Sample records for oc health practice

  1. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh.

    PubMed

    Sikder, Shegufta S; Labrique, Alain B; Ali, Hasmot; Hanif, Abu A M; Klemm, Rolf D W; Mehra, Sucheta; West, Keith P; Christian, Parul

    2015-01-31

    Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access to healthcare and key constraints to EmOC provision. Using data from a large population-based community trial, we identified and surveyed the 14 health facilities (7 public, 7 private) most frequently visited for obstetric complications and near misses as reported by women. Availability of EmOC was based on provision of medical services, assessed through clinician interviews and record review. Levels of EmOC availability were defined as basic or comprehensive. Readiness for EmOC provision was based on scores in four categories: staffing, equipment, laboratory capacity, and medicines. Readiness scores were calculated using unweighted averages. Costs of C-section procedures and geographic locations of facilities were described. Textual analysis was used to identify key constraints. The seven surveyed private facilities offered comprehensive EmOC compared to four of the seven public facilities. With 100% representing full readiness, mean EmOC readiness was 81% (range: 63%-91%) among surveyed private facilities compared to 67% (range: 48%-91%) in public facilities (p = 0.040). Surveyed public clinics had low scores on staffing and laboratory capacity (69%; 50%). The mean cost of the C-section procedure in private clinics was $77 (standard deviation: $16) and free in public facilities. The public sub-district facilities were the only facilities located in rural areas, with none providing comprehensive EmOC. Shortages in specialized staff were listed as the main barrier to EmOC provision in

  2. Might generic OCs create contraceptive price war?

    PubMed

    1987-02-01

    Genora 1/35 and 1/50, the 1st generic oral contraceptives (OCs) in the world, are now being marketed in the US. Clinicians interviewed by "Contraceptive Technology Update" (CTU) offer differing opinions as to what this new OC may mean in the marketplace. Products of Rugby Laboratories, the pills are copy products of Ortho Pharmaceutical's ON 1/35 and ON 1/50 formulations. Most clinicians believe that Genora's success or failure in the OC market depends on its eventual retail price. The price difference of $3-$4 may be sufficiently substantial for retailers to charge less for the generic OCs. If that is the case, many doctors may prescribe a pill which will save their patients $4/month. Dr. Mildred Hanson, a Minneapolis gynecologist/obstetrician, feels any cost savings from Genora will have a significant impact on the OC market. She suggests that the less expensive OCs will catch the attention of health maintenance organizations (HMOs) and the business of women who participate in such health plans. Yet James Burns, director of family planning services for the Hartford City Health Department, thinks that even a full-scale retail price war won't have much effect from a clinic standpoint. He reports that clinics are able to obtain contraceptive supplies rather inexpensively through the contracting system. Hanson also expressed doubt over the potential popularity of Genora 1/50 as clinical concerns about the effects of combined OCs on serum lipid levels and carbohydrate metabolism have resulted in a nationwide push toward OCs containing less than 50 micrograms of estrogen. He indicated concern that declines in pharmaceutical house products from pricing competition with generic pills might have a negative impact on contraceptive research and development. Dick Haskitt, director of business planning for Syntex Laboratories, Inc., who will produce the OCs for Rugby, reports that their market research shows that people are very interested in having a generic OC available

  3. Public health within the EU policy space: a qualitative study of Organized Civil Society (OCS) and the Health in All Policies (HiAP) approach.

    PubMed

    Franklin, P K

    2016-07-01

    This article reviews how Organized Civil Society (OCS) groups in the field of public health work across the boundaries between European institutions and policy areas. In particular, it explores 1) how the Health in All Policies (HiAP) approach is conducted by these groups informally within the formal governance structures, and 2) how this advocacy work creates space for public health within the broader political determinants of health. A qualitative mixed-methods framework. Political ethnography, including 20 semi-structured interviews conducted with EU health strategy stakeholders and participant observations in public health events (n = 22) in Brussels over a three-year period (2012-2015), as well as four interviews with EU Member State representatives. Three additional semi-structured interviews were conducted with World Health Organization Regional Office for Europe staff members who had been involved in the drafting of the Health 2020 framework and strategy and the accompanying main implementation pillar, European Action Plan for Strengthening Public Health Capacities and Services (EAP-PHS). The findings provide an insight into OCS work in the field of European public health, offering an account of the experiences of HiAP work conducted by the research participants. The OCS groups perceive themselves as communicators between policy areas within European institutions and between local and supranational levels. The structures and political determinants of health that impose limitations on a public institution can at points be transcended by stakeholders, who conduct HiAP work at supranational level, thus negotiating space for public health within the competitive, globalized policy space. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. 7 CFR 43.105 - Operating characteristics (OC) curves.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 43.105 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER REGULATIONS STANDARDS FOR SAMPLING PLANS Sampling Plans § 43.105 Operating characteristics (OC...

  5. On the differences between 1.5oC and 2oC of global warming

    NASA Astrophysics Data System (ADS)

    King, A.

    2017-12-01

    The Paris Agreement of 2015 has resulted in a drive to limit global warming to 2oC with an aim for a lower 1.5oC target. It is therefore vital that we understand some of the differences we would expect between these two levels of global warming. My research uses coupled climate model projections to investigate where and for what variables we can differentiate between worlds of 1.5oC and 2oC global warming. I place a particular focus on climate extremes and population exposure to those extremes. I have found that there are perceptible benefits in limiting global warming to 1.5oC as opposed to 2oC through reduced frequency and intensity of heat extremes, both over land and in ocean areas where thermal stress on coral has resulted in bleaching. Differences in high and low precipitation extremes between the 1.5oC and 2oC global warming levels are projected for some regions. I have also examined how "scalable" changes from the 1.5oC to 2oC level are. In areas of the world such as Eastern China I find that changes in anthropogenic aerosol concentrations will influence the level of change projected at 1.5oC and 2oC, such that past warming is likely to be a poor indicator of future changes. Overall, my research finds clear benefits to limiting global warming to 1.5oC relative to higher levels.

  6. Portable Cathode-Air Vapor-Feed Electrochemical Medical Oxygen Concentrator (OC)

    NASA Technical Reports Server (NTRS)

    Balasubramanian, Ashwin

    2015-01-01

    Missions on the International Space Station and future space exploration will present significant challenges to crew health care capabilities, particularly in the efficient utilization of onboard oxygen resources. Exploration vehicles will require lightweight, compact, and portable oxygen concentrators that can provide medical-grade oxygen from the ambient cabin air. Current pressure-swing adsorption OCs are heavy and bulky, require significant start-up periods, operate in narrow temperature ranges, and require a liquid water feed. Lynntech, Inc., has developed an electrochemical OC that operates with a cathode-air vapor feed, eliminating the need for a bulky onboard water supply. Lynntech's OC is smaller and lighter than conventional pressure-swing OCs, is capable of instant start-up, and operates over a temperature range of 5-80 C. Accomplished through a unique nanocomposite proton exchange membrane and catalyst technology, the unit delivers 4 standard liters per minute of humidified oxygen at 60 percent concentration. The technology enables both ambient-pressure operating devices for portable applications and pressurized (up to 3,600 psi) OC devices for stationary applications.

  7. 15 CFR 930.73 - OCS plan.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false OCS plan. 930.73 Section 930.73...) Exploration, Development and Production Activities § 930.73 OCS plan. (a) The term “OCS plan” means any plan... described in detail in OCS plans approved by the Secretary of the Interior or designee prior to management...

  8. Generic OCs bioequivalent, but much maligned.

    PubMed

    1989-06-01

    Although generic oral contraceptives (OCs) are bioequivalent to brand-name formulations, many family planning professionals do not prescribe the significantly lower-priced generics. The Planned Parenthood Federation of America, for example, has refused to approve generic OCs for use in the organization's clinics, presumably because of concerns about their equivalent efficacy and safety. However, much of this skepticism may be fueled by misleading marketing by brand-name OC manufacturers. Sales representatives have reportedly told clinicians that generic OCs can be as much as 20% different from brand-name formulations, despite evidence collected by the US Food and Drug Administration confirming that there is virtually no difference except in terms of inert ingredients. In the case of many formulations, the variability between the generic and brand-name products is no different than the variability found between different lots of the same brand-name drug. Another obstacle to wider use of generic OCs is that discounts for large volume purchases make brand-name OCs the best buy for family planning clinics. Clinicians also note that clients complain of minor side effects whenever OC brands are changed, even if the compounds are the same. As the price of medication continues to rise, the more widespread availability of generic OCs will be especially important for teenagers and other low-income clients.

  9. First Observation and Analysis of OCS-C_4H_2 Dimer and (OCS)_2-C_4H_2 Trimer

    NASA Astrophysics Data System (ADS)

    Sheybani-Deloui, S.; Yousefi, Mahdi; Norooz Oliaee, Jalal; McKellar, Bob; Moazzen-Ahmadi, Nasser

    2014-06-01

    Infrared spectrum of a slipped near parallel isomer of OCS-C_4H_2 was observed in the region of νb{1} fundamental band of OCS monomer (˜2062 wn) using a diode laser to probe the supersonic slit jet expansion. The ab initio calculations at MP2 level indicate that the observed structure is the lowest energy isomer. The OCS-C_4H_2 band is composed of hybrid a/b-type transitions and was simulated by a conventional asymmetric top Hamiltonian with rotational constants of A=2892.15(10) MHz, B=1244.178(84) MHz, and C=868.692(52) MHz. The spectrum shows a relatively large red-shift of ˜6 wn with respect to the OCS monomer band origin. Also, one band for (OCS)_2-C_4H_2 trimer is observed around 2065 wn. This band is blue-shifted by 3 wn relative to the νb{1} fundamental band of OCS monomer. Our analysis shows that this trimer has C2 symmetry with rotational constants of A= 855.854(61) MHz, B=733.15(11) MHz, and C=610.10(38) MHz and c-type transitions. This structure is comparable with that of (OCS)_2-C_2H_2 where the OCS dimer unit within the trimer is non-polar. In addition to the normal isotoplogues, OCS-C_4D_2 and (OCS)_2-C_4D_2 were observed. In this talk, we discuss our observations and analysis on OCS-C_4H_2 dimer and (OCS)_2-C_4H_2 trimer. Mojtaba Rezaei, A. R. W. McKellar, and N. Moazzen-Ahmadi, J. Phys. Chem. A, 115, 10416 (2011).

  10. OCS National Compendium

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gould, G.J.; Karpas, R.M.; Slitor, D.L.

    1991-06-01

    The Minerals Management Service's (MMS) Outer Continental Shelf Information Program (OCSIP) is responsible for making available to affected coastal States, local governments, and other interested parties data and information related to the Outer Continental Shelf (OCS) Oil and Gas Program. Since its establishment through Section 26 of the OCS Lands Act (OCSLA) Amendments of 1978, OCSIP has prepared regional summary reports, updates, and indexes on leasing, exploration, development, and production activities to fulfill the mandates of the OCSLA Amendments. The OCSIP receives many requests for out-of-print summary reports, updates, and indexes. The purpose of the OCS National Compendium is tomore » consolidate these historical data and to present the data on an OCS-wide and regional scale. The single-volume approach allows the reader access to historical information and facilitates regional comparisons. The fold-out chart in the front of this publication provides the reader with a timeline (January 1988--November 1990) of events since publication of the last Compendium. Some of the events are directly related to the 5-year Oil and Gas Program, whereas others may or may not have an effect on the program. A predominantly graphic format is used in the report so that the large accumulation of data can be more readily comprehended. In some cases, it is not possible to update information through October 21, 1990, because of the nature of the data. For example, production data normally lags 3 months. 58 figs., 37 tabs.« less

  11. IR photodissociation spectroscopy of (OCS){sub n}{sup +} and (OCS){sub n}{sup −} cluster ions: Similarity and dissimilarity in the structure of CO{sub 2}, OCS, and CS{sub 2} cluster ions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Inokuchi, Yoshiya, E-mail: y-inokuchi@hiroshima-u.ac.jp; Ebata, Takayuki

    2015-06-07

    Infrared photodissociation (IRPD) spectra of (OCS){sub n}{sup +} and (OCS){sub n}{sup −} (n = 2–6) cluster ions are measured in the 1000–2300 cm{sup −1} region; these clusters show strong CO stretching vibrations in this region. For (OCS){sub 2}{sup +} and (OCS){sub 2}{sup −}, we utilize the messenger technique by attaching an Ar atom to measure their IR spectra. The IRPD spectrum of (OCS){sub 2}{sup +}Ar shows two bands at 2095 and 2120 cm{sup −1}. On the basis of quantum chemical calculations, these bands are assigned to a C{sub 2} isomer of (OCS){sub 2}{sup +}, in which an intermolecular semi-covalent bondmore » is formed between the sulfur ends of the two OCS components by the charge resonance interaction, and the positive charge is delocalized over the dimer. The (OCS){sub n}{sup +} (n = 3–6) cluster ions show a few bands assignable to “solvent” OCS molecules in the 2000–2080 cm{sup −1} region, in addition to the bands due to the (OCS){sub 2}{sup +} ion core at ∼2090 and ∼2120 cm{sup −1}, suggesting that the dimer ion core is kept in (OCS){sub 3–6}{sup +}. For the (OCS){sub n}{sup −} cluster anions, the IRPD spectra indicate the coexistence of a few isomers with an OCS{sup −} or (OCS){sub 2}{sup −} anion core over the cluster range of n = 2–6. The (OCS){sub 2}{sup −}Ar anion displays two strong bands at 1674 and 1994 cm{sup −1}. These bands can be assigned to a C{sub s} isomer with an OCS{sup −} anion core. For the n = 2–4 anions, this OCS{sup −} anion core form is dominant. In addition to the bands of the OCS{sup −} core isomer, we found another band at ∼1740 cm{sup −1}, which can be assigned to isomers having an (OCS){sub 2}{sup −} ion core; this dimer core has C{sub 2} symmetry and {sup 2}A electronic state. The IRPD spectra of the n = 3–6 anions show two IR bands at ∼1660 and ∼2020 cm{sup −1}. The intensity of the latter component relative to that of the former one becomes stronger and

  12. The LSST OCS scheduler design

    NASA Astrophysics Data System (ADS)

    Delgado, Francisco; Schumacher, German

    2014-08-01

    The Large Synoptic Survey Telescope (LSST) is a complex system of systems with demanding performance and operational requirements. The nature of its scientific goals requires a special Observatory Control System (OCS) and particularly a very specialized automatic Scheduler. The OCS Scheduler is an autonomous software component that drives the survey, selecting the detailed sequence of visits in real time, taking into account multiple science programs, the current external and internal conditions, and the history of observations. We have developed a SysML model for the OCS Scheduler that fits coherently in the OCS and LSST integrated model. We have also developed a prototype of the Scheduler that implements the scheduling algorithms in the simulation environment provided by the Operations Simulator, where the environment and the observatory are modeled with real weather data and detailed kinematics parameters. This paper expands on the Scheduler architecture and the proposed algorithms to achieve the survey goals.

  13. Commitment among state health officials & its implications for health sector reform: lessons from Gujarat.

    PubMed

    Maheshwari, Sunil; Bhat, Ramesh; Saha, Somen

    2008-02-01

    Commitment, competencies and skills of people working in the health sector can significantly impact the performance and its reform process. In this study we attempted to analyse the commitment of state health officials and its implications for human resource practices in Gujarat. A self-administered questionnaire was used to measure commitment and its relationship with human resource (HR) variables. Employee's organizational commitment (OC) and professional commitment (PC) were measured using OC and PC scale. Fifty five medical officers from Gujarat participated in the study. Professional commitment of doctors (3.21 to 4.01) was found to be higher than their commitment to the organization (3.01 to 3.61). Doctors did not perceive greater fairness in the system on promotion (on the scale of 5, score: 2.55) and were of the view that the system still followed seniority based promotion (score: 3.42). Medical officers were upset about low autonomy in the department with regard to reward and recognition, accounting procedure, prioritization and synchronization of health programme and other administrative activities. Our study provided some support for positive effects of progressive HR practices on OC, specifically on affective and normative OC. Following initiatives were identified to foster a development climate among the health officials: providing opportunities for training, professional competency development, developing healthy relationship between superiors and subordinates, providing useful performance feedback, and recognising and rewarding performance. For reform process in the health sector to succeed, there is a need to promote high involvement of medical officers. There is a need to invest in developing leadership quality, supervision skills and developing autonomy in its public health institutions.

  14. 30 CFR 581.14 - OCS mining area identification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false OCS mining area identification. 581.14 Section 581.14 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE... § 581.14 OCS mining area identification. The Secretary, after considering the available OCS mineral...

  15. 30 CFR 581.14 - OCS mining area identification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false OCS mining area identification. 581.14 Section 581.14 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE... § 581.14 OCS mining area identification. The Secretary, after considering the available OCS mineral...

  16. 30 CFR 581.14 - OCS mining area identification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false OCS mining area identification. 581.14 Section 581.14 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE... § 581.14 OCS mining area identification. The Secretary, after considering the available OCS mineral...

  17. JSpOC Cognitive Task Analysis

    NASA Astrophysics Data System (ADS)

    Aleva, D.; McCracken, J.

    This paper will overview a Cognitive Task Analysis (CTA) of the tasks accomplished by space operators in the Combat Operations Division (COD) of the Joint Space Operations Center (JSpOC). The methodology used to collect data will be presented. The work was performed in support of the AFRL Space Situation Awareness Fusion Intelligent Research Environment (SAFIRE) effort. SAFIRE is a multi-directorate program led by Air Force Research Laboratory (AFRL), Space Vehicles Directorate (AFRL/RV) and supporting Future Long Term Challenge 2.6.5. It is designed to address research areas identified from completion of a Core Process 3 effort for Joint Space Operations Center (JSpOC). The report is intended to be a resource for those developing capability in support of SAFIRE, the Joint Functional Component Command (JFCC) Space Integrated Prototype (JSIP) User-Defined Operating Picture (UDOP), and other related projects. The report is under distribution restriction; our purpose here is to expose its existence to a wider audience so that qualified individuals may access it. The report contains descriptions of the organization, its most salient products, tools, and cognitive tasks. Tasks reported are derived from the data collected and presented at multiple levels of abstraction. Recommendations for leveraging the findings of the report are presented. The report contains a number of appendices that amplify the methodology, provide background or context support, and includes references in support of cognitive task methodology. In a broad sense, the CTA is intended to be the foundation for relevant, usable capability in support of space warfighters. It presents, at an unclassified level, introductory material to familiarize inquirers with the work of the COD; this is embedded in a description of the broader context of the other divisions of the JSpOC. It does NOT provide guidance for the development of Tactics, Techniques, and Procedures (TT&Ps) in the development of JSpOC processes

  18. OC-2-KB: A software pipeline to build an evidence-based obesity and cancer knowledge base.

    PubMed

    Lossio-Ventura, Juan Antonio; Hogan, William; Modave, François; Guo, Yi; He, Zhe; Hicks, Amanda; Bian, Jiang

    2017-11-01

    Obesity has been linked to several types of cancer. Access to adequate health information activates people's participation in managing their own health, which ultimately improves their health outcomes. Nevertheless, the existing online information about the relationship between obesity and cancer is heterogeneous and poorly organized. A formal knowledge representation can help better organize and deliver quality health information. Currently, there are several efforts in the biomedical domain to convert unstructured data to structured data and store them in Semantic Web knowledge bases (KB). In this demo paper, we present, OC-2-KB (Obesity and Cancer to Knowledge Base), a system that is tailored to guide the automatic KB construction for managing obesity and cancer knowledge from free-text scientific literature (i.e., PubMed abstracts) in a systematic way. OC-2-KB has two important modules which perform the acquisition of entities and the extraction then classification of relationships among these entities. We tested the OC-2-KB system on a data set with 23 manually annotated obesity and cancer PubMed abstracts and created a preliminary KB with 765 triples. We conducted a preliminary evaluation on this sample of triples and reported our evaluation results.

  19. 33 CFR 143.120 - Floating OCS facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) OUTER CONTINENTAL SHELF ACTIVITIES DESIGN AND EQUIPMENT OCS Facilities § 143.120 Floating OCS facilities... (Marine Engineering) and J (Electrical Engineering) of 46 CFR chapter I and 46 CFR part 108 (Design and Equipment). Where unusual design or equipment needs make compliance impracticable, alternative proposals...

  20. Tactile/kinesthetic stimulation (TKS) increases tibial speed of sound and urinary osteocalcin (U-MidOC and unOC) in premature infants (29-32weeks PMA).

    PubMed

    Haley, S; Beachy, J; Ivaska, K K; Slater, H; Smith, S; Moyer-Mileur, L J

    2012-10-01

    Preterm delivery (<37 weeks post-menstrual age) is associated with suboptimal bone mass. We hypothesized that tactile/kinesthetic stimulation (TKS), a form of infant massage that incorporates kinesthetic movement, would increase bone strength and markers of bone accretion in preterm infants. Preterm, AGA infants (29-32 weeks) were randomly assigned to TKS (N=20) or Control (N=20). Twice daily TKS was provided 6 days per week for 2 weeks. Control infants received the same care without TKS treatment. Treatment was masked to parents, health care providers, and study personnel. Baseline and week two measures were collected for tibial speed of sound (tSOS, m/sec), a surrogate for bone strength, by quantitative ultrasound (Sunlight8000) and urine markers of bone metabolism, pyridinium crosslinks and osteocalcin (U-MidOC and unOC). Infant characteristics at birth and study entry as well as energy/nutrient intake were similar between TKS and Control. TKS intervention attenuated the decrease in tSOS observed in Control infants (p<0.05). Urinary pyridinium crosslinks decreased over time in both TKS and CTL (p<0.005). TKS infants experienced greater increases in urinary osteocalcin (U-MidOC, p<0.001 and unOC, p<0.05). We conclude that TKS improves bone strength in premature infants by attenuating the decrease that normally follows preterm birth. Further, biomarkers of bone metabolism suggest a modification in bone turnover in TKS infants in favor of bone accretion. Taken together, we speculate that TKS improves bone mineralization. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. 77 FR 18260 - Outer Continental Shelf (OCS), Alaska OCS Region, Cook Inlet Planning Area, Proposed Oil and Gas...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... OCS Region, Cook Inlet Planning Area, Proposed Oil and Gas Lease Sale 244 for OCS Oil and Gas Leasing...) identifies Sale 244 as a potential special interest sale for the Cook Inlet Planning Area in Alaska. While...-central region of the state, as evidenced by acreage leased in state sales and announced discoveries of...

  2. Variations in the OM/OC ratio of urban organic aerosol next to a major roadway.

    PubMed

    Brown, Steven G; Lee, Taehyoung; Roberts, Paul T; Collett, Jeffrey L

    2013-12-01

    Understanding the organic matter/organic carbon (OM/OC) ratio in ambient particulate matter (PM) is critical to achieve mass closure in routine PM measurements, to assess the sources of and the degree of chemical processing organic aerosol particles have undergone, and to relate ambient pollutant concentrations to health effects. Of particular interest is how the OM/OC ratio varies in the urban environment, where strong spatial and temporal gradients in source emissions are common. We provide results of near-roadway high-time-resolution PM1 OM concentration and OM/OC ratio observations during January 2008 at Fyfe Elementary School in Las Vegas, NV, 18 m from the U.S. 95 freeway soundwall, measured with an Aerodyne high-resolution time-of-flight aerosol mass spectrometer (HR-AMS). The average OM/OC ratio was 1.54 (+/- 0.20 standard deviation), typical of environments with a low amount of secondary aerosol formation. The 2-min average OM/OC ratios varied between 1.17 and 2.67, and daily average OM/OC ratios varied between 1.44 and 1.73. The ratios were highest during periods of low OM concentrations and generally low during periods of high OM concentrations. OM/OC ratios were low (1.52 +/- 0.14, on average) during the morning rush hour (average OM = 2.4 microg/m3), when vehicular emissions dominate this near-road measurement site. The ratios were slightly lower (1.46 +/- 0.10) in the evening (average OM = 6.3 microg/m3), when a combination of vehicular and fresh residential biomass burning emissions was typically present during times with temperature inversions. The hourly averaged OM/OC ratio peaked at 1.66 at midday. OM concentrations were similar regardless of whether the monitoring site was downwind or upwind of the adjacent freeway throughout the day, though they were higher during stagnant conditions (wind speed < 0.5 m/sec). The OM/OC ratio generally varied more with time of day than with wind direction and speed.

  3. Large CH4 production fueled by autochthonous OC in an anoxic sediment

    NASA Astrophysics Data System (ADS)

    Grasset, Charlotte; Mendonça, Raquel; Villamor Saucedo, Gabriella; Sobek, Sebastian

    2017-04-01

    River damming and human-induced eutrophication both affect river and lake functioning, increase organic carbon (OC) sedimentation rates and generate anoxic conditions in bottom waters. Under these conditions, OC in sediments is decomposed into CO2 and CH4, a high potential greenhouse gas. It has been shown that the decomposition of land-derived (allochthonous) OC is inhibited at anoxic conditions, compared to OC internally produced (autochthonous). However, the overall extent and end products (CO2 or CH4) of anoxic decomposition remain poorly known for different types of OC, making it difficult to judge the effect of river damming and eutrophication on greenhouse gas emissions from inland waters. We incubated different types of allochthonous OC (terrestrial plants) and autochthonous OC (phytoplankton and aquatic vascular plants) in an anoxic sediment during 130 days. We aimed to test 1) if this addition of relatively fresh OC resulted in an increase of CH4 production and 2) if autochthonous OC would produce more CH4 than allochthonous OC. We assessed the contribution to CH4 production of the different OC sources (i.e. sediment or added OC) with stable isotope measurements. We found that the addition of relatively fresh OC greatly increased CH4 production. Autochthonous OC generally produced more CH4 than allochthonous OC, but the overall extent of CH4 production was highly variable between the different autochthonous OC types. The d13C-CH4 measurements indicated that CH4 originated exclusively from the added OC. We conclude that the production of CH4 is likely to to be high in eutrophic as well as in artificial lakes, especially when these systems have anoxic bottom waters and high internal primary productivity and thus a high supply of autochthonous OC to the sediment. The current expansion of reservoir construction in concert with almost globally prevalent anthropogenic eutrophication are therefore likely to increase CH4 production in inland waters.

  4. Autism and ADHD Symptoms in Patients with OCD: Are They Associated with Specific OC Symptom Dimensions or OC Symptom Severity?

    ERIC Educational Resources Information Center

    Anholt, Gideon E.; Cath, Danielle C.; van Oppen, Patricia; Eikelenboom, Merijn; Smit, Johannes H.; van Megen, Harold; van Balkom, Anton J. L. M.

    2010-01-01

    In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and…

  5. Association between organizational capacity and involvement in chronic disease prevention programming among Canadian public health organizations

    PubMed Central

    Hanusaik, Nancy; Sabiston, Catherine M.; Kishchuk, Natalie; Maximova, Katerina; O’Loughlin, Jennifer

    2015-01-01

    In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement in core chronic disease prevention practices) and (ii) examined differences in the nature of these relationships among organizations operating in more and less facilitating external environments. OC was conceptualized as skills and resources/supports for chronic disease prevention programming. Data were from a census of 210 Canadian public health organizations with mandates for chronic disease prevention. The hypothesized relationships were tested using structural equation modeling. Overall, the results supported the model. Organizational supports for evaluation accounted for 33% of the variance in skills. Skills and resources/supports were directly and strongly related to involvement. Organizations operating within facilitating external contexts for chronic disease prevention had more effective partnerships, more resources/supports, stronger skills and greater involvement in core chronic disease prevention practices. Results also suggested that organizations functioning in less facilitating environments may not benefit as expected from partnerships. Empirical testing of this conceptual model helps develop a better understanding of public health OC. PMID:25361958

  6. 30 CFR 281.14 - OCS mining area identification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false OCS mining area identification. 281.14 Section 281.14 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF... mining area identification. The Secretary, after considering the available OCS mineral resources and...

  7. 30 CFR 281.14 - OCS mining area identification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false OCS mining area identification. 281.14 Section 281.14 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION, AND ENFORCEMENT, DEPARTMENT OF... SHELF Leasing Procedures § 281.14 OCS mining area identification. The Secretary, after considering the...

  8. Stable estimate of primary OC/EC ratios in the EC tracer method

    NASA Astrophysics Data System (ADS)

    Chu, Shao-Hang

    In fine particulate matter studies, the primary OC/EC ratio plays an important role in estimating the secondary organic aerosol contribution to PM2.5 concentrations using the EC tracer method. In this study, numerical experiments are carried out to test and compare various statistical techniques in the estimation of primary OC/EC ratios. The influence of random measurement errors in both primary OC and EC measurements on the estimation of the expected primary OC/EC ratios is examined. It is found that random measurement errors in EC generally create an underestimation of the slope and an overestimation of the intercept of the ordinary least-squares regression line. The Deming regression analysis performs much better than the ordinary regression, but it tends to overcorrect the problem by slightly overestimating the slope and underestimating the intercept. Averaging the ratios directly is usually undesirable because the average is strongly influenced by unrealistically high values of OC/EC ratios resulting from random measurement errors at low EC concentrations. The errors generally result in a skewed distribution of the OC/EC ratios even if the parent distributions of OC and EC are close to normal. When measured OC contains a significant amount of non-combustion OC Deming regression is a much better tool and should be used to estimate both the primary OC/EC ratio and the non-combustion OC. However, if the non-combustion OC is negligibly small the best and most robust estimator of the OC/EC ratio turns out to be the simple ratio of the OC and EC averages. It not only reduces random errors by averaging individual variables separately but also acts as a weighted average of ratios to minimize the influence of unrealistically high OC/EC ratios created by measurement errors at low EC concentrations. The median of OC/EC ratios ranks a close second, and the geometric mean of ratios ranks third. This is because their estimations are insensitive to questionable extreme

  9. An Efficient Method for Co-purification of Eggshell Matrix Proteins OC-17, OC-116, and OCX-36

    PubMed Central

    2016-01-01

    In this study, we improved the eggshell-membrane separation process by separating the shell and membrane with EDTA solution, evaluating effects of three different extraction solutions (acetic acid, EDTA, and phosphate solution), and co-purifying multiple eggshell proteins with two successive ion-exchange chromatography procedures (CM Sepharose Fast Flow and DEAE Sepharose Fast Flow). The recovery and residual rates of eggshell and membrane separated by the modified method with added EDTA solution were 93.88%, 91.15% and 1.01%, 2.87%, respectively. Ovocleidin-116 (OC-116) and ovocalyxin-36 (OCX-36) were obtained by loading 50 mM Na-Hepes, pH 7.5, 2 mM DTT and 350 mM NaCl buffer onto the DEAE-FF column at a flow rate of 1 mL/min, ovocleidin-17 (OC-17) was obtained by loading 100 mM NaCl, 50 mM Tris, pH 8.0 on the CM-FF column at a flow rate of 0.5 mL/min. The purities of OCX-36, OC-17 and OC-116 were 96.82%, 80.15% and 73.22%, and the recovery rates were 55.27%, 53.38% and 36.34%, respectively. Antibacterial activity test suggested that phosphate solution extract exhibited significantly higher activity against the tested bacterial strains than the acetic acid or EDTA extract, probably due to more types of proteins in the extract. These results demonstrate that this separation method is feasible and efficient. PMID:28115888

  10. Some indirect effects of positive practice overcorrection.

    PubMed

    Peters, Lindsay C; Thompson, Rachel H

    2013-01-01

    We evaluated the effects of positive practice overcorrection (PP OC) on levels of motor stereotypy and appropriate engagement in the activity practiced during treatment with 3 young men with autism. We also measured preference for the practiced activities during preference probes to determine if these activities might acquire aversive properties as a result of the frequent pairing with PP OC. Treatment reduced motor stereotypy for all 3 participants, and engagement increased for 2 of the 3 participants. Relative preference for the activities was not disrupted by the implementation of PP OC, although overall contact with the activities decreased for 1 participant. Results from 1 participant suggest that PP OC may be less effective when stereotypy results in access to a more highly preferred activity. © Society for the Experimental Analysis of Behavior.

  11. The influence of temperature calibration on the OC-EC results from a dual-optics thermal carbon analyzer

    NASA Astrophysics Data System (ADS)

    Pavlovic, J.; Kinsey, J. S.; Hays, M. D.

    2014-09-01

    Thermal-optical analysis (TOA) is a widely used technique that fractionates carbonaceous aerosol particles into organic and elemental carbon (OC and EC), or carbonate. Thermal sub-fractions of evolved OC and EC are also used for source identification and apportionment; thus, oven temperature accuracy during TOA analysis is essential. Evidence now indicates that the "actual" sample (filter) temperature and the temperature measured by the built-in oven thermocouple (or set-point temperature) can differ by as much as 50 °C. This difference can affect the OC-EC split point selection and consequently the OC and EC fraction and sub-fraction concentrations being reported, depending on the sample composition and in-use TOA method and instrument. The present study systematically investigates the influence of an oven temperature calibration procedure for TOA. A dual-optical carbon analyzer that simultaneously measures transmission and reflectance (TOT and TOR) is used, functioning under the conditions of both the National Institute of Occupational Safety and Health Method 5040 (NIOSH) and Interagency Monitoring of Protected Visual Environment (IMPROVE) protocols. The application of the oven calibration procedure to our dual-optics instrument significantly changed NIOSH 5040 carbon fractions (OC and EC) and the IMPROVE OC fraction. In addition, the well-known OC-EC split difference between NIOSH and IMPROVE methods is even further perturbed following the instrument calibration. Further study is needed to determine if the widespread application of this oven temperature calibration procedure will indeed improve accuracy and our ability to compare among carbonaceous aerosol studies that use TOA.

  12. Public Health Advocacy to Change Corporate Practices: Implications for Health Education Practice and Research

    ERIC Educational Resources Information Center

    Freudenberg, Nicholas

    2005-01-01

    Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article…

  13. Petroleum exploration and the Atlantic OCS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Edson, G.; Adinolfi, F.; Gray, F.

    1993-08-01

    The largest Atlantic outer continental shelf (OCS) lease sale was the first one, Sale 40 in 1976. Ninety-three Baltimore Canyon Trough petroleum leases were issued, and industry's winning bids total $1.1 billion. The highest bonus bids were for leases overlying the Schlee Dome, then called Great Stone Dome, a large structure with a very large fetch area. By 1981, seven dry wells on the dome moderated this initial flush of optimism. However, subeconomic quantities of gas and light oil were discovered on the nearby Hudson Canyon Block 598-642 structure. Now after 9 lease sales, 410 lease awards, and 46 explorationmore » wells, United States Atlantic petroleum exploration activity is in a hiatus. Fifty-three leases remain active under suspensions of operation. Twenty-one lease blocks, about 50 mi offshore from Cape Hatteras, have been combined as the Manteo Exploration Unit. Mobil and partners submitted an exploration plant for the unit in 1989. The Atlantic OCS has petroleum potential, especially for gas. With only 46 exploration wells, entire basins and plays remain untested. During the present exploration inactivity, some petroleum evaluation of the Atlantic OCS continues by the Minerals Management Service and others. Similarities and differences are being documented between United States basins and the Canadian Scotian Basin, which contains oil and gas in commercial quantities. Other initiatives include geochemical, thermal history, seismic stratigraphic, and petroleum system modeling studies. The gas-prone Atlantic OCS eventually may make an energy contribution, especially to nearby East Coast markets.« less

  14. Health Practices of School Nurses

    ERIC Educational Resources Information Center

    Petch-Levine, Deborah; Cureton, Virginia Young; Canham, Daryl; Murray, Meg

    2003-01-01

    The health practices of school nurses affect our role as advocates and educators to promote the health of youth. This study describes the health practices of a convenience sample of 388 school nurses who attended the business meeting at an annual school nurse conference. A self-administered, 40-item questionnaire identified health practices of…

  15. Public health advocacy to change corporate practices: implications for health education practice and research.

    PubMed

    Freudenberg, Nicholas

    2005-06-01

    Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article describes how corporate policies influence health and reviews recent health campaigns aimed at changing corporate behavior in six industries selected for their central role in the U.S. economy and their influence on major causes of mortality and morbidity. These are the alcohol, automobile, food, gun, pharmaceutical, and tobacco industries. The article defines corporate disease promotion and illustrates the range of public health activities that have emerged to counter such corporate behaviors. It analyzes the role of health professionals, government, and advocacy groups in these campaigns and assesses the implications of this domain for health education practice and research.

  16. Association between organizational capacity and involvement in chronic disease prevention programming among Canadian public health organizations.

    PubMed

    Hanusaik, Nancy; Sabiston, Catherine M; Kishchuk, Natalie; Maximova, Katerina; O'Loughlin, Jennifer

    2015-04-01

    In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement in core chronic disease prevention practices) and (ii) examined differences in the nature of these relationships among organizations operating in more and less facilitating external environments. OC was conceptualized as skills and resources/supports for chronic disease prevention programming. Data were from a census of 210 Canadian public health organizations with mandates for chronic disease prevention. The hypothesized relationships were tested using structural equation modeling. Overall, the results supported the model. Organizational supports for evaluation accounted for 33% of the variance in skills. Skills and resources/supports were directly and strongly related to involvement. Organizations operating within facilitating external contexts for chronic disease prevention had more effective partnerships, more resources/supports, stronger skills and greater involvement in core chronic disease prevention practices. Results also suggested that organizations functioning in less facilitating environments may not benefit as expected from partnerships. Empirical testing of this conceptual model helps develop a better understanding of public health OC. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  17. Distinct high molecular weight organic compound (HMW-OC) types in aerosol particles collected at a coastal urban site

    NASA Astrophysics Data System (ADS)

    Dall'Osto, M.; Healy, R. M.; Wenger, J. C.; O'Dowd, C.; Ovadnevaite, J.; Ceburnis, D.; Harrison, Roy M.; Beddows, D. C. S.

    2017-12-01

    Organic oligomers were discovered in laboratory-generated atmospheric aerosol over a decade ago. However, evidence for the presence of oligomers in ambient aerosols is scarce and mechanisms for their formation have yet to be fully elucidated. In this work, three unique aerosol particle types internally mixed with High molecular weight organic compounds (HMW-OC) species - likely oligomers - were detected in ambient air using single particle Aerosol Time-Of-Flight Mass Spectrometry (ATOFMS) in Cork (Ireland) during winter 2009. These particle types can be described as follows: (1) HMW-OCs rich in organic nitrogen - possibly containing nitrocatechols and nitroguaiacols - originating from primary emissions of biomass burning particles during evening times; (2) HMW-OCs internally mixed with nitric acid, occurring in stagnant conditions during night time; and (3) HMW-OCs internally mixed with sea salt, likely formed via photochemical reactions during day time. The study exemplifies the power of methodologies capable of monitoring the simultaneous formation of organic and inorganic particle-phase reaction products. Primary emissions and atmospheric aging of different types of HMW-OC contributes to aerosol with a range of acidity, hygroscopic and optical properties, which can have different impacts on climate and health.

  18. Rotational spectra of the van der Waals complexes of molecular hydrogen and OCS.

    PubMed

    Yu, Zhenhong; Higgins, Kelly J; Klemperer, William; McCarthy, Michael C; Thaddeus, Patrick; Liao, Kristine; Jäger, Wolfgang

    2007-08-07

    The a- and b-type rotational transitions of the weakly bound complexes formed by molecular hydrogen and OCS, para-H2-OCS, ortho-H2-OCS, HD-OCS, para-D2-OCS, and ortho-D2-OCS, have been measured by Fourier transform microwave spectroscopy. All five species have ground rotational states with total rotational angular momentum J=0, regardless of whether the hydrogen rotational angular momentum is j=0 as in para-H2, ortho-D2, and HD or j=1 as in ortho-H2 and para-D2. This indicates quenching of the hydrogen angular momentum for the ortho-H2 and para-D2 species by the anisotropy of the intermolecular potential. The ground states of these complexes are slightly asymmetric prolate tops, with the hydrogen center of mass located on the side of the OCS, giving a planar T-shaped molecular geometry. The hydrogen spatial distribution is spherical in the three j=0 species, while it is bilobal and oriented nearly parallel to the OCS in the ground state of the two j=1 species. The j=1 species show strong Coriolis coupling with unobserved low-lying excited states. The abundance of para-H2-OCS relative to ortho-H2-OCS increases exponentially with decreasing normal H2 component in H2He gas mixtures, making the observation of para-H2-OCS in the presence of the more strongly bound ortho-H2-OCS dependent on using lower concentrations of H2. The determined rotational constants are A=22 401.889(4) MHz, B=5993.774(2) MHz, and C=4602.038(2) MHz for para-H2-OCS; A=22 942.218(6) MHz, B=5675.156(7) MHz, and C=4542.960(7) MHz for ortho-H2-OCS; A=15 970.010(3) MHz, B=5847.595(1) MHz, and C=4177.699(1) MHz for HD-OCS; A=12 829.2875(9) MHz, B=5671.3573(7) MHz, and C=3846.7041(6) MHz for ortho-D2-OCS; and A=13 046.800(3) MHz, B=5454.612(2) MHz, and C=3834.590(2) MHz for para-D2-OCS.

  19. Menstrual cyclicity post OC withdrawal in PCOS: Use of non-hormonal options.

    PubMed

    Kulshreshtha, Bindu; Arora, Arpita; Pahuja, Isha; Sharma, Neera; Pant, Shubhi

    2016-08-01

    There is no data on menstrual cyclicity post oral contraceptive (OC) withdrawal with nonhormonal options in PCOS patients. OC could affect obesity, insulin and gonadotropins factors integral to pathogenesis of PCOS, thereby adversely affecting the HPG axis. Menstrual cycles of PCOS patients were retrospectively studied post OCP. Patients developing regular versus irregular cycles post OC were compared. Forty-eight PCOS patients were followed for an average of 1.9 years post OC. Thirty-six (75%) achieved regular cycles over a period of one year with other nonhormonal options like spironolactone and metformin. Seven patients required no treatment. Patients who continued to have irregular cycles had a longer pre OC cycle length (p < 0.01) and a greater duration of menstrual irregularity (p < 0.02), though age, BMI and hormones were similar in the two groups. In conclusion, spironolactone and metformin are effective nonhormonal options for regular periods post OC. Around 15% PCOS may not require any treatment post OC.

  20. 46 CFR 32.15-30 - Radar-T/OC.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Radar-T/OC. 32.15-30 Section 32.15-30 Shipping COAST... Navigation Equipment § 32.15-30 Radar—T/OC. All tankships of 1,600 gross tons and over in ocean or coastwise service must be fitted with a marine radar system for surface navigation. Facilities for plotting radar...

  1. 46 CFR 32.15-30 - Radar-T/OC.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Radar-T/OC. 32.15-30 Section 32.15-30 Shipping COAST... Navigation Equipment § 32.15-30 Radar—T/OC. All tankships of 1,600 gross tons and over in ocean or coastwise service must be fitted with a marine radar system for surface navigation. Facilities for plotting radar...

  2. 46 CFR 32.15-30 - Radar-T/OC.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Radar-T/OC. 32.15-30 Section 32.15-30 Shipping COAST... Navigation Equipment § 32.15-30 Radar—T/OC. All tankships of 1,600 gross tons and over in ocean or coastwise service must be fitted with a marine radar system for surface navigation. Facilities for plotting radar...

  3. 46 CFR 32.15-30 - Radar-T/OC.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Radar-T/OC. 32.15-30 Section 32.15-30 Shipping COAST... Navigation Equipment § 32.15-30 Radar—T/OC. All tankships of 1,600 gross tons and over in ocean or coastwise service must be fitted with a marine radar system for surface navigation. Facilities for plotting radar...

  4. 46 CFR 32.15-30 - Radar-T/OC.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Radar-T/OC. 32.15-30 Section 32.15-30 Shipping COAST... Navigation Equipment § 32.15-30 Radar—T/OC. All tankships of 1,600 gross tons and over in ocean or coastwise service must be fitted with a marine radar system for surface navigation. Facilities for plotting radar...

  5. Characterisation of an OCS-dependent severe asthma population treated with mepolizumab.

    PubMed

    Prazma, C M; Wenzel, S; Barnes, N; Douglass, J A; Hartley, B F; Ortega, H

    2014-12-01

    A subpopulation of patients with asthma treated with maximal inhaled treatments is unable to maintain asthma control and requires additional therapy with oral corticosteroids (OCS); a subset of this population continues to have frequent exacerbations. Alternate treatment options are needed as daily use of OCS is associated with significant systemic adverse effects that affect many body systems and have a direct association with the dose and duration of OCS use. We compared the population demographics, medical conditions and efficacy responses of the OCS-dependent group from the DREAM study of mepolizumab with the group not managed with daily OCS. NCT01000506. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Thermal Properties of SiOC Glasses and Glass Ceramics at Elevated Temperatures

    PubMed Central

    Stabler, Christina; Reitz, Andreas; Stein, Peter; Albert, Barbara; Riedel, Ralf

    2018-01-01

    In the present study, the effect of the chemical and phase composition on the thermal properties of silicon oxide carbides (SiOC) has been investigated. Dense monolithic SiOC materials with various carbon contents were prepared and characterized with respect to their thermal expansion, as well as thermal conductivity. SiOC glass has been shown to exhibit low thermal expansion (e.g., ca. 3.2 × 10−6 K−1 for a SiOC sample free of segregated carbon) and thermal conductivity (ca. 1.5 W/(m∙K)). Furthermore, it has been observed that the phase separation, which typically occurs in SiOC exposed to temperatures beyond 1000–1200 °C, leads to a decrease of the thermal expansion (i.e., to 1.83 × 10−6 K−1 for the sample above); whereas the thermal conductivity increases upon phase separation (i.e., to ca. 1.7 W/(m∙K) for the sample mentioned above). Upon adjusting the amount of segregated carbon content in SiOC, its thermal expansion can be tuned; thus, SiOC glass ceramics with carbon contents larger than 10–15 vol % exhibit similar coefficients of thermal expansion to that of the SiOC glass. Increasing the carbon and SiC content in the studied SiOC glass ceramics leads to an increase in their thermal conductivity: SiOC with relatively large carbon and silicon carbides (SiC) volume fractions (i.e., 12–15 and 20–30 vol %, respectively) were shown to possess thermal conductivities in the range from 1.8 to 2.7 W/(m∙K). PMID:29439441

  7. 46 CFR 35.20-40 - Maneuvering characteristics-T/OC.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Maneuvering characteristics-T/OC. 35.20-40 Section 35.20-40 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Navigation § 35.20-40 Maneuvering characteristics—T/OC. For each ocean and coastwise tankship of 1,600 gross tons or...

  8. Space Weather Forecasting at the Joint Space Operations Center (JSpOC)

    NASA Astrophysics Data System (ADS)

    Nava, O.

    2012-12-01

    The Joint Space Operations Center (JSpOC) at Vandenberg Air Force Base is the command and control focal point for the operational employment of worldwide joint space forces. The JSpOC focuses on planning and executing US Strategic Command's Joint Functional Component Command for Space (JFCC SPACE) mission. Through the JSpOC, the Weather Specialty Team (WST) monitors space and terrestrial weather effects, plans and assesses weather impacts on military operations, and provides reach-back support for deployed theater solar and terrestrial needs. This presentation will detail how space weather affects the JSpOC mission set and how the scientific community can enhance the WST's capabilities and effectiveness.

  9. Field-free molecular orientation of nonadiabatically aligned OCS

    NASA Astrophysics Data System (ADS)

    Sonoda, Kotaro; Iwasaki, Atsushi; Yamanouchi, Kaoru; Hasegawa, Hirokazu

    2018-02-01

    We investigate an enhancement of the orientation of OCS molecules by irradiating them with a near IR (ω) ultrashort laser pulse for alignment followed by another ultrashort laser pulse for orientation, which is synthesized by a phase-locked coherent superposition of the near IR laser pulse and its second harmonic (2ω). On the basis of the asymmetry in the ejection direction of S3+ fragment ions generated by the Coulomb explosion of multiply charged OCS, we show that the extent of the orientation of OCS is significantly enhanced when the delay between the alignment pulse and the orientation pulse is a quarter or three quarters of the rotational period. The recorded enhanced orientation was interpreted well by a numerical simulation of the temporal evolution of a rotational wave packet prepared by the alignment and orientation pulses.

  10. The Relative Contributions of Experiential Avoidance and Distress Tolerance to OC Symptoms.

    PubMed

    Blakey, Shannon M; Jacoby, Ryan J; Reuman, Lillian; Abramowitz, Jonathan S

    2016-07-01

    Obsessive beliefs account for substantial (but not all) obsessive-compulsive (OC) symptoms. Intolerance of internal experiences (IIE), which encompasses the constructs of experiential avoidance (EA) and distress tolerance (DT), refers to difficulty managing unwanted thoughts, emotions, and other internal states, and might add to current explanatory models. Although IIE appears to be conceptually relevant to obsessive-compulsive (OC) symptoms, scant research has examined this relationship empirically. The present study examined the relative contributions of EA and DT as predictors of OC symptom dimensions. A nonclinical sample (n = 496) completed self-report questionnaires measuring general distress, EA, DT and OC symptom dimensions. All variables of interest were significantly (all ps ≤ .001) correlated with one another, such that higher general distress, higher EA, and lower DT were associated with greater OC symptom severity for all symptom dimensions; however, only EA independently predicted obsessional symptoms, but not other OC symptom dimensions. One's willingness to endure (i.e. EA), rather than their ability to tolerate (i.e. DT) unpleasant internal experiences best predicts obsessional symptoms (i.e. obsessing) above and beyond general distress. Potential implications for understanding, assessing, and treating OC symptoms are discussed.

  11. Drinking Patterns, Gender and Health I: Attitudes and Health Practices

    PubMed Central

    Polen, Michael R.; Green, Carla A.; Perrin, Nancy A.; Anderson, Bradley M.; Weisner, Constance M.

    2012-01-01

    Background Despite considerable research, relationships among gender, alcohol consumption, and health remain controversial, due to potential confounding by health-related attitudes and practices associated with drinking, measurement challenges, and marked gender differences in drinking. We examined gender/alcohol consumption differences in health-related attitudes and practices, and evaluated how these factors affected relationships among gender, alcohol consumption, and health status. Methods A stratified random sample of adult health-plan members completed a mail survey, yielding 7884 respondents (2995 male/4889 female). Using MANCOVAs and adjusting for health-related attitudes, values, and practices, we examined gender differences in relationships between alcohol consumption and health. Results More frequent heavy drinking was associated with worse health-related attitudes and values, worse feelings about visiting the doctor, and worse health-related practices. Relationships between health-related practices and alcohol use differed by gender, and daily or almost daily heavy drinking was associated with significantly lower physical and mental health for women compared to men. Drinking status (lifelong abstainers, former drinkers, and level of regular alcohol consumption) was related to health status and vitality, even after adjusting for health-related attitudes, values, and practices. Relationships did not differ by gender. Former drinkers reported lower physical and mental health status than either lifelong abstainers or current drinkers. Conclusions Drinking status is independently related to physical health, mental health, and vitality, even after controlling for the health-related attitudes, values, and practices expected to confound these relationships. Among current drinkers, women who engage in very frequent heavy drinking have worse physical and mental health than their male counterparts. PMID:23946720

  12. Health promotion practice and its implementation in Swedish health care.

    PubMed

    Brobeck, E; Odencrants, S; Bergh, H; Hildingh, C

    2013-09-01

    Health promotion practice is an important work assignment within the entire health and medical care sector. Nurses are important for the development and implementation of health promotion in clinical practice. The aim was to describe how district nurses view health promotion practice and how it was implemented in clinical practice following a training initiative. The study has a descriptive design and a qualitative method. The sample consisted of three focus groups with 16 participants. The interviews were conducted as a conversation with focus on the district nurses view of health promotion and its implementation in clinical practice. The data have been processed using manifest qualitative content analysis. Three categories, titled Training as motivation, Lack of grounding and Lack of scope were identified. The result demonstrated that training provides motivation, but also the importance of grounding in the organization and the need for scope in performing health promotion practice. Our results show that the training initiative has contributed positively to the district nurses' view of health promotion practice, but that they also feel that there are obstacles. The district nurses in our study suggest that health promotion practice should be more visible, and not something that is done when time permits. The district nurses feel motivated and have an enthusiasm for health promotion practice but more time and resources are required to design successful health-promoting initiatives. Before implementing a major training initiative for healthcare personnel in health promotion, it is essential to examine whether the conditions for this exist in the organization. © 2013 International Council of Nurses.

  13. 33 CFR 147.815 - ExxonMobil Hoover Floating OCS Facility safety zone.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false ExxonMobil Hoover Floating OCS... HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.815 ExxonMobil Hoover Floating OCS Facility safety zone. (a) Description. The ExxonMobil Hoover Floating OCS Facility, Alaminos...

  14. 33 CFR 147.815 - ExxonMobil Hoover Floating OCS Facility safety zone.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false ExxonMobil Hoover Floating OCS... HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.815 ExxonMobil Hoover Floating OCS Facility safety zone. (a) Description. The ExxonMobil Hoover Floating OCS Facility, Alaminos...

  15. 33 CFR 147.815 - ExxonMobil Hoover Floating OCS Facility safety zone.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false ExxonMobil Hoover Floating OCS... HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.815 ExxonMobil Hoover Floating OCS Facility safety zone. (a) Description. The ExxonMobil Hoover Floating OCS Facility, Alaminos...

  16. 33 CFR 147.815 - ExxonMobil Hoover Floating OCS Facility safety zone.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false ExxonMobil Hoover Floating OCS... HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.815 ExxonMobil Hoover Floating OCS Facility safety zone. (a) Description. The ExxonMobil Hoover Floating OCS Facility, Alaminos...

  17. Global carbonyl sulfide (OCS) measured by MIPAS/Envisat during 2002-2012

    NASA Astrophysics Data System (ADS)

    Glatthor, Norbert; Höpfner, Michael; Leyser, Adrian; Stiller, Gabriele P.; von Clarmann, Thomas; Grabowski, Udo; Kellmann, Sylvia; Linden, Andrea; Sinnhuber, Björn-Martin; Krysztofiak, Gisèle; Walker, Kaley A.

    2017-02-01

    We present a global carbonyl sulfide (OCS) data set covering the period June 2002 to April 2012, derived from FTIR (Fourier transform infrared) limb emission spectra measured with the Michelson Interferometer for Passive Atmospheric Sounding (MIPAS) on the ENVISAT satellite. The vertical resolution is 4-5 km in the height region 6-15 km and 15 at 40 km altitude. The total estimated error amounts to 40-50 pptv between 10 and 20 km and to 120 pptv at 40 km altitude. MIPAS OCS data show no systematic bias with respect to balloon observations, with deviations mostly below ±50 pptv. However, they are systematically higher than the OCS volume mixing ratios of the ACE-FTS instrument on SCISAT, with maximum deviations of up to 100 pptv in the altitude region 13-16 km. The data set of MIPAS OCS exhibits only moderate interannual variations and low interhemispheric differences. Average concentrations at 10 km altitude range from 480 pptv at high latitudes to 500-510 pptv in the tropics and at northern mid-latitudes. Seasonal variations at 10 km altitude amount to up to 35 pptv in the Northern and up to 15 pptv in the Southern Hemisphere. Northern hemispheric OCS abundances at 10 km altitude peak in June in the tropics and around October at high latitudes, while the respective southern hemispheric maxima were observed in July and in November. Global OCS distributions at 250 hPa (˜ 10-11 km) show enhanced values at low latitudes, peaking during boreal summer above the western Pacific and the Indian Ocean, which indicates oceanic release. Further, a region of depleted OCS amounts extending from Brazil to central and southern Africa was detected at this altitude, which is most pronounced in austral summer. This depletion is related to seasonally varying vegetative uptake by the tropical forests. Typical signatures of biomass burning like the southern hemispheric biomass burning plume are not visible in MIPAS data, indicating that this process is only a minor source of upper

  18. Tunneling Characteristics Depending on Schottky Barriers and Diffusion Current in SiOC.

    PubMed

    Oh, Teresa; Kim, Chy Hyung

    2016-02-01

    To obtain a diffusion current in SiOC, the aluminum doped zinc oxide films were deposited on SiOC/Si wafer by a RF magnetron sputtering. All the X-ray patterns of the SiOC films showed amorphous phases. The level of binding energy of Si atoms will lead to an additional potential modulation by long range Coulombic and covalent interactions with oxygen ions. The growth of the AZO film was affected by the characteristics of SiOC, resulting in similar trends in XPS spectra and a shift to higher AZO lattice d values than the original AZO d values in XRD analyses. The charges trapped by the defects at the interlayer between AZO and SiOC films induced the decreased mobility of carriers. In the absence of trap charges, AZO grown on SiOC film such as the sample prepared at O2 = 25 or 30 sccm, which has low charge carrier concentration and high mobility, showed high mobility in an ambipolar characteristic of oxide semiconductor due to the tunneling effect and diffusion current. The structural matching of an interface between AZO and amorphous SiOC enhanced the height of Schottky Barrier (SB), and then the mobility was increased by the tunneling effect from band to band through the high SB.

  19. Theory vs. experiment for molecular clusters: Spectra of OCS trimers and tetramers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Evangelisti, Luca; Dipartimento di Chimica “G. Ciamician,” University of Bologna, Via Selmi 2, Bologna 40126; Perez, Cristobal

    All singly substituted {sup 13}C, {sup 18}O, and {sup 34}S isotopomers of the previously known OCS trimer are observed in natural abundance in a broad-band spectrum measured with a chirped-pulse Fourier transform microwave spectrometer. The complete substitution structure thus obtained critically tests (and confirms) the common assumption that monomers tend to retain their free structure in a weakly bound cluster. A new OCS trimer isomer is also observed, and its structure is determined to be barrel-shaped but with the monomers all approximately aligned, in contrast to the original trimer which is barrel-shaped with two monomers aligned and one anti-aligned. Anmore » OCS tetramer spectrum is assigned for the first time, and the tetramer structure resembles an original trimer with an OCS monomer added at the end with two sulfur atoms. Infrared spectra observed in the region of the OCS ν{sub 1} fundamental (≈2060 cm{sup −1}) are assigned to the same OCS tetramer, and another infrared band is tentatively assigned to a different tetramer isomer. The experimental results are compared and contrasted with theoretical predictions from the literature and from new cluster calculations which use an accurate OCS pair potential and assume pairwise additivity.« less

  20. 33 CFR 147.815 - ExxonMobil Hoover Floating OCS Facility safety zone.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false ExxonMobil Hoover Floating OCS... Floating OCS Facility safety zone. (a) Description. The ExxonMobil Hoover Floating OCS Facility, Alaminos... (1640.4 feet) from each point on the structure's outer edge is a safety zone. (b) Regulation. No vessel...

  1. Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations.

    PubMed

    Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J

    2016-04-01

    Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap.

  2. The impact of corporate practices on health: implications for health policy.

    PubMed

    Freudenberg, Nicholas; Galea, Sandro

    2008-04-01

    Although corporate practices play a substantial role in shaping health and health behavior, public health researchers have rarely systematically studied these practices as a social determinant of health. We consider case studies of three products - trans fat, a food additive and a preservative; Vioxx, a pain killer; and sports utility vehicles - to illustrate the role of corporate policies and practices in the production of health and disease and the implications for health policy. In recent years, public health advocates, researchers, and lawyers have used strategies to reduce the adverse health impact of corporate practices. Systematic analysis of these experiences yields insights that can guide the development of health policies that increase opportunities for primary prevention by discouraging harmful corporate practices.

