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Sample records for personal health maintenance

  1. 30 CFR 90.203 - Certified person; maintenance and calibration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Certified person; maintenance and calibration. 90.203 Section 90.203 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... OF PNEUMOCONIOSIS Sampling Procedures § 90.203 Certified person; maintenance and calibration. (a...

  2. Flight Crew Health Maintenance

    NASA Technical Reports Server (NTRS)

    Gullett, C. C.

    1970-01-01

    The health maintenance program for commercial flight crew personnel includes diet, weight control, and exercise to prevent heart disease development and disability grounding. The very high correlation between hypertension and overweight in cardiovascular diseases significantly influences the prognosis for a coronary prone individual and results in a high rejection rate of active military pilots applying for civilian jobs. In addition to physical fitness the major items stressed in pilot selection are: emotional maturity, glucose tolerance, and family health history.

  3. Flight Crew Health Maintenance

    NASA Technical Reports Server (NTRS)

    Gullett, C. C.

    1970-01-01

    The health maintenance program for commercial flight crew personnel includes diet, weight control, and exercise to prevent heart disease development and disability grounding. The very high correlation between hypertension and overweight in cardiovascular diseases significantly influences the prognosis for a coronary prone individual and results in a high rejection rate of active military pilots applying for civilian jobs. In addition to physical fitness the major items stressed in pilot selection are: emotional maturity, glucose tolerance, and family health history.

  4. 30 CFR 90.203 - Certified person; maintenance and calibration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Certified person; maintenance and calibration. 90.203 Section 90.203 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT...

  5. 30 CFR 90.203 - Certified person; maintenance and calibration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Certified person; maintenance and calibration. 90.203 Section 90.203 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT...

  6. 30 CFR 90.203 - Certified person; maintenance and calibration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Certified person; maintenance and calibration. 90.203 Section 90.203 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT...

  7. 30 CFR 90.203 - Certified person; maintenance and calibration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Certified person; maintenance and calibration. 90.203 Section 90.203 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT...

  8. Perceived benefits and barriers to exercise among persons with physical disabilities or chronic health conditions within action or maintenance stages of exercise.

    PubMed

    Malone, Laurie A; Barfield, J P; Brasher, Joel D

    2012-10-01

    Information regarding factors that affect the initial step to exercise behavior change among persons with physical disabilities or chronic health conditions is available in the literature but much less is known regarding perceived benefits and barriers to exercise among those who are regularly active. The purpose of this study was to examine the perceived benefits and barriers to exercise among persons with physical disabilities or chronic health conditions within action or maintenance stages of exercise. Participants (n = 152) completed the Exercise Benefits and Barriers Scale (EBBS). For data analyses, disabilities and health conditions were grouped as neuromuscular, orthopedic, cardiovascular/pulmonary, or multiple conditions. Multivariate analysis of variance (MANOVA) was conducted to determine if mean differences on EBBS benefits and barriers scores existed among disability types, between sexes, among age groups, and between physical activity levels. Sum scores were computed to determine the strongest benefit and barrier responses. No significant mean differences in EBBS scores were found between disability types, sexes, age groups, or physical activity levels (p > 0.05). Strongest benefit responses varied by group. Strongest barrier responses were the same for all demographic groups: "Exercise tires me," "Exercise is hard work for me," and "I am fatigued by exercise." EBBS scores were similar across disability/health condition, sex, age, and physical activity level. Primary benefits reported were in the areas of improved physical performance and psychological outlook whereas the primary barriers were in the area of physical exertion. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Preventive Health Maintenance.

    ERIC Educational Resources Information Center

    Blai, Boris, Jr.

    The principal health-related killers of modern man--heart disease, cancer, stroke, and accidents--are best described as lifestyle diseases, for the etiology of these killers includes the abuse and neglect of the body. Health depends essentially upon the control of environmental influences, including those aspects that the individual creates.…

  10. Preventive Health Maintenance.

    ERIC Educational Resources Information Center

    Blai, Boris, Jr.

    The principal health-related killers of modern man--heart disease, cancer, stroke, and accidents--are best described as lifestyle diseases, for the etiology of these killers includes the abuse and neglect of the body. Health depends essentially upon the control of environmental influences, including those aspects that the individual creates.…

  11. The Benefits of Health Maintenance.

    ERIC Educational Resources Information Center

    Rosenstein, Alan H.

    1987-01-01

    The article focuses on the merits of a comprehensive, medically-oriented health maintenance/risk assessment program, and suggests that such conditions as heart disease, cancer, and arteriosclerosis can be prevented or postponed through proper nutrition, weight control, exercise, smoking cessation, and stress management. (Author/CB)

  12. The Benefits of Health Maintenance.

    ERIC Educational Resources Information Center

    Rosenstein, Alan H.

    1987-01-01

    The article focuses on the merits of a comprehensive, medically-oriented health maintenance/risk assessment program, and suggests that such conditions as heart disease, cancer, and arteriosclerosis can be prevented or postponed through proper nutrition, weight control, exercise, smoking cessation, and stress management. (Author/CB)

  13. [Personal health folder].

    PubMed

    Cerdà-Calafat, Ismael; Continente-Gonzalo, Marta; García-López, Cristina; Guanyabens-Calvet, Joan

    2010-02-01

    Personal Health Records shared between patients and their health team can improve the capacity of the patients to become active partners in the care of their own health. PHR can offer the patients access to their medical information, services, such as resources programming, or communication between the members of the health team and the patient. They could also allow patients themselves to directly register certain data, be picked up from home monitoring devices, thus becoming a very useful tool in the management of chronic disease and for the prevention and promotion of health. The Government of Catalonia is developing the Personal Health Folder, a space where the Health Department will give the people of Catalonia secure and confidential access to their health information. The Personal Health Folder is within the framework of the Catalonian Shared Clinical History project, which is based on a index system of medical records shared between different personnel, using interoperability tools and is in accordance with the legislation applicable in Catalonia and within its healthcare system. Within the framework of this project and these principles, the Personal Health Folder has the aim to give people responsibility for their own health, allowing them to take part in the management of the preventive actions and care, and to improve the quality of care, and coordination between the different health areas and professionals. 2010 Elsevier España S.L. All rights reserved.

  14. Personality and oral health.

    PubMed

    Thomson, W Murray; Caspi, Avshalom; Poulton, Richie; Moffitt, Terrie E; Broadbent, Jonathan M

    2011-10-01

    We investigated age-26 personality characteristics and age-32 oral health in a prospective study of a complete birth cohort born in Dunedin, New Zealand. Personality was measured using the Multidimensional Personality Questionnaire (MPQ). Oral health was measured using the short-form Oral Health Impact Profile (OHIP-14), a global measure, and dental examinations. Personality profiles were constructed for 916 individuals (50.8% men) using standardized MPQ scores, and multivariate analyses examined their association with oral health. Those reporting 1+ OHIP-14 impacts had higher Negative Emotionality scores (and lower Constraint and Positive Emotionality MPQ superfactor scores) than those who did not. After controlling for gender, clinical status, and the other two MPQ superfactors, those scoring higher on Negative Emotionality had a greater risk of reporting 1+ OHIP-14 impacts, as well as 3+ OHIP-14 impacts and worse-than-average oral health. They also had a greater risk of having lost at least one tooth from caries and of having 3+ decayed surfaces. Personality characteristics appear to shape self-reports of oral health. Personality is also a risk factor for clinical disease status, at least with respect to dental caries and its sequelae. Because the attitudes and values tapped into by personality tests can be altered by brief cognitive interventions, those might be useful in preventive dentistry. © 2011 Eur J Oral Sci.

  15. The Personal Health Survey

    ERIC Educational Resources Information Center

    Thorne, Frederick C.

    1978-01-01

    The Personal Health Survey (PHS) is a 200-item inventory designed to sample symptomatology as subjective experiences from the 12 principal domains of organ system and psychophysiological functioning. This study investigates the factorial validity of the empirically constructed scales. (Author)

  16. Personal Health Records

    MedlinePlus

    ... chart there, too. These charts are your medical records. They may be on paper or electronic. To keep track of all this information, it's a good idea to keep your own personal health record. What kind of information would you put in ...

  17. Health Maintenance Organization (HMO) Plan

    MedlinePlus

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

  18. Debating personal health budgets

    PubMed Central

    Alakeson, Vidhya; Boardman, Jed; Boland, Billy; Crimlisk, Helen; Harrison, Charlotte; Iliffe, Steve; Khan, Masood; O'Shea, Rory; Patterson, Janet

    2016-01-01

    Personal health budgets (PHBs) were piloted in the National Health Service (NHS) in England between 2009 and 2012 and were found to have greater positive effects on quality of life and psychological well-being for those with mental health problems than commissioned service, as well as reducing their use of unplanned care. The government intends to extend PHBs in England for long-term conditions, including mental health, from April 2015. Given the importance of engaging clinicians in the next phase of PHB development, we provide an overview of the approach, synthesise the evidence from the national pilot and debate some of the opportunities and challenges. Balancing individual choice and recovery with concerns for risk, equity and the sustainability of existing community services is the central tension underpinning this innovation in mental health service delivery. PMID:26958358

  19. Health maintenance on Space Station

    NASA Technical Reports Server (NTRS)

    Logan, J. S.

    1987-01-01

    Medical support for extended manned missions aboard such spacecraft as the NASA Space Shuttle must encompass prevention, diagnosis, and therapy capabilities in the preflight and postflight as well as actual mission phases. An evaluation is presently made of the technological and management challenges that must be met in order to furnish an adequate inflight health care delivery system that possesses adequate inflight health care, real-time environmental monitoring, physiological countermeasures, and medical rescue/recovery facilities for ill or injured crew members.

  20. [Social support contribution to health and the adoption and maintenance of health behaviors].

    PubMed

    Chouinard, Maud-Christine; Robichaud-Ekstrand, Sylvie

    2003-12-01

    Social support refers to the presence of individuals providing emotional or material resources. Its four components are: integration, structure, function, and quality. This article presents empirical and theoretical data, as well as criticism of studies which examine the relationship between social support, global health and cardiovascular health, also evaluating direct or moderating contributions to the adoption and maintenance of health behaviours in persons with cardiovascular disease. Concrete implications for nursing practice are reviewed.

  1. Psychological health maintenance on Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Santy, Patricia A.

    1990-01-01

    The scheduling of crew rotations at intervals of as much as 180 days on NASA's Space Station Freedom entails that the cumulative effects of psychological, emotional, and social stressors on astronauts be monitored. The Space Station's Health Maintenance Facility (HMF) will furnish preventive, diagnostic, and therapeutic assistance for significant psychiatric and interpersonal problems. Mental health professionals must be part of the team of medical personnel charged with facilitating the physiological and phychological transition from earth to space and back. An account is presently given of the critical factors to be addressed by HMF personnel on extended-duration missions.

  2. Psychological health maintenance on Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Santy, Patricia A.

    1990-01-01

    The scheduling of crew rotations at intervals of as much as 180 days on NASA's Space Station Freedom entails that the cumulative effects of psychological, emotional, and social stressors on astronauts be monitored. The Space Station's Health Maintenance Facility (HMF) will furnish preventive, diagnostic, and therapeutic assistance for significant psychiatric and interpersonal problems. Mental health professionals must be part of the team of medical personnel charged with facilitating the physiological and phychological transition from earth to space and back. An account is presently given of the critical factors to be addressed by HMF personnel on extended-duration missions.

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

    PubMed

    Waymack, M H

    1990-12-01

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

  4. Psychological health maintenance on Space Station Freedom.

    PubMed

    Santy, P A

    1990-01-01

    The scheduling of crew rotations for up to 180 days on Space Station Freedom presents a special challenge for behavioral scientists who are tasked with providing psychological support for the crews, their families, and mission flight controllers. Preflight psychological support planning may minimize the negative impact of psychological and social issues on mission success, as well as assist NASA management in making real-time mission planning decisions in the event of a significant social event (for example, the death of a family member). During flight, the combined psychological, emotional, and social stressors on the astronauts must be monitored, along with other aspects of their health. The Health Maintenance Facility (HMF) will have the capability of providing preventive, diagnostic, and therapeutic assistance for significant psychiatric and interpersonal problems which may develop. Psychological support will not end with the termination of the mission. Mental health professionals must be part of the team of medical personnel whose job will be to facilitate the transition--physical and mental--from the space environment back to planet Earth. This paper reviews each phase of mission planning for Space Station Freedom and specifies those factors that may be critical for psychological health maintenance on extended-duration space missions.

  5. Electronic health records and personal health records.

    PubMed

    Caligtan, Christine A; Dykes, Patricia C

    2011-08-01

    To provide an overview of electronic personal health information technology. Peer reviewed research studies, review articles, and web resources. As technology develops and electronic health records become more common, patients and clinicians are working toward a safer, more personal form of health care delivery. Improving access and input to personal health information is still in its infancy, but with government funding, development of patient health records will continue to grow. Patients are the consumers of health care and are witness to the paradigm shift of access to health information and changes in information communication technology (ICT). For the oncology nurse, the transformation of health care and ICT will require nurses to educate patients and family members on available online resources for self management and health promotion. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Health maintenance facility: Dental equipment requirements

    NASA Technical Reports Server (NTRS)

    Young, John; Gosbee, John; Billica, Roger

    1991-01-01

    The objectives were to test the effectiveness of the Health Maintenance Facility (HMF) dental suction/particle containment system, which controls fluids and debris generated during simulated dental treatment, in microgravity; to test the effectiveness of fiber optic intraoral lighting systems in microgravity, while simulating dental treatment; and to evaluate the operation and function of off-the-shelf dental handheld instruments, namely a portable dental hand drill and temporary filling material, in microgravity. A description of test procedures, including test set-up, flight equipment, and the data acquisition system, is given.

  7. Manned Mars mission health maintenance facility

    NASA Technical Reports Server (NTRS)

    Degioanni, Joseph C.

    1986-01-01

    The Health Maintenance Facility (HMF) requirements which enable/enhance manned Mars missions (MMMs) are addressed. It does not attempt to resolve any issues that may affect the feasibility of any given element in the HMF. Reference is made to current work being conducted in the design of the space station HMF. The HMF requirements are discussed within the context of two distinctly different scenarios: HMF as part of the Mars surface infrastructure, and HMF as part of the nine months translation from low Earth orbit to Mars orbit. Requirements for an HMF are provided, and a concept of HMF is shown.

  8. Maintenance of gingival health post professional care.

    PubMed

    Bosma, Mary Lynn

    2011-08-01

    Oral hygiene habits are strongly associated with general health behaviours; good oral self care should result in good dental health. Clinical dental hygiene services have limited long range probability of success if the patient is not diligent in the daily procedures of personal care to remove and control dental plaque. Therefore, it is important to help make the individual aware of their own ability to control and maintain good oral health after a dental prophylaxis through oral care instruction and the use of select antimicrobials to maintain the gingival health. This paper reviews the evidence outlining the relative roles of prophylaxis and correct oral self-care in maintaining gingival health. © 2011 FDI World Dental Federation.

  9. 14 CFR 43.3 - Persons authorized to perform maintenance, preventive maintenance, rebuilding, and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND... maintain, rebuild, alter, or perform preventive maintenance on an aircraft, airframe, aircraft engine... under part 61 may perform preventive maintenance on any aircraft owned or operated by that pilot which...

