURPOSE Americans receive only one-half of recommended preventive services. Information technologies have been advocated to engage patients. We tested the effectiveness of an interactive preventive health record (IPHR) that links patients to their clinician’s record, explains information in lay language, displays tailored recommendations and educational resources, and generates reminders. METHODS This randomized controlled trial involved 8 primary care practices. Four thousand five hundred patients were randomly selected to receive a mailed invitation to use the IPHR or usual care. Outcomes were measured using patient surveys and electronic medical record data and included IPHR use and service delivery. Comparisons were made between invited and usual-care patients and between users and nonusers among those invited to use the IPHR. RESULTS At 4 and 16 months, 229 (10.2%) and 378 (16.8%) of invited patients used the IPHR. The proportion of patients up-to-date with all services increased between baseline and 16 months by 3.8% among intervention patients (from 11.4% to 15.2%, P <.001) and by 1.5% among control patients (from 11.1% to 12.6%, P = .07), a difference of 2.3% (P = .05). Greater increases were observed among patients who used the IPHR. At 16 months, 25.1% of users were up-to-date with all services, double the rate among nonusers. At 4 months, delivery of colorectal, breast, and cervical cancer screening increased by 19%, 15%, and 13%, respectively, among users. CONCLUSIONS Information systems that feature patient-centered functionality, such as the IPHR, have potential to increase preventive service delivery. Engaging more patients to use systems could have important public health benefits. PMID:22778119

  8. A critical exploration of the International Classification of Functioning, Disability, and Health (ICF) framework from the perspective of oncology: recommendations for revision

    PubMed Central

    Bornbaum, Catherine C; Doyle, Philip C; Skarakis-Doyle, Elizabeth; Theurer, Julie A

    2013-01-01

    Background: In 2001, the World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) framework in an effort to attend to the multidimensional health-related concerns of individuals. Historically, although the ICF has frequently been used in a rehabilitation-based context, the World Health Organization has positioned it as a universal framework of health and its related states. Consequently, the ICF has been utilized for a diverse array of purposes in the field of oncology, including: evaluating functioning in individuals with cancer, guiding assessment in oncology rehabilitation, assessing the comprehensiveness of outcome measures utilized in oncology research, assisting in health-related quality of life instrument selection, and comparing the primary concerns of health professionals with those of their patients. Discussion: Examination of the ICF through the lens of cancer care highlights the fact that this framework can be a valuable tool to facilitate comprehensive care in oncology, but it currently possesses some areas of limitation that require conceptual revision; to this end, several recommendations have been proposed. Specifically, these proposed recommendations center on the following three areas of the ICF framework: (1) the replacement of the term “health condition” with the more inclusive and dynamic term “health state;” (2) the continuing development and refinement of the personal factors component to ensure issues such as comorbidities can be accounted for appropriately; and (3) the inclusion of a mechanism to account for the subjective dimension of health and functioning (eg, quality of life). Summary: It is through the expansion of these conceptual parameters that the ICF may become more relevant and applicable to the field of oncology. With these important revisions, the ICF has the potential to provide a broader biopsychosocial perspective of care that captures the diverse range of

  9. A critical exploration of the International Classification of Functioning, Disability, and Health (ICF) framework from the perspective of oncology: recommendations for revision.

    PubMed

    Bornbaum, Catherine C; Doyle, Philip C; Skarakis-Doyle, Elizabeth; Theurer, Julie A

    2013-01-01

    In 2001, the World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) framework in an effort to attend to the multidimensional health-related concerns of individuals. Historically, although the ICF has frequently been used in a rehabilitation-based context, the World Health Organization has positioned it as a universal framework of health and its related states. Consequently, the ICF has been utilized for a diverse array of purposes in the field of oncology, including: evaluating functioning in individuals with cancer, guiding assessment in oncology rehabilitation, assessing the comprehensiveness of outcome measures utilized in oncology research, assisting in health-related quality of life instrument selection, and comparing the primary concerns of health professionals with those of their patients. Examination of the ICF through the lens of cancer care highlights the fact that this framework can be a valuable tool to facilitate comprehensive care in oncology, but it currently possesses some areas of limitation that require conceptual revision; to this end, several recommendations have been proposed. Specifically, these proposed recommendations center on the following three areas of the ICF framework: (1) the replacement of the term "health condition" with the more inclusive and dynamic term "health state;" (2) the continuing development and refinement of the personal factors component to ensure issues such as comorbidities can be accounted for appropriately; and (3) the inclusion of a mechanism to account for the subjective dimension of health and functioning (eg, quality of life). It is through the expansion of these conceptual parameters that the ICF may become more relevant and applicable to the field of oncology. With these important revisions, the ICF has the potential to provide a broader biopsychosocial perspective of care that captures the diverse range of concerns that arise throughout the continuum

  10. Advocacy for mental health: roles for consumer and family organizations and governments.

    PubMed

    Funk, Michelle; Minoletti, Alberto; Drew, Natalie; Taylor, Jacob; Saraceno, Benedetto

    2006-03-01

    The World Health Organization urges countries to become more active in advocacy efforts to put mental health on governments' agendas. Health policy makers, planners and managers, advocacy groups, consumer and family organizations, through their different roles and actions, can move the mental health agenda forward. This paper outlines the importance of the advocacy movement, describes some of the roles and functions of the different groups and identifies some specific actions that can be adopted by Ministries of Health. The mental health advocacy movement has developed over the last 30 years as a means of combating stigma and prejudice against people with mental disorders and improving services. Consumer and family organizations and related NGOs have been able to influence governments on mental health policies and laws and educating the public on social integration of people with mental disorders. Governments can promote the development of a strong mental health advocacy sector without compromising this sector's independence. For instance, they can publish and distribute a directory of mental health advocacy groups, include them in their mental health activities and help fledgling groups become more established. There are also some advocacy functions that government officials can, and indeed, should perform themselves. Officials in the ministry of health can persuade officials in other branches of government to make mental health more of a priority, support advocacy activities with both general health workers and mental health workers and carry out public information campaigns about mental disorders and how to maintain good mental health. In conclusion, the World Health Organization believes mental health advocacy is one of the pillars to improve mental health care and the human rights of people with mental disorders. It is hoped that the recommendations in this article will help government officials and activists to strengthen national advocacy movements.

  11. Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice.

    PubMed

    Hagger, Martin S; Luszczynska, Aleksandra; de Wit, John; Benyamini, Yael; Burkert, Silke; Chamberland, Pier-Eric; Chater, Angel; Dombrowski, Stephan U; van Dongen, Anne; French, David P; Gauchet, Aurelie; Hankonen, Nelli; Karekla, Maria; Kinney, Anita Y; Kwasnicka, Dominika; Hing Lo, Siu; López-Roig, Sofía; Meslot, Carine; Marques, Marta Moreira; Neter, Efrat; Plass, Anne Marie; Potthoff, Sebastian; Rennie, Laura; Scholz, Urte; Stadler, Gertraud; Stolte, Elske; Ten Hoor, Gill; Verhoeven, Aukje; Wagner, Monika; Oettingen, Gabriele; Sheeran, Paschal; Gollwitzer, Peter M

    2016-07-01

    The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural medicine who convened to discuss priority issues in planning interventions in health contexts and develop a set of recommendations for future research and practice. The expert group adopted a nominal groups approach and voting system to elicit and structure priority issues in planning interventions and implementation intentions research. Forty-two priority issues identified in initial discussions were further condensed to 18 key issues, including definitions of planning and implementation intentions and 17 priority research areas. Each issue was subjected to voting for consensus among group members and formed the basis of the position statement and recommendations. Specifically, the expert group endorsed statements and recommendations in the following areas: generic definition of planning and specific definition of implementation intentions, recommendations for better testing of mechanisms, guidance on testing the effects of moderators of planning interventions, recommendations on the social aspects of planning interventions, identification of the preconditions that moderate effectiveness of planning interventions and recommendations for research on how people use plans.

  12. Collective-Intelligence Recommender Systems: Advancing Computer Tailoring for Health Behavior Change Into the 21st Century

    PubMed Central

    Cutrona, Sarah L; Kinney, Rebecca L; Marlin, Benjamin M; Mazor, Kathleen M; Lemon, Stephenie C; Houston, Thomas K

    2016-01-01

    Background What is the next frontier for computer-tailored health communication (CTHC) research? In current CTHC systems, study designers who have expertise in behavioral theory and mapping theory into CTHC systems select the variables and develop the rules that specify how the content should be tailored, based on their knowledge of the targeted population, the literature, and health behavior theories. In collective-intelligence recommender systems (hereafter recommender systems) used by Web 2.0 companies (eg, Netflix and Amazon), machine learning algorithms combine user profiles and continuous feedback ratings of content (from themselves and other users) to empirically tailor content. Augmenting current theory-based CTHC with empirical recommender systems could be evaluated as the next frontier for CTHC. Objective The objective of our study was to uncover barriers and challenges to using recommender systems in health promotion. Methods We conducted a focused literature review, interviewed subject experts (n=8), and synthesized the results. Results We describe (1) limitations of current CTHC systems, (2) advantages of incorporating recommender systems to move CTHC forward, and (3) challenges to incorporating recommender systems into CTHC. Based on the evidence presented, we propose a future research agenda for CTHC systems. Conclusions We promote discussion of ways to move CTHC into the 21st century by incorporation of recommender systems. PMID:26952574

  13. Collective-Intelligence Recommender Systems: Advancing Computer Tailoring for Health Behavior Change Into the 21st Century.

    PubMed

    Sadasivam, Rajani Shankar; Cutrona, Sarah L; Kinney, Rebecca L; Marlin, Benjamin M; Mazor, Kathleen M; Lemon, Stephenie C; Houston, Thomas K

    2016-03-07

    What is the next frontier for computer-tailored health communication (CTHC) research? In current CTHC systems, study designers who have expertise in behavioral theory and mapping theory into CTHC systems select the variables and develop the rules that specify how the content should be tailored, based on their knowledge of the targeted population, the literature, and health behavior theories. In collective-intelligence recommender systems (hereafter recommender systems) used by Web 2.0 companies (eg, Netflix and Amazon), machine learning algorithms combine user profiles and continuous feedback ratings of content (from themselves and other users) to empirically tailor content. Augmenting current theory-based CTHC with empirical recommender systems could be evaluated as the next frontier for CTHC. The objective of our study was to uncover barriers and challenges to using recommender systems in health promotion. We conducted a focused literature review, interviewed subject experts (n=8), and synthesized the results. We describe (1) limitations of current CTHC systems, (2) advantages of incorporating recommender systems to move CTHC forward, and (3) challenges to incorporating recommender systems into CTHC. Based on the evidence presented, we propose a future research agenda for CTHC systems. We promote discussion of ways to move CTHC into the 21st century by incorporation of recommender systems.

  14. Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop.

    PubMed

    Michie, Susan; Yardley, Lucy; West, Robert; Patrick, Kevin; Greaves, Felix

    2017-06-29

    Devices and programs using digital technology to foster or support behavior change (digital interventions) are increasingly ubiquitous, being adopted for use in patient diagnosis and treatment, self-management of chronic diseases, and in primary prevention. They have been heralded as potentially revolutionizing the ways in which individuals can monitor and improve their health behaviors and health care by improving outcomes, reducing costs, and improving the patient experience. However, we are still mainly in the age of promise rather than delivery. Developing and evaluating these digital interventions presents new challenges and new versions of old challenges that require use of improved and perhaps entirely new methods for research and evaluation. This article discusses these challenges and provides recommendations aimed at accelerating the rate of progress in digital behavior intervention research and practice. Areas addressed include intervention development in a rapidly changing technological landscape, promoting user engagement, advancing the underpinning science and theory, evaluating effectiveness and cost-effectiveness, and addressing issues of regulatory, ethical, and information governance. This article is the result of a two-day international workshop on how to create, evaluate, and implement effective digital interventions in relation to health behaviors. It was held in London in September 2015 and was supported by the United Kingdom's Medical Research Council (MRC), the National Institute for Health Research (NIHR), the Methodology Research Programme (PI Susan Michie), and the Robert Wood Johnson Foundation of the United States (PI Kevin Patrick). Important recommendations to manage the rapid pace of change include considering using emerging techniques from data science, machine learning, and Bayesian approaches and learning from other disciplines including computer science and engineering. With regard to assessing and promoting engagement, a key

  15. Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop

    PubMed Central

    Yardley, Lucy; West, Robert; Patrick, Kevin; Greaves, Felix

    2017-01-01

    Devices and programs using digital technology to foster or support behavior change (digital interventions) are increasingly ubiquitous, being adopted for use in patient diagnosis and treatment, self-management of chronic diseases, and in primary prevention. They have been heralded as potentially revolutionizing the ways in which individuals can monitor and improve their health behaviors and health care by improving outcomes, reducing costs, and improving the patient experience. However, we are still mainly in the age of promise rather than delivery. Developing and evaluating these digital interventions presents new challenges and new versions of old challenges that require use of improved and perhaps entirely new methods for research and evaluation. This article discusses these challenges and provides recommendations aimed at accelerating the rate of progress in digital behavior intervention research and practice. Areas addressed include intervention development in a rapidly changing technological landscape, promoting user engagement, advancing the underpinning science and theory, evaluating effectiveness and cost-effectiveness, and addressing issues of regulatory, ethical, and information governance. This article is the result of a two-day international workshop on how to create, evaluate, and implement effective digital interventions in relation to health behaviors. It was held in London in September 2015 and was supported by the United Kingdom’s Medical Research Council (MRC), the National Institute for Health Research (NIHR), the Methodology Research Programme (PI Susan Michie), and the Robert Wood Johnson Foundation of the United States (PI Kevin Patrick). Important recommendations to manage the rapid pace of change include considering using emerging techniques from data science, machine learning, and Bayesian approaches and learning from other disciplines including computer science and engineering. With regard to assessing and promoting engagement, a key

  16. Drawing the line: the cultural cartography of utilization recommendations for mental health problems.

    PubMed

    Olafsdottir, Sigrun; Pescosolido, Bernice A

    2009-06-01

    In the 1990s, sociologists began to rethink the failure of utilization models to explain whether and why individuals accessed formal treatment systems. This effort focused on reconceptualizing the underlying assumptions and processes that shaped utilization patterns. While we have built a better understanding of how social networks structure pathways to care and how disadvantaged sociocultural groups face substantial barriers to treatment, we have less understanding of the larger cultural context in which individuals recognize and respond to symptoms. Drawing from recent innovations in the sociology of culture, we develop the concept of "cultural mapping" to describe if and how individuals discriminate among different available sources of formal treatment. Using data from the 1996 Mental Health Module of the General Social Survey, we compare Americans' willingness to recommend providers in the general medical and specialty mental health sectors. The results indicate that, despite unrealistically high levels of endorsement, individuals do discriminate between providers based on their evaluation of the problem, underlying causes, and likely consequences. While perceived severity leads individuals to suggest any type of formal care, problems attributed to biological causes are directed to general or specialty medical providers (doctors, psychiatrists, and hospitals); those matching symptoms for schizophrenia or seen as eliciting violence are allocated to the specialty mental health sector (psychiatry, mental hospital); and those seen as being caused by stress are sent to nonmedical mental health providers (i.e., counselors). These findings help to explain inconsistencies in previous utilization studies, and they suggest the critical importance of maintaining a dialogue between medical sociology and the sociology of culture.