  3. Association of health professional leadership behaviors on health promotion practice beliefs.

    PubMed

    Stone, Jacqueline D; Belcher, Harolyn M E; Attoh, Prince; D'Abundo, Michelle; Gong, Tao

    2017-04-01

    Leadership is a process by which an individual influences a group or individual to achieve a common goal, in this case health promotion for individuals with disabilities. (1) To examine the association between the transformational leadership behaviors of the Association of University Centers on Disabilities (AUCD) network professionals and their practice beliefs about health promotion activities, specifically cardiovascular fitness and healthy weight, for people with disabilities. (2) To determine if discipline and/or years of practice moderate the association between transformational leadership behaviors and practice beliefs regarding health promotion. There is a positive association between transformational leadership behaviors and health professionals practice beliefs regarding health promotion activities for persons with disabilities. A quantitative cross-sectional web-based survey design was used to determine the association between leadership behaviors and practices beliefs regarding health promotion for people with disabilities. The Multifactor Leadership Questionnaire and an adapted version of the Role of Health Promotion in Physical Therapy Survey were used to measure leadership and practice beliefs, respectively. Multiple regression analysis was applied to determine the association of leadership behaviors with health promotion practice beliefs variables. Transformational leadership behaviors of the AUCD network professionals were positively associated with health promotion practice beliefs about cardiovascular fitness for people with disabilities. Years post licensure and discipline did not moderate the association between transformational leadership and practice beliefs regarding health promotion. Transformational leadership may facilitate health professionals' health promotion practices for people with disabilities. Further research and training in leadership is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. The O.C.: Our Guide to ALA in Anaheim

    ERIC Educational Resources Information Center

    Hardstark, Georgia

    2008-01-01

    For those who grew up in Orange County (O.C.), Disneyland is the metaphoric morsel of food that gets stuck between the teeth of someone one does not like. While D-land is a must-see for millions of visitors each year, there is much more to Anaheim. Although O.C. is portrayed on numerous reality TV shows as a mecca for rich white people with…

  5. Inter-comparison of NIOSH and IMPROVE protocols for OC and EC determination: implications for inter-protocol data conversion

    NASA Astrophysics Data System (ADS)

    Wu, Cheng; Huang, X. H. Hilda; Ng, Wai Man; Griffith, Stephen M.; Zhen Yu, Jian

    2016-09-01

    Organic carbon (OC) and elemental carbon (EC) are operationally defined by analytical methods. As a result, OC and EC measurements are protocol dependent, leading to uncertainties in their quantification. In this study, more than 1300 Hong Kong samples were analyzed using both National Institute for Occupational Safety and Health (NIOSH) thermal optical transmittance (TOT) and Interagency Monitoring of Protected Visual Environment (IMPROVE) thermal optical reflectance (TOR) protocols to explore the cause of EC disagreement between the two protocols. EC discrepancy mainly (83 %) arises from a difference in peak inert mode temperature, which determines the allocation of OC4NSH, while the rest (17 %) is attributed to a difference in the optical method (transmittance vs. reflectance) applied for the charring correction. Evidence shows that the magnitude of the EC discrepancy is positively correlated with the intensity of the biomass burning signal, whereby biomass burning increases the fraction of OC4NSH and widens the disagreement in the inter-protocol EC determination. It is also found that the EC discrepancy is positively correlated with the abundance of metal oxide in the samples. Two approaches (M1 and M2) that translate NIOSH TOT OC and EC data into IMPROVE TOR OC and EC data are proposed. M1 uses direct relationship between ECNSH_TOT and ECIMP_TOR for reconstruction: M1 : ECIMP_TOR = a × ECNSH_TOT + b; while M2 deconstructs ECIMP_TOR into several terms based on analysis principles and applies regression only on the unknown terms: M2 : ECIMP_TOR = AECNSH + OC4NSH - (a × PCNSH_TOR + b), where AECNSH, apparent EC by the NIOSH protocol, is the carbon that evolves in the He-O2 analysis stage, OC4NSH is the carbon that evolves at the fourth temperature step of the pure helium analysis stage of NIOSH, and PCNSH_TOR is the pyrolyzed carbon as determined by the NIOSH protocol. The implementation of M1 to all urban site data (without considering seasonal specificity

  6. Spatial and Temporal Variations of EC and OC Aerosol Combustion Sources in a Polluted Metropolitan Area

    NASA Astrophysics Data System (ADS)

    Mouteva, G.; Randerson, J. T.; Fahrni, S.; Santos, G.; Bush, S. E.; Ehleringer, J. R.; Czimczik, C. I.

    2015-12-01

    Anthropogenic emissions of carbonaceous aerosols are a major component of fine air particulate matter (PM2.5) in polluted metropolitan areas and in the global atmosphere. Elemental (EC) and organic carbon (OC) aerosols influence Earth's energy balance by means of direct and indirect pathways and EC has been suggested as a better indicator of public health impacts from combustion-related sources than PM mass. Quantifying the contribution of fossil fuel and biomass combustion to the EC and OC emissions and their temporal and spatial variations is critical for developing efficient legislative air pollution control measures and successful climate mitigation strategies. In this study, we used radiocarbon (14C) to separate and quantify fossil and biomass contributions to a time series of EC and OC collected at 3 locations in Salt Lake City (SLC). Aerosol samples were collected on quartz fiber filters and a modified OC/EC analyzer was used with the Swiss_4S protocol to isolate and trap the EC fraction. Together with the total carbon (TC) content of the samples, the EC was analyzed for its 14C content with accelerator mass spectrometry. The 14C of OC was derived as a mass balance difference between TC and EC. EC had an annual average fraction modern of 0.13±0.06 and did not vary significantly across seasons. OC had an annual average FM of 0.49±0.13, with the winter mean (0.43±0.11) lower than the summer mean (0.64±0.13) at the 5% significance level. While the 3 stations were chosen to represent a variety of environmental conditions within SLC, no major differences in this source partitioning were observed between stations. During winter, the major sources of air pollutants in SLC are motor vehicles and wood stove combustion and determining their relative contributions has been the subject of debate. Our results indicated that fossil fuels were the dominant source of carbonaceous aerosols during winter, contributing 87% or more of the total EC mass and 40-75% of the OC

  7. Oil-Spill Analysis: Gulf of Mexico Outer Continental Shelf (OCS) Lease Sales, Eastern Planning Area, 2003-2007 and Gulfwide OCS Program, 2003-2042

    NASA Astrophysics Data System (ADS)

    2002-09-01

    The Federal Government plans to offer U.S. Outer Continental Shelf (OCS) lands in the Eastern Planning Area of the Gulf of Mexico (GOM) for oil and gas leasing. This report summarizes results of that analysis, the objective of which was to estimate the risk of oil-spill contact to sensitive offshore and onshore environmental resources and socioeconomic features from oil spills accidentally occurring from the OCS activities.

  8. Health promotion practices in primary care groups.

    PubMed

    Heidemann, Ivonete Teresinha Schulter Buss; Alonso da Costa, Maria Fernanda Baeta Neves; Hermida, Patrícia Madalena Vieira; Marçal, Cláudia Cossentino Bruck; Antonini, Fabiano Oliveira; Cypriano, Camilla Costa

    2018-04-01

    This is a descriptive-exploratory study using a qualitative approach, conducted in ten municipalities in southern Brazil. Data were obtained by talking to 21 nurses from February to November 2012, through semi-structured interviews using questions to probe their health promotion practices. Data were analyzed through thematic analysis focused on health promotion concepts. We identified four themes about health promotion practices of family health nurses in Brazil: a) training of nurses for health promotion practice was weak; b) nurses formed health promotion groups around diseases and life stages; c) nurses formed groups to meet community needs; and d) nurses used health promotion techniques in group work. These family health nurses were somewhat aware of the importance of health promotion, and how to assist the population against various ailments using some health promotion strategies. The main weaknesses were the lack of understanding about health promotion concepts, and the difficulty of understanding the relevance of its practice, probably attributable to limitations in training. We conclude that primary care groups in Brazil's unified health system could do better in applying health promotion concepts in their practice.

  9. 46 CFR 35.20-5 - Draft of tankships-T/OC.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Draft of tankships-T/OC. 35.20-5 Section 35.20-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Navigation § 35.20-5 Draft of tankships—T/OC. The master of every tankship shall, whenever leaving port, enter the maximum draft of his...

  10. 46 CFR 35.20-5 - Draft of tankships-T/OC.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Draft of tankships-T/OC. 35.20-5 Section 35.20-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Navigation § 35.20-5 Draft of tankships—T/OC. The master of every tankship shall, whenever leaving port, enter the maximum draft of his...

  11. 46 CFR 35.20-5 - Draft of tankships-T/OC.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Draft of tankships-T/OC. 35.20-5 Section 35.20-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Navigation § 35.20-5 Draft of tankships—T/OC. The master of every tankship shall, whenever leaving port, enter the maximum draft of his...

  12. 46 CFR 35.20-5 - Draft of tankships-T/OC.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Draft of tankships-T/OC. 35.20-5 Section 35.20-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Navigation § 35.20-5 Draft of tankships—T/OC. The master of every tankship shall, whenever leaving port, enter the maximum draft of his...

  13. 46 CFR 35.20-5 - Draft of tankships-T/OC.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Draft of tankships-T/OC. 35.20-5 Section 35.20-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Navigation § 35.20-5 Draft of tankships—T/OC. The master of every tankship shall, whenever leaving port, enter the maximum draft of his...

  14. Reminder card helps patients remember OCs.

    PubMed

    1999-11-01

    Organon has developed the Reminder Card to help women patients remember their regular intake of oral contraceptive (OC) pills. About 50% of women take birth control pills as prescribed, 25% miss a pill per month, and 25% miss two or more pills in the same time frame. The plastic card, about the size and shape of a credit card, contains a microchip timer. Reminder cards are available to providers who use the Starter Kits issued by the company for new-start patients on the Mircette OC. When patients begin their first pack of pills, they select the time of day they prefer to have the Reminder Card emit its tiny beep. The time is set into the microchip timer and the card is programmed to sound automatically at the pre-set time each day for the next three months. The direction for using the Reminder Card is outlined.

  15. Adolescent mothers: resilience, family health work and health-promoting practices.

    PubMed

    Black, Claire; Ford-Gilboe, Marilyn

    2004-11-01

    This paper reports a study examining the relationships among mother's resilience, family health promotion (i.e. health work) and mother's health-promoting lifestyle practices in single-parent families led by adolescent mothers by testing hypotheses derived from the Developmental Model of Health and Nursing. Research on families led by adolescent mothers has focussed primarily on negative maternal and child outcomes while ignoring the capacities of these families, including their efforts to promote the health and well-being of both mothers and children. This replication study was conducted with convenience sample of 41 adolescent mothers recruited using a variety of strategies. Mothers were asked to provide verbal responses to items on three study instruments: The Resilience Scale, a measure of mother's resilience, the Health Options Scale, a measure of family health work and the Health Promoting Lifestyle Profile a measure of mother's health promoting lifestyle practices, as well as a demographic questionnaire. Consistent with the theory, moderate positive relationships were observed between mothers' resilience and both family health work (r = 0.34, P = 0.01) and mothers' health-promoting lifestyle practices (r = 0.42, P < 0.001). As predicted, moderate correlations were also observed between health work and mother's health promoting lifestyle practices (r = 0.62, P < 0.001). With the effects of employment status and professional support held constant, mother's resilience and health work explained 30.2% of the variance in mother's health-promoting lifestyle practices. The study validates theoretical relationships among concepts in the developmental model of health and nursing and contributes to better understanding health promotion in families led by adolescent mothers.

  16. Putting Public Health Into Practice: A Model for Assessing the Relationship Between Local Health Departments and Practicing Physicians

    PubMed Central

    Perlman, Sharon E.; Koppaka, Ram; Greene, Carolyn M.

    2012-01-01

    The New York City (NYC) Department of Health and Mental Hygiene (Health Department) surveyed practicing NYC physicians to quantify Health Department resource use. Although the Health Department successfully reaches most physicians, and information is valued in practice, knowledge of several key resources was low. Findings suggested 3 recommendations for all local health departments seeking to enhance engagement with practicing physicians: (1) capitalize on physician interest, (2) engage physicians early and often, and (3) make interaction with the health department easy. Also, older physicians may require targeted outreach. PMID:22690968

  17. OCS, stratospheric aerosols and climate

    NASA Technical Reports Server (NTRS)

    Turco, R. P.; Whitten, R. C.; Toon, O. B.; Pollack, J. B.; Hamill, P.

    1980-01-01

    The carbonyl sulfide budget in the atmosphere is examined, and the effects of stratospheric sulfate aerosol particles, formed in part from atmospheric carbonyl sulfate, on global climate are considered. From tropospheric measurements of carbon disulfide and the rate constant for the conversion of carbon disulfide to carbonyl sulfide, it is estimated that five Tg of carbonyl sulfide/year could be generated from carbon disulfide in the atmosphere. Direct sources of OCS include the refining and combustion of fossil fuels (1 Tg/year), natural and agricultural fires (0.2 to 0.3 Tg/year), and soils (0.5 Tg/year), yielding a total influx of from 1 to 10 Tg/year, up to 50% of which may be anthropogenic. Considerations of carbonyl sulfide sinks and concentrations indicate an atmospheric lifetime of one year, with OCS the major atmospheric sulfur compound. It is estimated that a ten-fold increase in atmospheric carbonyl sulfide would cause an optical depth perturbation comparable to that of a modest volcanic eruption, leading to an average global surface temperature decrease of 0.1 K, in addition to a possible greenhouse effect.

  18. Definition of the Floating System for Phase IV of OC3

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jonkman, J.

    Phase IV of the IEA Annex XXIII Offshore Code Comparison Collaboration (OC3) involves the modeling of an offshore floating wind turbine. This report documents the specifications of the floating system, which are needed by the OC3 participants for building aero-hydro-servo-elastic models.

  19. Health Literacy Practices and Educational Competencies for Health Professionals: A Consensus Study

    PubMed Central

    Coleman, Clifford A.; Hudson, Stan; Maine, Lucinda L.

    2013-01-01

    Health care professionals often lack adequate knowledge about health literacy and the skills needed to address low health literacy among patients and their caregivers. Many promising practices for mitigating the effects of low health literacy are not used consistently. Improving health literacy training for health care professionals has received increasing emphasis in recent years. The development and evaluation of curricula for health professionals has been limited by the lack of agreed-upon educational competencies in this area. This study aimed to identify a set of health literacy educational competencies and target behaviors, or practices, relevant to the training of all health care professionals. The authors conducted a thorough literature review to identify a comprehensive list of potential health literacy competencies and practices, which they categorized into 1 or more educational domains (i.e., knowledge, skills, attitudes) or a practice domain. The authors stated each item in operationalized language following Bloom's Taxonomy. The authors then used a modified Delphi method to identify consensus among a group of 23 health professions education experts representing 11 fields in the health professions. Participants rated their level of agreement as to whether a competency or practice was both appropriate and important for all health professions students. A predetermined threshold of 70% agreement was used to define consensus. After 4 rounds of ratings and modifications, consensus agreement was reached on 62 out of 64 potential educational competencies (24 knowledge items, 27 skill items, and 11 attitude items), and 32 out of 33 potential practices. This study is the first known attempt to develop consensus on a list of health literacy practices and to translate recommended health literacy practices into an agreed-upon set of measurable educational competencies for health professionals. Further work is needed to prioritize the competencies and practices in

  20. Oral health knowledge and practices of dentists practicing in a teaching hospital in Nigeria.

    PubMed

    Jegede, Akinlolu Tolulope; Oyedele, Titus Ayodeji; Sodipo, Babasola Olufemi; Folayan, Morenike Oluwatoyin

    2016-01-01

    To assess the oral health practices and knowledge of practicing dentists at a tertiary health institution in Nigeria, and the possible association of age and sex with caries prevention practices. A cross-sectional study was conducted. All practicing dentists in the institution were eligible to participate in the study. A questionnaire that assessed oral health practices and knowledge was administered. Respondents were expected to select the most appropriate responses that reflected their knowledge of oral health practices and caries prevention practices. Questions included assessment of knowledge and practice of tooth brushing, flossing, refined carbohydrate intake, and dental service utilization. Participants' responses were scored and dichotomized to poor and good knowledge, and poor and good practices, using the median scores. Bivariate analysis was conducted to identify factors associated with good and poor oral health practices, and good and poor knowledge. Fifty-two eligible study participants were accessible at the time of questionnaire administration. Only 46 respondents returned the filled questionnaire giving a response rate of 88.5%. The age of respondents ranged between 25 and 48 years. The majority of respondents had good oral health practices (65.2%) and good oral health knowledge (85%). However, few respondents had good caries prevention practices: 39.2% brushed at least twice daily, 45.7% took refined carbohydrate less than once daily, 36.9% used dental floss at least once daily, and 60.9% undertook preventive dental care. The correlation between the dentists' oral health knowledge score and oral health practices score was insignificant (0.90; P = 0.55). A large number of dentists practicing in the tertiary hospital had good oral health practices and good oral health knowledge. However, the proportion of dentists with good caries prevention practices was low.

  1. Making health information meaningful: Children's health literacy practices.

    PubMed

    Fairbrother, Hannah; Curtis, Penny; Goyder, Elizabeth

    2016-12-01

    Children's health and wellbeing is high on the research and policy agenda of many nations. There is a wealth of epidemiological research linking childhood circumstances and health practices with adult health. However, echoing a broader picture within child health research where children have typically been viewed as objects rather than subjects of enquiry, we know very little of how, in their everyday lives, children make sense of health-relevant information. This paper reports key findings from a qualitative study exploring how children understand food in everyday life and their ideas about the relationship between food and health. 53 children aged 9-10, attending two socio-economically contrasting schools in Northern England, participated during 2010 and 2011. Data were generated in schools through interviews and debates in small friendship groups and in the home through individual interviews. Data were analysed thematically using cross-sectional, categorical indexing. Moving beyond a focus on what children know the paper mobilises the concept of health literacy (Nutbeam, 2000), explored very little in relation to children, to conceptualise how children actively construct meaning from health information through their own embodied experiences. It draws on insights from the Social Studies of Childhood (James and Prout, 2015), which emphasise children's active participation in their everyday lives as well as New Literacy Studies (Pahl and Rowsell, 2012), which focus on literacy as a social practice. Recognising children as active health literacy practitioners has important implications for policy and practice geared towards improving child health.

  2. Dose dependence of radiation damage in nano-structured amorphous SiOC/crystalline Fe composite

    DOE PAGES

    Su, Qing; Price, Lloyd; Shao, Lin; ...

    2015-10-29

    Here, through examination of radiation tolerance properties of amorphous silicon oxycarbide (SiOC) and crystalline Fe composite to averaged damage levels, from approximately 8 to 30 displacements per atom (dpa), we demonstrated that the Fe/SiOC interface and the Fe/amorphous Fe xSi yO z interface act as efficient defect sinks and promote the recombination of vacancies and interstitials. For thick Fe/SiOC multilayers, a clear Fe/SiOC interface remained and no irradiation-induced mixing was observed even after 32 dpa. For thin Fe/SiOC multilayers, an amorphous Fe xSi yO z intermixed layer was observed to form at 8 dpa, but no further layer growth wasmore » observed for higher dpa levels.« less

  3. 33 CFR 146.202 - Notice of arrival or relocation of MODUs on the OCS.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... OF HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Mobile Offshore Drilling Units § 146.202 Notice of arrival or relocation of MODUs on the OCS. (a) The owner of any mobile offshore drilling unit engaged in OCS activities shall, 14 days before arrival of the unit on the OCS or as...

  4. Effects of Maternal Mental Health on Engagement in Favorable Health Practices During Pregnancy

    PubMed Central

    Alhusen, Jeanne L.; Ayres, Lauren; DePriest, Kelli

    2016-01-01

    Introduction A woman’s health practices during pregnancy are associated with maternal and neonatal outcomes. Yet limited research has examined predictors of a woman’s engagement in favorable health practices, particularly in pregnant women at greatest risk for adverse outcomes. We examined the role of mental health on engagement in favorable health practices during pregnancy in a sample of pregnant, low-income, predominantly African American women. Methods A convenience sample of pregnant women was obtained from 3 obstetric clinics within a large Mid-Atlantic academic health system. Pregnant women (N = 166) completed measures of depression, social support, and engagement in favorable health practices during their second trimester. Six domains of health practices (ie, balance of rest and exercise, safety measures, nutrition, substance use, health care access, access to pregnancy-related information) were assessed by the Health Practices in Pregnancy Questionnaire-II. Multiple linear regression was used to examine predictors of engagement in favorable health practices. Results Fifty-nine percent of the study participants experienced depressive symptomatology during pregnancy. Multivariate linear regression modeling demonstrated that increased depressive symptoms, decreased social support, young age, and prepregnancy overweight or obesity were significant predictors of nonengagement in favorable health practices during pregnancy. Discussion Findings suggest that pregnant women with poor mental health (eg, depressive symptomatology, poor social support) and specific sociodemographic characteristics (eg, young age, prepregnancy overweight or obesity) were less likely to engage in favorable health practices during pregnancy. Health care providers are uniquely positioned to assess a woman’s mental health and related indicators to optimize pregnancy and neonatal outcomes. PMID:26849176

  5. Effects of Maternal Mental Health on Engagement in Favorable Health Practices During Pregnancy.

    PubMed

    Alhusen, Jeanne L; Ayres, Lauren; DePriest, Kelli

    2016-01-01

    A woman's health practices during pregnancy are associated with maternal and neonatal outcomes. Yet limited research has examined predictors of a woman's engagement in favorable health practices, particularly in pregnant women at greatest risk for adverse outcomes. We examined the role of mental health on engagement in favorable health practices during pregnancy in a sample of pregnant, low-income, predominantly African American women. A convenience sample of pregnant women was obtained from 3 obstetric clinics within a large Mid-Atlantic academic health system. Pregnant women (N = 166) completed measures of depression, social support, and engagement in favorable health practices during their second trimester. Six domains of health practices (ie, balance of rest and exercise, safety measures, nutrition, substance use, health care access, access to pregnancy-related information) were assessed by the Health Practices in Pregnancy Questionnaire-II. Multiple linear regression was used to examine predictors of engagement in favorable health practices. Fifty-nine percent of the study participants experienced depressive symptomatology during pregnancy. Multivariate linear regression modeling demonstrated that increased depressive symptoms, decreased social support, young age, and prepregnancy overweight or obesity were significant predictors of nonengagement in favorable health practices during pregnancy. Findings suggest that pregnant women with poor mental health (eg, depressive symptomatology, poor social support) and specific sociodemographic characteristics (eg, young age, prepregnancy overweight or obesity) were less likely to engage in favorable health practices during pregnancy. Health care providers are uniquely positioned to assess a woman's mental health and related indicators to optimize pregnancy and neonatal outcomes. © 2016 by the American College of Nurse-Midwives.

  6. 46 CFR 32.15-35 - Magnetic Compass and Gyrocompass-T/OC.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., MACHINERY, AND HULL REQUIREMENTS Navigation Equipment § 32.15-35 Magnetic Compass and Gyrocompass—T/OC. (a) All tankships in ocean or coastwise service must be fitted with a magnetic compass. (b) All tankships... 46 Shipping 1 2012-10-01 2012-10-01 false Magnetic Compass and Gyrocompass-T/OC. 32.15-35 Section...

  7. 46 CFR 32.15-35 - Magnetic Compass and Gyrocompass-T/OC.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Magnetic Compass and Gyrocompass-T/OC. 32.15-35 Section..., MACHINERY, AND HULL REQUIREMENTS Navigation Equipment § 32.15-35 Magnetic Compass and Gyrocompass—T/OC. (a) All tankships in ocean or coastwise service must be fitted with a magnetic compass. (b) All tankships...

  8. 46 CFR 32.15-35 - Magnetic Compass and Gyrocompass-T/OC.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Magnetic Compass and Gyrocompass-T/OC. 32.15-35 Section..., MACHINERY, AND HULL REQUIREMENTS Navigation Equipment § 32.15-35 Magnetic Compass and Gyrocompass—T/OC. (a) All tankships in ocean or coastwise service must be fitted with a magnetic compass. (b) All tankships...

  9. Islamic Cultures: Health Care Beliefs and Practices.

    ERIC Educational Resources Information Center

    Kemp, Charles

    1996-01-01

    Presents an overview of Islamic health care beliefs and practices, noting health-related social and spiritual issues, fundamental beliefs and themes in Islam, health care beliefs and practices common among Muslims, and health-affecting social roles among Muslims. Cultural, religious, and social barriers to health care and ways to reduce them are…

  10. Flutamide-metformin plus an oral contraceptive (OC) for young women with polycystic ovary syndrome: switch from third- to fourth-generation OC reduces body adiposity.

    PubMed

    Ibáñez, Lourdes; De Zegher, Francis

    2004-08-01

    Low-dose flutamide-metformin has been developed as a background therapy for non-obese adolescents and young women with hyperinsulinaemic hyperandrogenism, a variant of polycystic ovary syndrome (PCOS). We verified whether the lipolytic efficacy of flutamide-metformin in women with PCOS is enhanced by giving an oral contraceptive (OC) co-therapy that contains drospirenone, instead of gestodene, as progestin. An open-labelled study was carried out in which non-obese women with PCOS (n = 29; age approximately 20 years), who had been on a combination of flutamide (62.5 mg/day), metformin (850 mg/day) and ethinylestradiol-gestodene for 8-15 months, were randomized for replacement of the gestodene OC by a drospirenone OC. Assessments of endocrine-metabolic state and body composition (by dual-energy X-ray absorptiometry) were performed at randomization and after 6 months. The switch to drospirenone OC was accompanied by a reduction of total and abdominal fat (mean -0.8 and -0.5 kg) and by an increment of lean body mass (+0.6 kg; all P < 0.01), so that body adiposity was strikingly reduced without changing body weight. In non-obese women with PCOS, low-dose flutamide-metformin reduces total and abdominal fat excess more effectively if contraceptive co-therapy contains drospirenone, instead of gestodene, as progestin. Copyright 2004 European Society of Human Reproduction and Embryology

  11. 30 CFR 281.12 - Request for OCS mineral information and interest.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Request for OCS mineral information and interest. 281.12 Section 281.12 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF MINERALS OTHER THAN OIL, GAS, AND SULPHUR IN THE OUTER CONTINENTAL SHELF Leasing Procedures § 281.12 Request for OCS mineral...

  12. Primary health care registered nurses' types in implementation of health promotion practices.

    PubMed

    Maijala, Virpi; Tossavainen, Kerttu; Turunen, Hannele

    2016-09-01

    Aim This study aimed to identify and reach consensus among primary health care participants [registered nurses (RNs) who receive clients, directors of nursing, senior physicians, health promotion officers, and local councillors] on the types of service provider that RNs who receive clients represent in the implementation of health promotion practices in primary health care in Eastern Finland. There is an increasing focus on public health thinking in many countries as the population ages. To meet the growing needs of the health promotion practices of populations, advance practice has been recognized as effective in the primary health care setting. The advance practice nurses share many common features, such as being RNs with additional education, possessing competencies to work independently, treating clients in both acute and primary care settings, and applying a variety of health promotion practices into nursing. The two-stage modified Delphi method was applied. In round one, semi-structured interviews were conducted among primary health care participants (n=42) in 11 health centres in Eastern Finland. In round two, a questionnaire survey was conducted in the same health centres. The questionnaire was answered by 64% of those surveyed (n=56). For data analysis, content analysis and descriptive statistics were used. Findings This study resulted in four types of service provider that RNs who receive clients represented in the implementation of health promotion practices in the primary health care setting in Eastern Finland. First, the client-oriented health promoter demonstrated four dimensions, which reached consensus levels ranging between 82.1 and 89.3%. Second, the developer of health promotion practices comprised four dimensions, which reached consensus levels between 71.4 and 85.7%. Third, the member of multi-professional teams of health promotion practices representing three dimensions, with consensus levels between 69.6 and 82.1%. Fourth, the type who showed

  13. Exchange of carbonyl sulfide (OCS) between soils and atmosphere under various CO2 concentrations

    NASA Astrophysics Data System (ADS)

    Bunk, Rüdiger; Behrendt, Thomas; Yi, Zhigang; Andreae, Meinrat O.; Kesselmeier, Jürgen

    2017-06-01

    A new continuous integrated cavity output spectroscopy analyzer and an automated soil chamber system were used to investigate the exchange processes of carbonyl sulfide (OCS) between soils and the atmosphere under laboratory conditions. The exchange patterns of OCS between soils and the atmosphere were found to be highly dependent on soil moisture and ambient CO2 concentration. With increasing soil moisture, OCS exchange ranged from emission under dry conditions to an uptake within an optimum moisture range, followed again by emission at high soil moisture. Elevated CO2 was found to have a significant impact on the exchange rate and direction as tested with several soils. There is a clear tendency toward a release of OCS at higher CO2 levels (up to 7600 ppm), which are typical for the upper few centimeters within soils. At high soil moisture, the release of OCS increased sharply. Measurements after chloroform vapor application show that there is a biotic component to the observed OCS exchange. Furthermore, soil treatment with the fungi inhibitor nystatin showed that fungi might be the dominant OCS consumers in the soils we examined. We discuss the influence of soil moisture and elevated CO2 on the OCS exchange as a change in the activity of microbial communities. Physical factors such as diffusivity that are governed by soil moisture also play a role. Comparing KM values of the enzymes to projected soil water CO2 concentrations showed that competitive inhibition is unlikely for carbonic anhydrase and PEPCO but might occur for RubisCO at higher CO2 concentrations.

  14. District health manager and mid-level provider perceptions of practice environments in acute obstetric settings in Tanzania: a mixed-method study.

    PubMed

    Ng'ang'a, Njoki; Byrne, Mary Woods; Kruk, Margaret E; Shemdoe, Aloisia; de Pinho, Helen

    2016-08-08

    In sub-Saharan Africa, the capacity of human resources for health (HRH) managers to create positive practice environments that enable motivated, productive, and high-performing HRH is weak. We implemented a unique approach to examining HRH management practices by comparing perspectives offered by mid-level providers (MLPs) of emergency obstetric care (EmOC) in Tanzania to those presented by local health authorities, known as council health management teams (CHMTs). This study was guided by the basic strategic human resources management (SHRM) component model. A convergent mixed-method design was utilized to assess qualitative and quantitative data from the Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers project. Survey data was obtained from 837 mid-level providers, 83 of whom participated in a critical incident interview whose aim was to elicit negative events in the practice environment that induced intention to leave their job. HRH management practices were assessed quantitatively in 48 districts with 37 members of CHMTs participating in semi-structured interviews. The eight human resources management practices enumerated in the basic SHRM component model were implemented unevenly. On the one hand, members of CHMTs and mid-level providers agreed that there were severe shortages of health workers, deficient salaries, and an overwhelming workload. On the other hand, members of CHMTs and mid-level providers differed in their perspectives on rewards and allocation of opportunities for in-service training. Although written standards of performance and supervision requirements were available in most districts, they did not reflect actual duties. Members of CHMTs reported high levels of autonomy in key HRH management practices, but mid-level providers disputed the degree to which the real situation on the ground was factored into job-related decision-making by CHMTs. The incongruence in perspectives offered by members of CHMTs

  15. Carbonyl sulfide (OCS) as a proxy for GPP: Complications derived from studies on the impact of CO2, soil humidity and sterilization on the OCS exchange between soils and atmosphere

    NASA Astrophysics Data System (ADS)

    Bunk, Rüdiger; Behrendt, Thomas; Yi, Zhigang; Kesselmeier, Jürgen

    2016-04-01

    Carbonyl sulfide is discussed to be used as a proxy for gross primary productivity (GPP) of forest ecosystems. However, soils may interfere. Soils play an important role in budgeting global and local carbonyl sulfide (OCS) fluxes, yet the available data on the uptake and emission behavior of soils in conjunction with environmental factors is limited. The work of many authors has shown that the OCS exchange of soils depends on various factors, such as soil type, atmospheric OCS concentrations, temperature or soil water content (Kesselmeier et al., J. Geophys. Res., 104, No. D9, 11577-11584, 1999; Van Diest & Kesselmeier, Biogeosciences, 5, 475-483, 2008; Masyek et al., PNAS, 111, No 25, 9064-9069, doi: 10.1073/pnas.1319132111, 2014; Whelan and Rhew, J. Geophys. Res. Biogeosciences., 120, 54-62, doi: 10.1002/2014JG002661, 2015) and the light dependent and obviously abiotic OCS production as reported by Whelan and Rhew (2015). To get a better constraint on the impact of some environmental factors on the OCS exchange of soils we used a new laser based integrated cavity output spectroscopy instrument (LGR COS/CO Analyzer Model 907-0028, Los Gatos, Mountain View, California, USA) in conjunction with an automated soil chamber system (as described in Behrendt et al, Biogeosciences, 11, 5463-5492, doi: 10.5194/bg-11-5463-2014, 2014). The OCS exchange of various soils under the full range of possible soil humidity and various CO2 mixing ratios was examined. Additionally OCS exchange of chloroform sterilized subsamples was compared to their live counterparts to illuminate the influence of microorganisms. Results were quite heterogeneous between different soils. With few exceptions, all examined soils show dependence between OCS exchange and soil humidity, usually with strongest uptake at a certain humidity range and less uptake or even emission at higher and lower humidity. Differences in CO2 mixing ratio also clearly impacts on OCS exchange, but trends for different soils

  16. Public health practice is not research.

    PubMed

    Otto, Jean Lin; Holodniy, Mark; DeFraites, Robert F

    2014-04-01

    Scientific and clinical activities undertaken by public health agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of public health practice. As a result, public health agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and public health practice that could assist public health practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research.

  17. Public Health Practice Is Not Research

    PubMed Central

    Holodniy, Mark; DeFraites, Robert F.

    2014-01-01

    Scientific and clinical activities undertaken by public health agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of public health practice. As a result, public health agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and public health practice that could assist public health practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research. PMID:24524499

  18. Operational experience of the OC-OTEC experiments at NELH

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Link, H

    1989-02-01

    The Solar Energy Research Institute, under funding and program direction from the US Department of Energy, has been operating a small-scale test apparatus to investigate key components of open- cycle ocean thermal energy conversion (OC-OTEC). The apparatus started operations in October 1987 and continues to provide valuable information on heat-and mass-transfer processes in evaporators and condensers, gas sorption processes as seawater is depressurized and repressurized, and control and instrumentation characteristics of open-cycle systems. Although other test facilities have been used to study some of these interactions, this is the largest apparatus of its kind to use seawater since Georges Claude`smore » efforts in 1926. The information obtained from experiments conducted in this apparatus is being used to design a larger scale experiment in which a positive net power production is expected to be demonstrated for the first time with OC-OTEC. This paper describes the apparatus, the major tests conducted during its first 18 months of operation, and the experience gained in OC-OTEC system operation. 13 refs., 8 figs.« less

  19. Practicing health promotion in primary care -a reflective enquiry.

    PubMed

    Pati, S; Chauhan, A S; Mahapatra, S; Sinha, R; Pati, S

    2017-12-01

    Health promotion is an integral part of routine clinical practice. The physicians' role in improving the health status of the general population, through effective understanding and delivery of health promotion practice, is evident throughout the international literature. Data from India suggest that physicians have limited skills in delivering specific health promotion services. However, the data available on this is scarce. This study was planned to document the current health promotion knowledge, perception and practices of local primary care physicians in Odisha. An exploratory study was planned between the months of January - February 2013 in Odisha among primary care physicians working in government set up. This exploratory study was conducted, using a two-step self-administered questionnaire, thirty physicians practicing under government health system were asked to map their ideal and current health promotion practice, and potential health promotion elements to be worked upon to enhance the practice. The study recorded a significant difference between the mean of current and ideal health promotion practices. The study reported that physicians want to increase their practice on health education. We concluded that inclusion of health promotion practices in routine care is imperative for a strong healthcare system. It should be incorporated as a structured health promotion module in medical curriculum as well.

  20. Effects of relativity for atomization and isomerization energies of seaborgium carbonyl SgCO and seaborgium isocarbonyl SgOC: Relativity predicts SgOC to be more stable than SgCO

    DOE PAGES

    Malli, Gulzari L.

    2015-12-31

    Our ab initio all-electron fully relativistic Dirac-Fock (DF) and nonrelativistic Hartree-Fock (NR) calculations for seaborgium isocarbonyl SgOC predict atomization energy (AE) of 13.04 and 11.05 eV, respectively. However, the corresponding DF and NR atomization energies for the seaborgium carbonyl SgCO are predicted as 12.75 and 12.45 eV, respectively. This is the first such result in Chemistry where an isocarbonyl (and especially for a system of superheavy element Sg) is predicted to be more stable at the DF level of theory than the corresponding carbonyl. The predicted energy for the formation of the carbonyl SgCO at the relativistic DF and NRmore » levels of theory is -54.90 and -50.95 kJ /mol, whereas the corresponding energy of formation of the isocarbonyl SgOC is -64.44 and -18.64 kJ/mol, respectively. Ours are the first results of relativistic effects for isomerization and atomization energies of the superheavy seaborgium isocarbonyl SgOC and its isomer SgCO. Lastly, the formation of isocarbonyl SgOC, should be favored over the carbonyl isomer SgCO in the first step of the reaction Sg+CO →SgOC.« less

  1. Long-term intensive management increased carbon occluded in phytolith (PhytOC) in bamboo forest soils

    NASA Astrophysics Data System (ADS)

    Huang, Zhang-Ting; Li, Yong-Fu; Jiang, Pei-Kun; Chang, Scott X.; Song, Zhao-Liang; Liu, Juan; Zhou, Guo-Mo

    2014-01-01

    Carbon (C) occluded in phytolith (PhytOC) is highly stable at millennium scale and its accumulation in soils can help increase long-term C sequestration. Here, we report that soil PhytOC storage significantly increased with increasing duration under intensive management (mulching and fertilization) in Lei bamboo (Phyllostachys praecox) plantations. The PhytOC storage in 0-40 cm soil layer in bamboo plantations increased by 217 Mg C ha-1, 20 years after being converted from paddy fields. The PhytOC accumulated at 79 kg C ha-1 yr-1, a rate far exceeding the global mean long-term soil C accumulation rate of 24 kg C ha-1 yr-1 reported in the literature. Approximately 86% of the increased PhytOC came from the large amount of mulch applied. Our data clearly demonstrate the decadal scale management effect on PhytOC accumulation, suggesting that heavy mulching is a potential method for increasing long-term organic C storage in soils for mitigating global climate change.

  2. Going for gold: the health promoting general practice.

    PubMed

    Watson, Michael

    2008-01-01

    The World Health Organization's Ottawa Charter for Health Promotion has been influential in guiding the development of 'settings' based health promotion. Over the past decade, settings such as schools have flourished and there has been a considerable amount of academic literature produced, including theoretical papers, descriptive studies and evaluations. However, despite its central importance, the health-promoting general practice has received little attention. This paper discusses: the significance of this setting for health promotion; how a health promoting general practice can be created; effective health promotion approaches; the nursing contribution; and some challenges that need to be resolved. In order to become a health promoting general practice, the staff must undertake a commitment to fulfil the following conditions: create a healthy working environment; integrate health promotion into practice activities; and establish alliances with other relevant institutions and groups within the community. The health promoting general practice is the gold standard for health promotion. Settings that have developed have had the support of local, national and European networks. Similar assistance and advocacy will be needed in general practice. This paper recommends that a series of rigorously evaluated, high-quality pilot sites need to be established to identify and address potential difficulties, and to ensure that this innovative approach yields tangible health benefits for local communities. It also suggests that government support is critical to the future development of health promoting general practices. This will be needed both directly and in relation to the capacity and resourcing of public health in general.

  3. Mental Health Nurses Attitudes and Practice Toward Physical Health Care in Jordan.

    PubMed

    Ganiah, Amal N; Al-Hussami, Mahmoud; Alhadidi, Majdi M B

    2017-08-01

    Patients with mental illnesses are at high risk for physical disorders and death. The aim of this study is to describe mental health nurses' attitudes and practice toward physical health care for patients with mental illnesses. A descriptive cross-sectional design was used to collect data using self- reported questionnaire from 202 mental health nurses working in mental health settings in Jordan. The study adopted translated version of Robson and Haddad Physical Health Attitudes Scale to the Arabic language. There was significant positive correlation between the participants' positive attitudes and their current practice (r = .388, p = .000), mental health nurses who have more positive attitudes regarding physical health care involved physical health care more in their current practice. Mental health nurses' attitudes affect the quality of care provided to patients with mental illnesses. The results provide implications for practice, education, and research.

  4. Reaction of amorphous/crystalline SiOC/Fe interfaces by thermal annealing

    DOE PAGES

    Su, Qing; Zhernenkov, Mikhail; Ding, Hepeng; ...

    2017-06-12

    The development of revolutionary new alloys and composites is crucial to meeting materials requirements for next generation nuclear reactors. The newly developed amorphous silicon oxycarbide (SiOC) and crystalline Fe composite system has shown radiation tolerance over a wide range of temperatures. To advance understanding of this new composite, we investigate the structure and thermal stability of the interface between amorphous SiOC and crystalline Fe by combining various experimental techniques and simulation methods. We show that the SiOC/Fe interface is thermally stable up to at least 400 °C. When the annealing temperature reaches 600 °C, an intermixed region forms at thismore » interface. This region appears to be a crystalline phase that forms an incoherent interface with the Fe layer. Density functional theory (DFT) Molecular dynamics (MD) is performed on the homogeneous SiFeOC phase to study the early stages of 2 formation of the intermixed layer. Both experimental and simulation results suggest this phase has the fayalite crystal structure. As a result, the physical processes involved in the formation of the intermixed region are discussed.« less

  5. Definition of the Semisubmersible Floating System for Phase II of OC4

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Robertson, A.; Jonkman, J.; Masciola, M.

    Phase II of the Offshore Code Comparison Collaboration Continuation (OC4) project involved modeling of a semisubmersible floating offshore wind system as shown below. This report documents the specifications of the floating system, which were needed by the OC4 participants for building aero-hydro-servo-elastic models.

  6. The practice of certified community health CNSs.

    PubMed

    Logan, Leanne

    2005-01-01

    This study explored the practice of clinical nurse specialists (CNSs) certified in Community Health nursing in the United States and described demographic and employment characteristics and perspectives about professional practice. The survey method was used. Of the 209 Community Health CNSs certified by American Nurses Credentialing Center (ANCC) invited to complete the investigator-designed mail questionnaire, 111 (53%) returned a completed questionnaire. The questionnaire contained 27 items about employment, income, years in practice, certification, career satisfaction, and educational preparation, and asked participants to indicate the fit between the Community Health CNS role and the traditional CNS subroles model described by the American Nurses Association (ANA) (The Role of the Clinical Nurse Specialist, 1986) and the updated National Association of Clinical Nurse Specialists (NACNS) CNS practice model (Statement on Clinical Nurse Specialist Practice and Education, 1998). Content validity was established by Community Health CNS reviewer feedback. Quantifiable data were tallied and analyzed using standard spreadsheet computer software. Qualitative data were summarized for content themes. The majority of participants were white, middle-aged females who reported being satisfied with their careers as Community Health CNSs. Most indicated that they were respected by colleagues, that they had been adequately prepared by their education, and that their current work made good use of their education and expertise. When asked to identify, by percentage of effort, the fit between their job responsibilities and the traditional subroles model of practice, the mean of reported fit was as follows: educator, 35%; administrator/leader, 22%; clinician, 21%; consultant, 14%; and researcher, 8%. The fit between job responsibilities and the spheres of influence in the NACNS model of practice was reported to average 39% for patient/client, 35% for organization/network, and 25

  7. Soil water content plays an important role in soil-atmosphere exchange of carbonyl sulfide (OCS)

    NASA Astrophysics Data System (ADS)

    Yi, Zhigang; Behrendt, Thomas; Bunk, Rüdiger; Wu, Dianming; Kesselmeier, Jürgen

    2016-04-01

    Carbonyl sulfide (OCS) is a quite stable gas in the troposphere and is transported up to the stratosphere, where it contributes to the sulfate aerosol layer (Crutzen 1976). The tropospheric concentration seems to be quite constant, indicating a balance between sinks and sources. Recent work by Sandoval-Soto et al. (2005) demonstrated the enormous strength of the vegetation sink and the urgent needs to understand the sinks and sources. The role of soils is a matter of discussion (Kesselmeier et al., 1999; Van Diest and Kesselmeier, 2008; Maseyk et al., 2014; Whelan et al., 2015). To better understand the influence of soil water content and OCS mixing ratio on OCS fluxes, we used an OCS analyzer (LGR COS/CO Analyzer 907-0028, Los Gatos, CA, USA) coupled with automated soil chamber system (Behrendt et al., 2014) to measure the OCS fluxes with a slow drying of four different types of soil (arable wheat soil in Mainz, blueberry soil in Waldstein, spruce soil in Waldstein and needle forest soil in Finland). Results showed that OCS fluxes as well as the optimum soil water content for OCS uptake varied significantly for different soils. The net production rates changed significantly with the soil drying out from 100% to about 5% water holding capacity (WHC), implying that soil water content play an important role in the uptake processes. The production and uptake processes were distinguished by the regression of OCS fluxes under different OCS mixing ratios. OCS compensation points (CP) were found to differ significantly for different soil types and water content, with the lowest CP at about 20% WHC, implying that when estimating the global budgets of OCS, especially for soils fluxes, soil water content should be taken into serious consideration. References Crutzen, P. J. 1976, Geophys. Res. Lett., 3, 73-76. Sandoval-Soto, L. et al., 2005, Biogeosciences, 2, 125-132. Kesselmeier, J. et al., 1999, J. Geophys. Res., 104, 11577-11584. Van Diest, H. and Kesselmeier, J. 2008

  8. Developing health-promoting practice with families: one pedagogical experience.

    PubMed

    Hartrick, G

    2000-01-01

    As the significance of social determinants of health has been revealed and the socio-environmental perspective of health promotion has become prominent, family nurses have attempted to move away from disease-treatment models of practice towards emancipatory, health promoting practice. This paper describes a multidisciplinary team's pedagogical experience of developing emancipatory family health promoting practices. The discussion includes a description of the significant educational processes that supported the development of health promoting family practice and an outline of the transformative changes the team members experienced as they evolved their health promoting practices.

  9. PRIMARY AND SECONDARY ORGANIC AEROSOLS OVER THE UNITED STATES: ESTIMATES ON THE BASIS OF OBSERVED ORGANIC CARBON (OC) AND ELEMENTAL CARBON (EC), AND AIR QUALITY MODELED PRIMARY (OC/EC) RATIOS

    EPA Science Inventory

    The temporal and spatial distributions of primary and secondary organic carbon aerosols (OC) over the continental US during June 15 to August 31, 1999, were estimated by using observational OC and elemental carbon (EC) data from Interagency Monitoring of Protected Visual Environm...

  10. Chemical shift and surface characteristics of Al-doped ZnO thin film on SiOC dielectrics.

    PubMed

    Oh, Teresa; Lee, Sang Yeol

    2013-10-01

    Aluminum doped zinc oxide (AZO) films were fabricated on SiOC/p-Si wafer and SiOC film was prepared on a p-type Si substrate with the SiC target at oxygen ambient with the gas flow rate of 5-30 sccm by a RF magnetron sputter. C-V curve of SiOC/Si wafer was measured to observe the relationship between the polarity of SiOC dielectrics and the change of capacitance depending on oxygen gas flow rate. The SiOC film could be controlled to be polar or nonpolar, and their surface energy was changed depending on the polarity. Smooth surface is essential to improve the TFT performance. AZO-TFTs used smooth SiOC film with low polarity as a gate insulator was observed to show low leakage current (IL) and low subthreshold voltage swing. It is proposed that SiOC film with high degree amorphous structure as a gate insulator between AZO and Si wafer could solve problems of the mismatched interfaces, which was originated from the electron scattering due to the grain boundary.

  11. Practice Notes: Strategies in Health Education

    ERIC Educational Resources Information Center

    Health Education & Behavior, 2009

    2009-01-01

    The "Practice Notes" section is intended to keep readers informed about health education practice around the country. It is an attempt to spread the word about exemplary strategies, initiatives, and programs and share successes in overcoming obstacles or challenges. This article features two new programs on health education: (1) Project FIESTA;…

  12. Long-term intensive management increased carbon occluded in phytolith (PhytOC) in bamboo forest soils

    PubMed Central

    Huang, Zhang-ting; Li, Yong-fu; Jiang, Pei-kun; Chang, Scott X.; Song, Zhao-liang; Liu, Juan; Zhou, Guo-mo

    2014-01-01

    Carbon (C) occluded in phytolith (PhytOC) is highly stable at millennium scale and its accumulation in soils can help increase long-term C sequestration. Here, we report that soil PhytOC storage significantly increased with increasing duration under intensive management (mulching and fertilization) in Lei bamboo (Phyllostachys praecox) plantations. The PhytOC storage in 0–40 cm soil layer in bamboo plantations increased by 217 Mg C ha−1, 20 years after being converted from paddy fields. The PhytOC accumulated at 79 kg C ha−1 yr−1, a rate far exceeding the global mean long-term soil C accumulation rate of 24 kg C ha−1 yr−1 reported in the literature. Approximately 86% of the increased PhytOC came from the large amount of mulch applied. Our data clearly demonstrate the decadal scale management effect on PhytOC accumulation, suggesting that heavy mulching is a potential method for increasing long-term organic C storage in soils for mitigating global climate change. PMID:24398703

  13. Health practices of Canadian physicians.

    PubMed

    Frank, Erica; Segura, Carolina

    2009-08-01

    To study the health and health practices of Canadian physicians, which can often influence patient health. Mailed survey. Canada. A random sample of 8100 Canadian physicians; 7934 were found to be eligible and 3213 responded (40.5% response rate). Factors that influence health, such as consumption of fruits and vegetables, amount of exercise and alcohol consumption, smoking status, body mass idex, and participation in preventive health screening measures, as well as work-life balance and emotional stability. Canadian physicians are healthy. More than 90% reported being in good to excellent health, and only 5% reported that poor physical or mental health made it difficult to handle their workload more than half the time in the previous month (although a quarter had reduced work activity because of long-term health conditions). Eight percent were obese, 3% currently smoked cigarettes, and 1% typically consumed 5 drinks or more on days when they drank alcohol. Physicians averaged 4.7 hours of exercise per week and ate fruits and vegetables 4.8 times a day. Their personal screening practices were largely compliant with Canadian Task Force on Preventive Health Care recommendations. They averaged 38 hours per week on patient care and 11 hours on other professional activities. Fifty-seven percent agreed that they had a good work-life balance, and 11% disagreed with the statement "If I can, I work when I am ill." Compared with self-reports from the general Canadian population, Canadian physicians, like American physicians, seem to be healthy and to have generally healthy behaviour. There is, however, room for improvement in physicians' personal and professional well-being, and improving their personal health practices could be an efficient and beneficent way to improve the health of all Canadians.

  14. Health promotion: challenges revealed in successful practices

    PubMed Central

    Silva, Kênia Lara; de Sena, Roseni Rosângela; Belga, Stephanie Marques Moura Franco; Silva, Paloma Morais; Rodrigues, Andreza Trevenzoli

    2014-01-01

    OBJECTIVE To examine successful practices of health promotion in health, education, culture, welfare and sport, leisure, identifying the elements of success and challenges in the field. METHODS A qualitative study with data obtained from in-depth analysis that included participant observation, interviews with managers, coordinators, professionals and participants from 29 practices reported as successful for promoting health in six municipalities of the metropolitan region of Belo Horizonte, MG, Southeastern Brazil, in 2011. The variables of the study were concept, dimension, dissemination and ease of access, identified in practices guided by content analysis. RESULTS The results indicate a conceptual and methodological uncertainty about health promotion as evidenced by conflicting objects and contradictory purposes. The practices differ in size, coverage and ease of access, determined by inter-sector coordination and political and financial investment. CONCLUSIONS We identified challenges to health promotion focusing on vulnerable populations, limits to financing and intersectoral partnerships. PMID:24789640

  15. Health Care Waste Management Practice in Health Care Institutions of Nepal.

    PubMed

    Joshi, H D; Acharya, T; Ayer, R; Dhakal, P; Karki, K B; Dhimal, M

    2017-01-01

    Medical waste is considered as a major public health hazard. In a developing country like Nepal, there is much concern about the management practice of medical waste. This study aimed to assess Health Care Waste Management practice among Health Care Institutions in Nepal. A cross sectional study was carried out between July 2012 to June 2013 in 62 different Health Care Institutions, selected from stratified proportionate random sampling technique from all administrative regions of Nepal. A structured questionnaire and observation checklist were used for data collection. The waste generation rate is found significantly correlated with bed capacity, patient flow rate and annual budget spent in the hospital. It is found significantly higher in Teaching hospital than other Health Care Institutions of Nepal. An average of 3.3 kg/day/patient of medical waste (2.0 kg/day/patient non-hazardous and 1.0 kg/day/patient hazardous waste) was generated during the study period. Further, it was found that most of the Health care wastes were not disinfected before transportation to waste disposal sites. Very limited number of Health Care Institutions had conducted Environmental Assessment. Similarly, some of the Health Care Institutions had not followed Health care waste management guideline 2009 of Nepal Government. We found poor compliance of medical waste management practice as per existing legislation of Government of Nepal. Hence, additional effort is needed for improvement of Health care waste management practice at Health Care Institutions of Nepal.

  16. Efficiency in mental health practice and research.

    PubMed

    Lagomasino, Isabel T; Zatzick, Douglas F; Chambers, David A

    2010-01-01

    Limited financial resources, escalating mental health-related costs and opportunities for capitalizing on advances in health information technologies have brought the theme of efficiency to the forefront of mental health services research and clinical practice. In this introductory article to the journal series stemming from the 20th NIMH Mental Health Services Research Conference, we first delineate the need for a new focus on efficiency in both research and clinical practice. Second, we provide preliminary definitions of efficiency for the field and discuss issues related to measurement. Finally, we explore the interface between efficiency in mental health services research and practice and the NIMH strategic objectives of developing improved interventions for diverse populations and enhancing the public health impact of research. Case examples illustrate how perspectives from dissemination and implementation research may be used to maximize efficiencies in the development and implementation of new service delivery models. Allowing findings from the dissemination and implementation field to permeate and inform clinical practice and research may facilitate more efficient development of interventions and enhance the public health impact of research. Copyright © 2010 Elsevier Inc. All rights reserved.

  17. Evidence-based practice curriculum in allied health professions for teaching-research-practice nexus.

    PubMed

    Asokan, G V

    2012-11-01

    Allied healthcare workers are from diverse professions and the key skill required is providing evidence-based care but this concept has not permeated enough for using it skillfully in their professions. A well structured curriculum in allied health professions is needed to strengthen concerted teaching, research, and practice to empower their professionals and make considerable differences in the lives of people by adopting evidence-based practice. Information sources for allied health professionals have relied on advice of their supervisors and colleagues, personal experiences, authoritative theory and texts for practice. Because of "research-practice" gap, often the use of evidence is not reflected in an individual day to day professional practice. Although allied health professionals work in resource and evidence challenged settings, there are certain barriers and facilitators, which need to be addressed. To implement practice-related research findings and uptake of evidence requires two essential components, namely, practical component and knowledge component. Research bench marking and research metrics for quality assurance and standardization through evidence-based practice will promote academic status and credibility of allied health profession. © 2012 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  18. Values and principles evident in current health promotion practice.

    PubMed

    Gregg, Jane; O'Hara, Lily

    2007-04-01

    Modern health promotion practice needs to respond to complex health issues that have multiple interrelated determinants. This requires an understanding of the values and principles of health promotion. A literature review was undertaken to explore the values and principles evident in current health promotion theory and practice. A broad range of values and principles are espoused as being integral to modern health promotion theory and practice. Although there are some commonalities across these lists, there is no recognised, authoritative set of values and principles accepted as fundamental and applicable to modern health promotion. There is a continuum of values and principles evident in health promotion practice from those associated with holistic, ecological, salutogenic health promotion to those more in keeping with conventional health promotion. There is a need for a system of values and principles consistent with modern health promotion that enables practitioners to purposefully integrate these values and principles into their understanding of health, as well as their needs assessment, planning, implementation and evaluation practice.

  19. Health knowledge, attitude and practice among Iranian pilgrims.

    PubMed

    Tabatabaei, Aminreza; Mortazavi, Seyyed Mostafa; Shamspour, Navvab; Shushtarizadeh, Naser

    2015-02-01

    Iran has the highest number of Umrah pilgrims among Islamic countries. Health care plays a major role in fulfilling the Umrah rites. Pilgrims' health situation depends on their health knowledge, attitude, and practice (KAP). In this study, we aimed to determine the health KAP among Iranian Umrah pilgrims. In this cross-sectional study, 157 Iranian Umrah pilgrims were randomly selected in Mecca, Saudi Arabia in June 2011. Data were collected using a questionnaire. The questionnaire consisted of demographic information (sex, age, degree of education, and resource of health knowledge), health knowledge (5 questions), health attitude (5 questions) and health practice (10 questions). Level of knowledge were very low in 12.1%, low in 25.2%, average in 38.1%, good in 20.4% and very good in 4.2% of respondents. Mean and standard deviation of attitude score was 18.58 ± 2.20 out of 25 (ranged between 13.00 and 25.00). The pilgrims were given 74.2 % out of total score. The Mean and standard deviation of practice score was 8.19 ± 1.32 out of 10 (ranged between 3 and 10). Although the old and low educated pilgrims had little knowledge of health tips, they had a good health attitude and practice. Educational strategy to improve knowledge regarding health-related problems and to develop health practices among pilgrims is needed.

  20. Geological sulfur isotopes indicate elevated OCS in the Archean atmosphere, solving faint young sun paradox.

    PubMed

    Ueno, Yuichiro; Johnson, Matthew S; Danielache, Sebastian O; Eskebjerg, Carsten; Pandey, Antra; Yoshida, Naohiro

    2009-09-01

    Distributions of sulfur isotopes in geological samples would provide a record of atmospheric composition if the mechanism producing the isotope effects could be described quantitatively. We determined the UV absorption spectra of 32SO2, 33SO2, and 34SO2 and use them to interpret the geological record. The calculated isotopic fractionation factors for SO2 photolysis give mass independent distributions that are highly sensitive to the atmospheric concentrations of O2, O3, CO2, H2O, CS2, NH3, N2O, H2S, OCS, and SO2 itself. Various UV-shielding scenarios are considered and we conclude that the negative Delta33S observed in the Archean sulfate deposits can only be explained by OCS shielding. Of relevant Archean gases, OCS has the unique ability to prevent SO2 photolysis by sunlight at lambda >202 nm. Scenarios run using a photochemical box model show that ppm levels of OCS will accumulate in a CO-rich, reducing Archean atmosphere. The radiative forcing, due to this level of OCS, is able to resolve the faint young sun paradox. Further, the decline of atmospheric OCS may have caused the late Archean glaciation.

  1. Geological sulfur isotopes indicate elevated OCS in the Archean atmosphere, solving faint young sun paradox

    PubMed Central

    Ueno, Yuichiro; Johnson, Matthew S.; Danielache, Sebastian O.; Eskebjerg, Carsten; Pandey, Antra; Yoshida, Naohiro

    2009-01-01

    Distributions of sulfur isotopes in geological samples would provide a record of atmospheric composition if the mechanism producing the isotope effects could be described quantitatively. We determined the UV absorption spectra of 32SO2, 33SO2, and 34SO2 and use them to interpret the geological record. The calculated isotopic fractionation factors for SO2 photolysis give mass independent distributions that are highly sensitive to the atmospheric concentrations of O2, O3, CO2, H2O, CS2, NH3, N2O, H2S, OCS, and SO2 itself. Various UV-shielding scenarios are considered and we conclude that the negative Δ33S observed in the Archean sulfate deposits can only be explained by OCS shielding. Of relevant Archean gases, OCS has the unique ability to prevent SO2 photolysis by sunlight at λ >202 nm. Scenarios run using a photochemical box model show that ppm levels of OCS will accumulate in a CO-rich, reducing Archean atmosphere. The radiative forcing, due to this level of OCS, is able to resolve the faint young sun paradox. Further, the decline of atmospheric OCS may have caused the late Archean glaciation. PMID:19706450

  2. Getting the most out of your practice--the Practice Health Atlas and business modelling opportunities.

    PubMed

    Del Fante, Peter; Allan, Don; Babidge, Elizabeth

    2006-01-01

    The Practice Health Atlas (PHA) is a decision support tool for general practice, designed by the Adelaide Western Division of General Practice (AWDGP). This article describes the features of the PHA and its potential role in enhancing health care. In developing the PHA, the AWDGP utilises a range of software tools and consults with a practice to understand its clinical data management approach. The PHA comprises three sections: epidemiology, business and clinical modelling systems, access to services. The objectives include developing a professional culture around quality health data and synthesis of aggregated de-identified general practice data at both practice and divisional level (and beyond) to assist with local health needs assessment, planning, and funding. Evaluation occurs through group feedback sessions and from the general practitioners and staff. It has demonstrated its potential to fulfill the objectives in outcome areas such as data quality and management, team based care, pro-active practice population health care, and business systems development, thereby contributing to improved patient health outcomes.

  3. The Relationship Between School Health Curriculum and Family Practices.

    ERIC Educational Resources Information Center

    Hearne, Jill; Andrews, Richard L.

    A study investigated the differential relationship between children's involvement in an experiential health curriculum and past-reported health practices and changes in family health practices. The research is based on the assumption that established patterns of health practices in families are not immutable patterns, but are susceptible to change…

  4. [Mental health in primary health care: practices of the family health team].

    PubMed

    Correia, Valmir Rycheta; Barros, Sônia; Colvero, Luciana de Almeida

    2011-12-01

    The inclusion of mental health care actions in the context of the Brazilian Public Health System (SUS; Sistema Único de Saúde) contributes to the consolidation of the Brazilian Psychiatric reform and demands redirecting the practices of family health teams with users with mental health needs. The objective of this study is to identify and analyze the scientific production and actions developed by family health team professionals in mental health care. Systematic analysis originated the following themes: home visits to mentally ill patients and their relatives; attachment and welcoming; referrals; therapeutic workshops. In conclusion, the mental health actions developed in primary care are not performed consistently and depend on the professional or on the political decision of the administrator, which shows that professionals should use new practices to develop comprehensive care, and, therefore, there is a need to invest in improving the qualification of the professionals.

