Comparison between diagnosis and treatment of community-acquired pneumonia in children in various medical centres across Europe with the United States, United Kingdom and the World Health Organization guidelines.

PubMed

Usonis, Vytautas; Ivaskevicius, Rimvydas; Diez-Domingo, Javier; Esposito, Susanna; Falup-Pecurariu, Oana G; Finn, Adam; Rodrigues, Fernanda; Spoulou, Vana; Syrogiannopoulos, George A; Greenberg, David

2016-01-01

The aim of this study was to review the current status and usage of guidelines in the diagnosis and treatment of community-acquired pneumonia (CAP) in European countries and to compare to established guidelines in the United States (US), United Kingdom (UK), and the World Health Organization (WHO). A questionnaire was developed and distributed by the Community-Acquired Pneumonia Paediatric Research Initiative (CAP-PRI) working group and distributed to medical centres across Europe. Out of 19 European centres, 6 (31.6 %) used WHO guidelines (3 in combination with other guidelines), 5 (26.3 %) used national guidelines, and 5 (26.3 %) used local guidelines. Chest radiograph and complete blood count were the most common diagnostic examinations, while evaluation of clinical symptoms and laboratory tests varied significantly. Tachypnoea and chest recession were considered criteria for diagnosis in all three guidelines. In US and UK guidelines blood cultures, atypical bacterial and viral detection tests were recommended. In European centres in outpatient settings, amoxicillin was used in 16 (84 %) centers, clarithromycin in 9 (37 %) centers and azithromycin in 7 (47 %) centers, whereas in hospital settings antibiotic treatment varied widely. Amoxicillin is recommended as the first drug of choice for outpatient treatment in all guidelines. Although local variations in clinical criteria, laboratory tests, and antibiotic resistance rates may necessitate some differences in standard empirical antibiotic regimens, there is considerable scope for standardisation across European centres for the diagnosis and treatment of CAP.

Organization of the Saudi health system.

PubMed

Al-Yousuf, M; Akerele, T M; Al-Mazrou, Y Y

2002-01-01

Using existing data, we reviewed the organizational structure of the Saudi Arabian health system: its demography and history, principal health indicators, organization and management, type and distribution of facilities, financial base, and the impact on it of the Haj. We noted duplication of services, inadequate coordination between some health industry sectors, and the need for a more extensive and rational health centre network with improved information systems and data collection. We also noted scope for a greater role for the private health sector and increased cooperation between it and the public sector to improve health service delivery and population health.

42 CFR 422.2268 - Standards for MA organization marketing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Standards for MA organization marketing. 422.2268... § 422.2268 Standards for MA organization marketing. Link to an amendment published at 76 FR 54634, Sept. 1, 2011. In conducting marketing activities, MA organizations may not— (a) Provide cash or other...

Six essential roles of health promotion research centres: the Atlantic Canada experience

PubMed Central

Langille, Lynn L.; Crowell, Sandra J.; Lyons, Renée F.

2009-01-01

SUMMARY Over the past 20 years, the federal government and universities across Canada have directed resources towards the development of university-based health promotion research centres. Researchers at health promotion research centres in Canada have produced peer-reviewed papers and policy documents based on their work, but no publications have emerged that focus on the specific roles of the health promotion research centres themselves. The purpose of this paper is to propose a framework, based on an in-depth examination of one centre, to help identify the unique roles of health promotion research centres and to clarify the value they add to promoting health and advancing university goals. Considering the shifting federal discourse on health promotion over time and the vulnerability of social and health sciences to changes in research funding priorities, health promotion research centres in Canada and elsewhere may need to articulate their unique roles and contributions in order to maintain a critical focus on health promotion research. The authors briefly describe the Atlantic Health Promotion Research Centre (AHPRC), propose a framework that illustrates six essential roles of health promotion research centres and describe the policy contexts and challenges of health promotion research centres. The analysis of research and knowledge translation activities over 15 years at AHPRC sheds light on the roles that health promotion research centres play in applied research. The conclusion raises questions regarding the value of university-based research centres and challenges to their sustainability. PMID:19171668

The methodology for defining the European Standards for the certification of Haemophilia Centres in Europe

PubMed Central

Candura, Fabio; Menichini, Ivana; Calizzani, Gabriele; Giangrande, Paul; Mannucci, Pier Mannuccio; Makris, Michael

2014-01-01

Introduction Work Package 4 Development of the standardisation criteria of the European Haemophilia Network project has the main objective of implementing a common and shared European strategy for a certification system for two levels of Haemophilia Centres: European Haemophilia Treatment Centres and European Haemophilia Comprehensive Care Centres in the Member States of the European Union. Materials and methods An inclusive and participatory process for developing shared standards and criteria for the management of patients with inherited bleeding disorders has been carried out. The process has been implemented through four different consultation events involving the entire European community of stakeholders that significantly contributed in the drafting of the European Guidelines for the certification of Haemophilia Centres. Results The Guidelines set the standards for the designation of centres that provide specialised and multidisciplinary care (Haemophilia Comprehensive Care Centres) as well as local routine care (Haemophilia Treatment Centres). Standards cover several issues such as: general requirements; patient care; advisory services; laboratory; networking of clinical and specialised services. Conclusions The drafting of the European Guidelines for the certification of Haemophilia Centres was performed adopting a rigorous methodological approach. In order to build the widest possible consensus to the quality standards, the main institutional and scientific stakeholders have been involved. The resulting document will significantly contribute in promoting standardisation in the quality of diagnosis and treatment in European Haemophilia Centres. PMID:24922292

Health and safety management systems: liability or asset?

PubMed

Bennett, David

2002-01-01

Health and safety management systems have a background in theory and in various interests among employers and workplace health and safety professionals. These have resulted in a number of national systems emanating from national standard-writing centres and from employers' organizations. In some cases these systems have been recognized as national standards. The contenders for an international standard have been the International Organization of Standardization (ISO) and the International Labour Organization (ILO). The quality and environmental management systems of ISO indicate what an ISO health and safety management standard would look like. The ILO Guidelines on Safety and Health Management Systems, by contrast, are stringent, specific and potentially effective in improving health and safety performance in the workplace.

Taiwanese maternal health in the postpartum nursing centre.

PubMed

Hung, Chich-Hsiu; Yu, Ching-Yun; Ou, Chu-Chun; Liang, Wei-Wen

2010-04-01

To investigate the association between postpartum stress as well as social support and the general health status of women recently discharged from postpartum nursing centres where the ritual of Tso-Yueh-Tzu is followed. Taiwanese women stay in postpartum nursing centres to take care of their newborn babies and perform the traditional Chinese ritual of Tso-Yueh-Tzu, the custom of a postpartum month-long rest. A non-experimental research design was used in the study. Two hundred and fifty-eight postpartum women who had stayed in postpartum nursing centres for at least 20 days were recruited at eight postpartum nursing centres in the Kaohsiung metropolitan area of southern Taiwan. They were administered the Hung Postpartum Stress Scale, the Social Support Scale and the Chinese Health Questionnaire. Women without minor psychiatric morbidity had higher social support, lower postpartum stress and longer length-of-stays in the postpartum care centre than women with minor psychiatric morbidity. Postpartum stress revolved around changes in body shape. A one-point increase in postpartum stress increased the likelihood that a mother would suffer minor psychiatric morbidity by 1.04 times; while giving birth to a boy decreased that likelihood by 0.51 times. This study found Tso-Yueh-Tzu as practised in postpartum nursing centres gave the postpartum women the opportunity to receive tangible support and, therefore, helped decrease postpartum stress and improved their general health. The greatest source of postpartum stress was concern over negative body changes. The postpartum nursing centre plays an important role in helping postpartum Taiwanese women observe the traditional ritual of Tso-Yueh-Tzu and in improving these women's general health. These centres may want to pay more attention to providing exercise that promotes body toning and relaxation.

Assessment of primary health care in a rural health centre in Enugu South east Nigeria.

PubMed

M Chinawa, Josephat; T Chinawa, Awoere

2015-01-01

Primary health care (PHC) is a vital in any community. Any health centre with a well implemented PHC program can stand the test of time in curbing under five mortality and morbidity. This study was therefore aimed at assessing the activities in a health centre located in a rural area in Enugu state and to determine the pattern and presentation of various diseases in the health centre. This is retrospective study undertaken in a primary health care centre in Abakpa Nike in Enugu east LGA of Enugu State of Nigeria from December 2011 to December 31(st) 2013. Data retrieved were collected with the aid of a structured study proforma and analyzed using SPSS Version 18. Total number of children that attended immunization program in the health centre over 20 months period was 25,438 (12,348 males and 13090 females), however only 17745 children (7998 males and 9747 females) were actually registered in the hospital records. None of the children was immunized for DPT2 and OPV(0) and HBV(1) in the course of this study. The dropout rate using DPT1, 2 and 3 (DPT1-DPT2/DPT3) was very high (494%). The mean immunization coverage rate was 8.3%. Family planning activities, integrated management of childhood illnesses program were also carried out in the health centre but at very low level. The major fulcrum of events in the health centre which include immunization coverage, IMCI, and management of common illnesses were simply non operational. However the health centre had a well knitted referral system.

Assessment of primary health care in a rural health centre in Enugu South east Nigeria

PubMed Central

M Chinawa, Josephat; T Chinawa, Awoere

2015-01-01

Objective: Primary health care (PHC) is a vital in any community. Any health centre with a well implemented PHC program can stand the test of time in curbing under five mortality and morbidity. This study was therefore aimed at assessing the activities in a health centre located in a rural area in Enugu state and to determine the pattern and presentation of various diseases in the health centre. Methods: This is retrospective study undertaken in a primary health care centre in Abakpa Nike in Enugu east LGA of Enugu State of Nigeria from December 2011 to December 31st 2013. Data retrieved were collected with the aid of a structured study proforma and analyzed using SPSS Version 18. Results: Total number of children that attended immunization program in the health centre over 20 months period was 25,438 (12,348 males and 13090 females), however only 17745 children (7998 males and 9747 females) were actually registered in the hospital records. None of the children was immunized for DPT2 and OPV0 and HBV1 in the course of this study. The dropout rate using DPT1, 2 and 3 (DPT1-DPT2/DPT3) was very high (494%). The mean immunization coverage rate was 8.3%. Family planning activities, integrated management of childhood illnesses program were also carried out in the health centre but at very low level. Conclusions: The major fulcrum of events in the health centre which include immunization coverage, IMCI, and management of common illnesses were simply non operational. However the health centre had a well knitted referral system. PMID:25878615

Building up careers in translational neuroscience and mental health research: Education and training in the Centre for Biomedical Research in Mental Health.

PubMed

Rapado-Castro, Marta; Pazos, Ángel; Fañanás, Lourdes; Bernardo, Miquel; Ayuso-Mateos, Jose Luis; Leza, Juan Carlos; Berrocoso, Esther; de Arriba, Jose; Roldán, Laura; Sanjuán, Julio; Pérez, Victor; Haro, Josep M; Palomo, Tomás; Valdizan, Elsa M; Micó, Juan Antonio; Sánchez, Manuel; Arango, Celso

2015-01-01

The number of large collaborative research networks in mental health is increasing. Training programs are an essential part of them. We critically review the specific implementation of a research training program in a translational Centre for Biomedical Research in Mental Health in order to inform the strategic integration of basic research into clinical practice to have a positive impact in the mental health system and society. Description of training activities, specific educational programs developed by the research network, and challenges on its implementation are examined. The Centre for Biomedical Research in Mental Health has focused on training through different activities which have led to the development of an interuniversity master's degree postgraduate program in mental health research, certified by the National Spanish Agency for Quality Evaluation and Accreditation. Consolidation of training programs within the Centre for Biomedical Research in Mental Health has considerably advanced the training of researchers to meet competency standards on research. The master's degree constitutes a unique opportunity to accomplish neuroscience and mental health research career-building within the official framework of university programs in Spain. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

Developments in the instruction of biostatistics at the Kuwait University Health Science Centre in a decade.

PubMed

Moussa, Mohamed A A

2002-01-01

Kuwait has witnessed many changes that influenced, among other things, the structure of medical education including biostatistics. This article describes the developments in biostatistics instruction and curriculum in the Health Science Centre, University of Kuwait, during the past 10 years. Instead of teaching biostatistics as an independent component, the university has developed an integrated course (35 hr of lectures and 12 hr of tutorial sessions) of biostatistics, epidemiology, and demography that is taught to undergraduate medical and dentistry students to ensure interdisciplinary interaction, to remove redundancies, and to standardize terminology across the three disciplines. The core curriculum of the biostatistics course is compatible with the recommendations of the American Statistical Association. Separate biostatistics courses are also offered to pharmacy and allied health students to address their diverse interests. In addition, new biostatistics and computer applications instruction courses were developed and are taught to the students of the Master of Science (MSc), Master of Public Health (MPH), and PhD programs. For continuing medical education, a workshop on biostatistics and computer applications is organized annually for the medical profession as a collaboration between the Health Science Centre and the Kuwait Institute for Medical Specialization. The instructor and curriculum content of the biostatistics courses are confidentially evaluated and independently analyzed by the office of the Vice Dean for Academic Affairs. Overall, students evaluate the biostatistics instructors highly and are pleased with the content of the biostatistics curriculum. During the last decade, biostatistics instruction in the Kuwait Health Science Centre had many new developments. An integrated course on biostatistics, epidemiology, and demography was developed with emphasis on problem solving and small group learning. Another biostatistics course is offered to the

Cost of maternal health services in selected primary care centres in Ghana: a step down allocation approach

PubMed Central

2013-01-01

Background There is a paucity of knowledge on the cost of health care services in Ghana. This poses a challenge in the economic evaluation of programmes and inhibits policy makers in making decisions about allocation of resources to improve health care. This study analysed the overall cost of providing health services in selected primary health centres and how much of the cost is attributed to the provision of antenatal and delivery services. Methods The study has a cross-sectional design and quantitative data was collected between July and December 2010. Twelve government run primary health centres in the Kassena-Nankana and Builsa districts of Ghana were randomly selected for the study. All health-care related costs for the year 2010 were collected from a public service provider’s perspective. The step-down allocation approach recommended by World Health Organization was used for the analysis. Results The average annual cost of operating a health centre was $136,014 US. The mean costs attributable to ANC and delivery services were $23,063 US and $11,543 US respectively. Personnel accounted for the largest proportion of cost (45%). Overall, ANC (17%) and delivery (8%) were responsible for less than a quarter of the total cost of operating the health centres. By disaggregating the costs, the average recurrent cost was estimated at $127,475 US, representing 93.7% of the total cost. Even though maternal health services are free, utilization of these services at the health centres were low, particularly for delivery (49%), leading to high unit costs. The mean unit costs were $18 US for an ANC visit and $63 US for spontaneous delivery. Conclusion The high unit costs reflect underutilization of the existing capacities of health centres and indicate the need to encourage patients to use health centres .The study provides useful information that could be used for cost effectiveness analyses of maternal and neonatal care interventions, as well as for policy makers to

Standardizing the atomic description, axis and centre of biological ion channels.

PubMed

Kaats, Adrian J; Galiana, Henrietta L; Nadeau, Jay L

2007-09-15

A general representation of the atomic co-ordinates of a biological ion channel is obtained from a definition of channel axis and centre. Through rotation and translation of the channel, its centre becomes the origin of the standard co-ordinate system, and the channel axis becomes the system's z-axis. A method for determining the channel axis and centre based on the concepts of mass centre and mass moment of inertia is presented. The method for determining the channel axis can be directly applied to channels that adhere to two specific conditions regarding their geometry and mass distribution. Specific examples are given for Gramicidin A (GA), and the mammalian potassium channel Kv 1.2. For channels that do not adhere to these conditions, minor modifications of these procedures can be applied in determining the channel axis. Specific examples are given for the outer membrane bacterial porin OmpF, and for the staphylococcal pore-forming toxin alpha-hemolysin (alpha HL). The definitions and procedures presented are made in an effort to establish a standard basis for performing, sharing, and comparing computations in a consistent manner.

[The contribution of the Russian Research Centre of Medical Rehabilitation and Balneotherapeutics to the development of the health resort business in this country].

PubMed

Povazhnaia, E A; Bobrovnitskiĭ, I P

2013-01-01

The definition of the notion of health resort business is proposed in the context of the legislation pertinent to the natural therapeutic resources, health and recreational localities, spa and resort facilities currently in force in this country. The main landmark events in the history of the Russian Research Centre of Rehabilitative Medicine and Balneotherapeutics are highlighted, its role in the development of balneotherapeutic science and health resort business is described. The major achievements of the Centre in the investigations of therapeutic properties of natural physical factors (climate, mineral waters, peloids, etc.), their action on the human organism, the possibilities of their application for the treatment and prevention of various pathological conditions in and outside health resort facilities are presented. The contribution of the specialists of the Centre to the search for and discovery of new resort resources is emphasized. Community needs in balneotheraputic treatment are estimated, scientific basis for its organization, principles and normatives of health resort business are discussed along with the problems of sanitary control and protection. The activities of the Centre as an organizer of the unique system of rehabilitative and balneotherapeutic aid to the population are overviewed. Scientifically substantiated indications and contraindications for the spa and resort-based treatment of various diseases are proposed in conjunction with the methods for the application of physiotherapeutic factors. The tasks currently facing the Centre and prospects for its future research activities in the fields of rehabilitative medicine and balneotherapeutics are discussed.

[The design and development of a quality system for the diagnosis of exotic animal diseases at the National Centre for Animal and Plant Health in Cuba].

PubMed

de Oca, N Montes; Villoch, A; Pérez Ruano, M

2004-12-01

A quality system for the diagnosis of exotic animal diseases was developed at the national centre for animal and plant health (CENSA), responsible for coordinating the clinical, epizootiological and laboratory diagnosis of causal agents of exotic animal diseases in Cuba. A model was designed on the basis of standard ISO 9001:2000 of the International Organization for Standardization (ISO), standard ISO/IEC 17025:1999 of ISO and the International Electrotechnical Commission, recommendations of the World Organisation for Animal Health (OIE) and other regulatory documents from international and national organisations that deal specifically with the treatment of emerging diseases. Twenty-nine standardised operating procedures were developed, plus 13 registers and a checklist to facilitate the evaluation of the system. The effectiveness of the quality system was confirmed in the differential diagnosis of classical swine fever at an animal virology laboratory in Cuba.

45 CFR 170.207 - Vocabulary standards for representing electronic health information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... health information. 170.207 Section 170.207 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH.... International Health Terminology Standards Development Organization (IHTSDO) Systematized Nomenclature of... States National Library of Medicine. (e) Immunizations. Standard. HL7 Standard Code Set CVX—Vaccines...

78 FR 42084 - Cooperative Agreement to Support the World Trade Organization's Standards and Trade Development...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

... Organization for Animal Health, World Bank, World Health Organization (WHO) and the WTO. The STDF supports...] Cooperative Agreement to Support the World Trade Organization's Standards and Trade Development Facility... cooperative agreement in fiscal year 2013 (FY 2013) to the World Trade Organization's (WTO) Standards and...

Risk of antenatal psychosocial distress in indigenous women and its management at primary health care centres in Australia.

PubMed

Gausia, Kaniz; Thompson, Sandra C; Nagel, Tricia; Schierhout, Gill; Matthews, Veronica; Bailie, Ross

2015-01-01

This study explored the risk of antenatal psychosocial distress (APD) and associated potential factors and examined management aspects of risk of APD in women attending Aboriginal primary health care services in Australia. Audits of medical records of 797 pregnant women from 36 primary health centres in five jurisdictions (NSW, QLD, SA, WA and NT) were undertaken as part of a quality improvement programme. Information collected included mental health assessed by a standard screening tools, enquiry regarding social and emotional well-being (SEWB), depression management (including antidepressant medications) and referral. Around 18% (n=141) of women were at risk of APD based on assessment using a standard screening tool or by SEWB enquiry. There was a significant association between risk of distress and women's life style behaviours (e.g., alcohol, illicit drug use) and health centre characteristics. Of the 141 women, 16% (n= 22) were prescribed antidepressant drugs during pregnancy. A range of nonpharmaceutical mental health interventions were also recorded, including brief intervention of 61% (n=86), counselling of 57% (n=80) and cognitive behaviour therapy of 5% (n=7). About 39% (n=55) of women with APD were referred to external services for consultations with a psychiatrist, psychologist or social worker or to a women's refuge centre. The higher risk of APD associated with women's life style behaviour indicates that the better understanding of mental health in its cultural context is essential. Copyright © 2015 Elsevier Inc. All rights reserved.

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

Balancing Health Information Exchange and Privacy Governance from a Patient-Centred Connected Health and Telehealth Perspective.

PubMed

Kuziemsky, Craig E; Gogia, Shashi B; Househ, Mowafa; Petersen, Carolyn; Basu, Arindam

2018-04-22

 Connected healthcare is an essential part of patient-centred care delivery. Technology such as telehealth is a critical part of connected healthcare. However, exchanging health information brings the risk of privacy issues. To better manage privacy risks we first need to understand the different patterns of patient-centred care in order to tailor solutions to address privacy risks.  Drawing upon published literature, we develop a business model to enable patient-centred care via telehealth. The model identifies three patient-centred connected health patterns. We then use the patterns to analyse potential privacy risks and possible solutions from different types of telehealth delivery.  Connected healthcare raises the risk of unwarranted access to health data and related invasion of privacy. However, the risk and extent of privacy issues differ according to the pattern of patient-centred care delivery and the type of particular challenge as they enable the highest degree of connectivity and thus the greatest potential for privacy breaches.  Privacy issues are a major concern in telehealth systems and patients, providers, and administrators need to be aware of these privacy issues and have guidance on how to manage them. This paper integrates patient-centred connected health care, telehealth, and privacy risks to provide an understanding of how risks vary across different patterns of patient-centred connected health and different types of telehealth delivery. Georg Thieme Verlag KG Stuttgart.

Canadian community health centres and the Internet: exploring the challenges and solutions.

PubMed

Jamieson, R

1997-01-01

Community Health Centres (CHCs) across Canada are providing essential health and social services to many communities, and this function is becoming more vital as provinces concentrate on cutting costs and developing more economic and efficient solutions to the current healthcare system. More than 300 of these community-based organizations currently serve upwards to 13% of the Canadian population, providing a wide range of services in an attempt to promote total wellness in their communities. Over one half of all CHCs are located in rural or remote areas. However, despite the apparent need for, and success of, CHCs, they are among the most underserved health provision groups in the country. Many CHCs lack critical funding and resources, particularly in the area of technology. In this Information Age, the health sector is realizing the importance of using information technologies to increase efficiency, improve services, and maintain viability. Community Health Centres, however, often do not have money for even the most basic technologies such as fax machines, let alone computers and Internet access. Community Health Centres in Canada need to be given the tools they need in order to continue providing quality health care to their communities. This article provides an overview of the current situation of CHCs in Canada vis(-)à-vis the Internet and other information technologies. Some of the practical and organizational challenges facing CHCs in this area will be discussed, as well as potential solutions that could and are being developed to overcome these barriers. It is an objective of this article to facilitate information and resource-sharing and the creation of links between CHCs across Canada. Community Health Centres may benefit from better understanding of the implications of these new technologies, discovering ways in which their peers are using the Internet, and communicating with one another in order to begin basic planning and needs assessments. As part of

World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia.

PubMed

Gelb, Adrian W; Morriss, Wayne W; Johnson, Walter; Merry, Alan F; Abayadeera, Anuja; Belîi, Natalia; Brull, Sorin J; Chibana, Aline; Evans, Faye; Goddia, Cyril; Haylock-Loor, Carolina; Khan, Fauzia; Leal, Sandra; Lin, Nan; Merchant, Richard; Newton, Mark W; Rowles, Jackie S; Sanusi, Arinola; Wilson, Iain; Velazquez Berumen, Adriana

2018-06-01

The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a nonprofit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving the quality and safety of anesthesia care. The Standards cover professional aspects; facilities and equipment; medications and intravenous fluids; monitoring; and the conduct of anesthesia. HIGHLY RECOMMENDED standards, the functional equivalent of mandatory standards, include (amongst other things): the continuous presence of a trained and vigilant anesthesia provider; continuous monitoring of tissue oxygenation and perfusion by clinical observation and a pulse oximeter; intermittent monitoring of blood pressure; confirmation of correct placement of an endotracheal tube (if used) by auscultation and carbon dioxide detection; the use of the WHO Safe Surgery Checklist; and a system for transfer of care at the end of an anesthetic. The International Standards represent minimum standards and the goal should always be to practice to the highest possible standards, preferably exceeding the standards outlined in this document.

World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia.

PubMed

Gelb, Adrian W; Morriss, Wayne W; Johnson, Walter; Merry, Alan F

2018-05-07

The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a non-profit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving the quality and safety of anesthesia care. The Standards cover professional aspects; facilities and equipment; medications and intravenous fluids; monitoring; and the conduct of anesthesia. HIGHLY RECOMMENDED standards, the functional equivalent of mandatory standards, include (amongst other things): the continuous presence of a trained and vigilant anesthesia provider; continuous monitoring of tissue oxygenation and perfusion by clinical observation and a pulse oximeter; intermittent monitoring of blood pressure; confirmation of correct placement of an endotracheal tube (if used) by auscultation and carbon dioxide detection; the use of the WHO Safe Surgery Checklist; and a system for transfer of care at the end of an anesthetic. The International Standards represent minimum standards and the goal should always be to practice to the highest possible standards, preferably exceeding the standards outlined in this document.

People at the centre of complex adaptive health systems reform.

PubMed

Sturmberg, Joachim P; O'Halloran, Diana M; Martin, Carmel M

2010-10-18

Health systems are increasingly recognised to be complex adaptive systems (CASs), functionally characterised by their continuing and dynamic adaptation in response to core system drivers, or attractors. The core driver for our health system (and for the health reform strategies intended to achieve it) should clearly be the improvement of people's health - the personal experience of health, regardless of organic abnormalities; we contend that a patient-centred health system requires flexible localised decision making and resource use. The prevailing trend is to use disease protocols, financial management strategies and centralised control of siloed programs to manage our health system. This strategy is suggested to be fatally flawed, as: people's health and health experience as core system drivers are inevitably pre-empted by centralised and standardised strategies; the context specificity of personal experience and the capacity of local systems are overlooked; and in line with CAS patterns and characteristics, these strategies will lead to "unintended" consequences on all parts of the system. In Australia, there is still the time and opportunity for health system redesign that truly places people and their health at the core of the system.

"PHC leadership: are health centres in good hands? Perspectives from 3 districts in Malawi".

PubMed

Hana, J; Maleta, K; Kirkhaug, R; Hasvold, T

2012-09-01

The study aimed to document the kinds of leadership styles are practiced at health centres (H/C) and how these styles can be explained by the contexts, characteristics of the health centre in charge (IC) and subordinate trained health staff (STHS). A well-researched leadership style model was applied, which included task, relation and change styles. This is a cross-sectional study using self-administered questionnaires in 47 H/C in 3 districts. 347 STHSs (95%) and 46 ICs (98%) responded. Questions explored background data and perceived leadership behaviour. Style items were factor analysed, and bivariate analyses and hierarchical regressions determined how styles could be explained. Two leadership styles were revealed: "Trans" style contained all relation and the majority of task and change items; "Control" style focused on health statistics (Health Management Information System), reporting and evaluation. STHS and IC had a median age/median work experience of 34/5 years and 38,5/2 years, respectively. 48% of IC reported having no management training. CHAM H/Cs had the lowest score on "Control" style. Distance to referral hospital had no impact on style scores. No contexts or STHS characteristics predicted any leadership styles. For ICs, young age and increasing work experience were significant predictors for both styles, while Nurse ICs were negative predictors for "Control style". Management training was not a significant predictor for any style. Frontline PHC leadership may be forced by situation and context to use a comprehensive style which could lack the diversity and flexibility needed for effective leadership. The missing associations between staff characteristics and leadership styles might indicate that this group is not sufficiently considered and included in leadership processes in the PHC organization. Leadership competency for the ICs seems not to be based on formal training, but substituted by young age and work experience. Health centre organization

Public accountability for health: new standards for health system performance.

PubMed

Lansky, D; Purdy, S

1995-01-01

This article reviews the failure of contemporary quality oversight organizations to respond to the changing health care environment and suggests an overhaul of quality measurement and assurance functions. The authors examine the factors that have limited public accountability for health care, emphasizing the limited agreement that exists on the purpose of American health care, standards for evaluating care, or the appropriate locus of responsibility for quality of care. A five-part quality oversight system is proposed including development of quality measures, promulgation of national standards, validation and accreditation, use of data for purchasing and provider selection, and use of data for quality improvement.

Standards of care for obsessive–compulsive disorder centres

PubMed Central

Menchón, José M.; van Ameringen, Michael; Dell’Osso, Bernardo; Denys, Damiaan; Figee, Martijn; Grant, Jon E.; Hollander, Eric; Marazziti, Donatella; Nicolini, Humberto; Pallanti, Stefano; Ruck, Christian; Shavitt, Roseli; Stein, Dan J.; Andersson, Erik; Bipeta, Rajshekhar; Cath, Danielle C.; Drummond, Lynne; Feusner, Jamie; Geller, Daniel A.; Hranov, Georgi; Lochner, Christine; Matsunaga, Hisato; McCabe, Randy E.; Mpavaenda, Davis; Nakamae, Takashi; O'Kearney, Richard; Pasquini, Massimo; Pérez Rivera, Ricardo; Poyurovsky, Michael; Real, Eva; do Rosário, Maria Conceição; Soreni, Noam; Swinson, Richard P.; Vulink, Nienke; Zohar, Joseph; Fineberg, Naomi

2016-01-01

Abstract In recent years, many assessment and care units for obsessive–compulsive disorder (OCD) have been set up in order to detect, diagnose and to properly manage this complex disorder, but there is no consensus regarding the key functions that these units should perform. The International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) together with the Obsessive Compulsive and Related Disorders Network (OCRN) of the European College of Neuropsychopharmacology (ECNP) and the Anxiety and Obsessive Compulsive Disorders Section of the World Psychiaric Association (WPA) has developed a standards of care programme for OCD centres. The goals of this collaborative initiative are promoting basic standards, improving the quality of clinical care and enhance the validity and reliability of research results provided by different facilities and countries. PMID:27359333

Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis

PubMed Central

Topp, Stephanie M; Chipukuma, Julien M; Hanefeld, Johanna

2015-01-01

Background Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform. Little research exists to adequately explain how and why this is the case. This study aimed to test the relevance and usefulness of an adapted conceptual framework for improving our understanding of the mechanisms and causal pathways influencing primary health centre performance. Methods A theory-driven, case-study approach was adopted. Four Zambian health centres were purposefully selected with case data including health-care worker interviews (n = 60); patient interviews (n = 180); direct observation of facility operations (2 weeks/centre) and key informant interviews (n = 14). Data were analysed to understand how the performance of each site was influenced by the dynamic interactions between system ‘hardware’ and ‘software’ acting on mechanisms of accountability. Findings Structural constraints including limited resources created challenging service environments in which work overload and stockouts were common. Health workers’ frustration with such conditions interacted with dissatisfaction with salary levels eroding service values and acting as a catalyst for different forms of absenteeism. Such behaviours exacerbated patient–provider ratios and increased the frequency of clinical and administrative shortcuts. Weak health information systems and lack of performance data undermined providers’ answerability to their employer and clients, and a lack of effective sanctions undermined supervisors’ ability to hold providers accountable for these transgressions. Weak answerability and enforceability contributed to a culture of impunity that masked and condoned weak service performance in all four sites. Conclusions Health centre performance is influenced by mechanisms of accountability, which are in turn shaped by dynamic interactions between system hardware and system software. Our

Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis.

PubMed

Topp, Stephanie M; Chipukuma, Julien M; Hanefeld, Johanna

2015-05-01

Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform. Little research exists to adequately explain how and why this is the case. This study aimed to test the relevance and usefulness of an adapted conceptual framework for improving our understanding of the mechanisms and causal pathways influencing primary health centre performance. A theory-driven, case-study approach was adopted. Four Zambian health centres were purposefully selected with case data including health-care worker interviews (n = 60); patient interviews (n = 180); direct observation of facility operations (2 weeks/centre) and key informant interviews (n = 14). Data were analysed to understand how the performance of each site was influenced by the dynamic interactions between system 'hardware' and 'software' acting on mechanisms of accountability. Structural constraints including limited resources created challenging service environments in which work overload and stockouts were common. Health workers' frustration with such conditions interacted with dissatisfaction with salary levels eroding service values and acting as a catalyst for different forms of absenteeism. Such behaviours exacerbated patient-provider ratios and increased the frequency of clinical and administrative shortcuts. Weak health information systems and lack of performance data undermined providers' answerability to their employer and clients, and a lack of effective sanctions undermined supervisors' ability to hold providers accountable for these transgressions. Weak answerability and enforceability contributed to a culture of impunity that masked and condoned weak service performance in all four sites. Health centre performance is influenced by mechanisms of accountability, which are in turn shaped by dynamic interactions between system hardware and system software. Our findings confirm the usefulness of combining Sheikh et al

Evaluation of health centre community nurse team.

PubMed

Dixon, P N; Trounson, E

1969-02-01

This report gives an account of the work during six months of a community nurse team attached to the doctors working from a new health centre. The team consisted of two community nurses, who had both health visiting and Queen's nursing qualifications, and a State-enrolled nurse. The community nurses, in addition to undertaking all the health visiting for the population at risk, assessed the social and nursing needs of patients at the request of the general practitioners and ensured that these needs were met. When necessary they undertook practical nursing tasks in the home and in the health centre, but most of the bedside nursing in the home was done by the State-enrolled nurse.The needs of the population at risk were such that only one State-enrolled nurse could usefully be employed, and this proved to be a considerable disadvantage. Despite this, the experimental work pattern held advantages to patients, doctors, and nurses, and is potentially capable of providing a satisfying and economic division of responsibilities, with different tasks being carried out by the individual most appropriately qualified.

Double Standards in Global Health

PubMed Central

Admay, Catherine; Shakow, Aaron; Keshavjee, Salmaan

2016-01-01

Abstract The human rights arguments that underpinned the fight against HIV over the last three decades were poised, but ultimately failed, to provide a similar foundation for success against multidrug-resistant TB (MDR-TB) and other diseases of the poor. With more than 1.5 million deaths since 2000 attributed to strains of MDR-TB, and with half a million new, and mostly untreated, MDR-TB cases in the world each year, the stakes could not be higher. The World Health Organization (WHO), whose mandate is to champion the attainment by all peoples of the highest possible level of health, recommended unsound medical treatment for MDR-TB patients in resource-poor settings from 1993-2002. Citing cost considerations, WHO did not recommend the available standard of care that had been successfully used to contain and defeat MDR-TB in rich countries. By acting as a strategic gatekeeper in its technical advisory role to donor agencies and countries, it also facilitated the global implementation of a double standard for TB care in low- and middle-income countries (LMICs), upending important legal and scientific priorities. This raises serious questions about whether the organization violated international human rights standards and those established in its own constitution. While calling for additional analysis and discussion on this topic, the authors propose that policymakers should reject double standards of this kind and instead embrace the challenge of implementing the highest standard of care on a global level. PMID:27781001

Kidney and liver transplants from donors after cardiac death: initial experience at the London Health Sciences Centre.

PubMed

Hernandez-Alejandro, Roberto; Caumartin, Yves; Chent, Cameron; Levstik, Mark A; Quan, Douglas; Muirhead, Norman; House, Andrew A; McAlister, Vivian; Jevnikar, Anthony M; Luke, Patrick P W; Wall, William

2010-04-01

The disparity between the number of patients waiting for an organ transplant and availability of donor organs increases each year in Canada. Donation after cardiac death (DCD), following withdrawal of life support in patients with hopeless prognoses, is a means of addressing the shortage with the potential to increase the number of transplantable organs. We conducted a retrospective, single-centre chart review of organs donated after cardiac death to the Multi-Organ Transplant Program at the London Health Sciences Centre between July 2006 and December 2007. In total, 34 solid organs (24 kidneys and 10 livers) were procured from 12 DCD donors. The mean age of the donors was 38 (range 18-59) years. The causes of death were craniocerebral trauma (n = 7), cerebrovascular accident (n = 4) and cerebral hypoxia (n = 1). All 10 livers were transplanted at our centre, as were 14 of the 24 kidneys; 10 kidneys were transplanted at other centres. The mean renal cold ischemia time was 6 (range 3-9.5) hours. Twelve of the 14 kidney recipients (86%) experienced delayed graft function, but all kidneys regained function. After 1-year follow-up, kidney function was good, with a mean serum creatinine level of 145 (range 107-220) micromol/L and a mean estimated creatinine clearance of 64 (range 41-96) mL/min. The mean liver cold ischemia time was 5.8 (range 5.5-8) hours. There was 1 case of primary nonfunction requiring retransplantation. The remaining 9 livers functioned well. One patient developed a biliary anastomotic stricture that resolved after endoscopic stenting. All liver recipients were alive after a mean follow-up of 11 (range 3-20) months. Since the inception of this DCD program, the number of donors referred to our centre has increased by 14%. Our initial results compare favourably with those from the transplantation of organs procured from donors after brain death. Donation after cardiac death can be an important means of increasing the number of organs available for

‘Smashed by the National Health’? A Closer Look at the Demise of the Pioneer Health Centre, Peckham

PubMed Central

Conford, Philip

2016-01-01

The Pioneer Health Centre, based in South London before and after the Second World War, remains a source of interest for advocates of a positive approach to health promotion in contrast with the treatment of those already ill. Its closure in 1950 for lack of funds has been blamed on the then recently established National Health Service, but this article argues that such an explanation is over-simplified and ignores a number of other factors. The Centre had struggled financially during the 1930s and tried to gain support from the Medical Research Council. The Council appeared interested in the Centre before the war, but was less sympathetic in the 1940s. Around the time of its closure and afterwards, the Centre was also involved in negotiations with London County Council; these failed because the Centre’s directors would not accept the changes which the Council would have needed to make. Unpublished documents reveal that the Centre’s directors were uncompromising and that their approach to the situation antagonised their colleagues. Changes in medical science also worked against the Centre. The success of sulphonamide drugs appeared to render preventive medicine less significant, while the development of statistical techniques cast doubt on the Centre’s experimental methods. The Centre was at the heart of the nascent organic farming movement, which opposed the rapid growth of chemical cultivation. But what might be termed ‘chemical triumphalism’ was on the march in both medicine and agriculture, and the Centre was out of tune with the mood of the times. PMID:26971599

A Few Observations on Health Service for Immigrants at a Primary Health Care Centre

PubMed Central

2016-01-01

Objective. Icelandic society is rapidly changing, from being an ethnically homogeneous population towards a multicultural immigrant society. In the hope of optimizing the service for immigrants at the health care centre, we decided to evaluate health care utilization by immigrants. Methods. As a case control study we invited all immigrants that attended the health care centre during a two-week period to participate. Paired controls of Icelanders were invited for comparison. Results. There were 57 immigrants, 48 females and 9 males, from 27 countries. Significantly more of the immigrant women were married, P < 0.001. Interpreters were needed in 21% of the consultations. The immigrants often attended the clinic and had the same diagnoses as did the nonimmigrants. The immigrants evaluated the quality of the service in Iceland as 4.3 and the service in their homeland as 1.68, P < 0.001. Conclusion. Immigrants attending a health care centre in Iceland came from all over the world, had the same diagnoses, and attended the clinic as often per annum as the nonimmigrants. Only one-fifth of them needed translators. The health and health care utilization of immigrants were similar to those of nonimmigrants. PMID:27563465

A Few Observations on Health Service for Immigrants at a Primary Health Care Centre.