  17. A recommended guideline for the development of mHealth Apps

    PubMed Central

    Christoforidou, Sofia A.; Vlachopoulou, Maro

    2016-01-01

    Background Mobile Health or mHealth applications cope with medical or health issues supported by smartphones. Being a part of great importance in healthcare, mHealth apps are able to improve both the quality of medical services and the safety of the patients. It is regarded to be a new field with great prospect that attracts the interest of the stakeholders and the developers, above all. Of all the entities involved, developers have to face many challenges classified in four pillars: the regulation framework, the market, the technical issues and society. This paper aims to describe the role of the developers in the mHealth apps’ market, the barriers they deal with and also, the impact of their work in the mobile healthcare domain. In our viewpoint, we propose a guideline with all of the developers’ requirements for the buildup of mHealth apps. Methods The methodology followed includes a Boolean search strategy used in academic libraries (PubMed, IEEE Xplore, JMIR, The Cochrane Library) and search engines additionally (Google and Google Scholar), aiming to identify the developers’ perspective. Results Our research from October until December of 2014 led us to academic papers referring to the various demands that developers have to confront. The major outcome of our research is the general acknowledgement of the dominant role that developers own in the mHealth apps’ process. Conclusions Mobile technology allies multiple groups such as users, patients, providers of medical services, software developers, governments and even, non-governmental organizations. In particular, the developers’ perspective involves the legal boundaries, the side of the market, the technological requirements (programming, devices, designing) and the moral aspects, as well. Developers should define the purposes of their apps—either diagnostic or therapeutic—and gain the confidence of the users in order to dominate the market, yet comply with the regulations. PMID:28293597

  18. A recommended guideline for the development of mHealth Apps.

    PubMed

    Chatzipavlou, Ioannis A; Christoforidou, Sofia A; Vlachopoulou, Maro

    2016-01-01

    Mobile Health or mHealth applications cope with medical or health issues supported by smartphones. Being a part of great importance in healthcare, mHealth apps are able to improve both the quality of medical services and the safety of the patients. It is regarded to be a new field with great prospect that attracts the interest of the stakeholders and the developers, above all. Of all the entities involved, developers have to face many challenges classified in four pillars: the regulation framework, the market, the technical issues and society. This paper aims to describe the role of the developers in the mHealth apps' market, the barriers they deal with and also, the impact of their work in the mobile healthcare domain. In our viewpoint, we propose a guideline with all of the developers' requirements for the buildup of mHealth apps. The methodology followed includes a Boolean search strategy used in academic libraries (PubMed, IEEE Xplore, JMIR, The Cochrane Library) and search engines additionally (Google and Google Scholar), aiming to identify the developers' perspective. Our research from October until December of 2014 led us to academic papers referring to the various demands that developers have to confront. The major outcome of our research is the general acknowledgement of the dominant role that developers own in the mHealth apps' process. Mobile technology allies multiple groups such as users, patients, providers of medical services, software developers, governments and even, non-governmental organizations. In particular, the developers' perspective involves the legal boundaries, the side of the market, the technological requirements (programming, devices, designing) and the moral aspects, as well. Developers should define the purposes of their apps-either diagnostic or therapeutic-and gain the confidence of the users in order to dominate the market, yet comply with the regulations.

  19. [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

  20. 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. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: Council on Education for Public Health

    ERIC Educational Resources Information Center

    US Department of Education, 2010

    2010-01-01

    Between 1945-1973, the American Public Health Association (APHA), a membership organization for public professionals, accredited graduate programs in public health. In 1974, the APHA and the Association of Schools of Public Health (ASPH), a national association representing deans, faculty, and students of accredited schools of public health,…

  2. Authorship in Global Mental Health Research: Recommendations for Collaborative Approaches to Writing and Publishing

    PubMed Central

    Kohrt, Brandon A.; Upadhaya, Nawaraj; Luitel, Nagendra P.; Maharjan, Sujen M.; Kaiser, Bonnie N.; MacFarlane, Elizabeth K.; Khan, Noreen

    2014-01-01

    Background Collaborations among researchers, clinicians, and individuals with mental illness from high-income countries (HICs) and low- and middle-income countries (LMICs) are crucial to produce research, interventions, and policies that are relevant, feasible, and ethical. However, global mental health and cultural psychiatry research publications have been dominated by HIC investigators. Objective The aim of this review was to present recommendations for collaborative writing with a focus on early career researchers in HICs and LMICs. Methods A workshop was conducted with HIC and LMIC investigators in Nepal to discuss lessons learned for collaborative writing. The researchers had experience in cross-cultural psychiatric epidemiology, health services research, randomized controlled trials, and projects with war and disaster-affected populations in complex humanitarian emergencies including child soldiers and refugees. Additional lessons learned were contributed from researchers engaged in similar collaborations in Haiti. Findings A step-by-step process for collaborative writing was developed. Conclusions HIC and LMIC writing collaborations will encourage accurate, ethical, and contextually grounded publications to foster understanding and facilitate reduction of the global burden of mental illness. PMID:24976552

  3. The Effects of Bikram Yoga on Health: Critical Review and Clinical Trial Recommendations

    PubMed Central

    Hewett, Zoe L.; Cheema, Birinder S.; Pumpa, Kate L.; Smith, Caroline A.

    2015-01-01

    Bikram yoga is a style of hatha yoga involving a standarized series of asanas performed to an instructional dialogue in a heated environment (40.6°C, 40% humidity). Several studies evaluating the effect of Bikram yoga on health-related outcomes have been published over the past decade. However, to date, there are no comprehensive reviews of this research and there remains a lack of large-scale, robustly-designed randomised controlled trials (RCT) of Bikram yoga training. The purpose of this review is to contextualise and summarise trials that have evaluated the effects of Bikram yoga on health and to provide recommendations for future research. According to published literature, Bikram yoga has been shown to improve lower body strength, lower and upper body range of motion, and balance in healthy adults. Non-RCTs report that Bikram yoga may, in some populations, improve glucose tolerance, bone mineral density, blood lipid profile, arterial stiffness, mindfulness, and perceived stress. There is vast potential for further, improved research into the effects of Bikram yoga, particularly in unhealthy populations, to better understand intervention-related adaptations and their influence on the progression of chronic disease. Future research should adhere to CONSORT guidelines for better design and reporting to improve research quality in this field. PMID:26504475

  4. Review of Refugee Mental Health Interventions Following Resettlement: Best Practices and Recommendations

    PubMed Central

    Murray, Kate E; Davidson, Graham R; Schweitzer, Robert D

    2013-01-01

    There are increasing numbers of refugees worldwide, with approximately 16 million refugees in 2007 and over 2.5 million refugees resettled in the United States since the start of its humanitarian program. Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. The current review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction. Further evaluations of the array of psychotherapeutic, psychosocial, pharmacological, and other therapeutic approaches, including psycho-educational and community-based interventions that facilitate personal and community growth and change, are encouraged. There is a need for increased awareness, training and funding to implement longitudinal interventions that work collaboratively with clients from refugee backgrounds through the stages of resettlement. PMID:20950298

  5. Carbon financing of household water treatment: background, operation and recommendations to improve potential for health gains.

    PubMed

    Hodge, James M; Clasen, Thomas F

    2014-11-04

    Household water treatment (HWT) provides a means for vulnerable populations to take charge of their own drinking water quality as they patiently wait for the pipe to finally reach them. In many low-income countries, however, promoters have not succeeded in scaling up the intervention among the target population or securing its consistent and sustained use. Carbon financing can provide the funding for reaching targeted populations with effective HWT solutions and the incentives to ensure their long-term uptake. Nevertheless, programs have been criticized because they do not actually reduce carbon emissions. We summarize the background and operation of carbon financing of HWT interventions, including the controversial construct of "suppressed demand". We agree that these programs have limited potential to reduce greenhouse gas emissions and that their characterization of trading "carbon for water" is misleading. Nevertheless, we show that the Kyoto Protocol expressly encouraged the use of suppressed demand as a means of allowing low-income countries to benefit from carbon financing provided it is used to advance development priorities such as health. We conclude by recommending changes to existing criteria for eligible HWT programs that will help ensure that they meet the conditions of microbiological effectiveness and actual use that will improve their potential for health gains.

  6. The Effects of Bikram Yoga on Health: Critical Review and Clinical Trial Recommendations.

    PubMed

    Hewett, Zoe L; Cheema, Birinder S; Pumpa, Kate L; Smith, Caroline A

    2015-01-01

    Bikram yoga is a style of hatha yoga involving a standarized series of asanas performed to an instructional dialogue in a heated environment (40.6°C, 40% humidity). Several studies evaluating the effect of Bikram yoga on health-related outcomes have been published over the past decade. However, to date, there are no comprehensive reviews of this research and there remains a lack of large-scale, robustly-designed randomised controlled trials (RCT) of Bikram yoga training. The purpose of this review is to contextualise and summarise trials that have evaluated the effects of Bikram yoga on health and to provide recommendations for future research. According to published literature, Bikram yoga has been shown to improve lower body strength, lower and upper body range of motion, and balance in healthy adults. Non-RCTs report that Bikram yoga may, in some populations, improve glucose tolerance, bone mineral density, blood lipid profile, arterial stiffness, mindfulness, and perceived stress. There is vast potential for further, improved research into the effects of Bikram yoga, particularly in unhealthy populations, to better understand intervention-related adaptations and their influence on the progression of chronic disease. Future research should adhere to CONSORT guidelines for better design and reporting to improve research quality in this field.

  7. Health effects of electric and magnetic fields: Overview of research recommendations

    SciTech Connect

    Savitz, D.A.

    1993-12-01

    We developed a series of articles concerning epidemiologic research on potential health effects of electric and magnetic fields. Our goal was to identify methodological issues that have arisen through past studies of cancer, reproduction, and neurobehavioral outcomes in order to suggest strategies to extend knowledge. Following an overview of relevant physics and engineering principles, cancer epidemiology of electric and magnetic fields is discussed separately with a focus on epidemiologic methods and cancer biology, respectively. Reproductive health studies, many of which focus on exposure from video display terminals are then summarized, followed by an evaluation of the limited literature on neurobehavioral outcomes, including suicide and depression. Methodological issues in exposure assessment are discussed, focusing on the challenges in residential exposure assessment and interpretation of wire configuration codes. An overview offers recommendations for priorities across these topic areas, emphasizing the importance of resolving the question of wire codes and childhood cancer. Collectively, these articles provide an array of observations and suggestions regarding the epidemiologic literature, recognizing the potential benefits to science and public policy. 10 refs.

  8. 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.

  9. Dietary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health.

    PubMed

    Stephen, Alison M; Champ, Martine M-J; Cloran, Susan J; Fleith, Mathilde; van Lieshout, Lilou; Mejborn, Heddie; Burley, Victoria J

    2017-07-05

    Research into the analysis, physical properties and health effects of dietary fibre has continued steadily over the last 40-50 years. From the knowledge gained, countries have developed guidelines for their populations on the optimal amount of fibre to be consumed each day. Food composition tables from many countries now contain values for the dietary fibre content of foods, and, from these, combined with dietary surveys, population intakes have been determined. The present review assessed the uniformity of the analytical methods used, health claims permitted, recommendations and intakes, particularly from national surveys across Europe and around the world. It also assessed current knowledge on health effects of dietary fibre and related the impact of different fibre types on health. The overall intent was to be able to provide more detailed guidance on the types of fibre which should be consumed for good health, rather than simply a total intake figure, the current situation. Analysis of data indicated a fair degree of uniformity in the definition of dietary fibre, the method used for analysis, the recommended amount to be consumed and a growing literature on effects on digestive health and disease risk. However, national dietary survey data showed that intakes do not reach recommendations and very few countries provide guidance on the types of fibre that are preferable to achieve recommended intakes. Research gaps were identified and ideas suggested to provide information for more detailed advice to the public about specific food sources that should be consumed to achieve health benefits.

  10. Director of anesthesiology for liver transplantation: existing practices and recommendations by the United Network for Organ Sharing.

    PubMed

    Mandell, M Susan; Pomfret, Elizabeth A; Steadman, Randall; Hirose, Ryutaro; Reich, David J; Schumann, Roman; Walia, Ann

    2013-04-01

    A new Organ Procurement and Transplantation Network/United Network for Organ Sharing bylaw recommends that all centers appoint a director of liver transplant anesthesia with a uniform set of criteria. We obtained survey data from the Liver Transplant Anesthesia Consortium so that we could compare existing criteria for a director in the United States with the current recommendations. The data set included responses from adult academic liver transplant programs before the new bylaw. The respondent rates were within statistical limits to exclude sampling bias. All centers had a director of liver transplant anesthesia. The criteria varied between institutions, and the data suggest that the availability of resources influenced the choice of criteria. The information suggests that the criteria used in the new bylaw reflect existing practices. The bylaw plays an important role in supporting emerging leadership roles in liver transplant anesthesia and brings greater uniformity to the directorship position.

  11. The Emergence of Undergraduate Majors in Global Health: Systematic Review of Programs and Recommendations for Future Directions.

    PubMed

    Drain, Paul K; Mock, Charles; Toole, David; Rosenwald, Anne; Jehn, Megan; Csordas, Thomas; Ferguson, Laura; Waggett, Caryl; Obidoa, Chinekwu; Wasserheit, Judith N

    2017-01-11

    Global health education has been expanding rapidly and several universities have created an undergraduate major degree (bachelor's degree) in global heath or global health studies. Because there are currently no national guidelines for undergraduate degrees in global health, each of these programs was developed along individual lines. To guide the development of future global health majors, we conducted a systematic review of undergraduate majors in global health. We identified eight programs and invited program directors or representatives to a symposium at the Consortium of Universities for Global Health 2016 conference to review their existing undergraduate major in global health and to discuss lessons learned and recommendations for other colleges and universities seeking to develop undergraduate degrees in global health. We noted significant diversity among the existing programs in terms of required courses, international field experiences, and thesis research projects. In this review, we describe these global health programs, their student characteristics, as well as the key educational competencies, program requirements, and core global health courses. Based on program reviews and discussions, we identify seven recommendations for the development and expansion of an undergraduate major in global health and discuss issues that have arisen in the curricular development of these programs that warrant further exploration. As the field of global health education continues to expand, following these students after graduation will be essential to ensure that the degree programs in global health both meet student needs and launch students on viable career pathways. © The American Society of Tropical Medicine and Hygiene.

  12. Recommendations from the EGAPP Working Group: genomic profiling to assess cardiovascular risk to improve cardiovascular health.

    PubMed

    2010-12-01

    The Evaluation of Genomic Applications in Practice and Prevention Working Group (EWG) found insufficient evidence to recommend testing for the 9p21 genetic variant or 57 other variants in 28 genes (listed in ) to assess risk for cardiovascular disease (CVD) in the general population, specifically heart disease and stroke. The EWG found that the magnitude of net health benefit from use of any of these tests alone or in combination is negligible. The EWG discourages clinical use unless further evidence supports improved clinical outcomes. Based on the available evidence, the overall certainty of net health benefit is deemed "Low." It has been suggested that an improvement in CVD risk classification (adjusting intermediate risk of CVD into high- or low-risk categories) might lead to management changes (e.g., earlier initiation or higher rates of medical interventions, or targeted recommendations for behavioral change) that improve CVD outcomes. In the absence of direct evidence to support this possibility, this review sought indirect evidence aimed at documenting the extent to which genomic profiling alters CVD risk estimation, alone and in combination with traditional risk factors, and the extent to which risk reclassification improves health outcomes. Assay-related evidence on available genomic profiling tests was deemed inadequate. However, based on existing technologies that have been or may be used and on data from two of the companies performing such testing, the analytic sensitivity and specificity of tests for individual gene variants might be at least satisfactory. Twenty-nine gene candidates were evaluated, with 58 different gene variant/disease associations. Evidence on clinical validity was rated inadequate for 34 of these associations (59%) and adequate for 23 (40%). Inadequate grades were based on limited evidence, poor replication, existence of possible biases, or combinations of these factors. For heart disease (25 combined associations) and stroke (13

  13. Public health policy for management of hepatitis B virus infection: historical review of recommendations for immunization.