  5. Draft Genome Sequence of Desulfovibrio BerOc1, a Mercury-Methylating Strain

    PubMed Central

    Gassie, Claire; Bouchez, Oliver; Klopp, Christophe; Guyoneaud, Rémy

    2017-01-01

    ABSTRACT Desulfovibrio BerOc1 is a sulfate-reducing bacterium isolated from the Berre lagoon (French Mediterranean coast). BerOc1 is able to methylate and demethylate mercury. The genome size is 4,081,579 bp assembled into five contigs. We identified the hgcA and hgcB genes involved in mercury methylation, but not those responsible for mercury demethylation. PMID:28104657

  6. Integrating self-help materials into mental health practice.

    PubMed

    Church, Elizabeth; Cornish, Peter; Callanan, Terrence; Bethune, Cheri

    2008-10-01

    Patients' mental health issues have become an increasing focus of Canadian family physicians' practices. A self-help approach can help meet this demand, but there are few guidelines for professionals about how to use mental health self-help resources effectively. To aid health professionals in integrating self-help materials into their mental health practices. A resource library of print, audiotape, and videotape self-help materials about common mental health issues was developed for a rural community. The materials were prescreened in order to ensure high quality, and health professionals were given training on how to integrate self-help into their practices. The library was actively used by both health professionals and community members, and most resources were borrowed, particularly the nonprint materials. Health professionals viewed the resources as a way to supplement their mental health practice and reduce demands on their time, as patients generally worked through the resources independently. Some improvements are planned for future implementations of the program, such as providing health professionals with a "prescription pad" of resources and implementing Stages of Change and stepped-care models to maximize the program's effectiveness. Although more evidence is needed regarding the effectiveness of self-help within a family practice context, this program offers a promising way for family physicians to address mild to moderate mental health problems.

  7. Cultural Reflexivity in Health Research and Practice

    PubMed Central

    Aronowitz, Robert; Deener, Andrew; Keene, Danya; Schnittker, Jason

    2015-01-01

    Recent public health movements have invoked cultural change to improve health and reduce health disparities. We argue that these cultural discourses have sometimes justified and maintained health inequalities when those with power and authority designated their own social practices as legitimate and healthy while labeling the practices of marginalized groups as illegitimate or unhealthy. This “misrecognition,” which creates seemingly objective knowledge without understanding historical and social conditions, sustains unequal power dynamics and obscures the fact that what is deemed legitimate and healthy can be temporally, geographically, and socially relative. We use examples from research across multiple disciplines to illustrate the potential consequences of cultural misrecognition, highlight instances in which culture was invoked in ways that overcame misrecognition, and discuss how cultural reflexivity can be used to improve health research and practice. PMID:25905833

  8. Public Health Interventions: School Nurse Practice Stories.

    PubMed

    Anderson, Linda J W; Schaffer, Marjorie A; Hiltz, Cynthia; O'Leary, Stacie A; Luehr, Ruth Ellen; Yoney, Erika L

    2018-06-01

    This study describes and analyzes school nurses' (SN) experiences with understanding and using public health interventions from the Public Health Intervention Wheel. The Wheel offers a model for naming interventions provided by SNs from a public health perspective. Research teams from academic and SN practice settings conducted six focus groups with school nurses from Minnesota. Participants were asked to share experiences through telling stories from their practice that represented a specific wedge of the Wheel. Researchers organized data by intervention; often stories represented more than one intervention. Stories represented all levels of practice. This study highlights important contributions of school nurses to promote the health of school populations through the use of Wheel interventions. The integration of Wheel interventions in the application of the Framework for 21st-Century School Nursing Practice™ provides SNs with a language to document and communicate their expert professional practice.

  9. STS-60 crew walkout from O&C

    NASA Image and Video Library

    1994-02-03

    STS-60 pilot Ken Reightler (front left) and Mission Commander Charlie Bolden (front right) lead the way from the O&C bldg. enroute to Discovery at Pad 39A. Behidn are (from felt) Mission Specs Sega adn Krikalev: Payload Commander Chang-Diaz: and Misssion Spec Davis. (Op. No. D6022)(Item D-112C)

  10. Side reactions of nitroxide-mediated polymerization: N-O versus O-C cleavage of alkoxyamines.

    PubMed

    Hodgson, Jennifer L; Roskop, Luke B; Gordon, Mark S; Lin, Ching Yeh; Coote, Michelle L

    2010-09-30

    Free energies for the homolysis of the NO-C and N-OC bonds were compared for a large number of alkoxyamines at 298 and 393 K, both in the gas phase and in toluene solution. On this basis, the scope of the N-OC homolysis side reaction in nitroxide-mediated polymerization was determined. It was found that the free energies of NO-C and N-OC homolysis are not correlated, with NO-C homolysis being more dependent upon the properties of the alkyl fragment and N-OC homolysis being more dependent upon the structure of the aminyl fragment. Acyclic alkoxyamines and those bearing the indoline functionality have lower free energies of N-OC homolysis than other cyclic alkoxyamines, with the five-membered pyrrolidine and isoindoline derivatives showing lower free energies than the six-membered piperidine derivatives. For most nitroxides, N-OC homolysis is normally favored above NO-C homolysis only when a heteroatom that is α to the NOC carbon center stabilizes the NO-C bond and/or the released alkyl radical is not sufficiently stabilized. As part of this work, accurate methods for the calculation of free energies for the homolysis of alkoxyamines were determined. Accurate thermodynamic parameters to within 4.5 kJ mol(-1) of experimental values were found using an ONIOM approximation to G3(MP2)-RAD combined with PCM solvation energies at the B3-LYP/6-31G(d) level.

  11. OM/OC Ratio and Specific Attenuation Coefficient in Ambient Particulate Matter at a Rural Site in Southern Ontario: Implications for Aerosol Aging and Emission Sources

    NASA Astrophysics Data System (ADS)

    Chan, T. W.; Huang, L.; Leaitch, R.; Sharma, S.; Brook, J.; Slowik, J.; Abbatt, J.

    2008-05-01

    Carbonaceous species (organic carbon (OC) and elemental carbon (EC)) contribute a large portion of atmospheric fine particle mass and influence air quality, human health, and climate forcing. However, their emission sources and atmospheric aging processes are not well understood. The OM/OC ratio, defined as the organic mass per unit OC mass, is useful to understand the degree of oxidation of aerosol particles in atmospheric processes. We define the modified BC/EC (mod BC/EC) ratio as the ratio of the non-scattering corrected absorption coefficient per unit mass of EC. The mod BC/EC ratio has a similar meaning as the site specific attenuation coefficient, which is an important parameter used to convert light absorption measurements to black carbon mass. The mod BC/EC ratio can vary due to light scattering effect on absorption measurements, in which the oxygenated organics may play a role. The pyrolysis organic carbon (POC) is defined as the carbon mass fraction obtained at T= 870°C under a pure helium environment using the thermal separation method [Huang et al., 2006]. Since POC mass is generally proportional to the amount of oxygenated OC, studying the relationships among OC, EC, POC, as well as OM/OC and mod BC/EC ratios may help us understand the mechanisms of aerosol aging from different emission sources. Two 1-month field studies were conducted at a rural site in southern Ontario (NW of Toronto) during fall 2005 and spring 2007. Quartz filter samples were collected and analyzed for OC, POC, and EC concentrations using a thermal/optical method [Huang et al., 2006]. Together with the total organic matter measured by an Aerodyne Aerosol Mass Spectrometer (AMS) and the absorption coefficient obtained from a Particle Soot Absorption Photometer (PSAP), the OM/OC and mod BC/EC ratios for ambient aerosols were obtained. Our results show that when air mass was mainly from south, OC, POC, and EC were relatively high, with average ratios of OC/EC, OM/OC, and POC/EC as 1

  12. Practice Notes: Strategies in Health Education

    ERIC Educational Resources Information Center

    Health Education & Behavior, 2007

    2007-01-01

    The Practice Notes section is intended to keep readers informed about health education practice around the country. It is an attempt to spread the word about exemplary strategies, initiatives, and programs and share successes in overcoming obstacles or challenges. Periodically, articles presenting perspectives on practice-related issues are also…

  13. Draft Genome Sequence of Desulfovibrio BerOc1, a Mercury-Methylating Strain.

    PubMed

    Goñi Urriza, Marisol; Gassie, Claire; Bouchez, Oliver; Klopp, Christophe; Guyoneaud, Rémy

    2017-01-19

    Desulfovibrio BerOc1 is a sulfate-reducing bacterium isolated from the Berre lagoon (French Mediterranean coast). BerOc1 is able to methylate and demethylate mercury. The genome size is 4,081,579 bp assembled into five contigs. We identified the hgcA and hgcB genes involved in mercury methylation, but not those responsible for mercury demethylation. Copyright © 2017 Goñi Urriza et al.

  14. 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...

  15. 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...

  16. 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...

  17. Horizontal transfer of OC1 transposons in the Tasmanian devil.

    PubMed

    Gilbert, Clement; Waters, Paul; Feschotte, Cedric; Schaack, Sarah

    2013-02-27

    There is growing recognition that horizontal DNA transfer, a process known to be common in prokaryotes, is also a significant source of genomic variation in eukaryotes. Horizontal transfer of transposable elements (HTT) may be especially prevalent in eukaryotes given the inherent mobility, widespread occurrence, and prolific abundance of these elements in many eukaryotic genomes. Here, we provide evidence for a new case of HTT of the transposon family OposCharlie1 (OC1) in the Tasmanian devil, Sarcophilus harrisii. Bioinformatic analyses of OC1 sequences in the Tasmanian devil genome suggest that this transposon infiltrated the common ancestor of the Dasyuridae family ~17 million years ago. This estimate is corroborated by a PCR-based screen for the presence/absence of this family in Tasmanian devils and closely-related species. This case of HTT is the first to be reported in dasyurids. It brings the number of animal lineages independently invaded by OC1 to 12, and adds a fourth continent to the pandemic-like pattern of invasion of this transposon. In the context of these data, we discuss the evolutionary history of this transposon family and its potential impact on the diversification of marsupials.

  18. Horizontal transfer of OC1 transposons in the Tasmanian devil

    PubMed Central

    2013-01-01

    Background There is growing recognition that horizontal DNA transfer, a process known to be common in prokaryotes, is also a significant source of genomic variation in eukaryotes. Horizontal transfer of transposable elements (HTT) may be especially prevalent in eukaryotes given the inherent mobility, widespread occurrence, and prolific abundance of these elements in many eukaryotic genomes. Results Here, we provide evidence for a new case of HTT of the transposon family OposCharlie1 (OC1) in the Tasmanian devil, Sarcophilus harrisii. Bioinformatic analyses of OC1 sequences in the Tasmanian devil genome suggest that this transposon infiltrated the common ancestor of the Dasyuridae family ~17 million years ago. This estimate is corroborated by a PCR-based screen for the presence/absence of this family in Tasmanian devils and closely-related species. Conclusions This case of HTT is the first to be reported in dasyurids. It brings the number of animal lineages independently invaded by OC1 to 12, and adds a fourth continent to the pandemic-like pattern of invasion of this transposon. In the context of these data, we discuss the evolutionary history of this transposon family and its potential impact on the diversification of marsupials. PMID:23445260

  19. Strengthening practical wisdom: mental health workers' learning and development.

    PubMed

    Eriksen, Kristin Ådnøy; Dahl, Hellen; Karlsson, Bengt; Arman, Maria

    2014-09-01

    Practical wisdom, understood as knowing how to be or act in any present situation with clients, is believed to be an essential part of the knowledge needed to be a professional mental health worker. Exploring processes of adapting, extending knowledge and refining tacit knowledge grounded in mental health workers' experiences with being in practice may bring awareness of how mental health workers reflect, learn and practice professional 'artistry'. The aim of the article was to explore mental health workers' processes of development and learning as they appeared in focus groups intended to develop practical wisdom. The main research question was 'How might the processes of development and learning contribute to developing practical wisdom in the individual as well as in the practice culture?' The design was multi-stage focus groups, and the same participants met four times. A phenomenological hermeneutical method for researching lived experience guided the analysis. Eight experienced mental health workers representing four Norwegian municipalities participated. The research context was community-based mental health services. The study was reported to Norwegian Social Data Services, and procedures for informed consent were followed. Two examples of processes of re-evaluation of experience (Association, Integration, Validation, Appropriation and Outcomes and action) were explored. The health workers had developed knowledge in previous encounters with clients. In sharing practice experiences, this knowledge was expressed and developed, and also tested and validated against the aims of practice. Discussions led to adapted and extended knowledge, and as tacit knowledge was expressed it could be used actively. Learning to reflect, being ready to be provoked and learning to endure indecisiveness may be foundational in developing practical wisdom. Openness is demanding, and changing habits of mind is difficult. Reflection on, and confrontation with, set practices are

  20. Primary care and behavioral health practice size: the challenge for health care reform.

    PubMed

    Bauer, Mark S; Leader, Deane; Un, Hyong; Lai, Zongshan; Kilbourne, Amy M

    2012-10-01

    We investigated the size profile of US primary care and behavioral health physician practices since size may impact the ability to institute care management processes (CMPs) that can enhance care quality. We utilized 2009 claims data from a nationwide commercial insurer to estimate practice size by linking providers by tax identification number. We determined the proportion of primary care physicians, psychiatrists, and behavioral health providers practicing in venues of >20 providers per practice (the lower bound for current CMP practice surveys). Among primary care physicians (n=350,350), only 2.1% of practices consisted of >20 providers. Among behavioral health practitioners (n=146,992) and psychiatrists (n=44,449), 1.3% and 1.0% of practices, respectively, had >20 providers. Sensitivity analysis excluding single-physician practices as "secondary" confirmed findings, with primary care and psychiatrist practices of >20 providers comprising, respectively, only 19.4% and 8.8% of practices (difference: P<0.0001). In secondary analyses, bipolar disorder was used as a tracer condition to estimate practice census for a high-complexity, high-cost behavioral health condition; only 1.3-18 patients per practice had claims for this condition. The tax identification number method for estimating practice size has strengths and limitations that complement those of survey methods. The proportion of practices below the lower bound of prior CMP studies is substantial, and care models and policies will need to address the needs of such practices and their patients. Achieving a critical mass of patients for disorder-specific CMPs will require coordination across multiple small practices.

  1. An Assessment of Organizational Health Literacy Practices at an Academic Health Center.

    PubMed

    Prince, Latrina Y; Schmidtke, Carsten; Beck, Jules K; Hadden, Kristie B

    Organizational health literacy is the degree to which an organization considers and promotes the health literacy of patients. Addressing health literacy at an organizational level has the potential to have a greater impact on more health consumers in a health system than individual-level approaches. The purpose of this study was to assess health care practices at an academic health center using the 10 attributes of a health-literate health care organization. Using a survey research design, the Health Literate Healthcare Organization 10-Item Questionnaire was administered online using total population sampling. Employees (N = 10 300) rated the extent that their organization's health care practices consider and promote patients' health literacy. Differences in responses were assessed using factorial analysis of variance. The mean response was 4.7 on a 7-point Likert scale. Employee training and communication about costs received the lowest ratings. Univariate analyses revealed that there were no statistically significant differences (P = .05) by employees' health profession, years of service, or level of patient contact. There were statistically significant differences by highest education obtained with lowest ratings from employees with college degrees. Survey responses indicate a need for improvements in health care practices to better assist patients with inadequate health literacy.

  2. 77 FR 47877 - Potential Commercial Leasing for Wind Power on the Outer Continental Shelf (OCS) Offshore Maine...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-10

    ... Commercial Leasing for Wind Power on the Outer Continental Shelf (OCS) Offshore Maine; Request for Interest... Request for a Commercial OCS Wind Lease, Request for Interest, and Request for Public Comment SUMMARY: The... (Statoil NA) to acquire an OCS wind lease; (2) solicit public input regarding the proposal, its potential...

  3. Spiritual Wellness, Holistic Health, and the Practice of Health Education

    ERIC Educational Resources Information Center

    Hawks, Steven

    2004-01-01

    The current practice of health education often fails to harmonize with the multidimensional, dynamic, and functional nature of health as generally defined within our profession. As a stepchild of the medical and public health professions, we have inherited a preoccupation with physical health as the most worthy outcome measure for most of our…

  4. E-mentoring in public health nursing practice.

    PubMed

    Miller, Louise C; Devaney, Susan W; Kelly, Glenda L; Kuehn, Alice F

    2008-09-01

    Attrition in the public health nursing work force combined with a lack of faculty to teach public health prompted development of a "long-distance" learning project. Practicing associate degree nurses enrolled in an online course in population-based practice worked with experienced public health nurse "e-mentors." Student-mentor pairs worked through course assignments, shared public health nursing experiences, and problem-solved real-time public health issues. Nursing faculty served as coordinators for student learning and mentor support. Over 3 years, 38 student-mentor pairs participated in the project. Students reported they valued the expertise and guidance of their mentors. Likewise, mentors gained confidence in their practice and abilities to mentor. Issues related to distance learning and e-mentoring centered around use of technology and adequate time to communicate with one another. E-mentoring is a viable strategy to connect nurses to a learning, sharing environment while crossing the barriers of distance, agency isolation, and busy schedules.

  5. International Active Surveillance Study of Women Taking Oral Contraceptives (INAS-OC Study).

    PubMed

    Dinger, Juergen C; Bardenheuer, Kristina; Assmann, Anita

    2009-11-18

    A 24-day regimen of contraceptive doses of drospirenone and ethinylestradiol (DRSP/EE 24d) was recently launched. This regimen has properties which may be beneficial for certain user populations (e.g., women suffering from premenstrual dysphoric disorder or acne). However, it is unknown whether this extended regimen has an impact on the cardiovascular risk associated with the use of oral contraceptives (OCs). The INternational Active Surveillance study of women taking Oral Contraceptives (INAS-OC) is designed to investigate the short- and long-term safety of the new regimen in a population which is representative for the typical user of oral contraceptives. A large, prospective, controlled, non-interventional, long-term cohort study with active surveillance of the study participants has been chosen to ensure reliable and valid results. More than 2,000 gynecologists in the US and 5 European countries (Austria, Germany, Italy, Poland, and Sweden) will recruit more than 80,000 OC users. The two to five year follow-up of these women will result in at least 220,000 documented women-years. The main clinical outcomes of interest for the follow-up are deep venous thrombosis, pulmonary embolism, acute myocardial infarction and cerebrovascular accidents. Secondary objectives are general safety, effectiveness and drug utilization pattern of DRSP/EE 24d, return to fertility after stop of OC use, as well as the baseline risk for users of individual OC formulations. Because of the non-interference character of this study, potential participants (first-time users or switchers) are informed about the study only after the decision regarding prescription of a new OC. There are no specific medical inclusion or exclusion criteria. Study participation is voluntary and a written informed consent is required. After the baseline questionnaire, follow-up questionnaires will be mailed to the participants every 6 months for up to 5 years after baseline. Self-reported serious adverse events

  6. Macro Trends and the Future of Public Health Practice.

    PubMed

    Erwin, Paul Campbell; Brownson, Ross C

    2017-03-20

    Public health practice in the twenty-first century is in a state of significant flux. Several macro trends are impacting the current practice of governmental public health and will likely have effects for many years to come. These macro trends are described as forces of change, which are changes that affect the context in which the community and its public health system operate. This article focuses on seven such forces of change: the Patient Protection and Affordable Care Act, public health agency accreditation, climate change, health in all policies, social media and informatics, demographic transitions, and globalized travel. Following the description of each of these, this article then turns to possible approaches to measuring, tracking, and understanding the impact of these forces of change on public health practice, including the use of evidence-based public health, practice-based research, and policy surveillance.

  7. Fine carbonaceous aerosol characteristics at a megacity during the Chinese Spring Festival as given by OC/EC online measurements

    NASA Astrophysics Data System (ADS)

    Liu, Baoshuang; Bi, Xiaohui; Feng, Yinchang; Dai, Qili; Xiao, Zhimei; Li, Liwei; Wu, Jianhui; Yuan, Jie; Zhang, YuFen

    2016-11-01

    The OC/EC online monitoring campaign was carried out in Tianjin of China from 8th February to 15th March 2015 during the Chinese Spring Festival period (CSFP). The concentrations of OC, EC, BC and other ambient pollutants (e.g. SO2, NO2 and PM2.5, etc.) in high time resolution were measured with related online-monitoring instruments. During the CSFP, according to the peaks of PM2.5 concentrations and number concentrations (NC) of aerosol particles with aerodynamic diameters between 0.3 and 2.5 μm, five pollution-events were generally identified and displayed. These pollution-events were closely associated with large-scale fireworks displaying, combustion activities such as heating for winter, and the stable meteorological conditions, etc. During the CSFP, EC and OC concentrations showed variations up to one order of magnitude. The uncertainty of instrument itself and the difference for measured methods, further caused the differences between thermal OC (measured OC by thermal method) and optical OC (measured OC by optical method) concentrations, as well as between thermal EC (measured EC by thermal method) and optical EC (measured EC by optical method) concentrations. The high-concentration carbonaceous aerosols could enlarge the uncertainty of measuring instrument, reducing the correlations between OC and EC, and enhance the differences among thermal EC, optical BC and optical EC. The OC/EC ratios and the percentages of SOC/OC would be declined, when the pollution-events formed during the CSFP. Due to the different sources for thermal POC and thermal SOC, the correlation of the two was relatively lower (R2 = 0.39). Thermal POC dominated over thermal OC during the CSFP.

  8. Selected Health Practices Among Ohio's Rural Residents.

    ERIC Educational Resources Information Center

    Phillips, G. Howard; Pugh, Albert

    Using a stratified random sample of 12 of Ohio's 88 counties, this 1967 study had as its objectives (1) to measure the level of participation in selected health practices by Ohio's rural residents, (2) to compare the level of participation in selected health practices of farm and rural nonfarm residents, and (3) to examine levels of participation…

  9. Dual practice in the health sector: review of the evidence

    PubMed Central

    Ferrinho, Paulo; Van Lerberghe, Wim; Fronteira, Inês; Hipólito, Fátima; Biscaia, André

    2004-01-01

    This paper reports on income generation practices among civil servants in the health sector, with a particular emphasis on dual practice. It first approaches the subject of public–private overlap. Thereafter it focuses on coping strategies in general and then on dual practice in particular. To compensate for unrealistically low salaries, health workers rely on individual coping strategies. Many clinicians combine salaried, public-sector clinical work with a fee-for-service private clientele. This dual practice is often a means by which health workers try to meet their survival needs, reflecting the inability of health ministries to ensure adequate salaries and working conditions. Dual practice may be considered present in most countries, if not all. Nevertheless, there is surprisingly little hard evidence about the extent to which health workers resort to dual practice, about the balance of economic and other motives for doing so, or about the consequences for the proper use of the scarce public resources dedicated to health. In this paper dual practice is approached from six different perspectives: (1) conceptual, regarding what is meant by dual practice; (2) descriptive, trying to develop a typology of dual practices; (3) quantitative, trying to determine its prevalence; (4) impact on personal income, the health care system and health status; (5) qualitative, looking at the reasons why practitioners so frequently remain in public practice while also working in the private sector and at contextual, personal life, institutional and professional factors that make it easier or more difficult to have dual practices; and (6) possible interventions to deal with dual practice. PMID:15509305

  10. The Fountain of Health: Bringing Seniors’ Mental Health Promotion into Clinical Practice

    PubMed Central

    Thoo, Vanessa; Freer, Janya; Cassidy, Keri-Leigh

    2015-01-01

    Background The Fountain of Health (FoH) initiative offers valuable evidence-based mental health knowledge and provides clinicians with evaluated tools for translating knowledge into practice, in order to reduce seniors’ risks of mental disorders, including dementia. Methods A presentation on mental health promotion and educational materials were disseminated to mental health clinicians including physicians and other allied health professionals either in-person or via tele-education through a provincial seniors’ mental health network. Measures included: 1) a tele-education quality evaluation form, 2) a knowledge transfer questionnaire, 3) a knowledge translation-to-practice evaluation tool, and 4) a quality assurance questionnaire. Results A total of 74 mental health clinicians received the FoH education session. There was a highly significant (p < .0001) difference in clinicians’ knowledge transfer questionnaire scores pre- and post-educational session. At a two-month follow-up, 19 (25.7%) participants completed a quality assurance questionnaire, with all 19 (100%) of respondents stating they would positively recommend the FoH information to colleagues and patients. Eleven (20.4%) translation-to-practice forms were also collected at this interval, tracking clinician use of the educational materials. Conclusions The use of a formalized network for knowledge transfer allows for education and evaluation of health-care practitioners in both acquisition of practical knowledge and subsequent clinical behavior change. PMID:26740830

  11. Interventions to manage dual practice among health workers.

    PubMed

    Kiwanuka, Suzanne N; Rutebemberwa, Elizeus; Nalwadda, Christine; Okui, Olico; Ssengooba, Freddie; Kinengyere, Alison A; Pariyo, George W

    2011-07-06

    Dual practice, whereby health workers hold two or more jobs, is a common phenomenon globally. In resource constrained low- and middle-income countries dual practice poses an ongoing threat to the efficiency, quality and equity of health services, especially in the public sector. Identifying effective interventions to manage dual practice is important. To assess the effects of regulations implemented to manage dual practice. Databases searched included: The Cochrane Central Register of Controlled Trials (CENTRAL) 2011, Issue 4, part of The Cochrane Library. www.thecochranelibrary.com, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (searched 26 May 2011); MEDLINE In-Process & Other Non-Indexed Citations May 24, 2011 (searched 26 May 2011); MEDLINE, Ovid (1948 to May week 2 2011) (searched 26 May 2011); EMBASE, Ovid (1980 to 2011 week 20) (searched 26 May 2011); Science Citation Index and Social Sciences Citation Index, ISI Web of Science (1975 to present) (searched 04 December 2009); LILACS (searched January 2010); and AIM (December 2009) (searched 18 December 2009). Randomized controlled trials, non-randomized controlled trials, controlled before-and-after studies and interrupted-time-series studies. Dual practice was defined as holding more than one job. Studies for inclusion were those focusing on interventions to manage dual practice among health professionals employed in the public health sector. Two review authors independently applied the criteria for inclusion and exclusion of studies when scanning the identified titles and abstracts. The same two review authors independently screened full reports of selected citations. At each stage, results were compared and discrepancies settled through discussion. No studies were found which were eligible for inclusion in this review. There is a need to rigorously evaluate the effects of interventions implemented to manage dual practice among health workers. However

  12. 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.

  13. Physiological inhibitory effect of ocs in arachidonic acid-rich Parietochloris incisa (trebouxiophyceae, chlorophyta)

    NASA Astrophysics Data System (ADS)

    Liu, Jian-Guo; Zhang, Cheng-Wu; Cohen, Zvi; Richmond, Amos

    2002-09-01

    Parietochloris incisa is an arachidonic acid-rich snow green alga. The main physiological profiles, such as ash free dry weight (AFDW), chlorophyll, carotenoid, protein and total fatty acids (TFA), in this alga exposed to old culture supernatant (OCS) at the decline phase or its crude ethyl acetate extracts (CEAE) were investigated by using tubular photobioreactors of different diameters. Results showed that both OCS and CEAE had strong inhibitory effect on the above physiological parameters. The longer the culture was exposed to OCS and the more CEAE were added into the algal culture, the more the above physiological properties were inhibited. Arachidonic acid (AA), the dominant component of fatty acids in this alga, was also seriously inhibited with respect to total TFA, AFDW of cell mass, or culture volume, due to a probable reduction of enzymes activities catalyzing chain elongation from C18; 1ω9 to AA. These results incontestably evidenced that some CEAE dissolving substances existing in OCS. like auto-inhibitors, inhibited P. incisa growth through feedback. Hence, any efficient removal of auto-inhibitors from algal culture to decrease their bioactivity could be good for maximal production of desired products like AA.

  14. Nurses' roles in health promotion practice: an integrative review.

    PubMed

    Kemppainen, Virpi; Tossavainen, Kerttu; Turunen, Hannele

    2013-12-01

    Nurses play an important role in promoting public health. Traditionally, the focus of health promotion by nurses has been on disease prevention and changing the behaviour of individuals with respect to their health. However, their role as promoters of health is more complex, since they have multi-disciplinary knowledge and experience of health promotion in their nursing practice. This paper presents an integrative review aimed at examining the findings of existing research studies (1998-2011) of health promotion practice by nurses. Systematic computer searches were conducted of the Cochrane databases, Cinahl, PubMed, Web of Science, PsycINFO and Scopus databases, covering the period January 1998 to December 2011. Data were analysed and the results are presented using the concept map method of Novak and Gowin. The review found information on the theoretical basis of health promotion practice by nurses, the range of their expertise, health promotion competencies and the organizational culture associated with health promotion practice. Nurses consider health promotion important but a number of obstacles associated with organizational culture prevent effective delivery.

  15. Assessing Culture and Climate of Federally Qualified Health Centers: A Plan for Implementing Behavioral Health Interventions.

    PubMed

    Kramer, Teresa L; Drummond, Karen L; Curran, Geoffrey M; Fortney, John C

    2017-01-01

    This study examines organizational factors relating to climate and culture that might facilitate or impede the implementation of evidence-based practices (EBP) targeting behavioral health in federally qualified health centers (FQHCs). Employees at six FQHCs participating in an evidence-based quality improvement (EBQI) initiative for mood disorders and alcohol abuse were interviewed (N=32) or surveyed using the Organizational Context Survey (OCS) assessing culture and climate (N=64). The FQHCs scored relatively well on proficiency, a previously established predictor of successful EBP implementation, but also logged high scores on scales assessing rigidity and resistance, which may hinder implementation. Qualitative data contextualized scores on FQHC culture and climate dimensions. Results suggest that the unique culture of FQHCs may influence implementation of evidence-based behavioral health interventions.

  16. The Hong Kong version of the Oxford Cognitive Screen (HK-OCS): validation study for Cantonese-speaking chronic stroke survivors.

    PubMed

    Kong, Anthony Pak-Hin; Lam, Pinky Hiu-Ping; Ho, Diana Wai-Lam; Lau, Johnny King; Humphreys, Glyn W; Riddoch, Jane; Weekes, Brendan

    2016-09-01

    This study reports the validation of the Hong Kong version of Oxford Cognitive Screen (HK-OCS). Seventy Cantonese-speaking healthy individuals participated to establish normative data and 46 chronic stroke survivors were assessed using the HK-OCS, Albert's Test of Visual Neglect, short test of gestural production, and Hong Kong version of the following assessments: Western Aphasia Battery, MMSE, MoCA, Modified Barthel Index, and Lawton Instrumental Activities of Daily Living scale. The validity of the HK-OCS was appraised by the difference between the two participant groups. Neurologically unimpaired individuals performed significantly better than stroke survivors on the HK-OCS. Positive and significant correlations found between cognitive subtests in the HK-OCS and related assessments indicated good concurrent validity. Excellent intra-rater and inter-rater reliabilities, fair test-retest reliability, and acceptable internal consistency suggested that the HK-OCS had good reliability. Specific HK-OCS subtests including semantics, episodic memory, number writing, and orientation were the best predictors of functional outcomes.

  17. Development and evaluation of oral Cancer quality-of-life questionnaire (QOL-OC).

    PubMed

    Nie, Min; Liu, Chang; Pan, Yi-Chen; Jiang, Chen-Xi; Li, Bao-Ru; Yu, Xi-Jie; Wu, Xin-Yu; Zheng, Shu-Ning

    2018-05-03

    In this study scales and items for the Oral Cancer Quality-of-life Questionnaire (QOL-OC) were designed and the instrument was evaluated. The QOL-OC was developed and modified using the international definition of quality of life (QOL) promulgated by the European Organization for Research and Treatment of Cancer (EORTC) and analysis of the precedent measuring instruments. The contents of each item were determined in the context of the specific characteristics of oral cancer. Two hundred thirteen oral cancer patients were asked to complete both the EORTC core quality of life questionnaire (EORTC QLC-C30) and the QOL-OC. Data collected was used to conduct factor analysis, test-retest reliability, internal consistency, and construct validity. Questionnaire compliance was relatively high. Fourteen of the 213 subjects accepted the same tests after 24 to 48 h demonstrating a high test-retest reliability for all five scales. Overall internal consistency surpasses 0.8. The outcome of the factor analysis coincides substantially with our theoretical conception. Each item shows a higher correlation coefficient within its own scale than the others which indicates high construct validity. QOL-OC demonstrates fairly good statistical reliability, validity, and feasibility. However, further tests and modification are needed to ensure its applicability to the quality-of-life assessment of Chinese oral cancer patients.

  18. Joint Space Operations Center (JSpOC) Mission System Increment 3 (JMS Inc 3)

    DTIC Science & Technology

    2016-03-01

    2016 Major Automated Information System Annual Report Joint Space Operations Center (JSpOC) Mission System Increment 3 (JMS Inc 3) Defense...1725 DSN Phone: DSN Fax: Date Assigned: May 16, 2014 Program Information Program Name Joint Space Operations Center (JSpOC) Mission System...approved program baseline; therefore, no Original Estimate has been established. JMS Inc 3 2016 MAR UNCLASSIFIED 4 Program Description The Joint Space

  19. Redesigning Health Care Practices to Address Childhood Poverty.

    PubMed

    Fierman, Arthur H; Beck, Andrew F; Chung, Esther K; Tschudy, Megan M; Coker, Tumaini R; Mistry, Kamila B; Siegel, Benjamin; Chamberlain, Lisa J; Conroy, Kathleen; Federico, Steven G; Flanagan, Patricia J; Garg, Arvin; Gitterman, Benjamin A; Grace, Aimee M; Gross, Rachel S; Hole, Michael K; Klass, Perri; Kraft, Colleen; Kuo, Alice; Lewis, Gena; Lobach, Katherine S; Long, Dayna; Ma, Christine T; Messito, Mary; Navsaria, Dipesh; Northrip, Kimberley R; Osman, Cynthia; Sadof, Matthew D; Schickedanz, Adam B; Cox, Joanne

    2016-04-01

    Child poverty in the United States is widespread and has serious negative effects on the health and well-being of children throughout their life course. Child health providers are considering ways to redesign their practices in order to mitigate the negative effects of poverty on children and support the efforts of families to lift themselves out of poverty. To do so, practices need to adopt effective methods to identify poverty-related social determinants of health and provide effective interventions to address them. Identification of needs can be accomplished with a variety of established screening tools. Interventions may include resource directories, best maintained in collaboration with local/regional public health, community, and/or professional organizations; programs embedded in the practice (eg, Reach Out and Read, Healthy Steps for Young Children, Medical-Legal Partnership, Health Leads); and collaboration with home visiting programs. Changes to health care financing are needed to support the delivery of these enhanced services, and active advocacy by child health providers continues to be important in effecting change. We highlight the ongoing work of the Health Care Delivery Subcommittee of the Academic Pediatric Association Task Force on Child Poverty in defining the ways in which child health care practice can be adapted to improve the approach to addressing child poverty. Copyright © 2016 Academic Pediatric Association. All rights reserved.

  20. A capacity-building conceptual framework for public health nutrition practice.

    PubMed

    Baillie, Elizabeth; Bjarnholt, Christel; Gruber, Marlies; Hughes, Roger

    2009-08-01

    To describe a conceptual framework to assist in the application of capacity-building principles to public health nutrition practice. A review of the literature and consideration of the determinants of effective public health nutrition practice has been used to inform the development of a conceptual framework for capacity building in the context of public health nutrition practice. The limited literature supports a greater integration and application of capacity-building strategies and principles in public health nutrition practice, and that this application should be overt and strategic. A framework is proposed that identifies a number of determinants of capacity for effective public health nutrition action. The framework represents the key foundations for building capacity including leadership, resourcing and intelligence. Five key strategic domains supported by these foundation elements, including partnerships, organisational development, project management quality, workforce development and community development, are proposed. This framework can be used to assist the systematic assessment, development and evaluation of capacity-building activity within public health nutrition practice. Capacity building is a strategy within public health nutrition practice that needs to be central to public health nutrition intervention management. The present paper defines, contextualises and outlines a framework for integrating and making explicit the importance of capacity building within public health nutrition practice at many levels.

  1. The O-C2 angle established at occipito-cervical fusion dictates the patient's destiny in terms of postoperative dyspnea and/or dysphagia.

    PubMed

    Izeki, Masanori; Neo, Masashi; Takemoto, Mitsuru; Fujibayashi, Shunsuke; Ito, Hiromu; Nagai, Koutatsu; Matsuda, Shuichi

    2014-02-01

    We have revealed that the cause of postoperative dyspnea and/or dysphagia after occipito-cervical (O-C) fusion is mechanical stenosis of the oropharyngeal space and the O-C2 alignment, rather than total or subaxial alignment, is the key to the development of dyspnea and/or dysphagia. The purpose of this study was to confirm the impact of occipito-C2 angle (O-C2A) on the oropharyngeal space and to investigate the chronological impact of a fixed O-C2A on the oropharyngeal space and dyspnea and/or dysphagia after O-C fusion. We reviewed 13 patients who had undergone O-C2 fusion, while retaining subaxial segmental motion (OC2 group) and 20 who had subaxial fusion without O-C2 fusion (SA group). The O-C2A, C2-C6 angle and the narrowest oropharyngeal airway space were measured on lateral dynamic X-rays preoperatively, when dynamic X-rays were taken for the first time postoperatively, and at the final follow-up. We also recorded the current dyspnea and/or dysphagia status at the final follow-up of patients who presented with it immediately after the O-C2 fusion. There was no significant difference in the mean preoperative values of the O-C2A (13.0 ± 7.5 in group OC2 and 20.1 ± 10.5 in group SA, Unpaired t test, P = 0.051) and the narrowest oropharyngeal airway space (17.8 ± 6.0 in group OC2 and 14.9 ± 3.9 in group SA, Unpaired t test, P = 0.105). In the OC2 group, the narrowest oropharyngeal airway space changed according to the cervical position preoperatively, but became constant postoperatively. In contrast, in the SA group, the narrowest oropharyngeal airway space changed according to the cervical position at any time point. Three patients who presented with dyspnea and/or dysphagia immediately after O-C2 fusion had not resolved completely at the final follow-up. The narrowest oropharyngeal airway space and postoperative dyspnea and/or dysphagia did not change with time once the O-C2A had been established at O-C fusion. The O-C2A established at O-C

  2. Practices of depression care in home health care: Home health clinician perspectives

    PubMed Central

    Bao, Yuhua; Eggman, Ashley A.; Richardson, Joshua E.; Sheeran, Thomas; Bruce, Martha L.

    2015-01-01

    Objective To assess any gaps between published best practices and real-world practices of treating depression in home health care (HHC), and barriers to closing any gaps. Methods A qualitative study based on semi-structured interviews with HHC nurses and administrators from five home health agencies in five states (n=20). Audio-recorded interviews were transcribed and analyzed by a multi-disciplinary team using grounded theory method to identify themes. Results Routine home health nursing care overlapped with all functional areas of depression care. However, there were reported gaps between best practices and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care. Conclusions Strategies to close gaps between typical and best practices need to enhance HHC clinician knowledge and self-efficacy with depression treatment and improve the quality of antidepressant management and communication with primary care. PMID:26423098

  3. Constraining gross primary production and ecosystem respiration estimates for North America using atmospheric observations of carbonyl sulfide (OCS) and CO2

    NASA Astrophysics Data System (ADS)

    He, W.; Ju, W.; Chen, H.; Peters, W.; van der Velde, I.; Baker, I. T.; Andrews, A. E.; Zhang, Y.; Launois, T.; Campbell, J. E.; Suntharalingam, P.; Montzka, S. A.

    2016-12-01

    Carbonyl sulfide (OCS) is a promising novel atmospheric tracer for studying carbon cycle processes. OCS shares a similar pathway as CO2 during photosynthesis but not released through a respiration-like process, thus could be used to partition Gross Primary Production (GPP) from Net Ecosystem-atmosphere CO2 Exchange (NEE). This study uses joint atmospheric observations of OCS and CO2 to constrain GPP and ecosystem respiration (Re). Flask data from tower and aircraft sites over North America are collected. We employ our recently developed CarbonTracker (CT)-Lagrange carbon assimilation system, which is based on the CT framework and the Weather Research and Forecasting - Stochastic Time-Inverted Lagrangian Transport (WRF-STILT) model, and the Simple Biosphere model with simulated OCS (SiB3-OCS) that provides prior GPP, Re and plant uptake fluxes of OCS. Derived plant OCS fluxes from both process model and GPP-scaled model are tested in our inversion. To investigate the ability of OCS to constrain GPP and understand the uncertainty propagated from OCS modeling errors to constrained fluxes in a dual-tracer system including OCS and CO2, two inversion schemes are implemented and compared: (1) a two-step scheme, which firstly optimizes GPP using OCS observations, and then simultaneously optimizes GPP and Re using CO2 observations with OCS-constrained GPP in the first step as prior; (2) a joint scheme, which simultaneously optimizes GPP and Re using OCS and CO2 observations. We will evaluate the result using an estimated GPP from space-borne solar-induced fluorescence observations and a data-driven GPP upscaled from FLUXNET data with a statistical model (Jung et al., 2011). Preliminary result for the year 2010 shows the joint inversion makes simulated mole fractions more consistent with observations for both OCS and CO2. However, the uncertainty of OCS simulation is larger than that of CO2. The two-step and joint schemes perform similarly in improving the consistence with

  4. Implications of dual practice for universal health coverage.

    PubMed

    McPake, Barbara; Russo, Giuliano; Hipgrave, David; Hort, Krishna; Campbell, James

    2016-02-01

    Making progress towards universal health coverage (UHC) requires that health workers are adequate in numbers, prepared for their jobs and motivated to perform. In establishing the best ways to develop the health workforce, relatively little attention has been paid to the trends and implications of dual practice - concurrent employment in public and private sectors. We review recent research on dual practice for its potential to guide staffing policies in relation to UHC. Many studies describe the characteristics and correlates of dual practice and speculate about impacts, but there is very little evidence that is directly relevant to policy-makers. No studies have evaluated the impact of policies on the characteristics of dual practice or implications for UHC. We address this lack and call for case studies of policy interventions on dual practice in different contexts. Such research requires investment in better data collection and greater determination on the part of researchers, research funding bodies and national research councils to overcome the difficulties of researching sensitive topics of health systems functions.

  5. Integrated health practices: development of a graduate nursing program.

    PubMed

    Jossens, Marilyn O R; Ganley, Barbara J

    2006-01-01

    This article describes pedagogical issues in the development of a graduate nursing program in Integrated Health Practices (IHP), reports early experiences in the program, and asserts the importance of a graduate program in the specialty. The experience is described, and unique pedagogical issues encountered are discussed. While noting the contributions made to health and health care by Western medicine and nursing practice, the authors elaborate on the benefits of integrating western health care with less technological, less invasive, and less expensive holistic approaches. Diverse populations often require attention to specific chronic conditions, rather than to acute conditions, and constitutional requirements for overall health may be influenced by diverse health philosophies and practices. These requirements may be grounded in cultural and religious beliefs that must be incorporated into culturally sensitive plans of care. Clinical nurse specialists in IHP can offer knowledge and leadership to nursing practice, which address these complex, yet subtle health care issues.

  6. Temperature-Dependent Helium Ion-Beam Mixing in an Amorphous SiOC/Crystalline Fe Composite

    DOE PAGES

    Su, Qing; Price, Lloyd; Shao, Lin; ...

    2016-10-31

    Temperature dependent He-irradiation-induced ion-beam mixing between amorphous silicon oxycarbide (SiOC) and crystalline Fe was examined with a transmission electron microscope (TEM) and via Rutherford backscattering spectrometry (RBS). The Fe marker layer (7.2 ± 0.8 nm) was placed in between two amorphous SiOC layers (200 nm). The amount of ion-beam mixing after 298, 473, 673, 873, and 1073 K irradiation was investigated. Both TEM and RBS results showed no ion-beam mixing between Fe and SiOC after 473 and 673 K irradiation and a very trivial amount of ion-beam mixing (~2 nm) after 298 K irradiation. At irradiation temperatures higher than 873more » K, the Fe marker layer broke down and RBS could no longer be used to quantitatively examine the amount of ion mixing. The results indicate that the Fe/SiOC nanocomposite is thermally stable and tends to demix in the temperature range from 473 to 673 K. For application of this composite structure at temperatures of 873 K or higher, layer stability is a key consideration.« less

  7. Integrating Social Theory Into Public Health Practice

    PubMed Central

    Potvin, Louise; Gendron, Sylvie; Bilodeau, Angèle; Chabot, Patrick

    2005-01-01

    The innovative practice that resulted from the Ottawa Charter challenges public health knowledge about programming and evaluation. Specifically, there is a need to formulate program theory that embraces social determinants of health and local actors’ mobilization for social change. Likewise, it is imperative to develop a theory of evaluation that fosters reflexive understanding of public health programs engaged in social change. We believe advances in contemporary social theory that are founded on a critique of modernity and that articulate a coherent theory of practice should be considered when addressing these critical challenges. PMID:15798114

  8. Use of Complementary Health Practices in a Church-Based African American Cohort.

    PubMed

    Escoto, Kamisha Hamilton; Milbury, Kathrin; Nguyen, Nga; Cho, Dalnim; Roberson, Crystal; Wetter, David; McNeill, Lorna H

    2018-06-08

    Few studies have examined the use of complementary health practices (e.g., mind/body practices and dietary supplements) among African Americans, particularly those who identify as being spiritual and/or religious. Furthermore, research on the health and health behavior profiles of such complementary health users is scant. The purpose of this study was to explore the use of complementary health practices and their lifestyle and health indicator correlates in a large, church-based African American population. Cross-sectional analysis of 1467 African American adults drawn from a church-based cohort study. Participants reported use of complementary health practices, lifestyle behaviors (e.g., diet and smoking status), and health indicators (e.g., physical health and medical problems). Multiple logistic regressions were conducted to examine associations between lifestyle variables, health indicators, and use of complementary health practices. Outcomes included prevalence of mind/body practices (e.g., meditation and Reiki) and dietary supplements (multivitamins) along with health indicator and lifestyle correlates of use. Use of complementary health practices was high; 40% reported using any mind/body practice and 50% reported using dietary supplements. Poorer physical health was associated with use of mind/body practices, while likelihood of meeting fruit and vegetable recommendations was significantly associated with dietary supplement use. Complementary health practices were used heavily in a church-based sample of African American adults. Poorer physical health was associated with use of complementary health practices, yet users also displayed health conscious behaviors. Given the high engagement in complementary health practices, it may be prudent to consider adapting complementary health approaches for use in wellness interventions targeting African Americans in faith-based settings.

  9. International Active Surveillance Study of Women Taking Oral Contraceptives (INAS-OC Study)

    PubMed Central

    2009-01-01

    Background A 24-day regimen of contraceptive doses of drospirenone and ethinylestradiol (DRSP/EE 24d) was recently launched. This regimen has properties which may be beneficial for certain user populations (e.g., women suffering from premenstrual dysphoric disorder or acne). However, it is unknown whether this extended regimen has an impact on the cardiovascular risk associated with the use of oral contraceptives (OCs). The INternational Active Surveillance study of women taking Oral Contraceptives (INAS-OC) is designed to investigate the short- and long-term safety of the new regimen in a population which is representative for the typical user of oral contraceptives. Methods/Design A large, prospective, controlled, non-interventional, long-term cohort study with active surveillance of the study participants has been chosen to ensure reliable and valid results. More than 2,000 gynecologists in the US and 5 European countries (Austria, Germany, Italy, Poland, and Sweden) will recruit more than 80,000 OC users. The two to five year follow-up of these women will result in at least 220,000 documented women-years. The main clinical outcomes of interest for the follow-up are deep venous thrombosis, pulmonary embolism, acute myocardial infarction and cerebrovascular accidents. Secondary objectives are general safety, effectiveness and drug utilization pattern of DRSP/EE 24d, return to fertility after stop of OC use, as well as the baseline risk for users of individual OC formulations. Because of the non-interference character of this study, potential participants (first-time users or switchers) are informed about the study only after the decision regarding prescription of a new OC. There are no specific medical inclusion or exclusion criteria. Study participation is voluntary and a written informed consent is required. After the baseline questionnaire, follow-up questionnaires will be mailed to the participants every 6 months for up to 5 years after baseline. Self

  10. Competition and performance in OCS oil and gas lease sales and lease development, 1954-1969

    USGS Publications Warehouse

    Mead, Walter J.; Sorensen, Philip Edward

    1980-01-01

    The oil and gas resources of the Outer Continental Shelf represent one of America's largest publicly-owned assets. Through 1978, OCS oil and gas leases had yielded \\$40.5 billion in gross production value and produced over \\$28.3 billion in direct revenue to the federal government.Policies and procedures for managing the oil and gas resources of the OCS were established by Congress in the Outer Continental Shelf Lands Act of 1953. The Department of Interior was given the central responsibility for carrying out this management role in the 1953 Act; this responsibility has been re-established in the 1978 Amendments to the OCS Lands Act. As stated in the 1978 legislation, the goals of OCS management are to:...preserve, protect and develop oil and natural gas resources in a manner which is consistent with the need (A) to make such resources available to meet the Nation's energy needs as rapidly as possible... (C) to insure the public a fair and equitable return on the resources of the Outer Continental Shelf, and (D) to preserve and maintain free enterprise competition.As part of its continuing effort to monitor the effectiveness of federal policies relating to OCS oil and gas resources, the Conservation Division of U.S. Geological Survey, Department of Interior, has sponsored the research which is the basis for the present report. The objectives of the research have been to determine the extent to which the historical policies of OCS management have resulted in achievement of the goals set forth by Congress in the section quoted above.

  11. New Insights into Understanding Irreversible and Reversible Lithium Storage within SiOC and SiCN Ceramics

    PubMed Central

    Graczyk-Zajac, Magdalena; Reinold, Lukas Mirko; Kaspar, Jan; Sasikumar, Pradeep Vallachira Warriam; Soraru, Gian-Domenico; Riedel, Ralf

    2015-01-01

    Within this work we define structural properties of the silicon carbonitride (SiCN) and silicon oxycarbide (SiOC) ceramics which determine the reversible and irreversible lithium storage capacities, long cycling stability and define the major differences in the lithium storage in SiCN and SiOC. For both ceramics, we correlate the first cycle lithiation or delithiation capacity and cycling stability with the amount of SiCN/SiOC matrix or free carbon phase, respectively. The first cycle lithiation and delithiation capacities of SiOC materials do not depend on the amount of free carbon, while for SiCN the capacity increases with the amount of carbon to reach a threshold value at ~50% of carbon phase. Replacing oxygen with nitrogen renders the mixed bond Si-tetrahedra unable to sequester lithium. Lithium is more attracted by oxygen in the SiOC network due to the more ionic character of Si-O bonds. This brings about very high initial lithiation capacities, even at low carbon content. If oxygen is replaced by nitrogen, the ceramic network becomes less attractive for lithium ions due to the more covalent character of Si-N bonds and lower electron density on the nitrogen atom. This explains the significant difference in electrochemical behavior which is observed for carbon-poor SiCN and SiOC materials. PMID:28347008

  12. Advanced practice nursing in performing arts health care.

    PubMed

    Weslin, Anna T; Silva-Smith, Amy

    2010-06-01

    Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care.

  13. Health Education 2.0: The Next Generation of Health Education Practice

    ERIC Educational Resources Information Center

    Fielding, Jonathan E.

    2013-01-01

    Social, physical, and economic environments are the greatest determinants of our individual and collective health. Inadequate or substandard environments of all types present barriers to health. Addressing these broader determinants will be the quintessential core in the next era of public health practice. The framework for health improvement is…

  14. When health care workers experience mental ill health: institutional practices of silence.

    PubMed

    Moll, Sandra; Eakin, Joan M; Franche, Renée-Louise; Strike, Carol

    2013-02-01

    Based on findings from an institutional ethnography in a large mental health organization, we explore how institutional forces shape the experiences of health care workers with mental health issues. We interviewed 20 employees about their personal experiences with mental health issues and work and 12 workplace stakeholders about their interactions with workers who had mental health issues. We also reviewed organizational texts related to health, illness, and productivity. In analyzing transcripts and texts, silence emerged as a core underlying process characterizing individual and organizational responses to employees with mental health issues. Silence was an active practice that took many forms; it was pervasive, complex, and at times, paradoxical. It served many functions for workers and the organization. We discuss the theoretical and practical implications of the findings for workers with mental health issues.

  15. Light-induced V{sub oc} increase and decrease in high-efficiency amorphous silicon solar cells

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Stuckelberger, M., E-mail: michael.stuckelberger@epfl.ch; Riesen, Y.; Despeisse, M.

    High-efficiency amorphous silicon (a-Si:H) solar cells were deposited with different thicknesses of the p-type amorphous silicon carbide layer on substrates of varying roughness. We observed a light-induced open-circuit voltage (V{sub oc}) increase upon light soaking for thin p-layers, but a decrease for thick p-layers. Further, the V{sub oc} increase is enhanced with increasing substrate roughness. After correction of the p-layer thickness for the increased surface area of rough substrates, we can exclude varying the effective p-layer thickness as the cause of the substrate roughness dependence. Instead, we explain the observations by an increase of the dangling-bond density in both themore » p-layer—causing a V{sub oc} increase—and in the intrinsic absorber layer, causing a V{sub oc} decrease. We present a mechanism for the light-induced increase and decrease, justified by the investigation of light-induced changes of the p-layer and supported by Advanced Semiconductor Analysis simulation. We conclude that a shift of the electron quasi-Fermi level towards the conduction band is the reason for the observed V{sub oc} enhancements, and poor amorphous silicon quality on rough substrates enhances this effect.« less

  16. Management of occupational health risks in small-animal veterinary practices.

    PubMed

    D'Souza, Eva; Barraclough, Richard; Fishwick, David; Curran, Andrew

    2009-08-01

    Small-animal work is a major element of veterinary practice in the UK and may be hazardous, with high levels of work-related injuries and ill-health reported in Australia and USA. There are no studies addressing the management of occupational health risks arising from small-animal work in the UK. To investigate the sources of health and safety information used and how health and safety and 12 specific occupational health risks are managed by practices. A cross-sectional postal survey of all small-animal veterinary practices in Hampshire. A response was mandatory as this was a Health & Safety Executive (HSE) inspection activity. A total of 118 (100%) practices responded of which 93 were eligible for inclusion. Of these, 99 and 86%, respectively, were aware of the Royal College of Veterinary Surgeons (RCVS) practice standards and had British Small Animal Veterinary Association (BSAVA) staff members, while only 51% had previous contact with HSE (publications, advice and visit). Ninety per cent had health and safety policies, but only 31% had trained responsible staff in health and safety. Specific health hazards such as occupational allergens and computer use were relatively overlooked both by practices and the RCVS/BSAVA guidance available in 2002. Failings in active health risk management systems could be due to a lack of training to ensure competence in those with responsibilities. Practices rely on guidance produced by their professional bodies. Current RCVS guidance, available since 2005, has remedied some previous omissions, but further improvements are recommended.

  17. Elaborating on systems thinking in health promotion practice.

    PubMed

    Naaldenberg, Jenneken; Vaandrager, Lenneke; Koelen, Maria; Wagemakers, Anne-Marie; Saan, Hans; de Hoog, Kees

    2009-03-01

    Health and well-being are the result of a series of complex processes in which an individual interacts with other people and the environment. A systematic approach ensures incorporation of individual, ecological, social and political factors. However, interactions between these factors can be overlooked within a systematical approach. A systemic approach can provide additional information by incorporating interactions and communication. The opportunities of a systems thinking perspective for health promotion were investigated for this paper. Although others have also made attempts to explore systems thinking in the field of health promotion, the implications of systems thinking in practice need attention. Other fields such as agricultural extension studies, organizational studies and development studies provide useful experiences with the use of a systems thinking perspective in practice. Building on experiences from these fields, we give a theoretical background in which processes of social learning and innovation play an important role. From this background, we derive an overview of important concepts for the practical application of a systems thinking perspective. These concepts are the structure of the system, meanings attached to actions, and power relations between actors. To make these concepts more explicit and reduce the theoretical character of systems thinking, we use an illustration to elaborate on these concepts in practice. For this purpose, we describe a health promotion partnership in The Netherlands using the concepts structure, meaning and power relations. We show how a systems perspective increases insight in the functioning of a partnership and how this can facilitate processes of social learning and innovation. This article concludes by identifying future opportunities and challenges in adopting systems thinking for health promotion practice. A systems perspective towards health promotion can help projects reaching a more integral and

  18. Ultrasensitive Analyzer for Realtime, In-Situ Airborne and Terrestrial Measurements of OCS, CO2, CO, and H2O

    NASA Astrophysics Data System (ADS)

    Provencal, R. A.; Gupta, M.; Baer, D. S.; Genty, B.

    2012-12-01

    Extensive research has suggested that OCS plays a critical role in Earth's environment. Due to its long atmospheric lifetime of ~ 35 years, OCS is the most abundant sulfur gas in the atmosphere and has been implicated in controlling the sulfur budget and aerosol loading of the stratosphere with tropical stratospheric levels exceeding 400 pptv as determined by remote satellite sensing. During volcanically-quiet periods, OCS is primarily responsible for the stratospheric aerosol layer, and flight data suggests that OCS may be used as an inverse tracer for biogenic volatile organic carbon compounds, including those thought to be responsible for the formation of secondary organic aerosols. Additionally, since the primary source and sink of non-anthropogenic OCS are considered to be the ocean emission and terrestrial vegetation uptake respectively, preliminary experimental and modeling studies have suggested that OCS/CO2 ratios may provide a tool to measure photosynthesis and help distinguish it from respiration. These results, and other similar data, have led researchers to propose that simultaneous measurements of OCS and CO2 can constrain the parameterizations of respiration and photosynthesis in carbon cycle models, and OCS gradients in the continental growing season may have broad use as a measurement-based tracer of photosynthesis. Despite the importance of carbonyl sulfide in atmospheric processes, the OCS atmospheric budget is poorly determined. Its primary sources are ocean outgassing, industrial processes (many of which produce CS2 that then oxidized into OCS), and biomass burning. Its primary sinks are vegetation and soils. However, the budget is poorly balanced with very high uncertainty. Improved, in-situ terrestrial flux and airborne measurements of OCS are required to improve this budget and further elucidate its role in stratospheric aerosol formation and as a tracer for biogenic volatile organics and photosynthesis. In this work, we have fabricated a

  19. Public Health Campaigns to Change Industry Practices that Damage Health: An Analysis of 12 Case Studies

    ERIC Educational Resources Information Center

    Freudenberg, Nicholas; Picard Bradley, Sarah; Serrano, Monica

    2009-01-01

    Industry practices such as advertising, production of unsafe products, and efforts to defeat health legislation play a major role in current patterns of U.S. ill health. Changing these practices may be a promising strategy to promote health. The authors analyze 12 campaigns designed to modify the health-related practices of U.S. corporations in…

  20. Quantum yield for carbon monoxide production in the 248 nm photodissociation of carbonyl sulfide (OCS)

    NASA Technical Reports Server (NTRS)

    Zhao, Z.; Stickel, R. E.; Wine, P. H.

    1995-01-01

    Tunable diode laser absorption spectroscopy has been coupled with excimer laser flash photolysis to measure the quantum yield for CO production from 248 nm photodissociation of carbonyl sulfide (OCS) relative to the well-known quantum yield for CO production from 248 nm photolysis of phosgene (Cl2CO2). The temporal resolution of the experiments was sufficient to distinguish CO formed directly by photodissociation from that formed by subsequent S((sup 3)P(sub J)) reaction with OCS. Under the experimental conditions employed, CO formation via the fast S((sup 1)D(sub 2)) + OCS reaction was minimal. Measurements at 297K and total pressures from 4 to 100 Torr N2 + N2O show the CO yield to be greater than 0.95 and most likely unity. This result suggests that the contribution of OCS as a precursor to the lower stratospheric sulfate aerosol layer is somewhat larger than previously thought.

  1. Quantification of amine functional groups and their influence on OM/OC in the IMPROVE network

    NASA Astrophysics Data System (ADS)

    Kamruzzaman, Mohammed; Takahama, Satoshi; Dillner, Ann M.

    2018-01-01

    Recently, we developed a method using FT-IR spectroscopy coupled with partial least squares (PLS) regression to measure the four most abundant organic functional groups, aliphatic C-H, alcohol OH, carboxylic acid OH and carbonyl C=O, in atmospheric particulate matter. These functional groups are summed to estimate organic matter (OM) while the carbon from the functional groups is summed to estimate organic carbon (OC). With this method, OM and OM/OC can be estimated for each sample rather than relying on one assumed value to convert OC measurements to OM. This study continues the development of the FT-IR and PLS method for estimating OM and OM/OC by including the amine functional group. Amines are ubiquitous in the atmosphere and come from motor vehicle exhaust, animal husbandry, biomass burning, and vegetation among other sources. In this study, calibration standards for amines are produced by aerosolizing individual amine compounds and collecting them on PTFE filters using an IMPROVE sampler, thereby mimicking the filter media and collection geometry of ambient standards. The moles of amine functional group on each standard and a narrow range of amine-specific wavenumbers in the FT-IR spectra (wavenumber range 1 550-1 500 cm-1) are used to develop a PLS calibration model. The PLS model is validated using three methods: prediction of a set of laboratory standards not included in the model, a peak height analysis and a PLS model with a broader wavenumber range. The model is then applied to the ambient samples collected throughout 2013 from 16 IMPROVE sites in the USA. Urban sites have higher amine concentrations than most rural sites, but amine functional groups account for a lower fraction of OM at urban sites. Amine concentrations, contributions to OM and seasonality vary by site and sample. Amine has a small impact on the annual average OM/OC for urban sites, but for some rural sites including amine in the OM/OC calculations increased OM/OC by 0.1 or more.