PubMed

Halldorsdottir, Thorhildur; Jonsson, Halldor; Gudmundsson, Kristjan G

2016-01-01

Objective. Icelandic society is rapidly changing, from being an ethnically homogeneous population towards a multicultural immigrant society. In the hope of optimizing the service for immigrants at the health care centre, we decided to evaluate health care utilization by immigrants. Methods. As a case control study we invited all immigrants that attended the health care centre during a two-week period to participate. Paired controls of Icelanders were invited for comparison. Results. There were 57 immigrants, 48 females and 9 males, from 27 countries. Significantly more of the immigrant women were married, P < 0.001. Interpreters were needed in 21% of the consultations. The immigrants often attended the clinic and had the same diagnoses as did the nonimmigrants. The immigrants evaluated the quality of the service in Iceland as 4.3 and the service in their homeland as 1.68, P < 0.001. Conclusion. Immigrants attending a health care centre in Iceland came from all over the world, had the same diagnoses, and attended the clinic as often per annum as the nonimmigrants. Only one-fifth of them needed translators. The health and health care utilization of immigrants were similar to those of nonimmigrants.

A comparative concept analysis of centring vs. opening meditation processes in health care.

PubMed

Birx, Ellen

2013-08-01

To report an analysis and comparison of the concepts centring and opening meditation processes in health care. Centring and opening meditation processes are included in nursing theories and frequently recommended in health care for stress management. These meditation processes are integrated into emerging psychotherapy approaches and there is a rapidly expanding body of neuroscience research distinguishing brain activity associated with different types of meditation. Currently, there is a lack of theoretical and conceptual clarity needed to guide meditation research in health care. A search of healthcare literature between 2006-2011 was conducted using Alt HealthWatch, CINAHL, PsychNET and PubMed databases using the keywords 'centring' and 'opening' alone and in combination with the term 'meditation.' For the concept centring, 10 articles and 11 books and for the concept opening 13 articles and 10 books were included as data sources. Rodgers' evolutionary method of concept analysis was used. Centring and opening are similar in that they both involve awareness in the present moment; both use a gentle, effortless approach; and both have a calming effect. Key differences include centring's focus on the individual's inner experience compared with the non-dual, spacious awareness of opening. Centring and opening are overlapping, yet distinct meditation processes. The term meditation cannot be used in a generic way in health care. The differences between centring and opening have important implications for the further development of unitary-transformative nursing theories. © 2012 Blackwell Publishing Ltd.

Service quality perceptions in primary health care centres in Greece

PubMed Central

Papanikolaou, Vicky; Zygiaris, Sotiris

2012-01-01

Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

Service quality perceptions in primary health care centres in Greece.

PubMed

Papanikolaou, Vicky; Zygiaris, Sotiris

2014-04-01

The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

World Health Organization International Standard to harmonize assays for detection of hepatitis E virus RNA.

PubMed

Baylis, Sally A; Blümel, Johannes; Mizusawa, Saeko; Matsubayashi, Keiji; Sakata, Hidekatsu; Okada, Yoshiaki; Nübling, C Micha; Hanschmann, Kay-Martin O

2013-05-01

Nucleic acid amplification technique-based assays are a primary method for the detection of acute hepatitis E virus (HEV) infection, but assay sensitivity can vary widely. To improve interlaboratory results for the detection and quantification of HEV RNA, a candidate World Health Organization (WHO) International Standard (IS) strain was evaluated in a collaborative study involving 23 laboratories from 10 countries. The IS, code number 6329/10, was formulated by using a genotype 3a HEV strain from a blood donation, diluted in pooled human plasma and lyophilized. A Japanese national standard, representing a genotype 3b HEV strain, was prepared and evaluated in parallel. The potencies of the standards were determined by qualitative and quantitative assays. Assay variability was substantially reduced when HEV RNA concentrations were expressed relative to the IS. Thus, WHO has established 6329/10 as the IS for HEV RNA, with a unitage of 250,000 International Units per milliliter.

Structural approaches to knowledge exchange: comparing practices across five centres of excellence in public health.

PubMed

Van der Graaf, P; Francis, O; Doe, E; Barrett, E; O'Rorke, M; Docherty, G

2018-03-01

In 2008, five UKCRC Public Health Research Centres of Excellence were created to develop a coordinated approach to policy and practice engagement and knowledge exchange. The five Centres have developed their own models and practices for achieving these aims, which have not been compared in detail to date. We applied an extended version of Saner's model for the interface between science and policy to compare five case studies of knowledge exchanges, one from each centre. We compared these practices on three dimensions within our model (focus, function and type/scale) to identify barriers and facilitators for knowledge exchange. The case studies shared commonalities in their range of activities (type) but illustrated different ways of linking these activities (function). The Centres' approaches ranged from structural to more organic, and varied in the extent that they engaged internal audiences (focus). Each centre addressed policymakers at different geographical levels and scale. This article emphasizes the importance of linking a range of activities that engage policymakers at different levels, intensities and points in their decision-making processes to build relationships. Developing a structural approach to knowledge exchange activities in different contexts presents challenges of resource, implementation and evaluation.

People-centred science: strengthening the practice of health policy and systems research.

PubMed

Sheikh, Kabir; George, Asha; Gilson, Lucy

2014-04-17

Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. Change occurs at many layers of a health system, shaped by social, political, and economic forces, and brought about by different groups of people who make up the system, including service users and communities. The seeds of transformative practice in HPSR lie in amplifying the breadth and depth of dialogue across health system actors in the conduct of research - recognizing that these actors are all generators, sources, and users of knowledge about the system. While building such a dialogic practice, those conducting HPSR must strive to protect the autonomy and integrity of their ideas and actions, and also clearly explain their own positions and the value-basis of their work. We conclude with a set of questions that health policy and systems researchers may wish to consider in making their practice more people-centred, and hence more oriented toward real-world change.

People-centred science: strengthening the practice of health policy and systems research

PubMed Central

2014-01-01

Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. Change occurs at many layers of a health system, shaped by social, political, and economic forces, and brought about by different groups of people who make up the system, including service users and communities. The seeds of transformative practice in HPSR lie in amplifying the breadth and depth of dialogue across health system actors in the conduct of research – recognizing that these actors are all generators, sources, and users of knowledge about the system. While building such a dialogic practice, those conducting HPSR must strive to protect the autonomy and integrity of their ideas and actions, and also clearly explain their own positions and the value-basis of their work. We conclude with a set of questions that health policy and systems researchers may wish to consider in making their practice more people-centred, and hence more oriented toward real-world change. PMID:24739525

Standards for education and training for interagency working in child protection in the UK: implications for nurses, midwives and health visitors.

PubMed

Long, Tony; Davis, Cathy; Johnson, Martin; Murphy, Michael; Race, David; Shardlow, Steven M

2006-01-01

This article presents a discussion of key issues for the education of nurses, midwives and health visitors following the completion of a Department of Health funded project, managed by the General Social Care Council and conducted jointly by two research centres; Salford Centre for Social Work Research and Salford Centre for Nursing, Midwifery and Collaborative Research. The work was initiated in response to Lord Laming's report on the circumstances leading to the death of Victoria Climbié. The project was conducted in relation to specified professions and occupational groups: doctors; health visitors; midwives; nurses; police; teachers, and social workers. It was undertaken in two stages. The first stage mapped existing material about standards in relation to education and training for interagency working. The second stage engaged in an extensive consultation exercise through which a model and a set of proposed standards for interagency education and training for interagency work were developed. The former is detailed fully in this report, while nine examples of standards are presented. The project final report was presented seven months after commencement.

The politics of patient-centred care.

PubMed

Kreindler, Sara A

2015-10-01

Despite widespread belief in the importance of patient-centred care, it remains difficult to create a system in which all groups work together for the good of the patient. Part of the problem may be that the issue of patient-centred care itself can be used to prosecute intergroup conflict. This qualitative study of texts examined the presence and nature of intergroup language within the discourse on patient-centred care. A systematic SCOPUS and Google search identified 85 peer-reviewed and grey literature reports that engaged with the concept of patient-centred care. Discourse analysis, informed by the social identity approach, examined how writers defined and portrayed various groups. Managers, physicians and nurses all used the discourse of patient-centred care to imply that their own group was patient centred while other group(s) were not. Patient organizations tended to downplay or even deny the role of managers and providers in promoting patient centredness, and some used the concept to advocate for controversial health policies. Intergroup themes were even more obvious in the rhetoric of political groups across the ideological spectrum. In contrast to accounts that juxtaposed in-groups and out-groups, those from reportedly patient-centred organizations defined a 'mosaic' in-group that encompassed managers, providers and patients. The seemingly benign concept of patient-centred care can easily become a weapon on an intergroup battlefield. Understanding this dimension may help organizations resolve the intergroup tensions that prevent collective achievement of a patient-centred system. © 2013 John Wiley & Sons Ltd.

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.

Negotiating relationships of power in a maternal and child health centre: the experience of WHO nurse Margaret Campbell Jackson in Iran, 1954-1956.

PubMed

Wytenbroek, Lydia

2015-01-01

From November 1954 to November 1956, Canadian nurse Margaret Campbell Jackson was employed by the World Health Organization (WHO) and was stationed in Tehran, Iran, where she participated in the establishment of a Maternal and Child Health (MCH) Centre. The objective of the project, known as Iran 10, was twofold: to set up a health service for mothers and children and to initiate a field training program for Iranian physicians, nurses, and other health care providers. Drawing on 180 letters Jackson wrote to her family in Canada from Iran, this article analyzes the MCH Centre as a contact zone and considers the relationships Jackson developed with staff affiliated with the project. The Centre became a space of cross-cultural encounters, where locally and foreign-trained Iranian staff and expatriates mingled and shared working relationships. I argue that authority was negotiated and contested through interactions and associations that were often unequal and framed by notions of progress, modernization, race, and health. Personality also played an important role.

Another HISA--the new standard: health informatics--service architecture.

PubMed

Klein, Gunnar O; Sottile, Pier Angelo; Endsleff, Frederik

2007-01-01

In addition to the meaning as Health Informatics Society of Australia, HISA is the acronym used for the new European Standard: Health Informatics - Service Architecture. This EN 12967 standard has been developed by CEN - the federation of 29 national standards bodies in Europe. This standard defines the essential elements of a Service Oriented Architecture and a methodology for localization particularly useful for large healthcare organizations. It is based on the Open Distributed Processing (ODP) framework from ISO 10746 and contains the following parts: Part 1: Enterprise viewpoint. Part 2: Information viewpoint. Part 3: Computational viewpoint. This standard is now also the starting point for the consideration for an International standard in ISO/TC 215. The basic principles with a set of health specific middleware services as a common platform for various applications for regional health information systems, or large integrated hospital information systems, are well established following a previous prestandard. Examples of large scale deployments in Sweden, Denmark and Italy are described.

Barriers to the widespread adoption of health data standards: an exploratory qualitative study in tertiary healthcare organizations in Saudi Arabia.

PubMed

Alkraiji, Abdullah; Jackson, Thomas; Murray, Ian

2013-04-01

Although health data standards are perceived to be the essential solution for interoperability barriers within medical IT systems, the level of adoption of those standards still remains frustratingly low. Little is known about the barriers facing their adoption within the healthcare organizations context. In addressing this gap in the literature, based on IT related standards adoption theories such as Diffusion of Innovation Theory and the theories surrounding the Economics of Standards, a qualitative multiple-case study was undertaken in Saudi Arabia to investigate those barriers. The results exposed that few standards were adopted because of four broad reasons, managerial, technical, educational and governmental. While some of the findings can be rooted to those related standards theories, others can be underpinned through the normative literature. Core barriers are the lack of a national regulator and a data exchange plan, and the lack of an adequate policy regarding medical IT systems and information management and national healthcare system; also important are technical barriers and the switching costs to the standards. The outcome of this study can be used in forming effective interventions when planning to use health data standards and, in particular those in developing countries.

42 CFR 422.618 - How an MA organization must effectuate standard reconsidered determinations or decisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false How an MA organization must effectuate standard... ADVANTAGE PROGRAM Grievances, Organization Determinations and Appeals § 422.618 How an MA organization must effectuate standard reconsidered determinations or decisions. (a) Reversals by the MA organization—(1...

42 CFR 422.618 - How an MA organization must effectuate standard reconsidered determinations or decisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false How an MA organization must effectuate standard... ADVANTAGE PROGRAM Grievances, Organization Determinations and Appeals § 422.618 How an MA organization must effectuate standard reconsidered determinations or decisions. (a) Reversals by the MA organization—(1...

42 CFR 422.618 - How an MA organization must effectuate standard reconsidered determinations or decisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false How an MA organization must effectuate standard... ADVANTAGE PROGRAM Grievances, Organization Determinations and Appeals § 422.618 How an MA organization must effectuate standard reconsidered determinations or decisions. (a) Reversals by the MA organization—(1...

[Establishing an Ambulatory Health-Care Centre (AHCC) at a University Hospital].

PubMed

Krüll, A; Debatin, J F

2013-02-01

Since January 2004 hospitals have the opportunity to establish an ambulatory health-care centre (Medizinisches Versorgungszentrum - MVZ) as a result of the introduction of the Health-care Modernisation Act (Gesetz zur Modernisierung der gesetzlichen Krankenversicherung - GMG). After about a half-year preparatory phase, the UKE, in September 2004, began operation of the "Ambulanzzentrum des UKE GmbH" (a limited liability company) as the first MVZ at a university hospital in Germany. We report here on the establishment of the MVZ and the experience made. In the initial phase, only the medical fields of radiation therapy and nuclear medicine were represented. Both disciplines, especially radiation therapy, were existentially threatened by the extensive loss of ambulatory patients. The central motive for the establishment of the ambulatory health-care centre was to secure the survival of both disciplines and to preserve existing jobs. After it was put into operation, the referrals from practice-based colleagues to both radiation therapy and nuclear medicine increased quickly. The positive developments caused other departments of the UKE to express their interest in supplementing their outpatient activities with facilities in the MVZ. Over the following years, the ambulance centre grew steadily. Now 24 departments are represented in the MVZ, and the centre has a total of 49 positions for physicians contracted by and registered within the German public health insurance system. The number of salaried doctors has risen to 85, although many of these only work part time in the MVZ. Also more than 83 non-medical staff members were hired over the years. These were mostly physiotherapists, radiographers, and medical assistants. With the growing number of departments in the MVZ, the number of treated cases grew steadily. Currently approximately 20 000 cases are treated in each quarter of a year. The experience made while establishing an ambulatory health-care centre is very

Seniors centre-based health intervention programmes in the United States and South Korea: A systematic review.

PubMed

Song, Misoon; Seo, Kyoungsan; Choi, Suyoung; Choi, Jeongshil; Ko, Hana; Lee, Soo Jin

2017-10-01

Despite the great need for health interventions among seniors centre participants, this matter has received little attention. This systematic review aimed to identify what types of health interventions are effective and feasible for seniors centre participants. MEDLINE, Ovid, CINAHL, Google Scholar, EMBASE, and RISS were searched. We searched for health intervention studies conducted in seniors centres published in English and Korean between 1990 and 2014. Of 907 screened articles, 22 studies of all types of experimental designs were selected. Selected studies were grouped by intervention domain: health promotion (n = 8), safety (n = 5), chronic disease management (n = 6), and comprehensive wellness (n = 3). Overall, 59.1% of the interventions were provided by nurses. The health interventions resulted in positive effects on seniors centre participants' knowledge, health behaviours, clinical indices, and hospitalization rates. Few studies reported on feasibility outcomes such as satisfaction and cost-effectiveness. Considering the impact and ease of access to older people at seniors centres, health interventions and services within seniors centres should be strengthened. There is potential for nursing to spearhead seniors centre health intervention programmes to enhance active ageing for participants. © 2017 John Wiley & Sons Australia, Ltd.

The OIE World Animal Health Information System: the role of OIE Reference Laboratories and Collaborating Centres in disease reporting.

PubMed

Ben Jebara, K

2010-12-01

One of the main objectives of the World Organisation for Animal Health (OIE) is to ensure transparency in and knowledge of the world animal health situation. To achieve this objective, the OIE relies on its network of Member Countries, which is complemented by the activities of 221 Reference Laboratories (RLs) and Collaborating Centres. The RL mandate states that, in the case of positive results for diseases notifiable to the OIE, the laboratory should inform the OIE Delegate of the Member Country from which the samples originated and send a copy of the information to OIE Headquarters. However, since 2006 the OIE has received a lower than expected number of notifications from RLs, which implies eitherthat the majority of samples are sent to national laboratories or that some RLs are not fully complying with their mandate. The OIE sent a questionnaire to RLs in preparation for the Second Global Conference of OIE Reference Laboratories and Collaborating Centres (Paris, France, 21-23 June 2010). Two main factors emerged: the need for RLs to clarify their role and responsibilities in disease reporting and the need for an awareness campaign to sensitise national Veterinary Services to the importance of conducting more surveillance (and consequently of submitting samples to RLs) for all OIE-listed diseases. Reference laboratories indicated two main reasons for not sharing more data on positive samples with the OIE: i) a perceived contradiction between their mandate as OIE RLs and the standards of the International Organization for Standardization (ISO) dealing with confidentiality; and ii) certain Member Countries or stakeholders asking RLs not to share positive results with the OIE, for political or economic reasons. The OIE has put forward proposals to help RLs resolve these problems in future. The use of ISO standards must be clarified and there must be improved communication between the OIE and its RLs. A lack of transparency about a significant disease event can

42 CFR 422.618 - How an MA organization must effectuate standard reconsidered determinations or decisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false How an MA organization must effectuate standard... Grievances, Organization Determinations and Appeals § 422.618 How an MA organization must effectuate standard reconsidered determinations or decisions. (a) Reversals by the MA organization—(1) Requests for service. If, on...

42 CFR 422.618 - How an MA organization must effectuate standard reconsidered determinations or decisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false How an MA organization must effectuate standard... Grievances, Organization Determinations and Appeals § 422.618 How an MA organization must effectuate standard reconsidered determinations or decisions. (a) Reversals by the MA organization—(1) Requests for service. If, on...

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

PubMed Central

2012-01-01

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

Integrating public health and medical intelligence gathering into homeland security fusion centres.

PubMed

Lenart, Brienne; Albanese, Joseph; Halstead, William; Schlegelmilch, Jeffrey; Paturas, James

Homeland security fusion centres serve to gather, analyse and share threat-related information among all levels of governments and law enforcement agencies. In order to function effectively, fusion centres must employ people with the necessary competencies to understand the nature of the threat facing a community, discriminate between important information and irrelevant or merely interesting facts and apply domain knowledge to interpret the results to obviate or reduce the existing danger. Public health and medical sector personnel routinely gather, analyse and relay health-related inform-ation, including health security risks, associated with the detection of suspicious biological or chemical agents within a community to law enforcement agencies. This paper provides a rationale for the integration of public health and medical personnel in fusion centres and describes their role in assisting law enforcement agencies, public health organisations and the medical sector to respond to natural or intentional threats against local communities, states or the nation as a whole.

Development of the First World Health Organization Lentiviral Vector Standard: Toward the Production Control and Standardization of Lentivirus-Based Gene Therapy Products

PubMed Central

Zhao, Yuan; Stepto, Hannah; Schneider, Christian K

2017-01-01

Gene therapy is a rapidly evolving field. So far, there have been >2,400 gene therapy products in clinical trials and four products on the market. A prerequisite for producing gene therapy products is ensuring their quality and safety. This requires appropriately controlled and standardized production and testing procedures that result in consistent safety and efficacy. Assuring the quality and safety of lentivirus-based gene therapy products in particular presents a great challenge because they are cell-based multigene products that include viral and therapeutic proteins as well as modified cells. In addition to the continuous refinement of a product, changes in production sites and manufacturing processes have become more and more common, posing challenges to developers regarding reproducibility and comparability of results. This paper discusses the concept of developing a first World Health Organization International Standard, suitable for the standardization of assays and enabling comparison of cross-trial and cross-manufacturing results for this important vector platform. The standard will be expected to optimize the development of gene therapy medicinal products, which is especially important, given the usually orphan nature of the diseases to be treated, naturally hampering reproducibility and comparability of results. PMID:28747142

Improving the Quality of Health Care Services for Adolescents, Globally: A Standards-Driven Approach

PubMed Central

Nair, Manisha; Baltag, Valentina; Bose, Krishna; Boschi-Pinto, Cynthia; Lambrechts, Thierry; Mathai, Matthews

2015-01-01

Purpose The World Health Organization (WHO) undertook an extensive and elaborate process to develop eight Global Standards to improve quality of health care services for adolescents. The objectives of this article are to present the Global Standards and their method of development. Methods The Global Standards were developed through a four-stage process: (1) conducting needs assessment; (2) developing the Global Standards and their criteria; (3) expert consultations; and (4) assessing their usability. Needs assessment involved conducting a meta-review of systematic reviews and two online global surveys in 2013, one with primary health care providers and another with adolescents. The Global Standards were developed based on the needs assessment in conjunction with analysis of 26 national standards from 25 countries. The final document was reviewed by experts from the World Health Organization regional and country offices, governments, academia, nongovernmental organizations, and development partners. The standards were subsequently tested in Benin and in a regional expert consultation of Latin America and Caribbean countries for their usability. Results The process resulted in the development of eight Global Standards and 79 criteria for measuring them: (1) adolescents' health literacy; (2) community support; (3) appropriate package of services; (4) providers' competencies; (5) facility characteristics; (6) equity and nondiscrimination; (7) data and quality improvement; and (8) adolescents' participation. Conclusions The eight standards are intended to act as benchmarks against which quality of health care provided to adolescents could be compared. Health care services can use the standards as part of their internal quality assurance mechanisms or as part of an external accreditation process. PMID:26299556

Gap Analysis for Chinese Drug Control Institutes to Achieve the Standards of World Health Organization Medicine Prequalification.

PubMed

Mao, Xin; Yang, Yue

2017-02-01

The study aims to explore the challenges and the gaps faced by Chinese Drug Control Institutes in achieving the standards of World Health Organization (WHO) Medicine Prequalification. The study was undertaken with 6 Provincial Drug Control Institutes in China from November 2012 to November 2013. The study assessed key elements required to comply with WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL). For GPPQCL, the study found gaps in quality management system, control of documentation, data-processing equipment, premises and equipment, contracts, reagents (water), reference substances and reference materials, calibration, verification of performance and qualification of equipment, instruments and other devices, analytical worksheet, evaluation of test results, personnel, and validation of analytical procedures. The study indicates that gaps are attributed to differences between the standards of Chinese Accreditation Standards and WHO-GPPQCL. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Profile: Manhiça Health Research Centre (Manhiça HDSS).

PubMed

Sacoor, Charfudin; Nhacolo, Ariel; Nhalungo, Delino; Aponte, John J; Bassat, Quique; Augusto, Orvalho; Mandomando, Inácio; Sacarlal, Jahit; Lauchande, Natu; Sigaúque, Betuel; Alonso, Pedro; Macete, Eusébio; Munguambe, Khátia; Guinovart, Caterina; Aide, Pedro; Menendez, Clara; Acácio, Sozinho; Quelhas, Diana; Sevene, Esperança; Nhampossa, Tacilta

2013-10-01

The Manhiça Health Research Centre, established in 1996 in a rural area of southern Mozambique, currently follows around 92 000 individuals living in approximately 20 000 enumerated and geo-positioned households. Its main strength is the possibility of linking demographic data and clinical data to promote and conduct biomedical research in priority health areas. Socio-demographic data are updated twice a year and clinical data are collected on a daily basis. The data collected in Manhiça HDSS comprises household and individual characteristics, household socio-economic assets, vital data, migration, individual health history and cause of death, among others. Studies conducted in this HDSS contributed to guide the health authorities and decision-making bodies to define or adjust health policies such as the introduction of Mozambique's expanded programme of immunization with different vaccines (Haemophilus influenzae type b, Pneumococcus) or the development of the concept of Intermittent Preventive Treatment for Infants (IPTi) that led to the World Health Organization recommendation of this method as best practice for the control of malaria among infants. Manhiça's data can be accessed through a formal request to Diana Quelhas (diana.quelhas@manhica.net) accompanied by a proposal that will be analysed by the Manhiça HDSS internal scientific and ethics committees.

Management of febrile children under five years in hospitals and health centres of rural Ghana.

PubMed

Webster, Jayne; Baiden, Frank; Bawah, Justina; Bruce, Jane; Tivura, Mathilda; Delmini, Rupert; Amenga-Etego, Seeba; Chandramohan, Daniel; Owusu-Agyei, Seth

2014-07-09

The case management of febrile children in hospitals' and health centres' pre-roll out of the new WHO policy on parasitological diagnosis was assessed. The delivery of artemisinin combination therapy (ACT) at these two levels of the health system was compared. Structured observations and exit interviews of 1,222 febrile children attending five hospitals and 861 attending ten health centres were conducted in six districts of the Brong Ahafo Region of Ghana. Effectiveness of delivery of case management of malaria was assessed. Proportions of children receiving ACT, anti-malarial monotherapy and antibiotics were described. Predictors of: a febrile child being given an ACT, a febrile child being given an antibiotic and of carers knowing how to correctly administer the ACT were assessed using logistic regression models stratified by hospitals and health centres. The system's effectiveness of delivering an ACT to febrile children diagnosed with malaria (parasitologically or clinically) was 31.4 and 42.4% in hospitals and health centres, respectively. The most ineffective process was that of ensuring that carers knew how to correctly administer the ACT. Overall 278 children who were not given an ACT were treated with anti-malarial monotherapy other than quinine. The majority of these children, 232/278 were given amodiaquine, 139 of these were children attending hospitals and 93 attending health centres. The cadre of health staff conducting consultation was a common predictor of the outcomes of interest. Presenting symptoms and examinations conducted were predictive of being given an ACT in hospitals and antibiotic in hospitals and health centres but not of being given an ACT in health centres. Treatment-seeking factors were predictive of being given an ACT if it was more than seven days since the fever began and an antibiotic in hospitals but not in health centres. Interventions to improve adherence to negative parasitological tests are needed, together with guidance on

[Patients' perception on attention received from Health Centres non-sanitary staff].

PubMed

Ruiz Moral, R; Alba Dios, A; Jiménez García, C; González Neubauer, V; García Torres, M; Pérula de Torres, L A; Barrios Blasco, L

2011-01-01

To know patients' perceptions about relational aspects and technical procedures when they are attended by the administrative staff in Health Centres. To assess the utility of two ways for measuring satisfaction. Cross-sectional study carried out in people attending the administrative sections of Health Centres for diverse reasons. Just after the interaction with the administrative they were interviewed using two different questions for assessing their opinions and satisfaction with communicational and technical aspects related with their demands. Descriptive analysis. Significant differences among mean was explored by χ(2) test. Open-ended questions were grouped in categories in a process involving three researchers independently. Over than 90% (360) of the attendees declared to be satisfied or very satisfied with the service received from the staff personal. Nevertheless, among 18-36% gave suggestions for improving the service after their consultation. Independently the domain explored, people suggested the communicational, personal capability, quality and quantity of explanations and waiting time as the main aspects to be improved. Surveys with open-ended questions are more useful to assess the quality of the attention the citizens receive from no-sanitary staff in Health Centres. These type of questions are also more useful for detecting problems and planning new interventions. Relational and informative issues seem to be the most prioritary areas to improve in this section of Health Centres. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

Cost analysis of a primary health centre in northern India.

PubMed

Anand, K; Kapoor, S K; Pandav, C S

1993-01-01

Cost data are useful in health planning, budgeting and for assessing the efficiency of services. However, such data are not easily available from developing countries. We therefore estimated the cost incurred for the year 1991-92 on a primary health centre in northern India, which is affiliated to an academic institution. The total costs incurred included the capital costs for land, building, furniture, vehicles and equipment as well as the recurrent costs for salaries, drugs and vaccines, diesel and maintenance. Except for land, where the 'opportunity cost' was calculated, the current market rates were considered for all other factors. A discount rate of 10% was used in the study. A total of Rs 777,015 (US $24,282) was incurred on the primary health centre in the study year, 80% being recurrent costs. Salaries constituted 62% of the total costs. A sum of Rs 30 (US $0.94) per head per year on primary health care was being incurred. Salaries constitute the bulk of the cost incurred on health. Approximately Rs 28 (40%) of the Rs 69 spent per head per year on health services by the Government of India is incurred on providing primary health care services.

Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

PubMed

Kuhlmann, Ellen; Ovseiko, Pavel V; Kurmeyer, Christine; Gutiérrez-Lobos, Karin; Steinböck, Sandra; von Knorring, Mia; Buchan, Alastair M; Brommels, Mats

2017-01-06

Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises

Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda.

PubMed

Lu, Chunling; Cook, Benjamin; Desmond, Chris

2017-01-01

Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities.

Family-centred care delivery

PubMed Central

Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-01-01

Abstract Objective To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Design Cross-sectional study. Setting Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. Participants A total of 137 practices, 363 providers, and 5144 patients. Main outcome measures Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Results Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Conclusion Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC. PMID:24235195

[The experience of a health centre undergoing an ecological transition].

PubMed

Bironneau, Rémy

2018-03-01

A health centre and its staff have undertaken a sustainable health approach which aims to reduce the impact of the environment on health. One of the initiatives focused on the improvement of indoor air quality. A change to practices was possible thanks to a participative approach, the support of the staff and constant communication. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Role of the "National Reference Centre for Genetically Modified Organisms (GMO) detection" in the official control of food and feed.

PubMed

Ciabatti, I; Marchesi, U; Froiio, A; Paternò, A; Ruggeri, M; Amaddeo, D

2005-08-01

The National Reference Centre for Genetically Modified Organisms (GMO) detection was established in 2002 within the Istituto Zooprofilattico Sperimentale Lazio e Toscana, with the aim of providing scientific and technical support to the National Health System and to the Ministry of Health within the scope of the regulation of GMO use in food and feed.The recently adopted EU legislation on GMOs (Regulation CE no. 1829/2003 and no. 1830/2003) introduced more rigorous procedures for the authorisation, labelling and analytical control of food and feed consisting, containing or derived from GMOs. The National Reference Centre, besides its institutional tasks as one of the laboratories of the Italian National Health System, collects and analyses data and results of the national official control of GMOs; carries out scientific research aimed at developing, improving, validating and harmonising detection and quantification methods, in cooperation with other scientific institutions, the Community Reference Laboratory and within the European Network of GMOs laboratories (ENGL); collaborates with the Ministry of Health in the definition of control programmes and promotes educational and training initiatives. Objectives defined for 2004-2006, activities in progress and goals already achieved are presented.

Applying Use Cases to Describe the Role of Standards in e-Health Information Systems

NASA Astrophysics Data System (ADS)

Chávez, Emma; Finnie, Gavin; Krishnan, Padmanabhan

Individual health records (IHRs) contain a person's lifetime records of their key health history and care within a health system (National E-Health Transition Authority, Retrieved Jan 12, 2009 from http://www.nehta.gov.au/coordinated-care/whats-in-iehr, 2004). This information can be processed and stored in different ways. The record should be available electronically to authorized health care providers and the individual anywhere, anytime, to support high-quality care. Many organizations provide a diversity of solutions for e-health and its services. Standards play an important role to enable these organizations to support information interchange and improve efficiency of health care delivery. However, there are numerous standards to choose from and not all of them are accessible to the software developer. This chapter proposes a framework to describe the e-health standards that can be used by software engineers to implement e-health information systems.

Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda

PubMed Central

Lu, Chunling; Cook, Benjamin; Desmond, Chris

2017-01-01

Background Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Methods Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Findings Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. Conclusions These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities. PMID:29082015

The Australian e-Health Research Centre: enabling the health care information and communication technology revolution.

PubMed

Hansen, David P; Gurney, Phil; Morgan, Gary; Barraclough, Bruce

2011-02-21

The CSIRO (Commonwealth Scientific and Industrial Research Organisation) and the Queensland Government have jointly established the Australian e-Health Research Centre (AEHRC) with the aim of developing innovative information and communication technologies (ICT) for a sustainable health care system. The AEHRC, as part of the CSIRO ICT Centre, has access to new technologies in information processing, wireless and networking technologies, and autonomous systems. The AEHRC's 50 researchers, software engineers and PhD students, in partnership with the CSIRO and clinicians, are developing and applying new technologies for improving patients' experience, building a more rewarding workplace for the health workforce, and improving the efficiency of delivering health care. The capabilities of the AEHRC fall into four broad areas: smart methods for using medical data; advanced medical imaging technologies; new models for clinical and health care interventions; and tools for medical skills development. Since its founding in 2004, new technology from the AEHRC has been adopted within Queensland (eg, a mobile phone-based cardiac rehabilitation program), around Australia (eg, medical imaging technologies) and internationally (eg, our clinical terminology tools).

Person-centred integrative diagnosis: conceptual bases and structural model.

PubMed

Mezzich, Juan E; Salloum, Ihsan M; Cloninger, C Robert; Salvador-Carulla, Luis; Kirmayer, Laurence J; Banzato, Claudio E M; Wallcraft, Jan; Botbol, Michel

2010-11-01

To review the conceptual bases of Person-centred Integrative Diagnosis (PID) as a component and contributor to person-centred psychiatry and medicine and to outline its design and development. An analysis was conducted of the historical roots of person-centred psychiatry and medicine, tracing them back to ancient Eastern and Western civilizations, to the vicissitudes of modern medicine, to recent clinical and conceptual developments, and to emerging efforts to reprioritize medicine from disease to patient to person in collaboration with the World Medical Association, the World Health Organization, the World Organization of Family Doctors, the World Federation for Mental Health, and numerous other global health entities, and with the coordinating support of the International Network for Person-centered Medicine. One of the prominent endeavours within the broad paradigmatic health development outlined above is the design of PID. This diagnostic model articulates science and humanism to obtain a diagnosis of the person (of the totality of the person's health, both ill and positive aspects), by the person (with clinicians extending themselves as full human beings), for the person (assisting the fulfillment of the person's health aspirations and life project), and with the person (in respectful and empowering relationship with the person who consults). This broader and deeper notion of diagnosis goes beyond the more restricted concepts of nosological and differential diagnoses. The proposed PID model is defined by 3 keys: broad informational domains, covering both ill health and positive health along 3 levels: health status, experience of health, and contributors to health; pluralistic descriptive procedures (categories, dimensions and narratives); and evaluative partnerships among clinicians, patients, and families. An unfolding research program is focused on the construction of a practical guide and its evaluation, followed by efforts to facilitate clinical

Developing global health technology standards: what can other industries teach us?

PubMed Central

2013-01-01

Background There is a lack of effective and affordable technologies to address health needs in the developing world. One way to address problems of innovation and affordability is to design global health technologies to follow agreed-upon standards. This Debate article argues that we can better develop standards for global health technologies if we learn lessons from other industries. Discussion The article’s Background section begins by explaining why standards are needed in global health. For example, if global health technologies can be modularized into independent interfacing parts, these parts can then interact via well-defined standards in a “plug and play” fashion. This can avoid development of mutually incompatible solutions by different organizations, speed the pace of innovation, unlock health systems from single providers and approaches, and lower barriers to entry. The Background then gives a brief primer on standards and discusses incentives for health standards. The article’s Discussion section begins with brief relevant cases of standards development from other industries, including electricity, container shipping, CD standards, Universal Serial Bus (USB), and the Internet. It then explores lessons from these and other industries that suggest how to develop standards for global health technologies. The remainder of the Discussion considers intellectual property and regulatory issues and standards-based global health business models, and ends with a checklist of considerations for health standards development leaders. (The associated Additional file discusses observations from standards development for cell phones and semiconductors, as well as challenges in the standards development process itself.) Throughout the article, point-of-care diagnostics are used as an illustrative example. An initiative is already underway to explore standardized diagnostics platforms. Summary This Debate article aims to convince the reader that standards can

Antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from peripheral health centres and STD clinic attendees of a tertiary care centre in India.

PubMed

Bala, M; Ray, K; Gupta, S M

2008-06-01

The aim of the study was to compare the antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from urban and rural peripheral health centres and from sexually transmitted disease (STD) clinic attendees. Antimicrobial susceptibility testing of 191 N. gonorrhoeae isolates (165 isolates from STD clinic attendees and 26 from peripheral health centres) was carried out in Delhi, India, using the calibrated dichotomous sensitivity technique for penicillin, tetracycline, ceftriaxone, ciprofloxacin, spectinomycin and nalidixic acid, and minimum inhibitory concentrations were determined using E-test. Penicillin-resistant, ciprofloxacin-resistant, penicillinase-producing N. gonorrhoeae and tetracycline-resistant N. gonorrhoeae strains were higher in STD clinic attendees than in peripheral health centres, probably because of less antibiotic pressure in the peripheral areas. High-level resistance to ciprofloxacin and multiresistant strains were also higher in STD clinic attendees. The present study emphasizes the importance of surveillance of antimicrobial resistance of N. gonorrhoeae in different population subgroups in order to monitor the spread of multiresistant strains and to update the national treatment recommendations.