    PubMed

    Lee, Haeok; Park, Wanju

    2010-01-01

    Chronic hepatitis B virus (HBV) infection is the leading cause of cirrhosis, liver failure, and liver cancer, and an estimated 620,000 persons die annually from HBV-related liver disease (Goldstein et al., 2005; World Health Organization, 2000). Immunization with the HBV vaccine is the most effective means of preventing HBV infection and its consequent acute and chronic liver diseases such as cirrhosis and hepatocellular carcinoma. The HBV vaccine has been used against HBV in the United States since 1982 (Centers for Disease Control and Prevention, 1982); during the last 25 years, HBV vaccine policy continued to evolve in response to public health issues and epidemiologic data. Although the number of newly acquired HBV infections has substantially declined as a result of implementation of a national immunization program, the prevalence of chronic HBV infection remains high. The purpose of this article is to review the epidemiology of HBV, provide a historical review of health policies for HBV immunization, and summarize the recent evidence-based public health guidelines for management of HBV infection in the United States.

  14. Organizational learning and the learning organization in health care.

    PubMed

    Dowd, S B

    2000-02-01

    Learning is seen as a systems-level phenomenon that stays within the organization regardless of the "players" involved. However, this article reviews some of the history of organizational learning and the learning organization and makes a proposal for how health care organizations are becoming learning organizations.

  15. Information and Communication Technologies in Behavioral Health: A Literature Review with Recommendations for the Air Force.

    PubMed

    Breslau, Joshua; Engel, Charles C

    2016-05-09

    The dramatic evolution in information and communication technologies (ICTs) online and on smartphones has led to rapid innovations in behavioral health care. To assist the U.S. Air Force in developing a strategy for use of ICTs, the authors reviewed the scientific literature on their use to prevent and treat behavioral health conditions, such as major depression, posttraumatic stress disorder, and alcohol misuse. There is currently little scientific evidence supporting additional investment in ICT-based psychosocial programs for resilience or prevention of posttraumatic stress symptoms, depression, or anxiety. Instead, preventive interventions might prioritize problems of alcohol misuse and intimate partner violence. ICT applications that play a role in the treatment process may be used for patient education and activation, to improve decisionmaking by clinicians, to provide a therapy, to improve adherence to treatment, or to maintain treatment gains over time. However, partly due to the rapid pace of development of the technology, there is little or no evidence in the literature regarding the efficacy of the most recently developed types of ICTs, in particular those using smartphones. Despite the lack of solid research evidence to date, ICTs hold promise in addressing the challenges of mental health care. One promising avenue is development of reliable methods for patient-clinician communication between therapy sessions; another is Internet-based cognitive behavioral therapy. The authors recommend that the Air Force should take an incremental approach to adopting the use of ICTs-one that involves a program of measurement-based implementation and process and outcome monitoring rather than urgent dissemination.

  16. Ethnographic Approach to Community Organization and Health Empowerment.

    ERIC Educational Resources Information Center

    Braithwaite, Ronald L.; And Others

    1994-01-01

    A case study of the use of ethnographic approaches in community organization and development demonstrates their utility in achieving health empowerment among communities of color. The importance of citizen participation in community-based health initiatives is stressed. (SK)

  17. 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)

  18. Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations

    PubMed Central

    Webb, Heather; Street, Jackie; Marshall, Helen

    2014-01-01

    Immunization against pertussis, influenza, and rubella reduces morbidity and mortality in pregnant women and their offspring. Health care professionals (HCPs) caring for women perinatally are uniquely placed to reduce maternal vaccine preventable diseases (VPDs). Despite guidelines recommending immunization during the perinatal period, maternal vaccine uptake remains low. This qualitative study explored the role of obstetricians, general practitioners, and midwives in maternal vaccine uptake. Semi-structured interviews (n = 15) were conducted with perinatal HCPs at a tertiary maternity hospital in South Australia. HCPs were asked to reflect on their knowledge, beliefs, and practice relating to immunization advice and vaccine provision. Interviews were transcribed and coded using thematic analysis. Data collection and analysis was an iterative process, with collection ceasing with theoretical saturation. Participants unanimously supported maternal vaccination as an effective way of reducing risk of disease in this vulnerable population, however only rubella immunity detection and immunization is embedded in routine care. Among these professionals, delegation of responsibility for maternal immunization was unclear and knowledge about maternal immunization was variable. Influenza and pertussis vaccine prevention measures were not included in standard pregnancy record documentation, information provision to patients was “ad hoc” and vaccinations not offered on-site. The key finding was that the incorporation of maternal vaccinations into standard care through a structured process is an important facilitator for immunization uptake. Incorporating vaccine preventable disease management measures into routine obstetric care including incorporation into the Pregnancy Record would facilitate HCPs in implementing recommendations. Rubella prevention provides a useful “template” for other vaccines. PMID:24509790

  19. Developing evidence-based recommendations in public health--incorporating the views of practitioners, service users and user representatives.

    PubMed

    Renfrew, Mary J; Dyson, Lisa; Herbert, Gill; McFadden, Alison; McCormick, Felicia; Thomas, James; Spiby, Helen

    2008-03-01

    Guidance based on a systematic assessment of the evidence base has become a fundamental tool in the cycle of evidence-based practice and policy internationally. The process of moving from the formal evidence base derived from research studies to the formation and agreement of recommendations is however acknowledged to be problematic, especially in public health; and the involvement of practitioners, service commissioners and service users in that process is both important and methodologically challenging. To test a structured process of developing evidence-based recommendations in public health while involving a broad constituency of practitioners, service commissioners and service user representatives. As part of the development of national public health recommendations to promote and support breastfeeding in England, the methodological challenges of involving stakeholders were examined and addressed. There were three main stages: (i) an assessment of the formal evidence base (210 studies graded); (ii) electronic and fieldwork-based consultation with practitioners, service commissioners and service user representatives (563 participants), and an in-depth analytical consultation in three 'diagonal slice' workshops (89 participants); (iii) synthesis of the previous two stages. The process resulted in widely agreed recommendations together with suggestions for implementation. It was very positively evaluated by participants and those likely to use the recommendations. Service users had a strong voice throughout and participated actively. This mix of methods allowed a transparent, accountable process for formulating recommendations based on scientific, theoretical, practical and expert evidence, with the added potential to enhance implementation.

  20. Advanced Dental Education: Recommendations for the 80's. Issues in Dental Health Policy.

    ERIC Educational Resources Information Center

    American Association of Dental Schools, Washington, DC.

    Six statements of working principles and 11 major recommendations falling within those areas, as established by the Task Force on Advanced Dental Education, are presented. Supporting recommendations are also provided. The six principles include: (1) no change is recommended in the present goal of predoctoral education, to prepare students for…

  1. Determining the optimal physician mix in health maintenance organizations.

    PubMed

    Vitiello, J R; Levary, R R

    1997-08-01

    Described is a simulation model for forecasting the appropriate mix of physicians needed to meet health service demands of patients in managed health care organizations. The model can be used by executives of managed health care organizations to plan for physician staffing levels by specialty. Uncertainties such as changes in the population size served by the managed health care organization, new developments in health care delivery technologies and changing attitudes of the population regarding healthier lifestyles are considered in this model. Use of the model is illustrated in an example.

  2. Organic Food in the Diet: Exposure and Health Implications.

    PubMed

    Brantsæter, Anne Lise; Ydersbond, Trond A; Hoppin, Jane A; Haugen, Margaretha; Meltzer, Helle Margrete

    2017-03-20

    The market for organic food products is growing rapidly worldwide. Such foods meet certified organic standards for production, handling, processing, and marketing. Most notably, the use of synthetic fertilizers, pesticides, and genetic modification is not allowed. One major reason for the increased demand is the perception that organic food is more environmentally friendly and healthier than conventionally produced food. This review provides an update on market data and consumer preferences for organic food and summarizes the scientific evidence for compositional differences and health benefits of organic compared with conventionally produced food. Studies indicate some differences in favor of organic food, including indications of beneficial health effects. Organic foods convey lower pesticide residue exposure than do conventionally produced foods, but the impact of this on human health is not clear. Comparisons are complicated by organic food consumption being strongly correlated with several indicators of a healthy lifestyle and by conventional agriculture "best practices" often being quite close to those of organic.

  3. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations

    PubMed Central

    Fazel, Seena; Geddes, John R; Kushel, Margot

    2015-01-01

    In the European Union, more than 400 000 individuals are homeless on any one night and more than 600 000 are homeless in the USA. The causes of homelessness are an interaction between individual and structural factors. Individual factors include poverty, family problems, and mental health and substance misuse problems. The availability of low-cost housing is thought to be the most important structural determinant for homelessness. Homeless people have higher rates of premature mortality than the rest of the population, especially from suicide and unintentional injuries, and an increased prevalence of a range of infectious diseases, mental disorders, and substance misuse. High rates of non-communicable diseases have also been described with evidence of accelerated ageing. Although engagement with health services and adherence to treatments is often compromised, homeless people typically attend the emergency department more often than non-homeless people. We discuss several recommendations to improve the surveillance of morbidity and mortality in homeless people. Programmes focused on high-risk groups, such as individuals leaving prisons, psychiatric hospitals, and the child welfare system, and the introduction of national and state-wide plans that target homeless people are likely to improve outcomes. PMID:25390578

  4. 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.

  5. Volatile Organic Compunds (Environmental Health Student Portal)

    MedlinePlus

    ... Home Mercury Lead Arsenic Volatile Organic Compounds Plastics Pesticides Climate Change Climate Change Home What is Climate ... Home Mercury Lead Arsenic Volatile Organic Compounds Plastics Pesticides Climate Change Climate Change Home What is Climate ...

  6. Pricing health care services: applications to the health maintenance organization.

    PubMed

    Sweeney, R E; Franklin, S P

    1986-01-01

    This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.

  7. Promoting correct car seat use in parents of young children: challenges, recommendations, and implications for health communication.

    PubMed

    Weaver, Nancy L; Brixey, Suzanne N; Williams, Janice; Nansel, Tonja R

    2013-03-01

    Injuries involving motor vehicles continue to be the biggest threat to the safety of children. Although child safety seats (CSS) have been established as a central countermeasure in decreasing injury risk, the majority of parents do not use the correct car seat correctly. There are many challenges in promoting correct car seat use, which itself is a complex behavior. To advance this critical protective behavior, the public health community would benefit from clarifying CSS messaging, communicating clearly, and addressing the conflicting recommendations of product use. In this article, we present current challenges in promoting CSS use and draw on health communication and other fields to offer recommendations for future work in this area.

  8. Updated CDC recommendations for the management of hepatitis B virus-infected health-care providers and students.

    PubMed

    2012-07-06

    This report updates the 1991 CDC recommendations for the management of hepatitis B virus (HBV)-infected health-care providers and students to reduce risk for transmitting HBV to patients during the conduct of exposure-prone invasive procedures (CDC. Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR 1991;40[No. RR-8]). This update reflects changes in the epidemiology of HBV infection in the United States and advances in the medical management of chronic HBV infection and policy directives issued by health authorities since 1991. The primary goal of this report is to promote patient safety while providing risk management and practice guidance to HBV-infected health-care providers and students, particularly those performing exposure-prone procedures such as certain types of surgery. Because percutaneous injuries sustained by health-care personnel during certain surgical, obstetrical, and dental procedures provide a potential route of HBV transmission to patients as well as providers, this report emphasizes prevention of operator injuries and blood exposures during exposure-prone surgical, obstetrical, and dental procedures. These updated recommendations reaffirm the 1991 CDC recommendation that HBV infection alone should not disqualify infected persons from the practice or study of surgery, dentistry, medicine, or allied health fields. The previous recommendations have been updated to include the following changes: no prenotification of patients of a health-care provider's or student's HBV status; use of HBV DNA serum levels rather than hepatitis B e-antigen status to monitor infectivity; and, for those health-care professionals requiring oversight, specific suggestions for composition of expert review panels and threshold value of serum HBV DNA considered "safe" for practice (<1,000 IU/ml). These recommendations also explicitly address the issue of medical and

  9. Relating Health Technology Assessment recommendations and reimbursement decisions in Poland in years 2012-2014, a retrospective analysis.

    PubMed

    Kawalec, Paweł; Malinowski, Krzysztof Piotr

    2016-11-01

    The aim of the study was to assess the influence of public advisory bodies (the Transparency Council and the President of AOTMiT, the Polish Agency for Health Technology Assessment and Tariff System) involved in the process on final reimbursement decisions performed by the Ministry of Health. We have analysed all statements of the Transparency Council as well as the President of the AOTMiT recommendations and final reimbursement decisions in Poland for the period of three years: 2012 till 2014. For each recommendation we collected data on decisions as well as potential additional requirements regarding the reimbursement; data was presented for the whole analysed period and separately for each year, to assess the general tendencies in the reimbursement decision-making in Poland. We collected all data accessible at February 2015. The kappa measurement of agreement was used to assess the compliance between statements, recommendations and reimbursement decisions. We collected data on 238 drugs evaluated by the Agency. The compliance between the Transparency Council and the President of the AOTMiT was 95% and remained constant in the analysed period. The agreement between the President of the AOTMiT recommendations and final reimbursement decisions was only fairly represented by a kappa coefficient of 0.23 and decreased in the subsequent years. We observed an increasing proportion of positive-conditional recommendations, with the introduction of a risk sharing scheme being the most common condition of a reimbursement recommendation. We observed that final reimbursement decisions did not reflect statements and recommendations issued by the advisory boards. Positive recommendations issued by the AOTMiT did not guarantee positive reimbursement status, and negative recommendations in some cases did not result in the lack of reimbursement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Maternal perceptions of social context and adherence to maternal and child health (MCH) clinic recommendations among marginalized Bedouin mothers.

    PubMed

    Daoud, Nihaya; Shoham-Vardi, Ilana

    2015-03-01

    National maternal and child health (MCH) care systems often deliver universal health care recommendations that do not take into consideration the social context of infant care (IC) for marginalized groups. We examined associations between maternal perceptions of social context (MPSC) and adherence by minority Bedouin mothers in Israel to three commonly recommended IC practices. We conducted personal interviews with 464 mothers visiting 14 MCH clinics using a structured questionnaire based on findings from a previous focus-group study, and guided by constructs of the Health Beliefs Model. Items were tested for validity and reliability. We used multivariate analysis to identify MPSC constructs associated with adherence to MCH clinic recommendations (timely postnatal first visit, sustaining breastfeeding, and use of infant car seat). Social context, when perceived as a barrier to IC, was negatively associated with adherence to timely first postnatal MCH clinic visit (odds ratio, 95 %, confidence intervals (OR 1.45, 95 % CI 1.24, 1.70) and use of infant car seat (OR 1.43, 95 % CI 1.21, 1.69). However, social context was positively associated with sustained breastfeeding (OR 0.54, 95 % CI 0.37, 0.79). Perceptions of the severity of infant health problems, and family financial and relationship problems had less significant associations with adherence to MCH clinic recommendations. Adherence by marginalized mothers to MCH clinic recommendations is related to their perceptions of social context. When there are higher financial and other living conditions barriers mothers tend toward lower adherence to these recommendations. MCH policy makers and service providers must consider MPSC in planning and delivery of MCH recommendations.