  10. Personalism for public health ethics.

    PubMed

    Petrini, Carlo; Gainotti, Sabina; Requena, Pablo

    2010-01-01

    In public health ethics, as in bioethics, utilitarian approaches usually prevail, followed by Kantian and communitarian foundations. If one considers the nature and core functions of public health, which are focused on a population perspective, utilitarianism seems still more applicable to public health ethics. Nevertheless, faulting additional protections towards the human person, utilitarianism doesn't offer appropriate solutions when conflicts among values do arise. Further criteria must be applied to protect the fundamental principles of respect for human life. Personalism offers similar advantages to utilitarianism but warrants more protection to the human person. We suggest a possible adaptation of personalism in the specific field of public health by means of four principles: absolute respect for life or principle of inviolability; subsidiarity and the "minimum" mandatory principle; solidarity; justice and non discrimination.

  11. Personal health promotion through personalized health technologies - Nuadu experience.

    PubMed

    Korhonen, I; Mattila, E; Ahtinen, A; Salminen, J; Hopsu, L; Lappalainen, R; Leino, T

    2009-01-01

    Poor lifestyles - overweight, unhealthy diet, physical inactivity, sleep deprivation, and stress - are significant risk factors to chronic illnesses, which cause majority of the health care costs. Hence, behavioral change towards healthy lifestyles is one of the keys to health care cost containment. Personal health systems (PHS) offer tools to support behavioral change. As health risks, personal needs and preferences vary from an individual to another, personalization of the PHS is needed. In Nuadu project we have developed a PHS integrating several different personal health technologies. This system was studied in a large (N=354) randomized controlled trial where employees with several health risks participated in a health promotion program. The study will finish in June 2009. User feedback and technology usage logs reveal that especially simple mobile technologies were actively used during the program. However, usage models varied between individuals and time, and there was a significant number of both active users and non-users. The results emphasize that "one size" does not fit all, and instead of individual "killer applications", PHS with different personalizable and interoperable options should be developed. In addition, screening and profiling methods should be developed to identify those users who would best accept and benefit from technology-supported health promotion. Successful technologies combine high usability and conceptual simplicity to clear and perceivable added value for the end users.

  12. Explorations in Personal Health.

    ERIC Educational Resources Information Center

    Haro, Michael S.; And Others

    This text, designed for college students, is oriented toward the social, emotional, and behavioral aspects of health. Eight health-related topics of major concern for college students were selected for inclusion: (1) interpersonal relationships; (2) coping strategies; (3) sexuality; (4) nutrition; (5) medical care and services; (6) health…

  13. Barriers and Bridges: Understanding Factors Affecting Health Maintenance.

    ERIC Educational Resources Information Center

    Dolan, Regina

    1981-01-01

    Among areas covered in a health maintenance survey are: (1) health maintenance and preventive medicine; (2) unhealthy lifestyles; (3) knowledge level; (4) obesity; (5) exercise; (6) nutrition; (7) mental health; (8) smoking; (9) drinking; (10) the role of the physician; and (11) the changing role of the employer. (JN)

  14. 14 CFR 43.3 - Persons authorized to perform maintenance, preventive maintenance, rebuilding, and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND... aircraft, airframe, aircraft engine, propeller, appliance, or component part to which this part applies... a pilot certificate issued under part 61 may perform preventive maintenance on any aircraft owned or...

  15. Drug and Health Mediagraphy: Personal Health.

    ERIC Educational Resources Information Center

    Dykstra, Ralph R.; Dirr, Peter J.

    The first in a series of bibliographies lists approximately 400 instructional materials grouped under the following four areas of personal health: dental health, first aid and survival, nutrition, and safety education. It is noted that all of the materials listed were suggested by teachers after careful screening, including evaluation with…

  16. 14 CFR 43.3 - Persons authorized to perform maintenance, preventive maintenance, rebuilding, and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND... a pilot certificate issued under part 61 may perform preventive maintenance on any aircraft owned or... pilot certificate may perform preventive maintenance on an aircraft owned or operated by that pilot and...

  17. Sexuality talk during adolescent health maintenance visits.

    PubMed

    Alexander, Stewart C; Fortenberry, J Dennis; Pollak, Kathryn I; Bravender, Terrill; Davis, J Kelly; Ostbye, Truls; Tulsky, James A; Dolor, Rowena J; Shields, Cleveland G

    2014-02-01

    Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. Total time per visit during which sexuality issues were discussed. RESULTS One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥ 36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥ 36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant associations between adolescent, physician, and visit characteristics were

  18. Sexuality Talk During Adolescent Health Maintenance Visits

    PubMed Central

    Alexander, Stewart C.; Fortenberry, J. Dennis; Pollak, Kathryn I.; Bravender, Terrill; Davis, J. Kelly; Østbye, Truls; Tulsky, James A.; Dolor, Rowena J.; Shields, Cleveland G.

    2015-01-01

    Importance Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. Objective To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. Design, Setting, and Participants Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. Main Outcomes and Measures Total time per visit during which sexuality issues were discussed. Results One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant

  19. Health maintenance facility system effectiveness testing

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.; Gosbee, John; Bueker, Richard; Kupra, Debra; Ruta, Mary

    1993-01-01

    The Medical Simulations Working Group conducted a series of medical simulations to evaluate the proposed Health Maintenance Facility (HMF) Preliminary Design Review (PDR) configuration. The goal of these simulations was to test the system effectiveness of the HMF PDR configurations. The objectives of the medical simulations are to (1) ensure fulfillment of requirements with this HMF design, (2) demonstrate the conformance of the system to human engineering design criteria, and (3) determine whether undesirable design or procedural features were introduced into the design. The simulations consisted of performing 6 different medical scenarios with the HMF mockup in the KRUG laboratory. The scenarios included representative medical procedures and used a broad spectrum of HMF equipment and supplies. Scripts were written and simulations performed by medical simulations working group members under observation from others. Data were collected by means of questionnaires, debriefings, and videotapes. Results were extracted and listed in the individual reports. Specific issues and recommendations from each simulation were compiled into the individual reports. General issues regarding the PDR design of the HMF are outlined in the summary report.

  20. Personalizing public health: your health avatar.

    PubMed

    Pereira, Chrystian; McNamara, Anusha; Sorge, Lindsay; Arya, Vibhuti

    2013-01-01

    To describe the creation of a health avatar, with the goals of providing patients with complete health information from various sources, establishing an interactive and customizable platform, empowering users to determine how the health information best fits or speaks to their personal needs, and providing perspective by comparing the health status of the individual with that of the individual's community. The Internet is rapidly becoming integrated into Americans' daily lives. According to the 2007 Health Information National Trends Study, 69% of U.S. adults had access to the Internet and 23% reported using a social networking site. The impact of social media has further grown, and an estimated 50% of adults in America have a profile on social media. The potential for using cyber communities to improve health messaging is great. Several health care organizations have implemented the use of social media in a variety of ways to varying degrees of success. We propose a platform that automatically gathers information and reflects the health status of an individual back to the user. An avatar, which is a representation of a user, could be created and assigned characteristics that allow users to appreciate their health status. The health avatar platform also would allow users to compare their personal status with that of their community. The overall goal is to engage and then motivate users to improve their overall health status. Medicine must acknowledge the evolving relationships that the next generation of patients will have with technology. The health avatar is a platform that incorporates a connection with the health system through electronic medical records and connects individuals to the greater community.

  1. Governance for personal health records.

    PubMed

    Reti, Shane R; Feldman, Henry J; Safran, Charles

    2009-01-01

    Personal health records (PHR) are a modern health technology with the ability to engage patients more fully in their healthcare. Despite widespread interest, there has been little discussion around PHR governance at an organizational level. We develop a governance model and compare it to the practices of some of the early PHR adopters, including hospitals and ambulatory care settings, insurers and health plans, government departments, and commercial sectors. Decision-making structures varied between organizations. Business operations were present in all groups, but patients were not represented in any of the governance structures surveyed. To improve patient-centered care, policy making for PHRs needs to include patient representation at a governance level.

  2. A health maintenance facility for space station freedom

    NASA Technical Reports Server (NTRS)

    Billica, R. D.; Doarn, C. R.

    1991-01-01

    We describe a health care facility to be built and used on an orbiting space station in low Earth orbit. This facility, called the health maintenance facility, is based on and modeled after isolated terrestrial medical facilities. It will provide a phased approach to health care for the crews of Space Station Freedom. This paper presents the capabilities of the health maintenance facility. As Freedom is constructed over the next decade there will be an increase in activities, both construction and scientific. The health maintenance facility will evolve with this process until it is a mature, complete, stand-alone health care facility that establishes a foundation to support interplanetary travel. As our experience in space continues to grow so will the commitment to providing health care.

  3. A health maintenance facility for space station freedom

    NASA Technical Reports Server (NTRS)

    Billica, R. D.; Doarn, C. R.

    1991-01-01

    We describe a health care facility to be built and used on an orbiting space station in low Earth orbit. This facility, called the health maintenance facility, is based on and modeled after isolated terrestrial medical facilities. It will provide a phased approach to health care for the crews of Space Station Freedom. This paper presents the capabilities of the health maintenance facility. As Freedom is constructed over the next decade there will be an increase in activities, both construction and scientific. The health maintenance facility will evolve with this process until it is a mature, complete, stand-alone health care facility that establishes a foundation to support interplanetary travel. As our experience in space continues to grow so will the commitment to providing health care.

  4. Increment 23/24 Critical Readiness Review Health Maintenance System

    NASA Technical Reports Server (NTRS)

    Nieschwitz, Linda

    2010-01-01

    This slide presentation reviews the Health Maintenance System. It includes information on the carbon dioxide (CO2) and moisture removal system (CMRS), the variable oxygen system,rendevous station panels, and the crew contamination protection kit (CCPK).

  5. Health maintenance throughout the life span for individuals with Down syndrome.

    PubMed

    Bosch, Joni Jacobsen

    2003-01-01

    To describe the routine health maintenance needs of individuals with Down syndrome who have specialized health needs associated with the multi-system impact of the diagnosis. Review of scientific literature including peer-reviewed articles, books, and online resources. In addition to the routine health maintenance needs of all persons, those with Down syndrome have specialized needs. Failure to address these specific health maintenance concerns may lead to misdiagnoses and failure to reach the highest level of function possible. Patients with Down syndrome who have legitimate, treatable diagnoses may be misdiagnosed as having behavior problems or dementia. Failure to identify abnormalities such as cardiac problems or sleep apnea may shorten life and interfere with ability to live life to the fullest.

  6. [Health maintenance strategy for construction industry workers].

    PubMed

    Perminova, I Iu; Logvinenko, I I

    2011-01-01

    The authors analyzed work conditions and health state of workers engaged into construction industry in Kemerovo city. Findings are that complex approach to carrying out the strategy "Health for all in XXI century" causes health preservation.

  7. Health maintenance in older adults: combining evidence and individual preferences.

    PubMed

    Gestuvo, Maria Kristina

    2012-01-01

    There is increasing interest in maintaining health and delaying disability for older adults as this population segment expands. And instead of focusing on a traditional disease-specific approach to health maintenance, there is an ongoing shift to a patient-centered approach, and defining outcomes based on the older adults' goals. In this approach, their goals and preferences are central, and other factors such as their health status and prognosis help determine which goals may be realistic. These subjective goals and objective characteristics are then balanced with the risks, benefits, and harms of established evidence-driven health-maintenance recommendations. Hence, older adults share their goals and preferences with clinicians; while clinicians share information on risks, benefits, harms, and uncertainties of existing health-maintenance recommendations, and help guide the older adult through how existing evidence can respond to their health goals and preferences. In this article, the concept of patient-centered care in the context of health maintenance for older adults is discussed; and health maintenance recommendations for older adults are reviewed.

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

    PubMed Central

    Newcomer, R; Harrington, C; Friedlob, A

    1990-01-01

    The Social/Health Maintenance Organization (S/HMO) is a four-site national demonstration. This program combines Medicare Part A and B coverage, with various extended and chronic care benefits, into an integrated health plan. The provision of these services extends both the traditional roles of HMOs and that of long-term care community-service case management systems. During the initial 30 months of operation the four S/HMOs shared financial risk with the Health Care Financing Administration. This article reports on this developmental period. During this phase the S/HMOs had lower-than-expected enrollment levels due in part to market competition, underfunding of marketing efforts, the limited geographic area served, and an inability to differentiate the S/HMO product from that of other Medicare HMOs. The S/HMOs were allowed to conduct health screening of applicants prior to enrolling them. The number of nursing home-certifiable enrollees was controlled through this mechanism, but waiting lists were never very long. Persons joining S/HMOs and other Medicare HMOs during this period were generally aware of the alternatives available. S/HMO enrollees favored the more extensive benefits; HMO enrollees considerations of cost. The S/HMOs compare both newly formed HMOs and established HMOs. On the basis of administrator cost, it is more efficient to add chronic care benefits to an HMO than to add an HMO component to a community care provider. All plans had expenses greater than their revenues during the start-up period, but they were generally able to keep service expenditures within planned levels. PMID:2116384

  9. Risk Factor Intervention for Health Maintenance

    ERIC Educational Resources Information Center

    Breslow, Lester

    1978-01-01

    Risk factors for disease consist of personal habits such as cigarette smoking and excessive alcohol consumption, and bodily characteristics such as hypertension and high serum cholesterol. Progress in identifying, quantifying, and controlling risk factors is opening the way to the prevention of disease. (BB)

  10. Health Maintenance Organization: Concept and Functions. Conference Proceedings.

    ERIC Educational Resources Information Center

    Hornback, May, Ed.

    The proceedings published in the document are the outcomes from a conference to consider the role of professional nursing in relation to health maintenance organizations (HMOs) as one possible way to improve health care delivery. Emphasis is placed on strategies underlying the HMO concept and reviewing and extending understanding of factors which…

  11. Lack of health maintenance examinations and risk in myeloma patients.

    PubMed

    Tariman, Joseph D; Gleason, Charise; Faiman, Beth; Doss, Deborah; Catamero, Donna; Bishop-Royse, Jessica; Katz, Mike; Kurtin, Sandra; Moran, Diane; Lonial, Sagar

    2016-07-01

    Health maintenance (HM) practices are essential to prevent illness, promote well-being, and maximize health. Patients with multiple myeloma (MM) are at increased risk for cardiovascular disease and cancers, yet, research on HM practices and preventative care of MM survivors has limited report. The study comprised a descriptive, correlational, and cross-sectional online survey design. Survey of patients with MM was carried out through the International Myeloma Foundation (IMF) and the Association of Cancer Online Resources (ACOR) e-mail list services. The members of the IMF and ACOR e-mail list services were surveyed, of which 237 patients responded. The modified Medical Expenditure Preventive Survey-Preventive Care questionnaire was used; it included items that ask patients regarding their healthcare practices that relate to dental care, cancer prevention, addiction, lifestyles, sensory screening, immunizations, cardiovascular, endocrine, psychosocial, and bone health. Descriptive statistics, Pearson's chi-square, and Spearman's rho correlation coefficient were obtained. In this study, men had statistically significant inferior global health maintenance scores than women (P = 0.002). Being employed (P = 0.054) and married or partnered (P = 0.017) were significantly correlated with better health maintenance patterns among male respondents. In contrast, no statistically significant correlations between sociodemographic factors and health maintenance patterns were found in women. Patients with MM, particularly men, require continued education and close monitoring of health maintenance practices. These findings are consistent with publications looking at gender disparities in healthcare utilization in the United States. Studies show that men, in general, are less likely to seek preventative healthcare screenings. Healthcare providers must incorporate health maintenance promotion during clinic visits.

  12. Pricing health care services: applications to the health maintenance organization.

    PubMed

    Sweeney, R E; Franklin, S P

    1986-01-01

    This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.

  13. Health Maintenance System (HMS) CMO - Fundoscope

    NASA Image and Video Library

    2015-04-09

    ISS043E099306 (04/09/2015) --- NASA astronauts Terry Virts (bottom) and Scott Kelly (top) are seen here inside the Destiny Laboratory performing eye exams as part of ongoing studies into crew vision health. Vision changes in astronauts spending long periods of time in microgravity is a critical health issue that scientists are looking to solve as humanity prepares to travel to destinations far outside our planet like an asteroid and Mars.