Physico-chemical quality of drinking water in villages of Primary Health Centre, Waghodia, Gujarat (India).

PubMed

Desai, Gaurav; Vasisth, Smriti; Patel, Maharshi; Mehta, Vaibhav; Bhavsar, Bharat

2012-07-01

16 water samples were collected to study the physical and chemical quality of water of main source of drinking water in the villages of Primary Health Centre, Waghodia of Vadodara district of Gujarat. The values recommended by Indian Standard for Drinking Water (IS 10500:1991) were used for comparison of observed values. The study indicates that the contamination problem in these villages is not alarming at present, but Waghodia being industrial town, ground water quality may deteriorate with passage of time, which needs periodical monitoring. The study provides the local area baseline data which may be useful for the comparison of future study.

Using Academy Standards of Excellence in Nutrition and Dietetics for organization self-assessment and quality improvement.

PubMed

Price, Joyce A; Kent, Sue; Cox, Sharon A; McCauley, Sharon M; Parekh, Janki; Klein, Catherine J

2014-08-01

Standards of Excellence in Nutrition and Dietetics for an Organization is a self-assessment tool to measure and evaluate an organization's program, services, and initiatives that identify and distinguish the Registered Dietitian Nutritionist (RDN) brand as the professional expert in food and nutrition. The Standards of Excellence will serve as a road map to recognize RDNs as leaders and collaborators. Standards of Excellence criteria apply to all practice segments of nutrition and dietetics: health care, education and research, business and industry, and community nutrition and public health. Given the membership's call to action to be recognized for their professional expertise, the Academy of Nutrition and Dietetics Quality Management Committee developed four Standards of Excellence in Nutrition and Dietetics for Organizations: Quality of Leadership, Quality of Organization, Quality of Practice, and Quality of Outcomes. Within each standard, specific indicators provide strategies for an organization to demonstrate excellence. The Academy will develop a self-evaluation scoring tool to assist the organization in applying and implementing one or more of the strategies in the Standards of Excellence indicators. The organization can use the self-assessment tool to establish itself as a Center of Excellence in Nutrition and Dietetics. The role examples illustrate initiatives RDNs and organizations can take to identify themselves as a Center of Excellence in Nutrition and Dietetics. Achieving the Excellence level is an important collaborative initiative between nutrition and dietetics organizations and the Academy to provide increased autonomy, supportive management, respect within peers and community, opportunities for professional development, support for further education, and compensation for the RDN. For purposes of the Standards, "organization" means workplace or practice setting. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc

Quality, Organization Design, and Standards.

ERIC Educational Resources Information Center

Gardner, James F.

1992-01-01

This paper discusses regulations and voluntary standards within the context of organizational mission and management leadership for quality in human services. Regulation is seen as a measure of organizational formalism; formalism is seen as an attribute of the machine organization; and both are contrasted to organic control organization models and…

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.

New directions for patient-centred care in scleroderma: the Scleroderma Patient-centred Intervention Network (SPIN)

PubMed Central

Thombs, Brett D.; Jewett, Lisa R.; Assassi, Shervin; Baron, Murray; Bartlett, Susan J.; Costa Maia, Angela; El-Baalbaki, Ghassan; Furst, Daniel E.; Gottesman, Karen; Haythornthwaite, Jennifer A.; Hudson, Marie; Ann Impens, PhD; Korner, Annett; Leite, Catarina; Mayes, Maureen D.; Malcarne, Vanessa L.; Motivala, Sarosh J.; Mouthon, Luc; Nielson, Warren R.; Plante, Diane; Poiraudeau, Serge; Poole, Janet L.; Pope, Janet; Sauve, Maureen; Steele, Russell J.; Suarez-Almazor, Maria E.; Taillefer, Suzanne; van den Ende, Cornelia H.; Erin Arthurs, BSc; Bassel, Marielle; Delisle, Vanessa; Milette, Katherine; Leavens, Allison; Razykov, Ilya; Khanna, Dinesh

2014-01-01

Systemic sclerosis (SSc), or scleroderma, is a chronic multisystem autoimmune disorder characterised by thickening and fibrosis of the skin and by the involvement of internal organs such as the lungs, kidneys, gastrointestinal tract, and heart. Because there is no cure, feasibly-implemented and easily accessible evidence-based interventions to improve health-related quality of life (HRQoL) are needed. Due to a lack of evidence, however, specific recommendations have not been made regarding non-pharmacological interventions (e.g. behavioural/psychological, educational, physical/occupational therapy) to improve HRQoL in SSc. The Scleroderma Patient-centred Intervention Network (SPIN) was recently organised to address this gap. SPIN is comprised of patient representatives, clinicians, and researchers from Canada, the USA, and Europe. The goal of SPIN, as described in this article, is to develop, test, and disseminate a set of accessible interventions designed to complement standard care in order to improve HRQoL outcomes in SSc. PMID:22244687

Profiling health-care accreditation organizations: an international survey.

PubMed

Shaw, Charles D; Braithwaite, Jeffrey; Moldovan, Max; Nicklin, Wendy; Grgic, Ileana; Fortune, Triona; Whittaker, Stuart

2013-07-01

To describe global patterns among health-care accreditation organizations (AOs) and to identify determinants of sustainability and opportunities for improvement. Web-based questionnaire survey. Organizations offering accreditation services nationally or internationally to health-care provider institutions or networks at primary, secondary or tertiary level in 2010. s) External relationships, scope and activity public information. Forty-four AOs submitted data, compared with 33 in a survey 10 years earlier. Of the 30 AOs that reported survey activity in 2000 and 2010, 16 are still active and stable or growing. New and old programmes are increasingly linked to public funding and regulation. While the number of health-care AOs continues to grow, many fail to thrive. Successful organizations tend to complement mechanisms of regulation, health-care funding or governmental commitment to quality and health-care improvement that offer a supportive environment. Principal challenges include unstable business (e.g. limited market, low uptake) and unstable politics. Many organizations make only limited information available to patients and the public about standards, procedures or results.

Quality of haemophilia care in The Netherlands: new standards for optimal care.

PubMed

Leebeek, Frank W G; Fischer, Kathelijn

2014-04-01

In the Netherlands, the first formal haemophilia comprehensive care centre was established in 1964, and Dutch haemophilia doctors have been organised since 1972. Although several steps were taken to centralise haemophilia care and maintain quality of care, treatment was still delivered in many hospitals, and formal criteria for haemophilia treatment centres as well as a national haemophilia registry were lacking. In collaboration with patients and other stakeholders, Dutch haemophilia doctors have undertaken a formal process to draft new quality standards for the haemophilia treatment centres. First a project group including doctors, nurses, patients and the institute for harmonisation of quality standards undertook a literature study on quality standards and performed explorative visits to several haemophilia treatment centres in the Netherlands. Afterwards concept standards were defined and validated in two treatment centres. Next, the concept standards were evaluated by haemophilia doctors, patients, health insurance representatives and regulators. Finally, the final version of the standards of care was approved by Central body of Experts on quality standards in clinical care and the Dutch Ministry of Health. A team of expert auditors have been trained and, together with an independent auditor, will perform audits in haemophilia centres applying for formal certification. Concomitantly, a national registry for haemophilia and allied disorders is being set up. It is expected that these processes will lead to further concentration and improved quality of haemophilia care in the Netherlands.

Applying total quality management concepts to public health organizations.

PubMed Central

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

1992-01-01

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

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

PubMed Central

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

2014-01-01

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

Obligation for transparency regarding treating physician credentials at academic health centres.

PubMed

Martin, Paul J; Skill, N James; Koniaris, Leonidas G

2018-02-26

Academic health centres have historically treated patients with the most complex of diseases, served as training grounds to teach the next generations of physicians and fostered an innovative environment for research and discovery. The physicians who hold faculty positions at these institutions have long understood how these key academic goals are critical to serve their patient community effectively. Recent healthcare reforms, however, have led many academic health centres to recruit physicians without these same academic expectations and to partner with non-faculty physicians at other health systems. There has been limited transparency in regard to the expertise among the physicians and the academic faculty within these larger entities. Such lack of transparency may lead to confusion among patients regarding the qualifications of who is actually treating them. This could threaten the ethical principles of patient autonomy, benevolence and non-maleficence as patients risk making uninformed decisions that might lead to poorer outcomes. Furthermore, this lack of transparency unjustly devalues the achievements of physician faculty members as well as potentially the university they represent. In this paper, it is suggested that academic health centres have an obligation to foster total transparency regarding what if any role a physician has at a university or medical school when university or other academic monikers are used at a hospital. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The DIY Digital Medical Centre.

PubMed

Timmis, James Kenneth; Timmis, Kenneth

2017-09-01

Healthcare systems worldwide are confronted with major economic, organizational and logistical challenges. Historic evolution of health care has led to significant healthcare sector fragmentation, resulting in systemic inefficiencies and suboptimal resource exploitation. To attain a sustainable healthcare model, fundamental, system-wide improvements that effectively network, and ensure fulfilment of potential synergies between sectors, and include and facilitate coherent strategic planning and organisation of healthcare infrastructure are needed. Critically, they must be specifically designed to sustainably achieve peak performance within the current policy environment for cost-control, and efficiency and quality improvement for service delivery. We propose creation of a new healthcare cluster, to be embedded in existing healthcare systems. It consists of (i) local 24/7 walk-in virtually autonomous do-it-yourself Digital Medical Centres performing routine diagnosis, monitoring, prevention, treatment and standardized documentation and health outcome assessment/reporting, which are online interfaced with (ii) regional 24/7 eClinician Centres providing on-demand clinical supervision/assistance to Digital Medical Centre patients. Both of these are, in turn, online interfaced with (iii) the National Clinical Informatics Centre, which houses the national patient data centre (cloud) and data analysis units that conduct patient- and population-level, personalized and predictive(-medicine) intervention optimization analyses. The National Clinical Informatics Centre also interfaces with biomedical research and prioritizes and accelerates the translation of new discoveries into clinical practice. The associated Health Policy Innovation and Evaluation Centre rapidly integrates new findings with health policy/regulatory discussions. This new cluster would synergistically link all health system components in a circular format, enable not only access by all arms of the health

Quality comparisons between privately and publicly managed health care centres in a suburban area of Stockholm, Sweden.

PubMed

Hansagi, H; Calltorp, J; Andréasson, S

1993-03-01

As in many other countries, the health care system in Sweden is currently undergoing rapid changes. Within a framework of public financing, the delivery of health care is to an increasing extent being transferred to various entrepreneurs; private, public or cooperatives. A privately run, but publicly financed, health care centre was evaluated with regard to quality and costs. Quality was defined in terms of the central guidelines for Swedish primary health care: first level responsibility, accessibility, a holistic view of the patient, and continuity of care and safety. The services offered by the private health care centre were evaluated by different methods--questionnaires, health care utilization data and economic analyses--and found to be of similar quality but produced at a lower cost than by three publicly managed health care centres.

[Definition of endometriosis expert centres].

PubMed

Chanavaz-Lacheray, I; Darai, E; Descamps, P; Agostini, A; Poilblanc, M; Rousset, P; Bolze, P-A; Panel, P; Collinet, P; Hebert, T; Graesslin, O; Martigny, H; Brun, J-L; Dechaud, H; Mezan De Malartic, C; Piechon, L; Wattiez, A; Chapron, C; Golfier, F

2018-03-01

The Collège national des gynécologues obstétriciens français (CNGOF), in agreement with the Société de chirurgie gynécologique et pelvienne (SCGP), has set up a commission in 2017 to define endometriosis expert centres, with the aim of optimizing endometriosis care in France. The committee included members from university and general hospitals as well as private facilities, representing medical, surgical and radiological aspects of endometriosis care. Opinion of endometriosis patients' associations was obtained prior to writing this work. The final text was presented and unanimously validated by the members of the CNGOF Board of Directors at its meeting of October 13, 2017. Based on analysis of current management of endometriosis and the last ten years opportunities in France, the committee has been able to define the contours of endometriosis expert centres. The objectives, production specifications, mode of operation, missions and funding for these centres were described. The following missions have been specifically defined: territorial organization, global and referral care, communication and teaching as well as research and evaluation. Because of its daily impact for women and its economic burden in France, endometriosis justifies launching of expert centres throughout the country with formal accreditation by health authorities, ideally as part of the National Health Plan. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Using routine Haemophilia Joint Health Score for international comparisons of haemophilia outcome: standardization is needed.

PubMed

Nijdam, A; Bladen, M; Hubert, N; Pettersson, M; Bartels, B; van der Net, J; Liesner, R; Petrini, P; Kurnik, K; Fischer, K

2016-01-01

Haemophilia Joint Health Score (HJHS) is the most sensitive validated score for physical examination of joint health in haemophilia. HJHS performed at regular intervals can be used for clinical monitoring as well as for comparative outcomes research. To determine whether routinely collected HJHS could be used to compare outcome of three different prophylactic regimens in children with severe haemophilia A (primary) and which parameters caused variability in HJHS (secondary). International retrospective observational multi-centre study comparing routine HJHS in 127 children with severe haemophilia A born from 1995 to 2009, from London, Stockholm and Utrecht centres. Patient and treatment data were collected from the European Paediatric Network for Haemophilia Management registry and patient files. The independent effects of regimens, physiotherapists, age and inhibitor status on HJHS were explored, using multivariable regression analysis. Prophylaxis varied across participating centres, with differences in initial frequency of infusions (1× per week vs. 3× per week), age at reaching infusions ≥3× per week, and dose kg(-1) week(-1) at HJHS assessment. Evaluation at median age of 11 years showed an illogical association of HJHS with treatment regimen: the least intensive regimen had the lowest HJHS. The HJHS increased with age and history of inhibitor, as expected (internal validity). But the comparison of prophylactic regimens was obscured by systematic differences in assessment between physiotherapists, both within and between centres. Inter-physiotherapist discrepancies in routine HJHS hamper comparison of scores between treatment regimens. For multi-centre research, additional inter-observer standardization for HJHS scoring is needed. © 2015 John Wiley & Sons Ltd.

Standards for Prognostics and Health Management (PHM) Techniques within Manufacturing Operations

DTIC Science & Technology

2014-10-02

SOCIETY 2014 3 International Organization for Standardization (ISO), the Machinery Information Management Open Standards Alliance ( MIMOSA ), SAE...X X X X ISO TC 184/SC 4 X ISO TC 184/SC 5 X X ISO/IEC JTC 1/SC 7 X MIMOSA —— X SAE International AQPIC X SAE...THE PROGNOSTICS AND HEALTH MANAGEMENT SOCIETY 2014 4 HDBK is supported by the Machinery Information Management Open Standards Alliance ( MIMOSA ), a

Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden.

PubMed

Fredriksson, Ingela; Geidne, Susanna; Eriksson, Charli

2018-02-01

The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden. In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents ( n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis. As part of the youth centres' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills. There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

Expert Reliability for the World Health Organization Standardized Ultrasound Classification of Cystic Echinococcosis

PubMed Central

Solomon, Nadia; Fields, Paul J.; Tamarozzi, Francesca; Brunetti, Enrico; Macpherson, Calum N. L.

2017-01-01

Cystic echinococcosis (CE), a parasitic zoonosis, results in cyst formation in the viscera. Cyst morphology depends on developmental stage. In 2003, the World Health Organization (WHO) published a standardized ultrasound (US) classification for CE, for use among experts as a standard of comparison. This study examined the reliability of this classification. Eleven international CE and US experts completed an assessment of eight WHO classification images and 88 test images representing cyst stages. Inter- and intraobserver reliability and observer performance were assessed using Fleiss' and Cohen's kappa. Interobserver reliability was moderate for WHO images (κ = 0.600, P < 0.0001) and substantial for test images (κ = 0.644, P < 0.0001), with substantial to almost perfect interobserver reliability for stages with pathognomonic signs (CE1, CE2, and CE3) for WHO (0.618 < κ < 0.904) and test images (0.642 < κ < 0.768). Comparisons of expert performances against the majority classification for each image were significant for WHO (0.413 < κ < 1.000, P < 0.005) and test images (0.718 < κ < 0.905, P < 0.0001); and intraobserver reliability was significant for WHO (0.520 < κ < 1.000, P < 0.005) and test images (0.690 < κ < 0.896, P < 0.0001). Findings demonstrate moderate to substantial interobserver and substantial to almost perfect intraobserver reliability for the WHO classification, with substantial to almost perfect interobserver reliability for pathognomonic stages. This confirms experts' abilities to reliably identify WHO-defined pathognomonic signs of CE, demonstrating that the WHO classification provides a reproducible way of staging CE. PMID:28070008

Fellowship Program in Health System Improvement: A novel approach integrating leadership development and patient-centred health system transformation.

PubMed

Philippon, Donald J; Montesanti, Stephanie; Stafinski, Tania

2018-03-01

This article highlights a novel approach to professional development, integrating leadership, development and patient-centred health system transformation in the new Fellowship Program in Health System Improvement offered by the School of Public Health at the University of Alberta. Early assessment of the program is also provided.

The Isis Centre: a counselling service within the National Health Service.

PubMed Central

Agulnik, P; Holroyd, P; Mandelbrote, B

1976-01-01

A new centre has been established to provide readily accessible counselling, consultation, and mental health information. People may refer themselves or are recommended to attend by general practitioners or other agencies. The counsellors have varied backgrounds in paramedical or counselling services, and they are supported by psychiatrists. Of a sample of 100 clients, four were referred to one of the team's psychiatrists and 33 visited the centre only once. The centre's staff aim to adopt a flexible approach to the client and his problems, and formal psychiatric categories have not been found useful. Provision is made for people who want to solve their problems by discussion rather than medication and those for whom the existing psychiatric services may have little time to spare. Consequently, the approach adopted by the Isis Centre, whereby many people benefit from psychotherapy yet the psychiatrist deals directly with only a few selected cases, contributes towards meeting the great need for psychiatric services and using the psychiatrist's skills more effectively. PMID:947421

Avoiding "culture rejection" in healthcare mergers and acquisitions: how New Heights Community Health Centres and York Community Services minimized the culture risk when forming Unison Health and Community Services.

PubMed

Chan, Jeff

2013-01-01

Among the requirements for a successful merger or acquisition are strategic rationale, rigorous due diligence, the right price and revenue and cost synergies. However, bridging the culture gap between organizations is frequently overlooked. The leaders of New Heights Community Health Centres and York Community Services explicitly considered culture in their merger to form Unison Health and Community Services, and they used employee engagement surveys to assess culture in their merger planning and post-merger integration. How Unison Health leaders avoided the risk of culture rejection to achieve a successful merger, and the lessons learned from their experience, is the focus of this article.

Practice-centred evaluation and the privileging of care in health information technology evaluation.

PubMed

Darking, Mary; Anson, Rachel; Bravo, Ferdinand; Davis, Julie; Flowers, Steve; Gillingham, Emma; Goldberg, Lawrence; Helliwell, Paul; Henwood, Flis; Hudson, Claire; Latimer, Simon; Lowes, Paul; Stirling, Ian

2014-06-05

Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes. Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts - can complement and in some instances offer advantages over, outcome-centric evaluation models. We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An 'action learning' approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these

Using participatory methods to enhance patient-centred mental health care in a federally qualified community health center serving a Mexican American farmworker community.

PubMed

Ingram, Maia; Schachter, Ken A; Guernsey de Zapien, Jill; Herman, Patricia M; Carvajal, Scott C

2015-12-01

Mexican American farmworkers experience high rates of mental health conditions; however, it is difficult for them to access care. Patient-centred care is a systems-wide approach to improving the delivery of services for diverse populations in the primary care setting. We describe the application of community-based participatory research methods to assess and address gaps in perceptions of mental health care between providers and migrant workers living in a US-Mexico Border community. A federally qualified health centre (FQHC) serving a community of approximately 60 000 agricultural workers who live in Yuma County and harvest vegetables during the winter season. We conducted patient focus groups (n = 64) and FQHC staff interviews (n = 16) to explore attributes and dimensions of patient-centred mental health care. Patients and staff both prioritized increased access to mental health care and patient-centred care, while patients were more concerned with interpersonal care and providers with coordination of care. All participants stressed the relationship between life events and mental health and the centrality of family in care. Patients also emphasized the importance of a good attitude, the ability to solve problems, positive family relationships and reliance on faith. Patients suggested that the FQHC inform patients about mental health resources, provide community informational talks to address stigma, and offer support groups. The participatory approach of this qualitative study resulted in a wealth of data regarding patient preferences that will enable the FQHC to develop protocols and training to provide patient-centred mental health-care services for their community. © 2014 John Wiley & Sons Ltd.

Perceptions of antenatal care services by pregnant women attending government health centres in the Buea Health District, Cameroon: a cross sectional study.

PubMed

Edie, Gregory Edie Halle Ekane; Obinchemti, Thomas Egbe; Tamufor, Emmanuel Njuma; Njie, Martin Mafany; Njamen, Theophile Nana; Achidi, Eric Akum

2015-01-01

User'sperception of quality of ANC services crucially impacts continuity of use of these services and hence pregnancy outcome. However in our community, ANC user's perceptions of quality are not known. An observational analytic cross-sectional study was carried out amongst pregnant women attending selected government health centres in the Buea Health District. We recruited 385 consenting pregnant women for the study. Demographic and clinical data were collected using structured questionnaires. The data was entered into Microsoft Excel and exported toEpi-Info (Version 3.5.1) for analysis. Geographical accessibility and perceived quality of care were the predominant reasons for choosing or changing a site for ANC. One third of respondents (30.1%) attended a health centre out of their catchment health area with Buea Town health centre receiving the highest proportion of women out of the health area (56.8% of attendees). Knowledge about antenatal care varied and majority of respondents (96.4%) were satisfied with the antenatal services received. However, there were elements of dissatisfaction with health centre services, poor sitting facilities, amenities, few health education talks and poor nursing skills. High educational level (high school and university) (X(2) = 8.714; p = 0.01) and first time pregnancy(X(2)= 4.217; p= 0.04) were significantly associated with poor satisfaction. Policy makers should implement changes in the health care delivery system taking into account the users' preferences, more so in the light of increasing female education in Cameroon.

European union standards for tuberculosis care.

PubMed

Migliori, G B; Zellweger, J P; Abubakar, I; Ibraim, E; Caminero, J A; De Vries, G; D'Ambrosio, L; Centis, R; Sotgiu, G; Menegale, O; Kliiman, K; Aksamit, T; Cirillo, D M; Danilovits, M; Dara, M; Dheda, K; Dinh-Xuan, A T; Kluge, H; Lange, C; Leimane, V; Loddenkemper, R; Nicod, L P; Raviglione, M C; Spanevello, A; Thomsen, V Ø; Villar, M; Wanlin, M; Wedzicha, J A; Zumla, A; Blasi, F; Huitric, E; Sandgren, A; Manissero, D

2012-04-01

The European Centre for Disease Prevention and Control (ECDC) and the European Respiratory Society (ERS) jointly developed European Union Standards for Tuberculosis Care (ESTC) aimed at providing European Union (EU)-tailored standards for the diagnosis, treatment and prevention of tuberculosis (TB). The International Standards for TB Care (ISTC) were developed in the global context and are not always adapted to the EU setting and practices. The majority of EU countries have the resources and capacity to implement higher standards to further secure quality TB diagnosis, treatment and prevention. On this basis, the ESTC were developed as standards specifically tailored to the EU setting. A panel of 30 international experts, led by a writing group and the ERS and ECDC, identified and developed the 21 ESTC in the areas of diagnosis, treatment, HIV and comorbid conditions, and public health and prevention. The ISTCs formed the basis for the 21 standards, upon which additional EU adaptations and supplements were developed. These patient-centred standards are targeted to clinicians and public health workers, providing an easy-to-use resource, guiding through all required activities to ensure optimal diagnosis, treatment and prevention of TB. These will support EU health programmes to identify and develop optimal procedures for TB care, control and elimination.

European Union Standards for Tuberculosis Care

PubMed Central

Migliori, G.B.; Zellweger, J.P.; Abubakar, I.; Ibraim, E.; Caminero, J.A.; De Vries, G.; D'Ambrosio, L.; Centis, R.; Sotgiu, G.; Menegale, O.; Kliiman, K.; Aksamit, T.; Cirillo, D.M.; Danilovits, M.; Dara, M.; Dheda, K.; Dinh-Xuan, A.T.; Kluge, H.; Lange, C.; Leimane, V.; Loddenkemper, R.; Nicod, L.P.; Raviglione, M.C.; Spanevello, A.; Thomsen, V.Ø.; Villar, M.; Wanlin, M.; Wedzicha, J.A.; Zumla, A.; Blasi, F.; Huitric, E.; Sandgren, A.; Manissero, D.

2012-01-01

The European Centre for Disease Prevention and Control (ECDC) and the European Respiratory Society (ERS) jointly developed European Union Standards for Tuberculosis Care (ESTC) aimed at providing European Union (EU)-tailored standards for the diagnosis, treatment and prevention of tuberculosis (TB). The International Standards for TB Care (ISTC) were developed in the global context and are not always adapted to the EU setting and practices. The majority of EU countries have the resources and capacity to implement higher standards to further secure quality TB diagnosis, treatment and prevention. On this basis, the ESTC were developed as standards specifically tailored to the EU setting. A panel of 30 international experts, led by a writing group and the ERS and ECDC, identified and developed the 21 ESTC in the areas of diagnosis, treatment, HIV and comorbid conditions, and public health and prevention. The ISTCs formed the basis for the 21 standards, upon which additional EU adaptations and supplements were developed. These patient-centred standards are targeted to clinicians and public health workers, providing an easy-to-use resource, guiding through all required activities to ensure optimal diagnosis, treatment and prevention of TB. These will support EU health programmes to identify and develop optimal procedures for TB care, control and elimination. PMID:22467723

The Dutch Birth Centre Study: study design of a programmatic evaluation of the effect of birth centre care in the Netherlands.

PubMed

Hermus, Marieke A A; Wiegers, Therese A; Hitzert, Marit F; Boesveld, Inge C; van den Akker-van Marle, M Elske; Akkermans, Henk A; Bruijnzeels, Marc A; Franx, Arie; de Graaf, Johanna P; Rijnders, Marlies E B; Steegers, Eric A P; van der Pal-de Bruin, Karin M

2015-07-16

Birth centres are regarded as settings where women with uncomplicated pregnancies can give birth, assisted by a midwife and a maternity care assistant. In case of (threatening) complications referral to a maternity unit of a hospital is necessary. In the last decade up to 20 different birth centres have been instituted in the Netherlands. This increase in birth centres is attributed to various reasons such as a safe and easy accessible place of birth, organizational efficiency in integration of care and direct access to obstetric hospital care if needed, and better use of maternity care assistance. Birth centres are assumed to offer increased integration and quality of care and thus to contribute to better perinatal and maternal outcomes. So far there is no evidence for this assumption as no previous studies of birth centres have been carried out in the Netherlands. The aims are 1) Identification of birth centres and measuring integration of organization and care 2) Measuring the quality of birth centre care 3) Effects of introducing a birth centre on regional quality and provision of care 4) Cost-effectiveness analysis 5) In depth longitudinal analysis of the organization and processes in birth centres. Different qualitative and quantitative methods will be used in the different sub studies. The design is a multi-centre, multi-method study, including surveys, interviews, observations, and analysis of registration data and documents. The results of this study will enable users of maternity care, professionals, policy makers and health care financers to make an informed choice about the kind of birth location that is appropriate for their needs and wishes.

Large Scale eHealth Deployment in Europe: Insights from Concurrent Use of Standards.

PubMed

Eichelberg, Marco; Chronaki, Catherine

2016-01-01

Large-scale eHealth deployment projects face a major challenge when called to select the right set of standards and tools to achieve sustainable interoperability in an ecosystem including both legacy systems and new systems reflecting technological trends and progress. There is not a single standard that would cover all needs of an eHealth project, and there is a multitude of overlapping and perhaps competing standards that can be employed to define document formats, terminology, communication protocols mirroring alternative technical approaches and schools of thought. eHealth projects need to respond to the important question of how alternative or inconsistently implemented standards and specifications can be used to ensure practical interoperability and long-term sustainability in large scale eHealth deployment. In the eStandards project, 19 European case studies reporting from R&D and large-scale eHealth deployment and policy projects were analyzed. Although this study is not exhaustive, reflecting on the concepts, standards, and tools for concurrent use and the successes, failures, and lessons learned, this paper offers practical insights on how eHealth deployment projects can make the most of the available eHealth standards and tools and how standards and profile developing organizations can serve the users embracing sustainability and technical innovation.

A Repository of Codes of Ethics and Technical Standards in Health Informatics

PubMed Central

Zaïane, Osmar R.

2014-01-01

We present a searchable repository of codes of ethics and standards in health informatics. It is built using state-of-the-art search algorithms and technologies. The repository will be potentially beneficial for public health practitioners, researchers, and software developers in finding and comparing ethics topics of interest. Public health clinics, clinicians, and researchers can use the repository platform as a one-stop reference for various ethics codes and standards. In addition, the repository interface is built for easy navigation, fast search, and side-by-side comparative reading of documents. Our selection criteria for codes and standards are two-fold; firstly, to maintain intellectual property rights, we index only codes and standards freely available on the internet. Secondly, major international, regional, and national health informatics bodies across the globe are surveyed with the aim of understanding the landscape in this domain. We also look at prevalent technical standards in health informatics from major bodies such as the International Standards Organization (ISO) and the U. S. Food and Drug Administration (FDA). Our repository contains codes of ethics from the International Medical Informatics Association (IMIA), the iHealth Coalition (iHC), the American Health Information Management Association (AHIMA), the Australasian College of Health Informatics (ACHI), the British Computer Society (BCS), and the UK Council for Health Informatics Professions (UKCHIP), with room for adding more in the future. Our major contribution is enhancing the findability of codes and standards related to health informatics ethics by compilation and unified access through the health informatics ethics repository. PMID:25422725

The pattern of antenatal visits with emphasis on gestational age at booking in Riyadh Health Centres.

PubMed

al-Shammari, S A; Khoja, T; Jarallah, J S

1994-04-01

1344 expectant mothers were selected by random sampling from the catchment population of 15 health centres in Riyadh. The health centres were taken to represent all areas of urban Riyadh. These mothers were asked to complete a pre-designed questionnaire in Arabic and undergo a structured interview by trained midwives to explore their knowledge, attitude and practice toward antenatal visits. It was found that the average gestational age at booking was 13 weeks. The number of antenatal visits achieved during the current pregnancy was 6. 97% of expectant mothers were aware of the importance of antenatal visits. Various demographic characteristics were studied in relation to the number of antenatal visits achieved and the gestational age at booking. It was found that the level of education of both husband and wife and poor obstetric history significantly affected gestational age at booking, (P-values) were less than 0.03 and 0.002 respectively). However the family income and gestational age at booking affected the number of antenatal visits (P-values were less than 0.0003 and 0.0001 respectively). The respondents' most striking reason for non-compliance was related to accessibility to health centre. 23.3% thought that the health centres were far away from their residence and they needed to involve the husbands in driving them to health centres. Recommendations were given to improve aspects of accessibility and inviting more antenatal visits in addition to improving quality of such service.

How Community Organizing Promotes Health Equity, And How Health Equity Affects Organizing.

PubMed

Pastor, Manuel; Terriquez, Veronica; Lin, May

2018-03-01

Public health scholarship increasingly recognizes community organizing as a vehicle for unleashing the collective power necessary to uproot socioeconomic inequities at the core of health disparities. In this article we reverse the analytical focus from how organizing can affect health equity, and we consider how the frame of health equity has shaped grassroots organizing. Using evidence from a range of cases in California, we suggest that the health equity frame can guide and justify grassroots groups' efforts to improve the health outcomes of marginalized populations; connect issues such as housing and school discipline to health; and provide a rationale for community organizing groups to directly address the trauma experienced by their own members and staff, who often come from communities at risk for poor health outcomes.

A travelling standard for radiopharmaceutical production centres in Italy

NASA Astrophysics Data System (ADS)

Capogni, M.; de Felice, P.; Fazio, A.

Short-lived radionuclides, γ, β+ and/or β- emitters, such as 18F, and 99mTc, particularly useful for nuclear medicine applications, both diagnostic and in radiotherapy, can be produced with high-specific activity in a small biomedical cyclotron or by a radionuclide generator. While [18F]Fludeoxyglucose ([18F]FDG) is a widely used radiopharmaceutical for positron emission tomography, the development of innovative diagnostic techniques and therapies involves the use of new radio-labelled molecules and emerging radionuclides, such as 64Cu and 124I. During the last 3 years, an extensive supply of [18F]FDG was started by many production sites in Italy, and new radiopharmaceuticals are being studied for future nuclear medical applications. Therefore, a special nuclear medicine research programme for primary standard development and transferral to the end-users has been carried out by the ENEA-INMRI. Because of the short half-lives of these nuclides, a portable well-type ionisation chamber was established as a secondary travelling standard. This device has been calibrated and transported to the radiopharmaceutical production centres in Italy where the local instrumentation, typically radionuclide calibrators, has been calibrated by a simple comparison, with an uncertainty level lower than 2%.

Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists

PubMed Central

2014-01-01

Background Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. Methods A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Results Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on ‘as needed’ basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS’ perceived 4 important ‘needs’ in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family

Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists.

PubMed

Abdul Aziz, Aznida F; Mohd Nordin, Nor Azlin; Abd Aziz, Noor; Abdullah, Suhazeli; Sulong, Saperi; Aljunid, Syed M

2014-03-02

Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on 'as needed' basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS' perceived 4 important 'needs' in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support. Post discharge

Perceptions of antenatal care services by pregnant women attending government health centres in the Buea Health District, Cameroon: a cross sectional study

PubMed Central

Edie, Gregory Edie Halle Ekane; Obinchemti, Thomas Egbe; Tamufor, Emmanuel Njuma; Njie, Martin Mafany; Njamen, Theophile Nana; Achidi, Eric Akum

2015-01-01

Introduction User'sperception of quality of ANC services crucially impacts continuity of use of these services and hence pregnancy outcome. However in our community, ANC user's perceptions of quality are not known. Methods An observational analytic cross-sectional study was carried out amongst pregnant women attending selected government health centres in the Buea Health District. We recruited 385 consenting pregnant women for the study. Demographic and clinical data were collected using structured questionnaires. The data was entered into Microsoft Excel and exported toEpi-Info (Version 3.5.1) for analysis. Results Geographical accessibility and perceived quality of care were the predominant reasons for choosing or changing a site for ANC. One third of respondents (30.1%) attended a health centre out of their catchment health area with Buea Town health centre receiving the highest proportion of women out of the health area (56.8% of attendees). Knowledge about antenatal care varied and majority of respondents (96.4%) were satisfied with the antenatal services received. However, there were elements of dissatisfaction with health centre services, poor sitting facilities, amenities, few health education talks and poor nursing skills. High educational level (high school and university) (X2 = 8.714; p = 0.01) and first time pregnancy(X2= 4.217; p= 0.04) were significantly associated with poor satisfaction. Conclusion Policy makers should implement changes in the health care delivery system taking into account the users’ preferences, more so in the light of increasing female education in Cameroon. PMID:26405481

A knowledge translation project on community-centred approaches in public health.

PubMed

Stansfield, J; South, J

2018-03-01

This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice.The article outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilization as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency.

Private Health Plans’ Contracts with Managed Behavioral Healthcare Organizations

PubMed Central

Garnick, Deborah W.; Horgan, Constance M.; Merrick, Elizabeth L.; Hodgkin, Dominic; Reif, Sharon; Quinn, Amity E.; Stewart, Maureen; Creedon, Timothy B.

2015-01-01

Contracts between health plans and managed behavioral health care organizations (MBHOs) influence access and quality of behavioral health care. This report presents information on performance requirements, information sharing, and financial risk from a nationally representative survey of private health plans. Most contracts include geographic access to providers (93.3%) and NCQA’s performance standards (84.2%). Health plans and MBHOs share data (99.0%), generally by the MBHO sending information to the health plan (96.3%). About a quarter of contracts impose financial penalties (23.0%), but few include incentives related to performance standards (<1.0%). Contract terms can shape the provision of behavioral health services in response to changes such as parity legislation or health reform. If current trends continue towards increases in value-based purchasing in the privately financed behavioral health sector, the focus on quality in contracts between health plans and MBHOs will be critical to understand. PMID:26276421

Future Direction of IMIA Standardization

PubMed Central

Kimura, M.; Ogishima, S.; Shabo, A.; Kim, I. K.; Parisot, C.; de Faria Leao, B.

2014-01-01

Summary Objectives Standardization in the field of health informatics has increased its importance and global alliance for establishing interoperability and compatibility internationally. Standardization has been organized by standard development organizations (SDOs) such as ISO (International Organization for Standardization), CEN (European Committee for Standardization), IHE (Integrating the Healthcare Enterprise), and HL7 (Health Level 7), etc. This paper reports the status of these SDOs’ activities. Methods In this workshop, we reviewed the past activities and the current situation of standardization in health care informatics with the standard development organizations such as ISO, CEN, IHE, and HL7. Then we discussed the future direction of standardization in health informatics toward “future medicine” based on standardized technologies. Results We could share the status of each SDO through exchange of opinions in the workshop. Some WHO members joined our discussion to support this constructive activity. Conclusion At this meeting, the workshop speakers have been appointed as new members of the IMIA working groups of Standards in Health Care Informatics (WG16). We could reach to the conclusion that we collaborate for the international standardization in health informatics toward “future medicine”. PMID:25123729

The Effect of Standardized Interviews on Organ Donation.