  11. Mental health needs of visible minority immigrants in a small urban center: recommendations for policy makers and service providers.

    PubMed

    Reitmanova, Sylvia; Gustafson, Diana L

    2009-02-01

    This qualitative pilot study explored the mental health needs of visible minority immigrants in St. John's--a small urban center in Atlantic Canada with limited ethnoracial diversity and ethnospecific infrastructure. The study examined the facilitators and barriers to maintaining immigrants' mental health and their perspectives on availability and access to support services and programs that support mental health. Our findings revealed several determinants of the mental health of visible minority immigrants: social support, income, employment, culture, physical environment, coping skills, gender, and availability, accessibility and cultural appropriateness of mental health services. We offer 18 recommendations framed by Health Canada determinants of health that may be of interest to decision-makers in government, health agencies and social services in similar small urban centers.

  12. 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…

  13. Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations.

    PubMed

    Aguado, J M; Silva, J T; Fernández-Ruiz, M; Cordero, E; Fortún, J; Gudiol, C; Martínez-Martínez, L; Vidal, E; Almenar, L; Almirante, B; Cantón, R; Carratalá, J; Caston, J J; Cercenado, E; Cervera, C; Cisneros, J M; Crespo-Leiro, M G; Cuervas-Mons, V; Elizalde-Fernández, J; Fariñas, M C; Gavaldà, J; Goyanes, M J; Gutiérrez-Gutiérrez, B; Hernández, D; Len, O; López-Andujar, R; López-Medrano, F; Martín-Dávila, P; Montejo, M; Moreno, A; Oliver, A; Pascual, A; Pérez-Nadales, E; Román-Broto, A; San-Juan, R; Serón, D; Solé-Jover, A; Valerio, M; Muñoz, P; Torre-Cisneros, J

    2017-07-26

    Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Health technology assessment in middle-income countries: recommendations for a balanced assessment system

    PubMed Central

    Dankó, Dávid

    2014-01-01

    Because of significant differences in institutional contexts, health technology assessment (HTA) systems that are in place in core pharmaceutical markets may not be suitable, fully or in part, for middle-income countries (MICs) and for other noncore markets. Particular challenges may arise when systems based on the economic evaluation paradigm are conceptualized and implemented in MICs, sometimes with an insufficient level of awareness of the local institutional factors that influence pricing and reimbursement decision making. Focusing on pharmaceuticals, this article investigates possible development directions for HTA systems in MICs and noncore markets bearing similar institutional characteristics, and it provides recommendations for a balanced assessment system (BAS). For this, the main paradigms of HTA have also been reviewed briefly and factors influencing HTA and pricing and reimbursement decisions in MICs and in similar noncore countries have been summarized. The proposed BAS framework takes into account available resources and capabilities and is supposed to facilitate access to new pharmaceuticals while ensuring the transparency of decision-making processes and the stability of the pharmaceutical budget. PMID:27226832

  15. Copy, paste, and cloned notes in electronic health records: prevalence, benefits, risks, and best practice recommendations.

    PubMed

    Weis, Justin M; Levy, Paul C

    2014-03-01

    The modern medical record is not only used by providers to record nuances of patient care, but also is a document that must withstand the scrutiny of insurance payers and legal review. Medical documentation has evolved with the rapid growth in the use of electronic health records (EHRs). The medical software industry has created new tools and more efficient ways to document patient care encounters and record results of diagnostic testing. While these techniques have resulted in efficiencies and improvements in patient care and provider documentation, they have also created a host of new problems, including authorship attribution, data integrity, and regulatory concerns over the accuracy and medical necessity of billed services. Policies to guide provider documentation in EHRs have been developed by institutions and payers with the goal of reducing patient care risks as well as preventing fraud and abuse. In this article, we describe the major content-importing technologies that are commonly used in EHR documentation as well as the benefits and risks associated with their use. We have also reviewed a number of institutional policies and offer some best practice recommendations.

  16. Health technology assessment in middle-income countries: recommendations for a balanced assessment system.

    PubMed

    Dankó, Dávid

    2014-01-01

    Because of significant differences in institutional contexts, health technology assessment (HTA) systems that are in place in core pharmaceutical markets may not be suitable, fully or in part, for middle-income countries (MICs) and for other noncore markets. Particular challenges may arise when systems based on the economic evaluation paradigm are conceptualized and implemented in MICs, sometimes with an insufficient level of awareness of the local institutional factors that influence pricing and reimbursement decision making. Focusing on pharmaceuticals, this article investigates possible development directions for HTA systems in MICs and noncore markets bearing similar institutional characteristics, and it provides recommendations for a balanced assessment system (BAS). For this, the main paradigms of HTA have also been reviewed briefly and factors influencing HTA and pricing and reimbursement decisions in MICs and in similar noncore countries have been summarized. The proposed BAS framework takes into account available resources and capabilities and is supposed to facilitate access to new pharmaceuticals while ensuring the transparency of decision-making processes and the stability of the pharmaceutical budget.

  17. Guidelines for pharmacoeconomic studies. Recommendations from the panel on cost effectiveness in health and medicine. Panel on cost Effectiveness in Health and Medicine.

    PubMed

    Siegel, J E; Torrance, G W; Russell, L B; Luce, B R; Weinstein, M C; Gold, M R

    1997-02-01

    This article reports the recommendations of the Panel on Cost Effectiveness in Health and Medicine, sponsored by the US Public Health Service, on standardised methods for conducting cost-effectiveness analyses. Although not expressly directed at analyses of pharmaceutical agents, the Panel's recommendations are relevant to pharmacoeconomic studies. The Panel outlines a 'Reference Case' set of methodological practices to improve quality and comparability of analyses. Designed for studies that inform resource-allocation decisions, the Reference Case includes recommendations for study framing and scope, components of the numerator and denominator of cost-effectiveness ratios, discounting, handling uncertainty and reporting. The Reference Case analysis is conducted from the societal perspective, and includes all effects of interventions on resource use and health. Resource use includes 'time' resources, such as for caregiving or undergoing an intervention. The quality-adjusted life-year (QALY) is the common measure of health effect across Reference Case studies. Although the Panel does not endorse a measure for obtaining quality-of-life weights, several recommendations address the QALY. The Panel recommends a 3% discount rate for costs and health effects. Pharmacoeconomic studies have burgeoned in recent years. The Reference Case analysis will improve study quality and usability, and permit comparison of pharmaceuticals with other health interventions.

  18. Do youth in out-of-home care receive recommended mental health and educational services following screening evaluations?

    PubMed

    Petrenko, Christie L M; Culhane, Sara E; Garrido, Edward F; Taussig, Heather N

    2011-10-01

    For children in out-of-home care, a significant gap exists between those who need services and those who receive them. Screening all children in out-of-home care is recommended to reduce this gap. This study was designed to determine if recommendations from mental health and educational screening evaluations were related to service implementation for youth in out-of-home care. Screening evaluations were completed with 171 maltreated youth (ages 9 to 11) in out-of-home care within the prior year. Written reports summarizing the findings were provided to children's caseworkers. Service utilization was assessed at baseline (T1; before screening reports were completed) and follow-up (T2; 9-12 months later) interviews. For children not already receiving services at T1, logistic regression analyses tested the association between T1 recommendations for services and new service implementation by T2. Mental health (youth-report) and educational (teacher-report) outcomes were analyzed separately. Screening evaluations identified 22% of children with unmet mental health needs and 36% with unmet educational needs at T1. Children who received a recommendation for new services (i.e., all of those with unmet needs) were more likely to receive mental health (OR=2.50, p=.06) and/or educational (OR=3.54, p=.04) services by T2 than children who did not receive recommendations for services. While recommendations increased the odds of receiving services, almost half of the children with unmet mental health needs did not receive services, and 84% of children with unmet educational needs did not receive services by T2. Much work remains to ensure youth receive needed services.

  19. Do youth in out-of-home care receive recommended mental health and educational services following screening evaluations?

    PubMed Central

    Petrenko, Christie L. M.; Culhane, Sara E.; Garrido, Edward F.; Taussig, Heather N.

    2011-01-01

    For children in out-of-home care, a significant gap exists between those who need services and those who receive them. Screening all children in out-of-home care is recommended to reduce this gap. This study was designed to determine if recommendations from mental health and educational screening evaluations were related to service implementation for youth in out-of-home care. Screening evaluations were completed with 171 maltreated youth (ages 9 to 11) in out-of-home care within the prior year. Written reports summarizing the findings were provided to children's caseworkers. Service utilization was assessed at baseline (T1; before screening reports were completed) and follow-up (T2; 9-12 months later) interviews. For children not already receiving services at T1, logistic regression analyses tested the association between T1 recommendations for services and new service implementation by T2. Mental health (youth-report) and educational (teacher-report) outcomes were analyzed separately. Screening evaluations identified 22% of children with unmet mental health needs and 36% with unmet educational needs at T1. Children who received a recommendation for new services (i.e., all of those with unmet needs) were more likely to receive mental health (OR=2.50, p=.06) and/or educational (OR=3.54, p=.04) services by T2 than children who did not receive recommendations for services. While recommendations increased the odds of receiving services, almost half of the children with unmet mental health needs did not receive services, and 84% of children with unmet educational needs did not receive services by T2. Much work remains to ensure youth receive needed services. PMID:21912444

  20. Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system

    PubMed Central

    Kahn, Ben; Freeland, Zachary; Gopal, Purva; Agrawal, Deepak; Mayorga, Christian A.; Mithani, Rozina; Skinner, Celette Sugg; Halm, Ethan A.

    2017-01-01

    Purpose Appropriate surveillance intervals for colorectal cancer (CRC) screening is one of the Centers for Medicare and Medicaid Services 2014 physician quality reporting system measures. Appropriateness of surveillance intervals will continue to be monitored closely, particularly as reimbursements become tied to quality measures. Aims Quantify and identify predictors for guideline-concordant surveillance recommendations after adenoma polypectomy. Methods We conducted a retrospective cohort study of patients who had colonoscopy with polypectomy at a safety-net health system between June 2011 and December 2013. Surveillance recommendations shorter and longer than guideline recommendations were defined as potential overuse and underuse. We used multivariate logistic regression to identify correlates of guideline-concordant surveillance recommendations, overuse, and underuse. Results Among 1,822 patients with polypectomy, 1,329 had ≥1 adenoma. Surveillance interval recommendations were guideline-concordant in 1,410 (77.4 %) patients, potential overuse in 263 (14.4 %), potential underuse in 85 (4.7 %), and missing in 64 (3.5 %) patients. Predictors of guideline-concordant recommendations in multivariate analyses included age >65 years (OR 1.36, 95 % CI 1.02–1.80), incomplete resection (OR 3.58, 95 % CI 1.41–9.09), and good/excellent prep quality (OR 2.22, 95 % CI 1.72–2.86). Underuse recommendations were more likely in patients with ≥3 adenomas; overuse recommendations were more likely in patients with high-grade dysplasia or fair prep quality and less likely in those with piecemeal resection, ≥3 adenomas, age>65, or Hispanic ethnicity. Conclusions Surveillance recommendations are not concordant with guidelines in one of four cases. Interventions to improve prep quality and guideline concordance of surveillance recommendations can improve cost-effectiveness of CRC screening. PMID:26376891

  1. The Impact of Consumer-Directed Health Plans and Patient Socioeconomic Status on Physician Recommendations for Colorectal Cancer Screening

    PubMed Central

    Mallya, Giridhar; Polsky, Daniel

    2008-01-01

    Background Consumer-directed health plans are increasingly common, yet little is known about their impact on physician decision-making and preventive service use. Objective To determine how patients’ deductible levels and socioeconomic status may affect primary care physicians’ recommendations for colorectal cancer screening. Design, Setting, and Participants Screening recommendations were elicited using hypothetical vignettes from a national sample of 1,500 primary care physicians. Physicians were randomized to one of four vignettes describing a patient with either low or high socioeconomic status (SES) and either low- or high-deductible plan. Bivariate and multivariate analyses were used to examine how recommendations varied as a function of SES and deductible. Outcome Measures Rates of recommendation for home fecal occult blood testing, sigmoidoscopy, colonoscopy, and inappropriate screening, defined as no screening or office-based fecal occult blood testing. Results A total of 528 (49%) eligible physicians responded. Overall, 7.2% of physicians recommended inappropriate screening; 3.2% of patients with high SES in low-deductible plans received inappropriate screening recommendations and 11.4% of patients with low SES in high-deductible plans for an adjusted odds ratio of 0.22 (0.05–0.89). The odds of a colonoscopy recommendation were over ten times higher (AOR 11.46, 5.26–24.94) for patients with high SES in low-deductible plans compared to patients with low SES in high-deductible plans. Funds in medical savings accounts eliminated differences in inappropriate screening recommendations. Conclusions Patient SES and deductible-level affect physician recommendations for preventive care. Coverage of preventive services and funds in medical savings accounts may help to mitigate the impact of high-deductibles and SES on inappropriate recommendations. PMID:18629590

  2. 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.

  3. Research and Action Priorities for Linking Public Health, Food Systems, and Sustainable Agriculture: Recommendations from the Airlie Conference

    PubMed Central

    Story, Mary; Hamm, Michael W.; Wallinga, David

    2009-01-01

    One hundred leading researchers, practitioners, and advocates in public health, health care, nutrition, obesity, economics, sustainable agriculture, and food systems met at the Airlie Conference Center in April 2009 to discuss creating linkages among food systems, public health, and sustainable agriculture in order to achieve healthier diets, healthier communities, and a healthier planet. Participants convened in small groups to explore and discuss research that is needed to create a health-based and sustainable food system. The discussion and key recommendations from the small breakout sessions are presented PMID:23144680

  4. 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.

  5. Electronic medical records and the transgender patient: recommendations from the World Professional Association for Transgender Health EMR Working Group

    PubMed Central

    Deutsch, Madeline B; Green, Jamison; Keatley, JoAnne; Mayer, Gal; Hastings, Jennifer; Hall, Alexandra M

    2013-01-01

    Transgender patients have particular needs with respect to demographic information and health records; specifically, transgender patients may have a chosen name and gender identity that differs from their current legally designated name and sex. Additionally, sex-specific health information, for example, a man with a cervix or a woman with a prostate, requires special attention in electronic health record (EHR) systems. The World Professional Association for Transgender Health (WPATH) is an international multidisciplinary professional association that publishes recognized standards for the care of transgender and gender variant persons. In September 2011, the WPATH Executive Committee convened an Electronic Medical Records Working Group comprised of both expert clinicians and medical information technology specialists, to make recommendations for developers, vendors, and users of EHR systems with respect to transgender patients. These recommendations and supporting rationale are presented here. PMID:23631835

  6. Electronic medical records and the transgender patient: recommendations from the World Professional Association for Transgender Health EMR Working Group.

    PubMed

    Deutsch, Madeline B; Green, Jamison; Keatley, JoAnne; Mayer, Gal; Hastings, Jennifer; Hall, Alexandra M

    2013-01-01

    Transgender patients have particular needs with respect to demographic information and health records; specifically, transgender patients may have a chosen name and gender identity that differs from their current legally designated name and sex. Additionally, sex-specific health information, for example, a man with a cervix or a woman with a prostate, requires special attention in electronic health record (EHR) systems. The World Professional Association for Transgender Health (WPATH) is an international multidisciplinary professional association that publishes recognized standards for the care of transgender and gender variant persons. In September 2011, the WPATH Executive Committee convened an Electronic Medical Records Working Group comprised of both expert clinicians and medical information technology specialists, to make recommendations for developers, vendors, and users of EHR systems with respect to transgender patients. These recommendations and supporting rationale are presented here.