  2. Mental Health Professionals' Suicide Risk Assessment and Management Practices.

    PubMed

    Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

    2018-01-01

    Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

  3. 76 FR 51383 - Commercial Leasing for Wind Power on the Outer Continental Shelf (OCS) Offshore Rhode Island and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-18

    ... section). This section of the Call Area is approximately 1.25 square nmi and contains 1 partial OCS lease...). This section of the Call Area is approximately 246 square nmi and contains 31 whole OCS lease blocks as... section of the Call Area is approximately 1.25 square nmi and contains 1 partial OCS lease block. The...

  4. Quantum cascade laser spectroscopy of OCS isotopologues in 4He nanodroplets: A test of adiabatic following for a heavy rotor

    NASA Astrophysics Data System (ADS)

    Faulkner, Ty; Miller, Isaac; Raston, Paul L.

    2018-01-01

    We report high-resolution infrared spectra of OCS isotopologues embedded in helium nanodroplets that were recorded with a newly built spectrometer. For the normal isotopologue, we observed the relatively weak third bending overtone band, in addition to new high J transitions in the C-O stretching fundamental, which has previously been investigated by diode laser spectroscopy [S. Grebenev et al., J. Chem. Phys. 112, 4485 (2000)]. Similar to the gas phase, the overtone band is (only) 45 cm-1 higher in energy than the fundamental, and this leads to additional broadening due to rapid vibrational relaxation that is accompanied by the creation of real/virtual phonon excitations. We also observed spectra in the C-O stretching fundamental for several minor isotopologues of OCS, including 18OCS, O13CS, and OC33S, in addition to some new peaks for OC34S. A rovibrational analysis allowed for determination of the moment of inertia of helium (ΔIHe) that couples to the rotation of OCS for each isotopologue. In the context of the adiabatic following approximation, the helium density structure that follows the rotation of OCS should essentially remain unchanged between the isotopologues, i.e., there should be no dependence of ΔIHe on the gas phase moment of inertia of OCS (IG). While this behavior was expected for the "heavy" OCS rotor investigated here, we instead found an approximately linear 1:1 relation between ΔIHe and IG, which suggests partial breakdown of the adiabatic following approximation, making OCS the heaviest molecule for which evidence for this effect has been obtained.

  5. Where theory and practice of global health intersect: the developmental history of a Canadian global health initiative.

    PubMed

    Daibes, Ibrahim; Sridharan, Sanjeev

    2014-01-01

    This paper examines the scope of practice of global health, drawing on the practical experience of a global health initiative of the Government of Canada--the Teasdale-Corti Global Health Research Partnership Program. A number of challenges in the practical application of theoretical definitions and understandings of global health are addressed. These challenges are grouped under five areas that form essential characteristics of global health: equity and egalitarian North-South partnerships, interdisciplinary scope, focus on upstream determinants of health, global conceptualization, and global health as an area of both research and practice. Information in this paper is based on the results of an external evaluation of the program, which involved analysis of project proposals and technical reports, surveys with grantees and interviews with grantees and program designers, as well as case studies of three projects and a review of relevant literature. The philosophy and recent definitions of global health represent a significant and important departure from the international health paradigm. However, the practical applicability of this maturing area of research and practice still faces significant systemic and structural impediments that, if not acknowledged and addressed, will continue to undermine the development of global health as an effective means to addressing health inequities globally and to better understanding, and acting upon, upstream determinants of health toward health for all. While it strives to redress global inequities, global health continues to be a construct that is promoted, studied, and dictated mostly by Northern institutions and scholars. Until practical mechanisms are put in place for truly egalitarian partnerships between North and South for both the study and practice of global health, the emerging philosophy of global health cannot be effectively put into practice.

  6. Canadian community pharmacists' use of digital health technologies in practice.

    PubMed

    Leung, Valerie; Tharmalingam, Sukirtha; Cooper, Janet; Charlebois, Maureen

    2016-01-01

    In 2010, a pan-Canadian study on the current state and benefits of provincial drug information systems (DIS) found that substantial benefits were being realized and that pharmacists perceived DIS to be a valuable tool in the evolving models of pharmacy practice. To understand changes in digital health and the impact on practice since that time, a survey of community pharmacists in Canada was conducted. In 2014, Canada Health Infoway (Infoway) and the Canadian Pharmacists Association (CPhA) invited community pharmacists to participate in a Web-based survey to understand their use and perceived benefits of digital health in practice. The survey was open from April 15 to May 12, 2014. Of the 447 survey responses, almost all used some form of digital health in practice. Those with access to DIS and provincial laboratory information systems (LIS) reported increased productivity and better quality of care. Those without access to these systems would overwhelmingly like access. There have been significant advances in digital health and community pharmacy practice over the past several years. In addition to digital health benefits in the areas of productivity and quality of care, pharmacists are also experiencing substantial benefits in areas related to recently expanded scope of practice activities such as ordering lab tests. Community pharmacists frequently use digital health in practice and recognize the benefits of these technologies. Digital health is, and will continue to be, a key enabler for practice transformation and improved quality of care. Can Pharm J (Ott) 2016;149:xx-xx.

  7. Attitudes of mental health occupational therapists toward evidence-based practice.

    PubMed

    Hitch, Danielle P

    2016-02-01

    Evidence-based practice is an important driver in modern health care and has become a priority in mental health occupational therapy in recent years. The aim of this study was to measure the attitudes of a cohort of mental health occupational therapists toward evidence-based practice. Forty-one mental health occupational therapists were surveyed using the Evidence-Based Practice Attitude Scale (EBPAS). Mann-Whitney U tests and Spearman's rho were used to analyze the data. The occupational therapy respondents had generally positive attitudes toward evidence-based practices comparable to established norms. Respondents with further qualifications beyond their professional degree were significantly more likely to try new interventions (p = .31). Significant negative correlations were found also for the subscales of Appeal and Openness in relation to years of occupational therapy practice (rho = -.354, p = .023; rho = -.344, p = 0.28) and mental health experience (rho = -.390, p = 0.12; rho = -.386, p = .013). Therapist factors can significantly impact attitudes toward evidence-based practice. © CAOT 2015.

  8. The Large Synoptic Survey Telescope OCS and TCS models

    NASA Astrophysics Data System (ADS)

    Schumacher, German; Delgado, Francisco

    2010-07-01

    The Large Synoptic Survey Telescope (LSST) is a project envisioned as a system of systems with demanding science, technical, and operational requirements, that must perform as a fully integrated unit. The design and implementation of such a system poses big engineering challenges when performing requirements analysis, detailed interface definitions, operational modes and control strategy studies. The OMG System Modeling Language (SysML) has been selected as the framework for the systems engineering analysis and documentation for the LSST. Models for the overall system architecture and different observatory subsystems have been built describing requirements, structure, interfaces and behavior. In this paper we show the models for the Observatory Control System (OCS) and the Telescope Control System (TCS), and how this methodology has helped in the clarification of the design and requirements. In one common language, the relationships of the OCS, TCS, Camera and Data management subsystems are captured with models of the structure, behavior, requirements and the traceability between them.

  9. Clinical impact of human coronaviruses 229E and OC43 infection in diverse adult populations.

    PubMed

    Walsh, Edward E; Shin, Jae Hyun; Falsey, Ann R

    2013-11-15

    The incidence and clinical impact of coronavirus (CoV) infection in elderly persons and those with underlying cardiopulmonary disease over a long duration is not well described. We determined the incidence and clinical impact of 229E and OC43 CoV in this population during 4 consecutive winters, and compared illnesses to influenza A, respiratory syncytial virus, and human metapneumovirus. CoV 229E and OC43 were detected by reverse transcription polymerase chain reaction and serology in 4 adult populations under surveillance for acute respiratory illness during the winters of 1999-2003. Cohorts included healthy young adults, healthy elderly adults, high-risk adults with underlying cardiopulmonary disease, and a hospitalized group. Three hundred ninety-eight CoV infections were identified, with annual infection rates ranging from 2.8% to 26% in prospective cohorts, and prevalence ranging from 3.3% to 11.1% in the hospitalized cohort. The incidence of infections with each strain was similar, although asymptomatic infection and viral coinfection was significantly more common with 229E than OC43 infection. Although the incidence and clinical manifestations were similar for each strain, OC43-infected subjects tended to seek more medical care, as OC43 was twice as common as 229E among the hospitalized cohort. CoV infections in the elderly are frequent, likely causing substantial medical disease burden.

  10. Traditional vs. Contemporary Management Control Practices for Developing Public Health Policies

    PubMed Central

    Naranjo-Gil, David; Sánchez-Expósito, María Jesús; Gómez-Ruiz, Laura

    2016-01-01

    Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way. PMID:27428985

  11. Shifting public health practice to advance health equity: recommendations from experts and community leaders.

    PubMed

    Knight, Erin K

    2014-01-01

    While the evidence base regarding the social determinants of health and their relationship to health inequities grows, the field of public health is challenged to translate this knowledge into practice changes that advance health equity. Drawing on the knowledge, beliefs, and experiences of public health experts and community leaders working to advance health equity, our objective was to develop and disseminate recommendations for changing public health practice to better address this problem. We conducted semistructured, qualitative telephone interviews (n = 25) with key informants. Interviews were recorded and transcribed, and data were coded and analyzed using both inductive and deductive methods. Member checks were used to enhance quality. A purposeful sample of key informants was selected from content experts and community leaders involved with the development of the Unnatural Causes public impact campaign. Participants represented state and local health departments, community-based organizations, national research/advocacy organizations, and academic institutions across the country. Participants distinguished between social determinants of health and their structural precursors in social and political institutions. They believed that the field of public health has an obligation to address health inequities and shifts in practice are needed that focus more attention on societal factors that underlie such inequities. According to participants, specific practice changes are difficult to identify because actions should be community specific and community driven. Recommended approaches that may be adapted to community-based needs and assets include building nontraditional partnerships, engaging in political advocacy, promoting community leadership, collecting better data on social conditions and institutional factors, and enhancing communication for health equity. Recommended shifts in practice may be facilitated by revisiting our understanding of the 3 core

  12. 75 FR 16833 - Preliminary Revised 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing Program for 2007-2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... Continental Shelf (OCS) Oil and Gas Leasing Program for 2007-2012 AGENCY: Minerals Management Service... (MMS) requests comments on the Preliminary Revised 5-Year OCS Oil and Gas Leasing Program for 2007... Elden Street, MS-4010; Herndon, Virginia 20170-4817. Please reference ``Remand of the 2007-2012 OCS Oil...

  13. Resilient Practices in Maintaining Safety of Health Information Technologies

    PubMed Central

    Ash, Joan S.; Sittig, Dean F.; Singh, Hardeep

    2014-01-01

    Electronic health record systems (EHRs) can improve safety and reliability of health care, but they can also introduce new vulnerabilities by failing to accommodate changes within a dynamic EHR-enabled health care system. Continuous assessment and improvement is thus essential for achieving resilience in EHR-enabled health care systems. Given the rapid adoption of EHRs by many organizations that are still early in their experiences with EHR safety, it is important to understand practices for maintaining resilience used by organizations with a track record of success in EHR use. We conducted interviews about safety practices with 56 key informants (including information technology managers, chief medical information officers, physicians, and patient safety officers) at two large health care systems recognized as leaders in EHR use. We identified 156 references to resilience-related practices from 41 informants. Framework analysis generated five categories of resilient practices: (a) sensitivity to dynamics and interdependencies affecting risks, (b) basic monitoring and responding practices, (c) management of practices and resources for monitoring and responding, (d) sensitivity to risks beyond the horizon, and (e) reflecting on risks with the safety and quality control process itself. The categories reflect three functions that facilitate resilience: reflection, transcending boundaries, and involving sharp-end practitioners in safety management. PMID:25866492

  14. Biomarker-indicated extent of oxidation of plant-derived organic carbon (OC) in relation to geomorphology in an arsenic contaminated Holocene aquifer, Cambodia.

    PubMed

    Magnone, Daniel; Richards, Laura A; Polya, David A; Bryant, Charlotte; Jones, Merren; van Dongen, Bart E

    2017-10-12

    The poisoning of rural populations in South and Southeast Asia due to high groundwater arsenic concentrations is one of the world's largest ongoing natural disasters. It is important to consider environmental processes related to the release of geogenic arsenic, including geomorphological and organic geochemical processes. Arsenic is released from sediments when iron-oxide minerals, onto which arsenic is adsorbed or incorporated, react with organic carbon (OC) and the OC is oxidised. In this study we build a new geomorphological framework for Kandal Province, a highly studied arsenic affected region of Cambodia, and tie this into wider regional environmental change throughout the Holocene. Analyses shows that the concentration of OC in the sediments is strongly inversely correlated to grainsize. Furthermore, the type of OC is also related to grain size with the clay containing mostly (immature) plant derived OC and sand containing mostly thermally mature derived OC. Finally, analyses indicate that within the plant derived OC relative oxidation is strongly grouped by stratigraphy with the older bound OC more oxidised than younger OC.

  15. Practice Notes: Strategies in Health Education

    ERIC Educational Resources Information Center

    Health Education & Behavior, 2009

    2009-01-01

    This article is included in the Practice Notes section of this journal, which is intended to keep readers informed about health education practice around the country. It is an attempt to spread the word about exemplary strategies, initiatives, and programs and share successes in overcoming obstacles or challenges. In this article, two programs are…

  16. Practice Notes: Strategies in Health Education

    ERIC Educational Resources Information Center

    Health Education & Behavior, 2007

    2007-01-01

    This article is included in the Practice Notes section of this journal, which is intended to keep readers informed about health education practice around the country. It is an attempt to spread the word about exemplary strategies, initiatives, and programs and share successes in overcoming obstacles or challenges. In this article, two programs are…

  17. Maxima and O-C Diagrams for 489 Mira Stars

    NASA Astrophysics Data System (ADS)

    Karlsson, T.

    2013-11-01

    Maxima for 489 Mira stars have been compiled. They were computed with data from AAVSO, AFOEV, VSOLJ, and BAA-VSS and collected from published maxima. The result is presented in a mysql database and on web pages with O-C diagrams, periods and some statistical information for each star.

  18. Improving Mental Health Reporting Practices in Between Personnel Security Investigations

    DTIC Science & Technology

    2017-06-01

    Improving Mental Health Reporting Practices in Between Personnel Security Investigations Stephanie L. Jaros Donna L. Tadle David Ciani Keith B...2017 Improving Mental Health Reporting Practices in Between Personnel Security Investigations Stephanie L. Jaros, Donna L. Tadle, David Ciani, Keith...COVERED: 4. Improving Mental Health Reporting Practices in Between Personnel Security Investigations 5a. CONTRACT NUMBER: 5b. GRANT NUMBER: 5c

  19. Predictors and enablers of mental health nurses' family-focused practice.

    PubMed

    Grant, Anne; Reupert, Andrea; Maybery, Darryl; Goodyear, Melinda

    2018-06-27

    Family-focused practice improves outcomes for families where parents have a mental illness. However, there is limited understanding regarding the factors that predict and enable these practices. This study aimed to identify factors that predict and enable mental health nurses' family-focused practice. A sequential mixed methods design was used. A total of 343 mental health nurses, practicing in 12 mental health services (in acute inpatient and community settings), throughout Ireland completed the Family Focused Mental Health Practice Questionnaire, measuring family-focused behaviours and other factors that impact family-focused activities. Hierarchical multiple regression identified 14 predictors of family-focused practice. The most important predictors noted were nurses' skill and knowledge, own parenting experience, and work setting (i.e. community). Fourteen nurses, who achieved high scores on the questionnaire, subsequently participated in semistructured interviews to elaborate on enablers of family-focused practice. Participants described drawing on their parenting experiences to normalize parenting challenges, encouraging service users to disclose parenting concerns, and promoting trust. The opportunity to visit a service user's home allowed them to observe how the parent was coping and forge a close relationship with them. Nurses' personal characteristics and work setting are key factors in determining family-focused practice. This study extends current research by clearly highlighting predictors of family-focused practice and reporting how various enablers promoted family-focused practice. The capacity of nurses to support families has training, organizational and policy implications within adult mental health services in Ireland and elsewhere. © 2018 Australian College of Mental Health Nurses Inc.

  20. Carbon Inputs From Riparian Vegetation Limit Oxidation of Physically Bound Organic Carbon Via Biochemical and Thermodynamic Processes: OC Oxidation Processes Across Vegetation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Graham, Emily B.; Tfaily, Malak M.; Crump, Alex R.

    In light of increasing terrestrial carbon (C) transport across aquatic boundaries, the mechanisms governing organic carbon (OC) oxidation along terrestrial-aquatic interfaces are crucial to future climate predictions. Here, we investigate biochemistry, metabolic pathways, and thermodynamics corresponding to OC oxidation in the Columbia River corridor. We leverage natural vegetative differences to encompass variation in terrestrial C inputs. Our results suggest that decreases in terrestrial C deposition associated with diminished riparian vegetation induce oxidation of physically-bound (i.e., mineral and microbial) OC at terrestrial-aquatic interfaces. We also find that contrasting metabolic pathways oxidize OC in the presence and absence of vegetation and—in directmore » conflict with the concept of ‘priming’—that inputs of water-soluble and thermodynamically-favorable terrestrial OC protects bound-OC from oxidation. Based on our results, we propose a mechanistic conceptualization of OC oxidation along terrestrial-aquatic interfaces that can be used to model heterogeneous patterns of OC loss under changing land cover distributions.« less

  1. 75 FR 82055 - Commercial Leasing for Wind Power on the Outer Continental Shelf (OCS) Offshore Massachusetts...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... No. BOEM-2010-0063] Commercial Leasing for Wind Power on the Outer Continental Shelf (OCS) Offshore..., Interior. ACTION: RFI in Commercial Wind Energy Leasing Offshore Massachusetts, and Invitation for Comments... the construction of a wind energy project(s) on the Outer Continental Shelf (OCS) offshore...

  2. 77 FR 75656 - Research Lease for Renewable Energy on the Outer Continental Shelf (OCS) Offshore Virginia...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-21

    ... DEPARTMENT OF THE INTERIOR Bureau of Ocean Energy Management [Docket No. BOEM-2012-0079] Research... of an Unsolicited Request for an OCS Research Lease; Request for Competitive Interest; and Request... an OCS lease for wind energy research activities; (2) solicit public input regarding the proposal...

  3. 78 FR 36571 - North American Datum of 1983 (NAD 83) Outer Continental Shelf (OCS) Provisional Official...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... DEPARTMENT OF THE INTERIOR Bureau of Ocean Energy Management [MMAA104000] North American Datum of 1983 (NAD 83) Outer Continental Shelf (OCS) Provisional Official Protraction Diagram (OPDs) AGENCY... OPDs. SUMMARY: Notice is hereby given that effective with this publication two NAD 83-based OCS...

  4. Is universal health coverage the practical expression of the right to health care?

    PubMed

    Ooms, Gorik; Latif, Laila A; Waris, Attiya; Brolan, Claire E; Hammonds, Rachel; Friedman, Eric A; Mulumba, Moses; Forman, Lisa

    2014-02-24

    The present Millennium Development Goals are set to expire in 2015 and their next iteration is now being discussed within the international community. With regards to health, the World Health Organization proposes universal health coverage as a 'single overarching health goal' for the next iteration of the Millennium Development Goals.The present Millennium Development Goals have been criticised for being 'duplicative' or even 'competing alternatives' to international human rights law. The question then arises, if universal health coverage would indeed become the single overarching health goal, replacing the present health-related Millennium Development Goals, would that be more consistent with the right to health? The World Health Organization seems to have anticipated the question, as it labels universal health coverage as "by definition, a practical expression of the concern for health equity and the right to health".Rather than waiting for the negotiations to unfold, we thought it would be useful to verify this contention, using a comparative normative analysis. We found that--to be a practical expression of the right to health--at least one element is missing in present authoritative definitions of universal health coverage: a straightforward confirmation that international assistance is essential, not optional.But universal health coverage is a 'work in progress'. A recent proposal by the United Nations Sustainable Development Solutions Network proposed universal health coverage with a set of targets, including a target for international assistance, which would turn universal health coverage into a practical expression of the right to health care.

  5. The relationship between seven health practices and oral health status in community-dwelling elderly Thai.

    PubMed

    Samnieng, Patcharaphol; Ueno, Masayuki; Zaitsu, Takashi; Shinada, Kayoko; Wright, Fredrick A C; Kawaguchi, Yoko

    2013-12-01

    This study aims to analyse the relationship between seven health practices, oral health behaviors, and oral health status in community dwelling elderly Thai. The subjects were 612 elderly people (mean age = 68.8 ± 5.9 years). Questionnaires survey about sociodemographics, self-reported seven health practices and oral health behaviors were conducted by trained interviewers. Oral examinations investigated the number of teeth present, decayed teeth, periodontal status and functional tooth units (FTUs). Oral malodor was assessed by Organoleptic Test, and unstimulated saliva was collected for 5 min. Five health practices (smoking, drinking, physical activity, breakfast and weight maintenance) were significantly related with oral health behaviors. ancova analysis demonstrated the following significant associations: (i) smoking behavior with number of teeth present, number of FTUs, decayed teeth, periodontal disease, oral malodor and salivary flow rate, (ii) drinking alcohol behavior with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (iii) eating breakfast behavior with periodontal disease, oral malodor and salivary flow rate, (iv) eating between-meal snack with number of teeth present, number of FTUs, decayed teeth and periodontal disease, (v) maintaining weight with number of teeth present, number of FTUs, periodontal disease and oral malodor, (vi) sleeping with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (vii) physical activity with periodontal disease and salivary flow rate. Good health practices were related with good oral health behaviors. Moreover, general health practices were associated with the clinical oral health status such as number of teeth present, decayed teeth, FTUs, periodontal disease, oral malodor and salivary flow rate. The elderly with good general health practices were considered to have good oral health status. Improving general health

  6. Continuous In-situ Measurements of Carbonyl Sulfide (OCS) and Carbon Dioxide Isotopes to Constrain Ecosystem Carbon and Water Exchanges

    NASA Astrophysics Data System (ADS)

    Rastogi, B.; Still, C. J.; Noone, D. C.; Berkelhammer, M. B.; Whelan, M.; Lai, C. T.; Hollinger, D. Y.; Gupta, M.; Leen, J. B.; Huang, Y. W.

    2015-12-01

    Understanding the processes that control the terrestrial exchange of carbon and water are critical for examining the role of forested ecosystems in changing climates. A small but increasing number of studies have identified Carbonyl Sulfide (OCS) as a potential tracer for photosynthesis. OCS is hydrolyzed by an irreversible reaction in leaf mesophyll cells that is catalyzed by the enzyme, carbonic anhydrase. Leaf- level field and greenhouse studies indicate that OCS uptake is controlled by stomatal activity and that the ratio of OCS and CO2 uptake is reasonably constant. Existing studies on ecosystem OCS exchange have been based on laboratory measurements or short field campaigns and therefore little information on OCS exchange in a natural ecosystem over longer timescales is available. The objective of this study is to further assess the stability of OCS as a tracer for canopy photosynthesis in an active forested ecosystem and also to assess its utility for constraining transpiration, since both fluxes are mediated by canopy stomatal conductance. An off-axis integrated cavity output spectroscopy analyzer (Los Gatos Research Inc.) was deployed at the Wind River Experimental Forest in Washington (45.8205°N, 121.9519°W). Canopy air was sampled from four heights as well as the soil to measure vertical gradients of OCS within the canopy, and OCS exchange between the forest and the atmosphere for the growing season. Here we take advantage of simultaneous measurements of the stable isotopologues of H2O and CO2 at corresponding heights as well as NEE (Net Ecosystem Exchange) from eddy covariance measurements to compare GPP (Gross Primary Production) and transpiration estimates from a variety of independent techniques. Our findings also seek to allow assessment of the environmental and ecophysicological controls on evapotranspiration rates, which are projected to change in coming decades, and are otherwise poorly constrained.

  7. 40 CFR 55.14 - Requirements that apply to OCS sources located within 25 miles of States' seaward boundaries, by...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Requirements that apply to OCS sources... REGULATIONS § 55.14 Requirements that apply to OCS sources located within 25 miles of States' seaward boundaries, by State. (a) The requirements of this section shall apply to OCS sources as set forth below. In...

  8. Hemostatic action of OC-108, a novel agent for hemorrhoids, is associated with regional blood flow arrest induced by acute inflammation.

    PubMed

    Ono, Takashi; Nakagawa, Haruto; Fukunari, Atsushi; Hashimoto, Toshio; Komatsu, Hirotsugu

    2006-11-01

    Clinically, hemorrhoidal bleeding and prolapse disappeared immediately after injection of the sclerosing agent OC-108 into submucosa of hemorrhoids. The aim of this study was to elucidate the mechanism of action responsible for the immediate hemostatic effect of OC-108 using anesthetized rats. Subcutaneous injection of OC-108 in rats decreased blood flow at the injection site within 5 min. Aluminum potassium sulfate, one of the main ingredients of OC-108, reduced the skin blood flow. However, tannic acid, another main ingredient, did not. By perfusion of OC-108 on the mesenteric surface, microcirculatory blood flow was arrested without remarkable change in blood vessel diameter, accompanied by increased vascular permeability and venous hematocrit. These results indicate that OC-108 induces regional blood flow arrest with rapid onset, this effect being attributed to the action of aluminum potassium sulfate, and that hemoconcentration due to increased vascular permeability (plasma extravasation), an acute inflammatory reaction, is involved in the mechanisms of the immediate hemostatic action of OC-108.

  9. Sc2O@Cs(126339)-C92: Di-scandium oxide cluster encapsulated into a large fullerene cage

    NASA Astrophysics Data System (ADS)

    Gu, Yong-Xin; Li, Qiao-Zhi; Li, De-Huai; Zhao, Rui-Sheng; Zhao, Xiang

    2018-04-01

    The geometric, electronic structure and thermodynamic stability of Sc2O@C92 has been characterized by using hybrid density functional theory calculations combined with statistical thermodynamic analyses. Results indicate that the isolated pentagon rule (IPR) isomers Sc2O@Cs(126339)-C92, Sc2O@C1(126367)-C92 and Sc2O@C1(126390)-C92 are favorable. Noteworthy, it is the first time to declare that fullerene isomer Cs(126339)-C92 could be considered as the suitable cage to encapsulate metallic cluster. The electronic properties of these three isomers were performed with frontier molecular orbital (HOMO and LUMO) analyses and bond order calculations. Finally, 13C NMR and UV-vis-NIR spectra were simulated to provide valuable information for future experiments.

  10. Framework for Selecting Best Practices in Public Health: A Systematic Literature Review

    PubMed Central

    de Colombani, Pierpaolo

    2015-01-01

    Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions. Significance for public health Best practices are a valuable source of practice-based evidence on effective public health interventions implemented in real-life settings. Yet, despite

  11. Framework for Selecting Best Practices in Public Health: A Systematic Literature Review.

    PubMed

    Ng, Eileen; de Colombani, Pierpaolo

    2015-11-17

    Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions. Significance for public healthBest practices are a valuable source of practice-based evidence on effective public health interventions implemented in real-life settings. Yet, despite the

  12. Interaction between BaCO{sub 3} and OPC/BFS composite cements at 20 {sup o}C and 60 {sup o}C

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Utton, C.A., E-mail: c.utton@sheffield.ac.u; Gallucci, E.; Hill, J.

    2011-03-15

    A BaCO{sub 3} slurry, containing radioactive {sup 14}C, is produced during the reprocessing of spent nuclear fuel. This slurry is encapsulated in a Portland-blastfurnace slag composite cement. The effect of BaCO{sub 3} on the hydration of OPC and Portland-blastfurnace slag cements has been studied in this work. Samples containing a simulant BaCO{sub 3} slurry were cured for up to 720 days at 20 and 60 {sup o}C and analysed by XRD, SEM(EDX) and ICC. BaCO{sub 3} reacted with OPC to precipitate BaSO{sub 4} from a reaction between soluble sulfate and BaCO{sub 3}. Calcium monocarboaluminate subsequently formed from the carbonate released.more » The monocarboaluminate precipitated as crystals in voids formed during hydration. At 60 {sup o}C in OPC, it was not identified by XRD, suggesting the phase is unstable in this system around this temperature. In the Portland-blastfurnace slag cements containing BaCO{sub 3}, less monocarboaluminate and BaSO{sub 4} were formed, but the hydration of BFS was promoted and monocarboaluminate was stable up to 60 {sup o}C.« less

  13. Is universal health coverage the practical expression of the right to health care?

    PubMed Central

    2014-01-01

    The present Millennium Development Goals are set to expire in 2015 and their next iteration is now being discussed within the international community. With regards to health, the World Health Organization proposes universal health coverage as a ‘single overarching health goal’ for the next iteration of the Millennium Development Goals. The present Millennium Development Goals have been criticised for being ‘duplicative’ or even ‘competing alternatives’ to international human rights law. The question then arises, if universal health coverage would indeed become the single overarching health goal, replacing the present health-related Millennium Development Goals, would that be more consistent with the right to health? The World Health Organization seems to have anticipated the question, as it labels universal health coverage as “by definition, a practical expression of the concern for health equity and the right to health”. Rather than waiting for the negotiations to unfold, we thought it would be useful to verify this contention, using a comparative normative analysis. We found that – to be a practical expression of the right to health – at least one element is missing in present authoritative definitions of universal health coverage: a straightforward confirmation that international assistance is essential, not optional. But universal health coverage is a ‘work in progress’. A recent proposal by the United Nations Sustainable Development Solutions Network proposed universal health coverage with a set of targets, including a target for international assistance, which would turn universal health coverage into a practical expression of the right to health care. PMID:24559232

  14. Understanding health through social practices: performance and materiality in everyday life.

    PubMed

    Maller, Cecily Jane

    2015-01-01

    The importance of recognising structure and agency in health research to move beyond methodological individualism is well documented. To progress incorporating social theory into health, researchers have used Giddens' and Bourdieu's conceptualisations of social practice to understand relationships between agency, structure and health. However, social practice theories have more to offer than has currently been capitalised upon. This article delves into contemporary theories of social practice as used in consumption and sustainability research to provide an alternative, and more contextualised means, of understanding and explaining human action in relation to health and wellbeing. Two key observations are made. Firstly, the latest formulations of social practice theory distinguish moments of practice performance from practices as persistent entities across time and space, allowing empirical application to explain practice histories and future trajectories. Secondly, they emphasise the materiality of everyday life, foregrounding things, technologies and other non-humans that cannot be ignored in a technologically dependent social world. In concluding, I argue the value of using contemporary social practice theories in health research is that they reframe the way in which health outcomes can be understood and could inform more effective interventions that move beyond attitudes, behaviour and choices. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  15. Public Health Interventions: School Nurse Practice Stories

    ERIC Educational Resources Information Center

    Anderson, Linda J. W.; Schaffer, Marjorie A.; Hiltz, Cynthia; O'Leary, Stacie A.; Luehr, Ruth Ellen; Yoney, Erika L.

    2018-01-01

    This study describes and analyzes school nurses' (SN) experiences with understanding and using public health interventions from the Public Health Intervention Wheel. The Wheel offers a model for naming interventions provided by SNs from a public health perspective. Research teams from academic and SN practice settings conducted six focus groups…

  16. Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care.

    PubMed

    Cifuentes, Maribel; Davis, Melinda; Fernald, Doug; Gunn, Rose; Dickinson, Perry; Cohen, Deborah J

    2015-01-01

    This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. This was an observational, cross-case comparative study of 11 diverse practices, including 8 primary care clinics and 3 community mental health centers focused on the implementation of integrated care. Practice characteristics (eg, practice ownership, federal designation, geographic area, provider composition, EHR system, and patient panel characteristics) were collected using a practice information survey and analyzed to report descriptive information. A multidisciplinary team used a grounded theory approach to analyze program documents, field notes from practice observation visits, online diaries, and semistructured interviews. Eight primary care practices used a single EHR and 3 practices used 2 different EHRs, 1 to document behavioral health and 1 to document primary care information. Practices experienced common challenges with their EHRs' capabilities to 1) document and track relevant behavioral health and physical health information, 2) support communication and coordination of care among integrated teams, and 3) exchange information with tablet devices and other EHRs. Practices developed workarounds in response to these challenges: double documentation and duplicate data entry, scanning and transporting documents, reliance on patient or clinician recall for inaccessible EHR information, and use of freestanding tracking systems. As practices gained experience with integration, they began to move beyond workarounds to more permanent HIT solutions ranging in complexity from customized EHR templates, EHR upgrades, and unified EHRs. Integrating behavioral health and primary care further burdens EHRs. Vendors, in cooperation with

  17. 78 FR 45965 - Research Lease on the Outer Continental Shelf (OCS) Offshore Virginia, Request for Competitive...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-30

    ...; MMAA104000] Research Lease on the Outer Continental Shelf (OCS) Offshore Virginia, Request for Competitive... Unsolicited Request for an OCS Research Lease; Request for Competitive Interest (RFCI); and Request for Public... for wind energy research activities; (2) solicit indications of interest in a renewable energy lease...

  18. Practice Notes: Strategies in Health Education

    ERIC Educational Resources Information Center

    Health Education & Behavior, 2009

    2009-01-01

    This article features two exemplary programs in health education practice: (1) Project L.E.A.P (Learning Effective and Applicable Parenting); and (2) A program that uses a pedestrian count tool to measure environmental and health promotion efforts. Project L.E.A.P. was developed by the Atlanta Alliance on Developmental Disabilities to promote…

  19. Public Health Interventions for School Nursing Practice

    ERIC Educational Resources Information Center

    Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

    2016-01-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

  20. What interventions can improve the mental health nursing practice environment?

    PubMed

    Redknap, Robina; Twigg, Di; Towell, Amanda

    2016-02-01

    The nursing practice environment is an important factor for services to consider in the attraction and retention of a skilled workforce during future nursing shortages. Despite the significant number of international studies undertaken to understand the influence of the practice environment on nurse satisfaction and retention, few have been undertaken within the mental health setting. This paper reports on results from a survey conducted in a large Australian public mental health hospital to examine nurses' perceptions of their practice environment, and identifies interventions that could be implemented to improve the practice environment. The hospital is the only remaining, standalone public mental health hospital in Western Australia. © 2016 Australian College of Mental Health Nurses Inc.

  1. Do nurses' personal health behaviours impact on their health promotion practice? A systematic review.

    PubMed

    Kelly, Muireann; Wills, Jane; Sykes, Susie

    2017-11-01

    There is a growing expectation in national and international policy and from professional bodies that nurses be role models for healthy behaviours, the rationale being that there is a relationship between nurses' personal health and the adoption of healthier behaviours by patients. This may be from patients being motivated by, and modelling, the visible healthy lifestyle of the nurse or that nurses are more willing to promote the health of their patients by offering public health or health promotion advice and referring the patient to support services. An integrated systematic review was conducted to determine if nurses' personal health behaviour impacted on (1) their health promotion practices, and (2) patient responses to a health promotion message. Medline, CINAHL, SCOPUS, and PsycINFO databases were searched. A narrative synthesis was conducted. 31 studies were included in the review. No consistent associations were noted between nurses' weight, alcohol use, or physical activity level and their health promotion practice, although smoking appeared to negatively impact on the likelihood of discussing and engaging in cessation counselling. Nurses who reported confidence and skills around health promotion practice were more likely to raise lifestyle issues with patients, irrespective of their own personal health behaviours. The two studies included in the review that examined patient responses noted that the perceived credibility of a public health message was not enhanced by being delivered by a nurse who reported adopting healthy behaviours. Although it is assumed that nurses' personal health behaviour influences their health promotion practice, there is little evidence to support this. The assertion in health care policy that nurses should be role models for healthy behaviours assumes a causal relationship between their health behaviours and the patient response and adoption of public health messages that is not borne out by the research evidence. Copyright

  2. 30 CFR 250.1166 - What additional reporting is required for developments in the Alaska OCS Region?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Production Requirements Other Requirements § 250.1166... development in the Alaska OCS Region, you must submit an annual reservoir management report to the Regional... request an MER for each producing sensitive reservoir in the Alaska OCS Region, unless otherwise...

  3. Physical Education and Health: Global Perspectives and Best Practice

    ERIC Educational Resources Information Center

    Chin, Ming-Kai, Ed.; Edginton, Christopher R.

    2014-01-01

    "Physical Education and Health: Global Perspectives and Best Practice" draws together global scholars, researchers, and practitioners to provide a review and analysis of new directions in physical education and health worldwide. The book provides descriptive information from 40 countries regarding contemporary practices, models, and…

  4. Health decision making: lynchpin of evidence-based practice.

    PubMed

    Spring, Bonnie

    2008-01-01

    Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers' intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed.

  5. Health Decision Making: Lynchpin of Evidence-Based Practice

    PubMed Central

    Spring, Bonnie

    2008-01-01

    Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. Implications for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers’ intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed. PMID:19015288

  6. Incorporation of DNA and Protein Precursors into Macromolecules by Bacteria at −15oC

    PubMed Central

    Christner, Brent C.

    2002-01-01

    DNA and protein precursors were incorporated into trichloroacetic acid-precipitated material by bacterial cell suspensions during incubation for 50 to 100 days at −15oC. Incorporation did not occur at −70oC and was inhibited by antibiotics. The results demonstrate that bacteria can perform macromolecular synthesis under conditions that mimic entrapment in glacial ice. PMID:12450874

  7. Curriculum influence on interdisciplinary oral health education and practice.

    PubMed

    Clark, Melinda; Quinonez, Rocio; Bowser, Jonathan; Silk, Hugh

    2017-06-01

    Oral diseases are very prevalent across the lifespan and impact overall health, yet are largely preventable. The Smiles for Life (SFL) curriculum was created to educate healthcare providers about oral disease and support integration of oral health and primary care. This study examines SFL's influence on clinical practice and education. Surveys were sent to registered users of SFL. Users who self-identified as direct care providers (DCPs), or educators, were included in the analysis. Survey response rate was 18 percent, with 87 percent identifying as DCPs and 13 percent as educators. Across professions, 85 percent of DCPs reported SFL influencing their practice to some degree, with variance among profession type and experience. DCPs most commonly reported that SFL led them to improve how they conduct oral health activities, with 60 percent performing the activity more skillfully following completion of SFL. Fluoride varnish application was the most common practice behavior initiated, and caries risk assessments was the oral health activity affected to the greatest degree. A majority of educators (94 percent) reported that SFL led them to incorporate or enhance oral health in their teaching. SFL helped educators emphasize the importance of oral health, improved their ability to teach content, raised motivation, and reduced barriers to teaching oral health. Data supports that SFL is positively influencing oral health practice across professions, especially in areas of caries risk assessment and fluoride varnish application. SFL improves the frequency and quality with which DCPs and educators participate in oral health activities, and facilitates oral health inclusion in primary care. © 2017 American Association of Public Health Dentistry.

  8. Medical students' child oral-health-related knowledge, practices and attitudes.

    PubMed

    AlYousef, Y; Damiano, P; Weber-Gasparoni, K; Qian, F; Murph, J; Nothwehr, F

    2013-11-01

    This study evaluated medical interns' oral health knowledge, and other factors influencing their ability and willingness to perform oral-health-related practices for high-caries-risk children. A 15-item survey was emailed to all eligible graduating fifth-year medical students at King Khalid University Hospital to address these areas of interest. Chi-square statistics and logistic regression models were used to analyse data. One-hundred and twenty-one (49%) usable surveys were returned from two mailings. On questions regarding comfort levels when performing oral-health-related practices on children under age 3, physicians noted high levels of comfort with all specified oral health practices. Regarding satisfaction of students with medical training, the majority of respondents (87.5%) rated their medical training as fair or poor in preparing them for oral health assessments compared to only 35%, 29% and 7% of respondents giving fair or poor ratings to child abuse identification, caring for special needs patients and primary care paediatric practice, respectively. Additionally, although 90% of respondents noted that the role of primary physicians in counselling/referring children with oral health was important, 60% did not agree with the AAPD and AAP guidelines that state that all children should be referred to a dentist by 12 months of age. Multivariate logistic regression analyses revealed several statistically significant variables that predict the likelihood of performing various oral-health-related practices. The choice of public-health-oriented future clinical goals, the level of oral health knowledge, how interns rated their oral health training in medical school and the average number of children seen per week, all--to varying degrees--proved important predicator variables for the likelihood of performing them once in practice. More oral-health-related training of medical students seems warranted and could improve their interest in providing oral-health

  9. Public health nutrition practice in Canada: a situational assessment.

    PubMed

    Fox, Ann; Chenhall, Cathy; Traynor, Marie; Scythes, Cindy; Bellman, Jane

    2008-08-01

    Renewed focus on public health has brought about considerable interest in workforce development among public health nutrition professionals in Canada. The present article describes a situational assessment of public health nutrition practice in Canada that will be used to guide future workforce development efforts. A situational assessment is a planning approach that considers strengths and opportunities as well as needs and challenges, and emphasizes stakeholder participation. This situational assessment consisted of four components: a systematic review of literature on public health nutrition workforce issues; key informant interviews; a PEEST (political, economic, environmental, social, technological) factor analysis; and a consensus meeting. Information gathered from these sources identified key nutrition and health concerns of the population; the need to define public health nutrition practice, roles and functions; demand for increased training, education and leadership opportunities; inconsistent qualification requirements across the country; and the desire for a common vision among practitioners. Findings of the situational assessment were used to create a three-year public health nutrition workforce development strategy. Specific objectives of the strategy are to define public health nutrition practice in Canada, develop competencies, collaborate with other disciplines, and begin to establish a new professional group or leadership structure to promote and enhance public health nutrition practice. The process of conducting the situational assessment not only provided valuable information for planning purposes, but also served as an effective mechanism for engaging stakeholders and building consensus.

  10. Health care resource use and costs associated with possible side effects of high oral corticosteroid use in asthma: a claims-based analysis.

    PubMed

    Luskin, Allan T; Antonova, Evgeniya N; Broder, Michael S; Chang, Eunice Y; Omachi, Theodore A; Ledford, Dennis K

    2016-01-01

    The objective of this study was to estimate the prevalence of possible oral corticosteroid (OCS)-related side effects and health care resource use and costs in patients with asthma. This was a cross-sectional, matched-cohort, retrospective study using a commercial claims database. Adults with asthma diagnosis codes and evidence of asthma medication use were studied. Patients with high OCS use (≥30 days of OCS annually) were divided into those who did versus those who did not experience OCS-related possible side effects. Their health care resource use and costs were compared using linear regression or negative binomial regression models, adjusting for age, sex, geographic region, Charlson Comorbidity Index score, and chronic obstructive pulmonary disease status. After adjustment, high OCS users with possible side effects were more likely to have office visits (23.0 vs 19.6; P <0.001) and hospitalizations (0.44 vs 0.22; P <0.001) than those without possible side effects. Emergency department visits were similar between the groups. High OCS users with possible side effects had higher adjusted total annual mean health care costs ($25,168) than those without such side effects ($21,882; P =0.009). Among high OCS users, patients with possible OCS-related side effects are more likely to use health care services than those without such side effects. Although OCS may help control asthma and manage exacerbations, OCS side effects may result in additional health care resource use and costs, highlighting the need for OCS-sparing asthma therapies.

  11. Overshoot and Non-Overshoot Pathways to 1.5oC and Above: The Temperature Tunnel

    NASA Astrophysics Data System (ADS)

    Feijoo, F.; Edmonds, J.; Wise, M. A.; Mignone, B.; Kheshgi, H. S.

    2017-12-01

    We create 3000 temperature pathways that lead to a wide range of outcomes in 2100 from below 1.5oC to over 3oC. We use the Global Change Assessment Model (GCAM), which includes the HECTOR physical Earth system model, to generate emission, climate forcing and global temperature trajectories driven by a wide range of assumed carbon price trajectories. While no probability is estimated for the generated trajectories, we report the central estimate of temperature response to emissions from HECTOR. We find that despite the wide range of generated carbon emission trajectories, temperature pathways were constrained to a narrow range until shortly before mid-century. This "temperature tunnel" was the result of two phenomena: first, a narrow range of radiative forcing for 10-15 years created by the concurrent reduction of carbon and aerosol emissions; and second, the thermal lag of the climate response to radiative forcing change of roughly 10-15 years. Scenarios consistent with 1.5oC showed higher short-term temperatures than scenarios consistent with higher temperature outcomes. No scenarios were found that peak below approximately 1.9oC.

  12. Positive Health and Financial Practices: Does Budgeting Make a Difference?

    ERIC Educational Resources Information Center

    O'Neill, Barbara; Xiao, Jing Jian; Ensle, Karen

    2017-01-01

    This study explored relationships between the practice of following a hand-written or computer-generated budget and the frequency of performance of positive personal health and financial practices. Data were collected from an online quiz completed by 942 adults, providing a simultaneous assessment of individuals' health and financial practices.…

  13. Health information technology adoption in New Zealand optometric practices.

    PubMed

    Heidarian, Ahmadali; Mason, David

    2013-11-01

    Health information technology (HIT) has the potential to fundamentally change the practice of optometry and the relationship between optometrists and patients and to improve clinical outcomes. This paper aims to provide data on how health information technology is currently being used in New Zealand optometric practices. Also this paper aims to explore the potential benefits and barriers to the future adoption of health information technology in New Zealand. One hundred and six New Zealand optometrists were surveyed about their current use of health information technology and about potential benefits and barriers. In addition, 12 semi-structured interviews were carried out with leaders of health information technology in New Zealand optometry. The areas of interest were the current and intended use of HIT, the potential benefits of and barriers to using HIT in optometric offices and the level of investment in health information technology. Nearly all optometrists (98.7 per cent) in New Zealand use computers in their practices and 93.4 per cent of them use a computer in their consulting room. The most commonly used clinical assessment technology in optometric practices in New Zealand was automated perimeter (97.1 per cent), followed by a digital fundus/retinal camera (82.6 per cent) and automated lensometer (62.9 per cent). The pachymeter is the technology that most respondents intended to purchase in the next one to five years (42.6 per cent), followed by a scanning laser ophthalmoscope (36.8 per cent) and corneal topographer (32.9 per cent). The main benefits of using health information technology in optometric practices were improving patient perceptions of ‘state of the art’ practice and providing patients with information and digital images to explain the results of assessment. Barriers to the adoption of HIT included the need for frequent technology upgrades, cost, lack of time for implementation, and training. New Zealand optometrists are using HIT

  14. Organic contaminants in African aquatic systems: Current knowledge, health risks, and future research directions.

    PubMed

    Gwenzi, Willis; Chaukura, Nhamo

    2018-04-01

    Organic contaminants (OCs) are increasingly being reported in African aquatic systems, yet a critical evaluation of the literature is still lacking. The objectives of this review were to: (1) identify hotspot reservoirs, transfer pathways and ecological and human risks of OCs, (2) identify potential interventions to minimize the health risks, and (3) highlight knowledge gaps and research constraints. OCs widely reported in aquatic systems include pesticides, pharmaceuticals, plasticizers, solvents, endocrine disrupting compounds, and antimicrobial resistance genes, originating from applications in crop protection, veterinary and animal husbandry, human sanitation and hygiene, human vector and disease control. Potential hotspot reservoirs of OCs include wastewaters, on-site sanitation systems, leachates from non-engineered landfills and contaminated recharge of shallow groundwater systems. OCs could be transferred into humans via drinking of contaminated water, consumption of contaminated crops and aquatic foods, and to a lesser extent, inhalation and dermal contact. Ecological effects including intersex, estrogenicity, and acute and chronic toxicity occur in avian and aquatic species. Although the evidence base of human ecotoxicological effects of OC remains weak, pesticides have been reported in human milk, serum and sperms, pointing to potential chronic and acute toxicity and endocrine disruption. The prevalence of antimicrobials and their resistance genes could in turn lead to antimicrobial resistance in humans. The lack of OC monitoring in drinking water, coupled with over-reliance on untreated drinking water vulnerable to OC contamination predisposes humans to OC health risks. Appropriate water treatment methods, were identified, and a conceptual framework developed to minimize the ecological and human health risks. Future research directions on OC hotspot reservoirs, environmental behaviour and fate, ecotoxicology, epidemiology and interventions to minimize

  15. Private rural health providers in Haryana, India: profile and practices.

    PubMed

    Jarhyan, P; Singh, B; Rai, S K; Nongkynrih, B

    2012-01-01

    Despite a widespread public health system, the private healthcare sector is the major provider of health care in rural India. This study describes the profile and medical practices of private rural health providers (PRHPs) in rural Haryana, India. A cross-sectional study was conducted among PRHPs practicing in the villages of Comprehensive Rural Health Services Project (CRHSP) at Ballabgarh block located in the Faridabad district of Haryana State. The CRHSP is an Intensive Field Practice Area (IFPA) of the Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi. Eighty PRHPs participated in this study (response rate 93%). The majority (96%) did not possess a qualification in any formal system of medicine. Half of the PRHPs had a separate space (private area) for the examination of patients. Almost all had stethoscopes, thermometers and blood pressure apparatus. The PRHPs were involved in a wide range of practices, such as dispensing medicines (98.7%), providing injections (98.7%) and intravenous fluids (98.7%), and conducting minor surgery (78.5%). Dumping biomedical waste was a common practice among these practitioners. Some PRHPs (8.7%) were involved in national health programs. Unqualified PRHPs provide substantial outpatient healthcare services in rural Ballabgarh, India. Their biomedical waste disposal practices are inadequate. There is a need for training in waste disposal practices and monitoring of safe injection techniques among PRHPs. Consideration should be given to utilising PRHPs in important public health programs such as disease surveillance.

  16. Evidence-based Management: From Theory to Practice in Health Care

    PubMed Central

    Walshe, Kieran; Rundall, Thomas G.

    2001-01-01

    The rise of evidence-based clinical practice in health care has caused some people to start questioning how health care managers and policymakers make decisions, and what role evidence plays in the process. Though managers and policymakers have been quick to encourage clinicians to adopt an evidence-based approach, they have been slower to apply the same ideas to their own practice. Yet, there is evidence that the same problems (of the underuse of effective interventions and the overuse of ineffective ones) are as widespread in health care management as they are in clinical practice. Because there are important differences between the culture, research base, and decision-making processes of clinicians and managers, the ideas of evidence-based practice, while relevant, need to be translated for management rather than simply transferred. The experience of the Center for Health Management Research (CHMR) is used to explore how to bring managers and researchers together and promote the use of evidence in managerial decision-making. However, health care funders, health care organizations, research funders, and academic centers need wider and more concerted action to promote the development of evidence-based managerial practice. PMID:11565163

  17. Nursing practice environment: a strategy for mental health nurse retention?

    PubMed

    Redknap, Robina; Twigg, Di; Rock, Daniel; Towell, Amanda

    2015-06-01

    Historically, mental health services have faced challenges in their ability to attract and retain a competent nursing workforce in the context of an overall nursing shortage. The current economic downturn has provided some respite; however, this is likely to be a temporary reprieve, with significant nursing shortages predicted for the future. Mental health services need to develop strategies to become more competitive if they are to attract and retain skilled nurses and avoid future shortages. Research demonstrates that creating and maintaining a positive nursing practice environment is one such strategy and an important area to consider when addressing nurse retention. This paper examines the impact the nursing practice environment has on nurse retention within the general and mental health settings. Findings indicate, that while there is a wealth of evidence to support the importance of a positive practice environment on nurse retention in the broader health system, there is little evidence specific to mental health. Further research of the mental health practice environment is required. © 2015 Australian College of Mental Health Nurses Inc.

  18. Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

    PubMed

    Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

    2018-02-01

    Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

  19. Measurements of OC and EC in coarse particulate matter in the southeastern United States

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Edgerton, E.S.; Casuccio, G.S.; Saylor, R.D.

    The organic carbon (OC) and elemental carbon (EC) content of filter-based, 24-hr integrated particulate matter with aerodynamic diameters between 2.5 and 10 {mu}m (PM10-2.5) was measured at two urban and two rural locations in the southeastern United States. On average, total carbon (OC + EC) comprised approximately 30% of PM10-2.5 mass at these four sites. Carbonate carbon was measured on a subset of samples from three sites and was found to be undetectable at a rural site in central Alabama, less than 2% of PM10-2.5 at an urban site in Georgia, and less than 10% of PM10-2.5 at an urban-industrialmore » site in Alabama. Manual scanning electron microscopy (SEM) and computer-controlled SEM (CCSEM) along with energy dispersive X-ray spectroscopy (EDS) were used to identify individual carbonaceous particles in a selected subset of samples collected at one rural site and one urban-industrial site in Alabama. CCSEM results showed that biological material (e.g., fungal spores, pollen, and vegetative detritus) accounted for 60-70% of the carbonaceous mass in PM10-2.5 samples with concentrations in the range of 2-16 {mu}g/m{sup 3}. Samples with higher PM10-2.5 concentrations (25-42 {mu}g/m{sup 3}) at the urban-industrial site were found by manual SEM to have significant amounts of unidentified carbonaceous material, likely originating from local industrial activities. Both filter-based OC and EC concentrations and SEM-identified biological material tended to have higher concentrations during warmer months. Upper limits for organic mass (OM) to OC ratios (OM/OC) are estimated for PM10-2.5 samples at 2.1 for urban sites and 2.6-2.7 for rural sites. 40 refs., 12 figs., 5 tabs.« less

  20. The moderating role of overcommitment in the relationship between psychological contract breach and employee mental health.

    PubMed

    Reimann, Mareike

    2016-09-30

    This study investigated whether the association between perceived psychological contract breach (PCB) and employee mental health is moderated by the cognitive-motivational pattern of overcommitment (OC). Linking the psychological contract approach to the effort-reward imbalance model, this study examines PCB as an imbalance in employment relationships that acts as a psychosocial stressor in the work environment and is associated with stress reactions that in turn negatively affect mental health. The analyses were based on a sample of 3,667 employees who participated in a longitudinal linked employer-employee survey representative of large organizations (with at least 500 employees who are subject so social security contributions) in Germany. Fixed-effects regression models, including PCB and OC, were estimated for employee mental health, and interaction effects between PCB and OC were assessed. The multivariate fixed-effects regression analyses showed a significant negative association between PCB and employee mental health. The results also confirmed that OC does indeed significantly increase the negative effect of PCB on mental health and that OC itself has a significant and negative effect on mental health. The results suggest that employees characterized by the cognitive-motivational pattern of OC are at an increased risk of developing poor mental health if they experience PCB compared with employees who are not overly committed to their work. The results of this study support the assumption that psychosocial work stressors play an important role in employee mental health.

  1. The moderating role of overcommitment in the relationship between psychological contract breach and employee mental health

    PubMed Central

    Reimann, Mareike

    2016-01-01

    Objectives: This study investigated whether the association between perceived psychological contract breach (PCB) and employee mental health is moderated by the cognitive-motivational pattern of overcommitment (OC). Linking the psychological contract approach to the effort-reward imbalance model, this study examines PCB as an imbalance in employment relationships that acts as a psychosocial stressor in the work environment and is associated with stress reactions that in turn negatively affect mental health. Methods: The analyses were based on a sample of 3,667 employees who participated in a longitudinal linked employer-employee survey representative of large organizations (with at least 500 employees who are subject so social security contributions) in Germany. Fixed-effects regression models, including PCB and OC, were estimated for employee mental health, and interaction effects between PCB and OC were assessed. Results: The multivariate fixed-effects regression analyses showed a significant negative association between PCB and employee mental health. The results also confirmed that OC does indeed significantly increase the negative effect of PCB on mental health and that OC itself has a significant and negative effect on mental health. Conclusions: The results suggest that employees characterized by the cognitive-motivational pattern of OC are at an increased risk of developing poor mental health if they experience PCB compared with employees who are not overly committed to their work. The results of this study support the assumption that psychosocial work stressors play an important role in employee mental health. PMID:27488041

  2. Unconventional eating practices and their health implications.

    PubMed

    Hanning, R M; Zlotkin, S H

    1985-04-01

    The authors discuss a number of unconventional or faddist foods and eating practices and their health implications. Among the topics included are vegetarianism, Zen macrobiotic diets, fast foods, junk foods, megavitamins and their toxicity, health foods, fad diets in infancy, and elimination diets.

  3. Three-body dissociation of OCS3+: Separating sequential and concerted pathways

    NASA Astrophysics Data System (ADS)

    Kumar, Herendra; Bhatt, Pragya; Safvan, C. P.; Rajput, Jyoti

    2018-02-01

    Events from the sequential and concerted modes of the fragmentation of OCS3+ that result in coincident detection of fragments C+, O+, and S+ have been separated using a newly proposed representation. An ion beam of 1.8 MeV Xe9+ is used to make the triply charged molecular ion, with the fragments being detected by a recoil ion momentum spectrometer. By separating events belonging exclusively to the sequential mode of breakup, the electronic states of the intermediate molecular ion (CO2+ or CS2+) involved are determined, and from the kinetic energy release spectra, it is shown that the low lying excited states of the parent OCS3+ are responsible for this mechanism. An estimate of branching ratios of events coming from sequential versus concerted mode is presented.

  4. Health knowledge and health practices in Makeni, Sierra Leone: a community-based household survey.

    PubMed

    Abdelmalak, Mena J; Ahmed, Bilaal S; Mehta, Khanjan

    2016-05-01

    We characterize health knowledge and practices in urban and rural Makeni, Sierra Leone, drawing comparisons between areas served by community health workers (CHWs) with those that are not. We also inquire about causes of infant and maternal mortality and how they are understood in the local context. Our objective was to provide a baseline understanding of health knowledge and practices in Makeni during the implementation of a CHW program. We conducted 100 household interviews in Makeni City and rural villages in the surrounding area. We compared data between urban and rural areas to identify differences in health knowledge and practices. Our sample size covered 855 individuals. Insecticide treated bednet ownership was lower in urban settings compared to rural populations (58% vs 94%; p<.001). With regards to maternal mortality, most respondents indicated 'no clinic' (lack of clinical care or skipped antenatal care visits) as the primary cause (n=35), followed by bleeding (n=17), 'lack of blood' (anemia) (n=11) and 'will of God' (n=11). This initial survey of health knowledge and practices in rural and urban Makeni, Sierra Leone, highlights some simple opportunities for community health promotion, health education programming and behavioral interventions. Findings will inform future iterations of a CHW training module for community health education. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Emissions of EC, OC, and PAHs from cottonseed oil biodiesel in a heavy-duty diesel engine.

    PubMed

    Song, Wei W; He, Ke B; Wang, Jian X; Wang, Xin T; Shi, Xiao Y; Yu, Chao; Chen, Wen M; Zheng, Liang

    2011-08-01

    Biodiesel fuels, made from renewable resources, have emerged as viable alternatives to conventional diesel fuel, but their impact on emissions is not fully understood. This study examines elemental carbon (EC), organic carbon (OC), and polycyclic aromatic hydrocarbons (PAHs) emissions from cottonseed oil biodiesel (CSO-B100). Relative to normal diesel fuel, CSO-B100 reduced EC emissions by 64% (±16%). The bulk of EC emitted from CSO-B100 was in the fine particle mode (<1.4 μm), which is similar to normal diesel. OC was found in all size ranges, whereas emissions of OC(1.4-2.5) were proportionately higher in OC(2.5) from CSO-B100 than from diesel. The CSO-B100 emission factors derived from this study are significantly lower, even without aftertreatment, than the China-4 emission standards established in Beijing and Euro-IV diesel engine standards. The toxic equivalency factors (TEFs) for CSO-B100 was half the TEFs of diesel, which suggests that PAHs emitted from CSO-B100 may be less toxic.

  6. 30 CFR 254.51 - Modifying an existing OCS response plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Modifying an existing OCS response plan. 254.51 Section 254.51 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL-SPILL RESPONSE REQUIREMENTS FOR FACILITIES LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response...

  7. Health care waste management practice in a hospital.

    PubMed

    Paudel, R; Pradhan, B

    2010-10-01

    Health-care waste is a by-product of health care. Its poor management exposes health-care workers, waste handlers and the community to infections, toxic effects and injuries including damage of the environment. It also creates opportunities for the collection of disposable medical equipment, its re-sale and potential re-use without sterilization, which causes an important burden of disease worldwide. The purpose of this study was to find out health care waste management practice in hospital. A cross-sectional study was conducted in Narayani Sub-Regional Hospital, Birgunj from May to October 2006 using both qualitative and quantitative methods. Study population was four different departments of the hospital (Medical/Paediatric, Surgical/Ortho, Gynae/Obstetric and Emergency), Medical Superintendent, In-charges of four different departments and all sweepers. Data was collected using interview, group discussion, observation and measurement by weight and volume. Total health-care waste generated was 128.4 kg per day while 0.8 kg per patient per day. The composition of health care waste was found to be 96.8 kg (75.4%) general waste, 24.1 kg (8.8%) hazardous waste and 7.5 kg (5.8%) sharps per day by weight. Health staffs and sweepers were not practicing the waste segregation. Occupational health and safety was not given due attention. Majority of the sweepers were unaware of waste management and need of safety measures to protect their own health. Health care waste management practice in the hospital was unsatisfactory because of the lack of waste management plan and carelessness of patients, visitors and staffs. Therefore the hospital should develop the waste management plan and strictly follow the National Health Care Waste Management Guideline.