PubMed

Corman Dincer, Pelin; Birtan, Deniz; Arslantas, Mustafa Kemal; Tore Altun, Gulbin; Ayanoglu, Hilmi Omer

2018-03-01

Organ donation is the most important stage for organ transplant. Studies reveal that attitudes of families of brain-dead patients toward donation play a significant role in their decision. We hypothesized that supporting family awareness about the meaning of organ donation, including saving lives while losing a loved one, combined with being informed about brain death and the donation process must be maintained by intensive care unit physicians through standardized interviews and questionnaires to increase the donation rate. We retrospectively evaluated the final decisions of families of 52 brain-dead donors treated at our institution between 2014 and 2017. Data underwent descriptive analyses. The standard interview content was generated after literature search results were reviewed by the authors. Previously, we examined the impact of standardized interviews done by intensive care unit physicians with relatives of potential brain-dead donors regarding decisions to donate or reasons for refusing organ donation. After termination of that study, interviews were done according to the intensivist's orientation, resulting in significantly decreased donation rates. Standardized interviews were then started again, resulting in increased donation rates. Of 17 families who participated in standardized interviews, 5 families (29.4%) agreed to donate organs of their brain-dead relatives. In the other group of families, intensivists governed informing the families of donation without standardized interviews. In this group of 35 families, 5 families (14.3%) approved organ donation. The decision regarding whether to agree to organ donation was statistically different between the 2 family groups (P < .05). Conducting a standard interview between relatives of brain-dead donors and the intensivists, facilitating visits between relatives and the brain-dead patients, and informing relatives about the donation process resulted in an increased rate of organ donation compared with

Rural health care in New Zealand: the case of Coast to Coast Health Centre, Wellsford, an early Integrated Family Health Centre.

PubMed

Raymont, Antony; Boyd, Mary-Anne; Malloy, Timothy; Malloy, Nancy

2015-12-01

Primary health care is critical, particularly in rural areas distant from secondary care services. To describe the development of Coast to Coast Health Centre (CTCHC) at Wellsford, north of Auckland, New Zealand and reflect on its achievements and ongoing challenges. Interviews were conducted with staff and management of CTCHC and with other health service providers. Surveys of staff and a sample of enrolled patients were undertaken. Numerical data on service utilisation were obtained from the practice and from national datasets. The CTCHC provides a wide range of services, including after-hours care, maternity and radiology, across a network of electronically connected sites, as well as interdisciplinary training for a range of health students. General practitioner (GP) recruitment is problematic and nursing roles have been expanded. Staff report positively on the work environment. Consultation rates are higher than in comparable practices, especially consultations with nurses. Rates of hospital admission are relatively low. The development of the CTCHC was assisted by formation of a local primary health organisation (PHO) and by recognition by the local district health board (DHB). Issues with poor coordination of local services, and less service provision than is characteristic in urban areas, remain. Contracting processes with the DHB were complex and time-consuming. The merging of the local PHO into a larger PHO within the Waitemata DHB catchment inhibited progression towards more complete locality planning. A dedicated and locally controlled provider was able to generate a more than usually complete community health service for Wellsford and area.

Major differences in organization and availability of health care and medicines for HIV/TB coinfected patients across Europe

PubMed Central

Mansfeld, M; Skrahina, A; Shepherd, L; Schultze, A; Panteleev, AM; Miller, RF; Miro, JM; Zeltina, I; Tetradov, S; Furrer, H; Kirk, O; Grzeszczuk, A; Bolokadze, N; Matteelli, A; Post, FA; Lundgren, JD; Mocroft, A; Efsen, AMW; Podlekareva, DN

2016-01-01

Objectives The aim of the study was to investigate the organization and delivery of HIV and tuberculosis (TB) health care and to analyse potential differences between treatment centres in Eastern (EE) and Western Europe (WE). Methods Thirty-eight European HIV and TB treatment centres participating in the TB:HIV study within EuroCoord completed a survey on health care management for coinfected patients in 2013 (EE: 17 respondents; WE:21; 76% of all TB:HIV centres). Descriptive statistics were obtained for regional comparisons. The reported data on health care strategies were compared with actual clinical practice at patient level via data derived from the TB:HIV study. Results Respondent centres in EE comprised: Belarus (n = 3), Estonia (1), Georgia (1), Latvia (1), Lithuania (1), Poland (4), Romania (1), the Russian Federation (4) and Ukraine (1); those in WE comprised: Belgium (1), Denmark (1), France (1), Italy (7), Spain (2), Switzerland (1) and UK (8). Compared with WE, treatment of HIV and TB in EE are less often located at the same site (47% in EE versus 100% in WE; P < 0.001) and less often provided by the same doctors (41% versus 90%, respectively; P = 0.002), whereas regular screening of HIV-infected patients for TB (80% versus 40%, respectively; P = 0.037) and directly observed treatment (88% versus 20%, respectively; P < 0.001) were more common in EE. The reported availability of rifabutin and second- and third-line anti-TB drugs was lower, and opioid substitution therapy (OST) was available at fewer centres in EE compared with WE (53% versus 100%, respectively; P < 0.001). Conclusions Major differences exist between EE and WE in relation to the organization and delivery of health care for HIV/TB-coinfected patients and the availability of anti-TB drugs and OST. Significant discrepancies between reported and actual clinical practices were found in EE. PMID:25959854

Major differences in organization and availability of health care and medicines for HIV/TB coinfected patients across Europe.

PubMed

Mansfeld, M; Skrahina, A; Shepherd, L; Schultze, A; Panteleev, A M; Miller, R F; Miro, J M; Zeltina, I; Tetradov, S; Furrer, H; Kirk, O; Grzeszczuk, A; Bolokadze, N; Matteelli, A; Post, F A; Lundgren, J D; Mocroft, A; Efsen, Amw; Podlekareva, D N

2015-10-01

The aim of the study was to investigate the organization and delivery of HIV and tuberculosis (TB) health care and to analyse potential differences between treatment centres in Eastern (EE) and Western Europe (WE). Thirty-eight European HIV and TB treatment centres participating in the TB:HIV study within EuroCoord completed a survey on health care management for coinfected patients in 2013 (EE: 17 respondents; WE:21; 76% of all TB:HIV centres). Descriptive statistics were obtained for regional comparisons. The reported data on health care strategies were compared with actual clinical practice at patient level via data derived from the TB:HIV study. Respondent centres in EE comprised: Belarus (n = 3), Estonia (1), Georgia (1), Latvia (1), Lithuania (1), Poland (4), Romania (1), the Russian Federation (4) and Ukraine (1); those in WE comprised: Belgium (1), Denmark (1), France (1), Italy (7), Spain (2), Switzerland (1) and UK (8). Compared with WE, treatment of HIV and TB in EE are less often located at the same site (47% in EE versus 100% in WE; P < 0.001) and less often provided by the same doctors (41% versus 90%, respectively; P = 0.002), whereas regular screening of HIV-infected patients for TB (80% versus 40%, respectively; P = 0.037) and directly observed treatment (88% versus 20%, respectively; P < 0.001) were more common in EE. The reported availability of rifabutin and second- and third-line anti-TB drugs was lower, and opioid substitution therapy (OST) was available at fewer centres in EE compared with WE (53% versus 100%, respectively; P < 0.001). Major differences exist between EE and WE in relation to the organization and delivery of health care for HIV/TB-coinfected patients and the availability of anti-TB drugs and OST. Significant discrepancies between reported and actual clinical practices were found in EE. © 2015 British HIV Association.

National Health Care Skill Standards.

ERIC Educational Resources Information Center

National Consortium on Health Science and Technology Education, Okemos, MI.

This document presents the National Health Care Skill Standards, which were developed by the National Consortium on Health Science and Technology and West Ed Regional Research Laboratory, in partnership with educators and health care employers. The document begins with an overview of the purpose and benefits of skill standards. Presented next are…

Effects and meanings of a person-centred and health-promoting intervention in home care services - a study protocol of a non-randomised controlled trial.

PubMed

Bölenius, Karin; Lämås, Kristina; Sandman, Per-Olof; Edvardsson, David

2017-02-16

The literature indicates that current home care service are largely task oriented with limited focus on the involvement of the older people themselves, and studies show that lack of involvement might reduce older people's quality of life. Person-centred care has been shown to improve the satisfaction with care and quality of life in older people cared for in hospitals and nursing homes, with limited published evidence about the effects and meanings of person-centred interventions in home care services for older people. This study protocol outlines a study aiming to evaluate such effects and meanings of a person-centred and health-promoting intervention in home aged care services. The study will take the form of a non-randomised controlled trial with a before/after approach. It will include 270 older people >65 years receiving home care services, 270 relatives and 65 staff, as well as a matched control group of equal size. All participants will be recruited from a municipality in northern Sweden. The intervention is based on the theoretical concepts of person-centredness and health-promotion, and builds on the four pedagogical phases of: theory apprehension, experimental learning, operationalization, and clinical supervision. Outcome assessments will focus on: a) health and quality of life (primary outcomes), thriving and satisfaction with care for older people; b) caregiver strain, informal caregiving engagement and relatives' satisfaction with care: c) job satisfaction and stress of conscience among care staff (secondary outcomes). Evaluation will be conducted by means of self-reported questionnaires and qualitative research interviews. Person-centred home care services have the potential to improve the recurrently reported sub-standard experiences of home care services, and the results can point the way to establishing a more person-centred and health-promoting model for home care services for older people. NCT02846246 .

The Centre for International Mental Health Approach to Mental Health System Development

PubMed Central

Minas, Harry

2012-01-01

Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries. Recent years have seen a growing understanding of the importance of population mental health and increased attention to the need to developmental health systems for responding to population mental health service needs. In countries and regions where mental health services are all but nonexistent, and in postconflict and postdisaster settings, there are many impediments to establishing or scaling up mental health services. It is frequently necessary to act simultaneously on multiple fronts: generating local evidence that will inform decision makers; developing a policy framework; securing investment; determining the most appropriate service model for the context; training and supporting mental health workers; establishing or expanding existing services; putting in place systems for monitoring and evaluation; and strengthening leadership and governance capabilities. This article presents the approach of the Centre for International Mental Health in the Melbourne School of Population Health to mental health system development, and illustrates the way in which the elements of the program are integrated by giving a brief case example from Sri Lanka. (harv rev psychiatry 2012;20:37–46.) PMID:22335181

National Health Care Skill Standards.

ERIC Educational Resources Information Center

Far West Lab. for Educational Research and Development, San Francisco, CA.

This booklet contains draft national health care skill standards that were proposed during the National Health Care Skill Standards Project on the basis of input from more than 1,000 representatives of key constituencies of the health care field. The project objectives and structure are summarized in the introduction. Part 1 examines the need for…

Frambu Health Centre: Promoting Family Focused Care for Disabled Children.

ERIC Educational Resources Information Center

Storhaug, Kari; Vandvik, Inger Helene

1983-01-01

The article describes services of the Frambu Health Centre in Norway, which has evolved during the past 30 years from a summer camp for children with poliomyelitis to a modern information and treatment center for families with disabled members, and offers fortnightly courses for patients with rare congenital and/or hereditary disorders. (Author/MC)

Mental health in Sexual Assault Referral Centres: A survey of forensic physicians.

PubMed

Brooker, Charlie; Paul, Sheila; Sirdifield, Coral

2018-05-22

A national survey of Forensic Physicians (FPs) working in Sexual Assault Referral Centres was undertaken. The survey was advertised in the weekly bulletin sent out by the Faculty of Forensic and Legal Medicine. Response was relatively low (n = 45). It is estimated that this figures represents about 12% of the workforce. The aim of the survey was to investigate FPs experience of accessing mental health pathways out of a SARC for complainants of all ages. The results concurred with a previous survey of SARC clinical managers with mental health services proving unresponsive. Informed co-commissioning between NHS England and Clinical Commissioning groups can only improve if aspects of complainant's mental health are routinely assessed within SARCs using structured outcome measures. Structured outcomes should be integrated into NHS England's Sexual Assault Referral Centres Indicators of Performance (SARCIP). Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Quality of blood pressure measurement in community health centres.

PubMed

Sandoya-Olivera, Edgardo; Ferreira-Umpiérrez, Augusto; Machado-González, Federico

To determine the quality of the blood pressure measurements performed during routine care in community health centres. An observational, cross-sectional study was conducted in 5 private and public health centres in Maldonado, Uruguay, in July-August 2015. The observations were made during the measurements performed by health personnel, using the requirements established by the American Heart Association. An analysis was made on 36 variables that were grouped in categories related to environment, equipment, interrogation, patient, and observer. Statistical analysis was performed using Chi 2 test or Fisher test. Statistical significance was considered to be less than 5% (p<.05). The measurements were made by a registered nurse or nurse in 71% of cases, physician in 20%, and student nurse in 9%. An aneroid sphygmomanometer was used in 89%, and mercury 11%. Satisfactory results were found in variables related to environment (93%), equipment (99%), and patient attitude (82%), and intermediate in the attitudes of the operator (64%), and poor in relation to the interrogation (18%), with the mean of correct variables per measurement being 69%. The main flaws in the procedure were the operator. The measurement of blood pressure is a manoeuvre that healthcare professionals perform thousands of times a year. If the measurement is used for the diagnosis and/or chronic management of arterial hypertension, not systematically applying the established recommendations leads to an inappropriate care of a very significant number of patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Oral health content of early education and child care regulations and standards.

PubMed

Kranz, Ashley M; Rozier, R Gary

2011-01-01

Almost two out of every three US children younger than five receive child care from someone other than their parents. Health promotion in early education and child care (EECC) programs can improve the general health of children and families, but little is known about the role of these programs in oral health. We identified U.S. EECC program guidelines and assessed their oral health recommendations for infants and toddlers. State licensing regulations were obtained from the National Resource Center for Health and Safety in Child Care's online database. Professional standards were identified through a search of PubMed, early childhood organizations' websites, and early childhood literature. All EECC guidelines were reviewed for key terms related to oral health promotion in children and summarized by domains. Thirty-six states include oral health in their licensing regulations, but recommendations are limited and most often address the storage of toothbrushes. Eleven sets of standards were identified, four of which make recommendations about oral health. Standards from the American Academy of Pediatrics/American Public Health Association (AAP/APHA) and the Office of Head Start (OHS) provide the most comprehensive oral health recommendations regarding screening and referral, classroom activities, and education. Detailed guidelines for oral health practices exist but they exhibit large variation in number and content. States can use the comprehensive standards from the AAP/APHA and OHS to inform and strengthen the oral health content of their licensing regulations. Research is needed to determine compliance with regulations and standards, and their effect on oral health.

Relevance of eHealth standards for big data interoperability in radiology and beyond.

PubMed

Marcheschi, Paolo

2017-06-01

The aim of this paper is to report on the implementation of radiology and related information technology standards to feed big data repositories and so to be able to create a solid substrate on which to operate with analysis software. Digital Imaging and Communications in Medicine (DICOM) and Health Level 7 (HL7) are the major standards for radiology and medical information technology. They define formats and protocols to transmit medical images, signals, and patient data inside and outside hospital facilities. These standards can be implemented but big data expectations are stimulating a new approach, simplifying data collection and interoperability, seeking reduction of time to full implementation inside health organizations. Virtual Medical Record, DICOM Structured Reporting and HL7 Fast Healthcare Interoperability Resources (FHIR) are changing the way medical data are shared among organization and they will be the keys to big data interoperability. Until we do not find simple and comprehensive methods to store and disseminate detailed information on the patient's health we will not be able to get optimum results from the analysis of those data.

Addiction research centres and the nurturing of creativity: National Drug Dependence Treatment Centre, India--a profile.

PubMed

Ray, Rajat; Dhawan, Anju; Chopra, Anita

2013-10-01

The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution treatment in India. A nationwide database on the profile of patients seeking treatment (Drug Abuse Monitoring System) at government drug treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Community mental health centres initiated by the South-Eastern Europe Stability Pact: evaluation in seven countries.

PubMed

Priebe, Stefan; Matanov, Aleksandra; Demi, Neli; Blagovcanin Simic, Joka; Jovanovic, Sandra; Gajic, Milena; Radonic, Elizabeta; Bajraktarov, Stojan; Boderscova, Larisa; Konatar, Monika; Nica, Raluca; Muijen, Matthijs

2012-06-01

Eight community mental health care centres (initiated by the South-Eastern Europe Stability Pact) in Albania, Bosnia-Herzegovina, Croatia, Macedonia, Moldova, Montenegro and Romania were evaluated. Characteristics of patients, patient reported outcomes and patient views of care were assessed in 305 psychiatric patients. Patient characteristics varied across centres, with most patients having long term psychotic disorders. Treatment satisfaction and therapeutic relationships were rated favourably. Subjective quality of life mean scores were rather low, with higher satisfaction with health and dissatisfaction with the financial and employment situation. Being unemployed was the only factor associated with poor quality of life and lower treatment satisfaction. Most developing centres target patients with persistent psychotic disorders. Care appears highly valued by the patients. The findings encourage establishing more centres in the region and call for employment schemes for people with mental illnesses.

The Centre for History in Public Health at the London School of Hygiene and Tropical Medicine, University of London (LSHTM)

ERIC Educational Resources Information Center

Berridge, Virginia

2008-01-01

This article describes the origin of the Centre for History in Public Health and the significance of its location in a leading school of public health. It is in three parts: (1) A brief history of how the AIDS programme became the History Centre; (2) The distinctive approach of the Centre's staff as historians: their contribution and its…

Centre of Excellence For Simulation Education and Innovation (CESEI).

PubMed

Qayumi, A Karim

2010-01-01

Simulation is becoming an integral part of medical education. The American College of Surgeons (ACS) was the first organization to recognize the value of simulation-based learning, and to award accreditation for educational institutions that aim to provide simulation as part of the experiential learning opportunity. Centre of Excellence for Simulation Education and Innovation (CESEI) is a multidisciplinary and interprofessional educational facility that is based at the University of British Columbia (UBC) and Vancouver Costal Health Authority (VCH). Centre of Excellence for Simulation Education and Innovation's goal is to provide excellence in education, research, and healthcare delivery by providing a technologically advanced environment and learning opportunity using simulation for various groups of learners including undergraduate, postgraduate, nursing, and allied health professionals. This article is an attempt to describe the infrastructure, services, and uniqueness of the Centre of Excellence for Simulation Education and Innovation. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Advancing family-centred care in child and adolescent mental health: a critical review of the literature.

PubMed

MacKean, Gail; Spragins, Wendy; L'Heureux, Laura; Popp, Janice; Wilkes, Chris; Lipton, Harold

2012-01-01

Family-centred care (FCC) is a key factor in increasing health and related system responsiveness to the needs of children and families; unfortunately, it is an unfamiliar service model in children's mental health. This critical review of the literature addresses three key questions: What are the concepts, characteristics and principles of FCC in the context of delivering mental health services to children? What are the enablers, barriers and demonstrated benefits to using a family-centred approach to care in children's mental health? And how can we facilitate moving an FCC model forward in children's mental health? A range of databases was searched for the years 2000–2011, for children ages zero to 18 years. Articles were selected for inclusion if a family-centred approach to care was articulated and the context was the intervention and treatment side of the mental healthcare system. This literature review uncovered a multiplicity of terms and concepts, all closely related to FCC. Two of the most frequently used terms in children's mental health are family centred and family focused, which have important differences, particularly in regard to how the family is viewed. Initial benefits to FCC include improved child and family management skills and function, an increased stability of living situation, improved cost-effectiveness, increased consumer and family satisfaction and improved child and family health and well-being. Significant challenges exist in evaluating FCC because of varying interpretations of its core concepts and applications. Nonetheless, a shared understanding of FCC in a children's mental health context seems possible, and examples can be found of best practices, enablers and strategies, including opportunities for innovative policy change to overcome barriers.

[Behaviour concerning smoking among the patients making use of advice in women health centres].

PubMed

Kowalska, Alina; Szymański, Przemysław; Rzeźnicki, Adam; Stelmach, Włodzimierz

2007-01-01

The level of knowledge in the society about the harmful influence of smoking is increasing systematically. But there are still many people ignoring the warnings and prohibitions concerning smoking. The results of the research show that it is highly worrying that there are people for whom smoking is incredibly dangerous, e.g. children, youth, women, especially pregnant women. The aim of the work was to establish the percentage of smoking women among the patients of the women health centre, with the special focus on pregnant women. There were 120 women encompassed in this study in the health centre in Opoczno and 120 women using a similar health centre in Lodz between the 1st and the 15th March 2007, using a auditoria survey questionnaire. The collected data was worked out statistically. In the group of 240 tested people, 87 admitted to smoking, which is 36.3% of the respondents. Among the 185 women who were not pregnant, but were smoking, there were 75 (40.5%) and in the group of 55 pregnant women, there were 12 who smoked (f=0.22). Over 22% of the smoking women smoked over 10 cigarettes a day. From among 87 of the surveyed, 35.6% claimed they smoked everywhere they wanted. Majority of the respondents that is 52.9% lived with at least one other smoking person. Over 70% of them would like to quit smoking. Almost 48% stated their doctor has never talked with them about the influence of smoking on their health and almost 42% stated that no nurse or midwife has ever talked to them about this subject. Frequency of smoking among the tested people who were using the women health centre was high. Especially worrying was the percentage of the smoking pregnant women--every fifth of them smoked.

The role of academic health centres in building equitable health systems: a systematic review protocol

PubMed Central

Edelman, Alexandra; Taylor, Judy; Ovseiko, Pavel V; Topp, Stephanie M

2017-01-01

Introduction Academic health centres (AHCs) are complex organisations often defined by their ‘tripartite’ mission: to achieve high standards of clinical care, undertake clinical and laboratory research and educate health professionals. In the last decade, AHCs have moved away from what was a dominant focus on high impact (clinical) interventions for individuals, towards a more population-oriented paradigm requiring networked institutions and responsiveness to a range of issues including distribution of health outcomes and health determinants. Reflective of this paradigm shift is a growing interest in the role of AHCs in addressing health disparities and improving health system equity. This protocol outlines a systematic review that seeks to synthesise and critically appraise the current state of evidence on the role of AHCs in contributing to equitable health systems locally and globally. Methods and analysis Electronic searches will be conducted on a pilot list of bibliographic databases, including Google Scholar, Scopus, MEDLINE, PsycInfo, CINAHL, ERIC, ProQuest Dissertations & Theses, Cochrane Library, Evidence Based Medicine Reviews, Campbell Library and A+ Education, from 1 January 2000 to 31 December 2016. Apart from studies reporting clinical interventions or trials, all types of published peer-reviewed and grey literature will be included in the review. The single screening method will be employed in selecting studies, with two additional reviewers consulted where allocation is unclear. Quality and relevance appraisal utilising Joanna Briggs Institute critical appraisal tools will follow data extraction to a preprepared template. Thematic synthesis will be undertaken to develop descriptive themes and inform analysis. Ethics and dissemination As the review is focused on the analysis of secondary data, it does not require ethics approval. The results of the study will be disseminated through articles in peer-reviewed journals and trade publications as

The role of academic health centres in building equitable health systems: a systematic review protocol.

PubMed

Edelman, Alexandra; Taylor, Judy; Ovseiko, Pavel V; Topp, Stephanie M

2017-05-29

Academic health centres (AHCs) are complex organisations often defined by their 'tripartite' mission: to achieve high standards of clinical care, undertake clinical and laboratory research and educate health professionals. In the last decade, AHCs have moved away from what was a dominant focus on high impact (clinical) interventions for individuals, towards a more population-oriented paradigm requiring networked institutions and responsiveness to a range of issues including distribution of health outcomes and health determinants. Reflective of this paradigm shift is a growing interest in the role of AHCs in addressing health disparities and improving health system equity. This protocol outlines a systematic review that seeks to synthesise and critically appraise the current state of evidence on the role of AHCs in contributing to equitable health systems locally and globally. Electronic searches will be conducted on a pilot list of bibliographic databases, including Google Scholar, Scopus, MEDLINE, PsycInfo, CINAHL, ERIC, ProQuest Dissertations & Theses, Cochrane Library, Evidence Based Medicine Reviews, Campbell Library and A+ Education, from 1 January 2000 to 31 December 2016. Apart from studies reporting clinical interventions or trials, all types of published peer-reviewed and grey literature will be included in the review. The single screening method will be employed in selecting studies, with two additional reviewers consulted where allocation is unclear. Quality and relevance appraisal utilising Joanna Briggs Institute critical appraisal tools will follow data extraction to a preprepared template. Thematic synthesis will be undertaken to develop descriptive themes and inform analysis. As the review is focused on the analysis of secondary data, it does not require ethics approval. The results of the study will be disseminated through articles in peer-reviewed journals and trade publications as well as presentations at relevant national and international

Growth References of Preschool Children Based on the Taiwan Birth Cohort Study and Compared to World Health Organization Growth Standards.

PubMed

Li, Yi-Fan; Lin, Shio-Jean; Lin, Kuan-Chia; Chiang, Tung-Liang

2016-02-01

To develop new growth references for height, weight, and body mass index (BMI) for children aged 0-5 years in the Taiwan Birth Cohort Study (TBCS) and to compare these references with both 1997 Taiwan references and World Health Organization (WHO) standards. Data were obtained from the TBCS of a nationally representative sample of 24,200 children. A total of 18,466 children completed the baseline survey at 6 months of age and three follow-up surveys at 18 months, 3 years, and 5.5 years of age. The modified LMS method was used to construct percentile curves by sex, including length/height for age, weight for age, and BMI for age. TBCS children of both sexes were shorter and lighter at birth compared with 1997 Taiwan references and WHO standards. The growth patterns of TBCS children were close to those of the 1997 Taiwan references after 6 months of age. Compared with WHO standards, however, TBCS children were heavier after 6 months of age. This study has developed TBCS references to monitor the growth of children in Taiwan, whose weight growth patterns differed from those "prescribed" by WHO standards. Copyright © 2016. Published by Elsevier B.V.

Accountable Care Organizations and Population Health Organizations.

PubMed

Casalino, Lawrence P; Erb, Natalie; Joshi, Maulik S; Shortell, Stephen M

2015-08-01

Accountable care organizations (ACOs) and hospitals are investing in improving "population health," by which they nearly always mean the health of the "population" of patients "attributed" by Medicare, Medicaid, or private health insurers to their organizations. But population health can and should also mean "the health of the entire population in a geographic area." We present arguments for and against ACOs and hospitals investing in affecting the socioeconomic determinants of health to improve the health of the population in their geographic area, and we provide examples of ACOs and hospitals that are doing so in a limited way. These examples suggest that ACOs and hospitals can work with other organizations in their community to improve population health. We briefly present recent proposals for such coalitions and for how they could be financed to be sustainable. Copyright © 2015 by Duke University Press.

25 CFR 900.43 - What are the general financial management system standards that apply to a tribal organization...

Code of Federal Regulations, 2010 CFR

2010-04-01

... standards that apply to a tribal organization carrying out a self-determination contract? 900.43 Section 900... organization carrying out a self-determination contract? A tribal organization shall expend and account for..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION...

25 CFR 900.43 - What are the general financial management system standards that apply to a tribal organization...

Code of Federal Regulations, 2012 CFR

2012-04-01

... standards that apply to a tribal organization carrying out a self-determination contract? 900.43 Section 900... organization carrying out a self-determination contract? A tribal organization shall expend and account for..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION...

25 CFR 900.43 - What are the general financial management system standards that apply to a tribal organization...

Code of Federal Regulations, 2014 CFR

2014-04-01

... standards that apply to a tribal organization carrying out a self-determination contract? 900.43 Section 900... organization carrying out a self-determination contract? A tribal organization shall expend and account for..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION...

25 CFR 900.43 - What are the general financial management system standards that apply to a tribal organization...

Code of Federal Regulations, 2011 CFR

2011-04-01

... standards that apply to a tribal organization carrying out a self-determination contract? 900.43 Section 900... organization carrying out a self-determination contract? A tribal organization shall expend and account for..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION...

25 CFR 900.43 - What are the general financial management system standards that apply to a tribal organization...

Code of Federal Regulations, 2013 CFR

2013-04-01

... standards that apply to a tribal organization carrying out a self-determination contract? 900.43 Section 900... organization carrying out a self-determination contract? A tribal organization shall expend and account for..., DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION...

[Young first-time parents' experiences with family-centred postpartal health care in Switzerland].

PubMed

Kläusler-Troxler, Marianne; Kurth, Elisabeth; Spirig, Rebecca

2014-08-01

Routine postnatal care normally addresses only the mother and her child. In Switzerland, counselling for all parents and their children is provided by family nurses in a community-based health care setting. We implemented a new approach to ensure father involvement within the framework of the Calgary Family Assessment (CFAM) and the Calgary Intervention Model CFIM of Wright and Leahey (2013) in the northwest of Switzerland. This qualitative study explored how mothers and fathers experienced the newly developed family-centred consultation. Data collection was performed by means of participant observation and semi- structured interviews with a sample of five first-time parents with healthy neonates. Data were analysed by using content analysis according to Mayring. Mothers and fathers experienced family-centred consultation as effective. They felt more secure and confident "to handle the new situation" and obtained trustful, concrete and professional support to take care of their baby, particularly with regard to breast feeding, crying and sleeping patterns. Fathers felt included into postnatal care from the beginning. Family nursing offers a useful framework for family-centred postnatal health care.

IMPACT OF COMORBIDITY AND SOCIOECONOMIC STATUS ON QUALITY OF LIFE IN PATIENTS WITH CHRONIC DISEASES WHO ATTEND PRIMARY HEALTH CARE CENTRES.

PubMed

Tüzün, Hakan; Aycan, Sefer; İlhan, Mustafa Necmi

2015-09-01

The aim of the study was to analyse the impact of chronic disease on the quality of life (QoL) and how QoL changes with comorbidity and socioeconomic status in persons who attend primary health care centres. The group of participants comprised 2,560 people who contacted six primary health care centres in Ankara. The level of QoL was determined by the World Health Organization Quality of Life Questionnaire Abbreviated Version (WHOQOL-BREF). Mental disorders and diabetes-hypertension comorbidity had the most negative effect on the QoL. In the physical domain of the WHOQOL-BREF, the effect of diabetes-hypertension comorbidity is greater than the additive effect of hypertension and diabetes individually. The co-occurrence of any disease with cardiovascular disease does not change QoL within any domain, except for the co-occurrence of any disease with musculoskeletal diseases which deteriorated QoL in the physical domain. The higher income and socioeconomic status corresponded to higher QoL. The effect of comorbidity on QoL can be different from the additive effects of the co-occurring diseases. Socioeconomic factors undoubtedly affect the relationship between chronic diseases and QoL, and this relationship points to health inequities among socioeconomic groups.

WHO/INRUD patient care and facility-specific drug use indicators at primary health care centres in Eastern province, Saudi Arabia.

PubMed

El Mahalli, A A; Akl, O A M; Al-Dawood, S F; Al-Nehab, A A; Al-Kubaish, H A; Al-Saeed, S; Elkahky, A A A; Salem, A M A A

2012-11-01

This study aimed to measure the performance of primary health care centres in Eastern province, Saudi Arabia, using the WHO/International Network of Rational Use of Drugs patient care and facility-specific drug use indicators. In a cross-sectional study, 10 health centres were selected using systematic random sampling. A total of 300 patients were interviewed while visiting the centre from January to March 2011 and 10 pharmacists from the same centres were interviewed. Average consultation time was 7.3 min (optimal > or = 30 min), percentage of drugs adequately labelled was 10% (optimal 100%) and patient's knowledge of correct dosage was 79.3% (optimal 100%). The percentage of key drugs in stock was only 59.2% (optimal 100%). An overall index of rational facility-specific drug use was calculated and applied to rank the health centres for benchmarking.

Serbia National Poison Control Centre: organization and current activities.

PubMed

Jovanović, Dugan; Joksović, Dragan; Vucinić, Savica; Todorović, Veljko; Segrt, Zoran; Kilibarda, Vesna; Bokonjić, Dubravko

2005-01-01

Ministry of Health of the former Federal Republic of Yugoslavia established the National Poison Control Centre in 1995. However, that was only the formally solution since clinical, analytical and experimental services in toxicology had worked independently for at least 40 years. Besides the Headquarters, NPCC has currently 2 main units, the Clinic of Emergency and Clinical Toxicology and Pharmacology and the Institute of Toxicology and Pharmacology. The latter is consisted of Toxicological Information Department, Department of Analytical Toxicology and Department of Experimental Toxicology and Pharmacology. The Mobile Toxicological Chemical Unit is a separate department that is activated from personnel of the NPCC in a case of chemical accidents and/or disasters. Clinical, information and analytical parts of NPCC have a 365-day/24-hour working service. The Clinic of Emergency and Clinical Toxicology and Pharmacology is a place where the intoxicated patients are treated, including those that need the intensive care measures. Toxicological Information Department uses the data from a self-made computer Database for different information purposes. Department of Analytical Toxicology is equipped with a lot of contemporary analytical equipment that is giving the opportunity of identification and quantification of chemicals/metabolites/degradation products in biological material, food, water, air and soil. Basic pharmacological and toxicological research of chemicals and pre-clinical investigations of antidotes are realized in the Department of Experimental Toxicology and Pharmacology. In terms of medical prevention and rational treatment of human poison exposures in Serbia, the current organization of NPCC has so far proven to be effective.

A user-centred methodology for designing an online social network to motivate health behaviour change.

PubMed

Kamal, Noreen; Fels, Sidney

2013-01-01

Positive health behaviour is critical to preventing illness and managing chronic conditions. A user-centred methodology was employed to design an online social network to motivate health behaviour change. The methodology was augmented by utilizing the Appeal, Belonging, Commitment (ABC) Framework, which is based on theoretical models for health behaviour change and use of online social networks. The user-centred methodology included four phases: 1) initial user inquiry on health behaviour and use of online social networks; 2) interview feedback on paper prototypes; 2) laboratory study on medium fidelity prototype; and 4) a field study on the high fidelity prototype. The points of inquiry through these phases were based on the ABC Framework. This yielded an online social network system that linked to external third party databases to deploy to users via an interactive website.

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. full text

Improving accountability through alignment: the role of academic health science centres and networks in England.

PubMed

Ovseiko, Pavel V; Heitmueller, Axel; Allen, Pauline; Davies, Stephen M; Wells, Glenn; Ford, Gary A; Darzi, Ara; Buchan, Alastair M

2014-01-20

As in many countries around the world, there are high expectations on academic health science centres and networks in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth. Meeting these expectations increasingly depends on partnership working between university medical schools and teaching hospitals, as well as other healthcare providers. However, academic-clinical relationships in England are still characterised by the "unlinked partners" model, whereby universities and their partner teaching hospitals are neither fiscally nor structurally linked, creating bifurcating accountabilities to various government and public agencies. This article focuses on accountability relationships in universities and teaching hospitals, as well as other healthcare providers that form core constituent parts of academic health science centres and networks. The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability. Examples from North West London suggest that a number of mechanisms can be used to improve accountability for the tripartite mission through alignment, but that the simple creation of academic health science centres and networks is probably not sufficient. At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments. Given that a fundamental top-down system redesign is now extremely unlikely, local academic and clinical leaders face the challenge of aligning their institutions as a matter of priority in order to improve accountability for the tripartite mission from the bottom up. It remains to be

Improving accountability through alignment: the role of academic health science centres and networks in England

PubMed Central

2014-01-01

Background As in many countries around the world, there are high expectations on academic health science centres and networks in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth. Meeting these expectations increasingly depends on partnership working between university medical schools and teaching hospitals, as well as other healthcare providers. However, academic-clinical relationships in England are still characterised by the “unlinked partners” model, whereby universities and their partner teaching hospitals are neither fiscally nor structurally linked, creating bifurcating accountabilities to various government and public agencies. Discussion This article focuses on accountability relationships in universities and teaching hospitals, as well as other healthcare providers that form core constituent parts of academic health science centres and networks. The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability. Examples from North West London suggest that a number of mechanisms can be used to improve accountability for the tripartite mission through alignment, but that the simple creation of academic health science centres and networks is probably not sufficient. Summary At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments. Given that a fundamental top-down system redesign is now extremely unlikely, local academic and clinical leaders face the challenge of aligning their institutions as a matter of priority in order to improve accountability for the tripartite mission from

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.

Rapid Assessment Response (RAR) study: drug use, health and systemic risks--Emthonjeni Correctional Centre, Pretoria, South Africa.

PubMed

Dos Santos, Monika M L; Trautmann, Franz; Wolvaardt, Gustaaf; Palakatsela, Romeo

2014-04-03

Correctional centre populations are one of the populations most at risk of contracting HIV infection for many reasons, such as unprotected sex, violence, rape and tattooing with contaminated equipment. Specific data on drug users in correctional centres is not available for the majority of countries, including South Africa. The study aimed to identify the attitudes and knowledge of key informant (KI) offender and correctional centre staff regarding drug use, health and systemic-related problems so as to facilitate the long-term planning of activities in the field of drug-use prevention and systems strengthening in correctional centres, including suggestions for the development of appropriate intervention and rehabilitation programmes. A Rapid Assessment Response (RAR) methodology was adopted which included observation, mapping of service providers (SP), KI interviews (staff and offenders) and focus groups (FGs). The study was implemented in Emthonjeni Youth Correctional Centre, Pretoria, South Africa. Fifteen KI staff participants were interviewed and 45 KI offenders. Drug use is fairly prevalent in the centre, with tobacco most commonly smoked, followed by cannabis and heroin. The banning of tobacco has also led to black-market features such as transactional sex, violence, gangsterism and smuggling in order to obtain mainly prohibited tobacco products, as well as illicit substances. HIV, health and systemic-related risk reduction within the Correctional Service sector needs to focus on measures such as improvement of staff capacity and security measures, deregulation of tobacco products and the development and implementation of comprehensive health promotion programmes.

Relevance of Health Economics in Breast Cancer Treatment – the View of Certified Breast Centres and Their Patients

PubMed Central

Lux, Michael; Hildebrandt, Thomas; Beyer-Finkler, Elke; Bani, Mayada; Loehberg, Christian; Jud, Sebastian; Rauh, Claudia; Schrauder, Michael; Fasching, Peter; Beckmann, Matthias

2013-01-01

Summary Breast cancer centres – certified in accordance with the criteria of the German Cancer Association and the German Mastology Association – are established throughout Germany. Although the setting up of centres and the subsequent need for certification are associated with a marked increase in costs, initial data show positive effects on quality. Certified centres are cost-effective from the point of view of health economics – they lead to improved quality in processes and results without creating any increase in costs for the funding bodies. However, the organization of the necessary structures, with interdisciplinary treatment, documentation and quality-assurance measures, requires considerable resources. Increasing consolidation of inpatient services is also involved, while shortening of the patients’ hospitalization periods is leading to reduced remuneration from the funding bodies. The current cost deficits, which have resulted from the increased resources required, need to be recouped through additional charges. It will only be possible to maintain the high quality achieved if additional charges become available to cover the centres’ added costs. Good data are increasingly becoming available as a basis for negotiations on charges – e.g., with regard to the quality of results and the National Cancer Plan – as well as clear support from patients. PMID:24715838

Opening the black-box of person-centred care: An arts-informed narrative inquiry into mental health education and practice.