  7. 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.

  8. 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

  9. 78 FR 19491 - Walking as a Way for Americans To Get the Recommended Amount of Physical Activity for Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-01

    ... Sports Exerc. 2000; 32: 963-75. (7) Centers for Disease Control and Prevention. Physical activity among... HUMAN SERVICES Centers for Disease Control and Prevention Walking as a Way for Americans To Get the Recommended Amount of Physical Activity for Health AGENCY: Centers for Disease Control and Prevention (CDC...

  10. Weight Status, Gender, and Race/Ethnicity: Are There Differences in Meeting Recommended Health Behavior Guidelines for Adolescents?

    ERIC Educational Resources Information Center

    Minges, Karl E.; Chao, Ariana; Nam, Soohyun; Grey, Margaret; Whittemore, Robin

    2015-01-01

    Healthy behaviors including limited screen time (ST), high physical activity (PA), and adequate fruits and vegetables consumption (FV) are recommended for adolescents, but it is unclear how gender, race/ethnicity, and weight status relate to these public health guidelines in diverse urban adolescents. Participants (N = 384) were recruited from…

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

    USDA-ARS?s Scientific Manuscript database

    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...

  12. Health-related workplace productivity measurement: general and migraine-specific recommendations from the ACOEM Expert Panel.

    PubMed

    Loeppke, Ronald; Hymel, Pamela A; Lofland, Jennifer H; Pizzi, Laura T; Konicki, Doris L; Anstadt, George W; Baase, Catherine; Fortuna, Joseph; Scharf, Ted

    2003-04-01

    An establishment of health-related productivity measurements and critical evaluation of health-related productivity tools is needed. An expert panel was created. A literature search was conducted to identify health-related productivity measurement tools. Each instrument was reviewed for: 1) supporting scientific evidence (e.g., reliability and validity); 2) applicability to various types of occupations, diseases, and level of severity of disease; 3) ability to translate data into a monetary unit; and 4) practicality. A modified Delphi technique was used to build consensus. The expert panel recommended absenteeism, presenteeism, and employee turnover/replacement costs as key elements of workplace health-related productivity measurement. The panel also recommended that productivity instruments should: 1) have supporting scientific evidence, 2) be applicable to the particular work setting, 3) be supportive of effective business decision-making, and 4) be practical. Six productivity measurement tools were reviewed. The panel recommended necessary elements of workplace health-related productivity measurement, key characteristics for evaluating instruments, and tools for measuring work loss. Continued research, validation, and on-going evaluation of health-related productivity instruments are needed.

  13. The determination of organization stakeholder salience in public health.

    PubMed

    Page, Catherine G

    2002-09-01

    Because interorganizational arrangements are encouraged as necessary to meet public health goals, it is critical for the managers of public health services at any level to consider stakeholder theory from an organizational perspective. Public health managers are responsible for the stakeholders in public health as well as public health as a stakeholder in other organizations. This article presents an innovative tool for the determination of organization stakeholder salience that assists managers in establishing priorities for interorganizational relationships during strategic planning and day-to-day decision making.

  14. Designing Programs and Looking Ahead: Some Recommendations. Cultural Organizations in Career Education.

    ERIC Educational Resources Information Center

    Cultural Education Collaborative, Boston, MA.

    This booklet describes some things learned by education directors from fifteen museums and performing arts organizations in Boston and Springfield, Massachusetts, as they participated in a training project to help them design pilot career education programs, in conjunction with a partner school, for K-12 students, using the resources of their…

  15. The Organization of Mental Health Services in Cuba.

    ERIC Educational Resources Information Center

    Camayd-Freixas, Yohel; Uriarte, Miren

    1980-01-01

    Reviews the status and organization of the Cuban mental health system. Focuses on the deliberate and systematic interdependence of mental health, public health, and socio-political structures; inpatient treatment modes and rehabilitation programs; use of social networks to support discharged patients; community-based care; and primary to tertiary…

  16. [Portfolio of services in a public health organization].

    PubMed

    Villalbí, J R; Guix, J; Plasència, A; Armengou, J M; Llebaría, X; Torralba, L

    2003-01-01

    Health services in Spain are currently being improved. Definition of the services portfolio has been one of the elements in this process, from which public health services have been largely left out. In the present article public health services are examined from the perspective of the Public Health Agency of Barcelona. We propose a scheme to classify services into productive public health services, health care services, services that are intermediate products, support services, and liaison or coordinating services. Indicators of productivity, result, impact, and cost are explored, and a catalogue of services for a public health organization with a well defined population and area is proposed.

  17. Organizing health care within political turmoil: the Palestinian case.

    PubMed

    Hamdan, Motasem; Defever, Mia; Abdeen, Ziad

    2003-01-01

    Palestinians were given control over their own health services in late 1994. Since then they have been facing the challenge of reorganizing disordered health services into a cohesive, regulated and sustainable health care system. This paper focuses on the experience of organizing health care during political instability. It considers the ways that health care is currently provided and funded in the Palestinian Territories. The patterns of accessibility to health care services in terms of insurance coverage and provision (physical allocation) of services are discussed. Finally, the major health care policy changes in this transitional period are examined.

  18. Environmental Health Research Recommendations from the Inter-Environmental Health Sciences Core Center Working Group on Unconventional Natural Gas Drilling Operations

    PubMed Central

    Breysse, Patrick N.; Gray, Kathleen; Howarth, Marilyn; Yan, Beizhan

    2014-01-01

    Background: Unconventional natural gas drilling operations (UNGDO) (which include hydraulic fracturing and horizontal drilling) supply an energy source that is potentially cleaner than liquid or solid fossil fuels and may provide a route to energy independence. However, significant concerns have arisen due to the lack of research on the public health impact of UNGDO. Objectives: Environmental Health Sciences Core Centers (EHSCCs), funded by the National Institute of Environmental Health Sciences (NIEHS), formed a working group to review the literature on the potential public health impact of UNGDO and to make recommendations for needed research. Discussion: The Inter-EHSCC Working Group concluded that a potential for water and air pollution exists that might endanger public health, and that the social fabric of communities could be impacted by the rapid emergence of drilling operations. The working group recommends research to inform how potential risks could be mitigated. Conclusions: Research on exposure and health outcomes related to UNGDO is urgently needed, and community engagement is essential in the design of such studies. Citation: Penning TM, Breysse PN, Gray K, Howarth M, Yan B. 2014. Environmental health research recommendations from the Inter-Environmental Health Sciences Core Center Working Group on Unconventional Natural Gas Drilling Operations. Environ Health Perspect 122:1155–1159; http://dx.doi.org/10.1289/ehp.1408207 PMID:25036093

  19. Health and Nutritional Status of Vegetarian Candidates for Bariatric Surgery and Practical Recommendations.

    PubMed

    Sherf-Dagan, Shiri; Hod, Keren; Buch, Assaf; Mardy-Tilbor, Limor; Regev, Ziva; Ben-Porat, Tair; Sakran, Nasser; Goitein, David; Raziel, Asnat

    2017-07-11

    Data on vegetarianism and bariatric surgery (BS) are scarce. We herein describe the health and nutritional status of vegetarian patients who plan to undergo BS and propose combined recommendations for vegetarian patients who undergo BS, based on our clinical experience and current scientific literature in both nutrition fields. Cross-sectional analysis of a prospectively maintained database of all primary laparoscopic sleeve gastrectomies (LSG) performed at a bariatric center of excellence between January 2014 and November 2016 was carried out querying patients who declared a vegetarian or vegan lifestyle before surgery. Preoperative data collected included demographics, anthropometrics, dietary patterns, supplementation use, physical activity, smoking habits, co-morbidities, and blood tests. Each vegetarian was matched to five different omnivores based on age, gender, and BMI. During the study period, 1470 patients underwent primary LSG surgery (63.7% females). Twenty-one declared a vegetarian or vegan lifestyle (1.4%) pre-surgery. Most were classified as lacto-ovo (57.1%) and were driven from ethical reasons (85.7%). No differences were found between vegetarian and omnivore LSG candidates regarding co-morbidities and nutritional deficiencies, except for lower prevalence of impaired fasting glucose (14.3 vs. 47.1%;P = 0.007), lower ferritin levels (54.3 ± 50.5 vs. 96.8 ± 121.8 ng/ml; P = 0.052) and higher transferrin levels (313.9 ± 42.7 vs. 278.4 ± 40.4 mg/dl; P = 0.009) among the vegetarian cohort. Preoperative use of vitamin B12 and iron supplementation was higher among vegetarian LSG candidates than their omnivore counterparts (57.1 vs. 6.7%;P < 0.001 and 23.8 vs. 6.7%; P = 0.015, respectively). Vegetarians have comparable health status and nutritional deficiencies, lower iron stores, and higher supplementation use before surgery compared to omnivore LSG candidates.

  20. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

    PubMed

    Miller, R A; Gardner, R M

    1997-01-01

    In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention.

  1. State Medicaid Early and Periodic Screening, Diagnosis, and Treatment guidelines: adherence to professionally recommended best oral health practices.

    PubMed

    Hom, Jacqueline M; Lee, Jessica Y; Silverman, Janice; Casamassimo, Paul S

    2013-03-01

    The authors evaluated the adherence of state Medicaid Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) guidelines to recommended best oral health practices for infants and toddlers. The authors obtained state EPSDT guidelines via the Internet or from the Medicaid-CHIP State Dental Association, Washington. They identified best oral health practices through the American Academy of Pediatric Dentistry (AAPD), Chicago. They evaluated each EPSDT dental periodicity schedule with regard to the timing and content of seven key oral health domains. Thirty-two states and the District of Columbia (D.C.) had EPSDT dental periodicity schedules. With the exception of the dentist referral domain, 29 states (88 percent) adhered to the content and timing of best oral health practices, as established by the AAPD guideline. For the dentist referral domain, 31 of the 32 states and D.C. (94 percent) required referral of children to a dentist, but only 11 states (33 percent) adhered to best oral health practices by requiring referral by age 1 year. With the exception of the timing of the first dentist referral, there was high adherence to best oral health practices for infants and toddlers among states with separate EPSDT dental periodicity schedules. States with low adherence to best oral health practices, especially regarding the dental visit by age 1 year, can strengthen the oral health content of their EPSDT schedules by complying with the AAPD recommendations.

  2. Animal Health and Welfare Issues Facing Organic Production Systems

    PubMed Central

    Sutherland, Mhairi A.; Webster, Jim; Sutherland, Ian

    2013-01-01

    Simple Summary The demand for organically grown, animal derived produce is increasing due to a growing desire for consumer products that have minimal chemical inputs and high animal welfare standards. Evaluation of the scientific literature suggests that a major challenge facing organic animal production systems is the management and treatment of health-related issues. However, implementation of effective management practices can help organic animal producers achieve and maintain high standards of health and welfare, which is necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. Abstract The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. PMID:26479750

  3. Reducing Health Inequities in the United States: Insights and Recommendations from the National Heart, Lung, and Blood Institute’s Health Inequities Think Tank Meeting

    PubMed Central

    Sampson, Uchechukwu K.A.; Kaplan, Robert M.; Cooper, Richard S.; Diez Roux, Ana V.; Marks, James S.; Engelgau, Michael M.; Peprah, Emmanuel; Mishoe, Helena; Boulware, L. Ebony; Felix, Kaytura L.; Califf, Robert M.; Flack, John M.; Cooper, Lisa A.; Gracia, J. Nadine; Henderson, Jeffrey A.; Davidson, Karina W.; Krishnan, Jerry A.; Lewis, Tené T.; Sanchez, Eduardo; Luban, Naomi L.; Vaccarino, Viola; Wong, Winston F.; Wright, Jackson T.; Meyers, David; Ogedegbe, Olugbenga G.; Presley-Cantrell, Letitia; Chambers, David A.; Belis, Deshirée; Bennett, Glen C.; Boyington, Josephine E; Creazzo, Tony L.; de Jesus, Janet M.; Krishnamurti, Chitra; Lowden, Mia R.; Punturieri, Antonello; Shero, Susan T.; Young, Neal S.; Zou, Shimian; Mensah, George A.

    2016-01-01

    The National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. The panel recommended several specific actions, including: 1) Embrace broad and inclusive research themes; 2) Develop research platforms that optimize the ability to conduct informative and innovative research, and promote systems science approaches; 3) Develop networks of collaborators and stakeholders, and launch transformative studies that can serve as benchmarks; 4) Optimize the use of new data sources, platforms, and natural experiments; and 5) develop unique transdisciplinary training programs to build research capacity. Confronting health inequities will require engaging multiple disciplines and sectors (including communities), using systems science, and intervening through combinations of individual, family, provider, health system, and community-targeted approaches. Details of the panel’s remarks and recommendations are provided in this report. PMID:27470459

  4. Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

    PubMed

    Sehulster, Lynne; Chinn, Raymond Y W

    2003-06-06

    The health-care facility environment is rarely implicated in disease transmission, except among patients who are immunocompromised. Nonetheless, inadvertent exposures to environmental pathogens (e.g., Aspergillus spp. and Legionella spp.) or airborne pathogens (e.g., Mycobacterium tuberculosis and varicella-zoster virus) can result in adverse patient outcomes and cause illness among health-care workers. Environmental infection-control strategies and engineering controls can effectively prevent these infections. The incidence of health-care--associated infections and pseudo-outbreaks can be minimized by 1) appropriate use of cleaners and disinfectants; 2) appropriate maintenance of medical equipment (e.g., automated endoscope reprocessors or hydrotherapy equipment); 3) adherence to water-quality standards for hemodialysis, and to ventilation standards for specialized care environments (e.g., airborne infection isolation rooms, protective environments, or operating rooms); and 4) prompt management of water intrusion into the facility. Routine environmental sampling is not usually advised, except for water quality determinations in hemodialysis settings and other situations where sampling is directed by epidemiologic principles, and results can be applied directly to infection-control decisions. This report reviews previous guidelines and strategies for preventing environment-associated infections in health-care facilities and offers recommendations. These include 1) evidence-based recommendations supported by studies; 2) requirements of federal agencies (e.g., Food and Drug Administration, U.S. Environmental Protection Agency, U.S. Department of Labor, Occupational Safety and Health Administration, and U.S. Department of Justice); 3) guidelines and standards from building and equipment professional organizations (e.g., American Institute of Architects, Association for the Advancement of Medical Instrumentation, and American Society of Heating, Refrigeration, and Air

  5. Low health literacy and older adults: meanings, problems, and recommendations for social work.

    PubMed

    Findley, Aaron

    2015-01-01

    Many older adults struggle to manage their health care problems. Low health literacy exacerbates such struggles and contributes to a variety of adverse health behaviors and outcomes. Addressing how health literacy impinges on the lives of older adults is a neglected area of social work practice and knowledge. This article explores seven areas: defining health literacy, the problem and prevalence of low health literacy among older adults, health inequalities and health literacy, a brief literature review, neglected issues in the literature, suggestions for macro and micro social work interventions to improve health literacy for older adult populations, and conclusion.

  6. Organically Grown Food Provides Health Benefits to Drosophila melanogaster

    PubMed Central

    Chhabra, Ria; Kolli, Santharam; Bauer, Johannes H.