  8. [Breastfeeding: nurses' practice under the perspective of the International Classification of Collective Health Nursing Practices].

    PubMed

    Chaves, Maria Marta Nolasco; de Senna Ávila Farias, Fabiana Costa; Apostólico, Maíra Rosa; Cubas, Marcia Regina; Egry, Emiko Yoshikawa

    2011-03-01

    This descriptive and exploratory study aimed to describe nursing diagnoses and interventions under the International Nursing Practice Classification in Collective Health--CIPESC®--in Women's Health Care, sub-theme Pre-Natal and Puerperium, correlating them to nurses' competences at Curitiba's Mother Program. Data used were diagnoses and interventions during nursing consultation from April to July/ 2005. Basic Statistics was used for data treatment. Proper Breastfeeding was the most frequent diagnosis and most interventions are related to strengthening the user to face the health-disease process (68.9%). In spite of nurses' practice during puerperium, such a competence is not part of the Program Protocol. In conclusion, minor adjustments are necessary in the analyzed diagnoses and the Protocol should be reviewed to entail nurses' competences that are developed in their practice in health services according to CIPESC' s registers.

  9. The Red Lotus Health Promotion Model: a new model for holistic, ecological, salutogenic health promotion practice.

    PubMed

    Gregg, Jane; O'Hara, Lily

    2007-04-01

    There is a need for a system of values and principles consistent with modern health promotion that enables practitioners to use these values and principles to understand health and in their needs assessment, planning, implementation and evaluation practice. Grounded theory, document analysis and the authors' own practice experience were used to systematically collect and analyse data from key health promotion literature and to develop the Red Lotus Health Promotion Model. The Red Lotus Health Promotion Model is a new model for holistic, ecological, salutogenic health promotion practice. It is distinct from other health promotion models in that it incorporates a system of values and principles that is applied across the phases of health promotion, including determining the health paradigm, needs assessment, planning, implementation and evaluation. The Red Lotus Health Promotion Model enables practitioners to proactively and purposefully put into action a connected system of values and principles across the phases of a health promotion process.

  10. One Health: From theory to practice

    PubMed Central

    Little, Adam

    2012-01-01

    One Health approaches to human and veterinary medicine are critical to professionals addressing global issues of food security and disease prevention. However, we have yet to develop a sufficient strategy to translate our theoretical understanding to practical application. This paper will explore the current shortcomings of One Health, within both the medical and veterinary communities, and highlight solutions to overcome these challenges. PMID:23024395

  11. Promoting Mental Health and Preventing Mental Illness in General Practice.

    PubMed

    Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

    2016-01-01

    This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.

  12. Promoting Mental Health and Preventing Mental Illness in General Practice

    PubMed Central

    Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

    2016-01-01

    Abstract This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert ‘Think Tank’ convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your ‘cluster’ of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development. PMID:28250821

  13. 77 FR 72880 - Information Collection Activities: Notice to Lessees and/or Operators (NTL)-Gulf of Mexico OCS...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-06

    ... Offshore Drilling Units). OMB Control Number: 1014-0013. Abstract: The Outer Continental Shelf (OCS) Lands.... The subject of this ICR is an NTL, GPS (Global Positioning System) for MODUs (Mobile Offshore Drilling... Operators (NTL)--Gulf of Mexico OCS Region--GPS (Global Positioning System) for MODUs (Mobile Offshore...

  14. Electronic health record "super-users" and "under-users" in ambulatory care practices.

    PubMed

    Rumball-Smith, Juliet; Shekelle, Paul; Damberg, Cheryl L

    2018-01-01

    This study explored variation in the extent of use of electronic health record (EHR)-based health information technology (IT) functionalities across US ambulatory care practices. Use of health IT functionalities in ambulatory care is important for delivering high-quality care, including that provided in coordination with multiple practitioners. We used data from the 2014 Healthcare Information and Management Systems Society Analytics survey. The responses of 30,123 ambulatory practices with an operational EHR were analyzed to examine the extent of use of EHR-based health IT functionalities for each practice. We created a novel framework for classifying ambulatory care practices employing 7 domains of health IT functionality. Drawing from the survey responses, we created a composite "use" variable indicating the extent of health IT functionality use across these domains. "Super-user" practices were defined as having near-full employment of the 7 domains of health IT functionalities and "under-users" as those with minimal or no use of health IT functionalities. We used multivariable logistic regression to investigate how the odds of super-use and under-use varied by practice size, type, urban or rural location, and geographic region. Seventy-three percent of practices were not using EHR technologies to their full capability, and nearly 40% were classified as under-users. Under-user practices were more likely to be of smaller size, situated in the West, and located outside a metropolitan area. To achieve the broader benefits of the EHR and health IT, health systems and policy makers need to identify and address barriers to full use of health IT functionalities.

  15. Genomic Analysis of 15 Human Coronaviruses OC43 (HCoV-OC43s) Circulating in France from 2001 to 2013 Reveals a High Intra-Specific Diversity with New Recombinant Genotypes

    PubMed Central

    Kin, Nathalie; Miszczak, Fabien; Lin, Wei; Ar Gouilh, Meriadeg; Vabret, Astrid

    2015-01-01

    Human coronavirus OC43 (HCoV-OC43) is one of five currently circulating human coronaviruses responsible for respiratory infections. Like all coronaviruses, it is characterized by its genome’s high plasticity. The objectives of the current study were to detect genetically distinct genotypes and eventually recombinant genotypes in samples collected in Lower Normandy between 2001 and 2013. To this end, we sequenced complete nsp12, S, and N genes of 15 molecular isolates of HCoV-OC43 from clinical samples and compared them to available data from the USA, Belgium, and Hong-Kong. A new cluster E was invariably detected from nsp12, S, and N data while the analysis of nsp12 and N genes revealed the existence of new F and G clusters respectively. The association of these different clusters of genes in our specimens led to the description of thirteen genetically distinct genotypes, among which eight recombinant viruses were discovered. Identification of these recombinant viruses, together with temporal analysis and tMRCA estimation, provides important information for understanding the dynamics of the evolution of these epidemic coronaviruses. PMID:26008694

  16. Tuning the conductance of H2O@C60 by position of the encapsulated H2O

    PubMed Central

    Zhu, Chengbo; Wang, Xiaolin

    2015-01-01

    The change of conductance of single-molecule junction in response to various external stimuli is the fundamental mechanism for the single-molecule electronic devices with multiple functionalities. We propose the concept that the conductance of molecular systems can be tuned from inside. The conductance is varied in C60 with encapsulated H2O, H2O@C60. The transport properties of the H2O@C60-based nanostructure sandwiched between electrodes are studied using first-principles calculations combined with the non-equilibrium Green’s function formalism. Our results show that the conductance of the H2O@C60 is sensitive to the position of the H2O and its dipole direction inside the cage with changes in conductance up to 20%. Our study paves a way for the H2O@C60 molecule to be a new platform for novel molecule-based electronics and sensors. PMID:26643873

  17. Positive health practices and temporal perspective in low-income adults.

    PubMed

    Thompson, Cheryl W; Fitzpatrick, Joyce J

    2008-07-01

    The purpose of this study was to describe health-promoting behaviours and temporal perspective in low-income adults. Positive health practices represent a broad range of health-promoting behaviours. The ability to adopt positive health practices may be influenced by many factors, one of which is temporal perspective, the perceived relationship between past, present and future times. This exploratory study was conducted in a south central Pennsylvania community with a convenience sample of individuals who were eligible for a subsidized low-income housing programme. Positive health practices were measured using the Personal Lifestyle Questionnaire. Temporal perspective was measured with the Circles Test. The sample consisted of 75 subjects, 61 women (81%) and 14 men (19%). Positive health practices were relatively high (mean = 70 out of a possible score of 96). Forty three per cent of the subjects expressed future temporal dominance and 80% of the subjects in this study expressed non-continuous temporal relatedness. Health-promoting behaviours in this low-income sample were similar to those reported in other samples in middle-class adult samples. The percentage of subjects who expressed future dominance was similar to findings in other samples. The percentage of subjects who expressed non-continuous temporal relatedness was different from findings reported in other samples, suggesting that perception of the relationship of past, present and future times is different in this low-income sample compared with other samples. The temporal relatedness findings suggest that low-income individuals may not believe that adopting positive health practices will influence future health.

  18. Using mass media within health-promoting practice: a nursing perspective.

    PubMed

    Whitehead, D

    2000-10-01

    For some time health professionals have recognized the growing importance of utilizing mass media strategies as part of their health-promoting practice. The ever-evolving climate of technology and increasing reliance on mass communications has further reinforced the position of mass media initiatives. The enormous potential for mass media resources to reach certain audiences and influence their health-related behaviours has become particularly well established. Despite these facts, however, it is argued that the nursing profession has been less than pro-active in acknowledging, accommodating and adopting such practices. Consequently, the incorporation of health-related mass media initiatives into nursing's health-promotional role remains an elusive exercise. The maintenance of such a position, it is claimed, is potentially damaging for the profession as a whole. In light of this state of affairs, this paper seeks to review the literature surrounding the nature and processes of mass media strategies, their relevance to health promotion and nursing, how they are currently utilized and how they can be incorporated further into nursing practice. In conclusion, it is argued that nursing should seek to become a more active user of mass communication/media technology--especially in relation to its health-promotional practices.

  19. Maternal health practices, beliefs and traditions in southeast Madagascar.

    PubMed

    Morris, Jessica L; Short, Samm; Robson, Laura; Andriatsihosena, Mamy Soafaly

    2014-09-01

    Contextualising maternal health in countries with high maternal mortality is vital for designing and implementing effective health interventions. A research project was therefore conducted to explore practices, beliefs and traditions around pregnancy, delivery and postpartum in southeast Madagascar. Interviews and focus groups were conducted with 256 pregnant women, mothers of young children, community members and stakeholders; transcripts were analysed to identify and explore predetermined and emerging themes. A questionnaire was also conducted with 373 women of reproductive age from randomly selected households. Data was analysed using STATA. Results confirmed high local rates of maternal mortality and morbidity and revealed a range of traditional health care practices and beliefs impacting on women's health seeking behaviours. The following socio-cultural barriers to health were identified: 1) lack of knowledge, 2) risky practices, 3) delays seeking biomedical care, and 4) family and community expectations. Recommendations include educational outreach and behaviour change communications targeted for women, their partners and family, increased engagement with traditional midwives and healers, and capacity building of formal health service providers.

  20. The use of smartphone health apps and other mobile health (mHealth) technologies in dietetic practice: a three country study.

    PubMed

    Chen, J; Lieffers, J; Bauman, A; Hanning, R; Allman-Farinelli, M

    2017-08-01

    Smartphone health applications (apps) and other mobile health (mHealth) technologies may assist dietitians in improving the efficiency of patient care. The present study investigated the use of health apps and text messaging in dietetic practice and formulated intervention recommendations for supporting app uptake by dietitians based on the behavioural 'COM-B' system, where interactions between capability, opportunity and motivation influence behaviour. A 52-item online survey tool, taking 20 min to complete, was developed and piloted, with questions exploring the use of health apps and text messaging in dietetic practice, types of apps dietitians recommended and that patients used, and barriers and enablers to app use in dietetic practice. The Australian, New Zealand and British dietetic associations distributed the survey to their members. A 5% response rate was achieved internationally, with 570 completed responses included for further analysis. Health apps, namely nutrition apps, were used by 62% of dietitians in their practice, primarily as an information resource (74%) and for patient self-monitoring (60%). The top two nutrition apps recommended were MyFitnessPal ® (62%) and the Monash University Low FODMAP Diet ® (44%). Text messaging was used by 51% of respondents, mainly for appointment-related purposes (84%). Although the reported use of smartphone health apps in dietetic practice is high, health apps and other mHealth technologies are not currently being used for behaviour change, nor are they an integral part of the nutrition care process. Dietetic associations should provide training, education and advocacy to enable the profession to more effectively engage with and implement apps into their practice. © 2017 The British Dietetic Association Ltd.

  1. Health visiting assessment--unpacking critical attributes in health visitor needs assessment practice: a case study.

    PubMed

    Appleton, Jane V; Cowley, Sarah

    2008-02-01

    Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.

  2. Ethical Issues in Public Health Practice in Michigan

    PubMed Central

    Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.

    2009-01-01

    Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850

  3. Impacts of Outer Continental Shelf (OCS) development on recreation and tourism. Volume 3. Detailed methodology

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    The final report for the project is presented in five volumes. This volume, Detailed Methodology Review, presents a discussion of the methods considered and used to estimate the impacts of Outer Continental Shelf (OCS) oil and gas development on coastal recreation in California. The purpose is to provide the Minerals Management Service with data and methods to improve their ability to analyze the socio-economic impacts of OCS development. Chapter II provides a review of previous attempts to evaluate the effects of OCS development and of oil spills on coastal recreation. The review also discusses the strengths and weaknesses of differentmore » approaches and presents the rationale for the methodology selection made. Chapter III presents a detailed discussion of the methods actually used in the study. The volume contains the bibliography for the entire study.« less

  4. 75 FR 21653 - Commercial Leasing for Wind Power on the Outer Continental Shelf (OCS) Offshore Delaware-Request...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-26

    ... to enable MMS to gauge specific interest in commercial development of OCS wind resources in the area... (IP) to allow the issuance of leases to assess the renewable energy resource potential on the OCS and... resources that will guarantee stable prices for electricity. The Delaware legislature also passed a...

  5. Applications of health information exchange information to public health practice.

    PubMed

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

    2014-01-01

    Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health.

  6. Applications of Health Information Exchange Information to Public Health Practice

    PubMed Central

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

    2014-01-01

    Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health. PMID:25954386

  7. Research supporting the congruence between rehabilitation principles and home health nursing practice.

    PubMed

    Neal, L J

    1999-01-01

    A grounded-theory study of 30 home health nurses conducted in the Washington, DC, metropolitan area used unstructured audiotaped interviews to elicit data as to how home health nurses define their practice. The purpose of the study was to develop a beginning substantive research-based theory of home health nursing practice. The model that emerged consists of three stages by which nurses attain autonomy in their practice. Adaptation was found to be the core category, in that nurses cannot function effectively or successfully in the home health arena unless they are or learn to be adaptable. Data also revealed that home health nurses either knowingly or unknowingly use rehabilitation nursing principles in their practice, thereby lending credence to the supposition that home health nursing practice is congruent with rehabilitation nursing principles.

  8. A Thematic Analysis of Health Care Workers' Adoption of Mindfulness Practices.

    PubMed

    Valley, Morgan; Stallones, Lorann

    2018-05-01

    Mindfulness training, which teaches individuals to bring awareness and acceptance to the present moment, has been effective in improving the well-being of health care workers. Limited research examines the adoption of mindfulness practices using health behavior theories. The current study sought to conceptualize hospital health care workers' experiences in adopting mindfulness practices using the Health Belief Model (HBM), a theoretical framework used by health promotion practitioners to design and implement health behavior change interventions. Hospital health care workers in Colorado participated in an 8-week Mindfulness-Based Stress Reduction (MBSR) course. Participants ( n = 19) answered open-ended questions about their experiences adopting mindfulness practices. A theory-driven thematic analysis approach was used to analyze data with key constructs of the HBM acting as the framework for the analysis. Results showed that HBM constructs, including internal cues to action, perceived benefits and barriers, and self-efficacy, helped portray the participants' experiences and challenges in adopting and adhering to the mindfulness practices taught in the MBSR course.

  9. Mental health economics, health service provision, and the practice of geriatric psychiatry.

    PubMed

    Suh, Guk-Hee; Han, Changsu

    2008-11-01

    Economic evaluation is becoming more and more important as a means to assist policy makers in choosing the best intervention or treatment against a pervasive scarcity of resources relative to the demands. Health service provision and the practice of geriatric psychiatry are closely associated with costs and outcomes of health economics. Recently published literature raising unanswered questions in these areas is reviewed. Some studies on the costs, outcomes, and cost-effectiveness of certain interventions or treatments (e.g. respite care, home-visiting community service) compared with usual strategies show that these are not optimal in terms of health economics. The updated guidance by the National Institute for Health and Clinical Excellence that cholinesterase inhibitors should be used only for moderate severity dementia on the grounds of cost-effectiveness has been heavily criticized. Mental health provision for older people varies across 'developed' and 'developing' countries. Updated findings provide better understanding of recent progress and issues on mental health economics, health service provision, and the practice of geriatric psychiatry. The application of health economics to the field of mental health should make complicated issues simple and explicit. Constructive criticisms and scientific debates will hasten the development of better tools or methodologies to evaluate the cost-effectiveness of current and new interventions or treatments.

  10. Updated O-C Diagrams for Several Bright HW Vir Binaries Observed with the Evryscope

    NASA Astrophysics Data System (ADS)

    Corcoran, Kyle A.; Barlow, Brad; Corbett, Hank; Fors, Octavi; Howard, Ward S.; Law, Nicholas; Ratzloff, Jeff

    2018-01-01

    HW Vir systems are eclipsing, post-common-envelope binaries consisting of a hot subdwarf star and a cooler M dwarf or brown dwarf companion. They show a strong reflection effect and have characteristically short orbital periods of only a few hours, allowing observers to detect multiple eclipses per night. Observed minus calculated (O-C) studies allow one to measure miniscule variations in the orbital periods of these systems by comparing observed eclipse timings to a calculated ephemeris. This technique is useful for detecting period changes due to secular evolution of the binary, gravitational wave emission, or reflex motion from an orbiting circumbinary object. Numerous eclipse timings obtained over several years are vital to the proper interpretation and analysis of O-C diagrams. The Evryscope – an array of twenty-four individual telescopes built by UNC and deployed on Cerro Tololo – images the entire Southern sky once every two minutes, producing an insurmountable amount of data for objects brighter than 16th magnitude. The cadence with which Evryscope exposes makes it an unparalleled tool for O-C analyses of HW Vir binaries; it will catalogue thousands of eclipses over the next several years. Here we present updated O-C diagrams for several HW Vir binaries using recent measurements from the Evryscope. We also use observations of AA Dor, an incredibly stable astrophysical clock, to characterize the accuracy of the Evryscope’s timestamps.

  11. The rural health care workforce implications of practice guideline implementation.

    PubMed

    Yawn, B P; Casey, M; Hebert, P

    1999-03-01

    Rural health care workforce forecasting has not included adjustments for predictable changes in practice patterns, such as the introduction of practice guidelines. To estimate the impact of a practice guideline for a single health condition on the needs of a rural health professional workforce. The current care of a cohort of rural Medicare recipients with diabetes mellitus was compared with the care recommended by a diabetes practice guideline. The additional tests and visits that were needed to comply with the guideline were translated into additional hours of physician services and total physician full-time equivalents. The implementation of a practice guideline for Medicare recipients with diabetes in rural Minnesota would require over 30,000 additional hours of primary care physician services and over 5,000 additional hours of eye care professionals' time per year. This additional need represents a 1.3% to 2.4% increase in the number of primary care physicians and a 1.0% to 6.6% increase in the number of eye-care clinicians in a state in which the rural medical provider to population ratios already meet some recommended workforce projections. The implementation of practice guidelines could result in an increased need for rural health care physicians or other providers. That increase, caused by guideline implementation, should be accounted for in future rural health care workforce predictions.

  12. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    PubMed Central

    2009-01-01

    Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for

  13. Mental Health Practice Guidelines for Child Welfare

    ERIC Educational Resources Information Center

    Annie E. Casey Foundation, 2009

    2009-01-01

    The guidelines and supporting rationale presented in this paper were developed from the October 2007 "Best Practices for Mental Health in Child Welfare Consensus Conference" sponsored by Casey Family Programs, the Annie E. Casey Foundation and the REACH Institute (REsource for Advancing Children's Health). The purpose of the conference was to…

  14. Modelling the impact of soil Carbonic Anhydrase on the net ecosystem exchange of OCS at Harvard forest using the MuSICA model

    NASA Astrophysics Data System (ADS)

    Launois, Thomas; Ogée, Jérôme; Commane, Roisin; Wehr, Rchard; Meredith, Laura; Munger, Bill; Nelson, David; Saleska, Scott; Wofsy, Steve; Zahniser, Mark; Wingate, Lisa

    2016-04-01

    The exchange of CO2 between the terrestrial biosphere and the atmosphere is driven by photosynthetic uptake and respiratory loss, two fluxes currently estimated with considerable uncertainty at large scales. Model predictions indicate that these biosphere fluxes will be modified in the future as CO2 concentrations and temperatures increase; however, it still unclear to what extent. To address this challenge there is a need for better constraints on land surface model parameterisations. Additional atmospheric tracers of large-scale CO2 fluxes have been identified as potential candidates for this task. In particular carbonyl sulphide (OCS) has been proposed as a complementary tracer of gross photosynthesis over land, since OCS uptake by plants is dominated by carbonic anhydrase (CA) activity, an enzyme abundant in leaves that catalyses CO2 hydration during photosynthesis. However, although the mass budget at the ecosystem is dominated by the flux of OCS into leaves, some OCS is also exchanged between the atmosphere and the soil and this component of the budget requires constraining. In this study, we adapted the process-based isotope-enabled model MuSICA (Multi-layer Simulator of the Interactions between a vegetation Canopy and the Atmosphere) to include the transport, reaction, diffusion and production of OCS within a forested ecosystem. This model was combined with 3 years (2011-2013) of in situ measurements of OCS atmospheric concentration profiles and fluxes at the Harvard Forest (Massachussets, USA) to test hypotheses on the mechanisms responsible for CA-driven uptake by leaves and soils as well as possible OCS emissions during litter decomposition. Model simulations over the three years captured well the impact of diurnally and seasonally varying environmental conditions on the net ecosystem OCS flux. A sensitivity analysis on soil CA activity and soil OCS emission rates was also performed to quantify their impact on the vertical profiles of OCS inside the

  15. Uncertainty Analysis of OC5-DeepCwind Floating Semisubmersible Offshore Wind Test Campaign

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Robertson, Amy N

    This paper examines how to assess the uncertainty levels for test measurements of the Offshore Code Comparison, Continued, with Correlation (OC5)-DeepCwind floating offshore wind system, examined within the OC5 project. The goal of the OC5 project was to validate the accuracy of ultimate and fatigue load estimates from a numerical model of the floating semisubmersible using data measured during scaled tank testing of the system under wind and wave loading. The examination of uncertainty was done after the test, and it was found that the limited amount of data available did not allow for an acceptable uncertainty assessment. Therefore, thismore » paper instead qualitatively examines the sources of uncertainty associated with this test to start a discussion of how to assess uncertainty for these types of experiments and to summarize what should be done during future testing to acquire the information needed for a proper uncertainty assessment. Foremost, future validation campaigns should initiate numerical modeling before testing to guide the test campaign, which should include a rigorous assessment of uncertainty, and perform validation during testing to ensure that the tests address all of the validation needs.« less

  16. Initial Experience With Tofacitinib in Clinical Practice: Treatment Patterns and Costs of Tofacitinib Administered as Monotherapy or in Combination With Conventional Synthetic DMARDs in 2 US Health Care Claims Databases.

    PubMed

    Harnett, James; Curtis, Jeffrey R; Gerber, Robert; Gruben, David; Koenig, Andrew

    2016-06-01

    Tofacitinib is an oral Janus kinase inhibitor indicated for the treatment of rheumatoid arthritis (RA). Tofacitinib can be administered as a monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (DMARDs). This study describes RA patients' characteristics, treatment patterns, and costs for those initiating tofacitinib treatment as monotherapy or combination therapy, using US claims data from clinical practice. A retrospective cohort analysis of patients aged ≥18 years with RA (International Classification of Diseases, Ninth Revision code 714.xx) and with ≥1 tofacitinib claim in the Truven Marketscan (TM) or the Optum Clinformatics (OC) database. Index was defined as the first tofacitinib fill date (November 2012-June 2014). Patients were continuously enrolled for ≥12 months before and after index. Adherence was assessed using the proportion of days covered (PDC) and medication possession ratio (MPR). Persistence was evaluated using a 1.5× days' supply gap or switch. All-cause and RA-related costs in the 12-month pre- and post-index periods were evaluated. Unadjusted and adjusted analyses were conducted on data on treatment patterns and costs stratified by monotherapy status. A total of 337 (TM) and 118 (OC) tofacitinib patients met the selection criteria; 52.2% (TM) and 50.8% (OC) received monotherapy and 83.7% (TM) and 76.3% (OC) had pre-index biologic DMARD experience. Twelve-month mean PDC values were 0.56 (TM) and 0.53 (OC), and 12-month mean MPR was 0.84 (TM) and 0.80 (OC), with persistence of 140.0 (TM) and 124.6 (OC) days. Between 12-month pre- and post-index periods, mean (SD) 12-month RA-related medical costs decreased by $5784 ($31,832) in TM and $6103 ($25,897) in OC (both, P < 0.05), whereas total costs increased by $3996 ($30,397) in TM (P < 0.05) and $1390 ($26,603) in OC. There were no significant differences in adherence, persistence, or all-cause/RA-related costs between monotherapy and combination

  17. Geologic and operational summary, COST No. 1 well, Georges Bank area, North Atlantic OCS

    USGS Publications Warehouse

    Amato, Roger V.; Bebout, John W.

    1980-01-01

    The first Continental Offshore Stratigraphic Test (COST) well on the U.S. North Atlantic Outer Continental Shelf (OCS) was drilled by Ocean Production Company between April 6 and July 26, 1976, and designated the COST No. G-l. Geological and engineering data obtained from this deep well in the Georges Bank Basin were used by the 31 participating companies and the U.S. Geological Survey (USGS) for evaluating the petroleum potential and possible drilling problems in the U.S. North Atlantic OCS area in preparation for Lease Sale 42 held on December 18, 1979.

  18. Putting Public Health Ethics into Practice: A Systematic Framework

    PubMed Central

    Marckmann, Georg; Schmidt, Harald; Sofaer, Neema; Strech, Daniel

    2015-01-01

    It is widely acknowledged that public health practice raises ethical issues that require a different approach than traditional biomedical ethics. Several frameworks for public health ethics (PHE) have been proposed; however, none of them provides a practice-oriented combination of the two necessary components: (1) a set of normative criteria based on an explicit ethical justification and (2) a structured methodological approach for applying the resulting normative criteria to concrete public health (PH) issues. Building on prior work in the field and integrating valuable elements of other approaches to PHE, we present a systematic ethical framework that shall guide professionals in planning, conducting, and evaluating PH interventions. Based on a coherentist model of ethical justification, the proposed framework contains (1) an explicit normative foundation with five substantive criteria and seven procedural conditions to guarantee a fair decision process, and (2) a six-step methodological approach for applying the criteria and conditions to the practice of PH and health policy. The framework explicitly ties together ethical analysis and empirical evidence, thus striving for evidence-based PHE. It can provide normative guidance to those who analyze the ethical implications of PH practice including academic ethicists, health policy makers, health technology assessment bodies, and PH professionals. It will enable those who implement a PH intervention and those affected by it (i.e., the target population) to critically assess whether and how the required ethical considerations have been taken into account. Thereby, the framework can contribute to assuring the quality of ethical analysis in PH. Whether the presented framework will be able to achieve its goals has to be determined by evaluating its practical application. PMID:25705615

  19. Utilizing Ericksonian hypnosis in psychiatric-mental health nursing practice.

    PubMed

    Zahourek, Rothlyn P

    2002-01-01

    Ericksonian hypnosis conceptual framework. To acquaint psychiatric-mental health nurses with hypnotic principles and how these can be integrated into their practice. Published literature and author's clinical experience. Ericksonian hypnosis offers an array of potential interventions for psychiatric-mental health nurses to integrate into their practices in a framework familiar to nurses: holism, honoring and respecting individuality, and capitalizing on an individual's strengths.

  20. Impacts of Outer Continental Shelf (OCS) development on recreation and tourism. Volume 1. Executive summary

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    The study was intended to provide the Mineral Management Service (MMS) with an analytical tool to evaluate possible economic impacts from Outer Continental Shelf (OCS) development. In particular, the study was designed to provide MMS staff who work on lease sale Energy Impact Statements with an objective technique for estimating the impacts to coastal communities from events that might occur as a result of lease sales: oil spills, onshore construction, and construction of platforms offshore. The project had several specific objectives: (1) provide profiles of 1982 socio-economic conditions in coastal communities, including an analysis of the relative importance of themore » tourist industry in each coastal county; (2) develop a methodology for determining the effects of OCS development on coastal recreation; and recommend mitigation measure that may reduce the negative effect of OCS development on coastal recreation using gravity and economic effects models.« less

  1. Health Beliefs and Practices of African Immigrants in Canada.

    PubMed

    Cooper Brathwaite, Angela; Lemonde, Manon

    2016-12-01

    A purposive sample of 14 immigrants living in Ontario, Canada, participated in two focus groups. The researchers used semi-structured interviews to collect data and five themes emerged from the data: beliefs about diabetes were centered on diverse factors, preserving culture through food preferences and preparation, cultural practices to stay healthy, cultural practices determined number of servings of fruit and vegetables per day, and engaging in physical activity to stay healthy. Findings indicated how health beliefs and cultural practices influenced behavior in preventing type 2 diabetes (T2D). Future research should focus on other high-risk minority groups (South Asian, Caribbean, and Latin American) to examine their health beliefs and cultural practices and use these finding to develop best practice guidelines, which should be incorporated into culturally tailored interventions. © The Author(s) 2015.

  2. Positive feelings during pregnancy, early feeding practices, and infant health.

    PubMed

    McManus, Melissa A; Khalessi, Ali A; Lin, Joyce; Ashraf, Jahanzeb; Reich, Stephanie M

    2017-05-01

    Early parenting practices, such as infant feeding, can affect children's physical health. Additionally, negative prenatal maternal affect can influence feeding choices, such as breast-feeding, and can have a detrimental effect on children's health. Little is known, however, about the contribution of positive maternal affect during pregnancy on feeding practices and children's health. This study explored whether positive prenatal feelings influenced children's health during the first 18 months, and whether early feeding practices mediated the relationship between these two variables. Low-income, ethnically diverse, primiparous women (n = 114) reported their feelings of pregnancy uplifts and hassles during their third trimester. These women were interviewed again at 2, 4, 6, 9, 12, and 18 months post-partum about their feeding practices. A retrospective audit of their infants' medical charts was completed from birth to 18 months. Using structural equation modeling, having more uplifts than hassles during pregnancy was associated with longer breast-feeding duration and greater adherence to recommended schedules for introducing fruits and vegetables, solids, and baby cereal. These feeding practices were linked to better child health outcomes, including reduced risk of upper respiratory tract infections, conjunctivitis, otitis media, and thrush. Positive maternal feelings during pregnancy were associated with better feeding practices, and these better feeding practices were associated with fewer common childhood illnesses. Helping expectant women focus on the positive aspects of their pregnancy may lead to postnatal care methods that are fiscally advantageous, preventive of detrimental postnatal choices, and medically beneficial for children. © 2016 Japan Pediatric Society.

  3. Effects of holistic nursing course: a paradigm shift for holistic health practices.

    PubMed

    Downey, Marty

    2007-06-01

    A study of an undergraduate course in holistic nursing was conducted to determine its impact on personal and professional health care practices. A mixed method design was used to examine responses on a sample of 200 participants. Results indicated a positive personal impact with continued application of concepts into professional health practices. Personal and professional nursing practices were influenced from 1 to 7 years after completing the holistic nursing course. After introduction of the concepts of self-care and holistic approaches to health, students and graduates experienced a shift in values and beliefs related to their own health practices. Continued exposure to holistic practices creates a pattern of awareness toward health that affects future personal and professional nursing practice, creating a paradigm shift for emerging nursing students and graduates from the course. This affects the manner in which nurses meet the needs of their clients in a variety of settings.

  4. Explicit correlation treatment of the six-dimensional potential energy surface and predicted infrared spectra for OCS-H2

    NASA Astrophysics Data System (ADS)

    Liu, Jing-Min; Zhai, Yu; Li, Hui

    2017-07-01

    An effective six-dimensional ab initio potential energy surface (PES) for H2-OCS which explicitly includes the intramolecular stretch normal modes of carbonyl sulfide (OCS) is presented. The electronic structure computations are carried out using the explicitly correlated coupled cluster [CCSD(T)-F12] method with the augmented correlation-consistent aug-cc-pVTZ basis set, and the accuracy is critically tested by performing a series of benchmark calculations. Analytic four-dimensional PESs are obtained by least-squares fitting vibrationally averaged interaction energies to the Morse/long-range potential model. These fits to 13 485 points have a root-mean-square deviation (RMSD) of 0.16 cm-1. The combined radial discrete variable representation/angular finite basis representation method and the Lanczos algorithm were employed to evaluate the rovibrational energy levels for five isotopic species of the OCS-hydrogen complexes. The predicted transition frequencies and intensities based on the resulting vibrationally averaged PESs are in good agreement with the available experimental values, whose RMSDs are smaller than 0.004 cm-1 for five different species of OCS-hydrogen complexes. The calculated infrared band origin shifts for all five species of OCS-hydrogen complexes are only 0.03 cm-1 smaller than the corresponding experimental values. These validate the high quality of our PESs which can be used for modeling OCS doped in hydrogen clusters to further study quantum solution and microscopic superfluidity. In addition, the analytic coordinate transformation functions between isotopologues are also derived due to the center of mass shifting of different isotope substitutes.

  5. From theory to practice: what drives the core business of public health?

    PubMed

    Smith, Tina Anderson; Minyard, Karen J; Parker, Christopher A; Van Valkenburg, Rachel Ferencik; Shoemaker, John A

    2007-01-01

    In 1994, the Public Health Functions Steering Committee proffered a description of the Essential Public Health Services (Essential Services). Questions remain, however, about the relationship between the roles defined therein and current public health practice at state and local levels. This case study describes the core business of public health in Georgia relative to the theoretical ideal and elucidates the primary drivers of the core business, thus providing data to inform future efforts to strengthen practice in the state. The principal finding was that public health in Georgia is not aligned with the Essential Services. Further analysis revealed that the primary drivers or determinants of public health practice are finance-related rather than based in need or strategy, precluding an integrated and intentional focus on health improvement. This case study provides a systems context for public health financing discussions, suggests leverage points for public health system change, and furthers the examination of applications for systems thinking relative to public health finance, practice, and policy.

  6. 'Your experiences were your tools'. How personal experience of mental health problems informs mental health nursing practice.

    PubMed

    Oates, J; Drey, N; Jones, J

    2017-09-01

    WHAT IS KNOWN ON THE SUBJECT?: 'Expertise by experience' has become an increasingly valued element of service design and delivery by mental health service providers. The extent and influence of mental health professionals' personal experience of mental ill health on clinical practice has seldom been interrogated in depth. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We investigate how mental health nurses' own personal experience of mental ill health informs their mental health nursing practice with particular reference to direct work with service users. Participants said that personal experience could impact on work in three positive ways: to develop their relationship with service users, to enhance their understanding of service users and as a motivation for potential mental health nurses to join the profession. This study moves the discussion of the state of mental health nurses' mental health further towards the recovery and well-being focus of contemporary mental health care, where 'expertise by experience' is highly valued. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: We must address the taboo of disclosure within clinical nursing practice and debate the extent to which personal and professional boundaries are negotiated during clinical encounters. Introduction 'Expertise by experience' is a highly valued element of service delivery in recovery-oriented mental health care, but is unacknowledged within the mental health nursing literature. Aim To explore the extent and influence of mental health professionals' personal experience of mental ill health on clinical practice. Method Twenty-seven mental health nurses with their own personal experience of mental ill health were interviewed about how their personal experience informed their mental health nursing practice, as part of a sequential mixed methods study. Results The influence of personal experience in nursing work was threefold: first, through overt disclosure; second, through the 'use of the self as a tool

  7. Principled leadership in public health: integrating ethics into practice and management.

    PubMed

    Bernheim, Ruth Gaare; Melnick, Alan

    2008-01-01

    Public health officials frequently face ethical tensions and conflicting obligations when making decisions and managing health departments. Leadership requires an ongoing approach to ethics that focuses on two dimensions of practice: the professional relationships of officials developed over time with their communities and the ethical aspects of day-to-day public health activities. Education and competencies in ethics may be helpful in practice, by providing, at a minimum, frameworks and ethical principles to help structure analysis, discussion, and decision making in health departments and with community stakeholders. Such a "practical ethics" approach in public health practice begins with a focus on public health values and an agency mission statement and integrates ethics throughout the organization by, for example, setting performance measures based on them. Using a case in emergency preparedness, this article describes ways in which ethical frameworks and the Code of Ethics can be used as tools for education and to integrate ethics into agency activities and programs.

  8. Learning practice: a new model of health visitor intervention to drive outcomes.

    PubMed

    Ebeid, Ann

    2012-03-01

    Although there is a body of literature related to how hospital nurses develop skill, judgement or expertise there is little empirical work that focuses on understanding and developing health visiting expertise. The aims of this paper are: to identify a typology of health visitor skills, knowledge and cognition in use and the nature of health visitor expertise; to present an expert model of practice as a practice learning tool; to locate this model in context of my 2007 empirical research. This explored the problems of families and children in need and how they were supported by health visitors. This new practice model is timely in view of the need to train more health visitors, educators and practice facilitators as set out in the Health Visitor Implementation Plan.

  9. Collaboration: integrating practice and research in public health nursing.

    PubMed

    Henry, V; Schmitz, K; Reif, L; Rudie, P

    1992-12-01

    The need to integrate clinical practice and research has been stressed for many years in both public health and nursing. This article describes such a collaborative project between two rural upper Midwest public health nursing agencies and public health nursing faculty from a small, liberal arts, baccalaureate nursing program. The high-risk prenatal research project provided an opportunity for nursing staff and faculty research consultants to work together on a clinical study. A model for collaborative research is illustrated, and advantages and disadvantages for practice, administration, and research are discussed.

  10. Values-based practice in mental health and psychiatry.

    PubMed

    Woodbridge-Dodd, Kim

    2012-11-01

    Values-based practice (VBP) challenges traditions of clinical practice and moral decision-making and the literature published over the last 18 months demonstrates a growing momentum for its use. The VBP model has become part of the narrative of health and social care practice. It features in a range of publications and has been subject to philosophical analysis in relation to its theoretical rigour, and applied to clinical practice through education and training, implementation in the field and policy development. From a philosophical perspective the model faces several challenges; from a practice perspective it is welcomed as a necessary partner to Evidence-Based Practice. Both perspectives suggest VBP requires significant adjustment to professional ideas of good practice, expectations of the clinician service user relationship and notions of what constitutes good care. VBP is both a solution and a problem for clinicians. Whether VBP is seen as providing a much needed clinical skill for working with the complexity of mental health and psychiatry which is steeped in values or a solution to a dominant sociopolitical neoliberal ideology demand for choice and personalization of care, VBP will require clinicians to make personal changes to their values base that reach to the depths of their professional identity.

  11. Further evidence for lack of negative associations between hormonal contraception and mental health.

    PubMed

    Toffol, Elena; Heikinheimo, Oskari; Koponen, Päivikki; Luoto, Riitta; Partonen, Timo

    2012-11-01

    There is limited and inconsistent information concerning the effects of hormonal contraception [oral contraceptives (OCs) and the levonorgestrel-releasing intrauterine system (LNG-IUS)] on mental health. The aim of this work was to further study the association(s) between the use of OCs and the LNG-IUS and psychopathology. Data concerning adult women who participated in the national FINRISK Study Surveys in Finland in 1997, 2002 and 2007 were analyzed. The associations between the current use, as well as the duration of use of OCs and the LNG-IUS vs. mood symptoms, psychological and physical symptoms and recent psychiatric diagnoses were tested. A negative association between the current use of OCs and Beck Depression Inventory-13 (BDI-13) score was found. Some other negative associations, all characterized by a small effect size, were detected between current use of OCs and the BDI items feelings of dissatisfaction, feelings of uselessness, irritability, lost interest in people and lost appetite. Additionally, only weak positive associations were found between the duration of OC use and irregular heart rate, insomnia and recent anhedonia. No noteworthy associations emerged between current use of the LNG-IUS, or its duration, and any of the inquired items. The use of hormonal contraception is not associated with negative influence on mental health. Current OC use seems to be associated with better mood, whereas the associations between duration of use of hormonal contraception and mental health effects are not clear. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Cross-sectional analysis of health-related quality of life and elements of yoga practice.

    PubMed

    Birdee, Gurjeet S; Ayala, Sujata G; Wallston, Kenneth A

    2017-01-31

    Mind-body practices such as yoga have been studied for their generally positive effects on health-related quality of life (HRQOL). The association between how a person practices yoga and the person's HRQOL is not known. Yoga practitioners were sent invitations to participate in an online survey via email. Yoga characteristics, HRQOL, and other sociodemographics were collected. Analyses of data from 309 consenting responders evaluated associations between yoga practice characteristics (use of yoga tools, length of practice, location, method, etc.) and the 10-item PROMIS Global Health scale for both physical and mental health components. Multivariable regression models demonstrated higher mental health scores were associated with regular meditation practice, higher income, and the method of practicing in a community group class (versus one-on-one). Higher physical health scores were associated with length of lifetime practice, teacher status, Krishnamacharya yoga style, and practicing in a yoga school/studio (versus at home). Meditation practice in yoga is positively associated with mental health. Length of lifetime yoga practice was significantly associated with better physical health, suggesting yoga has a potential cumulative benefit over time. Different locations and methods of practice may be associated with varying effects on health outcomes. Comparative cross-sectional and longitudinal studies on the variations in yoga practice are needed to further characterize health benefits of yoga.

  13. Electric-dipole-coupled H2O@C60 dimer: Translation-rotation eigenstates from twelve-dimensional quantum calculations.

    PubMed

    Felker, Peter M; Bačić, Zlatko

    2017-02-28

    We report on variational solutions to the twelve-dimensional (12D) Schrödinger equation appertaining to the translation-rotation (TR) eigenstates of H 2 O@C 60 dimer, associated with the quantized "rattling" motions of the two encapsulated H 2 O molecules. Both H 2 O and C 60 moieties are treated as rigid and the cage-cage geometry is taken to be fixed. We consider the TR eigenstates of H 2 O@C 60 monomers in the dimer to be coupled by the electric dipole-dipole interaction between water moieties and develop expressions for computing the matrix elements of that interaction in a dimer basis composed of products of monomer 6D TR eigenstates reported by us recently [P. M. Felker and Z. Bačić, J. Chem. Phys. 144, 201101 (2016)]. We use these expressions to compute TR Hamiltonian matrices of H 2 O@C 60 dimer for two values of the water dipole moment and for various dimer geometries. 12D TR eigenstates of the dimer are then obtained by filter diagonalization. The results reveal two classes of eigenstates, distinguished by the leading order (first or second) at which dipole-dipole coupling contributes to them. The two types of eigenstates differ in the general magnitude of their dipole-induced energy shifts and in the dependence of those shifts on the value of the water dipole moment and on the distance between the H 2 O@C 60 monomers. The dimer results are also found to be markedly insensitive to any change in the orientations of the C 60 cages. Finally, the results lend some support for the interpretation that electric dipole-dipole coupling is at least partially responsible for the apparent reduced-symmetry environment experienced by H 2 O in the powder samples of H 2 O@C 60 [K. S. K. Goh et al., Phys. Chem. Chem. Phys. 16, 21330 (2014)], but only if the water dipole is taken to have a magnitude close to that of free water. The methodology developed in the paper is transferable directly to the calculation of TR eigenstates of larger H 2 O@C 60 assemblies, that will

  14. 78 FR 52562 - Outer Continental Shelf (OCS), Gulf of Mexico (GOM), Oil and Gas Lease Sales, Central Planning...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-23

    ... Prepare a Supplemental Environmental Impact Statement (EIS). SUMMARY: Consistent with the regulations... Supplemental EIS will update the environmental and socioeconomic analyses in the Gulf of Mexico OCS Oil and Gas... Area Lease Sales 227, 231, 235, 241, and 247, Final Environmental Impact Statement (OCS EIS/EA BOEM...

  15. 76 FR 4716 - Commercial Leasing for Wind Power on the Outer Continental Shelf (OCS) Off Delaware, Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... No. BOEM-2010-0075] Commercial Leasing for Wind Power on the Outer Continental Shelf (OCS) Off... commercial wind development on the OCS off Delaware and requests submission of indications of competitive... received two nominations of proposed lease areas: One from Bluewater Wind Delaware LLC (Bluewater) and...

  16. Possible ways for Public Health Surveillance practices evaluation.

    PubMed

    Vilela, Maria Filomena de Gouveia; Santos, Dario Nunes Dos; Kemp, Brigina

    2017-10-01

    This is an evaluative and qualitative study that proposes to investigate self-assessment evaluation as a device to analyze Health Surveillance practices through a questionnaire built by researchers, adapted from the Self-Assessment of Improved Access and Primary Care Quality (AMAQ) and available on the FORMSUS platform. Forty-one Health Surveillance workers and managers of a large municipality from São Paulo State evaluated the realms of "management", "teamwork" and their respective sub-realms. Two categories were created to analyze the results: "Management" and "Team" in dialogue with references from Management, Evaluation and Health Surveillance. Most "management" and "teamwork" sub-realms were deemed satisfactory. Self-assessment evaluation through an applied evaluation tool was shown to be a powerful resource for the analysis of Health Surveillance practices in combination with other devices adopted by the Unified Health System (SUS). Unlike usual evaluation processes guided by quantitative markers, this self-assessable evaluative process included subjects and enabled the possibility of incorporating a new look at itself to the way Health Surveillance is carried out and support future management contracts between workers and managers.

  17. Training for Collaboration: Collaborative Practice Skills for Mental Health Professionals

    ERIC Educational Resources Information Center

    Bischoff, Richard J.; Springer, Paul R.; Reisbig, Allison M. J.; Lyons, Sheena; Likcani, Adriatik

    2012-01-01

    The purpose of the study was to identify skills that mental health practitioners need for successful collaborative practice in medical settings. Known experts in the field of collaborative health care completed a survey designed to elicit their suggestions about what is needed for successful collaborative care practice. Through qualitative…

  18. 12. "SITE PLAN." Test Area 1100. Specifications No. OC35973; Drawing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. "SITE PLAN." Test Area 1-100. Specifications No. OC359-73; Drawing No. 5841-C-1; D.O. SERIES AW1525/7 Rev. A. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Leuhman Ridge near Highways 58 & 395, Boron, Kern County, CA

  19. ETV VR/VS SUNSET LABORATORY MODEL 4 OC-EC FIELD ANALYZER

    EPA Science Inventory

    This is a verification report statement that describes the verification test which was conducted over a period of approximately 30 days (April 5 to May 7, 2013) and involved the continuous operation of duplicate Model 4 OC-EC analyzers at the Battelle Columbus Operations Special ...

  20. [The practical measurement of health literacy in Hungary and in international comparison].

    PubMed

    Koltai, Júlia; Kun, Eszter

    2016-12-01

    The study presents results of an innovative measurement of practical health literacy in international context. To show the level of practical health literacy in the Hungarian society and in international comparison. We measured practical health literacy with Newest Vital Sign test on a Hungarian national representative sample, asked from 1008 persons, between May and June, 2015 from population 16 years or older, using methodological standards of Eurobarometer. The sample is representative to the above mentioned population by gender, age, region and settlement-size. Based on Newest Vital Sign test, members of the Hungarian society have good practical health literacy. The accomplishment is inconsistent with self-reported health literacy, since it shows weak results. As low level of self-reported health literacy implies that respondents don't have daily routine in practicing their skills, we could draw people's attention to food-information, that are important and show, how to utilize them. Orv. Hetil., 2016, 157(50), 2002-2006.

  1. Health promoting leadership practices in four Norwegian industries.

    PubMed

    Skarholt, Kari; Blix, Elisabeth H; Sandsund, Mariann; Andersen, Thale K

    2016-12-01

    The aim of this article is to address health promoting leadership; what do leaders actually do to promote health at work? Leadership practice plays a crucial role in the workplace and greatly affects the working environment and working conditions. Through a theoretical and empirical approach, we seek to find characteristics/patterns of health promoting leadership. The definition of health promoting leadership is a democratic and supportive leadership style, where leaders seek to motivate and inspire their employees. The study in this article is based on qualitative research methods. We have investigated and compared leadership practice in four different organizations/industries in Norway: construction, oil and gas, health care and cleaning. These organizations and professions are quite different, and thus leadership must be understood and developed within its context. However, we found some generic characteristics of health promoting leadership: hands-on, accessible, supportive, inclusive and democratic. Current literature only rarely addresses how leadership affects health promotion at work. Consequently, more knowledge is needed about how leaders really succeed in creating healthy workplaces and healthy employees. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. 76 FR 40725 - Approval of Outer Continental Shelf (OCS) Permit Issued to Cape Wind Associates, LLC (EPA Permit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... Cape Wind Associates, LLC (Cape Wind). The OCS permit, which was issued pursuant to regulations, authorizes Cape Wind to construct and operate an offshore renewable wind energy project in federal waters off... Issued to Cape Wind Associates, LLC (EPA Permit Number OCS-R1-01) AGENCY: Environmental Protection Agency...

  3. Enveloped Lives: Practicing Health and Care in Lithuania.

    PubMed

    Praspaliauskiene, Rima

    2016-12-01

    This article analyzes informal medical payments that the majority of Lithuanians give or feel compelled to give to doctors before or after treatment. It focuses on how patients and their caretakers encounter, practice, and enact informal payments in health care and how these payments create a reality of health care that is not limited to an economic rationality. Within such a frame, rather than being considered a gift or bribe, it conceptualizes these little white envelopes as a practice of health and care. The article shows how an envelope of money given to a doctor transcends the material patient-doctor transaction and emerges as a productive force for coping with illness, medical encounters, and misfortunes. © 2016 by the American Anthropological Association.

  4. Integrative Mental Health (IMH): paradigm, research, and clinical practice.

    PubMed

    Lake, James; Helgason, Chanel; Sarris, Jerome

    2012-01-01

    This paper provides an overview of the rapidly evolving paradigm of "Integrative Mental Health (IMH)." The paradigm of contemporary biomedical psychiatry and its contrast to non-allopathic systems of medicine is initially reviewed, followed by an exploration of the emerging paradigm of IMH, which aims to reconcile the bio-psycho-socio-spiritual model with evidence-based methods from traditional healing practices. IMH is rapidly transforming conventional understandings of mental illness and has significant positive implications for the day-to-day practice of mental health care. IMH incorporates mainstream interventions such as pharmacologic treatments, psychotherapy, and psychosocial interventions, as well as alternative therapies such as acupuncture, herbal and nutritional medicine, dietary modification, meditation, etc. Two recent international conferences in Europe and the United States show that interest in integrative mental health care is growing rapidly. In response, the International Network of Integrative Mental Health (INIMH: www.INIMH.org) was established in 2010 with the objective of creating an international network of clinicians, researchers, and public health advocates to advance a global agenda for research, education, and clinical practice of evidence-based integrative mental health care. The paper concludes with a discussion of emerging opportunities for research in IMH, and an exploration of potential clinical applications of integrative mental health care. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Knowledge and experience sharing practices among health professionals in hospitals under the Addis Ababa health bureau, Ethiopia.

    PubMed

    Asemahagn, Mulusew Andualem

    2014-09-24

    Health professionals need updated health information from credible sources to improve their knowledge and provide evidence based health care services. Various types of medical errors have occurred in resource-limited countries because of poor knowledge and experience sharing practices among health professionals. The aim of this study was to assess knowledge-sharing practices and determinants among health professionals in Addis Ababa, Ethiopia. An institutional based cross-sectional study was conducted among 320 randomly selected health professionals from August12-25/2012. A pretested, self-administered questionnaire was used to collect data about different variables. Data entry and analysis were done using Epi-Info version 3.5.4 and SPSS version20 respectively. Descriptive statistics and multivariate regression analyses were applied to describe study objectives and identify the determinants of knowledge sharing practices respectively. Odds ratio at 95% CI was used to describe the strength of association between the study and outcome variables. Most of the respondents approved the need of knowledge and experience sharing practices in their routine activities. Nearly half, 152 (49.0%) of the study participants had knowledge and experience sharing practices. A majority, 219 (70.0%) of the respondents showed a willingness to share their knowledge and experiences. Trust on others' knowledge, motivation, supportive leadership, job satisfaction, awareness, willingness and resource allocation are the determinants of knowledge and experience sharing practices. Supportive leadership, resources, and trust on others' knowledge can enhance knowledge and experience sharing by OR = 3.12, 95% CI = [1.89 - 5.78], OR = 2.3, 95% CI = [1.61- 4.21] and OR = 2.78, 95% CI = [1.66 - 4.64] times compared with their counterparts respectively. Even though most of the respondents knew the importance of knowledge and experience sharing practices, only a limited number

  6. Health cyberinfrastructure for collaborative use-inspired research and practice.

    PubMed

    Chismar, William; Horan, Thomas A; Hesse, Bradford W; Feldman, Sue S; Shaikh, Abdul R

    2011-05-01

    Rapid advances in information and networking technologies have greatly expanded the modes for conducting business and science. For the past two decades, the National Science Foundation (NSF) has been supporting efforts to develop a comprehensive cyberinfrastructure with the goal of transforming the nature of scientific investigations. More recently, the NIH began supporting efforts to develop a cyberinfrastructure of healthcare research and practice. However, the best structure and applications of cyberinfrastructure in health care have yet to be defined. To address these issues, the NIH and the Kay Center for E-Health Research at Claremont Graduate University sponsored a symposium on "Cyberinfrastructure for Public Health and Health Services: Research and Funding Directions." The symposium convened researchers, practitioners, and federal funders to discuss how to further cyberinfrastructure systems and research in the public health and health services sectors. This paper synthesizes findings of the symposium, the goals of which were to determine the dynamics necessary for executing and utilizing cyberinfrastructure in public health and health services; examine the requirements of transdisciplinary collaboration; and identify future research directions. A multi-faceted conception of use-inspired research for cyberinfrastructure is developed. Use-inspired research aims to further basic theory but is grounded, inspired, and informed by practical problems. A cyberinfrastructure framework is presented that incorporates three intersecting dimensions: research-practice, health services-public health, and social-technical dimensions. Within this framework, this paper discusses the ways in which cyberinfrastructure provides opportunities to integrate across these dimensions to develop research and actions that can improve both clinical outcomes and public health. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.

  7. Defining sustainable practice in community-based health promotion: a Delphi study of practitioner perspectives.

    PubMed

    Harris, Neil; Sandor, Maria

    2013-04-01

    Sustainability of practice must be a central imperative in the practice of community-based health promotion to achieve population health and attract a greater share of public health spending. Although there has been some consideration of sustainability at the project or program levels, often understood as intervention longevity, very limited attention has been given to understanding sustainable practice. The present study develops a definition and features of sustainable practice in community-based health promotion through a Delphi method with health promotion practitioners in Queensland, Australia. The study presents a consensus definition and features of sustainable practice. The definition highlights the importance of collaboration, health determinants and aspirations, processes and outcomes. The four features of sustainable practice identified in the study are: (1) effective relationships and partnerships; (2) evidence-based decision making and practice; (3) emphasis on building community capacity; and (4) supportive context for practice. The definition and features are, to a large extent, consistent with the limited literature around sustainability at the project and program levels of health promotion. Together, they provide insight into a form of community-based health promotion that will be both viable and productive. So what? This consensus understanding of sustainable practice articulates the foundations of working effectively with local communities in achieving improved population health within global limits.

  8. Alternative health practices in ethnically diverse rural areas: a collaborative research project.

    PubMed

    Vest, G W; Ronnau, J; Lopez, B R; Gonzales, G

    1997-05-01

    Many alternative health practices are gaining popularity in traditional medical centers throughout the country. However, social workers and allied health professionals are rarely educated in these practices. The collaborative pilot research project discussed in this article involved community health providers and a state university department of social work. The project, conducted in rural health clinics, introduced an approach to skillful, safe, and appropriate use of touch synthesized with an awareness of the breath for giver and receiver to a group of Mexican Americans diagnosed with diabetes and their families. This alternative health practice holds promise for reducing stress, promoting health and well-being, and building relationships and warrants further study.

  9. Identification of Pediatric Oral Health Core Competencies through Interprofessional Education and Practice.

    PubMed

    Hallas, D; Fernandez, J B; Herman, N G; Moursi, A

    2015-01-01

    Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD) and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP) program at New York University College of Nursing (NYUCN) have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice.

  10. Important interactional strategies for everyday public health nursing practice.

    PubMed

    Porr, Caroline J

    2015-01-01

    This Clinical Concepts article concerns the relational tools required by public health nurses to establish relationships with single mothers living on public assistance, mothers who are vulnerable and often stigmatized. The implications of stigmatization for relationship building are highlighted based on previous research investigating how public health nurses working in Canadian jurisdictions establish professional caring relationships with this cohort of mothers. Public health nurses employed interactional strategies including engaging in a positive manner and offering verbal commendations which served as effective relational tools to break through mothers' walls of defensiveness and to resume the dynamic process of relationship building. Building Relationship is a key practice standard for public health nurses and is instrumental to their work at both individual and community levels to improve social determinants of health. The author concludes with recommendations to facilitate building relationships during everyday public health nursing practice. © 2013 Wiley Periodicals, Inc.

  11. Child obesity prevention in primary health care: investigating practice nurse roles, attitudes and current practices.

    PubMed

    Robinson, Alison; Denney-Wilson, Elizabeth; Laws, Rachel; Harris, Mark

    2013-04-01

    Overweight and obesity affects approximately 20% of Australian pre-schoolers. The general practice nurse (PN) workforce has increased in recent years; however, little is known of PN capacity and potential to provide routine advice for the prevention of child obesity. This mixed methods pilot study aims to explore the current practices, attitudes, confidence and training needs of Australian PNs surrounding child obesity prevention in the general practice setting. PNs from three Divisions of General Practice in New South Wales were invited to complete a questionnaire investigating PN roles, attitudes and practices in preventive care with a focus on child obesity. A total of 59 questionnaires were returned (response rate 22%). Semi-structured qualitative interviews were also conducted with a subsample of PNs (n = 10). Questionnaire respondent demographics were similar to that of national PN data. PNs described preventive work as enjoyable despite some perceived barriers including lack of confidence. Number of years working in general practice did not appear to strongly influence nurses' perceived barriers. Seventy per cent of PNs were interested in being more involved in conducting child health checks in practice, and 85% expressed an interest in taking part in child obesity prevention training. Findings from this pilot study suggest that PNs are interested in prevention of child obesity despite barriers to practice and low confidence levels. More research is needed to determine the effect of training on PN confidence and behaviours in providing routine healthy life-style messages for the prevention of child obesity. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  12. Visual methods in health dialogues: A qualitative study of public health nurse practice in schools.

    PubMed

    Laholt, Hilde; Guillemin, Marilys; Mcleod, Kim; Olsen, Randi Elisabeth; Lorem, Geir Fagerjord

    2017-12-01

    We aimed to explore how using visual methods might improve or complicate the dynamics of the health dialogue between public health nurses (PHNs) and school pupils. This was done from the perspective of PHNs, specifically examining how they understood their role and practice as a PHN and the application of visual methods in this practice. The health dialogue is a method used by PHNs in school nursing in Norway. In this practice, there can be communicative barriers between pupils and PHNs. Investigating how PHNs understand their professional practice can lead to ways of addressing these communicative barriers, which can affect pupil satisfaction and achievement of health-related behaviours in the school context. Specifically, the use of visual methods by PHNs may address these communicative barriers. The research design was qualitative, using focus groups combined with visual methods. We conducted focus group interviews using a semi-structured discussion guide and visual methods with five groups of PHNs (n = 31) working in northern Norwegian school health services. The data were collected during January and February 2016. Discussions were audio recorded, transcribed and coded into themes and sub-themes using systematic text condensation and drawings were analysed using interpretive engagement, a method of visual analysis. Drawings and focus group discussions showed that PHNs perceived their professional practice as primarily a relational praxis. The PHNs used a variety of visual methods as part of the health dialogue with school pupils. This active use of visualization worked to build and strengthen relations when words were inadequate and served to enhance the flexible and relational practice employed by the PHNs. PHNs used different kinds of visualization methods to establish relations with school pupils, especially when verbalization by the pupils was difficult. PHNs were aware of both the benefits and challenges of using visualization with school pupils in

  13. The advent of mental health nurses in Australian general practice.

    PubMed

    Olasoji, Michael; Maude, Phil

    2010-01-01

    The remarkable progress that has been witnessed in the physical and material wellbeing for most Australians over the 20th century has not been paralleled by gains in the mental and subjective wellbeing of the population. General practice plays a strategic role in Australia's primary health care, which has been recognised as an essential health system that is able to deliver health to the population in a timely and equitable manner (World Health Organisation [WHO], 2008). General Practitioners are unable to provide adequate care to people experiencing a severe mental illness without support from specialist mental health professional such as a mental health nurse in the practice. The mental health nurse incentive program (MHNIP) offers opportunity for mental health nurses to work collaboratively with GPs in primary health care in the delivery of care to people with a severe mental illness.