PubMed

Schwind, Jasna K; Lindsay, Gail M; Coffey, Sue; Morrison, Debbie; Mildon, Barb

2014-08-01

Nursing education has a history of encouraging students to know their patients and to negotiate the in-between of art/science, person/profession, and intuition/evidence. Nurse-teachers know that students may abandon some values and practices when they encounter practice environments that are complex and have competing agendas. We are concerned that nursing knowledge is black-boxed, invisible and taken-for-granted, in healthcare settings. Our research explores how nursing students and nurses are constructing and enacting person-centred care in mental health education and practice. We want to understand the nursing standpoint on this significant ontological issue and to make nursing knowledge construction and utilization visible; illuminating how person-centred theory emerges from practice. The process involved four 3-hour group meetings and an individual follow-up telephone conversation. Students and nurses met at a tertiary-care mental health organization. Fourteen nurses (Registered Nurses and Registered Practical Nurses) and nursing students (Bachelor of Science in Nursing and Practical Nursing) participated in our inquiry. We used arts-informed narrative inquiry to explore experience through the arts such as metaphor, collage, poems, letters, and group conversations. The black-box is opened as the inquiry reveals how nursing knowledge is constructed, assumptions are challenged and new practices emerge. Our research is significant for education and for practice and is transferable to other populations and settings. Nurses are affirmed in person-centred values and practices that include partnership with those in their care, role modeling for colleagues and mentoring students and new nurses. Students participate in transferring their learning from school to practice, in the company of experienced colleagues; together they open the black-box to show how nurses conceptualize and enact person-centred care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Query Health: standards-based, cross-platform population health surveillance

PubMed Central

Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N

2014-01-01

Objective Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Materials and methods Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. Results We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. Discussions This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Conclusions Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. PMID:24699371

A metal-organic cage incorporating multiple light harvesting and catalytic centres for photochemical hydrogen production

NASA Astrophysics Data System (ADS)

Chen, Sha; Li, Kang; Zhao, Fang; Zhang, Lei; Pan, Mei; Fan, Yan-Zhong; Guo, Jing; Shi, Jianying; Su, Cheng-Yong

2016-11-01

Photocatalytic water splitting is a natural but challenging chemical way of harnessing renewable solar power to generate clean hydrogen energy. Here we report a potential hydrogen-evolving photochemical molecular device based on a self-assembled ruthenium-palladium heterometallic coordination cage, incorporating multiple photo- and catalytic metal centres. The photophysical properties are investigated by absorption/emission spectroscopy, electrochemical measurements and preliminary DFT calculations and the stepwise electron transfer processes from ruthenium-photocentres to catalytic palladium-centres is probed by ultrafast transient absorption spectroscopy. The photocatalytic hydrogen production assessments reveal an initial reaction rate of 380 μmol h-1 and a turnover number of 635 after 48 h. The efficient hydrogen production may derive from the directional electron transfers through multiple channels owing to proper organization of the photo- and catalytic multi-units within the octahedral cage, which may open a new door to design photochemical molecular devices with well-organized metallosupramolecules for homogenous photocatalytic applications.

Cytoplasmic E2f4 forms organizing centres for initiation of centriole amplification during multiciliogenesis

PubMed Central

Mori, Munemasa; Hazan, Renin; Danielian, Paul S.; Mahoney, John E.; Li, Huijun; Lu, Jining; Miller, Emily S.; Zhu, Xueliang; Lees, Jacqueline A.; Cardoso, Wellington V.

2017-01-01

Abnormal development of multiciliated cells is a hallmark of a variety of human conditions associated with chronic airway diseases, hydrocephalus and infertility. Multiciliogenesis requires both activation of a specialized transcriptional program and assembly of cytoplasmic structures for large-scale centriole amplification that generates basal bodies. It remains unclear, however, what mechanism initiates formation of these multiprotein complexes in epithelial progenitors. Here we show that this is triggered by nucleocytoplasmic translocation of the transcription factor E2f4. After inducing a transcriptional program of centriole biogenesis, E2f4 forms apical cytoplasmic organizing centres for assembly and nucleation of deuterosomes. Using genetically altered mice and E2F4 mutant proteins we demonstrate that centriole amplification is crucially dependent on these organizing centres and that, without cytoplasmic E2f4, deuterosomes are not assembled, halting multiciliogenesis. Thus, E2f4 integrates nuclear and previously unsuspected cytoplasmic events of centriole amplification, providing new perspectives for the understanding of normal ciliogenesis, ciliopathies and cancer. PMID:28675157

National Training and Education Standards for Health and Wellness Coaching: The Path to National Certification

PubMed Central

Wolever, Ruth Q.; Lawson, Karen; Moore, Margaret

2015-01-01

The purpose of this article is twofold: (1) to announce the findings of the job task analysis as well as national training and education standards for health and wellness coaching (HWC) that have been developed by the large-scale, collaborative efforts of the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC) and (2) to invite commentary from the public. The rapid proliferation of individuals and organizations using the terms of health and/or wellness coaches and the propagation of private industry and academic coach training and education programs endeavoring to prepare these coaches has created an urgent and pressing need for national standards for use of the term health and wellness coach, as well as minimal requirements for training, education, and certification. Professionalizing the field with national standards brings a clear and consistent definition of health and wellness coaching and accepted practice standards that are uniform across the field. In addition, clear standards allow for uniform curricular criteria to ensure a minimal benchmark for education, training, and skills and knowledge evaluation of professional health and wellness coaches. PMID:25984418

Diagnostic performance of body mass index using the Western Pacific Regional Office of World Health Organization reference standards for body fat percentage.

PubMed

Yoon, Jong Lull; Cho, Jung Jin; Park, Kyung Mi; Noh, Hye Mi; Park, Yong Soon

2015-02-01

Associations between body mass index (BMI), body fat percentage (BF%), and health risks differ between Asian and European populations. BMI is commonly used to diagnose obesity; however, its accuracy in detecting adiposity in Koreans is unknown. The present cross-sectional study aimed at assessing the accuracy of BMI in determining BF%-defined obesity in 6,017 subjects (age 20-69 yr, 43.6% men) from the 2009 Korean National Health and Nutrition Examination Survey. We assessed the diagnostic performance of BMI using the Western Pacific Regional Office of World Health Organization reference standard for BF%-defined obesity by sex and age and identified the optimal BMI cut-off for BF%-defined obesity using receiver operating characteristic curve analysis. BMI-defined obesity (≥25 kg/m(2)) was observed in 38.7% of men and 28.1% of women, with a high specificity (89%, men; 84%, women) but poor sensitivity (56%, men; 72% women) for BF%-defined obesity (25.2%, men; 31.1%, women). The optimal BMI cut-off (24.2 kg/m(2)) had 78% sensitivity and 71% specificity. BMI demonstrated limited diagnostic accuracy for adiposity in Korea. There was a -1.3 kg/m(2) difference in optimal BMI cut-offs between Korea and America, smaller than the 5-unit difference between the Western Pacific Regional Office and global World Health Organization obesity criteria.

38 CFR 9.10 - Health standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Health standards. 9.10... LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.10 Health standards. (a) For the purpose of... criteria used by the insurer in determining good health for persons applying to it for life insurance in...

38 CFR 9.10 - Health standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Health standards. 9.10... LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.10 Health standards. (a) For the purpose of... criteria used by the insurer in determining good health for persons applying to it for life insurance in...

38 CFR 9.10 - Health standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Health standards. 9.10... LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.10 Health standards. (a) For the purpose of... criteria used by the insurer in determining good health for persons applying to it for life insurance in...

38 CFR 9.10 - Health standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Health standards. 9.10... LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.10 Health standards. (a) For the purpose of... criteria used by the insurer in determining good health for persons applying to it for life insurance in...

38 CFR 9.10 - Health standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Health standards. 9.10... LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.10 Health standards. (a) For the purpose of... criteria used by the insurer in determining good health for persons applying to it for life insurance in...

Evaluating Three School-Based Integrated Health Centres Established by a Partnership in Cornwall to Inform Future Provision and Practice

ERIC Educational Resources Information Center

Macpherson, Reynold

2013-01-01

Purpose: The aim of this paper is to report the process, findings and implications of a three-year evaluation of integrated health centres (IHCs) established in three secondary schools in Cornwall by the School-Based Integrated Health Centres (SBIHC) partnership. Design/methodology/approach: When the partners had completed the capital works, an…

The role of non-governmental organizations in providing curative health services in North Darfur State, Sudan.

PubMed

Yagub, Abdallah I A; Mtshali, Khondlo

2015-09-01

Conflict in North Darfur state, Western Sudan started in 2003, and the delivering of curative health services was becoming a greater challenge for the country's limited resources. NGOs have played an important role in providing curative health services. To examine the role that Non-Governmental Organizations (NGOs) have played in providing curative health services, as well as to identify the difficulties and challenges that affect NGOs in delivering curative health services. Secondary data was collected from different sources, including government offices and medical organizations in Sudan and in North Darfur state. Primary data was obtained through interviews with government and NGOs representatives. The interviews were conducted with (1) expatriates working for international NGOs (N=15) (2) health professionals and administrators working in health sector (N= 45) in the period from November 2010 to January 2011. The government in North Darfur state spent 70% of its financial budget on security, while it spent it less than 1% on providing health services. The international NGOs have been providing 70% of curative health services to the State's population by contributing 52.9% of the health budget and 1 390 health personnel. Since 2003 NGOs have provided technical assistance to the health staff. As a result, more than fifty nurses have been trained to provide care and treatment, more than twenty-three doctors have been trained in laboratory equipment operation, and approximately six senior doctors and hospital directors have received management training. NGOs have been managing and supporting 89 public health facilities, and established 24 health centres in IDP camps, and 20 health centres across all the districts in North Darfur state. The NGOs have played an important role in providing curative health services and in establishing good health facilities, but a future problem is how the government will run these health facilities after a peaceful settlement has been

RTEMS Centre - Support and Maintenance Centre to RTEMS Operating System

NASA Astrophysics Data System (ADS)

Silva, H.; Constantino, A.; Freitas, D.; Coutinho, M.; Faustino, S.; Mota, M.; Colaço, P.; Sousa, J.; Dias, L.; Damjanovic, B.; Zulianello, M.; Rufino, J.

2009-05-01

RTEMS CENTRE - Support and Maintenance Centre to RTEMS Operating System is a joint ESA/Portuguese Task Force initiative to develop a support and maintenance centre to the Real-Time Executive for Multiprocessor Systems (RTEMS). This paper gives a high level visibility of the progress, the results obtained and the future work in the RTEMS CENTRE [6] and in the RTEMS Improvement [7] projects. RTEMS CENTRE started officially in November 2006, with the RTEMS 4.6.99.2 version. A full analysis of RTEMS operating system was produced. The architecture was analysed in terms of conceptual, organizational and operational concepts. The original objectives [1] of the centre were primarily to create and maintain technical expertise and competences in this RTOS, to develop a website to provide the European Space Community an entry point for obtaining support (http://rtemscentre.edisoft.pt), to design, develop, maintain and integrate some RTEMS support tools (Timeline Tool, Configuration and Management Tools), to maintain flight libraries and Board Support Packages, to develop a strong relationship with the World RTEMS Community and finally to produce some considerations in ARINC-653, DO-178B and ECSS E-40 standards. RTEMS Improvement is the continuation of the RTEMS CENTRE. Currently the RTEMS, version 4.8.0, is being facilitated for a future qualification. In this work, the validation material is being produced following the Galileo Software Standards Development Assurance Level B [5]. RTEMS is being completely tested, errors analysed, dead and deactivated code removed and tests produced to achieve 100% statement and decision coverage of source code [2]. The SW to exploit the LEON Memory Management Unit (MMU) hardware will be also added. A brief description of the expected implementations will be given.

Query Health: standards-based, cross-platform population health surveillance.

PubMed

Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N

2014-01-01

Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under

45 CFR 162.406 - Standard unique health identifier for health care providers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Standard unique health identifier for health care providers. 162.406 Section 162.406 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health Identifier...

45 CFR 162.406 - Standard unique health identifier for health care providers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Standard unique health identifier for health care providers. 162.406 Section 162.406 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health Identifier...

Cross-Sectional Study on the Prevalence of Intestinal Parasites and Associated Risk Factors in Teda Health Centre, Northwest Ethiopia.

PubMed

Abate, Abraraw; Kibret, Biniam; Bekalu, Eylachew; Abera, Sendeku; Teklu, Takele; Yalew, Aregawi; Endris, Mengistu; Worku, Ligabaw; Tekeste, Zinaye

2013-01-01

Objective. To assess the magnitude of intestinal parasitic infection and associated risk factors in Teda Health Centre, Northwest Ethiopia. Method. A cross-sectional study was conducted in Teda Health Centre from February to April, 2011. Stool samples were collected from 410 study participants and analysed by direct wet mount and formal ether concentration techniques. Furthermore, sociodemographic data were collected by using standardized questionnaire. Result. The overall prevalence of intestinal parasitic infection in this study was 62.3%. Ascaris lumbricoides was the most predominant parasite (23.2%) followed by Giardia intestinalis (12.4%), Entamoeba histolytica/dispar (4.6%), Schistosoma mansoni (8.9%), hookworm (6.6%), Hymenolepis nana (1.5%), Enterobius vermicularis (0.4%), and Strongyloides stercoralis (0.2%). Absence of toilet and hand washing after toilet was shown to be associated with intestinal parasitic infection (P < 0.05 for both). Furthermore, swimming and less shoe wearing habits showed a significant prevalence of S. mansoni and hookworm infections, respectively. Conclusion. The present study showed high prevalence of intestinal parasitic infection in the study area. Absence of toilet and hand washing after toilet was found to be associated with intestinal parasitic infection. Therefore, there is a need for integrated control programme to have a lasting impact on transmission of intestinal parasitic infection.

The Peckham Health Centre, “PEP”, and the concept of general practice during the 1930s and 1940s

PubMed Central

Lewis, Jane; Brookes, Barbara

1983-01-01

This paper documents the proposals put forward by George Scott Williamson and Innes Pearse, founders of the Peckham Health Centre and members of the Political and Economic Planning (PEP) Health Group, to enhance the role and status of the general practitioner (GP). Their ideas are significant in terms of their understanding of the threat that specialism posed to general practice and of the problems of control and finance raised by reform. Their solution - the establishment of GP therapeutic centres or cells - is located in terms of their own ideas regarding health and medical practice and is compared with the other major proposal for group practice in health centres, which emanated from the Dawson Committee in 1920. Finally, the paper provides some suggestions as to the reason for their failure. PMID:6345961

Tourist health as a new branch of public health.

PubMed

Pasini, W

1989-01-01

Tourism has been steadily expanding in recent years and continues to do so, with the result that the health and social problems related to this new mass phenomenon are growing likewise. Urgent and serious attention to the various implications is now required on the part of relevant national and international bodies and of all sectors interested in the health and wellbeing of tourists, both in their place of origin and at their destination. Tourist health is a new branch of public health concerned with the protection and promotion of the health of tourists. The traditional role of medicine has always been to deal with the health aspects of the most important of life's activities, such as work and sport. The medical profession cannot therefore neglect a leisure-time pursuit such as tourism, in view of its wide-ranging health implications. The Italian Association for Tourist Medicine (IATM) and the Tourist Health Centre, with headquarters in Rimini, were founded in 1983 to assist in the creation of tourist health as a discipline and to promote its development. An international meeting on Prevention and control of infections in tourists in the Mediterranean area, organized in close collaboration with the World Health Organization (WHO) and the World Tourism Organization (WTO) was held in Rimini on 8-11 February 1988. The meeting recommended that the IATM act as focal point in the promotion of tourist health and tourist medicine, especially for countries in the Mediterranean area. In December 1988, the Tourist Health Centre, Rimini was designated as a WHO collaborating centre for tourist health and tourist medicine.(ABSTRACT TRUNCATED AT 250 WORDS)

The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

PubMed Central

Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

2014-01-01

Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

Using discrete event simulation to compare the performance of family health unit and primary health care centre organizational models in Portugal.

PubMed

Fialho, André S; Oliveira, Mónica D; Sá, Armando B

2011-10-15

Recent reforms in Portugal aimed at strengthening the role of the primary care system, in order to improve the quality of the health care system. Since 2006 new policies aiming to change the organization, incentive structures and funding of the primary health care sector were designed, promoting the evolution of traditional primary health care centres (PHCCs) into a new type of organizational unit--family health units (FHUs). This study aimed to compare performances of PHCC and FHU organizational models and to assess the potential gains from converting PHCCs into FHUs. Stochastic discrete event simulation models for the two types of organizational models were designed and implemented using Simul8 software. These models were applied to data from nineteen primary care units in three municipalities of the Greater Lisbon area. The conversion of PHCCs into FHUs seems to have the potential to generate substantial improvements in productivity and accessibility, while not having a significant impact on costs. This conversion might entail a 45% reduction in the average number of days required to obtain a medical appointment and a 7% and 9% increase in the average number of medical and nursing consultations, respectively. Reorganization of PHCC into FHUs might increase accessibility of patients to services and efficiency in the provision of primary care services.

The health care learning organization.

PubMed

Hult, G T; Lukas, B A; Hult, A M

1996-01-01

To many health care executives, emphasis on marketing strategy has become a means of survival in the threatening new environment of cost attainment, intense competition, and prospective payment. This paper develops a positive model of the health care organization based on organizational learning theory and the concept of the health care offering. It is proposed that the typical health care organization represents the prototype of the learning organization. Thus, commitment to a shared vision is proposed to be an integral part of the health care organization and its diagnosis, treatment, and delivery of the health care offering, which is based on the exchange relationship, including its communicative environment. Based on the model, strategic marketing implications are discussed.

Out-of-pocket expenditure and catastrophic health spending on maternal care in public and private health centres in India: a comparative study of pre and post national health mission period.

PubMed

Mohanty, Sanjay K; Kastor, Anshul

2017-09-18

The National Health Mission (NHM), one of the largest publicly funded maternal health programs worldwide was initiated in 2005 to reduce maternal, neo-natal and infant mortality and out-of-pocket expenditure (OOPE) on maternal care in India. Though evidence suggests improvement in maternal and child health, little is known on the change in OOPE and catastrophic health spending (CHS) since the launch of NHM. The aim of this paper is to provide a comprehensive estimate of OOPE and CHS on maternal care by public and private health providers in pre and post NHM periods. The unit data from the 60th and 71st rounds of National Sample Survey (NSS) is used in the analyses. Descriptive statistics is used to understand the differentials in OOPE and CHS. The CHS is estimated based on capacity to pay, derived from household consumption expenditure, the subsistence expenditure (based on state specific poverty line) and household OOPE on maternal care. Data of both rounds are pooled to understand the impact of NHM on OOPE and CHS. The log-linear regression model and the logit regression models adjusted for state fixed effect, clustering and socio-economic and demographic correlates are used in the analyses. Women availing themselves of ante natal, natal and post natal care (all three maternal care services) from public health centres have increased from 11% in 2004 to 31% by 2014 while that from private health centres had increased from 12% to 20% during the same period. The mean OOPE on all three maternal care services from public health centres was US$60 in pre-NHM and US$86 in post-NHM periods while that from private health center was US$170 and US$300 during the same period. Controlling for socioeconomic and demographic correlates, the OOPE on delivery care from public health center had not shown any significant increase in post NHM period. The OOPE on delivery care in private health center had increased by 5.6 times compared to that from public health centers in pre NHM

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.

The informatics capability maturity of integrated primary care centres in Australia.

PubMed

Liaw, Siaw-Teng; Kearns, Rachael; Taggart, Jane; Frank, Oliver; Lane, Riki; Tam, Michael; Dennis, Sarah; Walker, Christine; Russell, Grant; Harris, Mark

2017-09-01

Integrated primary care requires systems and service integration along with financial incentives to promote downward substitution to a single entry point to care. Integrated Primary Care Centres (IPCCs) aim to improve integration by co-location of health services. The Informatics Capability Maturity (ICM) describes how well health organisations collect, manage and share information; manage eHealth technology, implementation, change, data quality and governance; and use "intelligence" to improve care. Describe associations of ICM with systems and service integration in IPCCs. Mixed methods evaluation of IPCCs in metropolitan and rural Australia: an enhanced general practice, four GP Super Clinics, a "HealthOne" (private-public partnership) and a Community Health Centre. Data collection methods included self-assessed ICM, document review, interviews, observations in practice and assessment of electronic health record data. Data was analysed and compared across IPCCs. The IPCCs demonstrated a range of funding models, ownership, leadership, organisation and ICM. Digital tools were used with varying effectiveness to collect, use and share data. Connectivity was problematic, requiring "work-arounds" to communicate and share information. The lack of technical, data and software interoperability standards, clinical coding and secure messaging were barriers to data collection, integration and sharing. Strong leadership and governance was important for successful implementation of robust and secure eHealth systems. Patient engagement with eHealth tools was suboptimal. ICM is positively associated with integration of data, systems and care. Improved ICM requires a health workforce with eHealth competencies; technical, semantic and software standards; adequate privacy and security; and good governance and leadership. Copyright © 2017 Elsevier B.V. All rights reserved.

Nurse managers' perceptions related to their leadership styles, knowledge, and skills in these areas-a viewpoint: case of health centre wards in Finland.

PubMed

Vesterinen, Soili; Suhonen, Marjo; Isola, Arja; Paasivaara, Leena; Laukkala, Helena

2013-01-01

The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles-visionary, coaching, affiliate, democratic, commanding, and isolating-were reflected on. Almost all respondents in every age group considered four leadership styles-visionary, coaching, affiliate, and democratic-to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing.

Nurse Managers' Perceptions Related to Their Leadership Styles, Knowledge, and Skills in These Areas—A Viewpoint: Case of Health Centre Wards in Finland

PubMed Central

Suhonen, Marjo; Isola, Arja; Paasivaara, Leena; Laukkala, Helena

2013-01-01

The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles—visionary, coaching, affiliate, democratic, commanding, and isolating—were reflected on. Almost all respondents in every age group considered four leadership styles—visionary, coaching, affiliate, and democratic—to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing. PMID:23691356

29 CFR 1925.2 - Safety and health standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 7 2014-07-01 2014-07-01 false Safety and health standards. 1925.2 Section 1925.2 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH STANDARDS FOR FEDERAL SERVICE CONTRACTS § 1925.2 Safety and health standards...

29 CFR 1925.2 - Safety and health standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Safety and health standards. 1925.2 Section 1925.2 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH STANDARDS FOR FEDERAL SERVICE CONTRACTS § 1925.2 Safety and health standards...

29 CFR 1925.2 - Safety and health standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 7 2012-07-01 2012-07-01 false Safety and health standards. 1925.2 Section 1925.2 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH STANDARDS FOR FEDERAL SERVICE CONTRACTS § 1925.2 Safety and health standards...

29 CFR 1925.2 - Safety and health standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Safety and health standards. 1925.2 Section 1925.2 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH STANDARDS FOR FEDERAL SERVICE CONTRACTS § 1925.2 Safety and health standards...

29 CFR 1925.2 - Safety and health standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 7 2013-07-01 2013-07-01 false Safety and health standards. 1925.2 Section 1925.2 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH STANDARDS FOR FEDERAL SERVICE CONTRACTS § 1925.2 Safety and health standards...

StaR Child Health: improving global standards for child health research.

PubMed

Offringa, Martin; Needham, Allison C; Chan, Winnie W Y

2013-11-01

Standards for Research (StaR) in Child Health, founded in 2009, addresses the current scarcity of and deficiencies in pediatric clinical trials. StaR Child Health brings together leading international experts devoted to developing practical, evidence-based standards to enrich the reliability and relevance of pediatric clinical research. Through a systematic "knowledge to action" plan, StaR Child Health creates opportunities to improve the evidence base for child health across the world. To date, six standards have been published and four more are under development. It is now time to use these standards. Improving the design, conduct and reporting of pediatric clinical trials will ultimately advance the quality of health care provided to children across the globe. Crown Copyright © 2013. All rights reserved.

10 CFR 851.23 - Safety and health standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Safety and health standards. 851.23 Section 851.23 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM Specific Program Requirements § 851.23 Safety and health standards. (a) Contractors must comply with the following safety and health standards that are...

10 CFR 851.23 - Safety and health standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Safety and health standards. 851.23 Section 851.23 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM Specific Program Requirements § 851.23 Safety and health standards. (a) Contractors must comply with the following safety and health standards that are...

10 CFR 851.23 - Safety and health standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Safety and health standards. 851.23 Section 851.23 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM Specific Program Requirements § 851.23 Safety and health standards. (a) Contractors must comply with the following safety and health standards that are...

10 CFR 851.23 - Safety and health standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Safety and health standards. 851.23 Section 851.23 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM Specific Program Requirements § 851.23 Safety and health standards. (a) Contractors must comply with the following safety and health standards that are...

10 CFR 851.23 - Safety and health standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Safety and health standards. 851.23 Section 851.23 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM Specific Program Requirements § 851.23 Safety and health standards. (a) Contractors must comply with the following safety and health standards that are...

Approaches to setting organism-based ballast water discharge standards

USGS Publications Warehouse

Lee, Henry; Reusser, Deborah A.; Frazier, Melanie

2013-01-01

As a vector by which foreign species invade coastal and freshwater waterbodies, ballast water discharge from ships is recognized as a major environmental threat. The International Maritime Organization (IMO) drafted an international treaty establishing ballast water discharge standards based on the number of viable organisms per volume of ballast discharge for different organism size classes. Concerns that the IMO standards are not sufficiently protective have initiated several state and national efforts in the United States to develop more stringent standards. We evaluated seven approaches to establishing discharge standards for the >50-μm size class: (1) expert opinion/management consensus, (2) zero detectable living organisms, (3) natural invasion rates, (4) reaction–diffusion models, (5) population viability analysis (PVA) models, (6) per capita invasion probabilities (PCIP), and (7) experimental studies. Because of the difficulty in synthesizing scientific knowledge in an unbiased and transparent fashion, we recommend the use of quantitative models instead of expert opinion. The actual organism concentration associated with a “zero detectable organisms” standard is defined by the statistical rigor of its monitoring program; thus it is not clear whether such a standard is as stringent as other standards. For several reasons, the natural invasion rate, reaction–diffusion, and experimental approaches are not considered suitable for generating discharge standards. PVA models can be used to predict the likelihood of establishment of introduced species but are limited by a lack of population vital rates for species characteristic of ballast water discharges. Until such rates become available, PVA models are better suited to evaluate relative efficiency of proposed standards rather than predicting probabilities of invasion. The PCIP approach, which is based on historical invasion rates at a regional scale, appears to circumvent many of the indicated problems

A One Health Evaluation of the Southern African Centre for Infectious Disease Surveillance.

PubMed

Hanin, Marie C E; Queenan, Kevin; Savic, Sara; Karimuribo, Esron; Rüegg, Simon R; Häsler, Barbara

2018-01-01

Rooted in the recognition that emerging infectious diseases occur at the interface of human, animal, and ecosystem health, the Southern African Centre for Infectious Disease Surveillance (SACIDS) initiative aims to promote a trans-sectoral approach to address better infectious disease risk management in five countries of the Southern African Development Community. Nine years after SACIDS' inception, this study aimed to evaluate the program by applying a One Health (OH) evaluation framework developed by the Network for Evaluation of One Health (NEOH). The evaluation included a description of the context and the initiative, illustration of the theory of change, identification of outputs and outcomes, and assessment of the One Healthness. The latter is the sum of characteristics that defines an integrated approach and includes OH thinking, OH planning, OH working, sharing infrastructure, learning infrastructure, and systemic organization. The protocols made available by NEOH were used to develop data collection protocols and identify the study design. The framework relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative evaluation (scoring). Data for the analysis were gathered during a document review, in group and individual interviews and in an online survey. Operational aspects (i.e., OH thinking, planning, and working) were found to be balanced overall with the highest score in the planning dimension, whereas the infrastructure (learning infrastructure, systemic organization, and sharing infrastructure) was high for the first two dimensions, but low for sharing. The OH index calculated was 0.359, and the OH ratio calculated was 1.495. The program was praised for its great innovative energy in a difficult landscape dominated by poor infrastructure and its ability to create awareness for OH and enthuse people for the concept; training of people and networking. Shortcomings were identified regarding the

Development of urine standard reference materials for metabolites of organic chemicals including polycyclic aromatic hydrocarbons, phthalates, phenols, parabens, and volatile organic compounds.

PubMed

Schantz, Michele M; Benner, Bruce A; Heckert, N Alan; Sander, Lane C; Sharpless, Katherine E; Vander Pol, Stacy S; Vasquez, Y; Villegas, M; Wise, Stephen A; Alwis, K Udeni; Blount, Benjamin C; Calafat, Antonia M; Li, Zheng; Silva, Manori J; Ye, Xiaoyun; Gaudreau, Éric; Patterson, Donald G; Sjödin, Andreas

2015-04-01

Two new Standard Reference Materials (SRMs), SRM 3672 Organic Contaminants in Smokers' Urine (Frozen) and SRM 3673 Organic Contaminants in Non-Smokers' Urine (Frozen), have been developed in support of studies for assessment of human exposure to select organic environmental contaminants. Collaborations among three organizations resulted in certified values for 11 hydroxylated polycyclic aromatic hydrocarbons (OH-PAHs) and reference values for 11 phthalate metabolites, 8 environmental phenols and parabens, and 24 volatile organic compound (VOC) metabolites. Reference values are also available for creatinine and the free forms of caffeine, theobromine, ibuprofen, nicotine, cotinine, and 3-hydroxycotinine. These are the first urine Certified Reference Materials characterized for metabolites of organic environmental contaminants. Noteworthy, the mass fractions of the environmental organic contaminants in the two SRMs are within the ranges reported in population survey studies such as the National Health and Nutrition Examination Survey (NHANES) and the Canadian Health Measures Survey (CHMS). These SRMs will be useful as quality control samples for ensuring compatibility of results among population survey studies and will fill a void to assess the accuracy of analytical methods used in studies monitoring human exposure to these organic environmental contaminants.

Development of urine standard reference materials for metabolites of organic chemicals including polycyclic aromatic hydrocarbons, phthalates, phenols, parabens, and volatile organic compounds

PubMed Central

Schantz, Michele M.; Benner, Bruce A.; Heckert, N. Alan; Sander, Lane C.; Sharpless, Katherine E.; Vander Pol, Stacy S.; Vasquez, Y.; Villegas, M.; Wise, Stephen A.; Alwis, K. Udeni; Blount, Benjamin C.; Calafat, Antonia M.; Li, Zheng; Silva, Manori J.; Ye, Xiaoyun; Gaudreau, Éric; Patterson, Donald G.; Sjödin, Andreas

2016-01-01

Two new Standard Reference Materials (SRMs), SRM 3672 Organic Contaminants in Smokers’ Urine (Frozen) and SRM 3673 Organic Contaminants in Non-Smokers’ Urine (Frozen), have been developed in support of studies for assessment of human exposure to select organic environmental contaminants. Collaborations among three organizations resulted in certified values for 11 hydroxylated polycyclic aromatic hydrocarbons (OH-PAHs) and reference values for 11 phthalate metabolites, 8 environmental phenols and parabens, and 24 volatile organic compound (VOC) metabolites. Reference values are also available for creatinine and the free forms of caffeine, theobromine, ibuprofen, nicotine, cotinine, and 3-hydroxycotinine. These are the first urine Certified Reference Materials characterized for metabolites of organic environmental contaminants. Noteworthy, the mass fractions of the environmental organic contaminants in the two SRMs are within the ranges reported in population survey studies such as the National Health and Nutrition Examination Survey (NHANES) and the Canadian Health Measures Survey (CHMS). These SRMs will be useful as quality control samples for ensuring compatibility of results among population survey studies and will fill a void to assess the accuracy of analytical methods used in studies monitoring human exposure to these organic environmental contaminants. PMID:25651899

Practice-centred evaluation and the privileging of care in health information technology evaluation

PubMed Central

2014-01-01

Background Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts – can complement and in some instances offer advantages over, outcome-centric evaluation models. Methods We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An ‘action learning’ approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these activities we asked: how can a practice-centred approach be embedded into evaluation of health information technologies? Discussion Organising EPR and telemedicine evaluation around predetermined outcome measures alone can be impractical given the complex and contingent nature of such projects. It also limits the extent to which unforeseen outcomes and new capabilities are recognised. Such evaluations often fail to improve understanding of ‘when’ and ‘under what conditions’ technology-enabled service improvements are realised, and crucially, how such innovation improves care. Summary Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In

Role of chromatography in the development of Standard Reference Materials for organic analysis.

PubMed

Wise, Stephen A; Phinney, Karen W; Sander, Lane C; Schantz, Michele M

2012-10-26

The certification of chemical constituents in natural-matrix Standard Reference Materials (SRMs) at the National Institute of Standards and Technology (NIST) can require the use of two or more independent analytical methods. The independence among the methods is generally achieved by taking advantage of differences in extraction, separation, and detection selectivity. This review describes the development of the independent analytical methods approach at NIST, and its implementation in the measurement of organic constituents such as contaminants in environmental materials, nutrients and marker compounds in food and dietary supplement matrices, and health diagnostic and nutritional assessment markers in human serum. The focus of this review is the important and critical role that separation science techniques play in achieving the necessary independence of the analytical steps in the measurement of trace-level organic constituents in natural matrix SRMs. Published by Elsevier B.V.

Creating Standards for Student Organizations at Public Institutions in Colorado

ERIC Educational Resources Information Center

Damania, Nicky Pessi

2012-01-01

At institutions of higher education, the environment for developing student organizations has been less than optimum due to a lack of development of effective and efficient standards for these organizations. Even though there are tools for improving organizations, there are no set standards for their operation and governance to ignite leadership…

Au generation centres doped n+-Si: hole-injection adjustable anode for efficient organic light emission

NASA Astrophysics Data System (ADS)

Li, Y. Z.; Ran, G. Z.; Zhao, W. Q.; Qin, G. G.

2008-08-01

An organic light-emitting diode (OLED) with an n-Si-anode usually has an efficiency evidently lower than the OLED with the same structure with a p-Si-anode due to insufficient hole injection from the n-Si anode compared with the p-Si-anode. In this study, we find that introducing Au as generation centres with a suitable concentration into the n+-Si anode can enhance hole injection to match electron injection and then considerably promote the power efficiency. With optimizing Au generation centre concentration in the n+-Si anode, the OLED with a structure of n+-Si: Au/NPB/AlQ/Sm/Au reaches a highest power efficiency of 1.0 lm W-1, evidently higher than the reported highest power efficiency of 0.2 lm W-1 for its p-Si-anode counterpart. Furthermore, when the electron injection is enhanced by adopting BPhen:Cs2CO3 partly instead of AlQ as the electron transport material, and the Au generation centre concentration in the n+-Si anode is promoted correspondingly, then a highest power efficiency of 1.8 lm W-1 is reached. The role of Au generation centres in the n+-Si anode is discussed.

Service users' expectations of treatment and support at the Community Mental Health Centre in their recovery.

PubMed

Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit

2017-09-01

Focus on service users' needs, coping and empowerment, user involvement, and comprehensiveness are supposed to be key elements of the Community Mental Health Centres in Norway. Taking a user-oriented approach means acknowledging the individual's own expectations, aims and hopes. However, studies that have investigated service users' expectations of treatment and support at Community Mental Health Centres are hard to find. The aim of the study was therefore to explore service users' expectations at the start of treatment at a Community Mental Health Centre. Within a collaborative framework, taking a hermeneutic-phenomenological approach, ten service users participated in in-depth interviews about their expectations, hopes and aims for treatment and recovery. The participants sought help due to various mental health issues that had interfered with their lives and created disability and suffering. A data-driven stepwise approach in line with thematic analysis was used. The study was approved by the Norwegian Social Science Data Services. The following four main themes representing participants' expectations at the start of treatment were elicited: hope for recovery, developing understanding, finding tools for coping and receiving counselling and practical assistance. Participants' expectations about treatment were tightly interwoven with their personal aims and hopes for their future life, and expectations were often related to practical and financial problems, the solution of which being deemed necessary to gain a safe basis for recovery in the long run. The transferability of the results may be limited by the small number of participants. The study emphasises how important it is that service users' personal aims and expectations guide the collaborative treatment process. In addition to providing treatment aimed at improving symptoms, Community Mental Health Centres should take a more comprehensive approach than today by providing more support with family issues

[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.

Nosocomial infection in a Nigerian rural maternity centre: a series of nine cases.

PubMed

Okezie, O A; Onyemelukwe, N F

2007-02-01

An outbreak of urinary tract infection in a rural maternity hospital near Enugu, Nigeria led to bacteriological assessment which identified Serratia marcescens as the causative organism. An epidemiological investigation was done to trace the source of this organism. To investigate an outbreak of urinary tract infection in a rural maternity centre. A descriptive study. Maternity centre in a rural community near Enugu run by local midwives assisted by auxiliary nurses trained by the midwives. Nine patients at term with symptoms of urinary tract infection. In all nine cases, the pigmented form of Serratia marcescens was found to be the cause of the urinary tract infection and the source of this organism was traced to the auxillary nurse who shaved the patients and the instrument she used. Since the causative organism of the outbreak of urinary infection in these women was traced to the shaving instruments used and the fingers of the auxillary nurse who shaved them, there is the need for better hygiene practices in the health centre and the use of properly trained staff to attend to pregnant and parturient women. It is recommended that the practice of shaving parturient women should be discarded.

Estimating the Minimum Number of Judges Required for Test-Centred Standard Setting on Written Assessments. Do Discussion and Iteration Have an Influence?

ERIC Educational Resources Information Center

Fowell, S. L.; Fewtrell, R.; McLaughlin, P. J.