    2013-01-01

    The “organic food” market is the fastest growing food sector, yet it is unclear whether organically raised food is nutritionally superior to conventionally grown food and whether consuming organic food bestows health benefits. In order to evaluate potential health benefits of organic foods, we used the well-characterized fruit fly Drosophila melanogaster as a model system. Fruit flies were raised on a diets consisting of extracts of either conventionally or organically raised produce (bananas, potatoes, raisins, soy beans). Flies were then subjected to a variety of tests designed to assess overall fly health. Flies raised on diets made from organically grown produce had greater fertility and longevity. On certain food sources, greater activity and greater stress resistance was additionally observed, suggesting that organic food bestows positive effects on fly health. Our data show that Drosophila can be used as a convenient model system to experimentally test potential health effects of dietary components. Using this system, we provide evidence that organically raised food may provide animals with tangible benefits to overall health. PMID:23326371

  7. Organically grown food provides health benefits to Drosophila melanogaster.

    PubMed

    Chhabra, Ria; Kolli, Santharam; Bauer, Johannes H

    2013-01-01

    The "organic food" market is the fastest growing food sector, yet it is unclear whether organically raised food is nutritionally superior to conventionally grown food and whether consuming organic food bestows health benefits. In order to evaluate potential health benefits of organic foods, we used the well-characterized fruit fly Drosophila melanogaster as a model system. Fruit flies were raised on a diets consisting of extracts of either conventionally or organically raised produce (bananas, potatoes, raisins, soy beans). Flies were then subjected to a variety of tests designed to assess overall fly health. Flies raised on diets made from organically grown produce had greater fertility and longevity. On certain food sources, greater activity and greater stress resistance was additionally observed, suggesting that organic food bestows positive effects on fly health. Our data show that Drosophila can be used as a convenient model system to experimentally test potential health effects of dietary components. Using this system, we provide evidence that organically raised food may provide animals with tangible benefits to overall health.

  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. Recommendations for Modeling Disaster Responses in Public Health and Medicine: A Position Paper of The Society for Medical Decision Making

    PubMed Central

    Brandeau, Margaret L.; McCoy, Jessica H.; Hupert, Nathaniel; Holty, Jon-Erik; Bravata, Dena M.

    2013-01-01

    Purpose Mathematical and simulation models are increasingly used to plan for and evaluate health sector responses to disasters, yet no clear consensus exists regarding best practices for the design, conduct, and reporting of such models. We examined a large selection of published health sector disaster response models to generate a set of best practice guidelines for such models. Methods We reviewed a spectrum of published disaster response models addressing public health or healthcare delivery, focusing in particular on the type of disaster and response decisions considered, decision makers targeted, choice of outcomes evaluated, modeling methodology, and reporting format. We developed initial recommendations for best practices for creating and reporting such models and refined these guidelines after soliciting feedback from response modeling experts and from members of the Society for Medical Decision Making. Results We propose six recommendations for model construction and reporting, inspired by the most exemplary models: Health sector disaster response models should address real-world problems; be designed for maximum usability by response planners; strike the appropriate balance between simplicity and complexity; include appropriate outcomes, which extend beyond those considered in traditional cost-effectiveness analyses; and be designed to evaluate the many uncertainties inherent in disaster response. Finally, good model reporting is particularly critical for disaster response models. Conclusions Quantitative models are critical tools for planning effective health sector responses to disasters. The recommendations we propose can increase the applicability and interpretability of future models, thereby improving strategic, tactical, and operational aspects of preparedness planning and response. PMID:19605887

  10. Adherence to diet, physical activity and body weight recommendations and breast cancer incidence in the Black Women's Health Study.

    PubMed

    Nomura, Sarah J O; Dash, Chiranjeev; Rosenberg, Lynn; Yu, Jeffrey; Palmer, Julie R; Adams-Campbell, Lucile L

    2016-12-15

    Adherence to cancer prevention recommendations has been associated with lower incidence of breast cancer in previous studies, but evidence in African American women is limited. This project evaluated the association between adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and breast cancer incidence among African American women. The Black Women's Health Study (analytic cohort = 49,103) is an ongoing prospective cohort study of African American women, ages 21-69 years at baseline (1995). Adherence scores for seven WCRF/AICR recommendations (adherent = 1, partial adherence = 0.5, non-adherence = 0) were calculated using questionnaire data and summed for overall (maximum = 7) and diet only (maximum = 5) scores. Associations between baseline and time-varying adherence scores and breast cancer incidence (N = 1,827 incident cases through 2011) were evaluated using proportional hazards regression. In this cohort, 8.5% adhered >4 recommendations. Adherence at baseline was not associated with breast cancer incidence. Higher overall time-varying adherence (per 0.5 point increase) was associated with lower breast cancer incidence (HR: 0.90, 95% CI: 0.84-0.96). Adherence to physical activity, sugar beverage and red and processed meat recommendations were also associated with reduced risk. Adherence to the WCRF/AICR recommendations was low and may be associated with lower breast cancer incidence in African American women. © 2016 UICC.

  11. [Individuals and changes in health organizations: a psychosociological approach].

    PubMed

    Azevedo, Creuza da Silva; Braga Neto, Francisco Campos; Sá, Marilene de Castilho

    2002-01-01

    The Brazilian health sector has undergone a severe crisis, affecting the case-resolving capacity, efficiency and governability of the health system as a whole and health organizations in particular. Although innovative management systems and tools have been encouraged, such innovations are limited in their ability to spawn organizational change, especially with regard to the challenge of enabling individual adherence to institutional projects and relations involving individuals and organizations. This paper focuses on the French psychosociological approach for analyzing and intervening in organizations, one of whose main thinkers is Eugène Enriquez. In its view of contemporary organizations, this approach focuses on the conflict between reproduction and creation as the main problem to be solved by management processes. While an organization is essentially seen as a place of order and repetition, organizational change implies the challenge of bringing creative individuals into the organization's project, avoiding the trap of controlling their minds and behavior.

  12. 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.

  13. World Health Organization treatment guidelines for drug-resistant tuberculosis, 2016 update.

    PubMed

    Falzon, Dennis; Schünemann, Holger J; Harausz, Elizabeth; González-Angulo, Licé; Lienhardt, Christian; Jaramillo, Ernesto; Weyer, Karin

    2017-03-01

    Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9-12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016. The composition of longer regimens for patients ineligible for the shorter regimen was modified. A first-ever meta-analysis of individual paediatric patient data allowed treatment recommendations for childhood MDR/RR-TB to be made. Delamanid is now also recommended in patients aged 6-17 years. Partial lung resection is a recommended option in MDR/RR-TB care. The 2016 revision highlighted the continued shortage of high-quality evidence and implementation research, and reiterated the need for clinical trials and best-practice studies to improve MDR/RR-TB patient treatment outcomes and strengthen policy.

  14. World Health Organization treatment guidelines for drug-resistant tuberculosis, 2016 update

    PubMed Central

    Schünemann, Holger J.; Harausz, Elizabeth; González-Angulo, Licé; Lienhardt, Christian; Jaramillo, Ernesto; Weyer, Karin

    2017-01-01

    Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9–12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016. The composition of longer regimens for patients ineligible for the shorter regimen was modified. A first-ever meta-analysis of individual paediatric patient data allowed treatment recommendations for childhood MDR/RR-TB to be made. Delamanid is now also recommended in patients aged 6–17 years. Partial lung resection is a recommended option in MDR/RR-TB care. The 2016 revision highlighted the continued shortage of high-quality evidence and implementation research, and reiterated the need for clinical trials and best-practice studies to improve MDR/RR-TB patient treatment outcomes and strengthen policy. PMID:28331043

  15. 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.

  16. Historical review of the List of Occupational Diseases recommended by the International Labour organization (ILO)

    PubMed Central

    2013-01-01

    The list of occupational diseases established in the international and national legal system has played important roles in both prevention of and compensation for workers’ diseases. This report reviewed the historical development in the ILO list of occupational diseases and suggested implications of the trends. Since the first establishment of the ILO list of occupational diseases in 1925, the list has played a key role in harmonizing the development of policies on occupational diseases at the international level. The three occupational diseases (anthrax, lead poisoning, and mercury poisoning) in the first ILO list of occupational diseases, set up in 1925 as workmen’s compensation convention represented an increase of occupational diseases from the Industrial Revolution. Until the 1960s, 10 occupational diseases had been representative compensable occupational diseases listed in Convention No. 121, which implies that occupational diseases in this era were equated to industrial poisoning. Since 1980, with advancements in diagnostic techniques and medical science, noise-induced hearing loss, and several bronchopulmonary diseases have been incorporated into the ILO occupational list. Since 2002, changes in the structure of industries, emerging new chemicals, and advanced national worker’s compensation schemes have provoked the ILO to revise the occupational disease list. A new format of ILO list appended in Recommendation 194 (R194) was composed of two dimensions (causes and diseases) and subcategories. Among 50 member states that had provided their national lists of occupational diseases, until 2012 thirty countries were found to have the list occupational diseases having similar structure to ILO list in R194. PMID:24472440

  17. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization.

    PubMed

    1995-11-01

    This paper describes the World Health Organization's project to develop a quality of life instrument (the WHOQOL). It outlines the reasons that the project was undertaken, the thinking that underlies the project, the method that has been followed in its development and the current status of the project. The WHOQOL assesses individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It has been developed collaboratively in several culturally diverse centres over four years. Piloting of the WHOQOL on some 4500 respondents in 15 cultural settings has been completed. On the basis of this data the revised WHOQOL Field Trial Form has been finalized, and field testing is currently in progress. The WHOQOL produces a multi-dimensional profile of scores across six domains and 24 sub-domains of quality of life.

  18. Indigenous health organizations in Australia: connections and capacity.

    PubMed

    Baeza, Juan I; Lewis, Jenny M

    2010-01-01

    The health of Aboriginal people is significantly worse than that of the rest of the Australian population. Aboriginal community-controlled health organizations live with uncertainty in terms of funding, and the amount of money spent on indigenous people through mainstream health services is less than that spent on the non-indigenous population, especially when the different needs of these two groups are taken into account. The Aboriginal population is small and widely dispersed, causing problems for policy and funding. This article provides an analysis of the network of health organizations in Victoria, with a specific focus on indigenous health, and analyzes the connections between mainstream and indigenous-specific health services. The research approach involved semi-structured interviews with informants from a range of health organizations within the state. This research illustrates the importance of Aboriginal community-controlled health organizations to the indigenous community. There is evidence that connections between the indigenous and mainstream health systems need to be further developed and strengthened to provide the indigenous population with a high-quality, culturally sensitive, and comprehensive health service.

  19. Knowledge and recommendations regarding breast cancer early screening in an upper middle income country: Primary and secondary health care professionals.

    PubMed

    Ortega-Olvera, C; Torres-Mejía, G; Sánchez-Zamorano, L M; Ángeles-Llerenas, A; Martínez-Matsushita, L; Rojas-Martínez, R; Montemayor-Varela, E; Navarro-Lechuga, Edgar; Lazcano-Ponce, E

    2016-05-01

    To compare the current breast cancer prevention and control Mexican standard with recommendations that health care professionals provide to women for breast self-exams, clinical breast exams and mammography, as well as health care professional knowledge of the risk factors for and main clinical signs of the disease. In 2012, using a cross-sectional design, trained interviewers surveyed health care providers in a sample of 798 medical units, of which 756 corresponded to the first and second levels of medical care. One health care professional from each unit was interviewed for the study. The sampling method was systematic and representative of the national and regional levels. Relative frequencies and 95% confidence intervals (CI) were obtained using the weighting factor assigned to each medical unit. Regarding the indicator about recommendations provided to the population regarding early screening for and risk factors and clinical signs of breast cancer, the average number of health care professional responses in accordance with the Mexican standard was 10.7 (95% CI 10.0-11.4) out of a maximum of 28 points, which corresponds to an average rate of 38.2% of responses (95% CI 35.6-40.8). The percentage of correct answers increased in all areas of breast exam knowledge as training hours in the previous year increased. Health care professionals are unaware of the current standards on breast cancer; therefore, these recommendations are not routinely translated into health care practice, which is a barrier to increasing the coverage of screening programs in health care services. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Oral health for people with special needs: consensus statement on implications and recommendations for the dental profession.

    PubMed

    Glassman, Paul; Henderson, Tim; Helgeson, Michael; Niessen, Linda; Demby, Neal; Miller, Christine; Meyerowitz, Cyril; Ingraham, Rick; Isman, Robert; Noel, David; Tellier, Rolande; Toto, Karen

    2005-08-01

    In November 2004, the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry, with support from the California Dental Association Foundation, hosted a conference to explore the issue of oral health for people with special needs. This conference was held in conjunction with the joint meetings of Pacific's Statewide Task Force on Oral Health for People With Special Needs and Pacific's Statewide Task Force on Oral Health and Aging. These groups of interested stakeholders meet several times a year to discuss the increasing problems faced by people with disabilities, elderly individuals, and other special populations in obtaining access to oral health services and maintaining good oral health. The purpose of this conference was to explore the changing population of people with special needs, analyze the implications for the dental profession and society, and describe systems and strategies that might lead to improved oral health for these populations. This conference also served as a forum for developing oral health recommendations as a part of the California Commission on Aging's Strategic Plan for an Aging Population. Seven nationally recognized speakers presented draft papers on various aspects of this topic. These presentations are published as the additional papers in this and the next issue of the Journal. There was time for audience reaction and discussion with the speakers. The speakers and a designated group of reactors then developed this consensus statement and recommendations for addressing these issues.

  1. Practical recommendations for strengthening national and regional laboratory networks in Africa in the Global Health Security era

    PubMed Central

    2016-01-01

    The role of national health laboratories in support of public health response has expanded beyond laboratory testing to include a number of other core functions such as emergency response, training and outreach, communications, laboratory-based surveillance and data management. These functions can only be accomplished by an efficient and resilient national laboratory network that includes public health, reference, clinical and other laboratories. It is a primary responsibility of the national health laboratory in the Ministry of Health to develop and maintain the national laboratory network in the country. In this article, we present practical recommendations based on 17 years of network development experience for the development of effective national laboratory networks. These recommendations and examples of current laboratory networks, are provided to facilitate laboratory network development in other states. The development of resilient, integrated laboratory networks will enhance each state’s public health system and is critical to the development of a robust national laboratory response network to meet global health security threats. PMID:28879137

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

    PubMed

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

    2015-02-01

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

  3. Applying Weick's model of organizing to health care and health promotion: highlighting the central role of health communication.

    PubMed

    Kreps, Gary L

    2009-03-01

    Communication is a crucial process in the effective delivery of health care services and the promotion of public health. However, there are often tremendous complexities in using communication effectively to provide the best health care, direct the adoption of health promoting behaviors, and implement evidence-based public health policies and practices. This article describes Weick's model of organizing as a powerful theory of social organizing that can help increase understanding of the communication demands of health care and health promotion. The article identifies relevant applications from the model for health communication research and practice. Weick's model of organizing is a relevant and heuristic theoretical perspective for guiding health communication research and practice. There are many potential applications of this model illustrating the complexities of effective communication in health care and health promotion. Weick's model of organizing can be used as a template for guiding both research and practice in health care and health promotion. The model illustrates the important roles that communication performs in enabling health care consumers and providers to make sense of the complexities of modern health care and health promotion, select the best strategies for responding effectively to complex health care and health promotion situations, and retain relevant information (develop organizational intelligence) for guiding future responses to complex health care and health promotion challenges.

  4. [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.

  5. Use of Electronic Nicotine Delivery Systems Among Adolescents: Status of the Evidence and Public Health Recommendations.