  14. Elder Care for the 1980s: Health and Social Service in One Prepaid Health Maintenance System.

    ERIC Educational Resources Information Center

    Diamond, Larry M.; And Others

    1983-01-01

    Discusses the feasibility of delivering combined health and social services to an elderly population. The social/health maintenance organization (S/HMO), incorporating features of health maintenance organizations with community social services, will be financed on a prepaid, capitated basis through premium contributions from Medicare, Medicaid,…

  15. Maintenance of forest ecosystem health and vitality

    Treesearch

    Ryan D. DeSantis; W. Keith Moser

    2016-01-01

    Forest health will likely be threatened by a number of factors - including fragmentation, fire regime alteration, and a variety of diseases, insects, and invasive plants - along with global climate change (Krist et al. 2007, Tkacz et al. 2008). By itself, global climate change could dramatically and rapidly alter forest composition and structure (Allen and Breshears...

  16. Romantic relationship formation, maintenance and changes in personal networks.

    PubMed

    Rözer, Jesper Jelle; Mollenhorst, Gerald; Volker, Beate

    2015-03-01

    According to the social withdrawal hypothesis, a personal network becomes smaller when a person starts dating, cohabitates and marries. This phenomenon is widely established in the literature. However, these studies were usually done with cross-sectional data. As a consequence, it is still unclear whether or how personal networks actually change after the formation of a romantic relationship (i.e. dating), after starting cohabitation and after getting married. It is also unclear how long and to what extent social withdrawal continues. To overcome these shortcomings, we examine how the size and composition of personal networks change after relationship formation. We use two waves of the PAIRFAM dataset (2008 and 2011), which include information about 6640 Germans who were between 16 and 39 years of age at the time of the second interview in 2008. Results from fixed effects regression models underscore that the association between romantic relationships and changes in personal networks is more dynamic than previous studies suggested. For example, after the formation of a romantic relationship people show a decrease in non-kin contacts, while an increase in non-kin contacts is observed after two years of dating, as well as after two years of cohabitation. These network changes suggest that people adapt their social networks to the demands and constraints of each phase of a romantic relationship. Because the decline in network size after dating is not stable, there is no need to be afraid that those who have a romantic partner remain isolated from other relationships. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Personality, Negative Interactions, and Mental Health

    PubMed Central

    Lincoln, Karen D.

    2010-01-01

    Research suggests that an individual’s personality traits may mediate the relationship between social support and mental health. This study uses two national data sets to test a conceptual model that integrates personality, social support, negative interactions, and psychological distress. Results suggest that, beyond the influence of personality, social support is negatively associated with psychological distress, and negative interactions are positively associated with such distress. The findings also suggest that personality has direct and indirect effects, through social support and negative interactions, on psychological distress. Findings specify how positive and negative facets of relationships and personality influence mental health outcomes. PMID:21151733

  18. [Influence of Japanese food on senility and health maintenance].

    PubMed

    Tsuduki, Tsuyoshi

    2015-01-01

      One of the factors that is believed to contribute to Japanese longevity is their dietary life, which is unique and distinct from Westerners. However, there has been no study that examined whether Japanese food in itself is effective for health maintenance. Therefore, we investigated in rats whether Japanese food is beneficial to health maintenance compared with American food. As a result, we revealed that modern Japanese food is useful for health maintenance compared with modern American food. We subsequently investigated the health benefits of Japanese food from different eras. The menus of Japanese foods from 4 different years, 2005, 1990, 1975 and 1960 were prepared, cooked, and powderized. Each of the Japanese foods was provided to mice. We found that the Japanese food from 1975 exhibited health benefits with respect to the stages of growth, adolescence, maturity and old age. Furthermore, we focused on fish oil, which is one of the beneficial ingredients of Japanese food, and investigated the effect of its long-term intake on lifespan in mice. Surprisingly, long-term intake of large amounts of fish oil shortened the lifespan of these mice. By contrast, intake of small amounts of fish oil with antioxidants extended the lifespan. Moreover, while intake of large amounts of fish oil also shortened the lifespan of Caenorhabditis elegans (C. elegans), intake of small amounts of fish oil extended the lifespan. Thus, it was suggested that even when foods have been reported to have health benefits, ingestion of large amounts of individual foods is undesirable for health maintenance.

  19. Dynamics of Implementation and Maintenance of Organizational Health Interventions

    PubMed Central

    Rahmandad, Hazhir; Bullock, Sally Lawrence; Ammerman, Alice

    2017-01-01

    In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes. PMID:28809807

  20. Personality Diagnosis for Personalized eHealth Services

    NASA Astrophysics Data System (ADS)

    Cortellese, Fabio; Nalin, Marco; Morandi, Angelica; Sanna, Alberto; Grasso, Floriana

    In this paper we present two different approaches to personality diagnosis, for the provision of innovative personalized services, as used in a case study where diabetic patients were supported in the improvement of physical activity in their daily life. The first approach presented relies on a static clustering of the population, with a specific motivation strategy designed for each cluster. The second approach relies on a dynamic population clustering, making use of recommendation systems and algorithms, like Collaborative Filtering. We discuss pro and cons of each approach and a possible combination of the two, as the most promising solution for this and other personalization services in eHealth.

  1. Health 2050: The Realization of Personalized Medicine through Crowdsourcing, the Quantified Self, and the Participatory Biocitizen.

    PubMed

    Swan, Melanie

    2012-09-12

    The concepts of health and health care are moving towards the notion of personalized preventive health maintenance and away from an exclusive focus on the cure of disease. This is against the backdrop of contemporary public health challenges that include increasing costs, worsening outcomes, 'diabesity' epidemics, and anticipated physician shortages. Personalized preventive medicine could be critical to solving public health challenges at their causal root. This paper sets forth a vision and plan for the realization of preventive medicine by 2050 and examines efforts already underway such as participatory health initiatives, the era of big health data, and qualitative shifts in mindset.

  2. Health 2050: The Realization of Personalized Medicine through Crowdsourcing, the Quantified Self, and the Participatory Biocitizen

    PubMed Central

    Swan, Melanie

    2012-01-01

    The concepts of health and health care are moving towards the notion of personalized preventive health maintenance and away from an exclusive focus on the cure of disease. This is against the backdrop of contemporary public health challenges that include increasing costs, worsening outcomes, ‘diabesity’ epidemics, and anticipated physician shortages. Personalized preventive medicine could be critical to solving public health challenges at their causal root. This paper sets forth a vision and plan for the realization of preventive medicine by 2050 and examines efforts already underway such as participatory health initiatives, the era of big health data, and qualitative shifts in mindset. PMID:25562203

  3. Sexual function in F-111 maintenance workers: the study of health outcomes in aircraft maintenance personnel.

    PubMed

    Brown, Anthony; Gibson, Richard; Tavener, Meredith; Guest, Maya; D'Este, Catherine; Byles, Julie; Attia, John; Horsley, Keith; Harrex, Warren; Ross, James

    2009-06-01

    In Australia, four formal F-111 fuel tank deseal/reseal (DSRS) repair programs were implemented over more than two decades, each involving different processes and using a range of hazardous substances. However, health concerns were raised by a number of workers. The "Study of Health Outcomes in Aircraft Maintenance Personnel" was commissioned by the Australian Department of Defence to investigate potential adverse health outcomes as a result of being involved in the deseal/reseal processes. To compare measures of sexual function in F-111 aircraft fuel tank DSRS maintenance workers, against two appropriate comparison groups. Exposed and comparison participants completed a postal questionnaire which included general questions of health and health behavior, and two specific questions on sexual functioning. They also completed the International Index of Erectile Function (IIEF) questionnaire. Logistic regression was used to explore exposure status and outcome while adjusting for potential confounders. The three outcomes of interest for this study were the proportion of participants with erectile dysfunction (ED) according to the IIEF, the proportion with self-reported loss of interest in sex, and the proportion with self-reported problems with sexual functioning. Compared with each of the comparison groups, a larger proportion of the exposed group reported sexual problems and were classified as having ED according to the IIEF. In logistic regression, the odds of all three outcomes were higher for exposed participants relative to each comparison group and after adjustment for potentially confounding variables including anxiety and depression. There was a consistent problem with sexual functioning in the exposed group that is not explained by anxiety and depression, and it appears related to DSRS activities.

  4. Your Health: Prevention, Safety and First Aid, Personal Health Care.

    ERIC Educational Resources Information Center

    Oxley, Gloria; Torre, Liz

    Information and accompanying exercises are provided in this learning module to reinforce students' basic reading and writing skills and, at the same time, increase their awareness of and motivation toward sound personal health practices. Written at an elementary level, the module considers eleven personal health topics: prevention of illness;…

  5. Your Health: Prevention, Safety and First Aid, Personal Health Care.

    ERIC Educational Resources Information Center

    Oxley, Gloria; Torre, Liz

    Information and accompanying exercises are provided in this learning module to reinforce students' basic reading and writing skills and, at the same time, increase their awareness of and motivation toward sound personal health practices. Written at an elementary level, the module considers eleven personal health topics: prevention of illness;…

  6. A Personalized Health Information Retrieval System

    PubMed Central

    Wang, Yunli; Liu, Zhenkai

    2005-01-01

    Consumers face barriers when seeking health information on the Internet. A Personalized Health Information Retrieval System (PHIRS) is proposed to recommend health information for consumers. The system consists of four modules: (1) User modeling module captures user’s preference and health interests; (2) Automatic quality filtering module identifies high quality health information; (3) Automatic text difficulty rating module classifies health information into professional or patient educational materials; and (4) User profile matching module tailors health information for individuals. The initial results show that PHIRS could assist consumers with simple search strategies. PMID:16779435

  7. Personal Health Information Management: Consumers’ Perspectives

    PubMed Central

    Civan, Andrea; Skeels, Meredith M.; Stolyar, Anna; Pratt, Wanda

    2006-01-01

    Personal health information management (PHIM) refers to activities that support consumers’ access, integration, organization, and use of their personal health information. We investigated PHIM in the health consumer population using a focus group and participatory design. In collaboration with health consumers, we identified PHIM activities and explored the design of new supportive technology. Our findings describe prominent PHIM activities such as monitoring and assessing health, as well as health-related decision making, planning, and action. We describe design principles our participants used during the participatory design of a PHIM tool. These include individual control, sharing, integration, security and flexibility. These findings provide new insights into emerging ideas in consumer health informatics research and technology design. Understanding health consumers’ PHIM needs is an important step in creating technology to support these needs. PMID:17238322

  8. The Vaccine Safety Datalink: immunization research in health maintenance organizations in the USA.

    PubMed Central

    Chen, R. T.; DeStefano, F.; Davis, R. L.; Jackson, L. A.; Thompson, R. S.; Mullooly, J. P.; Black, S. B.; Shinefield, H. R.; Vadheim, C. M.; Ward, J. I.; Marcy, S. M.

    2000-01-01

    The Vaccine Safety Datalink is a collaborative project involving the National Immunization Program of the Centers for Disease Control and Prevention and several large health maintenance organizations in the USA. The project began in 1990 with the primary purpose of rigorously evaluating concerns about the safety of vaccines. Computerized data on vaccination, medical outcome (e.g. outpatient visits, emergency room visits, hospitalizations, and deaths) and covariates (e.g. birth certificates, census data) are prospectively collected and linked under joint protocol at multiple health maintenance organizations for analysis. Approximately 6 million persons (2% of the population of the USA) are now members of health maintenance organizations participating in the Vaccine Safety Datalink, which has proved to be a valuable resource providing important information on a number of vaccine safety issues. The databases and infrastructure created for the Vaccine Safety Datalink have also provided opportunities to address vaccination coverage, cost-effectiveness and other matters connected with immunization as well as matters outside this field. PMID:10743283

  9. Effect of Mergers on Health Maintenance Organization Premiums

    PubMed Central

    Feldman, Roger; Wholey, Douglas; Christianson, Jon

    1996-01-01

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

  10. Does the Health Maintenance Facility Provide Speciality Capabilities?

    NASA Technical Reports Server (NTRS)

    Boyce, Joey; Wurgler, James; Broadwell, Kim; Martin, William; Stiernberg, Charles M.; Bove, Alfred; Fromm, Rob; O'Neill, Daniel

    1991-01-01

    The Health Maintenance Facility (HMF) is capable of handling all minor illnesses, most moderate illnesses, and some major illnesses on board a space station. Its primary purpose should be to treat problems that are mission threatening, not life threatening. The HMF will have greater medical capabilities than those currently on Navy submarines. Much of the discussion in this document focuses on the possibilities of treating specific medical conditions on board a space station. The HMF will be limited to caring for critically ill patients for a few days, so a crew return vehicle will be important.

  11. Characteristics of health maintenance organizations and their influence on efficiency.

    PubMed

    Draper, D A; Solti, I; Ozcan, Y A

    2000-02-01

    This study examines the efficiency of Health Maintenance Organizations (HMOs) based on a sample of 249 HMOs operating in the United States in 1995. Data Envelopment Analysis (DEA) was used to calculate the level of technical efficiency for each HMO included in the sample. Further descriptive analyses were conducted examining various structural and operational characteristics of HMOs and their impact on efficiency. Federal qualification status, Medicare programme participation, combined Medicare and Medicaid programmes participation, chain affiliation and size were found to be significant influences on HMO efficiency.

  12. Scale and scope economies among health maintenance organizations.

    PubMed

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

    1996-12-01

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

  13. Personal responsibility in oral health: ethical considerations.

    PubMed

    Albertsen, Andreas

    2012-11-30

    Personal responsibility is a powerful idea supported by many values central to West European thought. On the conceptual level personal responsibility is a complex notion. It is important to separate the concept of being responsible for a given state of affairs from the concept of holding people responsible by introducing measures that decrease their share of available resources. Introducing personal responsibility in oral health also has limitations of a more practical nature. Knowledge, social status and other diseases affect the degree to which people can be said to be responsible for their poor oral health. These factors affect people's oral health and their ability to take care of it. Both the conceptual and practical issues at stake are not reasons to abandon the idea of personal responsibility in oral health, but they do affect what the notion means and when it is reasonable to hold people responsible. They also commit people who support the idea of personal responsibility in oral health to supporting the idea of societal responsibility for mitigating the effects of factors that diminish people's responsibility and increase the available information and knowledge in the population.

  14. Health Status, Personal Definition of Health, and Health Behavior Choice in the Elderly.

    ERIC Educational Resources Information Center

    Wood, Norma J.

    The purpose of this study was to investigate the relationships among health status, personal definition of health, and health behavior choice in the elderly. Self-assessed health status was measured using a modified Cantril Ladder, personal definition of health was measured using the Laffrey Health Conception Scale (LHCS), and health behavior…

  15. Requirements and Solutions for Personalized Health Systems.

    PubMed

    Blobel, Bernd; Ruotsalainen, Pekka; Lopez, Diego M; Oemig, Frank

    2017-01-01

    Organizational, methodological and technological paradigm changes enable a precise, personalized, predictive, preventive and participative approach to health and social services supported by multiple actors from different domains at diverse level of knowledge and skills. Interoperability has to advance beyond Information and Communication Technologies (ICT) concerns, including the real world business domains and their processes, but also the individual context of all actors involved. The paper introduces and compares personalized health definitions, summarizes requirements and principles for pHealth systems, and considers intelligent interoperability. It addresses knowledge representation and harmonization, decision intelligence, and usability as crucial issues in pHealth. On this basis, a system-theoretical, ontology-based, policy-driven reference architecture model for open and intelligent pHealth ecosystems and its transformation into an appropriate ICT design and implementation is proposed.