2008-01-01

Absolute standard setting procedures are recommended for assessment in medical education. Absolute, test-centred standard setting procedures were introduced for written assessments in the Liverpool MBChB in 2001. The modified Angoff and Ebel methods have been used for short answer question-based and extended matching question-based papers,…

Achieving Excellence Through Contemporary and Relevant Psychiatric-Mental Health Nursing Standards of Practice.

PubMed

McInnis-Perry, Gloria; Greene, Ann; Mina, Elaine Santa

2015-09-01

Standards of practice (SOPs) comprise competency statements, which are grounded in current knowledge and research, and provide foundations for performance that support professional accountability. The nursing profession, and specifically the psychiatric-mental health specialty of nursing practice in Canada, develops and revises practice standards regularly. The current article describes the collaborative, evidence-informed journey of the Canadian Federation of Mental Health Nurses during its fourth revision of the Canadian Psychiatric-Mental Health Nursing SOPs. An intraprofessional team of psychiatric-mental health nurses from the clinical, academic, research, and policy areas developed and nurtured collaborative processes that emphasize collegial and authentic relationships. Effective communication and a respectful learning environment supported the process for all members of the team. The current article provides recommendations for other professional organizations considering developing and/or revising SOPs. Copyright 2015, SLACK Incorporated.

[Health situation of prisoners at a prison compliance centre, Chile].

PubMed

Osses-Paredes, C; Riquelme-Pereira, N

2013-02-01

There are population groups nowadays that are regarded as vulnerable, one of which is the prison population, considered to have major health needs. Nonetheless, people deprived of liberty maintain inherent human rights such as that of health care, which in some situations may take second place. Cross-sectional descriptive study, carried out at El Manzano Prison compliance centre, Concepción, from October 2011 to February 2012 with the implementation of a preventive health exam and a socio-demographic and health questionnaire, for 18+, female and male prisoners in a closed system, on reception of written informed consent. in the study, the population was 85% men, the average age was 34 years, 91.2% receive visits, average term of imprisonment 38 months. At least 45% have a diagnosed disease, prioritizing mental disorders, and respiratory and circulatory system diseases. 56% of prisoners have requested health care infrequently, 33% of which were very satisfied and 32% satisfied with prison health services. The health of the prison population is more impaired than that of the general population, with a larger number of needs that are also different, but there is a positive perception of health by prisoners and a high degree of satisfaction with health services.

Safe motherhood partners -- the International Children's Centre.

PubMed

1994-01-01

The International Children's Centre (ICC) works worldwide to improve child health in the least developed countries. In its training and research projects the agency contributes to the Safe Motherhood Initiative to improve the health of mothers and infants. ICC is based in Paris, it was established in 1949, and the agency has cooperated with governments, nongovernmental organizations and international bodies like the World Health Organization (WHO) in child care. ICC's activities reflect concern for the health of women before and during pregnancy and the rest of their lives. The center's work comprises training, research, local projects, and information and documentation. Following the 1987 Nairobi conference on safe motherhood, ICC organized a seminar in Paris on maternal mortality in Sub-Saharan francophone Africa, which led to participation in the Safe Motherhood Initiative with a variety of training and research programs. ICC training is integrated, community-based, and multidisciplinary. Anthropology, psychology, economics and management have played a role in ICC training courses. The center runs an international course on maternal and child health from January to April each year and also organizes distance training courses on problem solving in health care. ICC training programs have taken place in Laos, Senegal, and Vietnam to strengthen the work of maternal and child health training centers there. A 4-week course on economic evaluation of health programs is held in Paris each July. In 1989 and 1990, ICC organized in collaboration with WHO safe motherhood workshops on research methodology in Benin and in Burkina Faso with participants from 6 francophone African countries. One research project in Benin is on risk factors for maternal and perinatal mortality and morbidity, and the other in Cameroon on improving surveillance of pregnancy, delivery, and the postnatal period. ICC focuses on long-term planning and action for the benefit of mothers and children.

Duplication and Nuclear Envelope Insertion of the Yeast Microtubule Organizing Centre, the Spindle Pole Body.

PubMed

Rüthnick, Diana; Schiebel, Elmar

2018-05-10

The main microtubule organizing centre in the unicellular model organisms Saccharomyces cerevisiae and Schizosaccharomyces pompe is the spindle pole body (SPB). The SPB is a multilayer structure, which duplicates exactly once per cell cycle. Unlike higher eukaryotic cells, both yeast model organisms undergo mitosis without breakdown of the nuclear envelope (NE), a so-called closed mitosis. Therefore, in order to simultaneously nucleate nuclear and cytoplasmic MTs, it is vital to embed the SPB into the NE at least during mitosis, similarly to the nuclear pore complex (NPC). This review aims to embrace the current knowledge of the SPB duplication cycle with special emphasis on the critical step of the insertion of the new SPB into the NE.

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

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.

The WHO collaborating centre for public health palliative care programs: an innovative approach of palliative care development.

PubMed

Ela, Sara; Espinosa, Jose; Martínez-Muñoz, Marisa; Lasmarías, Cristina; Beas, Elba; Mateo-Ortega, Dolors; Novellas, Anna; Gómez-Batiste, Xavier

2014-04-01

The designation of the Catalan Institute of Oncology (Barcelona, Spain) as World Health Organization (WHO) Collaborating Centre for Public Health Palliative Care Programmes (WHOCC-ICO) in February 2008 turns the institution into the first ever center of international reference in regards to palliative care implementation from a public health perspective. The center aims to provide support to countries willing to develop palliative care programs, to identify models of success, to support WHO's policies, and to generate and spread evidence on palliative care. This article describes the WHOCC-ICO's contribution in the implementation of public health palliative care programs and services. The center's main features and future actions are emphasized. At the end of the initial four-year designation period, the organization evaluates the task done to reach its objectives. Such global assessment would take forward the quality of the institution, and generate a revision of its terms of reference for the next designation period. Based on new evidence, the center has recently decided to expand its scope by adopting a community-wide chronic care approach which moves beyond cancer and focuses on the early identification of patients with any chronic disease in need of palliative care. Moreover, the center advocates the development of comprehensive models of care that address patients' psychosocial needs. This center's new work plan includes additional significant innovations, such as the startup of the first chair of palliative care in Spain. Such a whole new approach responds to the main challenges of current palliative care.

Challenges for nurses who work in community mental health centres in the West Bank, Palestine.

PubMed

Marie, Mohammad; Hannigan, Ben; Jones, Aled

2017-01-01

Nurses in Palestine (occupied Palestinian territory) work in a significantly challenging environment. The mental health care system is underdeveloped and under-resourced. For example, the total number of nurses who work in community mental health centres in the West Bank is seventeen, clearly insufficient in a total population of approximately three million. This research explored daily challenges that Palestinian community mental health nurses (CMHNs) face within and outside their demanding workplaces. An interpretive qualitative design was chosen. Face-to-face interviews were completed with fifteen participants. Thirty-two hours of observations of the day-to-day working environment and workplace routines were conducted in two communities' mental health centres. Written documents relating to practical job-related policies were also collected from various workplaces. Thematic analysis was used across all data sources resulting in four main themes, which describe the challenges faced by CMHNs. These themes consist of the context of unrest, stigma, lack of resources, and organisational or mental health system challenges. The study concludes with a better understanding of challenges in nursing which draws on wider cultural contexts and resilience. The outcomes from this study can be used to decrease the challenges for health professionals and enhance the mental health care system in Palestine.

Different for girls? Feminism, health information and librarianship.

PubMed

Ilett, Rosie

2002-03-01

This paper focuses on the provision and organization of health information materials in women's health centres in UK and Ireland in the late 20th century Such centres sprung from the work of feminist activists and health workers from the late 1960s onwards, promoting health information and other interventions to counteract women's devalued status within society, and the stereotypes perpetuated by health care and other systems. Centres that developed were (and still are) typically within the voluntary sector, have a strong feminist perspective and are run by lay workers. This paper will draw on research into information provision in these centres, its scope, organization and who provides it. It will argue that this work is of interest to mainstream librarianship, but there are minimal linkages as feminist thinking within librarianship has been unable overall to make common cause with the work of these, and other such agencies, which has inhibited potential developments of mutual benefit. This paper draws on ongoing research into feminism and librarianship, and findings that have been presented in a number of settings.

Towards organizing health knowledge on community-based health services.

PubMed

Akbari, Mohammad; Hu, Xia; Nie, Liqiang; Chua, Tat-Seng

2016-12-01

Online community-based health services accumulate a huge amount of unstructured health question answering (QA) records at a continuously increasing pace. The ability to organize these health QA records has been found to be effective for data access. The existing approaches for organizing information are often not applicable to health domain due to its domain nature as characterized by complex relation among entities, large vocabulary gap, and heterogeneity of users. To tackle these challenges, we propose a top-down organization scheme, which can automatically assign the unstructured health-related records into a hierarchy with prior domain knowledge. Besides automatic hierarchy prototype generation, it also enables each data instance to be associated with multiple leaf nodes and profiles each node with terminologies. Based on this scheme, we design a hierarchy-based health information retrieval system. Experiments on a real-world dataset demonstrate the effectiveness of our scheme in organizing health QA into a topic hierarchy and retrieving health QA records from the topic hierarchy.

29 CFR 505.6 - Safety and health standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Safety and health standards. 505.6 Section 505.6 Labor... HUMANITIES § 505.6 Safety and health standards. (a) Standards. Section 5(i)(2) and section 7(g)(2) of the Act... dangerous to the health and safety of the employees engaged in such project or production. Compliance with...

29 CFR 505.6 - Safety and health standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Safety and health standards. 505.6 Section 505.6 Labor... HUMANITIES § 505.6 Safety and health standards. (a) Standards. Section 5(i)(2) and section 7(g)(2) of the Act... dangerous to the health and safety of the employees engaged in such project or production. Compliance with...

29 CFR 505.6 - Safety and health standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Safety and health standards. 505.6 Section 505.6 Labor... HUMANITIES § 505.6 Safety and health standards. (a) Standards. Section 5(i)(2) and section 7(g)(2) of the Act... dangerous to the health and safety of the employees engaged in such project or production. Compliance with...

29 CFR 505.6 - Safety and health standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Safety and health standards. 505.6 Section 505.6 Labor... HUMANITIES § 505.6 Safety and health standards. (a) Standards. Section 5(i)(2) and section 7(g)(2) of the Act... dangerous to the health and safety of the employees engaged in such project or production. Compliance with...

29 CFR 505.6 - Safety and health standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Safety and health standards. 505.6 Section 505.6 Labor... HUMANITIES § 505.6 Safety and health standards. (a) Standards. Section 5(i)(2) and section 7(g)(2) of the Act... dangerous to the health and safety of the employees engaged in such project or production. Compliance with...

Using a Standardized Donor Ratio to Assess Organ Procurement Organizations

PubMed Central

Stogis, Sheryl; Hirth, Richard A; Strawderman, Robert L; Banaszak-Holl, Jane; Smith, Dean G

2002-01-01

Objective To develop a Standardized Donor Ratio (SDR) as an outcome measure for evaluating the effectiveness of organ procurement organizations (OPOs). Data Sources/Study Setting All deaths by cause in the United States during 1993–1994 as reported in the Vital Mortality Statistics, Multiple Cause of Death files. The OPO-specific data were provided by the United Network for Organ Sharing (UNOS). Study Design Each OPO's expected number of donors was calculated by applying national donation rates to deaths with potential for donation in 24 age, sex, and race cells. The SDR was calculated by dividing the observed number of donors by the expected number. The X2 tests of the hypothesis that the OPO's performance differed from the national norm of 1.0 were performed. The SDR was compared to the existing performance standard based on the unadjusted number of donors per million live population in the OPO's service area. An ordinary least squares (OLS) regression assessed predictors of the SDR. Principal Findings The SDRs ranged from 0.41 to 1.99. Twenty-nine of 64 OPOs had SDRs significantly different than 1.0. The SDRs were positively associated with the percent of white living population and the number of organ types transplanted per transplant center served by the OPO. Conclusions The SDRs can be used by Centers for Medicare and Medicaid Services (CMS), UNOS, and OPOs to target quality improvement initiatives, present more accurate comparisons of OPO performance, and develop public policy on the evaluation of the effectiveness of organ procurement efforts. PMID:12479499

77 FR 21067 - Notice of Meeting of the National Organic Standards Board

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-09

... Service [Document Number AMS-NOP-12-0017; NOP-12-06] Notice of Meeting of the National Organic Standards... forthcoming meeting of the National Organic Standards Board (NOSB). Written public comments are invited in... materials, write to Ms. Michelle Arsenault, Special Assistant, National Organic Standards Board, USDA-AMS...

Wide variation in sexually transmitted infection testing and counselling at Aboriginal primary health care centres in Australia: analysis of longitudinal continuous quality improvement data.

PubMed

Nattabi, Barbara; Matthews, Veronica; Bailie, Jodie; Rumbold, Alice; Scrimgeour, David; Schierhout, Gill; Ward, James; Guy, Rebecca; Kaldor, John; Thompson, Sandra C; Bailie, Ross

2017-02-15

Chlamydia, gonorrhoea and syphilis are readily treatable sexually transmitted infections (STIs) which continue to occur at high rates in Australia, particularly among Aboriginal Australians. This study aimed to: explore the extent of variation in delivery of recommended STI screening investigations and counselling within Aboriginal primary health care (PHC) centres; identify the factors associated with variation in screening practices; and determine if provision of STI testing and counselling increased with participation in continuous quality improvement (CQI). Preventive health audits (n = 16,086) were conducted at 137 Aboriginal PHC centres participating in the Audit and Best Practice for Chronic Disease Program, 2005-2014. STI testing and counselling data were analysed to determine levels of variation in chlamydia, syphilis and gonorrhoea testing and sexual health discussions. Multilevel logistic regression was used to determine factors associated with higher levels of STI-related service delivery and to quantify variation attributable to health centre and client characteristics. Significant variation in STI testing and counselling exists among Aboriginal PHC centres with health centre factors accounting for 43% of variation between health centres and jurisdictions. Health centre factors independently associated with higher levels of STI testing and counselling included provision of an adult health check (odds ratio (OR) 3.40; 95% Confidence Interval (CI) 3.07-3.77) and having conducted 1-2 cycles of CQI (OR 1.34; 95% CI 1.16-1.55). Client factors associated with higher levels of STI testing and counselling were being female (OR 1.45; 95% CI 1.33-1.57), Aboriginal (OR 1.46; 95% CI 1.15-1.84) and aged 20-24 years (OR 3.84; 95% CI 3.07-4.80). For females, having a Pap smear test was also associated with STI testing and counselling (OR 4.39; 95% CI 3.84-5.03). There was no clear association between CQI experience beyond two CQI cycles and higher levels of

International Organization for Standardization (ISO) 15189

PubMed Central

Schneider, Frank; Friedberg, Richard C.

2017-01-01

The College of American Pathologists (CAP) offers a suite of laboratory accreditation programs, including one specific to accreditation to the international organization for standardization (ISO) 15189 standard for quality management specific to medical laboratories. CAP leaders offer an overview of ISO 15189 including its components, internal audits, occurrence management, document control, and risk management. The authors provide a comparison of its own ISO 15189 program, CAP 15189, to the CAP Laboratory Accreditation Program. The authors conclude with why laboratories should use ISO 15189. PMID:28643484

[Health promotion in day-care centres in Reykjavík--intervention and result of actions].

PubMed

Gudmarsdóttir, Agústa; Tómasson, Kristinn

2007-03-01

The purpose of the study was to compare wellbeing, health and work environment before and after intervention among employees of Reykjavík city day-care centre. The study is a prospective interventions study. In the year 2000 employees of 16 day-care centres responded to a questionnaire regarding work environment, health and wellbeing. Work environment evaluation was completed and the centre classified into four groups accordingly. Subsequently, the "equipment was renewed" noise protection improved and the employee received education concerning occupational health. Six months, after interventions, in the year 2002 the same questionnaire was readministered. Response rate in 2002 was 88% (n=267) but 90% in the year 2000. Work environment had improved. More employees had received instruction on good workposture and good work technique than 2 years earlier. Fewer employees used awkward posture than before. Better workspace resulted in reduced number of symptoms, also for the youngest employees. Symptoms were also fewer where unskilled employees were in majority and where the fewest of them had received proper education on work posture. In the year 2002, psychosocial wellbeing was better or equal than two years earlier. This was associated with better education and higher age even despite less workspace. Employees awareness towards noise was greatly improved. It is possible to improve work methods and work environment of employees with goal directed intervention, thus laying the ground for wellbeing at work. The interplay between the factors education and age is complex, though. Thus it is important, that all workplaces, adopt the process of "risk assessment", intervention, and then reassessment of the work environment. By doing so the goals of health promotion and good occupational health can be reached.

Bringing Person- and Family-Centred Care Alive in Home, Community and Long-Term Care Organizations.

PubMed

Bender, Danielle; Holyoke, Paul

2016-01-01

It is now more important than ever for person- and family-centred care (PFCC) to be at the forefront of program and service design and delivery; yet, to date, very little guidance is available to assist home, community and long-term care (LTC) organizations to operationalize this concept and overcome inherent challenges. This article provides a list of practical strategies for healthcare leaders to promote and support a culture shift towards PFCC in their organizations and identifies and addresses five common concerns. The unique opportunities and challenges for practicing PFCC in home, community and LTC settings are also discussed.

78 FR 54617 - Notice of Meeting of the National Organic Standards Board

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-05

... Service [Document Number AMS-NOP-13-0049; NOP-13-04] Notice of Meeting of the National Organic Standards... Service (AMS) is announcing an upcoming meeting of the National Organic Standards Board (NOSB). Written... Assistant, National Organic Standards Board, USDA-AMS-NOP, 1400 Independence Ave. SW., Room 2648-So., Mail...

Employers' perceptions and attitudes toward the Canadian national standard on psychological health and safety in the workplace: A qualitative study.

PubMed

Kunyk, Diane; Craig-Broadwith, Morgan; Morris, Heather; Diaz, Ruth; Reisdorfer, Emilene; Wang, JianLi

2016-01-01

The estimated societal and economic costs of mental illness and psychological injury in the workplace is staggering. Governments, employers and other stakeholders have been searching for policy solutions. This qualitative, exploratory study sought to uncover organizational receptivity to a voluntary comprehensive standard for dealing with psychological health and safety in the workplace. A series of five focus groups were conducted in a large Western Canadian city in November 2013. The seventeen participants were from the fields of healthcare, construction/utilities, manufacturing industries, business services, and finance. They worked in positions of management, consulting, human resources, health promotion, health and safety, mediation, and occupational health and represented organizations ranging in size from 20 to 100,000 employees. The findings confirm and illustrate the critical role that psychological health and safety plays across workplaces and occupations. This standard resonated across the represented organizations and fit with their values. This alignment posed challenges with articulating its added value. There appears to be a need for simplified engagement and implementation strategies of the standard that can be tailored to the nuanced differences between types and sizes of industries. It appears that organizations in the most need of improving psychological health and safety may be the least receptive. Copyright © 2015 Elsevier Ltd. All rights reserved.

45 CFR 162.506 - Standard unique health plan identifier.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Standard unique health plan identifier. 162.506 Section 162.506 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health Identifier for Health Plans § 162...

45 CFR 162.506 - Standard unique health plan identifier.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Standard unique health plan identifier. 162.506 Section 162.506 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health Identifier for Health Plans § 162...

Does patients' choice of health centre doctor depend on the organization? A comparative study of four municipalities with different forms of service provision in Finland.

PubMed

Laamanen, Ritva; Simonsen-Rehn, Nina; Suominen, Sakari; Brommels, Mats

2010-11-01

The aim of the study was to examine the use of physician services and the willingness to choose an health centre (HC) doctor rather than an alternative (i.e. private, occupational healthcare, other doctor) by the working age population in four municipalities in Finland. In a Southern municipality primary health care was contracted out to a non-profit organization whereas Eastern, Western and South-Western municipalities mainly provided services themselves. A mail survey of a random sample of the 15-64-age population was conducted in 2002 (n = 2,000, response rate 62%). Data were analyzed using descriptive statistics as well as bi- and multivariate logistic regression analyses. Of the respondents, 69% had visited an HC doctor during the past year, and of these, more than 40% had also visited another doctor outside the HC. The willingness to choose an HC doctor varied from 40% to 54% and was highest in the Southern municipality. When significantly associated variables - age, working status, perceived stress in life situation, access to an appointment, perceived interpersonal quality, and visits to doctors - were controlled for, the willingness to choose an HC doctor was, compared with the Southern municipality, less popular only in the Western municipality. The tendency to choose an HC doctor rather than an alternative was quite low, probably reflecting lack of attractiveness of HC to patients. However, contracting out service production did not additionally decrease patients' willingness to choose an HC doctor. More attention should be paid to improving access, interpersonal quality and continuity of care.

Implementing Home Health Standards in Clinical Practice.

PubMed

Gorski, Lisa A

2016-02-01

In 1986, the American Nurses Association (ANA) published the first Standards of Home Health Practice. Revised in 1992 and expanded in 1999 to become Home Health Nursing: Scope and Standards of Practice, it was revised in 2008 and again in 2014. In the 2014 edition, there are 6 standards of home healthcare nursing practice and 10 standards of professional performance for home healthcare nursing. The focus of this article is to describe the home healthcare standards and to provide guidance for implementation in clinical practice. It is strongly encouraged that home healthcare administrators, educators, and staff obtain a copy of the standards and fully read this essential home healthcare resource.

Leadership, mental health, and organizational efficacy in health care organizations. Psychosocial predictors of healthy organizational development based on prospective data from four different organizations.

PubMed

Arnetz, Bengt; Blomkvist, Vanja

2007-01-01

Only a few studies of psychosocial determinants of employee health and organizational development have been prospective, involving more than one organization and applying standardized assessment tools. This limits the ability of providing evidence-based guidance as how to carry out healthy organizational transformations. A total of 6,000 employees responded twice to a validated psychosocial-leadership questionnaire within a 2-year period. The assessment focused on changes over time in the three outcome measures - mental health, efficacy, and leadership, determined to be important indicators of a healthy organization. Changes within and between organization were assessed statistically using regular t tests and general linear modeling. There were major differences between organizations in psychosocial measures, both at the baseline and over time. At the organizational level, changes between study periods in management performance feedback, participatory management, and work tempo were the most consistent predictors of improvements over time in the three outcome measures. Performance feedback and participatory management might be two common predictors of healthy workplaces. Some of the psychosocial determinants of healthy organizations suggested in previous research might not be universally valid. It is suggested that future research should to a larger degree make use of multiple departments and organizations in studies of psychosocial determinants of healthy organizations. Copyright 2007 S. Karger AG, Basel.

Improving client-centred care and services: the role of front/back-office configurations.

PubMed

Broekhuis, Manda; de Blok, Carolien; Meijboom, Bert

2009-05-01

This paper is a report of a study conducted to explore the application of designing front- and back-office work resulting in efficient client-centred care in healthcare organizations that supply home care, welfare and domestic services. Front/back-office configurations reflect a neglected domain of design decisions in the development of more client-centred processes and structures without incurring major cost increases. Based on a literature search, a framework of four front/back-office configurations was constructed. To illustrate the usefulness of this framework, a single, longitudinal case study was performed in a large organization, which provides home care, welfare and domestic services for a sustained period (2005-2006). The case study illustrates how front/back-office design decisions are related to the complexity of the clients' demands and the strategic objectives of an organization. The constructed framework guides the practical development of front/back-office designs, and shows how each design contributes differently to such performance objectives as quality, speed and efficiency. The front/back-office configurations presented comprise an important first step in elaborating client-centred care and service provision to the operational level. It helps healthcare organizations to become more responsive and to provide efficient client-centred care and services when approaching demand in a well-tuned manner. In addition to its applicability in home care, we believe that a deliberate front/back-office configuration also has potential in other fields of health care.

Patient safety culture and leadership within Canada's Academic Health Science Centres: towards the development of a collaborative position paper.

PubMed

Nicklin, Wendy; Mass, Heather; Affonso, Dyanne D; O'Connor, Patricia; Ferguson-Paré, Mary; Jeffs, Lianne; Tregunno, Deborah; White, Peggy

2004-03-01

Currently, the Academy of Canadian Executive Nurses (ACEN) is working with the Association of Canadian Academic Healthcare Organizations (ACAHO) to develop a joint position paper on patient safety cultures and leadership within Academic Health Science Centres (AHSCs). Pressures to improve patient safety within our healthcare system are gaining momentum daily. Because AHSCs in Canada are the key organizations that are positioned regionally and nationally, where service delivery is the platform for the education of future healthcare providers, and where the development of new knowledge and innovation through research occurs, leadership for patient safety logically must emanate from them. As a primer, ACEN provides an overview of current patient safety initiatives in AHSCs to date. In addition, the following six key areas for action are identified to ensure that AHSCs continue to be leaders in delivering quality, safe healthcare in Canada. These include: (1) strategic orientation to safety culture and quality improvement, (2) open and transparent disclosure policies, (3) health human resources integral to ensuring patient safety practices, (4) effective linkages between AHSCs and academic institutions, (5) national patient safety accountability initiatives and (6) collaborative team practice.

A new model of collaborative research: experiences from one of Australia's NHMRC Partnership Centres for Better Health.

PubMed

Wutzke, Sonia; Redman, Sally; Bauman, Adrian; Hawe, Penelope; Shiell, Alan; Thackway, Sarah; Wilson, Andrew

2017-02-15

There is often a disconnection between the creation of evidence and its use in policy and practice. Cross-sectoral, multidisciplinary partnership research, founded on shared governance and coproduction, is considered to be one of the most effective means of overcoming this research-policy-practice disconnect. Similar to a number of funding bodies internationally, Australia's National Health and Medical Research Council has introduced Partnership Centres for Better Health: a scheme explicitly designed to encourage coproduced partnership research. In this paper, we describe our experiences of The Australian Prevention Partnership Centre, established in June 2013 to explore the systems, strategies and structures that inform decisions about how to prevent lifestyle-related chronic disease. We present our view on how the Partnership Centre model is working in practice. We comment on the unique features of the Partnership Centre funding model, how these features enable ways of working that are different from both investigator-initiated and commissioned research, and how these ways of working can result in unique outcomes that would otherwise not have been possible. Although not without challenges, the Partnership Centre approach addresses a major gap in the Australian research environment, whereby large-scale, research-policy-practice partnerships are established with sufficient time, resources and flexibility to deliver highly innovative, timely and accessible research that is of use to policy and practice.

The cost effectiveness of integrated care for people living with HIV including antiretroviral treatment in a primary health care centre in Bujumbura, Burundi.

PubMed

Renaud, A; Basenya, O; de Borman, N; Greindl, I; Meyer-Rath, G

2009-11-01

The incremental cost effectiveness of an integrated care package (i.e., medical care including antiretroviral therapy (ART) and other services such as psychological and social support) for people living with HIV/AIDS was calculated in a not-for-profit primary health care centre in Bujumbura run by Society of Women against AIDS-Burundi (SWAA-Burundi), an African non-governmental organisation (NGO). Results are expressed as cost-effectiveness ratio 2007, constant US$ per disability-adjusted life year (DALY) averted. Unit costs are estimated from the NGO's accounting data and activity reports, healthcare utilisation is estimated from the medical records of a cohort of 149 patients. Effectiveness is modelled on the survival of this cohort, using standard calculation methods. The incremental cost of integrated care for people living with HIV/AIDS in the Bujumbura health centre of SWAA-Burundi is 258 USD per DALY averted. The package of care provided by SWAA-Burundi is therefore a very cost-effective intervention in comparison with other interventions against HIV/AIDS that include ART. It is however, less cost effective than other types of interventions against HIV/AIDS, such as preventive activities.

International Organization for Standardization (ISO) 15189.

PubMed

Schneider, Frank; Maurer, Caroline; Friedberg, Richard C

2017-09-01

The College of American Pathologists (CAP) offers a suite of laboratory accreditation programs, including one specific to accreditation to the international organization for standardization (ISO) 15189 standard for quality management specific to medical laboratories. CAP leaders offer an overview of ISO 15189 including its components, internal audits, occurrence management, document control, and risk management. The authors provide a comparison of its own ISO 15189 program, CAP 15189, to the CAP Laboratory Accreditation Program. The authors conclude with why laboratories should use ISO 15189. © The Korean Society for Laboratory Medicine.

75 FR 38112 - Organization, Functions, and Delegations of Authority; Part G; Indian Health Service; Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Organization, Functions, and... Ethics Staff (PIES) (GAL1) (1) Directs the fact-finding and resolution of allegations of impropriety such as mismanagement of resources, fraud, waste, and abuse, violations of the Standards of Ethical...

A qualitative study on barriers in the prevention of anaemia during pregnancy in public health centres: perceptions of Indonesian nurse-midwives.

PubMed

Widyawati, Widyawati; Jans, Suze; Utomo, Sutarti; van Dillen, Jeroen; Janssen, A L M Lagro

2015-02-26

Anemia in pregnancy remains a major problem in Indonesia over the past decade. Early detection of anaemia in pregnancy is one of the components which is unsuccessfully implemented by nurse-midwives. This study aims to explore nurse-midwives' experiences in managing pregnant women with anaemia in Public Health Centres. We conducted a qualitative study with semi-structured face to face interviews from November 2011 to February 2012 with 23 nurse-midwives in five districts in Yogyakarta Special Province. Data analysis was thematic, using the constant comparison method, making comparison between participants and supported by ATLAS.ti software. Twelve nurse-midwives included in the interviews had less than or equal to 10 years' working experience (junior nurse-midwives) and 11 nurse-midwives had more than 10 years' working experience (senior nurse-midwives) in Public Health Centres. The senior nurse-midwives mostly worked as coordinators in Public Health Centres. Three main themes emerged: 1) the lack of competence and clinical skill; 2) cultural beliefs and low participation of family in antenatal care programme; 3) insufficient facilities and skilled support staff in Public Health Centres. The nurse-midwives realized that they need to improve their communication and clinical skills to manage pregnant women with anaemia. The husband and family involvement in antenatal care was constrained by the strength of cultural beliefs and lack of health information. Moreover, unfavourable work environment of the Public Health Centres made it difficult to apply antenatal care the pregnant womens' need. The availability of facilities and skilled staffs in Public Health Centre as well as pregnant women's husbands or family members contribute to the success of managing anaemia in pregnancy. Nurse-midwives and pregnant women need to be empowered to achieve the optimum result of anaemia management. We recommend a more comprehensive approach in managing pregnant women with anaemia

Risk analysis and its link with standards of the World Organisation for Animal Health.

PubMed

Sugiura, K; Murray, N

2011-04-01

Among the agreements included in the treaty that created the World Trade Organization (WTO) in January 1995 is the Agreement on the Application of Sanitary and Phytosanitary Measures (SPS Agreement) that sets out the basic rules for food safety and animal and plant health standards. The SPS Agreement designates the World Organisation for Animal Health (OIE) as the organisation responsible for developing international standards for animal health and zoonoses. The SPS Agreement requires that the sanitary measures that WTO members apply should be based on science and encourages them to either apply measures based on the OIE standards or, if they choose to adopt a higher level of protection than that provided by these standards, apply measures based on a science-based risk assessment. The OIE also provides a procedural framework for risk analysis for its Member Countries to use. Despite the inevitable challenges that arise in carrying out a risk analysis of the international trade in animals and animal products, the OIE risk analysis framework provides a structured approach that facilitates the identification, assessment, management and communication of these risks.

Complex organic molecules in the Galactic Centre: the N-bearing family

NASA Astrophysics Data System (ADS)

Zeng, S.; Jiménez-Serra, I.; Rivilla, V. M.; Martín, S.; Martín-Pintado, J.; Requena-Torres, M. A.; Armijos-Abendaño, J.; Riquelme, D.; Aladro, R.

2018-05-01

We present an unbiased spectral line survey toward the Galactic Centre (GC) quiescent giant molecular cloud (QGMC), G+0.693 using the GBT and IRAM 30 telescopes. Our study highlights an extremely rich organic inventory of abundant amounts of nitrogen (N)-bearing species in a source without signatures of star formation. We report the detection of 17 N-bearing species in this source, of which 8 are complex organic molecules (COMs). A comparison of the derived abundances relative to H2 is made across various galactic and extragalactic environments. We conclude that the unique chemistry in this source is likely to be dominated by low-velocity shocks with X-rays/cosmic rays also playing an important role in the chemistry. Like previous findings obtained for O-bearing molecules, our results for N-bearing species suggest a more efficient hydrogenation of these species on dust grains in G+0.693 than in hot cores in the Galactic disk, as a consequence of the low dust temperatures coupled with energetic processing by X-ray/cosmic ray radiation in the GC.

The use of ephemera with particular reference to blood and organ donation: a review of sources.

PubMed

Rose, G M

1994-06-01

Emphasis has been placed upon a study of the use made of ephemera such as leaflets, pamphlets and booklets by non-professional staff working in British statutory organizations such as health authorities, community health councils and family health services authorities as well as voluntary organizations such as charities, citizens' advice bureaux and patient participation groups. Publicity methods and the use made of ephemeral materials by those statutory and voluntary organizations involved in recruiting and retaining blood and organ donors is highlighted. Research findings confirm that patients, carers and others, wish to receive comprehendable and appropriate health information. Ephemera provided in support of this need are not comprehensive in subject coverage and lack any standardization of format. In particular, great care needs to be taken with the design of leaflets, pamphlets and booklets. Ephemeral materials are difficult to locate and obtain, and no bibliographical centre exists to coordinate and support existing activity by identifying, acquiring, storing, advertising and distributing such health care material. Marketing and publicity skills, and much time and effort are required to rectify this deficiency, and thus to satisfy the needs of consumers.

Detainees, staff, and health care services in immigration detention centres: a descriptive comparison of detention systems in Sweden and in the Benelux countries.

PubMed

Puthoopparambil, Soorej J; Bjerneld, Magdalena

2016-01-01

Immigration detention has been shown to negatively affect the health and well-being of detainees. The aim of the study was to describe and compare policies and practices that could affect the health and well-being of immigrant detainees in the Benelux countries (Belgium, the Netherlands, and Luxembourg) to those in Sweden. This was a case study. Data were collected in two phases using a questionnaire developed particularly for this study. In the first phase, authorities in the Benelux countries responded to the questionnaire via email. During the second phase, a research team visited detention centres in the Benelux countries to observe and further explore, strengthening findings through triangulation. Data on Swedish detention centres were collected in previous studies. Compared to the Benelux countries, Sweden has limited health care provision available in the detention centres. Swedish detention centres did not have mental health care professionals working at the centres and had fewer restrictions within the centres with regard to access to mobile phone, internet, and various recreational activities. Compared to Sweden, the detention centres in the Benelux countries have more staff categories providing services to the detainees that are provided with relevant and timely on-the-job training. All the countries, except Belgium, provide subsistence allowances to detainees. Despite the Common European Asylum System framework, differences exist among the four European Union member states in providing services to immigrant detainees. This study highlights these differences, thereby providing a window on how these diverse approaches may serve as a learning tool for improving services offered to immigrant detainees. In Sweden, the health care available to detainees and training and recruitment of staff should be improved, while the Benelux countries should strive to reduce restrictions within detention centres.

Standards for Health Sciences Libraries.

ERIC Educational Resources Information Center

Stinson, E. Ray

1982-01-01

Discusses service standards (level of excellence or adequacy in performance of library service) and their incorporation in the accreditation process for hospital library service and academic health sciences libraries. The certification program developed for health sciences librarians by the Medical Library Association is reviewed. Fifty-nine…

A prospective health impact assessment of the international astronomy and space exploration centre.

PubMed

Winters, L Y

2001-06-01

Assess the potential health impacts of the proposed International Astronomy and Space Exploration Centre on the population of New Wallasey. Contribute to the piloting of health impact assessment methods. Prospective health impact assessment involving brainstorming sessions and individual interviews with key informants and a literature review. New Wallasey Single Regeneration Budget 4 area. Key stakeholders including local residents' groups selected through purposeful snowball sampling. Recommendations are made that cover issues around: transport and traffic; civic design; security; public safety, employment and training. Health impact assessment is a useful pragmatic tool for facilitating wide consultation. In particular engaging the local population in the early planning stages of a proposed development, and assisting in highlighting changes to maximise the positive health influences on affected communities.

Headache service quality: evaluation of quality indicators in 14 specialist-care centres.

PubMed

Schramm, Sara; Uluduz, Derya; Gouveia, Raquel Gil; Jensen, Rigmor; Siva, Aksel; Uygunoglu, Ugur; Gvantsa, Giorgadze; Mania, Maka; Braschinsky, Mark; Filatova, Elena; Latysheva, Nina; Osipova, Vera; Skorobogatykh, Kirill; Azimova, Julia; Straube, Andreas; Eren, Ozan Emre; Martelletti, Paolo; De Angelis, Valerio; Negro, Andrea; Linde, Mattias; Hagen, Knut; Radojicic, Aleksandra; Zidverc-Trajkovic, Jasna; Podgorac, Ana; Paemeleire, Koen; De Pue, Annelien; Lampl, Christian; Steiner, Timothy J; Katsarava, Zaza

2016-12-01

The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients. Enquiries were in 9 domains: diagnostic accuracy, individualized management, referral pathways, patient's education and reassurance, convenience and comfort, patient's satisfaction, equity and efficiency of the headache care, outcome assessment and safety. Our study showed that highly experienced headache centres treated their patients in general very well. The centres were content with their work and their patients were content with their treatment. Including disability and quality-of-life evaluations in clinical assessments, and protocols regarding safety, proved problematic: better standards for these are needed. Some centres had problems with follow-up: many specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends, producing evidence of what is majority practice. They also uncovered deficits that might be remedied in order to improve quality. They offer the means of setting benchmarks against which service quality may be judged. The next step is to take the evaluation process into non-specialist care (EHF/LTB levels 1 and 2).

40 CFR 63.686 - Standards: Oil-water and organic-water separators.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 10 2011-07-01 2011-07-01 false Standards: Oil-water and organic-water... Operations § 63.686 Standards: Oil-water and organic-water separators. (a) The provisions of this section apply to the control of air emissions from oil-water separators and organic-water separators for which...