    PubMed

    Kamat, Aarti D; Van Dyke, Alison L

    2017-02-01

    Although the prevalence of tobacco smoking has been declining in recent years, the use of electronic nicotine delivery systems (ENDS) such as of electronic cigarettes, vaporizers, and hookahs has been steadily rising, especially among adolescents. ENDS are not only advertised to children, but their sale via the Internet has made them easily accessible to youth. In general, children perceive ENDS as safe, or at least safer than smoking traditional combustible tobacco products; however, exposure to nicotine may have deleterious effects on the developing brain. Concern also persists that ENDS may be a "starter" drug that may lead to further tobacco, drug, and/or alcohol use. In contrast to this precautionary stance that is associated with calls for legislative oversight of ENDS marketing and sales, harm reductionists claim that the risks posed by ENDS are minor in comparison with those of combustible tobacco products and that ENDS may be used as a means of nicotine replacement for smoking cessation, despite no concrete evidence to support this assertion. Many medical and health-related organizations have produced position statements concerning ENDS use, including among adolescents. This article summarizes the advantages and disadvantages of using ENDS espoused in these position statements, especially as they relate to use among adolescents. [Pediatr Ann. 2017;46(2):e69-e77.]. Copyright 2017, SLACK Incorporated.

  6. 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.

  7. Public Health Departments and Accountable Care Organizations: Finding Common Ground in Population Health

    PubMed Central

    Ingram, Richard; Scutchfield, F. Douglas

    2015-01-01

    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. PMID:25790392

  8. Social organization and the meaning of health.

    PubMed

    Kelman, S

    1980-06-01

    The meaning of the term "health" is properly the subject of social, rather than natural, investigation. The structure of modern industrial capitalist society appears to materially and unavoidably produce a meaning of "health" intrinsically involving substantially preventable disese. Because in such a society private investment responds to cyclical and geographic fluctuations in rates of return and competitive labor markets, much of the disease structure (heart disease, stroke, kidney failure, and cancer, among others) encompasses diseases which captive citizens cannot afford to do without. To prevent those disease through environmental and workplace cleanup, full employment and geographic capital stability is to drive away the very private capital on which economic life is based. Consequently, those diseases are as intrinsic to modern capitalist society as the law of supply and demand and are, therefore, a characteristic component of the meaning of "health," the socially optimum level of organismic condition, in this epoch. A necessary condition for the emancipation of "health" from socially preventable disease would appear to be the social, rather than private, control of production and accumulation.

  9. The health belief model and factors associated with adherence to treatment recommendations for positional plagiocephaly.

    PubMed

    Lam, Sandi; Luerssen, Thomas G; Hadley, Caroline; Daniels, Bradley; Strickland, Ben A; Brookshier, Jim; Pan, I-Wen

    2017-03-01

    OBJECTIVE This study aimed to examine factors associated with adherence to recommended treatment among pediatric patients with positional skull deformity by reviewing a single-institution experience (2007-2014) with the treatment of positional plagiocephaly. METHODS A retrospective chart review was conducted. Risk factors, treatment for positional head shape deformity, and parent-reported adherence were recorded. Univariate and multivariate analyses were used to assess the impact of patient clinical and demographic characteristics on adherence. RESULTS A total of 991 patients under age 12 months were evaluated for positional skull deformity at the Texas Children's Hospital Cranial Deformity Clinic between 2007 and 2014. According to an age- and risk factor-based treatment algorithm, patients were recommended for repositioning, physical therapy, or cranial orthosis therapy or crossover from repositioning/physical therapy into cranial orthosis therapy. The patients' average chronological age at presentation was 6.2 months; 69.3% were male. The majority were white (40.7%) or Hispanic (32.6%); 38.7% had commercial insurance and 37.9% had Medicaid. The most common initial recommended treatment was repositioning or physical therapy; 85.7% of patients were adherent to the initial recommended treatment. Univariate analysis showed differences in adherence rates among subgroups. Children's families with Medicaid were less likely to be adherent to treatment recommendations (adherence rate, 80.2%). Families with commercial insurance were more likely to be adherent to the recommended treatment (89.6%). Multivariate logistic regression confirmed that factors associated with parent-reported adherence to recommended treatment included primary insurance payer, diagnosis (plagiocephaly vs brachycephaly), and the nature of the recommended treatment. Families were less likely to be adherent if they had Medicaid, a child with a diagnosis of brachycephaly, or were initially recommended

  10. Animal Health and Welfare Issues Facing Organic Production Systems.

    PubMed

    Sutherland, Mhairi A; Webster, Jim; Sutherland, Ian

    2013-10-31

    The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare.

  11. Child Health Advice and Parental Obligation: The Case of Safe Sleep Recommendations and Sudden Unexpected Death in Infancy.

    PubMed

    Jonas, Monique

    2016-02-01

    This article considers whether there is a parental obligation to comply with child health advice which is aimed at the general population and grounded in population-based research. Drawing upon the concept of role obligations, I argue that there is a temptation to use child health advice as a set of rules to which parents are morally obligated to comply, but that this temptation should be resisted. Using the case of Safe Sleep recommendations, designed to reduce the risk of sleep-related infant deaths, I present three reasons for doubting that parents are obligated, as a matter of course, to comply with child health advice. I suggest that, rather than compliance, deliberation about child health advice is obligatory, and that parents should have reasons for not following credible child health advice.

  12. Organization and Function of a School Health Council.

    ERIC Educational Resources Information Center

    Valente, Carmine M.; Lumb, Karen J.

    1981-01-01

    The purpose, activities, organization, and responsibility of the Prince George's County School Health Council are described. The purposes of the Council include advisement, representation, screening, and the development of new programs. (JN)

  13. 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.

  14. 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

  15. Contribution of organically grown crops to human health.

    PubMed

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

    2014-04-08

    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.

  16. Bone Health in Patients with Breast Cancer: Recommendations from an Evidence-Based Canadian Guideline

    PubMed Central

    Paterson, Alexander H. G.; Shea-Budgell, Melissa A.

    2013-01-01

    Bone loss is common in patients with breast cancer. Bone modifying agents (BMAs), such as bisphosphonates and denosumab, have been shown to reverse or stabilize bone loss and may be useful in the primary and metastatic settings. The purpose of this review is to provide clear evidence-based strategies for the management of bone loss and its symptoms in breast cancer. A systematic review of clinical trials and meta-analyses published between 1996 and 2012 was conducted of MEDLINE and EMBASE. Reference lists were hand-searched for additional publications. Recommendations were developed based on the best available evidence. Zoledronate, pamidronate, clodronate, and denosumab are recommended for metastatic breast cancer patients; however, no one agent can be recommended over another. Zoledronate or any oral bisphosphonate and denosumab should be considered in primary breast cancer patients who are postmenopausal on aromatase inhibitor therapy and have a high risk of fracture and/or a low bone mineral density and in premenopausal primary breast cancer patients who become amenorrheic after therapy. No one agent can be recommended over another. BMAs are not currently recommended as adjuvant therapy in primary breast cancer for the purpose of improving survival, although a major Early Breast Cancer Cooperative Trialists’ Group meta-analysis is underway which may impact future practice. Adverse events can be managed with appropriate supportive care. PMID:26237149

  17. [Applicability of "do not do recommendations" from the National Institute for Health and Care Excellence in a quaternary care hospital].

    PubMed

    Martin, S; Miñarro, R; Cano, P; Aranda, J M

    2015-01-01

    To qualitatively and quantitatively identify the level of agreement between the clinical staff of a quaternary care hospital and the National Institute for Health and Care Excellence (NICE) "do not do" recommendations, and to submit a strategic alternative for effective implementation. An ad hoc form was designed to evaluate level of clinical disagreement from the experience and knowledge of the clinical staff, as well as the applicability, usefulness, effectivity and efficiency of all the NICE "do not do" recommendations that had been published up to June 2012, checking their stability up to the July 2014 update. Description of the process of design and implementation of the strategic alternative to improve compliance is presented. The great majority (90%) of Clinical Unit directors agree with the NICE recommendations, with 64% finding them useful or very useful, 52% finding them applicable, and 32% and 34% thinking they are of high effectivity and efficiency, respectively. However, 20% of the efficient ones are not being applied. Moreover, knowledge discordances that might lead to clinical disagreements were detected. A strategic intervention, combining culture and incentives for good clinical practices, has been implemented. The improvement in the use of the good clinical practice recommendations is directly related to the agreement of its definition and evidence. An evaluation strategy of its application by the health professionals is essential to achieve an impact in avoidable costs. Moreover, to control for harmful effects of the economic impact on patient safety, it will be necessary to simultaneously evaluate clinical/health outcome indicators tightly linked to the applied recommendations. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  18. 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.

  19. Reducing salt intake in the Americas: Pan American Health Organization actions.

    PubMed

    Legetic, Branka; Campbell, Norm

    2011-08-01

    This article outlines the rationale for reducing dietary salt and some of the Pan American Health Organization actions to facilitate reductions in dietary salt in the Americas. Excessive dietary salt (sodium chloride and other sodium salts) is a major cause of increased blood pressure, which increases risk for stroke, heart disease, and kidney disease. Reduction in salt intake is beneficial for people with hypertension and those with normal blood pressure. The World Health Organization recommends a population salt intake of less than 5 grams/person/day with a Pan American Health Organization expert group recommendation that this be achieved by 2020 in the Americas. In general, the consumption of salt is more than 6 grams/day by age 5 years, with consumption of salt averaging between 9 and 12 grams per day in many countries. Recent salt intake estimates from Brazil (11 grams of salt/day), Argentina (12 grams of salt/day), Chile (9 grams of salt/day) and the United States (8.7 grams of salt/day) confirm that high salt intakes are prevalent in Americas. Sources of dietary salt vary, from 75% of it coming from processed food in developed countries, to 70% coming from discretionary salt added in cooking or at the table in parts of Brazil. The Pan American Health Organization has launched a regionwide initiative called the ?Cardiovascular Disease Prevention Through Dietary Salt Reduction,? led by an expert working group. Working closely with countries, the expert group developed resources to aid policy development through five subgroups: (a) addressing industry engagement and product reformulation; (b) advocacy and communication; (c) surveillance of salt intake, sources of salt in the diet, and knowledge and opinions on salt and health; (d) salt fortification with iodine; and (e) national-level health economic studies on salt reduction.

  20. Nutritional Guidelines for School Lunch Programs: A Survey of Islamic Schools and Recommendations for Creating a Culture of Healthful Eating

    PubMed Central

    Khan, Sumiya; Saeed, Ziena; Diwan, Hanifa Hameed; Hussain, Iqra; Amer, Sarah; Haq, Mohamed M.

    2011-01-01

    Objective: To determine the status of lunch programs in Islamic schools in the United States and develop recommendations for improving them. Study Design: The Islamic Medical Association of North America (IMANA) conducted a survey of lunch programs by mailing questionnaires to 100 Islamic schools in the United States. Muslims in Dietetics and Nutrition (MIDAN) developed lunch menus using American and ethnic foods conforming to nationally recommended guidelines. Results: Forty-eight Islamic schools responded to the survey, revealing that 20 schools follow guidelines and only six have dietitians advising on menu planning. Based on this survey, IMANA, with the assistance of MIDAN, has developed a summary of guidelines that schools can follow. These guidelines include sample menus of American and ethnic foods, recommendations for creating a n environment for healthful eating, and sources for funding school lunch programs. Conclusions: IMANA and MIDAN, recognizing the scientific significance and religious relevance of a nutritious diet, have developed these recommendations. This information is provided to aid Islamic schools in implementing guidelines for nutritionally balanced school lunch menus and in creating a culture that fosters a healthful lifestyle. PMID:23610485

  1. Male circumcision for HIV prevention in Papua New Guinea: a summary of research evidence and recommendations for public health following a national policy forum.

    PubMed

    Vallely, A; MacLaren, D J; Kaleva, W; Millan, J; Tommbe, R; Marape, W; Manineng, C; Buchanan, H; Amos, A; Frank, R; Kelly, A; Kupul, M; Aeno, H; Trowalle, E; John, L N; Redman-Maclaren, M L; Ryan, C; Browne, K; Tynan, A; Hill, P S; Gray, R T; Murray, J; Wilson, D P; Law, G; Siba, P; McBride, W J H; Farley, T; Kaldor, J M

    2011-01-01

    In 2005, a clinical trial in South Africa found that circumcision of young men could reduce their risk of acquiring HIV (human immunodeficiency virus) infection by over 60%. In the following year, two more trials in Africa confirmed this finding, leading the World Health Organization to recommend male circumcision as a public health strategy for HIV prevention in high-incidence countries. In order to inform public health policy in Papua New Guinea (PNG), two major research projects were initiated with the goals of investigating the status of penile cutting practices and assessing understandings, acceptability, feasibility and cost-effectiveness of male circumcision for HIV prevention. In addition, behavioural surveillance surveys systematically asked questions on penile cutting practices and an ethnographic literature review informed historical perspectives of penile cutting in PNG. Key findings from these research activities were presented at a National Policy Forum on Male Circumcision for HIV Prevention held in Port Moresby in November 2011. The Forum made three key recommendations: (1) the formation of a joint National Department of HealthlNational AIDS Council Secretariat Policy Committee on male circumcision; (2) the establishment of an integrated harm reduction program; and (3) that future policy on wide-scale roll-out of male circumcision for HIV prevention in PNG be informed by a combination of data from (a) male circumcision intervention pilot programs and (b) research on the potential protective effect of other forms of penile cutting.

  2. Development of a culture of sustainability in health care organizations.

    PubMed

    Ramirez, Bernardo; West, Daniel J; Costell, Michael M

    2013-01-01

    This paper aims to examine the concept of sustainability in health care organizations and the key managerial competencies and change management strategies needed to implant a culture of sustainability. Competencies and management development strategies needed to engrain this corporate culture of sustainability are analyzed in this document. This paper draws on the experience of the authors as health care executives and educators developing managerial competencies with interdisciplinary and international groups of executives in the last 25 years, using direct observation, interviews, discussions and bibliographic evidence. With a holistic framework for sustainability, health care managers can implement strategies for multidisciplinary teams to respond to the constant change, fine-tune operations and successfully manage quality of care. Managers can mentor students and provide in-service learning experiences that integrate knowledge, skills, and abilities. Further empirical research needs to be conducted on these interrelated innovative topics. Health care organizations around the world are under stakeholders' pressure to provide high quality, cost-effective, accessible and sustainable services. Professional organizations and health care providers can collaborate with university graduate health management education programs to prepare competent managers in all the dimensions of sustainability. The newly designated accountable care organizations represent an opportunity for managers to address the need for sustainability. Sustainability of health care organizations with the holistic approach discussed in this paper is an innovative and practical approach to quality improvement that merits further development.

  3. Midwifery in the 21st century. Recommendations from the Pew Health Professions Commission/UCSF Center for the Health Professions 1998 Taskforce on Midwifery.

    PubMed

    Paine, L L; Dower, C M; O'Neil, E H

    1999-01-01

    Unprecedented changes in the delivery and financing of health care have produced angst and opportunity, criticism, and innovation. To explore the effects of these market-driven changes on midwifery, the University of California at San Francisco Center for the Health Professions convened a Taskforce on Midwifery in 1998. Consisting of eight experts from across the country, the Taskforce was charged with exploring the impact of health care system developments on midwifery, and identifying issues facing the profession and the roles midwives play in women's health care. The Taskforce answered its charge by offering 14 recommendations related to midwifery practice, regulation, education, research, and policy. The recommendations incorporate the Taskforce vision that the midwifery model of care should be embraced by, and incorporated into, the health care system in order to make it available to all women and their families. Midwives, educators, collaborators, and policymakers can use the recommendations to develop curricula, practice sites, and laws for an improved health care system that fully includes midwives and encompasses the midwifery model of care.