  14. 30 CFR 281.12 - Request for OCS mineral information and interest.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false Request for OCS mineral information and interest. 281.12 Section 281.12 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION, AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF MINERALS OTHER THAN OIL, GAS, AND SULPHUR IN THE...

  15. 30 CFR 581.12 - Request for OCS mineral information and interest.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false Request for OCS mineral information and interest. 581.12 Section 581.12 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF MINERALS OTHER THAN OIL, GAS, AND SULPHUR IN THE OUTER CONTINENTAL SHELF...

  16. 30 CFR 581.12 - Request for OCS mineral information and interest.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false Request for OCS mineral information and interest. 581.12 Section 581.12 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF MINERALS OTHER THAN OIL, GAS, AND SULPHUR IN THE OUTER CONTINENTAL SHELF...

  17. 30 CFR 581.12 - Request for OCS mineral information and interest.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false Request for OCS mineral information and interest. 581.12 Section 581.12 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF MINERALS OTHER THAN OIL, GAS, AND SULPHUR IN THE OUTER CONTINENTAL SHELF...

  18. Baby walkers--health visitors' current practice, attitudes and knowledge.

    PubMed

    Kendrick, Denise; Illingworth, Rachel; Hapgood, Rhydian; Woods, Amanda J; Collier, Jacqueline

    2003-09-01

    Baby walkers are a commonly used item of nursery equipment. Between 12% and 50% of parents whose infant uses a walker report that their child has suffered a walker-related injury. Health visitors' knowledge, attitudes and practice with regard to walkers and related health education has not been explored so far. The aim of the study was to describe health visitors' knowledge of walkers and walker-related injuries, their attitudes towards walkers and current practice with regard to walker health education, and to examine the relationship between knowledge and attitudes and knowledge and practice. A survey was carried out with 64 health visitors prior to participation in a randomized controlled trial assessing the effectiveness of an educational package in reducing baby walker use. The response rate was 95%. Half of the health visitors always discussed walkers postnatally, most frequently at the 6-9 month check. Most did not usually discuss the frequency of walker-related injuries. Most had negative attitudes towards walkers, but believed that parents hold positive attitudes to them and that it is hard to persuade parents not to use them. Health visitors had a limited knowledge of walker use and walker-related injuries. Those giving advice on walkers most often had higher knowledge scores than those giving advice less often (P = 0.03). Those with higher knowledge scores held more negative attitudes towards walkers (rs = 0.29, P = 0.023) and believed parents to have more positive attitudes towards walkers (rs = -0.49, P < 0.001). Few health visitors had resources to discuss walkers. Health visitor advice regarding walkers needs to be given earlier in the postnatal period than is currently common practice, and they need more knowledge about walker use and related injuries. Education about baby walkers needs to be incorporated into undergraduate and in-service education, which may need to include the development of skills in exploring reasons why parents use walkers and

  19. Nurses' performance on indigenous and African-Brazilian health care practices.

    PubMed

    Lima, Maria do Rosário de Araújo; Nunes, Maria Luísa de Almeida; Klüppel, Berta Lúcia Pinheiro; Medeiros, Soraya Maria de; Sá, Lenilde Duarte de

    2016-01-01

    to analyze the performance of nurses from the Estratégia Saúde da Família (Family Health Strategy) on health care practices rooted in African and Indigenous cultures. Thematic Oral History was used and interviews were conducted with seven participants, who worked with Primary Health Care in Northeastern Brazil. The analysis was based on Leininger's Theory of Cultural Care and the intercultural concept of human rights, among others. nurses are unaware of the religious and historical context of the ethnic groups cared for and do not appreciate their self-care practices in areas with a predominance of African and indigenous cultures. These practices coexist with the hegemonic biomedical model. the debate on cultural competence in the context of professional qualification and exercise is required, aiming to promote the nursing work in the perspective of diversity and comprehensiveness of health care.

  20. Mentoring for population health in general practice divisions.

    PubMed

    Moss, John R; Mickan, Sharon M; Fuller, Jeffrey D; Procter, Nicholas G; Waters, Barb A; O'Rourke, Peter K

    2006-02-01

    This paper describes the implementation and evaluation of a three-way model of service development mentoring. This population health mentoring program was funded by the Commonwealth Department of Health and Ageing to enable staff from eight Divisions of General Practice in South Australia to gain a sound understanding of population health concepts relevant to their workplace. The distinguishing features of service development mentoring were that the learning was grounded within an individual's work setting and experience; there was an identified population health problem or issue confronting the Division of General Practice; and there was an expectation of enhanced organisational performance. A formal evaluation found a consensus among all learners that mentoring was a positive and worthwhile experience, where they had achieved what they had set out to do. Mentors found the model of learning agreeable and effective. Division executive officers recognised enhanced skills among their "learner" colleagues, and commented positively on the benefits to their organisations through the development of well researched and relevant projects, with the potential to improve the efficiency of their population health activities.

  1. Rapid tranquilization: An audit of Irish mental health nursing practice.

    PubMed

    Nash, Michael; McDonagh, Caitriona; Culhane, Aisling; Noone, Imelda; Higgins, Agnes

    2018-02-12

    Rapid tranquillization is a pharmacological intervention sometimes employed in mental health care for the management of acute behavioural disturbance. It is a form of restrictive practice, which, along with seclusion and restraint, is a conventional and controversial intervention in the therapeutic management of risk in mental health settings. This study surveyed mental health nurses practice in rapid tranquillization. A self-report questionnaire was utilized which addressed aspects such as definitions of rapid tranquillization, presence of rapid tranquillization policy, types of incidents where it is used and postintervention monitoring. The results demonstrate that rapid tranquillization is an intervention used in the management of acute behavioural disturbance in various mental health settings in Ireland. Respondents showed a basic understanding of rapid tranquillization as an intervention; however, some areas reported not having a specific rapid tranquillization policy. There was some evidence of a variation in postrapid tranquillization monitoring of psychiatric/mental health and physical health. Service user debriefing following rapid tranquillization was reported to be common; however, the content of this was not elaborated on. In the light of variations in practice, specific training and the development of rapid tranquillization policies are recommended. © 2018 Australian College of Mental Health Nurses Inc.

  2. The proper contributions of social workers in health practice.

    PubMed

    Huntington, J

    1986-01-01

    Current and potential future contributions of social workers to health practice are considered at the three levels of direct service to patients, influence on the processes and procedures of the health setting and influence on its future planning and service development. The capacity of U.S.A. and U.K. social work to contribute at these levels is compared in the light of their contrasting relationships to the health system. U.S.A. social work in health care is practised as employees of the health setting or as private practitioners and contains the majority of U.S.A. social workers. It remains a specialism that sustains a major body of published work, commitment to knowledge-building, standard setting and performance review, and a psycho-social orientation shared by a growing number of medical and nursing professionals. Its approach to the health system is that of the pursuit of professional credibility in the secondary setting by adopting the professional-technical practice model of the clinician. U.K. social work since the early 1970s has been committed to generic education and practice and to the development of its own primary setting in social services departments which now employ almost all U.K. social workers. Area team social work in these departments, typified by statutory work with the most deprived sections of the population, has become the dominant culture of British social work, with implications for the occupational identity and career prospects of those social workers who are outposted or attached to health settings but no longer employed by them. British social work and its management now approach the health system from a position of organizational independence which should strengthen their capacity to influence the health system. The cultural differences between social work and medicine, however, are experienced more keenly than ever as many social workers adopt a socio-political practice model that is at odds with the professional-technical model

  3. Vietnamese Oral Health Beliefs and Practices: Impact on the Utilization of Western Preventive Oral Health Care.

    PubMed

    Nguyen, Kim Yen T; Smallidge, Dianne L; Boyd, Linda D; Rainchuso, Lori

    2017-02-01

    Purpose: Infrequent use of the Western health care by the Vietnamese may be explained by deeply-rooted traditional oral health beliefs and practices unique to the Asian culture. This study investigated Vietnamese oral health beliefs and practices and their relationship to the utilization of Western preventive oral health care services among Vietnamese-Americans. Methods: An exploratory, cross-sectional survey design with a convenience sample of 140 par-ticipants (n = 140) was used for this study. Participants were recruited on site of a Vietnamese-owned business, with questionnaires consisting of 28 questions that were distributed in hard copy by the principal investigator (PI) on multiple occasions and at various times of the day. Results: Spearman Rank Correlations tests showed participants who agreed with the statement, "Regular dental visits will help prevent dental problems," were more likely to utilize medical health services (p< 0.05) and visit a dentist if their "gums were bleeding" (p< 0.05). However, only 22.86% of the participants would visit a dentist if experiencing a toothache. Despite results showing a strong association between the use of medical health care services and the belief that dental visits can prevent future dental health problems, participants did not believe in seeking Western oral health care for all dental health issues. No statistical significance was found between age, gender, pri-mary language, years spent in the United States, education level, religion and the Vietnamese survey participants' individual oral beliefs and practices. Conclusion: The results suggest that Vietnamese Americans holding the belief that dental visits help prevent oral health problems, were more likely to utilize Western health care services. The study also supports existing literature that Vietnamese oral health beliefs and practices impact the use of Western health care services. Copyright © 2017 The American Dental Hygienists’ Association.

  4. Uncertainty Analysis of OC5-DeepCwind Floating Semisubmersible Offshore Wind Test Campaign: Preprint

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Robertson, Amy N

    This paper examines how to assess the uncertainty levels for test measurements of the Offshore Code Comparison, Continued, with Correlation (OC5)-DeepCwind floating offshore wind system, examined within the OC5 project. The goal of the OC5 project was to validate the accuracy of ultimate and fatigue load estimates from a numerical model of the floating semisubmersible using data measured during scaled tank testing of the system under wind and wave loading. The examination of uncertainty was done after the test, and it was found that the limited amount of data available did not allow for an acceptable uncertainty assessment. Therefore, thismore » paper instead qualitatively examines the sources of uncertainty associated with this test to start a discussion of how to assess uncertainty for these types of experiments and to summarize what should be done during future testing to acquire the information needed for a proper uncertainty assessment. Foremost, future validation campaigns should initiate numerical modeling before testing to guide the test campaign, which should include a rigorous assessment of uncertainty, and perform validation during testing to ensure that the tests address all of the validation needs.« less

  5. High-efficiency silicon solar-cell design and practical barriers

    NASA Technical Reports Server (NTRS)

    Mokashi, A.

    1985-01-01

    A numerical evaluation technique is used to study the impact of practical barriers, such as heavy doping effects (Auger recombination, band gap narrowing), surface recombination, shadowing losses and minority-carrier lifetime (Tau), on a high efficiency silicon solar cell performance. Considering a high Tau of 1 ms, efficiency of a silicon solar cell of the hypothetical case is estimated to be around 29%. This is comparable with (detailed balance limit) maximum efficiency of a p-n junction solar cell of 30%. Value of Tau is varied from 1 second to 20 micro. Heavy doping effects, and realizable values of surface recombination velocities and shadowing, are then considered in succession and their influence on cell efficiency is evaluated and quantified. These practical barriers cause the cell efficiency to reduce from the maximum value of 29% to the experimentally achieved value of about 19%. Improvement in open circuit voltage V sub oc is required to achieve cell efficiency greater than 20%. Increased value of Tau reduces reverse saturation current and, hence, improves V sub oc. Control of surface recombination losses becomes critical at higher V sub oc. Substantial improvement in Tau and considerable reduction in surface recombination velocities is essential to achieve cell efficiencies greater than 20%.

  6. Interdisciplinary collaboration: what private practice can learn from the health center experience.

    PubMed

    Hilton, Irene V

    2014-01-01

    Ideas on what medical-dental integration can look like on a practical level can be gained from studying efforts made in Federally Qualified Health Centers (Health Centers). Over the last 15 years, Health Centers have embarked on several initiatives that incorporated the development of infrastructure for medical-dental integration. This paper reviews these efforts and highlights successes, challenges and best practices that can bolster efforts in all dental practice settings.

  7. Alaska OCS socioeconomic studies program. Technical report number 44. Lower Cook Inlet petroleum development scenarios: commercial fishing industry analysis. Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Terry, J.M.; Scoles, R.G.; Larson, D.M.

    1980-07-01

    The objectives of the report are to increase the understanding of the potential relationships between the commercial fishing and Outer Continental Shelf (OCS) petroleum industries and to project the potential impacts on the commercial fishing industry of Cook Inlet and Shelikof Strait that may occur as a result of the proposed OCS Lease Sale Number 60. To meet this objective, the report consists of: (1) the documentation and examination of the history and current trends of the Cook Inlet and Shelikof Strait commercial fishing industry as necessary to develop a basis for projecting fishery development and potential interactions with themore » OCS petroleum industry, (2) the development of models used to forecast the level of commercial fishing industry activity through the year 2000 in the absence of OCS development pursuant to Lease Sale Number 60, and (3) an analysis of the potential impacts of Lease Sale Number 60 based on the hypothesized nature and magnitude of the activities of the commercial fishing and OCS petroleum industries. Both the harvesting and processing sectors of the fishing industry are considered. The sources of impacts considered are the competition for labor, ocean space use, and the infrastructure. Potential impacts due to environmental or biological changes resulting from OCS petroleum development are not considered.« less

  8. The Fate of Soil OC in the Marine Environment: Examples from the Rapidly Eroding Landscapes of Two New Zealand North Island Rivers

    NASA Astrophysics Data System (ADS)

    Blair, N. E.; Leithold, E. L.; Thompson, C. E.; Childress, L. B.; Fournillier, K. M.

    2014-12-01

    Approximately 10% of the OC lost from soils as a result of land use has been argued to be delivered to the ocean (Lal 2003). The fate of this OC is highly dependent on the organic geochemical composition of the soil pool and the nature of the marine environment that receives it. The conversion of bush to pastureland via burning in the Waipaoa and Waiapu watersheds increased erosion rates by an order of magnitude. Surface and bank erosion, coupled with landsliding and gullying deliver OC to the rivers. Visual observations, sediment budgets, C-isotope (12C, 13C, 14C) mass balances and biomarker analyses all indicate that the OC is a mixture of recent plant debris, charcoal, aged soil C (< 18 kyrs old) and Cretaceous - Neogene sedimentary rock-derived C. The vastly different ages of the OC pools might be expected to lead to different reactivities and fates in the seabed. Nearshore wave-driven deposition-resuspension cycles winnow fines from sands in water depths ~<50 m. The sand-sized sedimentary OC is dominated by rock C. Younger fractions of soil C are transported primarily as fines to deeper water. Marine OC is added to the fine-grained sediments as they encounter zones of primary production. Dissolved inorganic C (DIC) within the interstitial (pore) waters of the marine sediments is a mixture of seawater DIC and benthic respired C. The C-isotopic composition of the DIC reflects its source. Stable isotope and radiocarbon measurements indicate that contemporary terrestrial C3 plant OC oxidation dominates respiration on the Waiapu shelf nearshore (~60 m). Marine OC is preferentially oxidized at water depths >80 m. The rock-derived C does not seem to be oxidized on the shelf or upper slope. A comparison of riverine particulate organic C (POC) with shelf depocenter OC concentrations suggest the Waipaoa and Waiapu soil C burial efficiencies are ~50 and 85% respectively. This does not consider the fate of soil C dispersed beyond the depocenter where preservation

  9. Use of Intervention Mapping to Enhance Health Care Professional Practice: A Systematic Review.

    PubMed

    Durks, Desire; Fernandez-Llimos, Fernando; Hossain, Lutfun N; Franco-Trigo, Lucia; Benrimoj, Shalom I; Sabater-Hernández, Daniel

    2017-08-01

    Intervention Mapping is a planning protocol for developing behavior change interventions, the first three steps of which are intended to establish the foundations and rationales of such interventions. This systematic review aimed to identify programs that used Intervention Mapping to plan changes in health care professional practice. Specifically, it provides an analysis of the information provided by the programs in the first three steps of the protocol to determine their foundations and rationales of change. A literature search was undertaken in PubMed, Scopus, SciELO, and DOAJ using "Intervention Mapping" as keyword. Key information was gathered, including theories used, determinants of practice, research methodologies, theory-based methods, and practical applications. Seventeen programs aimed at changing a range of health care practices were included. The social cognitive theory and the theory of planned behavior were the most frequently used frameworks in driving change within health care practices. Programs used a large variety of research methodologies to identify determinants of practice. Specific theory-based methods (e.g., modelling and active learning) and practical applications (e.g., health care professional training and facilitation) were reported to inform the development of practice change interventions and programs. In practice, Intervention Mapping delineates a three-step systematic, theory- and evidence-driven process for establishing the theoretical foundations and rationales underpinning change in health care professional practice. The use of Intervention Mapping can provide health care planners with useful guidelines for the theoretical development of practice change interventions and programs.

  10. Guidelines for Psychological Practice in Health Care Delivery Systems

    ERIC Educational Resources Information Center

    American Psychologist, 2013

    2013-01-01

    Psychologists practice in an increasingly diverse range of health care delivery systems. The following guidelines are intended to assist psychologists, other health care providers, administrators in health care delivery systems, and the public to conceptualize the roles and responsibilities of psychologists in these diverse contexts. These…

  11. JSpOC Mission System Application Development Environment

    NASA Astrophysics Data System (ADS)

    Luce, R.; Reele, P.; Sabol, C.; Zetocha, P.; Echeverry, J.; Kim, R.; Golf, B.

    2012-09-01

    The Joint Space Operations Center (JSpOC) Mission System (JMS) is the program of record tasked with replacing the legacy Space Defense Operations Center (SPADOC) and Astrodynamics Support Workstation (ASW) capabilities by the end of FY2015 as well as providing additional Space Situational Awareness (SSA) and Command and Control (C2) capabilities post-FY2015. To meet the legacy replacement goal, the JMS program is maturing a government Service Oriented Architecture (SOA) infrastructure that supports the integration of mission applications while acquiring mature industry and government mission applications. Future capabilities required by the JSpOC after 2015 will require development of new applications and procedures as well as the exploitation of new SSA data sources. To support the post FY2015 efforts, the JMS program is partnering with the Air Force Research Laboratory (AFRL) to build a JMS application development environment. The purpose of this environment is to: 1) empower the research & development community, through access to relevant tools and data, to accelerate technology development, 2) allow the JMS program to communicate user capability priorities and requirements to the developer community, 3) provide the JMS program with access to state-of-the-art research, development, and computing capabilities, and 4) support market research efforts by identifying outstanding performers that are available to shepherd into the formal transition process. The application development environment will consist of both unclassified and classified environments that can be accessed over common networks (including the Internet) to provide software developers, scientists, and engineers everything they need (e.g., building block JMS services, modeling and simulation tools, relevant test scenarios, documentation, data sources, user priorities/requirements, and SOA integration tools) to develop and test mission applications. The developed applications will be exercised in these

  12. Integrating mental health and social development in theory and practice.

    PubMed

    Plagerson, Sophie

    2015-03-01

    In many low and middle income countries, attention to mental illness remains compartmentalized and consigned as a matter for specialist policy. Despite great advances in global mental health, mental health policy and practice dovetail only to a limited degree with social development efforts. They often lag behind broader approaches to health and development. This gap ignores the small but growing evidence that social development unavoidably impacts the mental health of those affected, and that this influence can be both positive and negative. This article examines the theoretical and practical challenges that need to be overcome for a more effective integration of social development and mental health policy. From a theoretical perspective, this article demonstrates compatibility between social development and mental health paradigms. In particular, the capability approach is shown to provide a strong framework for integrating mental health and development. Yet, capability-oriented critiques on 'happiness' have recently been applied to mental health with potentially detrimental outcomes. With regard to policy and practice, horizontal and vertical integration strategies are suggested. Horizontal strategies require stronger devolution of mental health care to the primary care level, more unified messages regarding mental health care provision and the gradual expansion of mental health packages of care. Vertical integration refers to the alignment of mental health with related policy domains (particularly the social, economic and political domains). Evidence from mental health research reinforces aspects of social development theory in a way that can have tangible implications on practice. First, it encourages a focus on avoiding exclusion of those affected by or at risk of mental illness. Secondly, it underscores the importance of the process of implementation as an integral component of successful policies. Finally, by retaining a focus on the individual, it seeks to

  13. 45 CFR 164.520 - Notice of privacy practices for protected health information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.520 Notice of privacy practices for protected health information. (a) Standard... 45 Public Welfare 1 2014-10-01 2014-10-01 false Notice of privacy practices for protected health...

  14. A Transdisciplinary Approach to Public Health Law: The Emerging Practice of Legal Epidemiology

    PubMed Central

    Burris, Scott; Ashe, Marice; Levin, Donna; Penn, Matthew; Larkin, Michelle

    2017-01-01

    Public health law has roots in both law and science. For more than a century, lawyers have helped develop and implement health laws; over the past 50 years, scientific evaluation of the health effects of laws and legal practices has achieved high levels of rigor and influence. We describe an emerging model of public health law that unites these two traditions. This transdisciplinary model adds scientific practices to the lawyerly functions of normative and doctrinal research, counseling, and representation. These practices include policy surveillance and empirical public health law research on the efficacy of legal interventions and the impact of laws and legal practices on health and health system operation. A transdisciplinary model of public health law, melding its legal and scientific facets, can help break down enduring cultural, disciplinary, and resource barriers that have prevented the full recognition and optimal role of law in public health. PMID:26667606

  15. A Transdisciplinary Approach to Public Health Law: The Emerging Practice of Legal Epidemiology.

    PubMed

    Burris, Scott; Ashe, Marice; Levin, Donna; Penn, Matthew; Larkin, Michelle

    2016-01-01

    Public health law has roots in both law and science. For more than a century, lawyers have helped develop and implement health laws; over the past 50 years, scientific evaluation of the health effects of laws and legal practices has achieved high levels of rigor and influence. We describe an emerging model of public health law that unites these two traditions. This transdisciplinary model adds scientific practices to the lawyerly functions of normative and doctrinal research, counseling, and representation. These practices include policy surveillance and empirical public health law research on the efficacy of legal interventions and the impact of laws and legal practices on health and health system operation. A transdisciplinary model of public health law, melding its legal and scientific facets, can help break down enduring cultural, disciplinary, and resource barriers that have prevented the full recognition and optimal role of law in public health.

  16. 30 CFR 519.413 - How will the coastal political subdivisions of Gulf producing States share in the qualified OCS...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Gulf producing States share in the qualified OCS revenues? 519.413 Section 519.413 Mineral Resources... coastal political subdivisions of Gulf producing States share in the qualified OCS revenues? Of the revenues allocated to a Gulf producing State, 20 percent will be distributed to the coastal political...

  17. 30 CFR 519.413 - How will the coastal political subdivisions of Gulf producing States share in the qualified OCS...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Gulf producing States share in the qualified OCS revenues? 519.413 Section 519.413 Mineral Resources... coastal political subdivisions of Gulf producing States share in the qualified OCS revenues? Of the revenues allocated to a Gulf producing State, 20 percent will be distributed to the coastal political...

  18. 30 CFR 519.413 - How will the coastal political subdivisions of Gulf producing States share in the qualified OCS...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Gulf producing States share in the qualified OCS revenues? 519.413 Section 519.413 Mineral Resources... coastal political subdivisions of Gulf producing States share in the qualified OCS revenues? Of the revenues allocated to a Gulf producing State, 20 percent will be distributed to the coastal political...

  19. Health visiting and refugee families: issues in professional practice.

    PubMed

    Drennan, Vari M; Joseph, Judy

    2005-01-01

    This paper reports on the perceptions of experienced health visitors working with refugee families in Inner London. Women who are refugees and asylum seekers in the United Kingdom are more likely to experience depression than either non-refugee women or male asylum seekers. Health visitors provide a universal public health service to all women on the birth of a child, or with children aged under five, and as such are well placed to identify emotional and mental health problems of women who are refugees. Despite successive waves of refugees to the United Kingdom in the 20th century, there are no empirical studies of health visiting practice with this vulnerable group. There is also no body of evidence to inform the practice of health visitors new to working with asylum seekers and refugees. An exploratory study was undertaken in Inner London in 2001. Semi-structured interviews were conducted with a purposive sample of 13 health visitors experienced in working with women and families who are refugees. A range of structural challenges was identified that mediated against the development of a health-promoting relationship between health visitors and refugee women. With refugee families, who were living in temporary accommodation, health visitors were prioritizing basic needs that had to be addressed: in addition, they prioritized the needs of children before those of women. Health visitors were aware of the emotional needs of women and had strategies for addressing these with women in more settled circumstances. Health visitors considered themselves ill-prepared to deal with the complexities of working with women in these situations. This study identifies issues for further exploration, not least from the perspective of refugee women receiving health visiting services. Health visitors in countries receiving refugee women are framing their work with these women in ways that reflect Maslow's theory of a hierarchy of needs. This study suggests ways that public health

  20. Identification of Pediatric Oral Health Core Competencies through Interprofessional Education and Practice

    PubMed Central

    Hallas, D.; Fernandez, J. B.; Herman, N. G.; Moursi, A.

    2015-01-01

    Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD) and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP) program at New York University College of Nursing (NYUCN) have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice. PMID:25653873

  1. Building health promotion capacity in a primary health care workforce in the Northern Territory: some lessons from practice.

    PubMed

    Judd, Jenni; Keleher, Helen

    2013-12-01

    Reorientation of the workforce in primary health care is a complex process and requires specific strategies and interventions. Primary health care providers are a key health care workforce that is expected to deliver tangible outcomes from disease prevention and health promotion strategies. This paper describes a training intervention that occurred as part of a broader participatory action research process for building health promotion capacity in the primary health care workforce. Participatory action research (PAR) was conducted over six action and reflection cycles in a two-year period (2001-02) in an urban community health setting in the Northern Territory. One of the PAR cycles was a training intervention that was identified as a need from a survey in the first action and reflection cycle. This training was facilitated by a health promotion specialist, face-to-face and comprised five 3.5-h sessions over a 5-month period. A pre-post questionnaire was used to measure the knowledge and skills components of the training intervention. The results reinforced the importance of using a participatory approach that involved the primary health care providers themselves. Multiple strategies such as workforce development within capacity building frameworks assisted in shifting work practice more upstream. Additionally, these strategies encouraged more reflective practice and built social capital within the primary health care workforce. Lessons from practice reinforce that workforce development influenced work practice change and is an important element in building the health promotion capacity of primary health care centres. SO WHAT?: Workforce development is critical for reorienting health services. Health promotion specialists play an important role in reorienting practice, which is only effective when combined with other strategies, and driven and led by the primary health care workforce.

  2. Association between Organizational Capacity and Involvement in Chronic Disease Prevention Programming among Canadian Public Health Organizations

    ERIC Educational Resources Information Center

    Hanusaik, Nancy; Sabiston, Catherine M.; Kishchuk, Natalie; Maximova, Katerina; O'Loughlin, Jennifer

    2015-01-01

    In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement…

  3. The role of C2-C7 and O-C2 angle in the development of dysphagia after cervical spine surgery.

    PubMed

    Tian, Wei; Yu, Jie

    2013-06-01

    Dysphagia is a known complication of cervical surgery and may be prolonged or occasionally serious. A previous study showed that dysphagia after occipitocervical fusion was caused by oropharyngeal stenosis resulting from O-C2 (upper cervical lordosis) fixation in a flexed position. However, there have been few reports analyzing the association between the C2-C7 angle (middle-lower cervical lordosis) and postoperative dysphagia. The aim of this study was to analyze the relationship between cervical lordosis and the development of dysphagia after anterior and posterior cervical spine surgery (AC and PC). Three hundred fifty-four patients were reviewed in this retrospective clinical study, including 172 patients who underwent the AC procedure and 182 patients who had the PC procedure between June 2007 and May 2010. The presence and duration of postoperative dysphagia were recorded via face-to-face questioning or telephone interview performed at least 1 year after the procedure. Plain cervical radiographs before and after surgery were collected. The O-C2 angle and the C2-C7 angle were measured. Changes in the O-C2 angle and the C2-C7 angle were defined as dO-C2 angle = postoperative O-C2 angle - preoperative O-C2 angle and dC2-C7 angle = postoperative C2-C7 angle - preoperative C2-C7 angle. The association between postoperative dysphagia with dO-C2 angle and dC2-C7 angle was studied. Results showed that 12.8 % of AC and 9.4 % of PC patients reported dysphagia after cervical surgery. The dC2-C7 angle has considerable impact on postoperative dysphagia. When the dC2-C7 angle is greater than 5°, the chance of developing postoperative dysphagia is significantly greater. The dO-C2 angle, age, gender, BMI, operative time, blood loss, procedure type, revision surgery, most cephalic operative level, and number of operative levels did not significantly influence the incidence of postoperative dysphagia. No relationship was found between the dC2-C7 angle and the degree of

  4. Variations in Mental Health Diagnosis and Prescribing Across Pediatric Primary Care Practices

    PubMed Central

    Mayne, Stephanie L.; Ross, Michelle E.; Song, Lihai; McCarn, Banita; Steffes, Jennifer; Liu, Weiwei; Margolis, Benyamin; Azuine, Romuladus; Gotlieb, Edward; Grundmeier, Robert W.; Leslie, Laurel K.; Localio, Russell; Wasserman, Richard

    2016-01-01

    BACKGROUND: Primary care pediatricians increasingly care for children’s mental health problems, but little is known about practice-level variation in diagnosis and psychotropic medication prescribing practices. METHODS: This retrospective review of electronic heath records from 43 US primary care practices included children aged 4 to 18 years with ≥1 office visit from January 1, 2009, to June 30, 2014. We examined variability in diagnosis and psychotropic prescribing across practices using logistic regression with practice fixed effects and evaluated associations of the availability of colocated or community-based mental health providers or the proportion of children in foster care with diagnosis and prescribing using generalized linear mixed models. RESULTS: Among 294 748 children, 40 932 (15%) received a mental health diagnosis and 39 695 (14%) were prescribed psychotropic medication. Attention deficit/hyperactivity disorder was most commonly diagnosed (1%–16% per practice). The proportion of children receiving any psychotropic medication (4%-26%) and the proportion receiving ≥2 medication classes (1%-12%) varied across practices. Prescribing of specific medication classes also varied (stimulants, 3%–18%; antidepressants, 1%–12%; α-agonists, 0%–8%; second-generation antipsychotics, 0%–5%). Variability was partially explained by community availability of psychiatrists (significantly higher odds of a diagnosis or prescription when not available) but not by colocation of mental health professionals or percentage of children in foster care. CONCLUSIONS: The prevalence of mental health diagnosis and psychotropic medication prescribing varies substantially across practices and is only partially explained by psychiatrist availability. Research is needed to better define the causes of variable practice-level diagnosis and prescribing and implications for child mental health outcomes. PMID:27244791

  5. A relational approach to health practices: towards transcending the agency-structure divide.

    PubMed

    Veenstra, Gerry; Burnett, Patrick John

    2014-02-01

    Many health scholars find that Pierre Bourdieu's theory of practice leaves too little room for individual agency. We contend that, by virtue of its relational, field-theoretic underpinnings, the idea of leaving room for agency in Bourdieu's theory of practice is misguided. With agency manifested in interactions and social structures consisting of relations built upon relations, the stark distinction between agency and structure inherent to substantialist thinking is undermined, even dissolved, in a relational field-theoretic context. We also contend that, when treated as relationally bound phenomena, Bourdieu's notions of habitus, doxa, capital and field illuminate creative, adaptive and future-looking practices. We conclude by discussing difficulties inherent to implementing a relational theory of practice in health promotion and public health. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  6. The growing impact of globalization for health and public health practice.

    PubMed

    Labonté, Ronald; Mohindra, Katia; Schrecker, Ted

    2011-01-01

    In recent decades, public health policy and practice have been increasingly challenged by globalization, even as global financing for health has increased dramatically. This article discusses globalization and its health challenges from a vantage of political science, emphasizing increased global flows (of pathogens, information, trade, finance, and people) as driving, and driven by, global market integration. This integration requires a shift in public health thinking from a singular focus on international health (the higher disease burden in poor countries) to a more nuanced analysis of global health (in which health risks in both poor and rich countries are seen as having inherently global causes and consequences). Several globalization-related pathways to health exist, two key ones of which are described: globalized diseases and economic vulnerabilities. The article concludes with a call for national governments, especially those of wealthier nations, to take greater account of global health and its social determinants in all their foreign policies.

  7. Why health visiting? Examining the potential public health benefits from health visiting practice within a universal service: a narrative review of the literature.

    PubMed

    Cowley, Sarah; Whittaker, Karen; Malone, Mary; Donetto, Sara; Grigulis, Astrida; Maben, Jill

    2015-01-01

    There is increasing international interest in universal, health promoting services for pregnancy and the first three years of life and the concept of proportionate universalism. Drawing on a narrative review of literature, this paper explores mechanisms by which such services might contribute to health improvement and reducing health inequalities. Through a narrative review of empirical literature, to identify: (1) What are the key components of health visiting practice? (2) How are they reflected in implementing the universal service/provision envisaged in the English Health Visitor Implementation Plan (HVIP)? The paper draws upon a scoping study and narrative review. We used three complementary approaches to search the widely dispersed literature: (1) broad, general search, (2) structured search, using topic-specific search terms, (3) seminal paper search. Our key inclusion criterion was information about health visiting practice. We included empirical papers from United Kingdom (UK) from 2004 to February 2012 and older seminal papers identified in search (3), identifying a total of 348 papers for inclusion. A thematic content analysis compared the older (up to 2003) with more recent research (2004 onwards). The analysis revealed health visiting practice as potentially characterized by a particular 'orientation to practice.' This embodied the values, skills and attitudes needed to deliver universal health visiting services through salutogenesis (health creation), person-centredness (human valuing) and viewing the person in situation (human ecology). Research about health visiting actions focuses on home visiting, needs assessment and parent-health visitor relationships. The detailed description of health visitors' skills, attitudes, values, and their application in practice, provides an explanation of how universal provision can potentially help to promote health and shift the social gradient of health inequalities. Identification of needs across an

  8. 40 CFR 55.13 - Federal requirements that apply to OCS sources.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... sources. 55.13 Section 55.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... sources. (a) The requirements of this section shall apply to OCS sources as set forth below. In the event that a requirement of this section conflicts with an applicable requirement of § 55.14 of this part and...

  9. [Knowledge, attitude and practice of breast self-examination in health centers].

    PubMed

    Marinho, Luiz Alberto Barcelos; Costa-Gurgel, Maria Salete; Cecatti, José Guilherme; Osis, Maria José Duarte

    2003-10-01

    Breast cancer is one of the most important problems of public health and education regarding breast self-examination is one of the important steps for identifying breast tumors at an early stage. The present study was carried out to assess knowledge, attitude, and practice of breast self-examination among patients attending health centers. In a KAP (Knowledge, Attitude and Practice) survey 663 women of 13 randomly selected municipal health centers were interviewed. The number of interviews in each health center was proportional to the mean number of women seen per month. In the data analysis, women's answers for knowledge, attitude and practice regarding breast self-examination were classified according to their adequacy as previously defined. Adequacy was compared among categories of control variables with Chi2 test. The results showed that knowledge and practice of breast self-examination were adequate in 7.4% and 16.7%, respectively. However, attitude was adequate in 95.9% of the women interviewed. The study also showed that 58.1% of the women interviewed referred that forgetfulness was the main barrier for not performing self-examination. Women attending the health centers sampled in this study had inadequate knowledge and practice about breast self-examination but they had an adequate and favorable attitude about it.

  10. 30 CFR 219.413 - How will the coastal political subdivisions of Gulf producing States share in the qualified OCS...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Gulf producing States share in the qualified OCS revenues? 219.413 Section 219.413 Mineral Resources... subdivisions of Gulf producing States share in the qualified OCS revenues? Of the revenues allocated to a Gulf producing State, 20 percent will be distributed to the coastal political subdivisions within that State. ...

  11. Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse

    PubMed Central

    Lindblad, Monica; Möller, Ulrika

    2017-01-01

    Abstract Introduction Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. Aim To describe patients' experiences of health care provided by an APN in primary health care. Methods An inductive, descriptive qualitative approach with qualitative open‐ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. Results The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. Conclusion The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. PMID:29071766

  12. Herd health status and management practices on 16 Irish suckler beef farms

    PubMed Central

    2013-01-01

    Background There have been few studies published internationally which document herd health management practices in suckler beef herds and no published Irish studies. The study objective was to document herd health status and management practices on sixteen Irish suckler beef herds over a two year period (2009–2010). The farms used in the study were part of the Teagasc BETTER farm beef programme. The mean (s.d.) herd size, stocking rate and farm size was 68 cows (27.6), 2.0 LU/ha (0.3) and 64.3 (21.6) adjusted hectares, respectively. Two questionnaires were designed; 1) a farmer questionnaire to collect information on farm background and current herd health control practices and 2) a veterinary questionnaire to collect information on the extent of animal health advice given by veterinarians to their clients and identification of any on-farm herd health issues. Results Dystocia, calf pneumonia, and calf diarrhoea, in that order, were identified as the primary herd health issues in these Irish suckler beef herds. In addition, substantial deficiencies in biosecurity practices were also identified on these farms. Conclusions The findings of this study may serve as the focus for future research in animal health management practices in Irish suckler beef herds. PMID:24195997

  13. Future time perspective and positive health practices in young adults: an extension.

    PubMed

    Mahon, N E; Yarcheski, T J; Yarcheski, A

    1997-06-01

    A sample of 69 young adults attending a public university responded to the Future Time Perspective Inventory, two subscales of the Time Experience Scales (Fast and Slow Tempo), and the Personal Lifestyle Questionnaire in classroom settings. A statistically significant correlation (.52) was found between scores for future time perspective and the ratings for the practice of positive health behaviors in young adults. This correlation was larger than those previously found for middle and late adolescents. Scores on subscales of individual health practices and future time perspective indicated statistically significant correlations for five (.25 to .56) of the six subscales. Scores on neither Fast nor Slow Tempo were related to ratings of positive health practices or ratings on subscales measuring positive health practices.

  14. Nursing practices in the primary health care context: a scoping review 1

    PubMed Central

    Barbiani, Rosangela; Nora, Carlise Rigon Dalla; Schaefer, Rafaela

    2016-01-01

    ABSTRACT Objective: to identify and categorize the practices performed by nurses working in Primary Health Care and Family Health Strategy Units in light of responsibilities established by the profession's legal and programmatic frameworks and by the Brazilian Unified Health System. Method: a scoping review was conducted in the following databases: LILACS, IBECS, BDENF, CINAHL and MEDLINE, and the Cochrane and SciELO libraries. Original research papers written by nurses addressing nursing practices in the primary health care context were included. Results: the review comprised 30 studies published between 2005 and 2014. Three categories emerged from the analysis: practices in the service; practices in the community; and management and education practices. Conclusion: the challenges faced by nurses are complex, as care should be centered on the population's health needs, which requires actions at other levels of clinical and health responsibility. Brazilian nursing has achieved important advancements since the implementation of policies intended to reorganize work. There is, however, a need to shift work processes from being focused on individual procedures to being focused on patients so that an enlarged clinic is the ethical-political imperative guiding the organization of services and professional intervention. PMID:27579928

  15. Women's self-perception and self-care practice: implications for health care delivery.

    PubMed

    Mendias, E P; Clark, M C; Guevara, E B

    2001-01-01

    Mexican American women experience unique health care needs related to integration of Mexican and American cultures. To learn how to better promote self-care practices and service utilization in women of Mexican origin living in Texas, researchers used a qualitative approach to interview a convenience sample of 11 low-income women attending a health clinic. Researchers collected narrative data about the women's perceptions of health, wellness, and self-care. Using the matrix approach described by Miles and Huberman, we organized findings around women's roles, including participants' descriptions of themselves, their health and wellness awareness, self-care practices for health/illness and wellness/nonwellness, barriers to self-care, origin of self-care practices, and perceptions of life control. Implications for health planning and service delivery are presented.

  16. Hormonal contraception and mental health: results of a population-based study.

    PubMed

    Toffol, E; Heikinheimo, O; Koponen, P; Luoto, R; Partonen, T

    2011-11-01

    The effects of oral contraceptives (OCs) on mental health are not clear, and no study has been focused on the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) on mental health. The aim of this study was to analyse the association between the use of OCs and the LNG-IUS and psychological well-being and psychopathology. The associations between the current use of OCs and the LNG-IUS, and their duration versus mood symptoms [Beck Depression Inventory (BDI)], psychological well-being [(General Health Questionnaire-12 (GHQ-12)] and recent psychiatric diagnoses [(Composite International Diagnostic Interview (CIDI)] were examined among women who participated in the Finnish-population-based Health 2000 study. Analyses were performed on the 30- to 54-year-old sample (n = 2310); some of the analyses were extended to include the younger age group (18- to 54-year-old sample; n = 3223). Overall, hormonal contraception was well tolerated with few significant effects on psychological well-being. The length of OC use was inversely associated with some BDI items ('dissatisfaction, irritability, lost interest in people, earlier waking and lost interest in sex'), and directly associated with 'worries about one's health' (BDI) and with a current diagnosis of 'alcohol dependence' (CIDI). The current use of the LNG-IUS was inversely associated with 'earlier waking' (BDI) and with 'impaired concentration' (GHQ), while the length of LNG-IUS use was inversely associated with 'strain' (GHQ). The influence of hormonal birth control on mental health is modest and mainly favourable. The length of current OC use seems to have some beneficial effects on mood although the longer the duration of use, the greater the association with a diagnosis of alcohol dependence. Knowledge of the use of hormonal contraception might be of value when assessing psychopathology in women. The cross-sectional design, with partly retrospective data collection, precludes any causal conclusions.

  17. Primary healthcare nurses' experiences with motivational interviewing in health promotion practice.

    PubMed

    Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine

    2011-12-01

    The aim of the study was to describe primary healthcare nurses' experiences with motivational interviewing as a method for health promotion practice. A person's lifestyle has a major effect on his or her health. Motivational interviewing is one way of working with lifestyle changes in health promotion practice. The basic plan of motivational interviewing is to help people understand their lifestyle problems and make positive lifestyle changes. Motivational interviewing has been proven to be more effective than conventional methods in increasing patient motivation. This study has a descriptive design and uses a qualitative method. Twenty nurses who worked in primary health care and actively used motivational interviewing in their work were interviewed. Qualitative content analysis was used to process the data. The primary healthcare nurses' experiences with motivational interviewing as a method of health promotion practice demonstrate that motivational interviewing is a demanding, enriching and useful method that promotes awareness and guidance in the care relationship. The results also show that motivational interviewing is a valuable tool for primary healthcare nurses' health promotion practice. This study shows that motivational interviewing places several different demands on nurses who use this method. Those who work with motivational interviewing must make an effort to incorporate this new method to avoid falling back into the former practice of simply giving advice. Maintaining an open mind while implementing motivational interviewing in real healthcare settings is crucial for nurses to increase this method's effectiveness. The nurses in the study had a positive experience with motivational interviewing, which can contribute to the increased use, adaption and development of motivational interviewing among primary healthcare professionals. Increased motivational interviewing knowledge and skills would also contribute to promotion of health lifestyle practices

  18. Environmental health training: a survey of family practice residency program directors.

    PubMed

    Musham, C; Bellack, J P; Graber, D R; Holmes, D

    1996-01-01

    The Institute of Medicine and the American College of Physicians have advocated that physicians broaden their participation in the environmental aspects of medical care. Accordingly, both organizations recommend training of future primary care physicians for greater competency in and appreciation of this area of medicine. This study assessed the present emphasis on environmental health in family practice residency programs by examining the extent program directors expect graduates to have specific competencies in environmental medicine. A written survey was mailed to directors of all 393 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs. Respondents were asked to indicate the extent to which each of eight environmental health competencies was expected of their graduates. The list of environmental health competencies was based on the literature and on interviews with family practice educators. Perceptions about the "present" and "ideal" environmental health emphasis in their programs were also measured. A total of 262 completed surveys were returned for a response rate of 67%. Respondents reported that they expected their graduates to have general knowledge of and competence in environmental health areas that pertain to patient care. Competencies with social and political implications were least likely to be expected. Two thirds of respondents indicated that "minimal emphasis" is presently placed on environmental health. Seventy percent indicated that the "ideal" amount of emphasis placed on this topic is "moderate." This survey's results suggest that family practice residency program directors expect their graduates to know basic environmental health concepts and be skilled in related aspects of patient care. The development of environmental health training programs must take into account that environmental health may be viewed as a topic of secondary importance and that in most residencies, faculty expertise in

  19. The Dynamics of Community Health Care Consolidation: Acquisition of Physician Practices

    PubMed Central

    Christianson, Jon B; Carlin, Caroline S; Warrick, Louise H

    2014-01-01

    Context Health care delivery systems are becoming increasingly consolidated in urban areas of the United States. While this consolidation could increase efficiency and improve quality, it also could raise the cost of health care for payers. This article traces the consolidation trajectory in a single community, focusing on factors influencing recent acquisitions of physician practices by integrated delivery systems. Methods We used key informant interviews, supplemented by document analysis. Findings The acquisition of physician practices is a process that will be difficult to reverse in the current health care environment. Provider revenue uncertainty is a key factor driving consolidation, with public and private attempts to control health care costs contributing to that uncertainty. As these efforts will likely continue, and possibly intensify, community health care systems now are less consolidated than they will be in the future. Acquisitions of multispecialty and primary care practices by integrated delivery systems follow a common process, with relatively predictable issues relating to purchase agreements, employment contracts, and compensation. Acquisitions of single-specialty practices are less common, with motivations for acquisitions likely to vary by specialty type, group size, and market structure. Total cost of care contracting could be an important catalyst for practice acquisitions in the future. Conclusions In the past, market and regulatory forces aimed at controlling costs have both encouraged and rewarded the consolidation of providers, with important new developments likely to create momentum for further consolidation, including acquisitions of physician practices. PMID:25199899

  20. The dynamics of community health care consolidation: acquisition of physician practices.

    PubMed

    Christianson, Jon B; Carlin, Caroline S; Warrick, Louise H

    2014-09-01

    Health care delivery systems are becoming increasingly consolidated in urban areas of the United States. While this consolidation could increase efficiency and improve quality, it also could raise the cost of health care for payers. This article traces the consolidation trajectory in a single community, focusing on factors influencing recent acquisitions of physician practices by integrated delivery systems. We used key informant interviews, supplemented by document analysis. The acquisition of physician practices is a process that will be difficult to reverse in the current health care environment. Provider revenue uncertainty is a key factor driving consolidation, with public and private attempts to control health care costs contributing to that uncertainty. As these efforts will likely continue, and possibly intensify, community health care systems now are less consolidated than they will be in the future. Acquisitions of multispecialty and primary care practices by integrated delivery systems follow a common process, with relatively predictable issues relating to purchase agreements, employment contracts, and compensation. Acquisitions of single-specialty practices are less common, with motivations for acquisitions likely to vary by specialty type, group size, and market structure. Total cost of care contracting could be an important catalyst for practice acquisitions in the future. In the past, market and regulatory forces aimed at controlling costs have both encouraged and rewarded the consolidation of providers, with important new developments likely to create momentum for further consolidation, including acquisitions of physician practices. © 2014 Milbank Memorial Fund.

  1. Additional studies of competition and performance in OCS oil and gas sales, 1954-1975

    USGS Publications Warehouse

    Mead, Walter J.; Sorensen, Philip Edward

    1980-01-01

    Economic rent is commonly defined in economics as any payment to a factor of production in excess of the minimum necessary to engage it in production. In the case of OCS lands owned by the federal government, the minimum supply price necessary to induce the federal government to lease production rights would be the costs of establishing and administering lease contracts. Assuming, for the sake of simplicity, that these costs are small enough to be ignored in the analysis, all payments to the federal government for use of OCS lands are forms of economic rent. An ideal leasing system should transfer the full amount of economic rent implicit in OCS resources to the federal government. Whether such a complete transfer of economic rent occurs depends upon the conditions of competition in the market for OCS leases. The principal means for capturing economic rent under the bidding system employed by the federal government over the years 1954-1969 are the bonus paid by the highest bidder and a royalty payment which has historically been fixed at 16 2/3 percent of gross production value. Of less importance is an annual rental payment, usually about \\$3.00 per acre, which is paid as long as a tract under lease is not producing.In the sections which follow, major factors affecting the capture of economic rent by the federal government are discussed and data are presented which demonstrate the importance of the different means used. In computing the amounts of economic rent captured by the federal government, the discounted cash flow technique is employed. This requires selection of an appropriate discount rate, in contrast to the internal rate of return analysis used in Part I, above.

  2. Midwives' perceptions and experiences of health promotion practice in Ghana.

    PubMed

    Owusu-Addo, Ebenezer

    2015-09-01

    This research explores midwives' perceptions and experiences of health promotion practice in Ghana. A qualitative descriptive exploratory design was used in order to gain better insight into midwives' perceptions and experiences of health promotion practice. A total of 21 midwives took part in the study. Data were collected by individual in-depth semi-structured interviews. Thematic analysis was used to analyse the transcript. Five dominant themes emerged from the interview transcripts, namely: health promotion as education, health promotion activities, the value of health promotion, client participation, and midwives' barriers to promoting health. Although midwives underscored the importance of health promotion to their work, their reports indicated that, in practice, midwives mostly delivered health education and behaviour change communication rather than health promotion. The midwives expressed the view that by way of their close association with women, they were in a better position to influence women's health. Health promotion activities engaged by the midwives included weight management, healthy eating, infection prevention, personal hygiene, counselling on family planning, and screening for hazardous and harmful substance use such as alcohol and smoking. All the midwives mentioned that clients participated in their health promotion activities. Factors that were identified by the midwives to enhance client participation were trust, attitude of the midwife, building rapport, creating enabling environment, listening and paying attention to clients and using simple language. The barriers to health promotion identified by the midwives included time, stress, culture, lack of training and inadequate health educational materials. Midwives in this study had limited knowledge about health promotion, yet could play a significant role in influencing health; thus there is a need for on-going in-service training for midwives to focus on health promotion. © The Author

  3. 30 CFR 219.413 - How will the coastal political subdivisions of Gulf producing States share in the qualified OCS...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Gulf producing States share in the qualified OCS revenues? 219.413 Section 219.413 Mineral Resources... § 219.413 How will the coastal political subdivisions of Gulf producing States share in the qualified OCS revenues? Of the revenues allocated to a Gulf producing State, 20 percent will be distributed to...

  4. Explaining outputs of primary health care: population and practice factors.

    PubMed Central

    Baker, D; Klein, R

    1991-01-01

    OBJECTIVE--To examine whether variations in the activities of general practice among family health service authorities can be explained by the populations characteristics and the organisation and resourcing of general practice. DESIGN--The family health services authorities were treated as discrete primary health care systems. Nineteen performance indicators reflecting the size, distribution, and characteristics of the population served; the organisation of general practice (inputs); and the activities generated by general practitioners and their staff (output) were analysed by stepwise regression. SETTING--90 family health services authorities in England. MAIN OUTCOME MEASURES--Rates of cervical smear testing, immunisation, prescribing, and night visiting. RESULTS--53% of the variation in uptake of cervical cytology was accounted for by Jarman score (t = -3.3), list inflation (-0.41), the proportion of practitioners over 65 (-0.64), the number of ancillary staff per practitioner (2.5), and 70% of the variation in immunisation rates by standardised mortality ratios (-6.6), the proportion of practitioners aged over 65 (-4.8), and the number of practice nurses per practitioner (3.5). Standardised mortality ratios (8.4), the number of practitioners (2.3), and the proportion over 65 (2.2), and the number of ancillary staff per practitioner (-3.1) accounted for 69% of variation in prescribing rates. 54% of the variation in night visiting was explained by standardised mortality ratios (7.1), the proportion of practitioners with lists sizes below 1000 (-2.2), the proportion aged over 65 (-0.4), and the number of practice nurses per practitioner (-2.5). CONCLUSIONS--Family health services authorities are appropriate systems for studying output of general practice. Their performance indicators need to be refined and to be linked to other relevant factors, notably the performance of hospital, community, and social services. PMID:1653065

  5. Validity of the Autism Spectrum Disorder Observation for Children (ASD-OC)

    ERIC Educational Resources Information Center

    Neal, Daniene; Matson, Johnny L.; Hattier, Megan A.

    2014-01-01

    The Autism Spectrum Disorder Observation for Children (ASD-OC) is a 45-item observation scale used to assess autistic symptomatology. The reliability of this measure has been established in previous research; therefore, the purpose of this study is to evaluate its validity among a sample of children (1-15 years). The large correlation between the…

  6. Advancing Efforts to Achieve Health Equity: Equity Metrics for Health Impact Assessment Practice

    PubMed Central

    Heller, Jonathan; Givens, Marjory L.; Yuen, Tina K.; Gould, Solange; Benkhalti Jandu, Maria; Bourcier, Emily; Choi, Tim

    2014-01-01

    Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric. PMID:25347193

  7. [The elderly care practices of indigenous-performance of health].

    PubMed

    Rissardo, Leidyani Karina; Alvim, Neide Aparecida Titonelli; Marcon, Sonia Silva; Carreira, Lígia

    2014-01-01

    This research aims to understand the care practices of health professionals who assist the elderly Kaingang. It is a qualitative study, supported in ethnography, conducted by ten professionals working in primary health care in the indigenous land of Faxinal, Paraná, Brazil. The data was collected from November 2010 to February 2012 by participant observation and interviews, and analyzed based on the Transcultural Care Theory. Was identified the preoccupation of the carers practices with the medication and immunization, as well as traditional medical care. To achieve these, care professionals had strategies that implemented maintenance of older people in care. We conclude that cultural values and integrate scientific need assistance to improve the health of elderly indigenous.

  8. Politics and public health ethics in practice: right and left meet right and wrong.

    PubMed

    Gollust, Sarah E; Baum, Nancy M; Jacobson, Peter D

    2008-01-01

    As public health practitioners are no doubt aware, public health practice and politics are closely linked. Although theoretical discussion of the emerging field of public health ethics has been rich, scholars have paid little attention to the relationship between ethical issues and politics in public health practice. We conducted semistructured interviews with 45 public health practitioners across a range of occupations (eg, health officers, medical directors, sanitarians, nurses, educators, and commissioners) working at 12 local health departments across Michigan and the state health department. Practitioners were asked to describe the ethical issues they faced in their daily practice. Ethical issues that resulted from the political environment emerged as one major category of ethical issues our interviewees described. This article illustrates how political issues engender ethical challenges in 4 main areas: public health agenda-setting, political pressures, political conflicts with best practices, and the scope of public health practice. The findings suggest that politics and public health ethics intrinsically intersect, because political pressures and priorities often impose ethical challenges that practitioners negotiate in their daily work.

  9. A clinical education and practice placements in the allied health professions: an international perspective.

    PubMed

    Rodger, Sylvia; Webb, Gillian; Devitt, Lorraine; Gilbert, John; Wrightson, Pat; McMeeken, Joan

    2008-01-01

    This report describes the outcomes of extensive discussions surrounding clinical education and practice placement issues undertaken by an international group of allied health educators (in audiology, occupational therapy, physiotherapy, and speech pathology) who have met since 2001 as part of Universitas 21 Health Sciences annual meetings. The report outlines key issues associated with clinical education and practice placements from an international perspective and across these four allied health professions. The allied health practice context is described in terms of the range of allied health educational programs in Universitas 21 and recent changes in health and tertiary education sectors in represented countries. Some issues and benefits related to supervision during allied health students' practice placements are addressed. A new approach is proposed through partnership such that frameworks for the provision of practice placements can be created to facilitate student learning and educate and support clinical educators. A set of guidelines that can enhance partnerships and collaborative practice for the benefit of clinical education within complex and changing health/human service and educational environments is proposed.

  10. Research and Practice Opportunities at the Intersection of Health Education, Health Behavior, and Genomics

    ERIC Educational Resources Information Center

    Wang, Catharine; Bowen, Deborah J.; Kardia, Sharon L. R.

    2005-01-01

    Researchers and practitioners in health behavior and health education (HBHE) can play a pivotal leadership role in the integration of genomic advances to improve the public's health. The purpose of this article is to outline research and practice opportunities at the intersection of genomics and HBHE. We begin this article by briefly summarizing…

  11. Disinfection methods in general practice and health authority clinics: a telephone survey

    PubMed Central

    Farrow, S.C.; Kaul, S.; Littlepage, B.C.

    1988-01-01

    Concern about the epidemic of the acquired immune deficiency syndrome led to discussions in one health district about the dangers of cross-infection from instruments in general practice and health authority clinics. In order to establish what current disinfection practices were in use a telephone survey was adopted as a quick and easy method of data collection. Information was collected on who was responsible for disinfection as well as details of how each instrument was disinfected. Results from 69 general practices and 21 health authority clinice in one health district are reported. Some form of sterilizer was used in 63 general practices. These included water boilers (49%), dry heat sterilizers (41%), autoclaves (5%) and pressure cookers (5%). Sixty one practices were using metal vaginal specula and of these 29 were disinfecting by boiling, three were using pressure cookers, 18 dry heat, seven chemical methods, three autoclaves and one the central sterile department of the local hospital. Of those who were boiling after simple washing, three practices boiled for five to 10 minutes and reused instruments during the same clinic. Of the 29 using simple boiling 20 (69%) were boiling for less than 20 minutes. The study highlights the fact that no formal advice has been given on disinfection practice by the DHSS, the health authorities or the family practitioner committees. The need to set up local guidelines and develop practical steps for their introduction are discussed. PMID:3271009

  12. ENANTIOMERIC RATIOS AS SOURCE TRACERS OF OC PESTICIDES IN GREAT LAKES AIR

    EPA Science Inventory

    Organochlorine (OC) pesticides were used heavily in the cornbelt regions during the 60's and 70's. Volatilization of these pesticides from agricultural soils may be a significant source of contaminants to the atmosphere which may later be deposited in the Great Lakes. Pesticide...

  13. Diels-Alder addition to H2O@C60 an electronic and structural study

    NASA Astrophysics Data System (ADS)

    Reveles, J. Ulises; Govinda, K. C.; Baruah, Tunna; Zope, Rajendra R.

    2017-10-01

    Exohedral reactivity of endohedral fullerenes has aroused a significant interest because of its potential applications. The present letter examines the effect of an entrapped single water molecule on the reactivity of C60. We study the thermodynamics and kinetics of a Diels-Alder reaction occurring at all non-identical bonds of free C60 and H2O@C60. Our calculations show that encapsulation of water does not have a significant effect on H2O@C60 reactivity compared to C60, as attested by the investigation of the reaction under several orientations of H2O inside C60. Reaction and activation energies indicate that [6,6] bonds are the most reactive sites.

  14. Sexual orientation and sex differences in adult chronic conditions, health risk factors, and protective health practices, Oregon, 2005-2008.

    PubMed

    Garland-Forshee, Rodney Y; Fiala, Steven C; Ngo, Duyen L; Moseley, Katarina

    2014-08-07

    Research on lesbian, gay, and bisexual (LGB) individuals' health and health practices has primarily consisted of convenience studies focused on HIV/AIDS, substance use, or mental illness. We examined health-related disparities among Oregon LGB men and women compared with heterosexual men and women using data from a population-based survey. Data from the 2005 through 2008 Oregon Behavioral Risk Factor Surveillance System were used to examine associations between sexual orientation and chronic conditions, health limitations, health risk factors, and protective health practices. Compared with heterosexual women, lesbian and bisexual women were significantly more likely to smoke cigarettes, be obese, binge drink, and have chronic conditions, and less likely to engage in protective health practices. Compared with heterosexual men, gay men were significantly less likely to be obese, more likely to binge drink, and more likely to engage in protective health practices. Compared with heterosexual men, bisexual men were significantly more likely to have a physical disability, smoke cigarettes, binge drink, and more likely to get an HIV test. Health disparities among Oregon LGB individuals were most prominent among lesbian and bisexual women. Gay men had the most protective health practices, but they were more likely than heterosexual men to engage in risky behaviors that lead to chronic diseases later in life. Targeted public health interventions should be provided in environments that avoid stigmatizing and discriminating against LGB individuals where they live, work, learn, and socialize.

  15. Beyond Research Ethics: Novel Approaches of 3 Major Public Health Institutions to Provide Ethics Input on Public Health Practice Activities.

    PubMed

    Klingler, Corinna; Barrett, Drue H; Ondrusek, Nancy; Johnson, Brooke R; Saxena, Abha; Reis, Andreas A

    2018-02-23

    Public health institutions increasingly realize the importance of creating a culture in their organizations that values ethics. When developing strategies to strengthen ethics, institutions will have to take into account that while public health research projects typically undergo thorough ethics review, activities considered public health practice may not be subjected to similar oversight. This approach, based on a research-practice dichotomy, is increasingly being criticized as it does not adequately identify and manage ethically relevant risks to those affected by nonresearch activities. As a reaction, 3 major public health institutions (the World Health Organization, US Centers for Disease Control and Prevention, and Public Health Ontario) have implemented mechanisms for ethics review of public health practice activities. In this article, we describe and critically discuss the different modalities of the 3 approaches. We argue that although further evaluation is necessary to determine the effectiveness of the different approaches, public health institutions should strive to implement procedures to ensure that public health practice adheres to the highest ethical standards.