  16. Security and privacy issues of personal health.

    PubMed

    Blobel, Bernd; Pharow, Peter

    2007-01-01

    While health systems in developed countries and increasingly also in developing countries are moving from organisation-centred to person-centred health service delivery, the supporting communication and information technology is faced with new risks regarding security and privacy of stakeholders involved. The comprehensively distributed environment puts special burden on guaranteeing communication security services, but even more on guaranteeing application security services dealing with privilege management, access control and audit regarding social implication and connected sensitivity of personal information recorded, processed, communicated and stored in an even internationally distributed environment.

  17. Early Experiences with Personal Health Records

    PubMed Central

    Halamka, John D.; Mandl, Kenneth D.; Tang, Paul C.

    2008-01-01

    Over the past year, several payers, employers, and commercial vendors have announced personal health record projects. Few of these are widely deployed and few are fully integrated into ambulatory or hospital-based electronic record systems. The earliest adopters of personal health records have many lessons learned that can inform these new initiatives. We present three case studies—MyChart at Palo Alto Medical Foundation, PatientSite at Beth Israel Deaconess Medical Center, and Indivo at Children’s Hospital Boston. We describe our implementation challenges from 1999 to 2007 and postulate the evolving challenges we will face over the next five years. PMID:17947615

  18. Personality, well-being, and health.

    PubMed

    Friedman, Howard S; Kern, Margaret L

    2014-01-01

    A lifespan perspective on personality and health uncovers new causal pathways and provides a deeper, more nuanced approach to interventions. It is unproven that happiness is a direct cause of good health or that negative emotion, worry, and depression are significant direct causes of disease. Instead, depression-related characteristics are likely often reflective of an already-deteriorating trajectory. It is also unproven that challenging work in a demanding environment usually brings long-term health risks; on the contrary, individual strivings for accomplishment and persistent dedication to one's career or community often are associated with sizeable health benefits. Overall, a substantial body of recent research reveals that conscientiousness plays a very significant role in health, with implications across the lifespan. Much more caution is warranted before policy makers offer narrow health recommendations based on short-term or correlational findings. Attention should be shifted to individual trajectories and pathways to health and well-being.

  19. The Design of a Prototype Personal Computer Database for the Expert System Advisor for Aircraft Maintenance Scheduling (ESAAMS)

    DTIC Science & Technology

    1991-12-01

    The Expert System Advisor for Aircraft Maintenance Scheduling (ESAAMS) was originally proposed in 1985 to assist in the scheduling of maintenance...critical maintenance decision making process. This theis addresses the design of the ESAAMS database which is of paramount importance to the expert ... system . Research on the use of the Naval Aviation Logistics Data Analysis (NALDA) database for a personal computer-based database, is documented. Review of

  20. The internet of things for personalized health.

    PubMed

    Schreier, Günter

    2014-01-01

    Advances in information and communications technologies (ICT) enable new personalized health care concepts which are often characterized by four "P" terms, i.e. personalized, predictive, preventive and participatory. However, real world implementations of the complete 4P spectrum hardly exist today. The Internet of Things (IoT) has been defined as an extension to the current Internet that enables pervasive communication between the physical and the virtual world. Smart devices and enabling elements like Near Field Communication (NFC) and Radio Frequency Identification (RFID) technology already exist and increasingly will be a mainstream element of our lives. This future vision paper attempts to assess if and how the Internet of Things for personalized health (IoT4pH) can help to facilitate the 4P healthcare paradigm and discusses related challenges and opportunities.

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

    PubMed

    Lang, J R; Collen, A

    2005-01-01

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

  2. [Supporting the health of the disabled person].

    PubMed

    Cole, Emilie

    2014-05-01

    In 2013, the French national agency for the assessment and quality of social and medical-social institutions and services (ANESM) issued recommendations concerningthe support of the health of disabled people. These guidelines underline that the training and support of professionals are necessary, as well as the participation of the disabled person in their care project.

  3. Students' Mental Health: Personal and University Determinants

    ERIC Educational Resources Information Center

    Khodarahimi, Siamak; Rasti, Ali; Khajehie, Malihe; Sattar, Rea

    2009-01-01

    The present study was to examine the effects of personal and university bounded factors in students mental health in north of Fars province, Iran. The effects of these factors on university students' psychopathology within a survey design were investigated among 300 participants--94 males and 206 females, who were selected through random sampling…

  4. Structure and performance of health maintenance organizations: A review

    PubMed Central

    Langwell, Kathryn M.

    1990-01-01

    During the past decade, the number of and enrollment in health maintenance organizations (HMOs) have grown dramatically. In 1980, 236 HMOs served 9 million members. By 1989, there were 591 HMOs with over 34 million enrollees. New HMOs are very different in organizational structure and arrangements than the HMOs that were operating in the 1970s, and the health care markets they serve also have changed substantially with the increasing supply of physicians and declining hospital admissions. Consequently, the accepted research findings on HMO performance in the 1970s may have only limited usefulness in understanding the role of HMOs and their effect on today's market for health services. This is of particular concern as the Health Care Financing Administration considers the further expansion of managed care options available to Medicare and Medicaid beneficiaries. In this article, the author reviews evidence on the relationship between HMO organizational arrangements and performance, and the trends within the HMO industry toward new organizational structures. The implications for Medicare and Medicaid risk contracting are also examined. PMID:10113464

  5. Personal Health: An Online Model for Health Education.

    ERIC Educational Resources Information Center

    Hohman, Stephen

    2003-01-01

    Ohio University's Community Health Program has developed a unique online personal health course that combines online learning and classroom participation to support student success. It has improved the consistency of information presented to students and increased overall quality. Guidelines are presented for preparing and implementing such…

  6. Maintenance of head and neck tumor on-chip: gateway to personalized treatment?

    PubMed

    Bower, Ruth; Green, Victoria L; Kuvshinova, Elena; Kuvshinov, Dmitriy; Karsai, Laszlo; Crank, Stephen T; Stafford, Nicholas D; Greenman, John

    2017-06-01

    Head and neck squamous cell carcinomas (HNSCC) are solid tumors with low overall survival (40-60%). In a move toward personalized medicine, maintenance of tumor biopsies in microfluidic tissue culture devices is being developed. HNSCC (n = 15) was dissected (5-10 mg) and either analyzed immediately or cultured in a microfluidic device (37°C) for 48 h. No difference was observed in morphology between pre- and postculture specimens. Dissociated samples were analyzed using trypan blue exclusion (viability), propidium iodide flow cytometry (death) and MTS assay (proliferation) with no significant difference observed highlighting tissue maintenance. Computational fluid dynamics showed laminar flow within the system. The microfluidic culture system successfully maintained HNSCC for 48 h, the culture system will allow testing of different treatment modalities with response monitoring.

  7. Policy Statement--Using personal health records to improve the quality of health care for children.

    PubMed

    2009-07-01

    A personal health record (PHR) is a repository of information from multiple contributors (eg, patient, family, guardians, physicians, and other health care professionals) regarding the health of an individual. The development of electronic PHRs presents new opportunities and challenges to the practice of pediatrics. This policy statement provides recommendations for actions that pediatricians can take to support the development and use of PHRs for children. Pediatric health care professionals must become actively involved in developing and adopting PHRs and PHR systems. The American Academy of Pediatrics supports development of: educational programs for families and clinicians on effective and efficient use of PHRs; incentives to facilitate PHR use and maintenance; and child- and adolescent-friendly standards for PHR content, portability, security, and privacy. Properly designed PHR systems for pediatric care can empower patients. PHRs can improve access to health information, improve coordination of preventive health and health maintenance activities, and support emergency and disaster management activities. PHRs provide support for the medical home for all children, including those with special health care needs and those in foster care. PHRs can also provide information to serve as the basis for pediatric quality improvement efforts. For PHRs to be adopted sufficiently to realize these benefits, we must determine how best to support their development and adoption. Privacy and security issues, especially with regard to children and adolescents, must be addressed.

  8. Predictors affecting personal health information management skills.

    PubMed

    Kim, Sujin; Abner, Erin

    2016-01-01

    This study investigated major factors affecting personal health records (PHRs) management skills associated with survey respondents' health information management related activities. A self-report survey was used to assess individuals' personal characteristics, health knowledge, PHR skills, and activities. Factors underlying respondents' current PHR-related activities were derived using principal component analysis (PCA). Scale scores were calculated based on the results of the PCA, and hierarchical linear regression analyses were used to identify respondent characteristics associated with the scale scores. Internal consistency of the derived scale scores was assessed with Cronbach's α. Among personal health information activities surveyed (N = 578 respondents), the four extracted factors were subsequently grouped and labeled as: collecting skills (Cronbach's α = 0.906), searching skills (Cronbach's α = 0.837), sharing skills (Cronbach's α = 0.763), and implementing skills (Cronbach's α = 0.908). In the hierarchical regression analyses, education and computer knowledge significantly increased the explanatory power of the models. Health knowledge (β = 0.25, p < 0.001) emerged as a positive predictor of PHR collecting skills. This study confirmed that PHR training and learning should consider a full spectrum of information management skills including collection, utilization and distribution to support patients' care and prevention continua.

  9. Predictors affecting personal health information management skills

    PubMed Central

    Abner, Erin

    2016-01-01

    Objectives This study investigated major factors affecting personal health records (PHRs) management skills associated with survey respondents’ health information management related activities. Methods A self-report survey was used to assess individuals’ personal characteristics, health knowledge, PHR skills, and activities. Factors underlying respondents current PHR-related activities were derived using Principle Component Analysis (PCA). Scale scores were calculated based on the results of the PCA, and hierarchical linear regression analyses were used to identify respondent characteristics associated with the scale scores. Internal consistency of the derived scale scores was assessed with Cronbach’s alpha. Results Among personal health information activities surveyed (N=578 respondents), the four extracted factors were subsequently grouped and labeled as: Collecting Skills (Cronbach’s α = .906), Searching skills (Cronbach’s α = .837), Sharing skills (Cronbach’s α = .763), and Implementing skills (Cronbach’s α = .908). In the hierarchical regression analyses, education and computer knowledge significantly increased the explanatory power of the models. Health knowledge (β = 0.25, P < 0.001) emerged as a positive predictor of PHR Collecting skills. Conclusions This study confirmed that PHR training and learning should consider a full spectrum of information management skills including collection, utilization, and distribution to support patients’ care and prevention continua. PMID:26268728

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

    PubMed Central

    Morrison, Ellen M.; Luft, Harold S.

    1990-01-01

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

  11. Regionalization of services within a multihospital health maintenance organization.

    PubMed Central

    Luft, H S; Crane, S

    1980-01-01

    Among the many factors that may explain lower costs for enrollees in Health Maintenance Organizations (HMOs) is the possibility that the HMO provides inpatient services more efficiently. While direct cost comparisons are in appropriate, it is reasonable to examine whether the Kaiser program in the San Francisco Bay Area regionalizes services among its ten hospitals. The presence of each of 43 facilities/services reported is examined in a regression model that includes type of hospital, size, a size-type interaction, and the distance to the nearest competing facility. When the generally smaller size of the Kaiser hospitals was controlled for, Kaiser hospitals had fewer technologically based services and concentrated these services in larger hospitals. Kaiser had more outpatient-oriented services. Among non-Kaiser hospitals, some specialized facilities were competitively distributed. PMID:7204063

  12. Patterns of Health Maintenance Organization Service Areas in Rural Counties

    PubMed Central

    Ricketts, Thomas C.; Slifkin, Rebecca T.; Johnson-Webb, Karen D.

    1995-01-01

    This study analyzes the 1993 National Directory of HMOs to determine the extent to which rural counties are included in health maintenance organization (HMO) service areas. Two specific questions are addressed: (1) How do the patterns of service areas differ across HMO model types? (2) What are the characteristics that distinguish rural counties served by HMOs from those that are not? Although a majority of rural counties are in HMO service areas, substantially fewer are served by non-individual practice association (non-IPA) models. Access to HMO services is found to decrease with county population density, and adjacency to metropolitan areas is an important predictor of inclusion in service areas. PMID:10153478

  13. Personality, Preventive Health Behaviour and Comparative Optimism about Health Problems.

    PubMed

    Ingledew, D K; Brunning, S

    1999-03-01

    The aim was to test a model whereby personality influences preventive health behaviour which in turn influences comparative optimism about possible future health problems. Students (N 5 150) completed measures of personality (five-factor), preventive health behaviour and comparative optimism. The model was tested using structural equation modelling with observed variables. In the final model, agreeableness and conscientiousness had positive main effects and an interactive effect upon preventive health behaviour. Preventive health behaviour had a positive effect upon comparative optimism. In addition, extraversion had a direct positive effect (not mediated by preventive health behaviour) upon comparative optimism. It is speculated that agreeableness and conscientiousness combine to produce a general regard for social convention that is conducive to healthier behaviour. The effect of extraversion is explicable in terms of positive affectivity.

  14. Environmental health and household demographics impacting biosand filter maintenance and diarrhea in Guatemala: an application of structural equation modeling.

    PubMed

    Divelbiss, Daniel William; Boccelli, Dominic Louis; Succop, Paul Allan; Oerther, Daniel Barton

    2013-02-05

    In rural health development practice, engineers and scientists must recognize the complex interactions that influence individuals' contact with disease-causing pathogens and understand how household habits may impact the adoption and long-term sustainability of new technology. The goal of this study was to measure the effect of various environmental health factors and household demographics on the operation and maintenance of the Biosand filter (Centre for Affordable Water and Sanitation Technology, Calgary, Alberta, Canada) and diarrhea health burden in the region. In July and August 2010, randomized household surveys (n = 286) were completed in rural Guatemala detailing water access, sanitation availability, hygiene practice, socio-economic status, education level, filter operation and maintenance, and diarrhea health burden of the home. A hypothesized structural equation model was developed based on a review of published research and tested using the surveyed data. Model-derived parameter estimates indicated that: (a) proper personal hygiene practices significantly promote proper filter operation and maintenance; and (b) higher household education level, proper filter operation and maintenance, and improved water supply significantly reduce diarrhea health burden. Additionally, a high level of unexplained variance in diarrhea indicated the filter, though protective of health, is not the only factor influencing diarrhea.

  15. The Emergence of Personalized Health Technology

    PubMed Central

    Christie, Gillian Pepall

    2016-01-01

    Personalized health technology is a noisy new entrant to the health space, yet to make a significant impact on population health but seemingly teeming with potential. Devices including wearable fitness trackers and healthy-living apps are designed to help users quantify and improve their health behaviors. Although the ethical issues surrounding data privacy have received much attention, little is being said about the impact on socioeconomic health inequalities. Populations who stand to benefit the most from these technologies are unable to afford, access, or use them. This paper outlines the negative impact that these technologies will have on inequalities unless their user base can be radically extended to include vulnerable populations. Frugal innovation and public–private partnership are discussed as the major means for reaching this end. PMID:27165944

  16. Usability Evaluation of a Personal Health Record

    PubMed Central

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

    2011-01-01

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

  17. The Emergence of Personalized Health Technology.

    PubMed

    Allen, Luke Nelson; Christie, Gillian Pepall

    2016-05-10

    Personalized health technology is a noisy new entrant to the health space, yet to make a significant impact on population health but seemingly teeming with potential. Devices including wearable fitness trackers and healthy-living apps are designed to help users quantify and improve their health behaviors. Although the ethical issues surrounding data privacy have received much attention, little is being said about the impact on socioeconomic health inequalities. Populations who stand to benefit the most from these technologies are unable to afford, access, or use them. This paper outlines the negative impact that these technologies will have on inequalities unless their user base can be radically extended to include vulnerable populations. Frugal innovation and public-private partnership are discussed as the major means for reaching this end.