  4. Promoting Correct Car Seat Use in Parents of Young Children: Challenges, Recommendations, and Implications for Health Communication

    PubMed Central

    Weaver, Nancy L.; Brixey, Suzanne N.; Williams, Janice; Nansel, Tonja R.

    2013-01-01

    Injuries involving motor vehicles continue to be the biggest threat to the safety of children. Although child safety seats (CSS) have been established as a central countermeasure in decreasing injury risk, the majority of parents do not use the correct car seat correctly. There are many challenges in promoting correct car seat use, which itself is a complex behavior. To advance this critical protective behavior, the public health community would benefit from clarifying CSS messaging, communicating clearly, and addressing the conflicting recommendations of product use. In this article, we present current challenges in promoting CSS use and draw on health communication and other fields to offer recommendations for future work in this area. PMID:22991278

  5. Barriers to prostate cancer prevention and community recommended health education strategies in an urban African American community in Jackson, Mississippi.

    PubMed

    Ekúndayò, Olúgbémiga T; Tataw, David B

    2013-01-01

    This article describes the use of survey research in collaboration with the African American urban community of Georgetown, Jackson, Mississippi to identify and understand prostate cancer knowledge, resource utilization, and health education strategies considered most effective in reaching the community with prostate cancer prevention messages. The study revealed profound needs in disease identification and resources awareness and utilization. Barriers to utilization were identified by participants to include lack of self-efficacy, low self-esteem, lack of trust in the health care system, limited knowledge of prostate pathology, and limited ability to pay. Participants' recommended strategies for reaching the community with prostate cancer education include traditional and nontraditional strategies. The list of recommendations exclude modern-day outlets such as handheld devices, Twitter, Facebook, blogs, wikis, and other Internet-based outlets. The findings provide a road map for program development and an intervention research agenda custom-tailored to the Georgetown community of Jackson, Mississippi.

  6. The role of behavioral health services in accountable care organizations.

    PubMed

    Kathol, Roger G; Patel, Kavita; Sacks, Lee; Sargent, Susan; Melek, Stephen P

    2015-02-01

    Nationally, care delivery organizations are developing accountable care organizations (ACOs), but few have an appreciation of the importance of behavioral health services or knowledge about how to include them in an ACO since their funding and delivery are currently segregated from other medical services. This commentary reviews data on the impact of patients with concurrent medical and behavioral health conditions. They indicate that three-fourths of patients with behavioral health disorders are seen in the medical setting, but are largely untreated because few medical patients choose to access the behavioral health sector, which is where behavioral health providers are paid to work. Untreated behavioral health conditions in medical patients are associated with persistent medical illness and significantly increased total medical healthcare service use and cost, especially in those with chronic medical conditions. At a national level, those with behavioral health conditions use one-third of total healthcare resources. This will not change unless at-risk ACOs can effectively correct the mismatch between behavioral health patients and behavioral healthcare delivery. The authors suggest that ACO subcontracting for traditional segregated behavioral health services, whether from local provider groups or external vendors, will not achieve ACO-mandated access, treatment, and cost reduction goals. Rather, behavioral health specialists will need to become core ACO member providers. This will allow them to be deployed along with other member providers using value-added delivery approaches in the medical setting to integrate medical and behavioral health service delivery, and to achieve synergistic health and cost improvement.

  7. Recommended System Design for the Occupational Health Management Information System (OHMIS). Volume 1.

    DTIC Science & Technology

    1983-04-01

    Management Information System (OHMIS). The system design includes: detailed function data flows for each of the core data processing functions of OHMIS, in the form of input/processing/output algorithms; detailed descriptions of the inputs and outputs; performance specifications of OHMIS; resources required to develop and operate OHMIS (Vol II). In addition, the report provides a summary of the rationale used to develop the recommended system design, a description of the methodology used to develop the recommended system design, and a review of existing

  8. Recommendation of standardized health learning contents using archetypes and semantic web technologies.

    PubMed

    Legaz-García, María del Carmen; Martínez-Costa, Catalina; Menárguez-Tortosa, Marcos; Fernández-Breis, Jesualdo Tomás

    2012-01-01

    Linking Electronic Healthcare Records (EHR) content to educational materials has been considered a key international recommendation to enable clinical engagement and to promote patient safety. This would suggest citizens to access reliable information available on the web and to guide them properly. In this paper, we describe an approach in that direction, based on the use of dual model EHR standards and standardized educational contents. The recommendation method will be based on the semantic coverage of the learning content repository for a particular archetype, which will be calculated by applying semantic web technologies like ontologies and semantic annotations.

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

    ERIC Educational Resources Information Center

    Hornback, May, Ed.

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

  10. Quality and Evaluation in a Comprehensive Health Organization.

    ERIC Educational Resources Information Center

    Anderson, Malcolm; Brazil, Kevin

    1995-01-01

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

  11. The Politics of Empiricism: Research Recommendations of the Joint Commission on Mental Health of Children

    ERIC Educational Resources Information Center

    Hamm, Norman H.

    1974-01-01

    Critically examines the efficacy, training, and administration of research in terms of meeting the goal of children's mental health; the emphasis is on rationally analyzing our empirical enterprise as it applies to practical payoff, especially mental health. (Author/JM)

  12. [On the clients of public health organizations].

    PubMed

    Duran, Júlia; Villalbí, Joan R; Guix, Joan

    2004-01-01

    Public services must satisfy a variety of agents: users of these services, the citizens who pay the taxes that finance them, politicians, and those that work in them. To obtain public services that give priority to the citizen-user, knowledge of clients, their expectations, preferences, complaints and degree of satisfaction is essential. This article presents the process of internal discussion in our agency about its clients, who differ from those of an industrial or commercial organization. A proposal for the classification of clients, as well as the process that has led to a client portfolio, are presented and steps to improve services from the perspective of the client are suggested.

  13. Training the next generation of global health experts: experiences and recommendations from Pacific Rim universities.

    PubMed

    Withers, Mellissa; Press, David; Wipfli, Heather; McCool, Judith; Chan, Chang-Chuan; Jimba, Masamine; Tremewan, Christopher; Samet, Jonathan

    2016-06-23

    Finding solutions to global health problems will require a highly-trained, inter-disciplinary workforce. Global health education and research can potentially have long-range impact in addressing the global burden of disease and protecting and improving the health of the global population. We conducted an online survey of twelve higher education institutions in the Pacific Rim that spanned the period 2005-2011. Program administrators provided data on program concentrations, student enrollment and student funding opportunities for 41 public health programs, including those specific to global health. The Master of Public Health (MPH) was the most common degree offered. A growing demand for global health education was evident. Enrollment in global health programs increased over three-fold between 2005-2011. Very few institutions had specific global health programs or offered training to undergraduates. Funding for student scholarships was also lacking. The growing demand for global health education suggests that universities in the Pacific Rim should increase educational and training opportunities in this field. Schools of medicine may not be fully equipped to teach global health-related courses and to mentor students who are interested in global health. Increasing the number of dedicated global health research and training institutions in the Pacific Rim can contribute to building capacity in the region. Faculty from different departments and disciplines should be engaged to provide multi-disciplinary global health educational opportunities for undergraduate and graduate students. New, innovative ways to collaborate in education, such as distance education, can also help universities offer a wider range of global health-related courses. Additional funding of global health is also required.

  14. Report and Recommendations of the Southern Rural Health Conference (Nashville, Tennessee, October 10-12, 1976).

    ERIC Educational Resources Information Center

    National Rural Center, Washington, DC.

    Included in this report on the Southern Rural Health Conference (held in Nashville, Tennessee in 1976) are: (1) an introduction (details the conference goals); (2) a program agenda; (3) "Summation: Southern Rural Health Conference" (a speech); (4) "Health Care and Rural Development" (a speech); (5) "Innovative Approaches…

  15. Women's Health in the Dental School Curriculum: Report of a Survey & Recommendations.

    ERIC Educational Resources Information Center

    Silverton, Susan; Sinkford, Jeanne; Inglehart, Marita; Tedesco, Lisa; Valachovic, Richard

    This report presents the analytical results of a survey of U.S. and Canadian dental schools conducted during 1997 by the American Association of Dental Schools. It documents how women's health and oral health issues are addressed in the curriculum. It also presents an annotated bibliography of research involving oral and craniofacial health and…

  16. Reflections and Recommendations Based on a Migrant Health Center's Participation in a CDC Study.

    ERIC Educational Resources Information Center

    Nolon, Anne K.; O'Barr, James

    Hudson Valley Migrant Health (HVMH) (a Public Health Service program) collaborated with the Center for Disease Control (CDC) and the New York State Department of Health (NYSDOH) on a study of the incidence of sexually transmitted diseases and tuberculosis among migrant farmworkers in the mid-Hudson region of New York. CDC research personnel…

  17. Allied Health Education/Transfer of Credit: Recommendations of the North Carolina Articulation Project.

    ERIC Educational Resources Information Center

    Boatman, Ralph H., Ed.; Huther, John W., Ed.

    The North Carolina Allied Health Articulation Project was launched to develop procedures which would enable an individual to transfer credit from an allied health education program in one setting to some program in higher education. In 1972-73, study committees were appointed to deal with the allied health professions of physical therapy,…

  18. 76 FR 54777 - Center for Devices and Radiological Health 510(k) Clearance Process; Recommendations Proposed in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... HUMAN SERVICES Food and Drug Administration Center for Devices and Radiological Health 510(k) Clearance... Health, The FDA 510(k) Clearance Process at 35 Years''; Public Meeting; Correction AGENCY: Food and Drug... Devices and the Public's Health, The FDA 510(k) Clearance Process at 35 Years.' '' The document...

  19. Sponsorship of National Health Organizations by Two Major Soda Companies.

    PubMed

    Aaron, Daniel G; Siegel, Michael B

    2017-01-01

    Obesity is a pervasive public health problem in the U.S. Reducing soda consumption is important for stemming the obesity epidemic. However, several articles and one book suggest that soda companies are using their resources to impede public health interventions that might reduce soda consumption. Although corporate sponsorship by tobacco and alcohol companies has been studied extensively, there has been no systematic attempt to catalog sponsorship activities of soda companies. This study investigates the nature, extent, and implications of soda company sponsorship of U.S. health and medical organizations, as well as corporate lobbying expenditures on soda- or nutrition-related public health legislation from 2011 to 2015. Records of corporate philanthropy and lobbying expenditures on public health legislation by soda companies in the U.S. during 2011-2015 were found through Internet and database searches. From 2011 to 2015, the Coca-Cola Company and PepsiCo were found to sponsor a total of 95 national health organizations, including many medical and public health institutions whose specific missions include fighting the obesity epidemic. During the study period, these two soda companies lobbied against 29 public health bills intended to reduce soda consumption or improve nutrition. There is surprisingly pervasive sponsorship of national health and medical organizations by the nation's two largest soda companies. These companies lobbied against public health intervention in 97% of cases, calling into question a sincere commitment to improving the public's health. By accepting funding from these companies, health organizations are inadvertently participating in their marketing plans. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  20. [Organic foods and human health: a study of controversies].

    PubMed

    Sousa, Anete Araújo de; Azevedo, Elaine de; Lima, Elinete Eliete de; Silva, Ana Paula Ferreira da

    2012-06-01

    The study of controversies is a methodological tool that generates knowledge about the social and political dimensions of science. This approach can be used to understand and explore the topic of organic foods. The present study aimed to analyze the controversies regarding the status of organic foods. We carried out a review of studies published since 1990 in three websites: International Foundation for Organic Agriculture, Soil Association, and Food and Agriculture Organization. The following controversies were identified: 1) effects on human health of the presence of chemical contaminants in organic foods; 2) the quality of organic foods as compared to conventionally grown foods; and 3) price of organic foods. Based on this review, it is possible to conclude that, even though organic foods stand out for their low toxicity, higher durability, and nutritional content of some items, more comparative studies are required to confirm the nutritional superiority of organic foods and to solve the controversies. The discussion must be contextualized within a broad spectrum of health promotion, in which organic farming appears associated with the support for small farming, biodiversity, and local sustainable development, so as to increase offer and demand for organic products at fair prices for individual and institutional consumers.

  1. Justifying medication decisions in mental health care: Psychiatrists’ accounts for treatment recommendations

    PubMed Central

    Angell, Beth; Bolden, Galina B.

    2015-01-01

    Psychiatric practitioners are currently encouraged to adopt a patient centered approach that emphasizes the sharing of decisions with their clients, yet recent research suggests that fully collaborative decision making is rarely actualized in practice. This paper uses the methodology of Conversation Analysis to examine how psychiatrists justify their psychiatric treatment recommendations to clients. The analysis is based on audio-recordings of interactions between clients with severe mental illnesses (such as, schizophrenia, bipolar disorders, etc.) in a long-term, outpatient intensive community treatment program and their psychiatrist. Our focus is on how practitioners design their accounts (or rationales) for recommending for or against changes in medication type and dosage and the interactional deployment of these accounts. We find that psychiatrists use two different types of accounts: they tailor their recommendations to the clients’ concerns and needs (client-attentive accounts) and ground their recommendations in their professional expertise (authority-based accounts). Even though psychiatrists have the institutional mandate to prescribe medications, we show how the use of accounts displays psychiatrists’ orientation to building consensus with clients in achieving medical decisions by balancing medical authority with the sensitivity to the treatment relationship. PMID:26046726

  2. [Asylum-seekers' mental and physical health problems: practices and recommendations].

    PubMed

    Kórász, Krisztián

    2016-01-03

    The Hungarian health care system faces new challenges with the unprecedented increased rate of migration. Asylum-seekers arriving are a heterogeneous group. Their health care needs vary depending on their country of origin and the quality of the health care they received prior to arrival, not to mention the impact of the migration process on their health. Described within this paper are the challenges an asylum seeker might face in obtaining care on arrival into the host country and the challenges clinicians face in providing that care. This review is designed to give health professionals the necessary knowledge to care for asylum-seekers in a culturally aware and clinically informed manner.

  3. Advancing Health Marketing Research and Policy Recommendations by Incorporating Source Perspectives.

    PubMed

    Mackert, Michael; Guadagno, Marie; Champlin, Sara

    2015-01-01

    Communication researchers, recognizing the message sent is not necessarily the same as the message received, have incorporated the perspective of advertising professionals into the study of advertising effects. Health marketing research could similarly benefit from incorporating this largely absent perspective into the academic and policy debate surrounding the impact of advertising on health issues ranging from obesity to alcohol use. This commentary serves as a call to action to stakeholders in this academic and policy debate: focus on the perspective of advertising professionals to enrich health marketing and public health research in which advertising is the delivery vehicle for health messages.

  4. Cross-functional teams in health care organizations.

    PubMed

    McKenzie, L

    1994-03-01

    Cross-functional teams in health care organizations provide a comprehensive view of problems and are highly useful in designing and implementing improvements in work processes. Several potential obstacles may impede team progress, but these can be overcome. Cross-functional teams must develop norms that guide the interactions of team members. Individual team members must display behaviors that serve task accomplishment and team spirit. The promise of cross-functional teams for health care organizations is great. These promises, however, will not be fulfilled without the positive support of health care supervisors.

  5. 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.

  6. [Bad results obtained from the current public health policies and recommendations of hydration].

    PubMed

    San Mauro Martín, Ismael; Romo Orozco, Denisse Aracely; Mendive Dubourdieu, Paula; Garicano Vilar, Elena; Valente, Ana; Betancor, Fabiana; Morales Hurtado, Alexis Daniel; Garagarza, Cristina

    2016-07-19