  16. Navigating systems ideas for health practice: Towards a common learning device.

    PubMed

    Reynolds, Martin; Sarriot, Eric; Swanson, Robert Chad; Rusoja, Evan

    2018-06-01

    Systems thinking and reference to complexity science have gained currency in health sector practice and research. The extent to which such ideas might represent a mere passing fad or might more usefully be mobilized to tackle wicked problems in health systems is a concern underpinning this paper. Developing the usefulness of the systems idea requires appreciating how systems ideas are used essentially as constructs conceptually bounded by practitioners. Systems are used for purposes of understanding and engaging the reality of health issues, with the intent of transforming the reality into one that is more manageable, equitable, and sustainable. We examine some manifestations of the systems idea in health practice and the traditions of systems practice that variously make use of them. This provides a platform for proposing a systems thinking in (health) practice heuristic: a learning device supporting how different tools and methods can address "wicked problems" in health praxis. The device is built on the use of "conversation" as a metaphor to help practitioners use systems ideas in tandem with existing disciplinary and professional skills and methods. We consider how the application of the heuristic requires, and helps to develop, human characteristics of humility, empathy, and recognition of fallibility. © 2018 John Wiley & Sons, Ltd.

  17. Online interprofessional health sciences education: From theory to practice.

    PubMed

    Luke, Robert; Solomon, Patty; Baptiste, Sue; Hall, Pippa; Orchard, Carole; Rukholm, Ellen; Carter, Lorraine

    2009-01-01

    Online learning (e-learning) has a nascent but established history. Its application to interprofessional education (IPE), however, is relatively new. Over the past 2 decades the Internet has been used increasingly to mediate education. We have come past the point of "should we use the Internet for education" to "how should we use the Internet for education." Research has begun on the optimal development of online learning environments to support IPE. Developing online IPE should follow best practices in e-learning generally, though there are some special considerations for acknowledging the interprofessional context and clinical environments that online IPE is designed to support. The design, development, and deployment of effective online IPE must therefore pay special attention to the particular constraints of the health care worker educational matrix, both pre- and postlicensure. In this article we outline the design of online, interprofessional health sciences education. Our work has involved 4 educational and 4 clinical service institutions. We establish the context in which we situate our development activities that created learning modules designed to support IPE and its transfer into new interprofessional health care practices. We illustrate some best practices for the design of effective online IPE, and show how this design can create effective learning for IPE. Challenges exist regarding the full implementation of interprofessional clinical practice that are beginning to be met by coordinated efforts of multiple health care education silos.

  18. Continuing Professional Development: Pedagogical Practices of Interprofessional Simulation in Health Care

    ERIC Educational Resources Information Center

    Nyström, Sofia; Dahlberg, Johanna; Edelbring, Samuel; Hult, Håkan; Abrandt Dahlgren, Madeleine

    2017-01-01

    The increasing complexity of health care practice makes continuing professional development (CPD) essential for health care professionals. Simulation-based training is a CPD activity that is often applied to improve interprofessional collaboration and the quality of care. The aim of this study is to explore simulation as a pedagogical practice for…

  19. Practice nurses mental health provide space to patients to discuss unpleasant emotions.

    PubMed

    Griep, E C M; Noordman, J; van Dulmen, S

    2016-03-01

    WHAT IS KNOWN ON THE SUBJECT?: A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Patients with mild psychosocial and psychological problems provide signs of worrying or express a clear unpleasant emotion in 94% of consultations with a practice nurse mental health. Nurses' responses to patients' signs of worrying or clear unpleasant emotions were mostly characterized by providing space for patients to talk about these emotions, by using minimal responses. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Practice nurses' mental health have passive listening skills, and to a lesser extent, use active listening techniques. Accurate emotion detection and the ability to pick out emotional signs during consultations must also be considered as an important skill for health providers to improve patient-centred communication. Patients with physical problems are known to express their emotional concerns in an implicit way only. Whether the same counts for patients presenting mental health problems in primary care is unknown. This study aims to examine how patients with mild psychosocial and psychological complaints express their concerns during consultations with the practice nurse mental health and how practice nurses respond to these expressions. Fifteen practice nurses mental health working in Dutch general practices participated in the study. Their consultations with 116 patients with mild psychosocial or psychological complaints were video recorded. patients' explicitly expressed emotional concerns and more implicit expressions of underlying emotional problems (cues) as well as nurses' responses to these expressions were rated using the Verona Coding Definition of Emotional Sequences. Almost all consultations contained at least one cue or

  20. Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal.

    PubMed

    Fazal, Nadia; Jackson, Suzanne F; Wong, Katy; Yessis, Jennifer; Jetha, Nina

    2017-11-01

    In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. The promising practices criteria were developed using the Public Health Agency of Canada's (PHAC's) existing best practices criteria as the foundation. They were modified and pilot tested (three rounds) using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal's screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

  1. Reverse quality management: developing evidence-based best practices in health emergency management.

    PubMed

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

  2. 76 FR 30956 - Outer Continental Shelf, Alaska OCS Region, Chukchi Sea Planning Area, Oil and Gas Lease Sale 193

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... Continental Shelf, Alaska OCS Region, Chukchi Sea Planning Area, Oil and Gas Lease Sale 193 AGENCY: Bureau of...: BOEMRE announces the availability of a Revised Draft SEIS, OCS Oil and Gas Lease Sale 193, Chukchi Sea.... The Revised Draft SEIS augments the analysis of the Final EIS, Oil and Gas Lease Sale 193, Chukchi Sea...

  3. 75 FR 17159 - Notice of Availability of the Proposed Notice of Sale (NOS) for Outer Continental Shelf (OCS) Oil...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-05

    ... Notice of Sale (NOS) for Outer Continental Shelf (OCS) Oil and Gas Lease Sale 215 in the Western Planning... matter of information to the public. With regard to oil and gas leasing on the OCS, the Secretary of the... NOS for Sale 215 and a ``Proposed Notice of Sale Package'' containing information essential to...

  4. 76 FR 52344 - Notice of Availability of the Proposed Notice of Sale (NOS) for Outer Continental Shelf (OCS) Oil...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... Availability of the Proposed Notice of Sale (NOS) for Outer Continental Shelf (OCS) Oil and Gas Lease Sale 218... matter of information to the public. With regard to oil and gas leasing on the OCS, the Secretary of the... NOS for Sale 218 and a ``Proposed Notice of Sale Package'' containing information essential to...

  5. Problem-posing in education: transformation of the practice of the health professional.

    PubMed

    Casagrande, L D; Caron-Ruffino, M; Rodrigues, R A; Vendrúsculo, D M; Takayanagui, A M; Zago, M M; Mendes, M D

    1998-02-01

    This study was developed by a group of professionals from different areas (nurses and educators) concerned with health education. It proposes the use of a problem-posing model for the transformation of professional practice. The concept and functions of the model and their relationships with the educative practice of health professionals are discussed. The model of problem-posing education is presented (compared to traditional, "banking" education), and four innovative experiences of teaching-learning are reported based on this model. These experiences, carried out in areas of environmental and occupational health and patient education have shown the applicability of the problem-posing model to the practice of the health professional, allowing transformation.

  6. Oral Health Care in the Future: Expansion of the Scope of Dental Practice to Improve Health.

    PubMed

    Lamster, Ira B; Myers-Wright, Noreen

    2017-09-01

    The health care environment in the U.S. is changing. The population is aging, the prevalence of non-communicable diseases (NCDs) is increasing, edentulism is decreasing, and periodontal infection/inflammation has been identified as a risk factor for NCDs. These trends offer an opportunity for oral health care providers to broaden the scope of traditional dental practice, specifically becoming more involved in the management of the general health of patients. This new practice paradigm will promote a closer integration with the larger health care system. This change is based on the realization that a healthy mouth is essential for a healthy life, including proper mastication, communication, esthetics, and comfort. Two types of primary care are proposed: screenings for medical conditions that are directly affected by oral disease (and may modify the provision of dental care), and a broader emphasis on prevention that focuses on lifestyle behaviors. Included in the former category are screenings for NCDs (e.g., the risk of cardiovascular disease and identification of patients with undiagnosed dysglycemia or poorly managed diabetes mellitus), as well as identification of infectious diseases, such as HIV or hepatitis C. Reducing the risk of disease can be accomplished by an emphasis on smoking cessation and dietary intake and the prevention of obesity. These activities will promote interprofessional health care education and practice. While change is always challenging, this new practice paradigm could improve both oral health and health outcomes of patients seen in the dental office. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  7. Correlation of maternal-fetal attachment and health practices during pregnancy with neonatal outcomes.

    PubMed

    Maddahi, Maryam Sadat; Dolatian, Mahrokh; Khoramabadi, Monirsadat; Talebi, Atefeh

    2016-07-01

    Low birth weight due to preterm delivery or intrauterine growth restriction (IUGR) is the strongest factor contributing to prenatal, neonatal, and postnatal mortality. Maternal-fetal attachment plays a significant role in maternal and fetal health. Health practices performed by the mother during pregnancy constitute one of the factors that may affect neonatal outcomes. The present study was conducted to identify the relationship between maternal-fetal attachment and health practices during pregnancy with neonatal outcomes. This cross-sectional study was conducted on 315 pregnant women with a gestational age of 33-41 weeks who presented to hospitals in Sirjan (Iran) between December 2014 and February 2015. The data collection tools used included the Health Practices in Pregnancy Questionnaire and the Maternal Fetal Attachment Scale. Data were analyzed using IBM-SPSS version 20, focusing on the Pearson product-moment correlation and the logistic regression model. Statistical significance was set to p<0.05. The mean score of maternal-fetal attachment was 60.34, and the mean score of health practices was 123.57. The mean birth weight of the neonates was 3052.38 g. Health practices (p<0.05, r=0.11) and maternal-fetal attachment (p<0.01, r=0.23) were positively and significantly correlated with neonatal outcomes. A significant positive relationship was also observed between maternal-fetal attachment and neonatal outcomes. No significant relationships were observed between health practices during pregnancy and neonatal outcomes. Maternal-fetal attachment and health practices during pregnancy are positively and significantly correlated with neonatal outcomes.

  8. Blowout Prevention System Events and Equipment Component Failures : 2016 SafeOCS Annual Report

    DOT National Transportation Integrated Search

    2017-09-22

    The SafeOCS 2016 Annual Report, produced by the Bureau of Transportation Statistics (BTS), summarizes blowout prevention (BOP) equipment failures on marine drilling rigs in the Outer Continental Shelf. It includes an analysis of equipment component f...

  9. NEW ENVIRONMENTAL PUBLIC HEALTH INDICATOR LINKING ORGANOCHLORINE COMPOUNDS AND TYPE 2 DIABETES

    EPA Science Inventory

    The project will develop an environmental public health indicator (EPHI) by linking soil residues of organochlorine (OC) insecticides and metabolites/degradates, OC compound levels in people and a disease with which they are implicated, type 2 diabetes (T2D). The proposed E...

  10. Marine cycling of the climate relevant trace gases carbonyl sulfide (OCS) and carbon disulfide (CS2) in the Peruvian upwelling regime

    NASA Astrophysics Data System (ADS)

    Lennartz, Sinikka; von Hobe, Marc; Booge, Dennis; Gonçalves-Araujo, Rafael; Bracher, Astrid; Röttgers, Rüdiger; Ksionzek, Kerstin B.; Koch, Boris P.; Fischer, Tim; Bittig, Henry; Quack, Birgit; Krüger, Kirstin; Marandino, Christa A.

    2017-04-01

    The ocean is a major source for the climate relevant trace gases carbonyl sulfide (OCS) and carbon disulfide (CS2). While the greenhouse gas CS2 quickly oxidizes to OCS in the atmosphere, the atmospheric lifetime of OCS of 2-7 years leads to an accumulation of this gas and makes it the most abundant reduced sulfur compound in the atmosphere. OCS has a counteracting effect on the climate: in the troposphere, it acts as a greenhouse gas causing warming, whereas it also sustains the stratospheric aerosol layer, and thus increases Earth's albedo causing cooling. To better constrain the important oceanic source of these trace gases, the marine cycling needs to be well understood and quantified. For OCS, the production and consumption processes are identified, but photoproduction and light-independent production rates remain to be quantified across different regions. In contrast, the processes that influence the oceanic cycling of CS2 are less well understood. Here we present new data from a cruise to the Peruvian upwelling regime and relate measurements of OCS and CS2 to key parameters, such as dissolved organic sulfur, chromophoric and fluorescent dissolved organic matter. We use a 1D water column model to further constrain their production and degradation rates. A focus is set on the influence of oxygen on the marine cycling of these two gases in oxygen depleted zones in the ocean, which are expected to expand in the future.

  11. Protective effect of Rehmannia glutinosa on the cisplatin-induced damage of HEI-OC1 auditory cells through scavenging free radicals.

    PubMed

    Yu, Hyeon-Hee; Seo, Se-Jeong; Kim, Yeon-Hwa; Lee, Hae-Youn; Park, Rae-Kil; So, Hong-Seob; Jang, Seon Ll; You, Yong-Ouk

    2006-10-11

    The steamed root of Rehmannia glutinosa has been used in traditional Oriental Medicine for treatment of inner ear diseases, such as tinnitus and hearing loss. In the present study, we showed that the ethanol extract of steamed roots of Rehmannia glutinosa (SRG) protected HEI-OC1 auditory cells from cisplatin cytotoxicity in a dose-dependent fashion. In addition, to investigate the protection mechanism of SRG on cisplatin cytotoxicity towards HEI-OC1, we measured the effects of SRG on lipid peroxidation of cisplatin treated cells as well as scavenging activities against superoxide radical, hydroxyl radical, hydrogen peroxide, and DPPH radical. SRG (5-100 microg/ml) had protective effect against the cisplatin-induced HEI-OC1 cell damage and reduced lipid peroxidation in a dose-dependent manner. Furthermore, SRG showed strong scavenging activity against superoxide radical, hydroxyl radical, hydrogen peroxide, and DPPH radical. These results indicate that SRG protects cisplatin-induced HEI-OC1 cell damage through inhibition of lipid peroxidation and scavenging activities of free radials.

  12. The health meanings and practices of older Greek-Canadian widows.

    PubMed

    Rosenbaum, J N

    1991-11-01

    Folk health and illness beliefs and practices were abstracted from a large-scale study of older Greek-Canadian widows conceptualized within Leininger's theory of Cultural Care Diversity and Universality using ethnographic, ethnonursing, and life health-care history methods. Data were collected using observation-participation and interviews in three Greek-Canadian communities with 12 widowed key informants and 30 general informants. Interview inquiry guides, Leininger's Life History Health Care Protocol, and field journal recordings assisted data collection. Data were analysed using Leininger's phases of analysis for qualitative data. A major health theme which was abstracted from the raw data and patterns was: health for Greek-Canadian widows meant a state of well-being, ability to perform daily role activities, and avoidance of pain and illness. The findings, which also included folk health care and illness beliefs and practices, will stimulate future nursing research related to health and nursing care of people of diverse cultures.

  13. [Advanced nursing practice: a must for the quality of care and mental health services].

    PubMed

    Ricard, Nicole; Page, Claire; Laflamme, France

    2014-01-01

    New professional legislation and reorganization of mental health services have had a significant influence on mental health nursing practice. Many nurses have demonstrated clinical leadership and have been able to adapt their services to the needs of the population specially in the primary health care setting. However, many believe that the role of nurses is not sufficiently known and optimally utilized in mental health services. In this article we take a critical look at the mental health nursing practice in Quebec and at the essential requirements for its development. This review aims to: 1) describe current trends in the changing roles and the modernization of mental health nursing practice in Quebec, 2) provide an overview of the development of advanced nursing practice and its impact on the quality of mental health services; 3) clarify the concept of advanced nursing practice and position its development in Quebec and 4) propose various strategies for optimizing the role of nurses and their complementarity with other professionals providing mental health services. This review presents innovative practices developed by nurses in the context of the restructuring of mental health services. For example, new nursing roles have been developed to improve the collaboration with general practitioners groups in primary care settings and facilitate the evaluation and monitoring of patient presenting medical and psychological problems. Another interesting innovation was set up by nurses in developing a new service to allow timely access to integrated care for patients with substance abuse and mental health problems. The various testimonies reported in this article illustrate the potential contribution of these nursing innovations in improving the mental health services in Quebec. Also, in few countries, the reform of mental health services has been a good time to recognize this potential. Thus, some countries have repositioned the role of mental health nurses and

  14. An Association between College Students' Health Promotion Practices and Perceived Stress

    ERIC Educational Resources Information Center

    Li, Ying; Lindsey, Billie J.

    2013-01-01

    This study was undertaken to gain a better understanding of health promotion practices among college students and the relationship of stress and the practice of various health behaviors. Method: In Fall 2008, 319 students from a mid-size university participated in a cross-sectional survey utilizing the Perceived Stress Scale (PSS) and the Health…

  15. 30 CFR 254.52 - Following the format for an OCS response plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Following the format for an OCS response plan. 254.52 Section 254.52 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL-SPILL RESPONSE REQUIREMENTS FOR FACILITIES LOCATED SEAWARD OF THE COAST LINE Oil-Spill...

  16. Parental knowledge and practices regarding their children's oral health in Kuwait.

    PubMed

    Alyahya, L

    2016-12-01

    The purpose of this study is to assess the knowledge and practices of parents toward their children's oral health in Kuwait. Study Design: A cross-sectional study was conducted among 300 parents who visited five dental specialty centers in Kuwait. Data were collected through a self-administered questionnaire. The statistical analysis was performed using SPSS software (version 21; Inc., Chicago IL, USA). Data were descriptively analysed, and a chi-square test was used to determine whether each individual question varied across different sociodemographic characteristics. The overall mean knowledge and practice scores were calculated. Statistical significance was set at p≤ 0.05. The study results revealed poor parental knowledge and practices with regard to their children's oral health. Oral hygiene and feeding practices were found to be disappointing. Major weakness were observed in infant oral health-related concepts including transmission of cariogenic bacteria, nocturnal bottle feeding, and the time of the first dental visit. However, most parents identified the meaning of gum bleeding and the role of bacteria in causing it. Furthermore, participants demonstrated positive role in their children's daily oral hygiene. A significant better knowledge was detected among female subjects in areas like bacterial transmission (P = 0.031) and aetiology of gingivitis (P = 0.001). Additionally, caregivers residing in Capital governorate showed a significantly better knowledge in bacterial transmission (P = 0.000) and meaning of bleeding gum (P = 0.001) and a significantly better practice with regard to the introduction of hot food to the child for the first time (P = 0.000). Parents in Kuwait seemed to have weak knowledge and practices with regard to their children's oral health. Coordinated efforts by health professionals, including paediatricians and paediatric dentists, are required to increase parental awareness regarding oral hygiene habits, diet and feeding practices

  17. Towards integration of health economics into medical education and clinical practice in Saudi Arabia.

    PubMed

    Da'ar, Omar B; Al Shehri, Ali M

    2015-04-01

    In an era of expanding health sectors and rising costs, doctors are expected to have a working knowledge of health economics to better use resources and improve outcomes and quality of health care. This article recognizes the dearth of knowledge and application of economic analyses in medical education and clinical practice in Saudi Arabia. In particular, it highlights the desirability of knowledge of health economics in ensuring certain competencies in medical education and the rationale for inviting doctors to apply knowledge of economics in Saudi Arabia. In addition, the article discusses challenges that hinder integrating health economics into clinical practice. Furthermore, the article typifies some of the important economic phenomena that physicians need to discern. Besides, the article provides implications for incorporating economic analysis into medical education and clinical practice in Saudi Arabia. Finally, the article concludes by demonstrating how health economics can enhance doctors' knowledge and recommends the country to move towards integrating health economics into medical education and clinical practice for best practice.

  18. SSA Sensor Calibration Best Practices

    NASA Astrophysics Data System (ADS)

    Johnson, T.

    Best practices for calibrating orbit determination sensors in general and space situational awareness (SSA) sensors in particular are presented. These practices were developed over the last ten years within AGI and most recently applied to over 70 sensors in AGI's Commercial Space Operations Center (ComSpOC) and the US Air Force Space Command (AFSPC) Space Surveillance Network (SSN) to evaluate and configure new sensors and perform on-going system calibration. They are generally applicable to any SSA sensor and leverage some unique capabilities of an SSA estimation approach using an optimal sequential filter and smoother. Real world results are presented and analyzed.

  19. From theory to practice: community health nursing in a public health neighborhood team.

    PubMed

    Westbrook, L O; Schultz, P R

    2000-12-01

    An interdisciplinary team in a local public health district tested its ability to implement the core public health functions of assessment, policy development, and assurance by changing its practice to a community-driven model of building partnerships for health with groups and communities in a designated locale. Evaluation of this innovation revealed that the public health nurse members of the team enacted their community health nursing knowledge to strengthen agency to cocreate health. Interdisciplinary collaboration was essential to the team's community mobilization efforts. Additional findings suggested that this organizational innovation was associated with developing a more participatory organizational climate, increasing system effectiveness, and building community capacity.

  20. Comparing Personal Health Practices: Individuals with mental illness and the general Canadian population.

    PubMed

    Schofield, Ruth; Forchui, Cheryl; Montgomery, Phyllis; Rudnic, Abraham; Edwards, Betty; Meier, Amanda; Speechley, Mark

    2016-06-01

    Individuals with mental illness often live in chronic poverty, which is associated with personal health practices such as tobacco use and poor nutrition that disrupt physical health. The purpose of our study was to examine whether differences exist in personal health and health practices - related to nutrition, physical activity, smoking, alcohol consumption and sleep - between a cohort of individuals with mental illness in southwestern Ontario and the general Canadian population. The study sample consisted of 250 individuals who had had a psychiatric diagnosis for at least one year. We conducted a structured quantitative interview with each person to gather information about their personal health and health practices, using question wording from the National Population Health Survey and the Canadian Community Health Survey. We calculated 95% confidence intervals for our results and used them to compare our data with Canadian norms. Individuals with mental illness are significantly more likely than the general population to have a poor diet, experience poor sleep and consume alcohol in excess. It is important for nurses, health-care organizations and policy-makers to be aware that a number of factors may be influencing the personal health and health practices of individuals with mental illness and that this population may require different health promotion strategies to support a healthy lifestyle.

  1. Practical ways to facilitate ergonomics improvements in occupational health practice.

    PubMed

    Kogi, Kazutaka

    2012-12-01

    Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.

  2. Governing the implementation of emergency obstetric care: experiences of rural district health managers, Tanzania.

    PubMed

    Mkoka, Dickson Ally; Kiwara, Angwara; Goicolea, Isabel; Hurtig, Anna-Karin

    2014-08-03

    Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development. The study revealed that

  3. Behavioral Health Integration into Primary Care: a Microsimulation of Financial Implications for Practices.

    PubMed

    Basu, Sanjay; Landon, Bruce E; Williams, John W; Bitton, Asaf; Song, Zirui; Phillips, Russell S

    2017-12-01

    New payments from Medicare encourage behavioral health services to be integrated into primary care practice activities. To evaluate the financial impact for primary care practices of integrating behavioral health services. Microsimulation model. We simulated patients and providers at federally qualified health centers (FQHCs), non-FQHCs in urban and rural high-poverty areas, and practices outside of high-poverty areas surveyed by the National Association of Community Health Centers, National Ambulatory Medical Care Survey, National Health and Nutrition Examination Survey, and National Health Interview Survey. A collaborative care model (CoCM), involving telephone-based follow-up from a behaviorist care manager, or a primary care behaviorist model (PCBM), involving an in-clinic behaviorist. Net revenue change per full-time physician. When behavioral health integration services were offered only to Medicare patients, net revenue was higher under CoCM (averaging $25,026 per MD in year 1 and $28,548/year in subsequent years) than PCBM (-$7052 in year 1 and -$3706/year in subsequent years). When behavioral health integration services were offered to all patients and were reimbursed by Medicare and private payers, only practices adopting the CoCM approach consistently gained net revenues. The outcomes of the model were sensitive to rates of patient referral acceptance, presentation, and therapy completion, but the CoCM approach remained consistently financially viable whereas PCBM would not be in the long-run across practice types. New Medicare payments may offer financial viability for primary care practices to integrate behavioral health services, but this viability depends on the approach toward care integration.

  4. Integrating relationship- and research-based approaches in Australian health promotion practice.

    PubMed

    Klinner, Christiane; Carter, Stacy M; Rychetnik, Lucie; Li, Vincy; Daley, Michelle; Zask, Avigdor; Lloyd, Beverly

    2015-12-01

    We examine the perspectives of health promotion practitioners on their approaches to determining health promotion practice, in particular on the role of research and relationships in this process. Using Grounded Theory methods, we analysed 58 semi-structured interviews with 54 health promotion practitioners in New South Wales, Australia. Practitioners differentiated between relationship-based and research-based approaches as two sources of knowledge to guide health promotion practice. We identify several tensions in seeking to combine these approaches in practice and describe the strategies that participants adopted to manage these tensions. The strategies included working in an evidence-informed rather than evidence-based way, creating new evidence about relationship-based processes and outcomes, adopting 'relationship-based' research and evaluation methods, making research and evaluation useful for communities, building research and evaluation skills and improving collaboration between research and evaluation and programme implementation staff. We conclude by highlighting three systemic factors which could further support the integration of research-based and relationship-based health promotion practices: (i) expanding conceptions of health promotion evidence, (ii) developing 'relationship-based' research methods that enable practitioners to measure complex social processes and outcomes and to facilitate community participation and benefit, and (iii) developing organizational capacity. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Educational outreach visits: effects on professional practice and health care outcomes.

    PubMed

    Thomson O'Brien, M A; Oxman, A D; Davis, D A; Haynes, R B; Freemantle, N; Harvey, E L

    2000-01-01

    Outreach visits have been identified as an intervention that may improve the practice of health care professionals, in particular prescribing. This type of 'face to face' visit has been referred to as university-based educational detailing, public interest detailing, and academic detailing. To assess the effects of outreach visits on improving health professional practice or patient outcomes. We searched MEDLINE up to March 1997, the Research and Development Resource Base in Continuing Medical Education, and reference lists of related systematic reviews and articles. Randomised trials of outreach visits (defined as a personal visit by a trained person to a health care provider in his or her own setting). The participants were health care professionals. Two reviewers independently extracted data and assessed study quality. Eighteen studies were included involving more than 1896 physicians. All of the outreach visit interventions consisted of several components, including written materials and conferences. Reminders or audit and feedback complemented some visits. In 13 studies, the targeted behaviours were prescribing practices. In three studies, the behaviours were preventive services, including counselling for smoking cessation. In two studies, the outreach visits were directed toward improving the general management of common problems encountered in general practice, including asthma, diabetes, otitis media, hypertension, anxiety, and acute bronchitis. All studies examined physician behaviour and in three studies other health professionals such as nurses, nursing home attendants or health care workers were targeted. Positive effects on practice were observed in all studies. Only one study measured a patient outcome. Few studies examined the cost effectiveness of outreach. Educational outreach visits, particularly when combined with social marketing, appear to be a promising approach to modifying health professional behaviour, especially prescribing. Further

  6. The Health Behavior Checklist: Factor structure in community samples and validity of a revised good health practices scale.

    PubMed

    Hampson, Sarah E; Edmonds, Grant W; Goldberg, Lewis R

    2017-01-01

    This study examined the factor structure and predictive validity of the commonly used multidimensional Health Behavior Checklist. A three-factor structure was found in two community samples that included men and women. The new 16-item Good Health Practices scale and the original Wellness Maintenance scale were the only Health Behavior Checklist scales to be related to cardiovascular and metabolic risk factors. While the other Health Behavior Checklist scales require further validation, the Good Health Practices scale could be used where more objective or longer measures are not feasible.

  7. Health educators' perceptions of ethics in professional preparation and practice.

    PubMed

    Shive, Steven E; Marks, Ray

    2008-07-01

    This commentary reflects health educators' views concerning perceptions of the need for increased awareness of the Code of Ethics for the Health Education Profession, improvement in professionals' ability to engage in ethical reflection, and the need for incorporation of ethical considerations into health education practice.

  8. Developing Effective Educational Materials Using Best Practices in Health Literacy

    ERIC Educational Resources Information Center

    Niebaum, Kelly; Cunningham-Sabo, Leslie; Bellows, Laura

    2015-01-01

    Health literacy is emerging as a leading issue affecting U.S. consumers' health. It has been shown to be a stronger predictor of a person's health than age, income, employment status, education level, or race. To best meet the health literacy needs of consumers, Extension educators can use best practice guidelines for improved health…

  9. Mental health care treatment initiation when mental health services are incorporated into primary care practice.

    PubMed

    Kessler, Rodger

    2012-01-01

    Most primary care patients with mental health issues are identified or treated in primary care rather than the specialty mental health system. Primary care physicians report that their patients do not have access to needed mental health care. When referrals are made to the specialty behavioral or mental health care system, rates of patients who initiate treatment are low. Collaborative care models, with mental health clinicians as part of the primary care medical staff, have been suggested as an alternative. The aim of this study is to examine rates of treatment startup in 2 collaborative care settings: a rural family medicine office and a suburban internal medicine office. In both practices referrals for mental health services are made within the practice. Referral data were drawn from 2 convenience samples of patients referred by primary care physicians for collaborative mental health treatment at Fletcher Allen Health Care in Vermont. The first sample consisted of 93 consecutively scheduled referrals in a family medicine office (sample A) between January 2006 and December 2007. The second sample consisted of 215 consecutive scheduled referrals at an internal medicine office (sample B) between January 2009 and December 2009. Referral data identified age, sex, and presenting mental health/medical problem. In sample A, 95.5% of those patients scheduling appointments began behavioral health treatment; in sample B this percentage was 82%. In sample B, 69% of all patients initially referred for mental health care both scheduled and initiated treatment. When referred to a mental health clinician who provides on-site access as part of a primary care mental health collaborative care model, a high percentage of patients referred scheduled care. Furthermore, of those who scheduled care, a high percentage of patients attend the scheduled appointment. Findings persist despite differences in practice type, populations, locations, and time frames of data collection. That the

  10. Discourse versus practice: are traditional practices and beliefs in pregnancy and childbirth included or excluded in the Ecuadorian health care system?

    PubMed

    Gallegos, Carlos Andres; Waters, William F; Kuhlmann, Anne Sebert

    2017-03-01

    Traditional beliefs, knowledge and practices are formally integrated into the Ecuadorian health system. We sought to understand whether they are integrated in practice. Qualitative data were collected in two rural parishes in the central highlands of Ecuador through four focus group discussions (30 participants), eight key informant interviews, three participatory exercises (24 participants), structured observations of health facilities and analysis of official documents. We found different levels of integration, coexistence, tolerance, and intolerance of traditional health beliefs and practices in health facilities. One parish has undergone dramatic social and cultural transformation, and the role of traditional birth attendants is limited. In the other parish, traditional indigenous norms and values persist, and traditional birth attendants are sought during pregnancy and childbirth. The degree to which traditional birth attendants, indigenous women and their families are included or excluded from public health services depends largely on decisions taken by local health professionals. Formal policies in Ecuador stipulate that health care should be intercultural, but the role of traditional birth attendants is not necessarily incorporated in practice. The integration of culturally-informed beliefs and practices is critical for providing appropriate health services to members of vulnerable populations. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Psychoanalysis in modern mental health practice.

    PubMed

    Yakeley, Jessica

    2018-05-01

    Like any discipline, psychoanalysis has evolved considerably since its inception by Freud over a century ago, and a multitude of different psychoanalytic traditions and schools of theory and practice now exist. However, some of Freud's original ideas, such as the dynamic unconscious, a developmental approach, defence mechanisms, and transference and countertransference remain essential tenets of psychoanalytic thinking to this day. This Review outlines several areas within modern mental health practice in which contemporary adaptations and applications of these psychoanalytic concepts might offer helpful insights and improvements in patient care and management, and concludes with an overview of evidence-based psychoanalytically informed treatments and the links between psychoanalysis, attachment research, and neuroscience. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Mental health practice and attitudes of family physicians can be changed!

    PubMed

    MacCarthy, Dan; Weinerman, Rivian; Kallstrom, Liza; Kadlec, Helena; Hollander, Marcus J; Patten, Scott

    2013-01-01

    An adult mental health module was developed in British Columbia to increase the use of evidence-based screening and cognitive behavioral self-management tools as well as medications that fit within busy family physician time constraints and payment systems. Aims were to enhance family physician skills, comfort, and confidence in diagnosing and treating mental health patients using the lens of depression; to improve patient experience and partnership; to increase use of action or care plans; and to increase mental health literacy and comfort of medical office assistants. The British Columbia Practice Support Program delivered the module using the Plan-Do-Study-Act cycle for learning improvement. Family physicians were trained in adult mental health, and medical office assistants were trained in mental health first aid. Following initial testing, the adult mental health module was implemented across the province. More than 1400 of the province's 3300 full-service family physicians have completed or started training. Family physicians reported high to very high success implementing self-management tools into their practices and the overall positive impact this approach had on patients. These measures were sustained or improved at 3 to 6 months after completion of the module. An Opening Minds Survey for health care professionals showed a decrease in stigmatizing attitudes of family physicians. The adult mental health module is changing the way participants practice. Office-based primary mental health care can be improved through reimbursed training and support for physicians to implement practical, time-efficient tools that conform to payment schemes. The module provided behavior-changing tools that seem to be changing stigmatizing attitudes towards this patient population. This unexpected discovery has piqued the interest of stigma experts at the Mental Health Commission of Canada.

  13. Self-rated oral health status, oral health service utilization, and oral hygiene practices among adult Nigerians.

    PubMed

    Olusile, Adeyemi Oluniyi; Adeniyi, Abiola Adetokunbo; Orebanjo, Olufemi

    2014-11-27

    There is scarce information available on oral health service utilization patterns and common oral hygiene practices among adult Nigerians. We conducted the 2010-2011 national oral health survey before the introduction of the national oral health policy to determine the prevalence of oral health service utilization, patterns of oral hygiene practices, and self reported oral health status, among adults in various social classes, educational strata, ethnic groups and geopolitical zones in Nigeria. We conducted a cross-sectional survey in North-Central, North-West, South-East, South-South and South-West geopolitical zones of Nigeria. Multi-stage cluster sampling method was used for the sample selection. We administered a structured questionnaire to a total of 7,630 participants. Information on the socio-demographic characteristics, oral hygiene practices and oral health services utilization pattern of participants was obtained. We interviewed 7, 630 participants (55.6% female). The participants ages ranged between 18 and 81 years, mean age was 37.96 (SD = 13.2). Overall 21.2% of the participants rated their oral health status as very good, 37.1% as good and 27.4% as fair. Only 26.4% reported having visited the dentist at least once prior to the conduct of the survey. More than half of these visits (54.9%) were for treatment purpose. Utilization of oral health services was significantly (p < 0.05) associated with being older, more educated and being engaged in a skilled profession. More educated persons, females and younger persons used toothbrushes for daily tooth cleaning. Age, sex, marital status, level of education and occupation were significantly related to daily frequency of tooth cleaning (p < 0.05). Our results show that while most Nigerian adults have a positive view of their oral health status, majority reported poor oral health utilization habits. Older persons resident in the northern zones of the country and less educated persons displayed

  14. Let's drink and be merry: the framing of alcohol in the prime-time American youth series The OC.

    PubMed

    Van Den Bulck, Hilde; Simons, Nele; Gorp, Baldwin Van

    2008-11-01

    This study analyzed the framing of alcohol consumption in the American adolescent drama series The OC. All 51 episodes of Seasons 1 and 2 of The OC were coded for visual and verbal references to beverage use on the level of the scene (n = 1,895) and on the level of the drinking act (n = 1,033). Subsequently, all episodes were analyzed qualitatively through an inductive frame analysis. Although the public's perception of The OC is that alcohol was overrepresented in this series, the quantitative results show the opposite. The focus was on active consumption and solitary drinking of alcohol, but in absolute terms there were more nonalcoholic drinking acts. The OC represents a trend break, compared with earlier analyses of alcohol consumption in television fiction: More than half of all alcoholic drinking acts involved women, and almost one third involved adolescents. The qualitative frame analysis revealed two commonly used frames (alcohol consumption as an "obligatory outlet" and alcohol consumption as "escapism") and two less frequently applied frames ("celebrate without the sauce" and alcohol addiction as "sickness"). The findings suggest that the concept of framing might contribute to this field of study by analyzing the underlying cultural frames that suggest how the receiver may interpret the consumption of alcohol in fictional television programs.

  15. Measurement of OCS, CO2, CO and H2O aboard NASA's WB-57 High Altitude Platform Using Off-Axis Integrated Cavity Output Spectroscopy (OA-ICOS)

    NASA Astrophysics Data System (ADS)

    Leen, J. B.; Owano, T. G.; Du, X.; Gardner, A.; Gupta, M.

    2014-12-01

    Carbonyl sulfide (OCS) is the most abundant sulfur gas in the atmosphere and has been implicated in controlling the sulfur budget and aerosol loading of the stratosphere. In the troposphere, OCS is irreversibly consumed during photosynthesis and may serve as a tracer for gross primary production (GPP). Its primary sources are ocean outgassing, industrial processes, and biomass burning. Its primary sinks are vegetation and soils. Despite the importance of OCS in atmospheric processes, the OCS atmospheric budget is poorly determined and has high uncertainty. OCS is typically monitored using either canisters analyzed by gas chromatography or integrated atmospheric column measurements. Improved in-situ terrestrial flux and airborne measurements are required to constrain the OCS budget and further elucidate its role in stratospheric aerosol formation and as a tracer for biogenic volatile organics and photosynthesis. Los Gatos Research has developed a flight capable mid-infrared Off-Axis Integrated Cavity Output Spectroscopy (OA-ICOS) analyzer to simultaneously quantify OCS, CO2, CO, and H2O in ambient air at up to 2 Hz. The prototype was tested on diluted, certified samples and found to be precise (OCS, CO2, CO, and H2O to better than ±4 ppt, ±0.2 ppm, ±0.31 ppb, and ±3.7 ppm respectively, 1s in 1 sec) and linear (R2 > 0.9997 for all gases) over a wide dynamic range (OCS, CO2, CO, and H2O ranging from 0.2 - 70 ppb, 500 - 3000 ppm, 150 - 480 ppb, and 7000 - 21000 ppm respectively). Cross-interference measurements showed no appreciable change in measured OCS concentration with variations in CO2 (500 - 3500 ppm) or CO. We report on high altitude measurements made aboard NASA's WB-57 research aircraft. Two research flights were conducted from Houston, TX. The concentration of OCS, CO2, CO, and H2O were continuously recorded from sea level to approximately 60,000 feet. The concentration of OCS was observed to increase with altitude through the troposphere due to the

  16. MiR-495 and miR-218 regulate the expression of the Onecut transcription factors HNF-6 and OC-2

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Simion, Alexandru; Laudadio, Ilaria; Prevot, Pierre-Paul

    2010-01-01

    MicroRNAs are small, non-coding RNAs that posttranscriptionally regulate gene expression mainly by binding to the 3'UTR of their target mRNAs. Recent data revealed that microRNAs have an important role in pancreas and liver development and physiology. Using cloning and microarray profiling approaches, we show that a unique repertoire of microRNAs is expressed at the onset of liver and pancreas organogenesis, and in pancreas and liver at key stages of cell fate determination. Among the microRNAs that are expressed at these stages, miR-495 and miR-218 were predicted to, respectively, target the Onecut (OC) transcription factors Hepatocyte Nuclear Factor-6 (HNF-6/OC-1) and OC-2,more » two important regulators of liver and pancreas development. MiR-495 and miR-218 are dynamically expressed in developing liver and pancreas, and by transient transfection, we show that they target HNF-6 and OC-2 3'UTRs. Moreover, when overexpressed in cultured cells, miR-495 and miR-218 decrease the endogenous levels of HNF-6 and OC-2 mRNA. These results indicate that the expression of regulators of liver and pancreas development is modulated by microRNAs. They also suggest a developmental role for miR-495 and miR-218.« less

  17. Health information technology workforce needs of rural primary care practices.

    PubMed

    Skillman, Susan M; Andrilla, C Holly A; Patterson, Davis G; Fenton, Susan H; Ostergard, Stefanie J

    2015-01-01

    This study assessed electronic health record (EHR) and health information technology (HIT) workforce resources needed by rural primary care practices, and their workforce-related barriers to implementing and using EHRs and HIT. Rural primary care practices (1,772) in 13 states (34.2% response) were surveyed in 2012 using mailed and Web-based questionnaires. EHRs or HIT were used by 70% of respondents. Among practices using or intending to use the technology, most did not plan to hire new employees to obtain EHR/HIT skills and even fewer planned to hire consultants or vendors to fill gaps. Many practices had staff with some basic/entry, intermediate and/or advanced-level skills, but nearly two-thirds (61.4%) needed more staff training. Affordable access to vendors/consultants who understand their needs and availability of community college and baccalaureate-level training were the workforce-related barriers cited by the highest percentages of respondents. Accessing the Web/Internet challenged nearly a quarter of practices in isolated rural areas, and nearly a fifth in small rural areas. Finding relevant vendors/consultants and qualified staff were greater barriers in small and isolated rural areas than in large rural areas. Rural primary care practices mainly will rely on existing staff for continued implementation and use of EHR/HIT systems. Infrastructure and workforce-related barriers remain and must be overcome before practices can fully manage patient populations and exchange patient information among care system partners. Efforts to monitor adoption of these skills and ongoing support for continuing education will likely benefit rural populations. © 2014 National Rural Health Association.

  18. Emotional intelligence in mental health nurses talking about practice.

    PubMed

    Akerjordet, Kristin; Severinsson, Elisabeth

    2004-09-01

    The aim of this study was to explore mental health nurses' experiences of emotional intelligence (EI) in their nursing practice by means of qualitative interviews. The interview questions where developed from the literature on EI. This study used a hermeneutic analysis. Four main themes emerged: relationship with the patient; the substance of supervision; motivation; and responsibility. It was concluded that EI stimulates the search for a deeper understanding of a professional mental health nursing identity. Emotional learning and maturation processes are central to professional competence, that is, personal growth and development. In addition, the moral character of the mental health nurse in relation to clinical practice is of importance. The findings imply multiple types of intelligence related to nursing science as well as further research possibilities within the area of EI.

  19. Health Regulation and the Prescription--and Proscription--of Educational Practice

    ERIC Educational Resources Information Center

    Tudor, Keith; Shaw, Susan

    2016-01-01

    This article discusses the interface between health policy and education. Taking as a case example the power that regulatory "responsible authorities" have under the New Zealand "Health Practitioners Competence Assurance Act 2003" to define scopes of practice of health professionals, including that of educator, the article…

  20. [Teaching practices and learning strategies in health careers].

    PubMed

    Carrasco Z, Constanza; Pérez V, Cristhian; Torres A, Graciela; Fasce H, Eduardo

    2016-09-01

    Medical Education, according to the constructivist education paradigm, puts students as the protagonists of the teaching and learning process. It demands changes in the practice of teaching. However, it is unclear whether this new model is coherent with the teachers’ ways to cope with learning. To analyze the relationship between teaching practices and learning strategies among teachers of health careers in Chilean universities. The Teaching Practices Questionnaire and Learning Strategies Inventory of Schmeck were applied to 200 teachers aged 24 to 72 years (64% females). Teachers use different types of teaching practices. They commonly use deep and elaborative learning strategies. A multiple regression analysis showed that learning strategies had a 13% predictive value to identify student-centered teaching, but they failed to predict teacher-centered teaching. Teaching practices and learning strategies of teachers are related. Teachers frequently select constructivist model strategies, using different teaching practices in their work.

  1. Practical Challenges of Systems Thinking and Modeling in Public Health

    PubMed Central

    Trochim, William M.; Cabrera, Derek A.; Milstein, Bobby; Gallagher, Richard S.; Leischow, Scott J.

    2006-01-01

    Objectives. Awareness of and support for systems thinking and modeling in the public health field are growing, yet there are many practical challenges to implementation. We sought to identify and describe these challenges from the perspectives of practicing public health professionals. Methods. A systems-based methodology, concept mapping, was used in a study of 133 participants from 2 systems-based public health initiatives (the Initiative for the Study and Implementation of Systems and the Syndemics Prevention Network). This method identified 100 key challenges to implementation of systems thinking and modeling in public health work. Results. The project resulted in a map identifying 8 categories of challenges and the dynamic interactions among them. Conclusions. Implementation by public health professionals of the 8 simple rules we derived from the clusters in the map identified here will help to address challenges and improve the organization of systems that protect the public’s health. PMID:16449581

  2. Oral Health Knowledge, Attitudes and Practice Behaviour among Secondary School Children in Chandigarh

    PubMed Central

    Blaggana, Anshu; Anjali; Kapoor, Anoop; Blaggana, Vikram; Tanwar, Renu; Kaur, Harleen; Haneet, Ryana Kaur

    2016-01-01

    Introduction Oral health knowledge is considered to be an essential prerequisite for health-related practices and better oral health. Healthy practices adopted at young age are more sustainable. Aim Present cross-sectional exploratory study was planned to assess oral health knowledge and practices of secondary school students in Chandigarh, India. Materials and Methods A cross-sectional survey was under-taken amongst 1027 secondary level school students, in Chandigarh, India. After obtaining informed consent subjects were administered pretested self administered questionnaire addressing demographics, knowledge, attitude and practice behaviour of participants. Frequency analysis was done using descriptive statistics. Results Survey revealed that only 40% subjects brushed twice daily. About 17% reported use of dental floss and 20% used either mouthwash or tongue cleaner as adjuncts. A total of 58% had knowledge that infrequent brushing led to dental caries, staining of teeth, dental plaque and bleeding from gums. Most of them knew sweets (92.7%) and soft drinks (67.8%) affected dental health. Only 12.9% visited dentist regularly after every 6-12 months. Conclusion Efficacy of dental health education can be increased only if health programs are tailored to directly impinge on attitudes of targeted population, especially school children in whom healthy practices can be inculcated easily and be sustained for long times. PMID:27891447

  3. A review of approaches for dental practice teams for promoting oral health.

    PubMed

    Kay, Elizabeth; Vascott, Donna; Hocking, Allice; Nield, Helen; Dorr, Charles; Barrett, Helen

    2016-08-01

    To determine the circumstances in which oral health promotion (OHP) in General Dental Practice is at its most effective, a systematic review was conducted to identify, critically appraise and synthesize the available evidence. The research question was: Is oral health promotion within dental practice effective and how can its effects be optimized? Systematic searches of 20 online resources (including Ovid Medline and Embase) were conducted. A call for evidence was also issued, and citation lists of other relevant systematic reviews were included. All studies published since 1994 which were set in the context of general dental practice and investigated promoting good oral health in adult or child patients were considered. 44 studies reported in 52 papers were included in the review. The evidence was heterogeneous and the quality of reporting was variable. Results showed that oral health promotion based on behavioural and psychological models was effective for improving oral health. Verbal advice affected knowledge and reported behaviour, written advice promoted oral health knowledge. There was moderate evidence that the attributes of the 'sender' of an oral health promotion message influenced its effectiveness. Many barriers and facilitators were shown to influence the effectiveness of OHP in dental practice. The results of this review suggest that the psychology of behaviour change is the key to oral health promotion and greater emphasis on teaching oral health professionals about health psychology would make oral health promotion in the dental surgery more effective. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Future trends in health and health care: implications for social work practice in an aging society.

    PubMed

    Spitzer, William J; Davidson, Kay W

    2013-01-01

    Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.

  5. National health insurance in America--can we practice with it? Can we continue to practice without it?

    PubMed Central

    Grumbach, K

    1989-01-01

    Health insurance in the United States is failing patients and physicians alike. In this country 37 million uninsured face economic barriers to care, and the health of many suffers as a result. The "corporatization" of medical care threatens professional values with an unprecedented administrative and commercial intrusion into the daily practice of medicine. Competitive strategies have also failed their most ostensible goal--cost control. In contrast, Canada offers a model of a national health insurance plan that provides universal and comprehensive coverage, succeeds at restraining health care inflation, and does little to abrogate the clinical autonomy of physicians in private practice. I propose that American physicians relent in their historical opposition to national health insurance and participate in the development of a universal, public insurance plan responsive to the needs of both patients and physicians. Images PMID:2672604

  6. School Social Work with Students with Mental Health Problems: Examining Different Practice Approaches

    ERIC Educational Resources Information Center

    McManama O'Brien, Kimberly H.; Berzin, Stephanie C.; Kelly, Michael S.; Frey, Andy J.; Alvarez, Michelle E.; Shaffer, Gary L.

    2011-01-01

    School social workers frequently serve as the primary mental health providers to youths with mental health problems. Although school social workers play a primary role in care, many students also receive outside counseling services. Previous research has not examined whether practice approaches differ when considering mental health practice with…

  7. A descriptive study of chiropractors' opinions and practices regarding office-based health product sales.

    PubMed

    Page, Stacey A; Grod, Jaroslaw P; McMorland, D Gordon

    2012-04-05

    Although the sale of non-prescription health products is ubiquitous, the views of health professionals, such as chiropractors, regarding the sale of such products are not well known. Practitioner opinion is important to understand and inform professional practice. The purpose of this study was to describe chiropractors' perspectives and practices on the sale of health care products from practitioners' offices. Chiropractors were invited to provide written comments about health product sales at the end of a fixed choice, mailed survey. Respondents' comments were analyzed using qualitative description. Ethics approval was received from the Conjoint Health Research Ethics Board at the University of Calgary. One hundred seven of the 265 respondents (response rate of 51%) provided written comments. Approximately 30 pages of double-spaced, typed text were gathered. Respondents did not consistently endorse or condemn health product sales, and engaged in the practice to greater and lesser extents. While some were opposed to health products sales, some accepted the practice with a degree of ambivalence whereas others clearly embraced it. Some respondents acknowledged a professional conflict of interest in such sales and marketing, and described strategies used to mitigate it. Others provided a range of justifications for the practice. Personal integrity and professional standards were discussed and a need for monitoring identified. A wide range of opinions and practices were described and this is consistent with resulting variation in practice. In light of this, standards that facilitate consistency in practice may benefit professionals and the public alike.

  8. Best practices in intercultural health: five case studies in Latin America

    PubMed Central

    Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

    2007-01-01

    The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria. PMID:17803820

  9. Best practices in intercultural health: five case studies in Latin America.

    PubMed

    Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

    2007-09-05

    The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria.

  10. Structure-function relationship of avian eggshell matrix proteins: a comparative study of two major eggshell matrix proteins, ansocalcin and OC-17.

    PubMed

    Lakshminarayanan, Rajamani; Joseph, Jeremiah S; Kini, R Manjunatha; Valiyaveettil, Suresh

    2005-01-01

    The role of individual matrix proteins in avian eggshell calcification is poorly understood despite numerous attempts to characterize and localize their presence in the eggshell matrix. Ansocalcin, the major matrix protein from goose eggshell, was found to induce the formation of calcite crystal aggregates under in vitro. Owing to its high similarity with the chicken eggshell matrix protein ovocleidin 17 (OC-17), a comparative investigation has been carried out to understand the structure-function relationship. RP-HPLC shows that ansocalcin is the major component in extracts of goose eggshells before and after bleach treatment. However, OC-17 was observed in minute quantities in the extract of bleach-treated chicken eggshells. In vitro crystal growth experiments showed that OC-17 and ansocalcin interact differently with the calcite crystals formed. Circular dichroism, intrinsic tryptophan fluorescence, and dynamic light scattering studies showed that, under the conditions used in our experiments, OC-17 does not aggregate in solution or induce the nucleation of calcite aggregates in the concentration range used. These observations indicate that OC-17 and ansocalcin play different roles in the eggshell calcification. To our knowledge, this is the first report on the comparison of properties of homologous eggshell proteins that belong to the same phylogeny.

  11. Interprofessional Practice and Education in Health Care: Their Relevance to School Psychology

    ERIC Educational Resources Information Center

    Margison, Judith A.; Shore, Bruce M.

    2009-01-01

    Calls for increased collaborative practices in school psychology parallel similar advances in the realm of health care. This article overviews the concepts associated with collaborative practice in school psychology and in health care (e.g., interaction, teamwork, and collaboration) and discusses how the literature emerging from interprofessional…

  12. Answers to the 50 Most Important Questions about Private Mental Health Practice.

    ERIC Educational Resources Information Center

    Forman, Bruce D.; Silverman, Wade H.

    Designed for anyone contemplating or presently established in private mental health practice, this book provides the answers to 50 pertinent questions concerning private practice. Questions were culled from a survey of graduate students in psychology, as well as experienced psychotherapists, psychiatrists, social workers, mental health counselors,…

  13. Health beliefs, practice, and priorities for health care of Arab Muslims in the United States.

    PubMed

    Yosef, Abdel Raheem Odeh

    2008-07-01

    The Arab Muslim population is one of the dramatically increasing minorities in the United States. In addition to other factors, religion and cultural background influence individuals' beliefs, behaviors, and attitudes toward health and illness. The author describes health beliefs and practices of the Arab Muslim population in the United States. That population is at an increased risk for several diseases and faces many barriers to accessing the American health care system. Some barriers, such as modesty, gender preference in healthcare providers, and illness causation misconceptions, arise out of their cultural beliefs and practices. Other barriers are related to the complexity of the health care system and the lack of culturally competent services within it. Nurses need to be aware of these religious and cultural factors to provide culturally competent health promotion services for this population. Nurses also need to integrate Islamic teachings into their interventions to provide appropriate care and to motivate healthy behaviors.

  14. Developing family practice to respond to global health challenges

    PubMed Central

    Arya, Neil; Dahlman, Bruce; Gibson, Christine; Ponka, David; Haq, Cynthia; Rouleau, Katherine; Hansel, Stephanie

    2017-01-01

    Abstract Objective To assess family medicine’s role in developing strong, coordinated, community-based, integrated health care systems in low-resource settings globally. Composition of the committee A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with selected international colleagues with expertise in international family medicine practice, health systems and capacity building, and teaching to map family medicine globally and give a bird’s eye view of family medicine internationally. Methods Following a background literature review, the authors collectively reflected on their substantial international experience to attempt to describe best practices for various contexts. Report With the failure of vertical, disease-oriented models to provide sustained improvements in health outcomes, the need to develop integrated primary care involving the most appropriate health professionals for differing contexts is becoming apparent worldwide. Health system planning is required to develop policies on health professional training to achieve this. Advocating and offering appropriate incentives for, and coordination of, local opportunities within the health system also becomes paramount. The adaptability and generalist nature of family medicine allows it to respond to the unique needs of a given population. Family physicians with adequate financial and physical resources can function most effectively as members of interdisciplinary teams, thus providing valuable, comprehensive health services in any area of the world. PMID:28807953

  15. Environmental justice and health practices: understanding how health inequities arise at the local level.

    PubMed

    Frohlich, Katherine L; Abel, Thomas

    2014-02-01

    While empirical evidence continues to show that people living in low socio-economic status neighbourhoods are less likely to engage in health-enhancing behaviour, our understanding of why this is so remains less than clear. We suggest that two changes could take place to move from description to understanding in this field; (i) a move away from the established concept of individual health behaviour to a contextualised understanding of health practices; and (ii) a switch from focusing on health inequalities in outcomes to health inequities in conditions. We apply Pierre Bourdieu's theory on capital interaction but find it insufficient with regard to the role of agency for structural change. We therefore introduce Amartya Sen's capability approach as a useful link between capital interaction theory and action to reduce social inequities in health-related practices. Sen's capability theory also elucidates the importance of discussing unequal chances in terms of inequity, rather than inequality, in order to underscore the moral nature of inequalities. We draw on the discussion in social geography on environmental injustice, which also underscores the moral nature of the spatial distribution of opportunities. The article ends by applying this approach to the 'Interdisciplinary study of inequalities in smoking' framework. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  16. Observations of infection prevention and control practices in primary health care, Kenya.

    PubMed

    Bedoya, Guadalupe; Dolinger, Amy; Rogo, Khama; Mwaura, Njeri; Wafula, Francis; Coarasa, Jorge; Goicoechea, Ana; Das, Jishnu

    2017-07-01

    To assess compliance with infection prevention and control practices in primary health care in Kenya. We used an observational, patient-tracking tool to assess compliance with infection prevention and control practices by 1680 health-care workers during outpatient interactions with 14 328 patients at 935 health-care facilities in 2015. Compliance was assessed in five domains: hand hygiene; protective glove use; injections and blood sampling; disinfection of reusable equipment; and waste segregation. We calculated compliance by dividing the number of correct actions performed by the number of indications and evaluated associations between compliance and the health-care worker's and facility's characteristics. Across 106 464 observed indications for an infection prevention and control practice, the mean compliance was 0.318 (95% confidence interval, CI: 0.315 to 0.321). The compliance ranged from 0.023 (95% CI: 0.021 to 0.024) for hand hygiene to 0.871 (95% CI: 0.866 to 0.876) for injection and blood sampling safety. Compliance was weakly associated with the facility's characteristics (e.g. public or private, or level of specialization) and the health-care worker's knowledge of, and training in, infection prevention and control practices. The observational tool was effective for assessing compliance with infection prevention and control practices across multiple domains in primary health care in a low-income country. Compliance varied widely across infection prevention and control domains. The weak associations observed between compliance and the characteristics of health-care workers and facilities, such as knowledge and the availability of supplies, suggest that a broader focus on behavioural change is required.

  17. Safe injection practice among health care workers, Gharbiya, Egypt.

    PubMed

    Ismail, Nanees A; Aboul Ftouh, Aisha M; El Shoubary, Waleed H

    2005-01-01

    A cross-sectional study was conducted in 25 health care facilities in Gharbiya governorate to assess safe injection practices among health care workers (HCWs). Two questionnaires, one to collect information about administrative issues related to safe injection and the other to collect data about giving injections, exposure to needle stick injuries, hepatitis B vaccination status and safe injection training. Practices of injections were observed using a standardized checklist. The study revealed that there was lack of both national and local infection control policies and lack of most of the supplies needed for safe injection practices. Many safe practices were infrequent as proper needle manipulation before disposal (41%), safe needle disposal (47.5%), reuse of used syringe & needle (13.2%) and safe syringe disposal (0%). Exposure to needle stick injuries were common among the interviewed HCWs (66.2%) and hand washing was the common post exposure prophylaxis measure (63.4%). Only 11.3% of HCWs had full course hepatitis B vaccination. Infection control -including safe injections- training programs should be afforded to all HCWs.

  18. Sustaining "meaningful use" of health information technology in low-resource practices.

    PubMed

    Green, Lee A; Potworowski, Georges; Day, Anya; May-Gentile, Rachelle; Vibbert, Danielle; Maki, Bruce; Kiesel, Leslie

    2015-01-01

    The implementation of electronic health records (EHRs) has been extensively studied, but their maintenance once implemented has not. The Regional Extension Center (REC) program provides implementation assistance to priority practices-those with limited financial, technical, and organizational resources-but the assistance is time limited. Our objective was to identify potential barriers to maintenance of meaningful use of EHRs in priority primary care practices using a qualitative observational study for federally qualified health centers (FQHCs) and priority practices in Michigan. We conducted cognitive task analysis (CTA) interviews and direct observations of health information technology implementation in FQHCs. In addition, we conducted semistructured interviews with implementation specialists serving priority practices to detect emergent themes relevant to maintenance. Maintaining EHR technology will require ongoing expert technical support indefinitely beyond implementation to address upgrades and security needs. Maintaining meaningful use for quality improvement will require ongoing support for leadership and change management. Priority practices not associated with larger systems lack access to the necessary technical expertise, financial resources, and leverage with vendors to continue alone. Rural priority practices are particularly challenged, because expertise is often not available locally. Priority practices, especially in rural areas, are at high risk for falling on the wrong side of a "digital divide" as payers and regulators enact increasing expectations for EHR use and information management. For those without affiliation to maintain the necessary expert staff, ongoing support will be needed for those practices to remain viable. © 2015 Annals of Family Medicine, Inc.

  19. Associations between Organochlorine Contaminant Concentrations and Clinical Health Parameters in Loggerhead Sea Turtles from North Carolina, USA

    PubMed Central

    Keller, Jennifer M.; Kucklick, John R.; Stamper, M. Andrew; Harms, Craig A.; McClellan-Green, Patricia D.