  18. Women's self-assessed personal health resources.

    PubMed

    Malterud, K; Hollnagel, H

    1997-12-01

    To contribute to the development of a resource-oriented medical language by identifying self-assessed personal health resources in women. Key questions were developed to invite the patient to tell the general practitioner about such resources. Patients' answers were audiotaped and analysed qualitatively according to Giorgi's phenomenological approach. The theoretical frame of reference included salutogenesis, patient-centredness, and gender perspectives. Two female general practitioners and their consultations. 37 consecutive female patients aged 24-85 years. Common aspects of personal qualities and strategies considered by women as their health resources. The material unveiled health resources related to 1) internal strength mobilized by external strain, 2) interactive networks within and outside the family, 3) lifestyle practices, 4) physical and social activity, 5) acceptance and facilitation of the natural course of Disease, and 6) constitution. Female patients have explicit and intelligible ideas about their self-assessed personal health resources, which can be identified and mobilized by the general practitioner and form part of potentially empowering strategies in medical practice.

  19. Trafficking in persons: a health concern?

    PubMed

    Zimmerman, Cathy; Kiss, Ligia; Houssain, Mazeda; Watts, Charlotte

    2009-01-01

    Human trafficking is a phenomenon that has now been documented in most regions in the world. Although trafficking of women and girls for sexual exploitation is the most commonly recognised form of trafficking, it is widely acknowledged that human trafficking also involves men, women and children who are trafficked for various forms of labour exploitation and into other abusive circumstances. Despite the violence and harm inherent in most trafficking situations, there remains extremely little evidence on the individual and public health implications of any form of human trafficking. The Brazilian government has recently launched a national plan to combat human trafficking. However, because the health risks associated with human trafficking have not been well-recognised or documented, there is extremely limited reliable data on the health needs of trafficked persons to inform policy and practices.. Brazilian policy-makers and service providers should be encouraged to learn about the likely range of health impacts of trafficking, and incorporate this into anti-trafficking protection and response strategies. As well as prevention activities, the government, international and local organisations should work together with the public health research community to study the health needs of trafficked persons and explore opportunities to provide safe and appropriate services to victims in need of care.

  20. Auditory and Visual Cues for Topic Maintenance with Persons Who Exhibit Dementia of Alzheimer's Type

    PubMed Central

    Teten, Amy F.; Dagenais, Paul A.; Friehe, Mary J.

    2015-01-01

    This study compared the effectiveness of auditory and visual redirections in facilitating topic coherence for persons with Dementia of Alzheimer's Type (DAT). Five persons with moderate stage DAT engaged in conversation with the first author. Three topics related to activities of daily living, recreational activities, food, and grooming, were broached. Each topic was presented three times to each participant: once as a baseline condition, once with auditory redirection to topic, and once with visual redirection to topic. Transcripts of the interactions were scored for overall coherence. Condition was a significant factor in that the DAT participants exhibited better topic maintenance under visual and auditory conditions as opposed to baseline. In general, the performance of the participants was not affected by the topic, except for significantly higher overall coherence ratings for the visually redirected interactions dealing with the topic of food. PMID:26171273

  1. [Personality changes in opioid-dependent subjects in a methadone maintenance treatment program].

    PubMed

    Trémeau, F; Darreye, A; Leroy, B; Renckly, V; Ertlé, S; Weibel, H; Khidichian, F; Macher, J-P

    2003-01-01

    Personality disorders and particularly antisocial personality disorders (APD) are quite frequent in opioid-dependent subjects. They show various personality traits: high neuroticism, high impulsivity, higher extraversion than the general population. Previous studies have reported that some but not all personality traits improved with treatment. In a previous study, we found a low rate of APD in a French population of opioid-dependent subjects. For this reason, we evaluated personality traits at intake and during maintenance treatment with methadone. Methods - The form A of the Eysenck Personality Inventory (EPI) was given to opioid addicts at intake and after 6 and 12 months of methadone treatment. Results - 134 subjects (96 males and 38 females) took the test at intake, 60 completed 12 months of treatment. After 12 months, the EPI Neuroticism (N) and the Extraversion-introversion (E) scale scores decreased significantly. The N score improved in the first 6 months, while the E score improved only during the second 6 months of treatment. Compared to a reference group of French normal controls, male and female opioid addicts showed high N and E scores. Demographic data and EPI scores of patients who stayed in treatment for 12 months did not differ significantly from those of dropouts (n=23). Patients with a history of suicide attempts (SA) started to use heroin at an earlier age and they showed a higher E score and a tendency for a higher N score at intake. Discussion - The two personality dimensions of the EPI changed during MMT, and the N score converged towards the score of normal controls. Opioid addicts differ from normal controls mostly in their N score. The EPI did not help to differentiate 12-month completers from dropouts. Higher E scores in patients with an SA history might reflect a higher impulsivity, which has been linked to suicidality in other patient groups.

  2. Personal and social functioning in schizophrenia: defining a clinically meaningful measure of maintenance in relapse prevention.

    PubMed

    Nicholl, Deborah; Nasrallah, Henry; Nuamah, Isaac; Akhras, Kasem; Gagnon, Dennis D; Gopal, Srihari

    2010-06-01

    Relapse prevention and maintenance of social functioning are important treatment objectives in the long-term management of schizophrenia. However, relatively little is known about measuring maintenance of social functioning to assess treatment benefit in relapse prevention clinical trials or as a tool to predict relapse in clinical practice. This study aims (1) to define a clinically meaningful decrease in the Personal and Social Performance scale (PSP) to assess antipsychotic treatment benefit in terms of maintenance of functioning and (2) to explore the threshold value of PSP decline as a useful tool to predict relapse in clinical practice. This post hoc analysis of two similar placebo-controlled relapse prevention clinical trials consisted of an exploration of change in PSP that would represent a clinically important decrement to measure treatment benefit in terms of time to PSP decrement (ITT analysis set; Study 1: n = 205) and an assessment of predictive value of PSP decrement and relapse status (ITT analysis set; Study 2: n = 408). A 10-point decrement in PSP score was the threshold value for a clinically meaningful decline in personal and social functioning in a relapse prevention trial (Study 1). A strong association was found with relapse status: 61% of subjects with at least a 10-point decrease in PSP experienced the decrement prior to (between start of double-blind phase and before day of relapse) or on the day of relapse (Study 2). Kaplan-Meier survival analysis of time to at least a 10-point decrement in PSP showed that the proportion of subjects who did not experience at least a 10-point PSP decrease was statistically significantly greater in the paliperidone palmitate group than in the placebo group (p = 0.0014) (Study 2). Findings suggest a 10-point PSP decrement is a clinically relevant measure of maintenance of functioning in patients stabilized with antipsychotic therapy. Paliperidone palmitate demonstrated a statistically significant treatment

  3. 27 CFR 447.34 - Maintenance of records by persons required to register as importers of Import List articles.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 3 2011-04-01 2010-04-01 true Maintenance of records by persons required to register as importers of Import List articles. 447.34 Section 447.34 Alcohol, Tobacco... of records by persons required to register as importers of Import List articles. (a) Registrants...

  4. 40 CFR 761.193 - Maintenance of monitoring records by persons who import, manufacture, process, distribute in...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... persons who import, manufacture, process, distribute in commerce, or use chemicals containing..., DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS General Records and Reports § 761.193 Maintenance of monitoring records by persons who import, manufacture, process, distribute in commerce, or use chemicals...

  5. Segmenting health maintenance organizations to study productivity and profitability.

    PubMed

    Sobol, M G

    2000-01-01

    As the decade ended, health maintenance organizations (HMOs) were increasing in popularity as a means of health care delivery. These groups take many forms, so it is important for the analyst to see if the efficiency and financial results for these different forms vary. The four major forms are profit vs. not-for-profit, chain vs. non-chain, group/staff vs. individual practice association (IPA), and federally qualified vs. non-federally qualified. Using a nationwide database of all the HMOs in the United States, the article compares liquidity rates, leverage ratios, profitability ratios, marketing, and per member ratios across the four groups using paired t tests. The two classifications that showed the most differences were group/staff vs. IPA and federally qualified vs. non-federally qualified. IPAs have a better liquidity position and lower leverage ratios than group/staff but their administrative costs are higher and the time to receive payments and to pay debts is higher. Non-federally qualified have somewhat higher liquidity ratios and higher profitability ratios. These significant differences in financial outcomes indicate that studies of HMOs should segment different major forms of organizations and study them separately before trying to show the effects of different policies on HMO efficiency and effectiveness.

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

    PubMed

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

    2002-01-01

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

  7. Verifiable CPD paper: factors that influence the dental attendance pattern and maintenance of oral health for people with multiple sclerosis.

    PubMed

    Baird, W O; McGrother, C; Abrams, K R; Dugmore, C; Jackson, R J

    2007-01-13

    To determine the impact of multiple sclerosis (MS) on patient attendance at dental practices and maintenance of oral health. A cross-sectional postal questionnaire-based study. Leicestershire, United Kingdom. People with MS in Leicestershire identified from local health authority records (n = 476). Number registered at dental practice, frequency of attendance, issues and perspectives relating to attendance and maintenance of oral health. A response rate of 61% (n = 289) was obtained. When compared to the general population, a higher number of people with MS were registered with a dentist (49%:88%) and displayed more frequent practice attendance (71%:81%) in the past year. People with MS reported difficulties in attending a dentist and maintaining oral health, which were exacerbated by deterioration in general health. Problems relating to reduced personal mobility had the greatest impact on attendance. MS has a negative impact on perceived patient attendance and maintenance of oral health. Patients with a progressive disability could benefit greatly from the provision of preventive oral health care. The importance of seeking care earlier rather than later needs to be emphasised to both professionals and patients alike. Further efforts are required to increase awareness of the importance of oral health to the quality of life of people with MS and ensure that individuals with physical disabilities receive the same access to dental services as the able-bodied.

  8. Personal health records: a scoping review

    PubMed Central

    Fevrier-Thomas, U; Lokker, C; McKibbon, K A; Straus, S E

    2011-01-01

    Electronic personal health record systems (PHRs) support patient centered healthcare by making medical records and other relevant information accessible to patients, thus assisting patients in health self-management. We reviewed the literature on PHRs including design, functionality, implementation, applications, outcomes, and benefits. We found that, because primary care physicians play a key role in patient health, PHRs are likely to be linked to physician electronic medical record systems, so PHR adoption is dependent on growth in electronic medical record adoption. Many PHR systems are physician-oriented, and do not include patient-oriented functionalities. These must be provided to support self-management and disease prevention if improvements in health outcomes are to be expected. Differences in patient motivation to use PHRs exist, but an overall low adoption rate is to be expected, except for the disabled, chronically ill, or caregivers for the elderly. Finally, trials of PHR effectiveness and sustainability for patient self-management are needed. PMID:21672914

  9. Personal health records: a scoping review.

    PubMed

    Archer, N; Fevrier-Thomas, U; Lokker, C; McKibbon, K A; Straus, S E

    2011-01-01

    Electronic personal health record systems (PHRs) support patient centered healthcare by making medical records and other relevant information accessible to patients, thus assisting patients in health self-management. We reviewed the literature on PHRs including design, functionality, implementation, applications, outcomes, and benefits. We found that, because primary care physicians play a key role in patient health, PHRs are likely to be linked to physician electronic medical record systems, so PHR adoption is dependent on growth in electronic medical record adoption. Many PHR systems are physician-oriented, and do not include patient-oriented functionalities. These must be provided to support self-management and disease prevention if improvements in health outcomes are to be expected. Differences in patient motivation to use PHRs exist, but an overall low adoption rate is to be expected, except for the disabled, chronically ill, or caregivers for the elderly. Finally, trials of PHR effectiveness and sustainability for patient self-management are needed.

  10. Remote personal health monitoring with radio waves

    NASA Astrophysics Data System (ADS)

    Nguyen, Andrew

    2008-03-01

    We present several techniques utilizing radio-frequency identification (RFID) technology for personal health monitoring. One technique involves using RFID sensors external to the human body, while another technique uses both internal and external RFID sensors. Simultaneous monitoring of many patients in a hospital setting can also be done using networks of RFID sensors. All the monitoring are done wirelessly, either continuously or periodically in any interval, in which the sensors collect information on human parts such as the lungs or heart and transmit this information to a router, PC or PDA device connected to the internet, from which patient's condition can be diagnosed and viewed by authorized medical professionals in remote locations. Instantaneous information allows medical professionals to intervene properly and timely to prevent possible catastrophic effects to patients. The continuously monitored information provides medical professionals more complete and long-term studies of patients. All of these result in not only enhancement of the health treatment quality but also significant reduction of medical expenditure. These techniques demonstrate that health monitoring of patients can be done wirelessly at any time and any place without interfering with the patients' normal activities. Implementing the RFID technology would not only help reduce the enormous and significantly growing medical costs in the U.S.A., but also help improve the health treatment capability as well as enhance the understanding of long-term personal health and illness.

  11. Privacy by design in personal health monitoring.

    PubMed

    Nordgren, Anders

    2015-06-01

    The concept of privacy by design is becoming increasingly popular among regulators of information and communications technologies. This paper aims at analysing and discussing the ethical implications of this concept for personal health monitoring. I assume a privacy theory of restricted access and limited control. On the basis of this theory, I suggest a version of the concept of privacy by design that constitutes a middle road between what I call broad privacy by design and narrow privacy by design. The key feature of this approach is that it attempts to balance automated privacy protection and autonomously chosen privacy protection in a way that is context-sensitive. In personal health monitoring, this approach implies that in some contexts like medication assistance and monitoring of specific health parameters one single automatic option is legitimate, while in some other contexts, for example monitoring in which relatives are receivers of health-relevant information rather than health care professionals, a multi-choice approach stressing autonomy is warranted.