40 CFR 63.686 - Standards: Oil-water and organic-water separators.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Standards: Oil-water and organic-water... Operations § 63.686 Standards: Oil-water and organic-water separators. (a) The provisions of this section apply to the control of air emissions from oil-water separators and organic-water separators for which...

40 CFR 63.686 - Standards: Oil-water and organic-water separators.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 11 2014-07-01 2014-07-01 false Standards: Oil-water and organic-water... Operations § 63.686 Standards: Oil-water and organic-water separators. (a) The provisions of this section apply to the control of air emissions from oil-water separators and organic-water separators for which...

40 CFR 63.686 - Standards: Oil-water and organic-water separators.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 11 2012-07-01 2012-07-01 false Standards: Oil-water and organic-water... Operations § 63.686 Standards: Oil-water and organic-water separators. (a) The provisions of this section apply to the control of air emissions from oil-water separators and organic-water separators for which...

40 CFR 63.686 - Standards: Oil-water and organic-water separators.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 11 2013-07-01 2013-07-01 false Standards: Oil-water and organic-water... Operations § 63.686 Standards: Oil-water and organic-water separators. (a) The provisions of this section apply to the control of air emissions from oil-water separators and organic-water separators for which...

A One Health Evaluation of the Southern African Centre for Infectious Disease Surveillance

PubMed Central

Hanin, Marie C. E.; Queenan, Kevin; Savic, Sara; Karimuribo, Esron; Rüegg, Simon R.; Häsler, Barbara

2018-01-01

Rooted in the recognition that emerging infectious diseases occur at the interface of human, animal, and ecosystem health, the Southern African Centre for Infectious Disease Surveillance (SACIDS) initiative aims to promote a trans-sectoral approach to address better infectious disease risk management in five countries of the Southern African Development Community. Nine years after SACIDS’ inception, this study aimed to evaluate the program by applying a One Health (OH) evaluation framework developed by the Network for Evaluation of One Health (NEOH). The evaluation included a description of the context and the initiative, illustration of the theory of change, identification of outputs and outcomes, and assessment of the One Healthness. The latter is the sum of characteristics that defines an integrated approach and includes OH thinking, OH planning, OH working, sharing infrastructure, learning infrastructure, and systemic organization. The protocols made available by NEOH were used to develop data collection protocols and identify the study design. The framework relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative evaluation (scoring). Data for the analysis were gathered during a document review, in group and individual interviews and in an online survey. Operational aspects (i.e., OH thinking, planning, and working) were found to be balanced overall with the highest score in the planning dimension, whereas the infrastructure (learning infrastructure, systemic organization, and sharing infrastructure) was high for the first two dimensions, but low for sharing. The OH index calculated was 0.359, and the OH ratio calculated was 1.495. The program was praised for its great innovative energy in a difficult landscape dominated by poor infrastructure and its ability to create awareness for OH and enthuse people for the concept; training of people and networking. Shortcomings were identified regarding the

Typology of birth centres in the Netherlands using the Rainbow model of integrated care: results of the Dutch Birth Centre Study.

PubMed

Boesveld, Inge C; Bruijnzeels, Marc A; Hitzert, Marit; Hermus, Marieke A A; van der Pal-de Bruin, Karin M; van den Akker-van Marle, M E; Steegers, Eric A P; Franx, Arie; de Vries, Raymond G; Wiegers, Therese A

2017-06-21

The goal of integrated care is to offer a continuum of care that crosses the boundaries of public health, primary, secondary, and tertiary care. Integrated care is increasingly promoted for people with complex needs and has also recently been promoted in maternity care systems to improve the quality of care. Especially when located near an obstetric unit, birth centres are considered to be ideal settings for the realization of integrated care. At present, however, we know very little about the degree of integration in these centres and we do not know if increased levels of integration improve the quality of the care delivered. The Dutch Birth Centre Study is designed to evaluate birth centres and their contribution to the Dutch maternity care system. The aim of this particular sub-study is to classify birth centres in clusters with similar characteristics based on integration profiles, to support the evaluation of birth centre care. This study is based on the Rainbow Model of Integrated Care. We used a survey followed by qualitative interviews in 23 birth centres in the Netherlands to determine which integration profiles can be distinguished and to describe their discriminating characteristics. Cluster analysis was used to classify the birth centres. Birth centres were classified into three clusters: 1)"Mono-disciplinary-oriented birth centres" (n = 10): which are mainly owned by primary care organizations and established as physical facilities to provide an alternative birthplace for low risk births; 2) "Multi-disciplinary-oriented birth centres" (n = 6): which are mainly multi-disciplinary oriented and can be regarded as facilities to give birth, with a focus on integrated birth care; 3) "Mixed Cluster of birth centres" (n = 7): which have a range of organizational forms that differentiate them from centres in the other clusters. We identified a recognizable classification, with similar characteristics between birth centres in the clusters. The results of

Family-centred care for hospitalised children aged 0-12 years.

PubMed

Shields, Linda; Zhou, Huaqiong; Pratt, Jan; Taylor, Marjory; Hunter, Judith; Pascoe, Elaine

2012-10-17

This is an update of the Cochrane systematic review of family-centred care published in 2007 (Shields 2007). Family-centred care (FCC) is a widely used model in paediatrics, is thought to be the best way to provide care to children in hospital and is ubiquitous as a way of delivering care. When a child is admitted, the whole family is affected. In giving care, nurses, doctors and others must consider the impact of the child's admission on all family members. However, the effectiveness of family-centred care as a model of care has not been measured systematically. To assess the effects of family-centred models of care for hospitalised children aged from birth (unlike the previous version of the review, this update excludes premature neonates) to 12 years, when compared to standard models of care, on child, family and health service outcomes. In the original review, we searched up until 2004. For this update, we searched: the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library, Issue 12 2011); MEDLINE (Ovid SP); EMBASE (Ovid SP); PsycINFO (Ovid SP); CINAHL (EBSCO Host); and Sociological Abstracts (CSA). We did not search three that were included in the original review: Social Work Abstracts, the Australian Medical Index and ERIC. We searched EMBASE in this update only and searched from 2004 onwards. There was no limitation by language. We performed literature searches in May and June 2009 and updated them again in December 2011. We searched for randomised controlled trials (RCTs) including cluster randomised trials in which family-centred care models are compared with standard models of care for hospitalised children (0 to 12 years, but excluding premature neonates). Studies had to meet criteria for family-centredness. In order to assess the degree of family-centredness, we used a modified rating scale based on a validated instrument, (same instrument used in the initial review), however, we decreased the family-centredness score for

The health care system is making 'too much noise' to provide family-centred care in neonatal intensive care units: Perspectives of health care providers and hospital administrators.

PubMed

Benzies, Karen M; Shah, Vibhuti; Aziz, Khalid; Lodha, Abhay; Misfeldt, Renée

2018-05-11

To describe the perspectives of health care providers and hospital administrators on their experiences of providing care for infants in Level II neonatal intensive care units and their families. We conducted 36 qualitative interviews with neonatal health care providers and hospital administrators and analysed data using a descriptive interpretive approach. 10 Level II Neonatal Intensive Care Units in a single, integrated health care system in one Canadian province. Three major themes emerged: (1) providing family-centred care, (2) working amidst health care system challenges, and (3) recommending improvements to the health care system. The overarching theme was that the health care system was making 'too much noise' for health care providers and hospital administrators to provide family-centred care in ways that would benefit infants and their families. Recommended improvements included: refining staffing models, enhancing professional development, providing tools to deliver consistent care, recognising parental capacity to be involved in care, strengthening continuity of care, supporting families to be with their infant, and designing family-friendly environments. When implementing family-centred care initiatives, health care providers and hospital administrators need to consider the complexity of providing care in Level II Neonatal Intensive Care Units, and recognise that health care system changes may be necessary to optimise implementation. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Asthma prevalence estimated using a standard algorithm based on electronic health data in various areas of Italy].

PubMed

Tessari, Roberta; Migliore, Enrica; Balzi, Daniela; Barchielli, Alessandro; Canova, Cristina; Faustini, Annunziata; Galassi, Claudia; Simonato, Lorenzo

2008-01-01

development of an algorithm to estimate asthma prevalence by record linkage of different health databases: causes of death (CM), hospital discharges (SDO), drug prescriptions archive (PF), health tax exemptions (ET) in three Italian areas. Venezia AULSS 12, city of Torino, Firenze ASL 10. residents aged between 0 and 34 years in the above three centres in the three year period 2002-2004, for a total of 661,275 inhabitants on 30 June 2003. annual crude and standardized prevalence (per 100 inhabitants) with 95% confidence intervals by gender and age groups (0-14, 15-34, total: 0-34 years). for each year of interest, we selected the following: cases with asthma as primary cause of death from CM; all persons discharged from hospitals with diagnosis (primary or secondary) of asthma (ICD9-CM code = 493*); selected prescriptions of anti-asthma drugs (ATC code = R03A, R03CC02, R03CC04, R03CK, R03DC01, R03DC03), and health-tax exemptions for asthma (code = 007.493) from ET. We defined as prevalent case a subject who was present every single year in at least one of four health databases. We reported the absolute and relative contribution of each information system by area, age, gender and year of interest. A sensitivity analysis using more restrictive criteria to identify prevalent cases (two or more prescriptions per year) was also performed. the PF archive is the most important information source in identifying prevalent cases (from 92.5% of Torino to 95.4% of Firenze). The standardized prevalence of asthma in 0-34 years of age is higher in Venezia (6.37%; 2003 year) than in the other two areas, which show similar values (4.01% in Firenze, 3.77% in Torino; 2003 year). In both genders, the standardized prevalence of asthma is, for all centers, clearly higher in the 0-14 age group than in the 15-34 age group. However, Venezia has a prevalence almost twice (11.21%) that of Firenze (6.20%) and Torino (5.60%) in the 0-14years age group. The use of more restrictive criteria in

The UK Haemophilia Doctors Organisation triennial audit of UK Comprehensive Care Haemophilia Centres.

PubMed

Wilde, J T

2012-07-01

Under the auspices of the United Kingdom Haemophilia Doctors Organisation (UKHCDO) the UK Comprehensive Care Haemophilia Centres (CCCs) have undergone a three yearly formal audit assessment since 1993. This report describes the evolution of the audit process and details the findings of the most recent audit round, the sixth since inception. The audit reports from the 2009 audit round were reviewed by the audit organizing group and a structured analysis of the data was compiled. CCCs in the UK offer a high standard of comprehensive care services. The main areas of concern were the state of the premises (seven centres), lack of dental services (seven centres), physiotherapy (seven centres) and social work support (11 centres). Major concerns were identified at eight centres requiring a formal letter from the chairman of UKHCDO to the chief executive of the host trust. Since inception of the triennial audit process centre report recommendations have resulted in major improvements in the services available at UK CCCs. The audit process is considered to be a highly effective means of improving the quality of care for patients with bleeding disorders and can be used as a model for the introduction of a similar process in other countries. © 2012 Blackwell Publishing Ltd.

Relationship between person-organization fit and objective and subjective health status (person-organization fit and health).

PubMed

Merecz, Dorota; Andysz, Aleksandra

2012-06-01

[corrected] Person-Environment fit (P-E fit) paradigm, seems to be especially useful in explaining phenomena related to work attitudes and occupational health. The study explores the relationship between a specific facet of P-E fit as Person-Organization fit (P-O fit) and health. Research was conducted on the random sample of 600 employees. Person-Organization Fit Questionnaire was used to asses the level of Person-Organization fit; mental health status was measured by General Health Questionnaire (GHQ-28); and items from Work Ability Index allowed for evaluation of somatic health. Data was analyzed using non parametric statistical tests. The predictive value of P-O fit for various aspects of health was checked by means of linear regression models. A comparison between the groups distinguished on the basis of their somatic and mental health indicators showed significant differences in the level of overall P-O fit (χ(2) = 23.178; p < 0.001) and its subdimensions: for complementary fit (χ(2) = 29.272; p < 0.001), supplementary fit (χ(2) = 23.059; p < 0.001), and identification with organization (χ(2) = 8.688; p = 0.034). From the perspective of mental health, supplementary P-O fit seems to be important for men's well-being and explains almost 9% of variance in GHQ-28 scores, while in women, complementary fit (5% explained variance in women's GHQ score) and identification with organization (1% explained variance in GHQ score) are significant predictors of mental well-being. Interestingly, better supplementary and complementary fit are related to better mental health, but stronger identification with organization in women produces adverse effect on their mental health. The results show that obtaining the optimal level of P-O fit can be beneficial not only for the organization (e.g. lower turnover, better work effectiveness and commitment), but also for the employees themselves. Optimal level of P-O fit can be considered as a factor maintaining workers' health

The Case for Information Brokering During Major Change: The Experience of the Transition Support Office of the McGill University Health Centre.

PubMed

Klag, Malvina; Richer, Marie-Claire

2016-01-01

This paper describes the emergence of an "information brokerage" in the project management office of the McGill University Health Centre (MUHC) in Montreal. This process evolved during unprecedented transformation linked to a redevelopment project. Information brokering became a core function in the MUHC's context of major change. To develop an information brokering model, the paper draws upon the literature on knowledge brokering, applies Daft and Lengel's (1986) seminal framework on information processing in organizations, and builds on the MUHC experience. The paper proposes that knowledge brokering and information brokering are related, yet distinct in content, purpose and structure.

5 CFR 890.202 - Minimum standards for health benefits carriers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Minimum standards for health benefits... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.202 Minimum standards for health benefits carriers. The minimum standards for health benefits carriers for the...

5 CFR 890.202 - Minimum standards for health benefits carriers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Minimum standards for health benefits... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.202 Minimum standards for health benefits carriers. The minimum standards for health benefits carriers for the...

77 FR 52679 - Notice of Meeting of the National Organic Standards Board

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... the organic program. The subcommittees are: Compliance, Accreditation, and Certification; Crops...-12] Notice of Meeting of the National Organic Standards Board AGENCY: Agricultural Marketing Service... the National Organic Standards Board (NOSB). Written public comments are invited in advance of the...

Centres for Leadership: a strategy for academic integration.

PubMed

King, Gillian; Parker, Kathryn; Peacocke, Sean; Curran, C J; McPherson, Amy C; Chau, Tom; Widgett, Elaine; Fehlings, Darcy; Milo-Manson, Golda

2017-05-15

Purpose The purpose of this paper is to describe how an Academic Health Science Centre, providing pediatric rehabilitation services, research, and education, developed a Centres for Leadership (CfL) initiative to integrate its academic functions and embrace the goal of being a learning organization. Design/methodology/approach Historical documents, tracked output information, and staff members' insights were used to describe the ten-year evolution of the initiative, its benefits, and transformational learnings for the organization. Findings The evolutions concerned development of a series of CfLs, and changes over time in leadership and management structure, as well as in operations and targeted activities. Benefits included enhanced clinician engagement in research, practice-based research, and impacts on clinical practice. Transformational learnings concerned the importance of supporting stakeholder engagement, fostering a spirit of inquiry, and fostering leaderful practice. These learnings contributed to three related emergent outcomes reflecting "way stations" on the journey to enhanced evidence-informed decision making and clinical excellence: enhancements in authentic partnerships, greater innovation capacity, and greater understanding and actualization of leadership values. Practical implications Practical information is provided for other organizations interested in understanding how this initiative evolved, its tangible value, and its wider benefits for organizational collaboration, innovation, and leadership values. Challenges encountered and main messages for other organizations are also considered. Originality/value A strategy map is used to present the structures, processes, and outcomes arising from the initiative, with the goal of informing the operations of other organizations desiring to be learning organizations.

Is the Australian 75+ Health Assessment person-centred? A qualitative descriptive study of older people's perceptions.

PubMed

Price, Kay; Grimmer, Karen; Foot, Jan

2017-12-01

Objective The aim of the present study was to explore the perspectives of older people following their recent participation in a 75+ Health Assessment (75+HA) and interrogate these perspectives using a person-centred lens. Methods A qualitative descriptive study design was used within a larger study funded by the Australian Primary Health Care Research Institute. Nineteen participants from four different general practices in one Australian state described their perceptions of the 75+HA in a face-to-face interview. Data were then analysed using a qualitative content analysis approach. Results The purpose of the 75+HA was not well understood by participants. Participant responses reveal that where, when, who and how a primary health professional conducted the 75+HA affected what older people talked about, the guidance they sought to deal with issues and, in turn, the actioning of issues that were discussed during the 75+HA. Conclusion To enable older people to make informed decisions about and successfully manage their own health and well being, and to choose when to invite others to act on their behalf, primary health professionals need to ask questions in the 75+HA within a person-centred mindset. The 75+HA is an opportunity to ensure older people know why they need support, which ones, and agree to, supports and services they require. What is known about the topic? The Australian Medicare Benefits Schedule includes the 75+HA, developed as a proactive primary care opportunity for general practitioners and practice nurses to identify issues affecting community-dwelling older people's health and well being. The aim of the 75+HA is to consider a broad range of factors that could affect physical, psychological and social functioning, which, in turn, affects overall health, and the capacity of older people to live independently in the community. Underlying the 75+HA is the importance of detecting early functional decline to enable healthy aging. What does this paper add

The illusion of client-centred practice.

PubMed

Gupta, Jyothi; Taff, Steven D

2015-07-01

A critical analysis of occupational therapy practice in the corporate health care culture in a free market economy was undertaken to demonstrate incongruence with the profession's philosophical basis and espoused commitment to client-centred practice. The current practice of occupational therapy in the reimbursement-driven practice arena in the United States is incongruent with the profession's espoused philosophy and values of client-centred practice. Occupational therapy differentiates itself from medicine's expert model aimed at curing disease and remediating impairment, by its claim to client-centred practice focused on restoring health through occupational enablement. Practice focused on impairment and function is at odds with the profession's core tenet, occupation, and minimizes the lasting impact of interventions on health and well-being. The profession cannot unleash the therapeutic power of human occupation in settings where body systems and body functions are not occupation-ready at the requisite levels for occupational participation. Client-centred practice is best embodied by occupation-focused interventions in the natural environment of everyday living. Providing services that are impairment-focused in unfamiliar settings is not a good fit for client-centred practice, which is the unique, authentic, and sustainable orientation for the profession.

78 FR 11137 - Notice of Meeting of the National Organic Standards Board (NOSB)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-15

...-17] Notice of Meeting of the National Organic Standards Board (NOSB) AGENCY: Agricultural Marketing... meeting of the National Organic Standards Board (NOSB). Written public comments are invited in advance of... information, write to Ms. Michelle Arsenault, Special Assistant, National Organic Standards Board, USDA-AMS...

Redesign of a health science centre: reflections on co-leadership.

PubMed

MacTavish, M; Norton, P

1995-01-01

Since 1988, the Sunnybrook Health Science Centre has been proactive in re-designing its system toward decentralized management, the purpose being to further enhance patient care. This process has involved numerous changes, among which were the establishment of three large clinical units. These clinical units are not defined following the historic medical model, but group patients with similar service and care needs. Subsequently, each of the clinical units defined Patient Service Units (PSUs). The hospital has chosen a co-leadership model for the lead management at each of the unit levels. This paper describes the model for clinical units.

Educational inequalities in patient-centred care: patients' preferences and experiences

PubMed Central

2012-01-01

Background Educational attainment is strongly related to specific health outcomes. The pathway in which individual patient-provider interactions contribute to (re)producing these inequalities has yet to be studied. In this article, the focus is on differences between less and more highly educated patients in their preferences for and experiences with patient-centred care., e.g. shared decision making, receiving understandable explanations and being able to ask questions. Methods Data are derived from several Consumer Quality-index (CQ-index) studies. The CQ-index is a family of standardized instruments which are used in the Netherlands to measure quality of care from the patient’s perspective. Results The educational level of patients is directly related to the degree of importance patients attribute to specific aspects of patient-centred care. It has a minor influence on the experienced level of shared decision making, but not on experiences regarding other aspects of patient-centred care. Conclusions All patients regard patient-centred care as important and report positive experiences. However, there is a discrepancy between patient preferences for patient-centred care on one hand and the care received on the other. Less educated patients might receive ‘too much’, and more highly educated patients ‘too little’ in the domains of communication, information and shared decision making. PMID:22900589

[Storage and transport of isolated M. tuberculosis at public and private health institutions in Japan].

PubMed

Ohkado, Akihiro; Takahashi, Chieko; Horiba, Masahide; Murase, Yoshiro; Mitarai, Satoshi

2008-08-01

To obtain basic data about the present practices on storage and transport of isolated M. tuberculosis at public and private health institutions in Japan. Survey forms regarding the practices on storage and transport of isolated M. tuberculosis were distributed and collected by post-mail in January 2007 to 76 local public health institutions, 145 public health centres, and 150 public or private hospitals. The questionnaire was adopted from the guidelines proposed by the Ministry of Health, Labour, and Welfare in 2006 on storage and transport of isolated M. tuberculosis. The respondents of the survey were as follows: 96.1% (73/76) from local public health institutions, 93.8% (136/145) from public health centres, and 73.3% (110/150) from hospitals. In general, local public health institutions conformed well to the proposed standards, however public health centres and hospitals were not compliant to some standards. Based on the survey conducted on the practice of storage and transport of isolated M. tuberculosis, certain discrepancy was found among public health centres and hospitals.

A prospective health impact assessment of the international astronomy and space exploration centre

PubMed Central

Winters, L

2001-01-01

STUDY OBJECTIVES—Assess the potential health impacts of the proposed International Astronomy and Space Exploration Centre on the population of New Wallasey. Contribute to the piloting of health impact assessment methods.
DESIGN—Prospective health impact assessment involving brainstorming sessions and individual interviews with key informants and a literature review.
SETTING—New Wallasey Single Regeneration Budget 4 area.
PARTICIPANTS—Key stakeholders including local residents' groups selected through purposeful snowball sampling.
MAIN RESULTS—Recommendations are made that cover issues around: transport and traffic; civic design; security; public safety, employment and training.
CONCLUSIONS—Health impact assessment is a useful pragmatic tool for facilitating wide consultation. In particular engaging the local population in the early planning stages of a proposed development, and assisting in highlighting changes to maximise the positive health influences on affected communities.


Keywords: health impact assessment; health determinants PMID:11351002

Interoperable and standard e-Health solution over Bluetooth.

PubMed

Martinez, I; Del Valle, P; Munoz, P; Trigo, J D; Escayola, J; Martínez-Espronceda, M; Muñoz, A; Serrano, L; Garcia, J

2010-01-01

The new paradigm of e-Health demands open sensors and middleware components that permit transparent integration and end-to-end interoperability of new personal health devices. The use of standards seems to be the internationally adopted way to solve these problems. This paper presents the implementation of an end-to-end standards-based e-Health solution. This includes ISO/IEEE11073 standard for the interoperability of the medical devices in the patient environment and EN13606 standard for the interoperable exchange of the Electronic Healthcare Record. The design strictly fulfills all the technical features of the most recent versions of both standards. The implemented prototype has been tested in a laboratory environment to demonstrate its feasibility for its further transfer to the healthcare system.

Addiction research centres and the nurturing of creativity. Monitoring the European drug situation: the ongoing challenge for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

PubMed

Griffiths, Paul; Mounteney, Jane; Lopez, Dominique; Zobel, Frank; Götz, Wolfgang

2012-02-01

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the designated hub for drug-related information in the European Union. The organization's role is to provide the European Union (EU) and its Member States with a factual overview of European drug problems and a common information framework to support the drugs debate. In order to achieve its mission, the EMCDDA coordinates and relies on a network of 30 national monitoring centres, the Reitox National Focal Points. The Centre publishes on a wide range of drug-related topics, across epidemiology, interventions, laws and policies. Every November, the EMCDDA publishes its Annual Report, providing a yearly update on the European drug situation, translated into 23 EU languages. In line with its founding regulation, the EMCDDA has a role acting as an interface between the worlds of science and policy. While not a research centre in the formal sense, the results the Centre generates serve as catalysts for new research questions and help to identify priorities. Current challenges facing the agency include continuing to increase scientific standards while maintaining a strong institutional role, as well as supporting European efforts to identify, share and codify best practice in the drugs field. © 2011 EMCDDA.

Determinants of Physicians' Intention to Collect Data Exhaustively in Registries: an Exploratory Study in Bamako's Community Health Centres.

PubMed

Ly, B A; Gagnon, M-P; Légaré, F; Rousseau, M; Simonyan, D

2015-06-01

The incomplete collection of health data is a prevalent problem in healthcare systems around the world, especially in developing countries. Missing data hinders progress in population health and perpetuates inefficiencies in healthcare systems. This study aims to identify the factors that predict the intention of physicians practicing in community health centres of Bamako, Mali, to collect data exhaustively in medical registries. A cross sectional study. In January and February 2011, we conducted a study with a random sample of thirty two physicians practicing in community health centres of Bamako, using a questionnaire. Data was analyzed by using descriptive statistics, correlations and linear regression. Trained investigators administered a questionnaire measuring physicians' sociodemographic and professional characteristics as well as constructs from the Theory of Planned Behaviour. Our results showed that physicians' intention to collect data exhaustively is influenced by subjective norms and by the physician's number of years in practice. the results of this study could be used as a guide for health workers and decision makers to improve the quality of health information collected in community health centers.

Human Centred Design Considerations for Connected Health Devices for the Older Adult

PubMed Central

Harte, Richard P.; Glynn, Liam G.; Broderick, Barry J.; Rodriguez-Molinero, Alejandro; Baker, Paul M. A.; McGuiness, Bernadette; O’Sullivan, Leonard; Diaz, Marta; Quinlan, Leo R.; ÓLaighin, Gearóid

2014-01-01

Connected health devices are generally designed for unsupervised use, by non-healthcare professionals, facilitating independent control of the individuals own healthcare. Older adults are major users of such devices and are a population significantly increasing in size. This group presents challenges due to the wide spectrum of capabilities and attitudes towards technology. The fit between capabilities of the user and demands of the device can be optimised in a process called Human Centred Design. Here we review examples of some connected health devices chosen by random selection, assess older adult known capabilities and attitudes and finally make analytical recommendations for design approaches and design specifications. PMID:25563225

Mental ill-health among adult patients at healthcare centres in Sweden: district nurses experiences.

PubMed

Janlöv, Ann-Christin; Johansson, Linda; Clausson, Eva K

2017-11-13

Mental ill-health among the general population is increasing in Sweden. Primary Health Care (PHC) and Healthcare Centres (HCC), where district nurses (DNs) work, bear the basic responsibility for treatment of mental ill-health, while severe mental ill-health fall under the responsibility of psychiatric specialist care. The increased prevalence of mental ill-health in the community means that DNs increasingly encounter people with mental health problems - not least as a comorbidity. How well DNs are equipped to deal with mental ill-health is currently unclear. The purpose of this study was to explore district nurses' experience of encountering and dealing with mental ill-health among adult patients at healthcare centres. A qualitative explorative approach was used to capture the experiences of the phenomena under study. Individual interviews were conducted with 10 DNs working at six HCCs. The interviews were transcribed and analysed by qualitative content analysis. The result emerged as several subcategories captured by three categories: (i) having competence - a prerequisite for feeling confident; (ii) nursing mental ill-health requires time and commitment; and (iii) working in an organisation without preparedness, encompassed by the synthesising theme; nursing mental ill-health requires specific competence and organisational support. Working as a DN requires formal and informal competence when encountering patients with complex health needs. The findings revealed that the DNs could feel insecure regarding how to deal with patients with mental ill-health due to lack of knowledge. Assessment of patients with mental ill-health is time- and energy-consuming and calls for improved teamwork at HCCs as well as effective collaboration with psychiatric specialist care and other care givers. The DNs responsibility to fulfil their work considering the increasing number of mental ill-health among people that seeks help at HCCs needs to be acknowledged and met by the PHC

Cooperative Working towards Family-Centred Health Education in Acute Care: Improvement in Client Satisfaction

ERIC Educational Resources Information Center

Bastani, Farideh; Golaghaie, Farzaneh; Farahani, Mansoureh A.; Rafeie, Mohammad

2014-01-01

Objective: To establish family-centred health education for patients in a neurosurgery unit and to evaluate its impact on patients' and families' satisfaction. Design: Cooperative participatory research through which a group of clinical nurses and an academic researcher engaged in cycles of action and reflection. Setting: The study was conducted…

Organ donation and transplantation in Canada: insights from the Canadian Organ Replacement Register.

PubMed

Kim, Sang Joseph; Fenton, Stanley Sa; Kappel, Joanne; Moist, Louise M; Klarenbach, Scott W; Samuel, Susan M; Singer, Lianne G; Kim, Daniel H; Young, Kimberly; Webster, Greg; Wu, Juliana; Ivis, Frank; de Sa, Eric; Gill, John S

2014-01-01

To provide an overview of the transplant component of the Canadian Organ Replacement Register (CORR). CORR is the national registry of organ failure in Canada. It has existed in some form since 1972 and currently houses data on patients with end-stage renal disease and solid organ transplants (kidney and/or non-kidney). The transplant component of CORR receives data on a voluntary basis from individual transplant centres and organ procurement organizations across the country. Coverage for transplant procedures is comprehensive and complete. Long-term outcomes are tracked based on follow-up reports from participating transplant centres. The longitudinal nature of CORR provides an opportunity to observe the trajectory of a patient's journey with organ failure over their life span. Research studies conducted using CORR data inform both practitioners and health policy makers alike. The importance of registry data in monitoring and improving care for Canadian transplant candidates/recipients cannot be over-stated. This paper provides an overview of the transplant data in CORR including its history, data considerations, recent findings, new initiatives, and future directions.

Prevention and control of carbapenemase-producing organisms at a regional burns centre.

PubMed

Teare, L; Myers, J; Kirkham, A; Tredoux, T; Martin, R; Boasman, S; Wisbey, A; Charlton, C; Dziewulski, P

2016-06-01

In many parts of the world, carbapenemase-producing organisms (CPOs) are endemic. The transfer of medical patients from such countries to the UK requires us to have control systems in place to avoid onward transmission. This report describes the experience of a regional burns centre challenged by its first four cases of CPO in two separate incidents. Key learning from our experience was the importance of CPOs being considered in empirical antibiotics for any patient from an endemic area. Using contact plates, we demonstrated high bacterial counts after cleaning and we describe a terminal cleaning strategy along with the importance of continuing staff engagement and education. Copyright © 2016. Published by Elsevier Ltd.

Dr Jekels' health resort in Bystra near Bielsko: the first treatment centre which adopted psychoanalysis in Poland.

PubMed

Dembińska, Edyta; Rutkowski, Krzysztof

2017-08-29

The paper sets out to present the history of a health resort and hydrotherapy centre in Bystra near Bielsko from 1898 to 1912. At that time Dr Ludwik Jekels, one of the Polish psychoanalysis forerunners, was the owner of the centre. Initially, Dr Jekels was very enthusiastic about climatic treatment and hydrotherapy, until 1905 when he got interested in psychoanalysis. Shortly afterwards he became its staunch supporter and adopted it as a curative procedure in his health resort. That was the first documented case of psychoanalysis use in Poland. This paper presents the development of the therapeutic centre in Bystra and the characteristic of typical patients receiving treatment there. It also briefly reports on medical histories of the conditions of patients who received psychoanalytic treatment. The paper also focuses on another significant area of Dr Jekels'contact with Sigmund Freud ranging from an accidental meeting in Vienna around 1898, through the summer of 1910 when Jekels looked after Freud's daughters in his spa, to 1912 which saw Jekels'receiving psychoanalytic treatment from Freud. It also presents a detailed analysis of hypotheses why Jekels decided to sell the health resort and move to Vienna. Finally, the significance of Jekels'currently underrated therapeutic work for the development of the Polish psychoanalysis is reiterated.

Standards for Pediatric Immunization Practices.

ERIC Educational Resources Information Center

Centers for Disease Control (DHHS/PHS), Atlanta, GA.

This booklet outlines 18 national standards for pediatric immunizations. The standards were developed by a 35-member working group drawn from 24 different public and private sector organizations and from numerous state and local health departments and approved by the U.S. Public Health Service. The first three standards state that: immunization…

Organizing and managing care in a changing health system.

PubMed

Kohn, L T

2000-04-01

To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. Site visits conducted in 12 randomly selected communities in 1996/ 1997. Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change.

A Community Standard: Equivalency of Healthcare in Australian Immigration Detention.

PubMed

Essex, Ryan

2017-08-01

The Australian government has long maintained that the standard of healthcare provided in its immigration detention centres is broadly comparable with health services available within the Australian community. Drawing on the literature from prison healthcare, this article examines (1) whether the principle of equivalency is being applied in Australian immigration detention and (2) whether this standard of care is achievable given Australia's current policies. This article argues that the principle of equivalency is not being applied and that this standard of health and healthcare will remain unachievable in Australian immigration detention without significant reform. Alternate approaches to addressing the well documented issues related to health and healthcare in Australian immigration detention are discussed.

41 CFR 50-204.2 - General safety and health standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... health standards. 50-204.2 Section 50-204.2 Public Contracts and Property Management Other Provisions Relating to Public Contracts PUBLIC CONTRACTS, DEPARTMENT OF LABOR 204-SAFETY AND HEALTH STANDARDS FOR FEDERAL SUPPLY CONTRACTS General Safety and Health Standards § 50-204.2 General safety and health...

Effects of person-centred care on health outcomes-A randomized controlled trial in patients with acute coronary syndrome.

PubMed

Pirhonen, Laura; Olofsson, Elisabeth Hansson; Fors, Andreas; Ekman, Inger; Bolin, Kristian

2017-02-01

To study the effects of person-centred care provided to patients with acute coronary syndrome, using four different health-related outcome measures. Also, to examine the performance of these outcomes when measuring person-centred care. The data used in this study consists of primary data from a multicentre randomized parallel group, controlled intervention study for patients with acute coronary syndrome at Sahlgrenska University Hospital in Gothenburg, Sweden. The intervention and control group consisted of 94 and 105 patients, respectively. The effect of the intervention on health-related outcomes was estimated, controlling for socio-economic and disease-related variables. Patients in the intervention group reported significantly higher general self-efficacy than those in the control group six months after intervention start-up. Moreover, the intervention group returned to work in a greater extent than controls; their physical activity level had increased more and they had a higher EQ-5D score, meaning higher health-related quality of life. These latter effects are not significant but are all pointing towards the beneficial effects of person-centred care. All the effects were estimated while controlling for important socio-economic and disease-related variables. The effectiveness of person-centred care varies between different outcomes considered. A statistically significant beneficial effect was found for one of the four outcome measures (self-efficacy). The other measures all captured beneficial, but not significant, effects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

An Evaluation of the Outcomes of Mutual Health Organizations in Benin

PubMed Central

Haddad, Slim; Ridde, Valery; Yacoubou, Ismaelou; Mák, Geneviève; Gbetié, Michel

2012-01-01

Background Mutual health organizations (MHO) have been seen as a promising alternative to the fee-based funding model but scientific foundations to support their generalization are still limited. Very little is known about the extent of the impact of MHOs on health-seeking behaviours, quality and costs. Methodology/Principal Findings We present the results of an evaluation of the effects attributable to membership in an MHO in a rural region of Benin. Two prospective studies of users (parturients and hospitalized patients) were conducted on the territory of an inter-mutual consisting of 10 MHOs and as many healthcare centres (one, Ouessé, serving as a referral hospital) and one hospital (Papané). Members and non-members were matched (142 pairs of parturients and 109 triads of hospitalized patients) and multilevel multiple regression was used. Results show that member parturients went to healthcare centres sooner (p = 0.049) and were discharged more quickly after delivery (p = 0.001) than non-members. Length of stay in some cases was longer for hospitalized member parturients (+41%). Being a member did not shorten hospital stay, total length of episode of care, or time between appearance of symptoms and recourse to care. Regarding expenses, member parturients paid one-third less than non-members for a delivery. For hospitalized patients, the average savings for members was around $35 US. Total expenses incurred by patients hospitalized at Papané Hospital were higher than at Ouessé but the two hospitals’ relative advantages were comparable at −36% and −39%, respectively. Conclusion/Significance These results confirm mutual health organizations’ capacity to protect households financially, even if benefits for the poor have not been clearly determined. The search for scientific evidence should continue, to understand their impacts with regard to services obtained by their members. PMID:23077556

Factors explaining priority setting at community mental health centres: a quantitative analysis of referral assessments.

PubMed

Grepperud, Sverre; Holman, Per Arne; Wangen, Knut Reidar

2014-12-14

Clinicians at Norwegian community mental health centres assess referrals from general practitioners and classify them into three priority groups (high priority, low priority, and refusal) according to need where need is defined by three prioritization criteria (severity, effect, and cost-effectiveness). In this study, we seek to operationalize the three criteria and analyze to what extent they have an effect on clinical-level priority setting after controlling for clinician characteristics and organisational factors. Twenty anonymous referrals were rated by 42 admission team members employed at 14 community mental health centres in the South-East Health Region of Norway. Intra-class correlation coefficients were calculated and logistic regressions were performed. Variation in clinicians' assessments of the three criteria was highest for effect and cost-effectiveness. An ordered logistic regression model showed that all three criteria for prioritization, three clinician characteristics (education, being a manager or not, and "guideline awareness"), and the centres themselves (fixed effects), explained priority decisions. The relative importance of the explanatory factors, however, depended on the priority decision studied. For the classification of all admitted patients into high- and low-priority groups, all clinician characteristics became insignificant. For the classification of patients, into those admitted and non-admitted, one criterion (effect) and "being a manager or not" became insignificant, while profession ("being a psychiatrist") became significant. Our findings suggest that variation in priority decisions can be reduced by: (i) reducing the disagreement in clinicians' assessments of cost-effectiveness and effect, and (ii) restricting priority decisions to clinicians with a similar background (education, being a manager or not, and "guideline awareness").

Influenza and the work of the World Health Organization.