    2004-01-01

    Widespread and persistent organochlorine (OC) contaminants, such as polychlorinated biphenyls (PCBs) and pesticides, are known to have broad-ranging toxicities in wildlife. In this study we investigated, for the first time, their possible health effects on loggerhead sea turtles (Caretta caretta). Nonlethal fat biopsies and blood samples were collected from live turtles for OC contaminant analysis, and concentrations were compared with clinical health assessment data, including hematology, plasma chemistry, and body condition. Concentrations of total PCBs (∑PCBs), ∑DDTs, ∑chlordanes, dieldrin, and mirex were determined in 44 fat biopsies and 48 blood samples. Blood concentrations of ∑chlordanes were negatively correlated with red blood cell counts, hemoglobin, and hematocrit, indicative of anemia. Positive correlations were observed between most classes of OC contaminants and white blood cell counts and between mirex and ∑TCDD-like PCB concentrations and the heterophil:lymphocyte ratio, suggesting modulation of the immune system. All classes of OCs in the blood except dieldrin were correlated positively with aspartate aminotransferase (AST) activity, indicating possible hepatocellular damage. Mirex and ∑TCDD-like PCB blood concentrations were negatively correlated with alkaline phosphatase (ALP) activity. Significant correlations to levels of certain OC contaminant classes also suggested possible alteration of protein (↑blood urea nitrogen, ↓albumin:globulin ratio), carbohydrate (↓glucose), and ion (↑sodium, ↓magnesium) regulation. These correlations suggest that OC contaminants may be affecting the health of loggerhead sea turtles even though sea turtles accumulate lower concentrations of OCs compared with other wildlife. PMID:15238280

  20. Personalized health care: from theory to practice.

    PubMed

    Snyderman, Ralph

    2012-08-01

    The practice of medicine stands at the threshold of a transformation from its current focus on the treatment of disease events to an emphasis on enhancing health, preventing disease and personalizing care to meet each individual's specific health needs. Personalized health care is a new and strategic approach that is driven by personalized health planning empowered by personalized medicine tools, which are facilitated by advances in science and technology. These tools improve the capability to predict health risks, to determine and quantify the dynamics of disease development, and to target therapeutic approaches to the needs of the individual. Personalized health care can be implemented today using currently available technologies and know-how and thereby provide a market for the rational introduction of new personalized medicine tools. The need for early adoption of personalized health care stems from the necessity to reduce the egregious and wasteful burden of preventable chronic diseases, which is not effectively addressed by our current approach to care. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Community mental health nurses' perspectives of recovery-oriented practice.

    PubMed

    Gale, J; Marshall-Lucette, S

    2012-05-01

    Recovery-oriented practice, an approach aligned towards the service user perspective, has dominated the mental health care arena. Numerous studies have explored service users' accounts of the purpose, meaning and importance of 'recovery'; however, far less is known about healthcare staff confidence in its application to care delivery. A self-efficacy questionnaire and content analysis of nursing course documents were used to investigate a cohort of community mental health nurses' recovery-oriented practice and to determine the extent to which the current continuing professional development curriculum met their educational needs in this regard. Twenty-three community mental health nurses completed a self-efficacy questionnaire and 28 course documents were analysed. The findings revealed high levels of nurses' confidence in their understanding and ability to apply the recovery model and low levels of confidence were found in areas of social inclusion. The content analysis found only one course document that used the whole term 'recovery model'. The findings suggest a gap in the nurses' perceived ability and confidence in recovery-oriented practice with what is taught academically. Hence, nursing education needs to be more explicitly focused on the recovery model and its application to care delivery. © 2011 Blackwell Publishing.

  2. One Health and EcoHealth in Ontario: a qualitative study exploring how holistic and integrative approaches are shaping public health practice in Ontario

    PubMed Central

    2012-01-01

    Background There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario. The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Methods Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Results Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Conclusions Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health

  3. One Health and EcoHealth in Ontario: a qualitative study exploring how holistic and integrative approaches are shaping public health practice in Ontario.

    PubMed

    Leung, Zee; Middleton, Dean; Morrison, Karen

    2012-05-16

    There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario.The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health actors interviewed in this study. This

  4. Best practices in managing child and adolescent behavioral health emergencies [digest].

    PubMed

    Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M; Wormley, Molly

    2018-01-22

    Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  5. Understanding the health beliefs and practices of East African refugees.

    PubMed

    Simmelink, Jennifer; Lightfoot, Elizabeth; Dube, Amano; Blevins, Jennifer; Lum, Terry

    2013-03-01

    To explore East African refugees' perceptions, ideas, and beliefs about health and health care, as well as the ways in which health information is shared within their communities. This study consisted of 2 focus groups with a total of 15 participants, including East African community leaders and health professionals. East African refugees in the United States have strong cultural, religious, and traditional health practices that shape their health behavior and influence their interactions with Western health care systems. Health care providers who understand refugees' beliefs about health may achieve more compliance with refugee patients.

  6. New approaches for moving upstream: how state and local health departments can transform practice to reduce health inequalities.

    PubMed

    Freudenberg, Nicholas; Franzosa, Emily; Chisholm, Janice; Libman, Kimberly

    2015-04-01

    Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are "upstream" drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on "downstream" behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators' role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities. © 2015 Society for Public Health Education.

  7. Evaluation of Ocean Color Scanner (OCS) photographic and digital data: Santa Barbara Channel test site, 29 October 1975 overflight

    NASA Technical Reports Server (NTRS)

    Kraus, S. P.; Estes, J. E.; Kronenberg, M. R.; Hajic, E. J.

    1977-01-01

    A summary of Ocean Color Scanner data was examined to evaluate detection and discrimination capabilities of the system for marine resources, oil pollution and man-made sea surface targets of opportunity in the Santa Barbara Channel. Assessment of the utility of OCS for the determination of sediment transport patterns along the coastal zone was a secondary goal. Data products provided 1975 overflight were in digital and analog formats. In evaluating the OCS data, automated and manual procedures were employed. A total of four channels of data in digital format were analyzed, as well as three channels of color combined imagery, and four channels of black and white imagery. In addition, 1:120,000 scale color infrared imagery acquired simultaneously with the OCS data were provided for comparative analysis purposes.

  8. Adoption of health promotion practices in a cohort of U.S. physician organizations.

    PubMed

    Bellows, Nicole M; McMenamin, Sara B; Halpin, Helen A

    2010-12-01

    Physician organizations such as medical groups and independent practice associations can play a vital role in health promotion through the adoption of effective health promotion practices such as health risk assessments, patient reminder systems, and health promotion education programs. To examine organizational changes in a cohort of physician organizations and changing health promotion practices. Data for a cohort of 369 physician organizations in the U.S. with 20 or more physicians were collected between September 2000 and September 2001 and subsequently from March 2006 to March 2007. Paired-sample t tests were used to identify changes in physician organization characteristics and the use of nine health promotion practices between 2000-2001 and 2006-2007. Compared to 2000-2001, the cohort of physician organizations in 2006-2007 was larger, more likely to be owned by physicians; less likely to be owned by a hospital, health system, or HMO; more profitable; and more likely to use electronic information technology. Between 2000-2001 and 2006-2007, physician organizations increased the use of health risk appraisals to contact high-risk patients and increased the use of reminders for eye exams for diabetic patients. During the same time period, physician organizations decreased the use of nutrition and weight-loss health promotion programs. The adding and dropping of programs among physician organizations is due to many factors, including changing regulatory environments, market conditions, populations, and new health promotion technologies. In the coming years, incentives and regulatory policy should encourage the adoption of effective health promotion practices by physician organizations. Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  9. The University of Washington's Community-Oriented Public Health Practice program and Public Health-Seattle & King County partnership.

    PubMed

    House, Peter J; Hartfield, Karen; Nicola, Bud; Bogan, Sharon L

    2014-01-01

    The Community-Oriented Public Health Practice (COPHP) program, a 2-year in-residence MPH degree program in the University of Washington School of Public Health, has partnered with Public Health-Seattle & King County (PHSKC) since 2002 to create a mutually beneficial set of programs to improve teaching and address community-based public health problems in a practice setting. The COPHP program uses a problem-based learning approach that puts students in small groups to work on public health problems. Both University of Washington-based and PHSKC-based faculty facilitate the classroom work. In the first year for students, COPHP, in concert with PHSKC, places students in practicum assignments at PHSKC; in the second year, students undertake a master's project (capstone) in a community or public health agency. The capstone project entails taking on a problem in a community-based agency to improve either the health of a population or the capacity of the agency to improve population health. Both the practicum and the capstone projects emphasize applying classroom learning in actual public health practice work for community-based organizations. This partnership brings PHSKC and COPHP together in every aspect of teaching. In essence, PHSKC acts as the "academic health department" for COPHP. There are detailed agreements and contracts that guide all aspects of the partnership. Both the practicum and capstone projects require written contracts. The arrangements for getting non-University of Washington faculty paid for teaching and advising also include formal contracts.

  10. Why give birth in health facility? Users’ and providers’ accounts of poor quality of birth care in Tanzania

    PubMed Central

    2013-01-01

    Background In Tanzania, half of all pregnant women access a health facility for delivery. The proportion receiving skilled care at birth is even lower. In order to reduce maternal mortality and morbidity, the government has set out to increase health facility deliveries by skilled care. The aim of this study was to describe the weaknesses in the provision of acceptable and adequate quality care through the accounts of women who have suffered obstetric fistula, nurse-midwives at both BEmOC and CEmOC health facilities and local community members. Methods Semi-structured interviews involving 16 women affected by obstetric fistula and five nurse-midwives at maternity wards at both BEmOC and CEmOC health facilities, and Focus Group Discussions with husbands and community members were conducted between October 2008 and February 2010 at Comprehensive Community Based Rehabilitation in Tanzania and Temeke hospitals in Dar es Salaam, and Mpwapwa district in Dodoma region. Results Health care users and health providers experienced poor quality caring and working environments in the health facilities. Women in labour lacked support, experienced neglect, as well as physical and verbal abuse. Nurse-midwives lacked supportive supervision, supplies and also seemed to lack motivation. Conclusions There was a consensus among women who have suffered serious birth injuries and nurse midwives staffing both BEmOC and CEmOC maternity wards that the quality of care offered to women in birth was inadequate. While the birth accounts of women pointed to failure of care, the nurses described a situation of disempowerment. The bad birth care experiences of women undermine the reputation of the health care system, lower community expectations of facility birth, and sustain high rates of home deliveries. The only way to increase the rate of skilled attendance at birth in the current Tanzanian context is to make facility birth a safer alternative than home birth. The findings from this study

  11. A study of health beliefs and practices of the Yoruba.

    PubMed

    Adepoju, Joseph A

    2012-01-01

    The issue of how immigrant populations combine traditional and Western health beliefs and practices has not been given due attention. Hence, this qualitative research study of Yoruba immigrants, an ethnic group from south-western Nigeria, living in the mid-Atlantic region of the United States, sheds some light on the question of how best to provide culturally appropriate health care to Yoruba immigrant groups with differences in health beliefs and practices. The study found that there are three types of Yoruba immigrant groups: (1) those who use only Western medicine (though mostly for pragmatic reason); (2) those who combine traditional Yoruba and Western beliefs; and (3) those who combine Western medicine and Christian beliefs.

  12. Sexual and reproductive health and rights and mHealth in policy and practice in South Africa.

    PubMed

    Waldman, Linda; Stevens, Marion

    2015-05-01

    Information and Communications Technology (ICT) offers enormous opportunity and innovation to improve public health and health systems.This paper explores the intersections between mHealth and sexual and reproductive health and rights in both policy and practice. It is a qualitative study, informed by policy review and key informant interviews. Three case studies provide evidence of what is happening on the ground in relation to ICTs and reproductive health and rights. We argue that in terms of policy, there is little overlap between health rights and communication technology. In the area of practice, however, significant interventions address aspects of reproductive health. At present, the extent to which mHealth addresses the full range of reproductive justice and sexual and reproductive health and rights is limited, particularly in terms of government initiatives. The paper argues that mHealth projects tend to avoid contentious aspects of sexual health, while addressing favourable topics such as pregnancy and motherhood. The ways in which information is framed in mHealth mirrors current gaps within sexual and reproductive health and rights, where a limited and conservative lens predominates, and which may result in narrow programming and implementation of services. Copyright © 2015. Published by Elsevier Ltd.

  13. Demystifying self-transcendence for mental health nursing practice and research.

    PubMed

    Reed, Pamela G

    2009-10-01

    Because human development is an integral aspect of life, pathways to mental health necessarily involve developmentally based issues or resources. This column provides an overview of self-transcendence as one developmentally based resource for mental health. The Self-Transcendence Scale is presented to encourage its use in mental health nursing practice and research.

  14. Pre-travel health seeking practices of Umrah pilgrims departing from Assiut International Airport, Egypt.

    PubMed

    Aziz, Mirette M; Abd El-Megeed, Hosnia S; Abd Ellatif, Mennat Allah M

    2018-04-22

    to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport. We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire. Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices. Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pre-travel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services. Copyright © 2018. Published by Elsevier Ltd.

  15. Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey.

    PubMed

    Kyei-Onanjiri, Minerva; Carolan-Olah, Mary; Awoonor-Williams, John Koku; McCann, Terence V

    2018-03-15

    Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies. The aim of this study was to examine the availability of emergency obstetric care interventions in the Upper East Region of Ghana. A cross-sectional survey of 120 health facilities was undertaken. Status of emergency obstetric care was assessed through an interviewer administered questionnaire to directors/in-charge officers of maternity care units in selected facilities. Data were analysed using descriptive statistics. Eighty per cent of health facilities did not meet the criteria for provision of emergency obstetric care. Comparatively, private health facilities generally provided EmOC interventions less frequently than public health facilities. Other challenges identified include inadequate skill mix of maternity health personnel, poor referral processes, a lack of reliable communication systems and poor emergency transport systems. Multiple factors combine to limit women's access to a range of essential maternal health services. The availability of EmOC interventions was found to be low across the region; however, EmOC facilities could be increased by nearly one-third through modest investments in some existing facilities. Also, the key challenges identified in this study can be improved by enhancing pre-existing health system structures such as Community-based Health Planning and Services (CHPS), training more midwifery personnel, strengthening in-service training and implementation of referral audits as part of health service

  16. Health Care Providers’ Attitudes and Practices Regarding the use of Advance Directives in a Military Health Care Setting

    DTIC Science & Technology

    1998-10-02

    PROVIDERS’ ATTITUDES AND PRACTICES REGARDING THE USE OF ADVANCE DIRECTIVES IN A MILITARY HEALTH CARE SETTING by Bridget L. Larew, Maj, USAF, NC Thesis...entitled: "HEALTH CARE PROVIDER’S ATTITUDES AND PRACTICES REGARDING THE PURPOSE AND USE OF ADVANCE DIRECTIVES IN A MILITARY HEALTH CARE SETTING" beyond...health care, recognized under State law (whether statutory or as recognized by the courts of the State) and relating to the provision of such care

  17. AERONET-OC: Strengths and Weaknesses of a Network for the Validation of Satellite Coastal Radiometric Products

    NASA Technical Reports Server (NTRS)

    Zibordi, Giuseppe; Holben, Brent; Slutsker, Ilya; Giles, David; D'Alimonte, Davide; Melin, Frederic; Berthon, Jean-Francois; Vandemark, Doug; Feng, Hui; Schuster, Gregory; hide

    2008-01-01

    The Ocean Color component of the Aerosol Robotic Network (AERONET-OC) has been implemented to support long-term satellite ocean color investigations through cross-site consistent and accurate measurements collected by autonomous radiometer systems deployed on offshore fixed platforms. The ultimate purpose of AERONET-OC is the production of standardized measurements performed at different sites with identical measuring systems and protocols, calibrated using a single reference source and method, and processed with the same code. The AERONET-OC primary data product is the normalized water leaving radiance determined at center-wavelengths of interest for satellite ocean color applications, with an uncertainty lower than 5% in the blue-green spectral regions and higher than 8% in the red. Measurements collected at 6 sites counting the northern Adriatic Sea, the Baltic Proper, the Gulf of Finland, the Persian Gulf, and, the northern and southern margins of the Middle Atlantic Bay, have shown the capability of producing quality assured data over a wide range of bio-optical conditions including Case-2 yellow substance- and sedimentdominated waters. This work briefly introduces network elements like: deployment sites, measurement method, instrument calibration, processing scheme, quality-assurance, uncertainties, data archive and products accessibility. Emphases is given to those elements which underline the network strengths (i.e., mostly standardization of any network element) and its weaknesses (i.e., the use of consolidated, but old-fashioned technology). The work also addresses the application of AERONET-OC data to the validation of primary satellite radiometric products over a variety of complex coastal waters and finally provides elements for the identification of new deployment sites most suitable to support satellite ocean color missions.

  18. Exploring the organizational culture of exemplary community health center practices.

    PubMed

    Craigie, Frederic C; Hobbs, Richard F

    2004-01-01

    A 1999 precursor to this study, published in Family Medicine, suggested that the organizational culture of practices was potentially important to health care providers and patients. In this research, we examined the experiences of people working in exemplary community health center practices to explore the components and maintaining factors of positive medical organizational culture. Two exemplary practices were identified through a process of nominations and selection with respect to a presumptive definition of positive organizational culture. Interpretive categories and themes were developed through qualitative content analysis of semi-structured interviews, along with field observation. Categories of culture in these practices included Community Mission and Values, Leadership and Organizational Dynamics, Relationships, and Physical Space. Cultural qualities were nurtured by leadership approaches, collaborative staff meetings, and shared values about mission and workplace relationships. Staff consistently indicated that the spirit or culture in their practices was beneficial for employees, patients, and the process of clinical care. The positive organizational culture in these practices was substantially characterized and cultivated by specific values, attitudes, behaviors, and relationships of employees. Further work is indicated in approaches to assessment and intervention with organizational culture in medical settings and in evaluating associations with medical outcomes.

  19. A Comparison of the Preventive Health Care Provided by Women's Health Centers and General Internal Medicine Practices

    PubMed Central

    Harpole, Linda H; Mort, Elizabeth A; Freund, Karen M; Orav, John; Brennan, Troyen A

    2000-01-01

    OBJECTIVE To evaluate women's health centers as alternatives to traditional internal medicine practices. DESIGN Cross-sectional mailed survey. SETTING A women's health center and an internal medicine practice at each of three university-affiliated teaching hospitals. PATIENTS There were 3,035 female patients randomly selected to receive a mailed survey after their office visits. MEASUREMENTS AND MAIN RESULTS The survey asked for patient characteristics, patient satisfaction, and rates of gender-specific preventive health services. The survey response rate was 64% (1,942/3,035). Patients at women's health centers were younger, more educated, had higher physical functioning but lower mental health functioning, and more of them were single and employed. Patient satisfaction was similar at the two types of practices, although patients at women's health centers were more satisfied with certain aspects of the patient-provider interaction. After adjusting for measured differences in patient characteristics and site, patients at women's health centers were more likely to receive discussions on hormone replacement therapy (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.1, 2.2) and dietary calcium (OR 1.3; 95% CI 1.1, 1.6). They were also more likely to receive their gender-specific preventive health services from their primary care provider: breast examination (OR 2.0; 95% CI 1.5, 2.6), Pap smear (OR 2.4; 95% CI 1.9, 3.1), hormone replacement therapy discussion (OR 2.2; 95% CI 1.5, 3.3), and dietary calcium discussion (OR 2.6; 95% CI 1.7, 3.9). These findings remained when the analyses were limited to patients of female providers only. CONCLUSIONS In this study, patients at women's health centers were more likely to receive gender-specific health prevention counseling than patients at internal medicine practices. Moreover, patients were more likely to receive their gender-specific preventive health services from their primary care providers. PMID:10632827

  20. Pueraria thunbergiana inhibits cisplatin-induced damage of HEI-OC1 auditory cells through scavenging free radicals.

    PubMed

    Yu, Hyeon-Hee; Jung, Su-Young; Shin, Mee-Kyung; Park, Raekil; So, Hong-Seob; You, Yong-Ouk

    2010-06-01

    The radix of Pueraria thunbergiana (P. thunbergiana) is traditionally prescribed to attenuate the clinical manifestation of inner ear dysfunction and various clinical situations including fevers, gastrointestinal disorders, skin problems, migraine headaches, lowering cholesterol, and treating chronic alcoholism in oriental medicine. In the present study, we examined the protective effect of ethanol extract of the radix of P. thunbergiana (RPT) on cisplatin-induced damage of HEI-OC1 auditory hair cells. When the cells were cultured in the medium containing 5-100 microg/mL of RPT, RPT showed protective effect against the cisplatin-induced HEI-OC1 cell damage. We also measured the effects of RPT on lipid peroxidation of cisplatin-treated cells as well as scavenging activities against superoxide radical, hydroxyl radical, hydrogen peroxide, and DPPH radical. RPT reduced cisplatin-induced lipid peroxidation in a dose-dependent manner. Furthermore, RPT showed strong scavenging activity against superoxide radical, hydroxyl radical, hydrogen peroxide, and DPPH radical. These results indicate that RPT protects cisplatin-induced HEI-OC1 cell damage through inhibition of lipid peroxidation and scavenging activities of free radials. (c) 2009 John Wiley & Sons, Ltd.

  1. Primary care practice and health professional determinants of immunisation coverage.

    PubMed

    Grant, Cameron C; Petousis-Harris, Helen; Turner, Nikki; Goodyear-Smith, Felicity; Kerse, Ngaire; Jones, Rhys; York, Deon; Desmond, Natalie; Stewart, Joanna

    2011-08-01

    To identify primary care factors associated with immunisation coverage. A survey during 2005-2006 of a random sample of New Zealand primary care practices, with over-sampling of practices serving indigenous children. An immunisation audit was conducted for children registered at each practice. Practice characteristics and the knowledge and attitudes of doctors, nurses and caregivers were measured. Practice immunisation coverage was defined as the percentage of registered children from 6 weeks to 23 months old at each practice who were fully immunised for age. Associations of practice, doctor, nurse and caregiver factors with practice immunisation coverage were determined using multiple regression analyses. One hundred and twenty-four (61%) of 205 eligible practices were recruited. A median (25th-75th centile) of 71% (57-77%) of registered children at each practice was fully immunised. In multivariate analyses, immunisation coverage was higher at practices with no staff shortages (median practice coverage 76% vs 67%, P = 0.004) and where doctors were confident in their immunisation knowledge (72% vs 67%, P= 0.005). Coverage was lower if the children's parents had received information antenatally, which discouraged immunisation (67% vs 73%, P = 0.008). Coverage decreased as socio-economic deprivation of the registered population increased (P < 0.001) and as the children's age (P = 0.001) and registration age (P = 0.02) increased. CONCLUSIONS Higher immunisation coverage is achieved by practices that establish an early relationship with the family and that are adequately resourced with stable and confident staff. Immunisation promotion should begin antenatally. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  2. Views of practice managers and general practitioners on implementing NHS Health Checks.

    PubMed

    Krska, Janet; du Plessis, Ruth; Chellaswamy, Hannah

    2016-03-01

    As part of an evaluation of a contract with general practices to deliver the national NHS Health Checks programme in Sefton, North West England, we surveyed general practitioners (GPs) and practice managers (PMs) in all 55 practices. The contract required practices to identify individuals from their practice registers with potentially high cardiovascular disease risk, and provide annual reviews. Responses were obtained from 43/178 GPs and 40/55 PMs representing 56 and 73% of practices, respectively. There was variation in many aspects of implementation. Time and software were viewed as barriers to implementation, the increased nurse workload impacted on other services and payments were insufficient to cover costs. The main enabler for successful implementation was IT support. Fewer than half the respondents viewed the programme as beneficial to their practice. Findings have been used to address many issues raised. Practices need more support from commissioners to help implement NHS Health Checks.

  3. 33 CFR 135.103 - Levy and payment of barrel fee on OCS oil.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Levy and payment of barrel fee on OCS oil. 135.103 Section 135.103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION...

  4. 33 CFR 135.103 - Levy and payment of barrel fee on OCS oil.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Levy and payment of barrel fee on OCS oil. 135.103 Section 135.103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION...

  5. 33 CFR 135.103 - Levy and payment of barrel fee on OCS oil.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Levy and payment of barrel fee on OCS oil. 135.103 Section 135.103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION...

  6. 33 CFR 135.103 - Levy and payment of barrel fee on OCS oil.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Levy and payment of barrel fee on OCS oil. 135.103 Section 135.103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION...

  7. 33 CFR 135.103 - Levy and payment of barrel fee on OCS oil.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Levy and payment of barrel fee on OCS oil. 135.103 Section 135.103 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION...

  8. Traditional child health practices in communities in north-west Ethiopia.

    PubMed

    Dagnew, M B; Damena, M

    1990-01-01

    A study in 3 villages in northwest Ethiopia was designed to find the type and extent of health damaging traditional child practices. The result of the survey showed high rates of uvulectomy and milk teeth extraction, and low rates of eyelid incision and female circumcision. More than 84.5% and 98.8% of the mothers surveyed, respectively, reported milk teeth extraction as a useful treatment for diarrhea and eyelid incision in the treatment of eye disease. The damage done by milk teeth extraction includes complications from unhygienic conditions (e.g. ostitis and osteomyelitis). Although many children survive these ill advised procedures and their complications, the considerable damage done to some of the children makes these procedures serious health hazards. Intensive health education with relevant health activities to correct the use of these traditional practices is advised.

  9. Measuring Best Practices for Workplace Safety, Health, and Well-Being: The Workplace Integrated Safety and Health Assessment.

    PubMed

    Sorensen, Glorian; Sparer, Emily; Williams, Jessica A R; Gundersen, Daniel; Boden, Leslie I; Dennerlein, Jack T; Hashimoto, Dean; Katz, Jeffrey N; McLellan, Deborah L; Okechukwu, Cassandra A; Pronk, Nicolaas P; Revette, Anna; Wagner, Gregory R

    2018-05-01

    To present a measure of effective workplace organizational policies, programs, and practices that focuses on working conditions and organizational facilitators of worker safety, health and well-being: the workplace integrated safety and health (WISH) assessment. Development of this assessment used an iterative process involving a modified Delphi method, extensive literature reviews, and systematic cognitive testing. The assessment measures six core constructs identified as central to best practices for protecting and promoting worker safety, health and well-being: leadership commitment; participation; policies, programs, and practices that foster supportive working conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change. The WISH Assessment holds promise as a tool that may inform organizational priority setting and guide research around causal pathways influencing implementation and outcomes related to these approaches.

  10. 6. "LAUNCH SILOS, PLAN AND DETAILS." Specifications No. OC15973; Drawing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. "LAUNCH SILOS, PLAN AND DETAILS." Specifications No. OC1-59-73; Drawing No. 5841 S-3; D.O. SERIES AW-1525/25 Rev. A.; Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract No. 6601, Rev. A., Date 11 Sep 59. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Missile Silo Type, Test Area 1-100, northeast end of Test Area 1-100 Road, Boron, Kern County, CA

  11. Observations of infection prevention and control practices in primary health care, Kenya

    PubMed Central

    Bedoya, Guadalupe; Dolinger, Amy; Rogo, Khama; Mwaura, Njeri; Wafula, Francis; Coarasa, Jorge; Goicoechea, Ana

    2017-01-01

    Abstract Objective To assess compliance with infection prevention and control practices in primary health care in Kenya. Methods We used an observational, patient-tracking tool to assess compliance with infection prevention and control practices by 1680 health-care workers during outpatient interactions with 14 328 patients at 935 health-care facilities in 2015. Compliance was assessed in five domains: hand hygiene; protective glove use; injections and blood sampling; disinfection of reusable equipment; and waste segregation. We calculated compliance by dividing the number of correct actions performed by the number of indications and evaluated associations between compliance and the health-care worker’s and facility’s characteristics. Findings Across 106 464 observed indications for an infection prevention and control practice, the mean compliance was 0.318 (95% confidence interval, CI: 0.315 to 0.321). The compliance ranged from 0.023 (95% CI: 0.021 to 0.024) for hand hygiene to 0.871 (95% CI: 0.866 to 0.876) for injection and blood sampling safety. Compliance was weakly associated with the facility’s characteristics (e.g. public or private, or level of specialization) and the health-care worker’s knowledge of, and training in, infection prevention and control practices. Conclusion The observational tool was effective for assessing compliance with infection prevention and control practices across multiple domains in primary health care in a low-income country. Compliance varied widely across infection prevention and control domains. The weak associations observed between compliance and the characteristics of health-care workers and facilities, such as knowledge and the availability of supplies, suggest that a broader focus on behavioural change is required. PMID:28670015

  12. Exploring the Use of Experiential Learning Workshops and Reflective Practice within Professional Practice Development for Post-Graduate Health Promotion Students

    ERIC Educational Resources Information Center

    Cronin, Mary; Connolly, Claire

    2007-01-01

    Objective: To explore and evaluate the use of two methods (1) experiential learning workshops and (2) reflective practice within post-graduate health promotion education, with a view to providing a foundation in professional practice based on health promotion principles and critical thinking. Design: This is an empirical study exploring the…

  13. [Harmful practices affecting women's health].

    PubMed

    1990-07-01

    The harmful practices discussed in this article are based on case histories form the Central Maternity in Niamey, yet these practices universally affect women throughout Africa. Nutritional taboos are aimed at certain diseases such as measles, diarrhea, dysentery, malnutrition and anemia and consumption of foods rich in proteins and lipids are forbidden. Children are forbidden from eating eggs; pregnant women are forbidden from eating fruits and vegetables because of the fear of hemorrhaging from the sugar content in the fruit; camel meat is forbidden for fear of extending the pregnancy. Female circumcision, a dangerous practice, especially during childbirth, causes many medical problems that remain permanent. Adolescent pregnancy and marriages are practiced to avoid delinquency among children; yet such practices take place because of arranged marriages for a dowry to young men or to older rich men and these forced marriages to adolescents are the causes of increases in divorce, prostitution and desertion. These young marriages have serious consequences on the health status of the mother and the infant, often leading to maternal and infant death. The high level of fertility in Niger is a response to the social structure of the family. It is a patrilineal system that encourages women to have many children, especially sons. In Niger, pregnancy is surrounded by supernatural and mysterious forces, where a child is the intervention for ancestral spirits. In Islam a child is considered a "Gift of God". A woman is expected to work until the delivery of her baby otherwise she is jeered by her neighbors. During delivery women are not expected to cry or show any pain for fear of dishonoring her family irregardless of any medical compilations she faces. Women in Africa are exploited as free labor, deteriorate and age rapidly, are generally illiterate and are not protected under any laws.

  14. Understanding human resource management practices in Botswana's public health sector.

    PubMed

    Seitio-Kgokgwe, Onalenna Stannie; Gauld, Robin; Hill, Philip C; Barnett, Pauline

    2016-11-21

    Purpose The purpose of this paper is to assess the management of the public sector health workforce in Botswana. Using institutional frameworks it aims to document and analyse human resource management (HRM) practices, and make recommendations to improve employee and health system outcomes. Design/methodology/approach The paper draws from a large study that used a mixed methods approach to assess performance of Botswana's Ministry of Health (MOH). It uses data collected through document analysis and in-depth interviews of 54 key informants comprising policy makers, senior staff of the MOH and its stakeholder organizations. Findings Public health sector HRM in Botswana has experienced inadequate planning, poor deployment and underutilization of staff. Lack of comprehensive retention strategies and poor working conditions contributed to the failure to attract and retain skilled personnel. Relationships with both formal and informal environments affected HRM performance. Research limitations/implications While document review was a major source of data for this paper, the weaknesses in the human resource information system limited availability of data. Practical implications This paper presents an argument for the need for consideration of formal and informal environments in developing effective HRM strategies. Originality/value This research provides a rare system-wide approach to health HRM in a Sub-Saharan African country. It contributes to the literature and evidence needed to guide HRM policy decisions and practices.

  15. Optimized approach to retrieve information on atmospheric carbonyl sulfide (OCS) above the Jungfraujoch station and change in its abundance since 1995

    NASA Astrophysics Data System (ADS)

    Lejeune, Bernard; Mahieu, Emmanuel; Vollmer, Martin K.; Reimann, Stefan; Bernath, Peter F.; Boone, Christopher D.; Walker, Kaley A.; Servais, Christian

    2017-01-01

    In this paper, we present an optimized retrieval strategy for carbonyl sulfide (OCS), using Fourier transform infrared (FTIR) solar observations made at the high-altitude Jungfraujoch station in the Swiss Alps. More than 200 lines of the ν3 fundamental band of OCS have been systematically evaluated and we selected 4 microwindows on the basis of objective criteria minimizing the effect of interferences, mainly by solar features, carbon dioxide and water vapor absorption lines, while maximizing the information content. Implementation of this new retrieval strategy provided an extended time series of the OCS abundance spanning the 1995-2015 time period, for the study of the long-term trend and seasonal variation of OCS in the free troposphere and stratosphere. Three distinct periods characterize the evolution of the tropospheric partial columns: a first decreasing period (1995-2002), an intermediate increasing period (2002-2008), and the more recent period (2008-2015) which shows no significant trend. Our FTIR tropospheric and stratospheric time series are compared with new in situ gas chromatography mass spectrometry (GCMS) measurements performed by Empa (Laboratory for Air Pollution/Environmental Technology) at the Jungfraujoch since 2008, and with space-borne solar occultation observations by the ACE-FTS instrument on-board the SCISAT satellite, respectively, and they show good agreement. The OCS signal recorded above Jungfraujoch appears to be closely related to anthropogenic sulfur emissions.

  16. Applying organizational science to health care: a framework for collaborative practice.

    PubMed

    Dow, Alan W; DiazGranados, Deborah; Mazmanian, Paul E; Retchin, Sheldon M

    2013-07-01

    Developing interprofessional education (IPE) curricula that improve collaborative practice across professions has proven challenging. A theoretical basis for understanding collaborative practice in health care settings is needed to guide the education and evaluation of health professions trainees and practitioners and support the team-based delivery of care. IPE should incorporate theory-driven, evidence-based methods and build competency toward effective collaboration.In this article, the authors review several concepts from the organizational science literature and propose using these as a framework for understanding how health care teams function. Specifically, they outline the team process model of action and planning phases in collaborative work; discuss leadership and followership, including how locus (a leader's integration into a team's usual work) and formality (a leader's responsibility conferred by the traditional hierarchy) affect team functions; and describe dynamic delegation, an approach to conceptualizing escalation and delegation within health care teams. For each concept, they identify competencies for knowledge, attitudes, and behaviors to aid in the development of innovative curricula to improve collaborative practice. They suggest that gaining an understanding of these principles will prepare health care trainees, whether team leaders or members, to analyze team performance, adapt behaviors that improve collaboration, and create team-based health care delivery processes that lead to improved clinical outcomes.

  17. Implementing the IT Infrastructure for Health Reform: Adoption of Health IT among Patient-Centered Medical Home Practices

    PubMed Central

    Adler-Milstein, Julia; Cohen, Genna R.

    2013-01-01

    While health IT is thought to be critical to the success of new models of care delivery, we know little about the extent to which those pursuing these models are relying on HIT. We studied a large patient-centered medical home (PCMH) demonstration project, a new model of care delivery that has received substantial policy attention, in order to assess which types of HIT were most widely used, and how adoption rates changed over time as PCMH practices matured. We found that clinically-focused HIT tools were both widely adopted, and increasingly adopted, in PCMH practices compared to non-PCMH practices. In contrast, HIT that supports patient-engagement, patient portals and personal health records, was neither in widespread use nor more likely to be adopted over time by PCMH practices compared to other practices. This suggests that these tools may not yet support the types of patient engagement and interactions that PCMH practices seek. PMID:24551318

  18. Incorporating soil health management practices into viable potato cropping systems

    USDA-ARS?s Scientific Manuscript database

    Soil health is critical to agricultural sustainability, environmental quality, and ecosystem function, but is generally degraded through intensive potato production. Soil and crop management practices beneficial to soil health, such as crop rotations, cover crops and green manures, organic amendment...

  19. The hierarchy of environmental health and safety practices in the U.S. nanotechnology workplace.

    PubMed

    Engeman, Cassandra D; Baumgartner, Lynn; Carr, Benjamin M; Fish, Allison M; Meyerhofer, John D; Satterfield, Terre A; Holden, Patricia A; Harthorn, Barbara Herr

    2013-01-01

    Manufacturing of nanoscale materials (nanomaterials) is a major outcome of nanotechnology. However, the potential adverse human health effects of manufactured nanomaterial exposure are not yet fully understood, and exposures in humans are mostly uncharacterized. Appropriate exposure control strategies to protect workers are still being developed and evaluated, and regulatory approaches rely largely on industry self-regulation and self-reporting. In this context of soft regulation, the authors sought to: 1) assess current company-reported environmental health and safety practices in the United States throughout the product life cycle, 2) consider their implications for the manufactured nanomaterial workforce, and 3) identify the needs of manufactured nanomaterial companies in developing nano-protective environmental health and safety practices. Analysis was based on the responses of 45 U.S.-based company participants in a 2009-2010 international survey of private companies that use and/or produce nanomaterials. Companies reported practices that span all aspects of the current government-recommended hierarchical approach to manufactured nanomaterials' exposure controls. However, practices that were tailored to current manufactured nanomaterials' hazard and exposure knowledge, whether within or outside the hierarchical approach, were reported less frequently than general chemical hygiene practices. Product stewardship and waste management practices-the influences of which are substantially downstream-were reported less frequently than most other environmental health and safety practices. Larger companies had more workers handling nanomaterials, but smaller companies had proportionally more employees handling nanomaterials and more frequently identified impediments to implementing nano-protective practices. Company-reported environmental health and safety practices suggest more attention to environmental health and safety is necessary, especially with regard to

  20. Empowering interventions in health and social care: recognition through 'ecologies of practice'.

    PubMed

    Fisher, Pamela; Owen, Jenny

    2008-12-01

    This article considers findings from two recent qualitative studies in the UK, identifying parallels in the ways in which 'ecologies of practice' in two high-profile areas of health-related intervention underpin processes of empowerment and recognition. The first project focused on policy and practice in relation to teenage motherhood in a city in the North of England. The second project was part of a larger research programme, Changing Families, Changing Food, and investigated the ways in which 'family' is constructed through policy and practice interventions concerning food and health. While UK Government health policy stresses that health and social care agencies should 'empower' service users, it is argued here that this predominantly reflects a managerialist discourse, equating citizenship with individualised self-sufficiency in the 'public' sphere. Drawing critically on Honneth's politics of recognition (Honneth, A. (2001). Recognition or redistribution? Changing perspective on the moral order of society. Theory, Culture and Society, 18(2-3), 43-55.), we suggest that formal health policy overlooks the inter-subjective processes that underpin a positive sense of self, emphasising instead an individualised ontology. While some research has positioned practitioners as one-dimensional in their adherence to the current audit culture of the public sector in the UK, our study findings demonstrate how practitioners often circumvent audit-based 'economies of performance' with more flexible 'ecologies of practice.' The latter open up spaces for recognition through inter-subjective processes of identification between practitioners and service users. Ecologies of practice are also informed by practitioners' experiential knowledge. However, this process is largely unacknowledged, partly because it does not fall within a managerialist framework of 'performativity' and partly because it often reflects taken-for-granted, gendered patterns. It is argued here that a critical

  1. Policy Surveillance: A Vital Public Health Practice Comes of Age.

    PubMed

    Burris, Scott; Hitchcock, Laura; Ibrahim, Jennifer; Penn, Matthew; Ramanathan, Tara

    2016-12-01

    Governments use statutes, regulations, and policies, often in innovative ways, to promote health and safety. Organizations outside government, from private schools to major corporations, create rules on matters as diverse as tobacco use and paid sick leave. Very little of this activity is systematically tracked. Even as the rest of the health system is working to build, share, and use a wide range of health and social data, legal information largely remains trapped in text files and pdfs, excluded from the universe of usable data. This article makes the case for the practice of policy surveillance to help end the anomalous treatment of law in public health research and practice. Policy surveillance is the systematic, scientific collection and analysis of laws of public health significance. It meets several important needs. Scientific collection and coding of important laws and policies creates data suitable for use in rigorous evaluation studies. Policy surveillance addresses the chronic lack of readily accessible, nonpartisan information about status and trends in health legislation and policy. It provides the opportunity to build policy capacity in the public health workforce. We trace its emergence over the past fifty years, show its value, and identify major challenges ahead.

  2. A practical scale for Multi-Faceted Organizational Health Climate Assessment.

    PubMed

    Zweber, Zandra M; Henning, Robert A; Magley, Vicki J

    2016-04-01

    The current study sought to develop a practical scale to measure 3 facets of workplace health climate from the employee perspective as an important component of a healthy organization. The goal was to create a short, usable yet comprehensive scale that organizations and occupational health professionals could use to determine if workplace health interventions were needed. The proposed Multi-faceted Organizational Health Climate Assessment (MOHCA) scale assesses facets that correspond to 3 organizational levels: (a) workgroup, (b) supervisor, and (c) organization. Ten items were developed and tested on 2 distinct samples, 1 cross-organization and 1 within-organization. Exploratory and confirmatory factor analyses yielded a 9-item, hierarchical 3-factor structure. Tests confirmed MOHCA has convergent validity with related constructs, such as perceived organizational support and supervisor support, as well as discriminant validity with safety climate. Lastly, criterion-related validity was found between MOHCA and health-related outcomes. The multi-faceted nature of MOHCA provides a scale that has face validity and can be easily translated into practice, offering a means for diagnosing the shortcomings of an organization or workgroup's health climate to better plan health and well-being interventions. (c) 2016 APA, all rights reserved).

  3. Health literacy assessment and patient satisfaction in surgical practice.

    PubMed

    Komenaka, Ian K; Nodora, Jesse N; Machado, Lorenzo; Hsu, Chiu-Hsieh; Klemens, Anne E; Martinez, Maria Elena; Bouton, Marcia E; Wilhelmson, Krista L; Weiss, Barry D

    2014-03-01

    Individuals with limited health literacy have barriers to patient-physician communication. Problems in communication are known to contribute to malpractice litigation. Concern exists, however, about the feasibility and patient acceptance of a health literacy assessment. This study was performed to determine the feasibility of health literacy assessment in surgical practice and its effect on patient satisfaction. Every patient seen in a Breast Surgery Clinic during a 2-year period was asked to undergo a health literacy assessment with the Newest Vital Sign (NVS) as part of the routine history and physical examination. During the year before routine NVS assessments and during the 2-year study period, all patients were asked to rate their "overall satisfaction with clinic visit" on a 5-point scale. A total of 2,026 of 2,097 patients (96.6%) seen during the study were eligible for the health literacy assessment. Of those, no patients refused assessment, and only one patient was missed. Therefore, 2,025 of 2,026 eligible patients (99.9%) underwent the assessment. The average time for NVS assessment was 2:02 minutes. Only 19% of patients had adequate health literacy. Patient satisfaction ratings were slightly greater during the first year of the health literacy assessment (3.8 vs 3.7, P = .049) compared with the year prior to health literacy assessment and greater during the second year of health literacy assessment (4.1 vs 3.7, P < .0001). Routine health literacy assessment is feasible in surgical practice and results in no decrease in patient satisfaction. In fact, satisfaction was greater during the years when health literacy assessments were performed. Copyright © 2014 Mosby, Inc. All rights reserved.

  4. Health promotion and health education viewed as symbiotic paradigms: bridging the theory and practice gap between them.

    PubMed

    Whitehead, Dean

    2003-11-01

    A recognized 'paradigm war' exists between the two distinct approaches of health education and health promotion practice. This tension is both unhealthy and unhelpful and is known to have a profound effect on nursing activity. Leading health promotionalists have begun to acknowledge the futility of the stated paradigm tension, realizing that health education and health promotion interventions are not that dissimilar in their origins and intentions. Progressive health education and health promotion programmes acknowledge the interrelatedness of both approaches and seek to incorporate favourable aspects of the two. The aim of this article is to present arguments and stances that help to diffuse/avoid the stated paradigm conflict, as a basis for health education and health promotion reform in nursing. It also seeks to clarify the nature of both health education and health promotion practice so as to avoid contextual confusion. In doing so, this article draws significantly from the author's previous work. This article concludes that the constructive review of any intended health education/health promotion programme lies in the consideration of each approach according to its own relative merits, what is required of the programme, and the nature of the setting in which the intervention takes place.

  5. Use of traditional health practices by Southeast Asian refugees in a primary care clinic.

    PubMed Central

    Buchwald, D.; Panwala, S.; Hooton, T. M.

    1992-01-01

    To determine the prevalence of use of traditional health practices among different ethnic groups of Southeast Asian refugees after their arrival in the United States, we conducted a convenience sample of 80 Cambodian, Lao, Mien, and ethnic Chinese patients (20 each) attending the University of Washington Refugee Clinic for a new or follow-up visit. Interpreters administered a questionnaire that dealt with demographics, medical complaints, traditional health practices, health beliefs, and attitudes toward Western practitioners. In all, 46 (58%) patients had used one or more traditional health practices, but the prevalence varied by ethnic group. Coining and massage were used by all groups except the Mien, whereas moxibustion and healing ceremonies were performed almost exclusively by the Mien. Traditional health practices were used for a variety of symptoms and, in 78% of reported uses, patients reported alleviation of symptoms. The use of traditional health practices is common among Southeast Asian refugees. Clinicians who care for this population should be aware of these practices because they may supersede treatments prescribed by physicians or leave cutaneous stigmata that may be confused with disease or physical abuse. Good patient care may necessitate the use or tolerance of both Western and traditional modalities in many Southeast Asian refugees. Images PMID:1595275

  6. Knowledge, Attitudes, and Practices of School Teachers toward Oral Health in Davangere, India.

    PubMed

    Maganur, Prabhadevi C; Satish, V; Marwah, Nikhil; Vishwas, T D; Dayanand, M C

    2017-01-01

    The aim of this study was to assess the knowledge, attitudes, and practices of school teachers toward oral health. Descriptive study. School teachers (n = 150) of Davangere city were recruited into this study. The subjects completed a questionnaire that aimed to evaluate teachers' knowledge, attitudes, and practices on oral health. The results were statistically analyzed and percentage was calculated. The participants' oral hygiene habits were found to be regular. The majority of teachers showed good knowledge on oral health. Most of the teachers in this study recognized the importance of oral health. The majority of teachers did incorporate the importance of oral health in teaching and educating children in the school. But, not all teachers are involved effectively. So, the teachers should be trained comprehensively regarding importance of oral health and creating awareness on oral health promotion for their students in combination with health care personnel. Maganur PC, Satish V, Marwah N, Vishwas TD, Dayanand MC. Knowledge, Attitudes, and Practices of School Teachers toward Oral Health in Davangere, India. Int J Clin Pediatr Dent 2017;10(1):89-95.

  7. Power and practices: questions concerning the legislation of health professions in Brazil.

    PubMed

    Velloso, Isabela S C; Ceci, Christine

    2015-07-01

    Developments in professional practice can be related to ongoing changes in relations of power among professionals, which often lead to changes in the boundaries of practices. The differing contexts of practices also influence these changing relations among health professionals. Legislation governing professional practice also differs from country to country. In Brazil, over the past 12 years, in a climate of deep disagreement, a new law to regulate medical practice has been discussed. It was sanctioned, or made into law, but with some notable changes, in July 2013. Of interest to us in this paper are the ways the proposed legislation, by setting out the boundaries and scope of medical practice, 'interfered' in the practices of other health professions, undermining many 'independent' practices that have developed over time. However, even taking into account the multiple routes through which practices are established and developed, the role of legislation that seems able to contradict and deny the historical realities of multiple, intersecting practices should be critically interrogated. In this paper, we use the theoretical resources of poststructuralist thinking to explore gaps, ambiguities, and power relations implicit in the discourses that constituted this law. We argue that although the new law can be understood as a social and political device that will interfere in the organization of other health professions' practices, such legislation is only part of what constitutes change in a consolidated professional practice. And while it is important to understand the effects of such legislation, healthcare practices are also realized or 'made real' through ongoing relations of knowledge and power, including, as we will see in this case, activities of resistance. The problem, then, is to understand the practical arrangements, including legislation, traditions and routines, values and knowledge that come to shape the practices of nursing in a particular context.

  8. A 25-Year Single Institution Analysis of Health, Practice, and Fate of General Surgeons

    PubMed Central

    Harms, Bruce A.; Heise, Charles P.; Gould, Jon C.; Starling, James R.

    2005-01-01

    Objective: The objective of this study was to analyze nearly 3 decades of surgical residents from an established training program to carefully define individual outcomes on personal and professional health and practice satisfaction. Summary Background Data: A paucity of data exists regarding the health and related practice issues of surgeons postresidency training. Despite several studies examining surgeon burnout and alcohol dependency problems, there have been no detailed reports defining health problems in practicing surgeons or preventive health patterns in this physician population. Important practice factors, including family and practice stress, that may impact on surgical career longevity and satisfaction have similarly received minimal focused examination. Methods: All former surgery residents at the University of Wisconsin from 1978 to 2002 were contacted. Detailed direct interview or phone contact was made to ensure confidentiality and to obtain reliable data. Interviews concentrated on serious health and practice issues since residency completion. Results: One hundred ten of 114 (97%) former residents were contacted. There were 100 males and 14 females with 2 deaths (accident, suicide). Including deaths and those lost to follow up, 15 (13.2%) were nonpracticing; 5 voluntarily (3 planned, 1 accident, 1 arthritis) and 4 involuntarily (alcohol/substance dependency). Eighty-nine percent were married or remarried with a 21.4% divorce rate postresidency. Major health issues occurred in 32% of all surveyed and in 50% of those ages ≥50. Only 10% reported complete lack of weekly exercise activity with 62% exercising at least 3 times per week. Body mass index increased from 23.9 ± 1.5 kg/m2 (age <40) to 26.6 ± 3.0 kg/m2 (P = 0.009) by age ≥50. Alcohol dependency was confirmed in 7.3%. Overall, 75% of surgeons surveyed were satisfied with their practice/career. Conclusion: Despite a high job satisfaction rate, surgeon health may be compromised in up to 50

  9. (abstract) Precision Time and Frequency Transfer Utilizing SONET OC-3

    NASA Technical Reports Server (NTRS)

    Stein, Sam; Calhoun, Malcom; Kuhnle, Paul; Sydnor, Richard; Gifford, Al

    1996-01-01

    An innovative method of distributing precise time and reference frequency to users located several kilometers from a frequency standard and master clock has been developed by the Timing Solutions Corporation of Boulder, CO. The Optical Two-Way Time Transfer System (OTWTTS) utilizes a commercial SONET OC-3 facility interface to physically connect a master unit to multiple slave units at remote locations. Optical fiber is a viable alternative to standard copper cable and microwave transmission. This paper discusses measurements of frequency and timing stability over the OTWTTS.

  10. Governing the implementation of Emergency Obstetric Care: experiences of Rural District Health Managers, Tanzania

    PubMed Central

    2014-01-01

    Background Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. Methods The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Results Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development

  11. Ready for practice: what child and family health nurses say about education.

    PubMed

    Fowler, Cathrine; Schmied, Virginia; Psaila, Kim; Kruske, Sue; Rossiter, Chris

    2015-02-01

    Australia has a well-established universal child and family health service predominately staffed by specialist/qualified child and family health nurses. Two common and interrelated concerns are the need for nurses to be ready for practice after completing a nursing education program and the means to ensure ongoing nursing competence. To investigate the readiness of CFH nurses to practise after qualification and their continuing engagement with learning. The study used an interpretive descriptive approach. This paper presents data from four questions from a larger survey of child and family health nurses across Australia. 1098 child and family health nurses responded to the survey. Qualitative survey responses from the four education questions were analysed using inductive thematic content analysis. Five significant themes were identified: hands-on experience (student clinical practice/placement); drawing on prior experience; learning on the job; learning (learning over time); and barriers to learning. This paper provides insights into nurses' readiness for practice at the completion of a postgraduate child and family health nursing qualification and their maintenance of competence and specialist knowledge. It highlights: the need for clinical placement to be retained and enhanced; the significant contribution of more experienced child and family health nurses mentoring newly graduated child and family health nurses; the need for minimum education standards; the importance of reviewing education courses in relation to graduates' readiness for child and family health nursing practice; the importance of supporting ongoing professional development; and the removal of barriers to accessing education opportunities. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Going Global: Toward Competency-Based Best Practices for Global Health in Dental Education.

    PubMed

    Seymour, Brittany; Shick, Elizabeth; Chaffee, Benjamin W; Benzian, Habib

    2017-06-01

    The Global Oral Health Interest Group of the Consortium of Universities for Global Health (GOHIG-CUGH) published recommended competencies to support development of competency-based global health education in dental schools. However, there has been no comprehensive, systematically derived, or broadly accepted framework for creating and delivering competency-based global health education to dental students. This article describes the results of a collaborative workshop held at the 2016 American Dental Education Association (ADEA) Annual Session & Exhibition designed to build on the GOHIG-CUGH competencies and start to develop systematic approaches for their practical application. Workshop organizers developed a preliminary theoretical framework for guiding the development of global health in dental education, grounded in published research. Collectively, workshop participants developed detailed outcomes for the theoretical framework with a focus on three educational practices: didactic, experiential, and research learning and how each can meet the competencies. Participants discussed learning objectives, keys to implementation, ethical considerations, challenges, and examples of success. Outcomes demonstrated that no educational practice on its own meets all 33 recommended competencies for dental students; however, the three educational practices combined may potentially cover all 33. Participants emphasized the significance of sustainable approaches to student learning for both students and communities, with identified partners in the communities to collaborate on the development, implementation, evaluation, and long-term maintenance of any student global health activity. These findings may represent early steps toward professional consensus and best practices for global health in dental education in the United States.

  13. Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers

    PubMed Central

    Toscos, Tammy; Carpenter, Maria; Flanagan, Mindy; Kunjan, Kislaya; Doebbeling, Bradley N.

    2018-01-01

    Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These “positive deviant” practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Participants: Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Methods: Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Results: Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient–provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. Conclusion: We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access. PMID:29552599

  14. A theory-based model of translation practices in public health participatory research.

    PubMed

    Clavier, Carole; Sénéchal, Yan; Vibert, Stéphane; Potvin, Louise

    2012-06-01

    This article explores the innovative practices of actors specifically mandated to support interactions between academic researchers and their partners from the community during public health participatory research. Drawing on the concept of translation as developed in actor-network theory and found in the literature on knowledge transfer and the sociology of intermediate actors, we build a theory-based model of the translation practices developed by these actors at the interface between community and university. We refine this model by using it to analyse material from two focus groups comprising participants purposively selected because they work at the nexus between research and practice. Our model of translation practices includes cognitive (dealing with the contents of the research), strategic (geared to facilitating the research process and balancing power relationships among the partners) and logistic practices (the hands-on tasks of coordination). Combined, these three types of translation practices demonstrate that actors working at the interface in participatory research contribute to multidirectional exchanges and the co-construction of knowledge among research partners. Beyond the case of participatory research, theorising translation practices helps understand how knowledge is produced at the interface between academic and experiential (or lay) knowledge. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  15. The public health nutrition intervention management bi-cycle: a model for training and practice improvement.

    PubMed

    Hughes, Roger; Margetts, Barrie

    2012-11-01

    The present paper describes a model for public health nutrition practice designed to facilitate practice improvement and provide a step-wise approach to assist with workforce development. The bi-cycle model for public health nutrition practice has been developed based on existing cyclical models for intervention management but modified to integrate discrete capacity-building practices. Education and practice settings. This model will have applications for educators and practitioners. Modifications to existing models have been informed by the authors' observations and experiences as practitioners and educators, and reflect a conceptual framework with applications in workforce development and practice improvement. From a workforce development and educational perspective, the model is designed to reflect adult learning principles, exposing students to experiential, problem-solving and practical learning experiences that reflect the realities of work as a public health nutritionist. In doing so, it assists the development of competency beyond knowing to knowing how, showing how and doing. This progression of learning from knowledge to performance is critical to effective competency development for effective practice. Public health nutrition practice is dynamic and varied, and models need to be adaptable and applicable to practice context to have utility. The paper serves to stimulate debate in the public health nutrition community, to encourage critical feedback about the validity, applicability and utility of this model in different practice contexts.

  16. Urban health in daily practice: livelihood, vulnerability and resilience in Dar es Salaam, Tanzania.

    PubMed

    Obrist, Brigit

    2003-12-01

    Health is the core value and ultimate goal of health development, yet we know very little about health conceptions in everyday life. Inspired by investigations into lay health concepts in Europe, our study explores experiences and meanings of health in a strikingly different context, namely, in a low-income neighbourhood of an African city. Grounded in ethnographic research in Dar es Salaam, we introduce the concept of 'health practice' and examine health definitions, explanations, and activities of urban Swahili women. Our findings show that representations of health form a set of experiences, meanings and embodied practice centring on the links between body, mind, and living conditions. We suggest that 'livelihood', 'vulnerability' and 'resilience' best capture women's main concerns of health practice in such a setting. All women face an emotional burden of being exposed to urban afflictions and an intellectual and practical burden of overcoming them, but some meet this challenge more successfully than others do. This approach tips the balance towards a positive view of health that has been neglected in medical anthropology. It also opens new lines of inquiry in urban health research by consequently following a resource orientation that acknowledges women's struggle to stay healthy and directs attention to their agency.

  17. Molecular epidemiology and evolutionary histories of human coronavirus OC43 and HKU1 among patients with upper respiratory tract infections in Kuala Lumpur, Malaysia.

    PubMed

    Al-Khannaq, Maryam Nabiel; Ng, Kim Tien; Oong, Xiang Yong; Pang, Yong Kek; Takebe, Yutaka; Chook, Jack Bee; Hanafi, Nik Sherina; Kamarulzaman, Adeeba; Tee, Kok Keng

    2016-02-25

    Despite the worldwide circulation of human coronavirus OC43 (HCoV-OC43) and HKU1 (HCoV-HKU1), data on their molecular epidemiology and evolutionary dynamics in the tropical Southeast Asia region is lacking. The study aimed to investigate the genetic diversity, temporal distribution, population history and clinical symptoms of betacoronavirus infections in Kuala Lumpur, Malaysia between 2012 and 2013. A total of 2,060 adults presented with acute respiratory symptoms were screened for the presence of betacoronaviruses using multiplex PCR. The spike glycoprotein, nucleocapsid and 1a genes were sequenced for phylogenetic reconstruction and Bayesian coalescent inference. A total of 48/2060 (2.4 %) specimens were tested positive for HCoV-OC43 (1.3 %) and HCoV-HKU1 (1.1 %). Both HCoV-OC43 and HCoV-HKU1 were co-circulating throughout the year, with the lowest detection rates reported in the October-January period. Phylogenetic analysis of the spike gene showed that the majority of HCoV-OC43 isolates were grouped into two previously undefined genotypes, provisionally assigned as novel lineage 1 and novel lineage 2. Sign of natural recombination was observed in these potentially novel lineages. Location mapping showed that the novel lineage 1 is currently circulating in Malaysia, Thailand, Japan and China, while novel lineage 2 can be found in Malaysia and China. Molecular dating showed the origin of HCoV-OC43 around late 1950s, before it diverged into genotypes A (1960s), B (1990s), and other genotypes (2000s). Phylogenetic analysis revealed that 27.3 % of the HCoV-HKU1 strains belong to genotype A while 72.7 % belongs to genotype B. The tree root of HCoV-HKU1 was similar to that of HCoV-OC43, with the tMRCA of genotypes A and B estimated around the 1990s and 2000s, respectively. Correlation of HCoV-OC43 and HCoV-HKU1 with the severity of respiratory symptoms was not observed. The present study reported the molecular complexity and evolutionary dynamics of human

  18. Prevalence of Mindfulness Practices in the US Workforce: National Health Interview Survey.

    PubMed

    Kachan, Diana; Olano, Henry; Tannenbaum, Stacey L; Annane, Debra W; Mehta, Ashwin; Arheart, Kristopher L; Fleming, Lora E; Yang, Xuan; McClure, Laura A; Lee, David J

    2017-01-05

    Mindfulness-based practices can improve workers' health and reduce employers' costs by ameliorating the negative effect of stress on workers' health. We examined the prevalence of engagement in 4 mindfulness-based practices in the US workforce. We used 2002, 2007, and 2012 National Health Interview Survey (NHIS) data for adults (aged ≥18 y, n = 85,004) to examine 12-month engagement in meditation, yoga, tai chi, and qigong among different groups of workers. Reported yoga practice prevalence nearly doubled from 6.0% in 2002 to 11.0% in 2012 (P < .001); meditation rates increased from 8.0% in 2002 to 9.9% in 2007 (P < .001). In multivariable models, mindfulness practice was significantly lower among farm workers (odds ratio [OR] = 0.42; 95% confidence interval [CI], 0.21-0.83]) and blue-collar workers (OR = 0.63; 95% CI, 0.54-0.74) than among white-collar workers. Worker groups with low rates of engagement in mindfulness practices could most benefit from workplace mindfulness interventions. Improving institutional factors limiting access to mindfulness-based wellness programs and addressing existing beliefs about mindfulness practices among underrepresented worker groups could help eliminate barriers to these programs.

  19. 76 FR 23331 - Outer Continental Shelf (OCS) Scientific Committee (SC); Announcement of Plenary Session

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-26

    ...., biology/ecology, physical sciences, and social sciences) to review the specific studies plans of the... Studies Program, Environmental Division, Bureau of Ocean Energy Management, Regulation and Enforcement... feasibility, appropriateness, and scientific value of the OCS Environmental Studies Program to the Secretary...

  20. 75 FR 20859 - Outer Continental Shelf (OCS) Policy Committee; Notice and Agenda for Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... DEPARTMENT OF THE INTERIOR Minerals Management Service Outer Continental Shelf (OCS) Policy Committee; Notice and Agenda for Meeting AGENCY: Minerals Management Service (MMS), Interior. ACTION: Notice.... Jeryne Bryant at Minerals Management Service, 381 Elden Street, Mail Stop 4001, Herndon, Virginia 20170...

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