  12. Personal Health Records: A Systematic Literature Review

    PubMed Central

    2017-01-01

    Background Information and communication technology (ICT) has transformed the health care field worldwide. One of the main drivers of this change is the electronic health record (EHR). However, there are still open issues and challenges because the EHR usually reflects the partial view of a health care provider without the ability for patients to control or interact with their data. Furthermore, with the growth of mobile and ubiquitous computing, the number of records regarding personal health is increasing exponentially. This movement has been characterized as the Internet of Things (IoT), including the widespread development of wearable computing technology and assorted types of health-related sensors. This leads to the need for an integrated method of storing health-related data, defined as the personal health record (PHR), which could be used by health care providers and patients. This approach could combine EHRs with data gathered from sensors or other wearable computing devices. This unified view of patients’ health could be shared with providers, who may not only use previous health-related records but also expand them with data resulting from their interactions. Another PHR advantage is that patients can interact with their health data, making decisions that may positively affect their health. Objective This work aimed to explore the recent literature related to PHRs by defining the taxonomy and identifying challenges and open questions. In addition, this study specifically sought to identify data types, standards, profiles, goals, methods, functions, and architecture with regard to PHRs. Methods The method to achieve these objectives consists of using the systematic literature review approach, which is guided by research questions using the population, intervention, comparison, outcome, and context (PICOC) criteria. Results As a result, we reviewed more than 5000 scientific studies published in the last 10 years, selected the most significant approaches

  13. Personal Health Records: A Systematic Literature Review.

    PubMed

    Roehrs, Alex; da Costa, Cristiano André; Righi, Rodrigo da Rosa; de Oliveira, Kleinner Silva Farias

    2017-01-06

    Information and communication technology (ICT) has transformed the health care field worldwide. One of the main drivers of this change is the electronic health record (EHR). However, there are still open issues and challenges because the EHR usually reflects the partial view of a health care provider without the ability for patients to control or interact with their data. Furthermore, with the growth of mobile and ubiquitous computing, the number of records regarding personal health is increasing exponentially. This movement has been characterized as the Internet of Things (IoT), including the widespread development of wearable computing technology and assorted types of health-related sensors. This leads to the need for an integrated method of storing health-related data, defined as the personal health record (PHR), which could be used by health care providers and patients. This approach could combine EHRs with data gathered from sensors or other wearable computing devices. This unified view of patients' health could be shared with providers, who may not only use previous health-related records but also expand them with data resulting from their interactions. Another PHR advantage is that patients can interact with their health data, making decisions that may positively affect their health. This work aimed to explore the recent literature related to PHRs by defining the taxonomy and identifying challenges and open questions. In addition, this study specifically sought to identify data types, standards, profiles, goals, methods, functions, and architecture with regard to PHRs. The method to achieve these objectives consists of using the systematic literature review approach, which is guided by research questions using the population, intervention, comparison, outcome, and context (PICOC) criteria. As a result, we reviewed more than 5000 scientific studies published in the last 10 years, selected the most significant approaches, and thoroughly surveyed the health

  14. Integrated Systems Health Management as an Enabler for Condition Based Maintenance and Autonomic Logistics

    DTIC Science & Technology

    2015-09-17

    downtime and cost? Methodology Overview The approach taken in this research builds upon prior work on health monitoring, condition based maintenance...adjudicate system condition . As cost is not included in this work making a true comparison among options is difficult. A program manager must weigh...INTEGRATED SYSTEMS HEALTH MANAGEMENT AS AN ENABLER FOR CONDITION BASED MAINTENANCE AND AUTONOMIC

  15. 75 FR 62684 - Health Insurance Reform; Announcement of Maintenance Changes to Electronic Data Transaction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ...; Announcement of Maintenance Changes to Electronic Data Transaction Standards Adopted Under the Health Insurance... clarifications of the standards adopted in our regulations entitled ``Health Insurance Reform; Modifications to... Administrative Simplification requirements by adopting standards developed by standard setting organizations...

  16. Personal Care in Learning Health Care Systems.

    PubMed

    Miller, Franklin G; Kim, Scott Y H

    2015-12-01

    The idea of a "learning health care system"--one that systematically integrates clinical research with medical care--has received considerable attention recently. Some commentators argue that under certain conditions pragmatic comparative effectiveness randomized trials can be conducted ethically within the context of a learning health care system without the informed consent of patients for research participation. In this article, we challenge this perspective and contend that conducting randomized trials of individual treatment options without consent is neither necessary nor desirable to promote and sustain learning health care systems. Our argument draws on the normative conception of personal care developed by Charles Fried in a landmark 1974 book on the ethics of randomized controlled trials.

  17. Genetics and Personal Responsibility for Health.

    PubMed

    Resnik, David B

    2014-06-30

    Advances in genetic medicine may have implications for how we should think about personal responsibility for health, because they may show how it is possible to exert some control over risk factors that were previously thought as beyond the individual's control. Although we cannot control the genes that we are born with, we can often make decisions concerning genetic testing, disease prevention, and treatment. One might argue, therefore, that individuals should be treated as morally responsible for taking effective action in response to genetic risks factors, since genetically-based health risks are similar to other health risks. While this argument makes sense as an abstract, philosophical position, it is not a useful guide to public policy. Given these concerns, there is little society can or should do to encourage individuals to address their genetic risk factors, other than praising those who make prudent choices.

  18. A personal health information toolkit for health intervention research.

    PubMed

    Kizakevich, Paul N; Eckhoff, Randall; Weger, Stacey; Weeks, Adam; Brown, Janice; Bryant, Stephanie; Bakalov, Vesselina; Zhang, Yuying; Lyden, Jennifer; Spira, James

    2014-01-01

    With the emergence of mobile health (mHealth) apps, there is a growing demand for better tools for developing and evaluating mobile health interventions. Recently we developed the Personal Health Intervention Toolkit (PHIT), a software framework which eases app implementation and facilitates scientific evaluation. PHIT integrates self-report and physiological sensor instruments, evidence-based advisor logic, and self-help interventions such as meditation, health education, and cognitive behavior change. PHIT can be used to facilitate research, interventions for chronic diseases, risky behaviors, sleep, medication adherence, environmental monitoring, momentary data collection health screening, and clinical decision support. In a series of usability evaluations, participants reported an overall usability score of 4.5 on a 1-5 Likert scale and an 85 score on the System Usability Scale, indicating a high percentile rank of 95%.

  19. Predicting the Use of Traditional Chinese Medicine Health Maintenance Approach from Cultural and Spiritual Perspectives.

    PubMed

    Mou, Yi

    2016-08-18

    Traditional Chinese medicine (TCM) health maintenance approach is widespread among the lay public as a tool of health maintenance and disease prevention across the globe. This study aims to investigate the factors that exert influences on the intention to adopt or continue using TCM health maintenance approach under the guideline of the extended theory of planned behavior. Based on an online survey on a Chinese national sample of 800 valid responses, this study indicates the respondents' spirituality and Chinese cultural orientation positively predict their attitude toward TCM health maintenance approach. In turn, their attitude, perceived behavioral control and norms positively predict the intention to adopt or continue using TCM health maintenance approach, as postulated in hypotheses. Theoretical and practical implications are discussed.

  20. Neuropsychological health in F-111 aircraft maintenance workers.

    PubMed

    Schofield, Peter W; Gibson, Richard; Tavener, Meredith; Attia, John R; D'Este, Catherine; Guest, Maya; Brown, Anthony M; Lee, Stephen J; Horsley, Keith; Harrex, Warren; Ross, James

    2006-09-01

    To contrast subjective and objective measures of neuropsychological health in F-111 aircraft Deseal/Reseal maintenance personnel, against two appropriate comparison groups. Exposed and comparison participants completed a postal questionnaire which included a validated memory questionnaire and additional questions relating to possible cognitive symptoms. They also underwent a comprehensive neuropsychological assessment and screening for a past or current disturbance of mood. Multiple linear or logistic regression was conducted for each outcome using exposure group and potential confounders as explanatory variables. There was a strong and consistent excess of self-reported cognitive problems among the exposed group relative to the comparison groups including a 2.8-4.3-fold increase in self-reported symptoms of forgetfulness, loss of concentration and difficulty finding the right word. On detailed neuropsychological testing, the exposed group performed significantly worse than comparisons on tests of psychomotor speed, executive functioning, and new learning/memory. These findings could not be accounted for by disturbances of mood or other potential confounders. There was a strong and consistent increase in self-reported cognitive problems among the exposed, and small but significant exposure-specific differences on objective tests of cognitive functioning. The findings are consistent with the development of adverse neuropsychiatric changes related to occupational exposure to solvents.

  1. Personalized Health Care and Business Success

    PubMed Central

    Ozbolt, Judy G.

    1999-01-01

    Perrow's models of organizational technologies provide a framework for analyzing clinical work processes and identifying the management structures and informatics tools to support each model. From this perspective, health care is a mixed model in which knowledge workers require flexible management and a variety of informatics tools. A Venn diagram representing the content of clinical decisions shows that uncertainties in the components of clinical decisions largely determine which type of clinical work process is in play at a given moment. By reducing uncertainties in clinical decisions, informatics tools can support the appropriate implementation of knowledge and free clinicians to use their creativity where patients require new or unique interventions. Outside health care, information technologies have made possible breakthrough strategies for business success that would otherwise have been impossible. Can health informatics work similar magic and help health care agencies fulfill their social mission while establishing sound business practices? One way to do this would be through personalized health care. Extensive data collected from patients could be aggregated and analyzed to support better decisions for the care of individual patients as well as provide projections of the need for health services for strategic and tactical planning. By making excellent care for each patient possible, reducing the “inventory” of little-needed services, and targeting resources to population needs, informatics can offer a route to the “promised land” of adequate resources and high-quality care. PMID:10495097

  2. The personal health record: consumers banking on their health.

    PubMed

    Ball, Marion J; Costin, Melinda Y; Lehmann, Christoph

    2008-01-01

    With personal health records (PHRs) acting much like ATM cards, increasingly wired consumers can "bank on health", accessing their own personal health information and a wide array of services. Consumer-owned, the PHR is dependent upon the existence of the legal electronic medical record (EMR) and interoperability. Working PHRs are in place in Veterans Health Administration, private health care institutions, and in the commercial sector. By allowing consumers to become involved in their own care, the PHR creates new roles and relationships. New tools change the clinician's workflow and thought flow, and pose new challenges for consumers. Key components of the PHR include the EMR and regional health information organizations (RHIOs); key strategies focus on human factors in successful project management. Online resources provided by the National Library of Medicine and Health On the Net help address consumer needs for information that is reliable and understandable. The growth of self-management tools adds to the challenge and the promise of PHRs for clinicians and consumers alike.

  3. Emotion dysregulation as a maintenance factor of borderline personality disorder features.

    PubMed

    Stepp, Stephanie D; Scott, Lori N; Morse, Jennifer Q; Nolf, Kimberly A; Hallquist, Michael N; Pilkonis, Paul A

    2014-04-01

    We examined within-individual changes in emotion dysregulation over the course of one year as a maintenance factor of borderline personality disorder (BPD) features. We evaluated the extent to which (1) BPD symptom severity at baseline predicted within-individual changes in emotion dysregulation and (2) within-individual changes in emotion dysregulation predicted four BPD features at 12-month follow-up: affective instability, identity disturbances, negative relationships, and impulsivity. The specificity of emotion dysregulation as a maintaining mechanism of BPD features was examined by controlling for a competing intervening variable, interpersonal conflict. BPD symptoms at baseline predicted overall level and increasing emotion dysregulation. Additionally, increasing emotion dysregulation predicted all four BPD features at 12-month follow-up after controlling for BPD symptoms at baseline. Further, overall level of emotion dysregulation mediated the association between BPD symptom severity at baseline and both affective instability and identity disturbance at 12-month follow-up, consistent with the notion of emotion dysregulation as a maintenance factor. Future research on the malleability of emotion dysregulation in laboratory paradigms and its effects on short-term changes in BPD features is needed to inform interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Emotion Dysregulation as a Maintenance Factor of Borderline Personality Disorder Features

    PubMed Central

    Stepp, Stephanie D.; Scott, Lori N.; Morse, Jennifer Q.; Nolf, Kimberly A.; Hallquist, Michael N.; Pilkonis, Paul A.

    2013-01-01

    We examined within-individual changes in emotion dysregulation over the course of one year as a maintenance factor of borderline personality disorder (BPD) features. We evaluated the extent to which (1) BPD symptom severity at baseline predicted within-individual changes in emotion dysregulation and (2) within-individual changes in emotion dysregulation predicted four BPD features at 12-month follow-up: affective instability, identity disturbances, negative relationships, and impulsivity. The specificity of emotion dysregulation as a maintaining mechanism of BPD features was examined by controlling for a competing intervening variable, interpersonal conflict. BPD symptoms at baseline predicted overall level and increasing emotion dysregulation. Additionally, increasing emotion dysregulation predicted all four BPD features at 12-month follow-up after controlling for BPD symptoms at baseline. Further, overall level of emotion dysregulation mediated the association between BPD symptom severity at baseline and both affective instability and identity disturbance at 12-month follow-up, consistent with the notion of emotion dysregulation as a maintenance factor. Future research on the malleability of emotion dysregulation in laboratory paradigms and its effects on short-term changes in BPD features is needed to inform interventions. PMID:24342056

  5. Systems medicine, personalized health and therapy.

    PubMed

    Siest, Gérard; Auffray, Charles; Taniguchi, Naoyuki; Ingelman-Sundberg, Magnus; Murray, Helena; Visvikis-Siest, Sophie; Ansari, Marc; Marc, Janja; Jacobs, Peter; Meyer, Urs; Van Schaik, Ron H N; Müller, Mathias M; Wevers, Ron A; Simmaco, Maurizio; Kussmann, Martin; Manolopoulos, Vangelis G; Alizadeh, Behrooz Z; Beastall, Graham; Németh, György

    2015-01-01

    The 7th Santorini Conference was held in Santorini, Greece, and brought together 200 participants from 40 countries in several continents, including Europe, USA but also Japan, Korea, Brazil and South Africa. The attendees had the opportunity to: listen to 60 oral presentations; participate in two lunch symposia; look at 103 posters, which were divided in two groups ('systems medicine and environment' and 'pharmacogenomics and cancer') and attend a dedicated exhibition with six companies. The meeting was organized by the Institut National de la Santé et de la Recherche Médicale (INSERM) U1122; IGE-PCV and by 'Biologie Prospective' with the collaboration of the European Society of Pharmacogenomics and Theranostics (ESPT), under the auspices of international organizations (e.g., International Federation of Clinical Chemistry and Laboratory medicine [IFCC], European Federation of Clinical Chemistry and Laboratory Medicine [EFLM], European Diagnostic Manufacturers Association [EDMA], Federation of European Pharmacological Societies [EPHAR], European Science Foundation [ESF]). The 3 days of the conference stimulated intensive discussions on systems biology and the influence of omics technologies on personalized health. Sixty speakers were invited or selected from early abstracts and gave presentations on the following topics: From systems biology to systems medicine/pharmacology; Omics/translating pharmacogenomics/proteomic biomarkers/metabolomics; Human nutrition and health/personalized medicine. We are summarizing here the main topics and presentations, according to the successive sessions.

  6. [Personal health records: the case of the Personal Health Folder of Catalonia (Spain)].

    PubMed

    Saigí, Francesc; Cerdá Calafat, Ismael; Guanyabens Calvet, Joan; Carrau Vidal, Elisenda

    2012-01-01

    The aims of this study were to explore the possibilities of the Personal Health Folder and to identify the gap between the potential applications of this tool and what it offers through the Internet. The Personal Health Folder is presented, a project linked to the Shared Medical Record of Catalonia (Spain), which provides citizens with an access point to information about their health insurance, customized and supported by information and communication technologies. The project was carried out by the Ministry of Health of the Government of Catalonia (Generalitat de Catalunya) and data were gathered through an anonymous survey. The results were critical to obtain information on the suitability of the published data and on the expectations of a tool aimed at the general population. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. Factors affecting usage of a personal health record (PHR) to manage health.

    PubMed

    Taha, Jessica; Czaja, Sara J; Sharit, Joseph; Morrow, Daniel G

    2013-12-01

    As the health care industry shifts into the digital age, patients are increasingly being provided with access to electronic personal health records (PHRs) that are tethered to their provider-maintained electronic health records. This unprecedented access to personal health information can enable patients to more effectively manage their health, but little is actually known about patients' ability to successfully use a PHR to perform health management tasks or the individual factors that influence task performance. This study evaluated the ability of 56 middle-aged adults (40-59 years) and 51 older adults (60-85 years) to use a simulated PHR to perform 15 common health management tasks encompassing medication management, review/interpretation of lab/test results, and health maintenance activities. Results indicated that participants in both age groups experienced significant difficulties in using the PHR to complete routine health management tasks. Data also showed that older adults, particularly those with lower numeracy and technology experience, encountered greater problems using the system. Furthermore, data revealed that the cognitive abilities predicting one's task performance varied according to the complexity of the task. Results from this study identify important factors to consider in the design of PHRs so that they meet the needs of middle-aged and older adults. As deployment of PHRs is on the rise, knowledge of the individual factors that impact effective PHR use is critical to preventing an increase in health care disparities between those who are able to use a PHR and those who are not. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  8. Sharing Personal Reflections on Health Locally

    NASA Astrophysics Data System (ADS)

    Grimes, Andrea

    Researchers are becoming increasingly interested in developing systems that help people live healthier lifestyles. Little attention has been paid, however, to how technology can address the significant health disparities in populations such as low-income African Americans. To address this research gap, I designed EatWell specifically for residents in low-income African American communities in Atlanta, GA. EatWell is a system for cell phones that lets people share how they have tried to eat healthfully with individuals in their local neighborhoods. In this chapter, I discuss the characteristics of the community that was created as people shared their personal stories and reflections in EatWell. Specifically, I describe the users themselves (the who), the context of use (the where), the kind of content people created (the what), and the way in which they interacted with the content (the how). Finally, I discuss the implications of designing health applications for people in local contexts, a class of systems that I call deeply local health applications.