PubMed

Kitler, M E; Gavinio, P; Lavanchy, D

2002-05-15

Before World War I, influenza was not considered a particularly serious problem. The great pandemic of 1918-1919 changed all that, and the possibility that such a catastrophe could occur again has conditioned all subsequent developments. In epidemiological terms, the hallmark of an influenza is the excess mortality that it causes combined with an enormous burden of ill-health that saps the energy of individuals, families and communities throughout the whole world. In order to engage in influenza prevention and control, the global influenza surveillance network was set up by World Health Organization (WHO) in 1948 as a worldwide alert system for the identification of new influenza viruses, gathering information from 110 participating laboratories in 82 countries and four WHO Collaborating Centers for Influenza reference and research: Centers for Disease Control and Prevention, Atlanta (USA), National Institute for Medical Research, London (UK), WHO Collaborating Centre for Influenza Reference and Research, Melbourne (Australia) and the National Institute for Infectious Diseases, Tokyo (Japan). This network helps WHO to monitor influenza activity all over the world and provides the organization with the viral isolates and information it requires to decide which new virus strains will be used to produce influenza vaccines during the following season. Each year, information about the isolates over the previous 12 months is analyzed and used to determine the composition of the influenza vaccine to be administered during the coming influenza season both for the northern and southern hemisphere. If necessary, the recommendations for the southern hemisphere differ from the ones formulated for the northern hemisphere vaccine. The information supplied by this network enables the organization to regularly update its World Wide Web (WWW) site (FluNet), which reports on the situation of diseases. This network will also enable the WHO to detect a new influenza pandemic as early

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.

Patient-centred assessment of social support, health status and quality of life in patients with acute coronary syndrome.

PubMed

de Jong-Watt, Wynne; Sherifi, Ines

2011-01-01

Measurement of health status (HS) and social support are becoming increasingly accepted as tools to guide clinical decision-making and patient-centred practice. To assess self-reported HS, cardiac-health related quality of life and social support in subjects with a diagnosis of acute coronary syndrome (ACS). The study used a quantitative descriptive design. 36 subjects with a diagnosis of ACS were selected from patients admitted to medical units at a teaching hospital in Toronto, Ontario. One-time, semi-structured interviews were conducted using valid and reliable cardiac-specific HS and social support measures. Analysis indicated that subjects with higher perceived social support and patients with higher income reported greater treatment satisfaction and C-HROL. Subjects with severe angina reported a higher perceived level of social support than those with more moderate physical limitation due to angina. Patients' social environment and HS significantly impact their satisfaction with treatment. Patient-centred measures assist in clinical decision-making, patient-centred care planning and patient involvement in their care.

[Accessibility barriers in the German health care system : Supporting and inhibiting factors when establishing medical centres for mentally and multiply disabled persons].

PubMed

Schülle, Mirjam; Hornberg, Claudia

2016-09-01

In addition to primary and secondary special care, a special type of care was created in the 2015 German Health Care Strengthening Act [GKV-Versorgungsstärkungsgesetz]: medical care centres for adult people with mental and multiple disabilities (MCAMD). This closed a gap in the German healthcare system and part of Article 25 of the UN Convention on the Rights of Persons with Disabilities was implemented. Experiences from pilot projects are useful while implementing these centres. The issue is therefore: which are the supporting (s) and inhibiting (i) factors when establishing MCAMDs in the view of health care providers? Based on open guided expert interviews medical directors and initiators of existing and planned centres were interviewed. Data analysis was done by qualitative content analysis. Healthcare providers think reducing barriers in people's minds is most important. In the course of approval procedures, reservations from different actors and institutions were considered (i). During financial negotiations, health insurance companies requested a characterisation of the target group using the ICD-lists, which doesn't comply with the needs of the users (i). Implementation was only possible with a great effort from the initiators paired with willingness from actors of the association of statutory health insurance physicians and the health insurances (s). This paper describes the process used to implement MCAMDs. Potential centre providers can be inspired by these results. Further research on the process of implementation of these medical centres is needed, especially taking into account all involved parties.

41 CFR 50-204.2 - General safety and health standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true General safety and health... Public Contracts PUBLIC CONTRACTS, DEPARTMENT OF LABOR 204-SAFETY AND HEALTH STANDARDS FOR FEDERAL SUPPLY CONTRACTS General Safety and Health Standards § 50-204.2 General safety and health standards. (a) Every...

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

PubMed

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

2013-06-14

Organizations, partnerships, and alliances form the building blocks of global governance. Global health organizations thus have the potential to play a formative role in determining the extent to which people are able to realize their right to health. This article examines how major global health organizations, such as WHO, the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, and GAVI approach human rights concerns, including equality, accountability, and inclusive participation. We argue that organizational support for the right to health must transition from ad hoc and partial to permanent and comprehensive. Drawing on the literature and our knowledge of global health organizations, we offer good practices that point to ways in which such agencies can advance the right to health, covering nine areas: 1) participation and representation in governance processes; 2) leadership and organizational ethos; 3) internal policies; 4) norm-setting and promotion; 5) organizational leadership through advocacy and communication; 6) monitoring and accountability; 7) capacity building; 8) funding policies; and 9) partnerships and engagement. In each of these areas, we offer elements of a proposed Framework Convention on Global Health (FCGH), which would commit state parties to support these standards through their board membership and other interactions with these agencies. We also explain how the FCGH could incorporate these organizations into its overall financing framework, initiate a new forum where they collaborate with each other, as well as organizations in other regimes, to advance the right to health, and ensure sufficient funding for right to health capacity building. We urge major global health organizations to follow the leadership of the UN Secretary-General and UNAIDS to champion the FCGH. It is only through a rights-based approach, enshrined in a new Convention, that we can expect to achieve health for all in our lifetimes. Copyright © 2013 Friedman, Gostin

International organizations and migrant health in Europe.

PubMed

Kentikelenis, Alexander E; Shriwise, Amanda

International organizations have defined and managed different aspects of migrant health issues for decades, yet we lack a systematic understanding of how they reach decisions and what they do on the ground. The present article seeks to clarify the state of knowledge on the relationship between international organizations and migrant health in Europe. To do so, we review the operations of six organizations widely recognized as key actors in the field of migrant health: the European Commission, the Regional Office for Europe of the World Health Organization, the International Organization on Migration, Médecins du Monde, Médecins Sans Frontières, and the Open Society Foundation. We find that international organizations operate in a complementary fashion, with each taking on a unique role in migrant health provision. States often rely on international organizations as policy advisors or sub-contractors for interventions, especially in the case of emergencies. These linkages yield a complex web of relationships, which can vary depending on the country under consideration or the health policy issue in question.

Antimicrobial resistance and the standards of the World Organisation for Animal Health.

PubMed

Orand, J P

2012-04-01

Antimicrobial resistance and the use of antimicrobial agents in veterinary medicine are complex issues that are currently a source of major international concern. It is therefore essential for the World Organisation for Animal Health (OIE) to consider this issue, while at the same time continuing to address the problem of zoonotic diseases. That is why the OIE has included objectives for veterinary drugs, especially antimicrobials, in its Strategic Plan. The OIE plays an active part in discussions on this subject in conjunction with other international organisations working in this field, such as the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO). Furthermore, the OIE has adopted guidelines both for defining harmonised methodologies for antimicrobial resistance surveillance and monitoring and for helping countries to conduct a risk analysis tailored to their situation and to take appropriate management measures. The OIE has included this issue in its programme of assistance to countries by offering them structural enhancement tools: the Tool for the Evaluation of Performance of Veterinary Services (O1E PVS Tool), PVS Gap Analysis, veterinary legislation support, and training for veterinary national focal points, with the aid of its Collaborating Centres for veterinary medicinal products. Only by mobilising all countries to improve the quality of antimicrobials, to introduce antimicrobial resistance surveillance and to implement measures for the responsible and prudent use of antimicrobials, will it be possible to halt the spread of antimicrobial resistance.

45 CFR 170.210 - Standards for health information technology to protect electronic health information created...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Standards for health information technology to... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION... FOR HEALTH INFORMATION TECHNOLOGY Standards and Implementation Specifications for Health Information...

45 CFR 170.210 - Standards for health information technology to protect electronic health information created...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Standards for health information technology to... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION... FOR HEALTH INFORMATION TECHNOLOGY Standards and Implementation Specifications for Health Information...

45 CFR 170.210 - Standards for health information technology to protect electronic health information created...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Standards for health information technology to... Welfare Department of Health and Human Services HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION... FOR HEALTH INFORMATION TECHNOLOGY Standards and Implementation Specifications for Health Information...

45 CFR 170.210 - Standards for health information technology to protect electronic health information created...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Standards for health information technology to... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION... FOR HEALTH INFORMATION TECHNOLOGY Standards and Implementation Specifications for Health Information...

45 CFR 170.210 - Standards for health information technology to protect electronic health information created...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Standards for health information technology to... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION... FOR HEALTH INFORMATION TECHNOLOGY Standards and Implementation Specifications for Health Information...

42 CFR 493.1263 - Standard: Mycology.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Standard: Mycology. 493.1263 Section 493.1263 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... intended reactivity with a control organism(s). (b) For antifungal susceptibility tests, the laboratory...

42 CFR 493.1263 - Standard: Mycology.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Standard: Mycology. 493.1263 Section 493.1263 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... intended reactivity with a control organism(s). (b) For antifungal susceptibility tests, the laboratory...

42 CFR 493.1263 - Standard: Mycology.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Standard: Mycology. 493.1263 Section 493.1263 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... intended reactivity with a control organism(s). (b) For antifungal susceptibility tests, the laboratory...

42 CFR 493.1263 - Standard: Mycology.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Standard: Mycology. 493.1263 Section 493.1263 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... intended reactivity with a control organism(s). (b) For antifungal susceptibility tests, the laboratory...

Enhanced semantic interoperability by profiling health informatics standards.

PubMed

López, Diego M; Blobel, Bernd

2009-01-01

Several standards applied to the healthcare domain support semantic interoperability. These standards are far from being completely adopted in health information system development, however. The objective of this paper is to provide a method and suggest the necessary tooling for reusing standard health information models, by that way supporting the development of semantically interoperable systems and components. The approach is based on the definition of UML Profiles. UML profiling is a formal modeling mechanism to specialize reference meta-models in such a way that it is possible to adapt those meta-models to specific platforms or domains. A health information model can be considered as such a meta-model. The first step of the introduced method identifies the standard health information models and tasks in the software development process in which healthcare information models can be reused. Then, the selected information model is formalized as a UML Profile. That Profile is finally applied to system models, annotating them with the semantics of the information model. The approach is supported on Eclipse-based UML modeling tools. The method is integrated into a comprehensive framework for health information systems development, and the feasibility of the approach is demonstrated in the analysis, design, and implementation of a public health surveillance system, reusing HL7 RIM and DIMs specifications. The paper describes a method and the necessary tooling for reusing standard healthcare information models. UML offers several advantages such as tooling support, graphical notation, exchangeability, extensibility, semi-automatic code generation, etc. The approach presented is also applicable for harmonizing different standard specifications.

Documentation Centre of the Association of African Universities.

ERIC Educational Resources Information Center

Chateh, Peter

This report presents the results of a study of the Documentation Centre of the Association of African Universities (AAU) undertaken to work out proposals for the rational organization of the Centre, and to explore the possibility of computerizing the Centre and linking it with other centers which provide automated documentation services. The…

Organizing the present, looking to the future: an online knowledge repository to facilitate collaboration.

PubMed

Burchill, C; Roos, L L; Fergusson, P; Jebamani, L; Turner, K; Dueck, S

2000-01-01

Comprehensive data available in the Canadian province of Manitoba since 1970 have aided study of the interaction between population health, health care utilization, and structural features of the health care system. Given a complex linked database and many ongoing projects, better organization of available epidemiological, institutional, and technical information was needed. The Manitoba Centre for Health Policy and Evaluation wished to develop a knowledge repository to handle data, document research Methods, and facilitate both internal communication and collaboration with other sites. This evolving knowledge repository consists of both public and internal (restricted access) pages on the World Wide Web (WWW). Information can be accessed using an indexed logical format or queried to allow entry at user-defined points. The main topics are: Concept Dictionary, Research Definitions, Meta-Index, and Glossary. The Concept Dictionary operationalizes concepts used in health research using administrative data, outlining the creation of complex variables. Research Definitions specify the codes for common surgical procedures, tests, and diagnoses. The Meta-Index organizes concepts and definitions according to the Medical Sub-Heading (MeSH) system developed by the National Library of Medicine. The Glossary facilitates navigation through the research terms and abbreviations in the knowledge repository. An Education Resources heading presents a web-based graduate course using substantial amounts of material in the Concept Dictionary, a lecture in the Epidemiology Supercourse, and material for Manitoba's Regional Health Authorities. Confidential information (including Data Dictionaries) is available on the Centre's internal website. Use of the public pages has increased dramatically since January 1998, with almost 6,000 page hits from 250 different hosts in May 1999. More recently, the number of page hits has averaged around 4,000 per month, while the number of unique hosts has

Organizing the Present, Looking to the Future: An Online Knowledge Repository to Facilitate Collaboration

PubMed Central

Burchill, Charles; Fergusson, Patricia; Jebamani, Laurel; Turner, Ken; Dueck, Stephen

2000-01-01

Background Comprehensive data available in the Canadian province of Manitoba since 1970 have aided study of the interaction between population health, health care utilization, and structural features of the health care system. Given a complex linked database and many ongoing projects, better organization of available epidemiological, institutional, and technical information was needed. Objective The Manitoba Centre for Health Policy and Evaluation wished to develop a knowledge repository to handle data, document research methods, and facilitate both internal communication and collaboration with other sites. Methods This evolving knowledge repository consists of both public and internal (restricted access) pages on the World Wide Web (WWW). Information can be accessed using an indexed logical format or queried to allow entry at user-defined points. The main topics are: Concept Dictionary, Research Definitions, Meta-Index, and Glossary. The Concept Dictionary operationalizes concepts used in health research using administrative data, outlining the creation of complex variables. Research Definitions specify the codes for common surgical procedures, tests, and diagnoses. The Meta-Index organizes concepts and definitions according to the Medical Sub-Heading (MeSH) system developed by the National Library of Medicine. The Glossary facilitates navigation through the research terms and abbreviations in the knowledge repository. An Education Resources heading presents a web-based graduate course using substantial amounts of material in the Concept Dictionary, a lecture in the Epidemiology Supercourse, and material for Manitoba's Regional Health Authorities. Confidential information (including Data Dictionaries) is available on the Centre's internal website. Results Use of the public pages has increased dramatically since January 1998, with almost 6,000 page hits from 250 different hosts in May 1999. More recently, the number of page hits has averaged around 4,000 per month

Double Standards in Global Health: Medicine, Human Rights Law and Multidrug-Resistant TB Treatment Policy.

PubMed

Nicholson, Thomas; Admay, Catherine; Shakow, Aaron; Keshavjee, Salmaan

2016-06-01

The human rights arguments that underpinned the fight against HIV over the last three decades were poised, but ultimately failed, to provide a similar foundation for success against multidrug-resistant TB (MDR-TB) and other diseases of the poor. With more than 1.5 million deaths since 2000 attributed to strains of MDR-TB, and with half a million new, and mostly untreated, MDR-TB cases in the world each year, the stakes could not be higher. The World Health Organization (WHO), whose mandate is to champion the attainment by all peoples of the highest possible level of health, recommended unsound medical treatment for MDR-TB patients in resource-poor settings from 1993-2002. Citing cost considerations, WHO did not recommend the available standard of care that had been successfully used to contain and defeat MDR-TB in rich countries. By acting as a strategic gatekeeper in its technical advisory role to donor agencies and countries, it also facilitated the global implementation of a double standard for TB care in low- and middle-income countries (LMICs), upending important legal and scientific priorities. This raises serious questions about whether the organization violated international human rights standards and those established in its own constitution. While calling for additional analysis and discussion on this topic, the authors propose that policymakers should reject double standards of this kind and instead embrace the challenge of implementing the highest standard of care on a global level.

[Implementation of good quality and safety practices. Descriptive study in a occupational mutual health centre].

PubMed

Manzanera, R; Plana, M; Moya, D; Ortner, J; Mira, J J

2016-01-01

To describe the level of implementation of quality and safety good practice elements in a Mutual Society health centre. A Cross-sectional study was conducted to assess the level of implementation of good practices using a questionnaire. Some quality dimensions were also assessed (scale 0 to 10) by a set of 87 quality coordinators of health centres and a random sample of 54 healthcare professionals working in small centres. Seventy quality coordinators and 27 professionals replied (response rates 80% and 50%, respectively. There were no differences in the assessment of quality attributes between both groups. They identified as areas for improvement: use of practice guidelines (7.6/10), scientific and technical skills (7.5/10), and patient satisfaction (7.7/10). Availability and accessibility to clinical reports, informed consent, availability of hydro-alcoholic solution, and to record allergies, were considered of high importance to be implemented, with training and research, improvements in equipment and technology plans, adherence to clinical practice guidelines and the preparation of risk maps, being of less importance. The good practices related to equipment and resources have a higher likelihood to be implemented, meanwhile those related to quality and safety attitudes have more barriers before being implemented. The mutual has a similar behaviour than other healthcare institutions. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Family-centred service coordination in childhood health and disability services: the search for meaningful service outcome measures.

PubMed

Trute, B; Hiebert-Murphy, D; Wright, A

2008-05-01

Potential service outcome measures were tested for their utility in the assessment of the quality of 'family centred' service coordination in the provincial network of children's disability services in Manitoba, Canada. This study is based on in-home survey data provided by 103 mothers at 6 and 18 months following assignment of a 'dedicated' service coordinator. Service outcome indicators included measures of parent self-esteem, parenting stress, family functioning and the need for family support resources. Hierarchical regression analyses showed no relationship between level of quality of family-centred service coordination and standardized psychosocial measures of parent and family functioning. However, family centredness of service coordination was found to predict significant reduction in level of family need for psychosocial support resources after 18 months of contact with a service coordinator. Outcome measures that are focused on specific and tangible results of service coordination appear to be of higher utility in service quality assessment than are more global, standardized measures of parent and family functioning.

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres.

PubMed

Topp, Stephanie M; Chipukuma, Julien M

2016-03-01

Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient-provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient-provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres

PubMed Central

Topp, Stephanie M; Chipukuma, Julien M

2016-01-01

Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Methods: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Results: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers’ organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers’ clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients’ trust in health workers’ service values and professionalism. Lack of patient–provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Conclusion: Lack of resourcing and poor leadership were key factors leading to providers’ weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance

Development of data representation standards by the human proteome organization proteomics standards initiative

PubMed Central

Albar, Juan Pablo; Binz, Pierre-Alain; Eisenacher, Martin; Jones, Andrew R; Mayer, Gerhard; Omenn, Gilbert S; Orchard, Sandra; Vizcaíno, Juan Antonio; Hermjakob, Henning

2015-01-01

Objective To describe the goals of the Proteomics Standards Initiative (PSI) of the Human Proteome Organization, the methods that the PSI has employed to create data standards, the resulting output of the PSI, lessons learned from the PSI’s evolution, and future directions and synergies for the group. Materials and Methods The PSI has 5 categories of deliverables that have guided the group. These are minimum information guidelines, data formats, controlled vocabularies, resources and software tools, and dissemination activities. These deliverables are produced via the leadership and working group organization of the initiative, driven by frequent workshops and ongoing communication within the working groups. Official standards are subjected to a rigorous document process that includes several levels of peer review prior to release. Results We have produced and published minimum information guidelines describing what information should be provided when making data public, either via public repositories or other means. The PSI has produced a series of standard formats covering mass spectrometer input, mass spectrometer output, results of informatics analysis (both qualitative and quantitative analyses), reports of molecular interaction data, and gel electrophoresis analyses. We have produced controlled vocabularies that ensure that concepts are uniformly annotated in the formats and engaged in extensive software development and dissemination efforts so that the standards can efficiently be used by the community. Conclusion In its first dozen years of operation, the PSI has produced many standards that have accelerated the field of proteomics by facilitating data exchange and deposition to data repositories. We look to the future to continue developing standards for new proteomics technologies and workflows and mechanisms for integration with other omics data types. Our products facilitate the translation of genomics and proteomics findings to clinical and

Directory of Book Trade and Related Organizations. Books Trade Associations, United States and Canada; International and Foreign Book Trade Associations; National Information Standards Organization (NISO) Standards; Calendar, 2003-2012; Acronyms; Index of Organizations; Subject Index.

ERIC Educational Resources Information Center

Bowker Annual Library and Book Trade Almanac, 2003

2003-01-01

Includes two lists: one of book trade associations in the United States and Canada, and one of international and foreign book trade associations. Concludes with National Information Standards Organization (NISO) standards; calendar, 2003-2012; acronyms; index of organizations; and subject index. (LRW)

RTEMS CENTRE- Support and Maintenance CENTRE to RTEMS Operating System

NASA Astrophysics Data System (ADS)

Silva, H.; Constantino, A.; Coutunho, M.; Freitas, D.; Faustino, S.; Mota, M.; Colaço, P.; Zulianello, M.

2008-08-01

RTEMS stands for Real-Time Operating System for Multiprocessor Systems. It is a full featured Real Time Operating System that supports a variety of open APIs and interface standards. It provides a high performance environment for embedded applications, including a fixed-priority preemptive/non-preemptive scheduler, a comprehensive set of multitasking operations and a large range of supported architectures. Support and maintenance CENTRE to RTEMS operating system (RTEMS CENTRE) is a joint initiative of ESA-Portugal Task force, aiming to build a strong technical competence in the space flight (on- board) software, to offer support, maintenance and improvements to RTEMS. This paper provides a high level description of the current and future activities of the RTEMS CENTRE. It presents a brief description of the RTEMS operating system, a description of the tools developed and distributed to the community [1] and the improvements to be made to the operating system, including facilitation for the qualification of RTEMS (4.8.0) [2] for the space missions.

INFOMAT: The international materials assessment and application centre's internet gateway

NASA Astrophysics Data System (ADS)

Branquinho, Carmen Lucia; Colodete, Leandro Tavares

2004-08-01

INFOMAT is an electronic directory structured to facilitate the search and retrieval of materials science and technology information sources. Linked to the homepage of the International Materials Assessment and Application Centre, INFOMAT presents descriptions of 392 proprietary databases with links to their host systems as well as direct links to over 180 public domain databases and over 2,400 web sites. Among the web sites are associations/unions, governmental and non-governmental institutions, industries, library holdings, market statistics, news services, on-line publications, standardization and intellectual property organizations, and universities/research groups.

Rational use of medicines: assessing progress using primary health centres in Shomolu local government area of Lagos, Nigeria.

PubMed

Oyeyemi, A S; Ogunleye, O A

2013-01-01

Medicines (drugs) are a critical component in the prevention and treatment of diseases. Their rational use is important to maximize their benefits and prevent undesirable effects. This study was conducted to assess progress with rational use of medicines at primary care level using recommended indicators. The cross-sectional descriptive study was conducted in four primary health centres in Somolu Local Government Area (LGA) of Lagos State, Nigeria. It employed retrospective and prospective data collection methods. From the four centres, prescription notes of 600 clinical encounters spanning one year were analyzed for prescribing indicators and a checklist was administered for facility indicators. For the 600 clinical encounters studied, 2802 drugs were prescribed. The mean number of drugs per encounter was 4.7 ± 2.1; 75.6% of drugs were prescribed by generic name; prescriptions containing at least an antibiotic averaged 48.5%, while those with at least an injection prescribed were 21%. Of all the drugs prescribed, 83.2% were from the National Essential Drugs List (NEDL). On the average, 86.5% of key essential drugs were available in the health centres but none of the centres had a copy of the NEDL or drug formulary. There were wide variations in some of the indicators across the four facilities. The study showed progress in some indicators when compared with previous studies but gaps still exist. We recommend training on rational use of medicines for health workers in the facilities and distribution of copies of NEDL to all the facilities.

Readability levels of health pamphlets distributed in hospitals and health centres in Athens, Greece.

PubMed

Kondilis, B K; Akrivos, P D; Sardi, T A; Soteriades, E S; Falagas, M E

2010-10-01

Health literacy is important in the medical and social sciences due to its impact on behavioural and health outcomes. Nevertheless, little is known about it in Greece, including patients' level of understanding health brochures and pamphlets distributed in Greek hospitals and clinics. Observational study in the greater metropolitan area of Athens, Greece. Pamphlets and brochures written in the Greek language were collected from 17 hospitals and healthcare centres between the spring and autumn of 2006. Readability of pamphlets using the Flesch-Kincaid, Simple Measure of Gobbledygook (SMOG) and Fog methods was calculated based on a Greek readability software. Out of 70 pamphlets collected from 17 hospitals, 37 pamphlets met the criteria for the study. The average readability level of all scanned pamphlets was ninth to 10th grade, corresponding to a readability level of 'average'. A highly significant difference (P<0.001) was found between private and public hospitals using the Flesch-Kincaid and SMOG readability scales. Pamphlets from private hospitals were one grade more difficult than those from public hospitals. Approximately 43.7% of the Greek population aged ≥20 years would not be able to comprehend the available pamphlets, which were found to have an average readability level of ninth to 10th grade. Further research examining readability levels in the context of health literacy in Greece is warranted. This effort paves the way for additional research in the field of readability levels of health pamphlets in the Greek language, the sources of health information, and the level of understanding of key health messages by the population. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Tests for qualitative treatment-by-centre interaction using a 'pushback' procedure.

PubMed

Ciminera, J L; Heyse, J F; Nguyen, H H; Tukey, J W

1993-06-15

In multicentre clinical trials using a common protocol, the centres are usually regarded as being a fixed factor, thus allowing any treatment-by-centre interaction to be omitted from the error term for the effect of treatment. However, we feel it necessary to use the treatment-by-centre interaction as the error term if there is substantial evidence that the interaction with centres is qualitative instead of quantitative. To make allowance for the estimated uncertainties of the centre means, we propose choosing a reference value (for example, the median of the ordered array of centre means) and converting the individual centre results into standardized deviations from the reference value. The deviations are then reordered, and the results 'pushed back' by amounts appropriate for the corresponding order statistics in a sample from the relevant distribution. The pushed-back standardized deviations are then restored to the original scale. The appearance of opposite signs among the destandardized values for the various centres is then taken as 'substantial evidence' of qualitative interaction. Procedures are presented using, in any combination: (i) Gaussian, or Student's t-distribution; (ii) order-statistic medians or outward 90 per cent points of the corresponding order statistic distributions; (iii) pooling or grouping and pooling the internally estimated standard deviations of the centre means. The use of the least conservative combination--Student's t, outward 90 per cent points, grouping and pooling--is recommended.

RACISM IN ORGANIZATIONS: THE CASE OF A COUNTY PUBLIC HEALTH DEPARTMENT.

PubMed

Griffith, Derek M; Childs, Erica L; Eng, Eugenia; Jeffries, Vanessa

2007-01-01

Racism is part of the foundation of U.S. society and institutions, yet few studies in community psychology or organizational studies have examined how racism affects organizations. This paper proposes a conceptual framework of institutional racism, which describes how, in spite of professional standards and ethics, racism functions within organizations to adversely affect the quality of services, the organizational climate, and staff job satisfaction and morale. Grounded in systems theory and organizational empowerment, the framework is based on data that describe how racism was made manifest in a county public health department. The findings highlight the importance of understanding how organizations are influenced by external forces and can negatively affect clients, communities, and their own staff members.

RACISM IN ORGANIZATIONS: THE CASE OF A COUNTY PUBLIC HEALTH DEPARTMENT

PubMed Central

Griffith, Derek M.; Childs, Erica L.; Eng, Eugenia; Jeffries, Vanessa

2008-01-01

Racism is part of the foundation of U.S. society and institutions, yet few studies in community psychology or organizational studies have examined how racism affects organizations. This paper proposes a conceptual framework of institutional racism, which describes how, in spite of professional standards and ethics, racism functions within organizations to adversely affect the quality of services, the organizational climate, and staff job satisfaction and morale. Grounded in systems theory and organizational empowerment, the framework is based on data that describe how racism was made manifest in a county public health department. The findings highlight the importance of understanding how organizations are influenced by external forces and can negatively affect clients, communities, and their own staff members. PMID:18852826

How did rapid scale-up of HIV services impact on workplace and interpersonal trust in Zambian primary health centres: a case-based health systems analysis

PubMed Central

Topp, Stephanie M; Chipukuma, Julien M

2016-01-01

Background In sub-Saharan Africa, large amounts of funding continue to be directed towards HIV-specific care and treatment, often with claims of ‘health system strengthening’ effect. Such claims rarely account for the impact on human relationships and decisions that are core to functional health systems. This research examined how establishment of externally funded HIV services influenced trusting relationships in Zambian health centres. Methods An in-depth, multicase study included four health centres selected for urban, peri-urban and rural characteristics. Case data included healthcare worker (HCW) interviews (60); patient interviews (180); direct observation of facility operations (2 weeks/centre) and key informant interviews (14) which were recorded and transcribed verbatim. Thematic analysis adopted inductive and deductive coding guided by a framework incorporating concepts of workplace trust, patient–provider trust, intrinsic and extrinsic motivation. Results HIV service scale-up impacted trust in positive and negative ways. Investment in HIV-specific infrastructure, supplies and quality assurance mechanisms strengthened workplace trust, HCW motivation and patient–provider trust in HIV departments in the short-term. In the health centres more broadly and over time, however, non-governmental organisation-led investment and support of HIV departments reinforced HCW's perceptions of the government as uninterested or unable to provide a quality work environment. Exacerbating existing perceptions of systemic workplace inequity and nepotism, uneven distribution of personal and professional opportunities related to HIV service establishment contributed to interdepartmental antagonism and reinforced workplace practices designed to protect individual HCW's interests. Conclusions Findings illustrate long-term negative effects of the vertical HIV resourcing and support structures which failed to address and sometimes exacerbated HCW (dis)trust with their own

Family-centred care delivery: comparing models of primary care service delivery in Ontario.

PubMed

Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-11-01

To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

Mapping the route to medication therapy management documentation and billing standardization and interoperabilility within the health care system: meeting proceedings.

PubMed

Millonig, Marsha K

2009-01-01

To convene a diverse group of stakeholders to discuss medication therapy management (MTM) documentation and billing standardization and its interoperability within the health care system. More than 70 stakeholders from pharmacy, health information systems, insurers/payers, quality, and standard-setting organizations met on October 7-8, 2008, in Bethesda, MD. The American Pharmacists Association (APhA) organized the invitational conference to facilitate discussion on strategic directions for meeting current market need for MTM documentation and billing interoperability and future market needs for MTM integration into electronic health records (EHRs). APhA recently adopted policy that specifically addresses technology barriers and encourages the use and development of standardized systems for the documentation and billing of MTM services. Day 1 of the conference featured six foundational presentations on health information technology (HIT) trends, perspectives on MTM from the profession and the Centers for Medicare & Medicaid Services, health care quality and medication-related outcome measures, integrating MTM workflow in EHRs, and the current state of MTM operalization in practice. After hearing presentations on day 1 and having the opportunity to pose questions to each speaker, conference participants were divided into three breakout groups on day 2. Each group met three times for 60 minutes each and discussed five questions from the perspective of a patient, provider, or payer. Three facilitators met with each of the groups and led discussion from one perspective (i.e., patient, provider, payer). Participants then reconvened as a complete group to participate in a discussion on next steps. HIT is expected to assist in delivering safe, effective, efficient, coordinated care as health professionals strive to improve the quality of care and outcomes for individual patients. The pharmacy profession is actively contributing to quality patient care through MTM services

7 CFR 205.238 - Livestock health care practice standard.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 3 2011-01-01 2011-01-01 false Livestock health care practice standard. 205.238... Requirements § 205.238 Livestock health care practice standard. (a) The producer must establish and maintain preventive livestock health care practices, including: (1) Selection of species and types of livestock with...

7 CFR 205.238 - Livestock health care practice standard.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Livestock health care practice standard. 205.238... Requirements § 205.238 Livestock health care practice standard. (a) The producer must establish and maintain preventive livestock health care practices, including: (1) Selection of species and types of livestock with...

7 CFR 205.238 - Livestock health care practice standard.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 3 2012-01-01 2012-01-01 false Livestock health care practice standard. 205.238... Requirements § 205.238 Livestock health care practice standard. (a) The producer must establish and maintain preventive livestock health care practices, including: (1) Selection of species and types of livestock with...

42 CFR 600.405 - Standard health plan coverage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Standard health plan coverage. 600.405 Section 600.405 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BASIC HEALTH PROGRAM ADMINISTRATION, ELIGIBILITY, ESSENTIAL HEALTH BENEFITS, PERFORMANCE...

5 CFR 890.201 - Minimum standards for health benefits plans.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Minimum standards for health benefits... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.201 Minimum standards for health benefits plans. (a) To qualify for approval by OPM, a health benefits plan...

5 CFR 890.201 - Minimum standards for health benefits plans.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Minimum standards for health benefits... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.201 Minimum standards for health benefits plans. (a) To qualify for approval by OPM, a health benefits plan...

The World Health Organization Global Programme on AIDS proposal for standardization of HIV sequence nomenclature. WHO Network for HIV Isolation and Characterization.

PubMed

Korber, B T; Osmanov, S; Esparza, J; Myers, G

1994-11-01

The World Health Organization Global Programme on AIDS (WHO/GPA) is conducting a large-scale collaborative study of human immunodeficiency virus type 1 (HIV-1) variation, based in four potential vaccine-trial site countries: Brazil, Rwanda, Thailand, and Uganda. Through the course of this study, it was crucial to keep track of certain attributes of the samples from which the viral nucleotide sequences were derived (e.g., country of origin and viral culture characterization), so that meaningful sequence comparisons could be made. Here we describe a system developed in the context of the WHO/GPA study that summarizes such critical attributes by representing them as standardized characters directly incorporated into sequence names. This nomenclature allows linkage of clinical, phenotypic, and geographic information with molecular data. We propose that other investigators involved in human immunodeficiency virus (HIV) nucleotide sequencing efforts adopt a similar standardized sequence nomenclature to facilitate cross-study sequence comparison. HIV sequence data are being generated at an ever-increasing rate; directly coupled to this increase is our deepening understanding of biological parameters that influence or result from sequence variability. A standardized sequence nomenclature that includes relevant biological information would enable researchers to better utilize the growing body of sequence data, and enhance their ability to interpret the biological implications of their own data through facilitating comparisons with previously published work.

The Role of the World Health Organization in Eliminating Iodine Deficiency Worldwide.

PubMed

Karwowska, Paulina; Breda, Joao

2017-01-01

Iodine deficiency has been one of the most prevalent micronutrient deficiencies in the world, causing many health disorders, particularly in pregnant women and children. Despite increased salt iodization in some countries and regions, the process has lacked global coordination and sustainability, two prerequisites for reaching the aim of eliminating iodine deficiency. This goal can be reached only by evidence-based, effectively monitored joint and committed actions of all countries. The aim of the article is to present the role of WHO in leading and coordinating public health actions aiming elimination of iodine deficiency. WHO was given a mandate to coordinate such public health actions, including developing and strengthening relevant public health legislation, issuing technically sound and evidence-based norms and standards, and monitoring the health situation and trends. WHO has coordinated and fostered collaboration between countries, international organizations, scientific associations and non-governmental organization to reach the goal of eliminating iodine deficiency. No recent patents are discussed for this WHO report. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Standardization of health data – ICAR guidelines including health key

USDA-ARS?s Scientific Manuscript database

Systematic improvement of animal health requires knowledge about the status quo and reliable measures to characterize it. In dairy herds, health monitoring has gained importance to ensure sustainable and cost-efficient milk production in accordance with public expectations. In this context, standard...

75 FR 39265 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Prevention, Classifications and Public Health Data Standards, 3311 Toledo Road, Room 2337, Hyattsville, MD...

78 FR 53148 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311 Toledo Road, Room 2337...

78 FR 9055 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the..., Medical Systems Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311 Toledo...

Nursing competency standards in primary health care: an integrative review.

PubMed

Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

2016-05-01

This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice. Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting. Integrative review. A comprehensive search of relevant electronic databases using keywords (e.g. 'competencies', 'competen*' and 'primary health care', 'general practice' and 'nurs*') was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000. Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment. Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers. Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content

75 FR 56549 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Public Health Data Standards Staff, NCHS, 3311 Toledo Road, Room 2337, Hyattsville, Maryland 20782, e...

Patient-centred care: a review for rehabilitative audiologists.

PubMed

Grenness, Caitlin; Hickson, Louise; Laplante-Lévesque, Ariane; Davidson, Bronwyn

2014-02-01

This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Literature review and synthesis. Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

Stakeholder perceptions of a nurse led walk-in centre.

PubMed

Parker, Rhian M; Desborough, Jane L; Forrest, Laura E

2012-11-05

As many countries face primary care medical workforce shortages and find it difficult to provide timely and affordable care they seek to find new ways of delivering first point of contact health care through developing new service models. In common with other areas of rural and regional Australia, the Australian Capital Territory (ACT) is currently experiencing a general practitioner (GP) workforce shortage which impacts significantly on the ability of patients to access GP led primary care services. The introduction of a nurse led primary care Walk-in Centre in the ACT aimed to fulfill an unmet health care need in the community and meet projected demand for health care services as well as relieve pressure on the hospital system. Stakeholders have the potential to influence health service planning and policy, to advise on the potential of services to meet population health needs and to assess how acceptable health service innovation is to key stakeholder groups. This study aimed to ascertain the views of key stakeholders about the Walk-in Centre. Stakeholders were purposively selected through the identification of individuals and organisations which had organisational or professional contact with the Walk-in Centre. Semi structured interviews around key themes were conducted with seventeen stakeholders. Stakeholders were generally supportive of the Walk-in Centre but identified key areas which they considered needed to be addressed. These included the service's systems, full utilisation of the nurse practitioner role and adequate education and training. It was also suggested that a doctor could be available to the Centre as a source of referral for patients who fall outside the nurses' scope of practice. The location of the Centre was seen to impact on patient flows to the Emergency Department. Nurse led Walk-in Centres are one response to addressing primary health care medical workforce shortages. Whilst some stakeholders have reservations about the model others

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. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

45 CFR 170.207 - Vocabulary standards for representing electronic health information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Standards and Implementation Specifications for Health Information Technology § 170.207 Vocabulary standards for representing electronic...

45 CFR 170.207 - Vocabulary standards for representing electronic health information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Standards and Implementation Specifications for Health Information Technology § 170.207 Vocabulary standards for representing electronic...