  9. Associations of health literacy with dialysis adherence and health resource utilization in patients receiving maintenance hemodialysis.

    PubMed

    Green, Jamie A; Mor, Maria K; Shields, Anne Marie; Sevick, Mary Ann; Arnold, Robert M; Palevsky, Paul M; Fine, Michael J; Weisbord, Steven D

    2013-07-01

    Although limited health literacy is common in hemodialysis patients, its effects on clinical outcomes are not well understood. Observational study. 260 maintenance hemodialysis patients enrolled in a randomized clinical trial of symptom management strategies from January 2009 through April 2011. Limited health literacy. Dialysis adherence (missed and abbreviated treatments) and health resource utilization (emergency department visits and end-stage renal disease [ESRD]-related hospitalizations). We assessed health literacy using the Rapid Estimate of Adult Literacy in Medicine (REALM) and used negative binomial regression to analyze the independent associations of limited health literacy with dialysis adherence and health resource utilization over 12-24 months. 41 of 260 (16%) patients showed limited health literacy (REALM score, ≤60). There were 1,152 missed treatments, 5,127 abbreviated treatments, 552 emergency department visits, and 463 ESRD-related hospitalizations. Limited health literacy was associated independently with an increased incidence of missed dialysis treatments (missed, 0.6% vs 0.3%; adjusted incidence rate ratio [IRR], 2.14; 95% CI, 1.10-4.17), emergency department visits (annual visits, 1.7 vs 1.0; adjusted IRR, 1.37; 95% CI, 1.01-1.86), and hospitalizations related to ESRD (annual hospitalizations, 0.9 vs 0.5; adjusted IRR, 1.55; 95% CI, 1.03-2.34). Generalizability and potential for residual confounding. Patients receiving maintenance hemodialysis who have limited health literacy are more likely to miss dialysis treatments, use emergency care, and be hospitalized related to their kidney disease. These findings have important clinical practice and cost implications. Copyright © 2013 National Kidney Foundation, Inc. All rights reserved.

  10. Identifying Health Maintenance Organization membership through self-report of health plan name: ascertainment and reliability.

    PubMed

    Clements, Karen M; Cohen, Bruce B; Brawarsky, Phyllis; Brooks, Daniel R; Mucci, Lorelei A; Wood, Phillip A

    2006-01-01

    To evaluate the feasibility and reliability of (1) identifying Health Maintenance Organization (HMO) membership by ascertaining self-reported health plan name in a telephone survey and (2) using external information to determine whether the plan was an HMO. Respondents to the 1999-2001 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS) and the 1999 Massachusetts Colorectal Cancer (CRC) survey were asked to name their health plan. The authors used information from external sources to classify the plan as an HMO or a non-HMO. Test-retest reliability of reported plan name was examined overall, by demographic characteristics, and by health plan name. Reliability of HMO classification was tested with the kappa statistic. More than 88 percent of respondents with commercial health insurance provided their health plan name; 84 percent reported a plan that could be assigned as either an HMO or a non-HMO. The percentage whose HMO status could be assigned differed by demographic characteristics. Among those assigned, the distribution of specific HMOs among survey respondents was similar to the distribution reported by the Massachusetts Division of Insurance. In a subsample, 78 percent reported the same health plan during a follow-up interview. Agreement was higher for men, and differed according to the plan reported at the first time point. Kappa for HMO classification from health plan name was 0.87. Self-report of health plan name is a feasible and reliable method to ascertain health insurance information in a telephone interview.

  11. Exploring Healthcare Consumer Acceptance of Personal Health Information Management Technology through Personal Health Record Systems

    ERIC Educational Resources Information Center

    Wu, Huijuan

    2013-01-01

    Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…

  12. Exploring Healthcare Consumer Acceptance of Personal Health Information Management Technology through Personal Health Record Systems

    ERIC Educational Resources Information Center

    Wu, Huijuan

    2013-01-01

    Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…

  13. A natural product telomerase activator as part of a health maintenance program: metabolic and cardiovascular response.

    PubMed

    Harley, Calvin B; Liu, Weimin; Flom, Peter L; Raffaele, Joseph M

    2013-10-01

    A short average telomere length is associated with low telomerase activity and certain degenerative diseases. Studies in animals and with human cells confirm a causal mechanism for cell or tissue dysfunction triggered by critically short telomeres, suggesting that telomerase activation may be an approach to health maintenance. Previously, we reported on positive immune remodeling in humans taking a commercial health maintenance program, PattonProtocol-1, composed of TA-65® (a natural product-derived telomerase activator) and other dietary supplements. In over a 5-year period and an estimated 7000 person-years of use, no adverse events or effects have been attributed to TA-65 by physicians licensed to sell the product. Here we report on changes in metabolic markers measured at baseline (n=97-107 subjects) and every 3-6 months (n=27-59 subjects) during the first 12 months of study. Rates of change per year from baseline determined by a multi-level model were -3.72 mg/dL for fasting glucose (p=0.02), -1.32 mIU/mL for insulin (p=0.01), -13.2 and -11.8 mg/dL for total cholesterol and low-density lipoprotein cholesterol (LDL-C) (p=0.002, p=0.002, respectively), -17.3 and -4.2 mmHg for systolic and diastolic blood pressure (p=0.007 and 0.001, respectively), and -3.6 μmole/L homocysteine (p=0.001). In a subset of individuals with bone mineral density (BMD) measured at baseline and 12 months, density increased 2.0% in the spine (p=0.003). We conclude that in addition to apparent positive immune remodeling, PattonProtocol-1 may improve markers of metabolic, bone, and cardiovascular health.

  14. Family physicians’ perspectives on personal health records

    PubMed Central

    Yau, Gary L.; Williams, Andrew S.; Brown, Judith Belle

    2011-01-01

    Abstract Objective To explore FPs’ perspectives on the value of personal health records (PHRs) in primary care and the implementation and adoption of PHRs in Canada. Design A qualitative design using semistructured interviews. Setting Southwestern Ontario. Participants Ten FPs. Methods The 10 FPs participated in semistructured interviews, which were audiotaped and transcribed verbatim. An iterative approach using immersion and crystallization was employed for analysis. Main findings Participants were generally positive about PHRs, and were attracted to their portability and potential to engage patients in health care. Their concerns focused on 3 main themes: data management, practice management, and the patient-physician relationship. Subthemes included security, privacy, reliability of data, workload, remuneration, physician obligations, patient misinterpretation of medical information, and electronic communication displacing face-to-face visits. Participants identified 3 key facilitators for adoption of PHR systems: integration with existing electronic health record systems, ease of use without being a burden on either time or money, and offering a demonstrated added value to family practice. Conclusion This study replicates previously published literature about FP concerns and opinions, and it further identifies remuneration as a potential barrier in Canadian fee-for-service payment models. Participants identified 3 key facilitators, which were suggested for implementation and adoption of PHRs, providing a basis for future research and development of these systems for use in Canadian family practice. PMID:21642732

  15. Health maintenance organizations, independent practice associations, and cesarean section rates.

    PubMed Central

    Tussing, A D; Wojtowycz, M A

    1994-01-01

    OBJECTIVE. This study tests two hypotheses: that a given delivery is less likely to be by cesarean section (c-section) in an HMO (closed-panel health maintenance organization) or IPA (independent practice association), than in other settings; and that where HMO and IPA penetration is high, the probability of a c-section will be reduced for all deliveries, whether in prepaid groups or not. DATA SOURCES AND STUDY SETTING. A data set consisting of 104,595 obstetric deliveries in New York state in 1986 is analyzed. STUDY DESIGN. A series of probit regressions is estimated, in which the dependent variable is either the probability that a given delivery is by c-section, or that a given delivery will result in a c-section for dystocia or fetal distress. DATA COLLECTION/EXTRACTION METHODS. The Live Birth File is linked with SPARCS hospital discharge data and other variables. PRINCIPAL FINDINGS. HMO setting reduces the probability of a cesarean section by 2.5 to 3.0 percentage points. However, this result is likely to be partly an artifact of offsetting diagnostic labeling and of choice of method of delivery, given diagnosis; a better estimate of the effect of HMO setting is -1.3 percentage points. IPA setting appears to affect the probability of a cesarean section even less, perhaps not at all. And HMO and IPA penetration in a region, as measured by HMO and IPA deliveries, respectively, as a percent of all deliveries, has relatively large depressing effects on the probability of a cesarean section. CONCLUSIONS. Ceteris paribus, the probability of a c-section is lower for an HMO delivery than for a fee-for-service delivery; however, HMO effects are smaller than previously reported in the literature for other types of inpatient care. For IPA deliveries, the effects are still smaller, perhaps nil. However, HMO and IPA penetration, possibly measuring the degree of competition in obstetrics markets, have important effects on c-section rates, not only in HMO/IPA settings, but

  16. A Comparison of Health Risk Behaviors among College Students Enrolled in a Required Personal Health Course vs. an Elective Personal Health Course

    ERIC Educational Resources Information Center

    Smith, Theresa M. Enyeart; Skaggs, Gary E.; Redican, Kerry J.

    2008-01-01

    Research on whether health education, specifically personal health classes affects behavior change is inconclusive. In this study, a sample of students from two large southeastern universities enrolled in a required personal health course and an elective personal health course were administered the National College Health Risk Behavior Survey…

  17. Engine health monitoring systems: Tools for improved maintenance management in the 1980's

    NASA Technical Reports Server (NTRS)

    Kimball, J. C.

    1981-01-01

    The performance monitoring aspect of maintenance, characteristic of the engine health monitoring system are discussed. An overview of the system activities is presented and a summary of programs for improved monitoring in the 1980's are discussed.

  18. 21 CFR 1250.35 - Health of persons handling food.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... SANITATION Food Service Sanitation on Land and Air Conveyances, and Vessels § 1250.35 Health of persons...

  19. Personal health records for people living with HIV: a review.

    PubMed

    Turner, Kea; Klaman, Stacey L; Shea, Christopher M

    2016-09-01

    Personal health records have the potential to improve patient outcomes, but the state of the literature on personal health record usage by people living with the human immunodeficiency virus (HIV) is unclear. The purpose of this review is to examine the impact of personal health records on HIV-related health beliefs and behaviors. We used the Health Belief Model to guide a review of studies examining the impact of electronic personal health records on the health beliefs and behaviors among people living with HIV. The search yielded 434 results. Following abstract review, 19 papers were selected for full-text review, and 12 were included in the review. A limited number of studies in this review found a positive impact of personal health records on HIV-related beliefs and behaviors. Additional research is needed to identify which personal health record features are most influential in changing health behaviors and why adoption rates remain low, particularly for groups at greatest risk for poor HIV outcomes. Theory-informed interventions are needed to identify which patients are likely to benefit from using personal health records and how to reduce barriers to personal health record adoption for people living with HIV.

  20. Navy Occupational Health Information Management System (NOHIMS). System-Wide Module. Program Maintenance Manual

    DTIC Science & Technology

    1987-06-01

    NAVY OCCUPATIONAL HEALTH INFORMATION MANAGEMENT SYSTEM NOHIMS SYSTEM-WIDE MODULE PROGRAM MAINTENANCE MANUAL JUNE 1987 DTIC 00 SEP I 21988DJ 0) 4... INFORMATION MANAGEMENT SYSTEM (NOHIMS) N 1.98 SYSTEM-WIDE MODULE PROGRAM MAINTENANCE MANUAL 7. Author(s) a. Performing Organization Rapt. No. MITRE... Management System (NOHIMS). NORIMS, whose initial version was ,eveloped at the Naval Health Research Center (NHRC), is a composite of 4 -’o subsystems: an

  1. Mechanisms by which Childhood Personality Traits Influence Adult Health Status

    PubMed Central

    Hampson, Sarah E.; Goldberg, Lewis R.; Vogt, Thomas M.; Dubanoski, Joan P.

    2008-01-01

    Objective To test a lifespan health-behavior model in which educational attainment and health behaviors (eating habits, smoking, and physical activity) were hypothesized as mechanisms to account for relations between teacher ratings of childhood personality traits and self-reported health status at midlife. Design The model was tested on 1,054 members of the Hawaii Personality and Health cohort, which is a population-based cohort participating in a longitudinal study of personality and health spanning 40 years from childhood to midlife. Outcome Self-reported health status as a latent construct indicated by general health, functional status, and body mass index. Results Childhood Agreeableness, Conscientiousness, and Intellect/Imagination influenced adult health status indirectly through educational attainment, healthy eating habits, and smoking. Several direct effects of childhood traits on health behaviors and health status were also observed. Conclusion The model extends past associations found between personality traits and health behaviors or health status by identifying a life-course pathway based on the health-behavior model through which early childhood traits influence adult health status. The additional direct effects of personality traits indicate that health-behavior mechanisms may not provide a complete account of relations between personality and health. PMID:17209705

  2. Interoperability design of personal health information import service.

    PubMed

    Tuomainen, Mika; Mykkänen, Juha

    2012-01-01

    Availability of personal health information for individual use from professional patient records is an important success factor for personal health information management (PHIM) solutions such as personal health records. In this paper we focus on this crucial part of personal wellbeing information management splutions and report the interoperability design of personal information import service. Key requirements as well as design factors for interfaces between PHRs and EPRs are discussed. Open standards, low implementation threshold and the acknowledgement of local market and conventions are emphasized in the design.

  3. Personal exposures to asbestos fibers during brake maintenance of passenger vehicles.

    PubMed

    Cely-García, María Fernanda; Sánchez, Mauricio; Breysse, Patrick N; Ramos-Bonilla, Juan P

    2012-11-01

    Brake linings and brake pads are among the asbestos-containing products that are readily available in Colombia. When sold separated from their support, brake linings require extensive manipulation involving several steps that include drilling, countersinking, riveting, bonding, cutting, beveling, and grinding. Without this manipulation, brake linings cannot be installed in a vehicle. The manipulation process may release asbestos fibers, which may expose brake mechanics to the fibers. Three brake repair shops located in Bogotá (Colombia) were sampled for 3 or 4 consecutive days using US National Institute for Occupational Safety and Health (NIOSH) methods 7400 and 7402. Standard procedures for quality control were followed during the sampling process, and asbestos samples were analyzed by an American Industrial Hygiene Association accredited laboratory. Personal samples were collected to assess full-shift and short-term exposures. Area samples were also collected close to the brake-lining manipulation equipment and within office facilities. Activities were documented during the sampling process. Using Phase Contrast Microscopy Equivalent counts to estimate air asbestos concentrations, all personal samples [i.e. 8-h time-weighted averages (TWAs) and 30-min personal samples] were in compliance with the US Occupational Safety and Health Administration standards. Personal asbestos concentrations based on transmission electron microscopy counts were extremely high, ranging from 0.006 to 3.493 f cm(-3) for 8-h TWA and from 0.015 to 8.835 f cm(-3) for 30-min samples. All asbestos fibers detected were chrysotile. Cleaning facilities and grinding linings resulted in the highest asbestos exposures based on transmission electron microscopy counts. There were also some samples that did not comply with the NIOSH's recommended exposure limits. The results indicate that the brake mechanics sampled are exposed to extremely high asbestos concentrations (i.e. based on transmission

  4. Family physician perceptions of personal health records.

    PubMed

    Witry, Matthew J; Doucette, William R; Daly, Jeanette M; Levy, Barcey T; Chrischilles, Elizabeth A

    2010-01-01

    The purpose of this qualitative study was to examine family practice physician and staff views on the benefits of, barriers to, and use of personal health records (PHRs). Four focus groups were conducted at four family medicine practices in Iowa and included a total of 28 providers. Overall, participants seemed to view PHRs as a source of medical information for healthcare providers when the patient's medical record is not available. Providers appeared unaware of the patient-centered features available in many electronic PHRs and how such features might affect patients and their medical practice. While physicians identified numerous patient groups that could benefit from using PHRs, they also perceived several unique barriers, including the potential of PHRs to facilitate narcotic abuse, low levels of patient computer and health literacy, low levels of patient motivation, and difficulties with PHR and electronic medical record interoperability. Physicians' relatively narrow view of PHR functions and benefits and perception of barriers to using PHRs may restrict widespread support of PHR use.

  5. The big five personality traits and individual job performance growth trajectories in maintenance and transitional job stages.

    PubMed

    Thoresen, Carl J; Bradley, Jill C; Bliese, Paul D; Thoresen, Joseph D

    2004-10-01

    This study extends the literature on personality and job performance through the use of random coefficient modeling to test the validity of the Big Five personality traits in predicting overall sales performance and sales performance trajectories--or systematic patterns of performance growth--in 2 samples of pharmaceutical sales representatives at maintenance and transitional job stages (K. R. Murphy, 1989). In the maintenance sample, conscientiousness and extraversion were positively associated with between-person differences in total sales, whereas only conscientiousness predicted performance growth. In the transitional sample, agreeableness and openness to experience predicted overall performance differences and performance trends. All effects remained significant with job tenure statistically controlled. Possible explanations for these findings are offered, and theoretical and practical implications of findings are discussed. (c) 2004 APA, all rights reserved

  6. 24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and...

  7. 24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and...

  8. Analysis model for personal eHealth solutions and services.

    PubMed

    Mykkänen, Juha; Tuomainen, Mika; Luukkonen, Irmeli; Itälä, Timo

    2010-01-01

    In this paper, we present a framework for analysing and assessing various features of personal wellbeing information management services and solutions such as personal health records and citizen-oriented eHealth services. The model is based on general functional and interoperability standards for personal health management applications and generic frameworks for different aspects of analysis. It has been developed and used in the MyWellbeing project in Finland to provide baseline for the research, development and comparison of many different personal wellbeing and health management solutions and to support the development of unified "Coper" concept for citizen empowerment.

  9. Enhancing patient experience through personalization of health services.

    PubMed

    Snowdon, Anne W; Alessi, Charles; Bassi, Harpreet; DeForge, Ryan T; Schnarr, Karin

    2015-09-01

    Patient engagement is a challenge many leaders are facing, as consumer expectations of health services demand a more personalized approach to care. This article examines consumer trends that are influencing patient engagement and empowerment relative to the use of digital technologies. Informed by consumer and population health trends that can personalize health services, three strategies leaders can engage to strengthen patient experience include placing greater focus on personal health and wellness, shifting towards personalized rather than standardized healthcare, and facilitating the democratization of healthcare information.

  10. Personal health technologies, micropolitics and resistance: A new materialist analysis.

    PubMed

    Fox, Nick J

    2017-03-01

    Personal health technologies are near-body devices or applications designed for use by a single individual, principally outside healthcare facilities. They enable users to monitor physiological processes or body activity, are frequently communication-enabled and sometimes also intervene therapeutically. This article explores a range of personal health technologies, from blood pressure or blood glucose monitors purchased in pharmacies and fitness monitors such as Fitbit and Nike+ Fuelband to drug pumps and implantable medical devices. It applies a new materialist analysis, first reverse engineering a range of personal health technologies to explore their micropolitics and then forward engineering personal health technologies to meet, variously, public health, corporate, patient and resisting-citizen agendas. This article concludes with a critical discussion of personal health technologies and the possibilities of designing devices and apps that might foster subversive micropolitics and encourage collective and resisting 'citizen health'.

  11. Mental health in F-111 maintenance workers: the study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP) general health and medical study.

    PubMed

    Attia, John R; D'Este, Catherine; Schofield, Peter W; Brown, Anthony M; Gibson, Richard; Tavener, Meredith; Horsley, Keith; Harrex, Warren; Ross, James

    2006-07-01

    We sought to contrast mood disorder symptoms in F-111 aircraft Deseal/Reseal maintenance personnel with appropriate comparisons. Participants completed a comprehensive health assessment, including measures of mood disorder, self-reported mood symptom questionnaire items, and review of anxiolytic and depression medication. Multiple logistic regression was conducted for each outcome using exposure group and potential confounders as explanatory variables. There was high agreement between self-reported mood disturbance and objective tests. The exposed group was more likely to self-report previous diagnoses of depression/anxiety, had higher use of antidepressant medications, and had increased risk of diagnosis of depression/anxiety. Results were consistently strong against both comparison groups, with the exposed more likely to have mental distress and social dysfunction when compared with the Australian population. There is robust evidence for an association between F-111 Deseal/Reseal exposure and impaired mental health.

  12. Applying Psychological Theories to Promote Long-Term Maintenance of Health Behaviors.

    PubMed

    Joseph, Rodney P; Daniel, Casey L; Thind, Herpreet; Benitez, Tanya J; Pekmezi, Dori

    2016-11-01

    Behavioral health theory provides a framework for researchers to design, implement, and evaluate the effects of health promotion programs. However, limited research has examined theories used in interventions to promote long-term maintenance of health behaviors. The purpose of this review was to evaluate the available literature and identify prominent behavioral health theories used in intervention research to promote maintenance of health behaviors. We reviewed theories used in intervention research assessing long-term maintenance (≥ 6 months post-intervention) of physical activity, weight loss, and smoking cessation. Five prominent behavioral theories were referenced by the 34 studies included in the review: Self-Determination Theory, Theory of Planned Behavior, Social Cognitive Theory, Transtheoretical Model, and Social Ecological Model. Descriptions and examples of applications of these theories are provided. Implications for future research are discussed.

  13. Applying Psychological Theories to Promote Long-Term Maintenance of Health Behaviors

    PubMed Central

    Joseph, Rodney P.; Daniel, Casey L.; Thind, Herpreet; Benitez, Tanya J.; Pekmezi, Dori

    2014-01-01

    Behavioral health theory provides a framework for researchers to design, implement, and evaluate the effects of health promotion programs. However, limited research has examined theories used in interventions to promote long-term maintenance of health behaviors. The purpose of this review was to evaluate the available literature and identify prominent behavioral health theories used in intervention research to promote maintenance of health behaviors. We reviewed theories used in intervention research assessing long-term maintenance (≥ 6 months post-intervention) of physical activity, weight loss, and smoking cessation. Five prominent behavioral theories were referenced by the 34 studies included in the review: Self-Determination Theory, Theory of Planned Behavior, Social Cognitive Theory, Transtheoretical Model, and Social Ecological Model. Descriptions and examples of applications of these theories are provided. Implications for future research are discussed. PMID:28217036

  14. Considerations for personal health record procurement.

    PubMed

    Monkman, Helen; Kushniruk, Andre

    2013-01-01

    Patients with chronic illnesses require tools and resources to facilitate self-management. Personal Health Records (PHRs) are a promising option for delivering these tools and resources to patients with chronic illnesses. As such, many organizations are becoming interested in PHR procurement. However, traditional procurement methods may not ensure the system success and adoption. In this study a group of subject matter experts discussed the possibility of converting a paper-based PHR into an electronic tool. These discussions resulted in generation of several important criteria for assessing commercially available PHR solutions and other considerations related to PHR procurement. These considerations should be contemplated and discussed with stakeholders prior to PHR procurement. In order to realize the benefits PHRs, it is imperative that the appropriate selection is made. Prior to purchase commitment, a trial period can prove extremely useful for performing usability analyses and ensuring interoperability. Supplementing traditional procurement methods with these preliminary user evaluations will increase the likelihood that the selected system best matches the needs of users and purchasers. Moreover, the risk of system failure and the risk of limited adoption of the PHR by the public will be reduced as a result of adopting these methods.

  15. Determining the optimal physician mix in health maintenance organizations.

    PubMed

    Vitiello, J R; Levary, R R

    1997-08-01

    Described is a simulation model for forecasting the appropriate mix of physicians needed to meet health service demands of patients in managed health care organizations. The model can be used by executives of managed health care organizations to plan for physician staffing levels by specialty. Uncertainties such as changes in the population size served by the managed health care organization, new developments in health care delivery technologies and changing attitudes of the population regarding healthier lifestyles are considered in this model. Use of the model is illustrated in an example.

  16. Maintenance of stellite and tungsten carbide saw tips: respiratory health and exposure-response evaluations.

    PubMed Central

    Kennedy, S M; Chan-Yeung, M; Marion, S; Lea, J; Teschke, K

    1995-01-01

    OBJECTIVE--To study exposure to cobalt and chromium in saw maintenance rooms and test respiratory health among saw filers at lumber mills. Hard-metal lung disease is associated with cobalt in the manufacture of tungsten carbide tools; recently it has also been reported among tool maintenance workers. Lumber mills often use saws tipped with tungsten carbide or with a newer alloy, stellite (containing more cobalt, as well as chromium). METHODS--A cross sectional study of 118 saw filers at eight lumber mills was carried out that included a standardised questionnaire, spirometry, personal air sampling, and examination of tasks every 10 minutes (by observation). Comparison data were from a study of bus mechanics tested with similar methods. RESULTS AND CONCLUSION--Cobalt exposure was associated with tungsten carbide grinding but not with stellite grinding. Chromium exposure was associated mainly with stellite welding. Saw filers had a twofold increase in phlegm and wheeze (P < 0.01) and a threefold increase in cough, phlegm, and wheeze related to work (P < 0.001), but no increase in breathlessness. Stellite welding was associated with a significant increase in nasal symptoms and cough related to work and a small decrease in airflow (forced expiratory volume in one second/forced vital capacity (FEV1/FVC%), P < 0.05). Saw filers wet grinding with tungsten carbide had significant reductions in forced expiratory lung volumes (FEV1 and FVC, P < 0.05) and were significantly more likely to have FEV1 and FVC values in the abnormal range. Cobalt exposure (in wet grinding) and duration of work that involved tungsten carbide grinding were both associated with significant reductions in FEV1 and FVC. Average cobalt exposures in this study were about 5 micrograms/m3, well below the currently accepted permissible concentration, which suggests that the current workplace limit for cobalt may be too high. PMID:7735392

  17. Personal health records: Consumer attitudes toward privacy and security of their personal health information.

    PubMed

    Lafky, Deborah Beranek; Horan, Thomas A

    2011-03-01

    Personal health record (PHR) systems are a subject of intense interest in the move to improve healthcare accessibility and quality. Although a number of vendors continue to put forward PHR systems, user-centered design research has lagged, and it has not been clear what features are important to prospective PHR users. Here, we report on a user-centered design study that combines qualitative and quantitative approaches to investigate several dimensions relevant to PHR design, and to look at the effect of health status on user needs. The results indicate that health status, especially disability and chronic illness, is relevant to PHR design. Further, the results provide empirical evidence about the role of privacy and security in users' attitudes toward PHR use. The exact nature of these attitudes differs from widely held perceptions about consumer values in healthcare information management.

  18. Personality, negative social exchanges, and physical health among bereaved adults

    PubMed Central

    Silva, Nicole M; Henrie, James A; Patrick, Julie Hicks

    2016-01-01

    While much research has investigated the association between personality and health, little research has done so using a bereaved sample. Additionally, little research has investigated how personality influences the frequency of negative social exchanges bereaved individuals receive. This study utilized a structural equation model to investigate the associations among age, gender, personality, negative social exchanges, length of bereavement, and self-reported physical health in a sample of bereaved adults. Results indicated that personality was associated with negative social exchanges and physical health. Therefore, these variables are important and should be studied further in this context. PMID:28070398

  19. Recent advances in understanding physical health problems in personality disorders.

    PubMed

    Dixon-Gordon, Katherine L; Conkey, Lindsey C; Whalen, Diana J

    2017-09-12

    Personality disorders are associated with a range of adverse health outcomes, contributing to the high healthcare utilization seen in patients with these disorders. A growing literature supports a robust association of personality disorders and health problems. The primary aim of this article is to summarize the most recent research documenting the associations between personality disorders and health conditions. Extending past reviews, we discuss the association of personality disorders with chronic physical illnesses, sleep disturbances, pain conditions, and obesity. We provide recommendations for future research in this area. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Older Persons' Reasoning about Responsibility for Health: Variations and Predictions

    ERIC Educational Resources Information Center

    Kjellstrom, Sofia; Ross, Sara Nora

    2011-01-01

    With many Western societies structured for adults to live longer and take responsibility for their health, it is valuable to investigate how older persons reason about this demand. Using mixed methods, this pilot studied how older persons reason about responsibility for health and their responsibility as a patient. Interviews with a small Swedish…

  1. Personality Characteristics and Learning Style Preferences of Allied Health Students.

    ERIC Educational Resources Information Center

    Lam, Rebecca

    Identifying personality types and learning style preferences of students and professionals in the allied health professions can aid college students in academic achievement and in career decision making. A literature review regarding personality types and learning style preferences of students enrolled in various allied health fields is presented.…

  2. Design of a decision support system for preventive maintenance planning in health structures.

    PubMed

    Miniati, Roberto; Dori, Fabrizio; Gentili, Guido Biffi

    2012-01-01

    The appropriate maintenance of medical devices, including performance inspections and preventive maintenance, is fundamental in mitigating clinical risk caused by adverse events in health care. Although several models for managing and planning preventive maintenance have been developed, the problem is lacking in standard methodology and still presents an open challenge for today's health experts. This paper aims to provide and develop methodology together with support systems able to assist decision makers in constructing preventive maintenance and performance inspection plans, taking into account both the technical and economic needs of hospital clinical engineering departments. Interventions by decision makers are of crucial importance within complex situations where large numbers, types of devices and different contractual situations are involved. SISMA system has achieved optimal results with minimum expense and maximum security for patients and technicians at the University Hospital of Florence where it has been applied in actual case studies.

  3. Criterion 3: Maintenance of forest ecosystem health and vitality

    Treesearch

    Stephen R. Shifley; Francisco X. Aguilar; Nianfu Song; Susan I. Stewart; David J. Nowak; Dale D. Gormanson; W. Keith Moser; Sherri Wormstead; Eric J. Greenfield

    2012-01-01

    Forest ecosystem health depends on stable forest composition and structure and on sustainable ecosystem processes. Forest disturbances that push an ecosystem beyond the range of conditions considered normal can upset the balance among processes, exacerbate forest health problems, and increase mortality beyond historical norms. Sometimes forest ecosystems respond to...

  4. Social Support and Health Maintenance among Older Married Women.

    ERIC Educational Resources Information Center

    Howze, Elizabeth H.

    Research in the areas of social networks and social support has illustrated some of the complex ways in which those areas contribute to health. A study was conducted to examine the structure of social support among older women, its influences on physical and emotional health status and on behaviors associated with increased risk of chronic…

  5. Randomized Control Trial of the 3Rs Health Knowledge Training Program for Persons with Intellectual Disabilities.

    PubMed

    Feldman, Maurice A; Owen, Frances; Andrews, Amy E; Tahir, Munazza; Barber, Rachel; Griffiths, Dorothy

    2016-05-01

    Persons with intellectual disabilities (ID) experience a wide range of health problems. Research is needed on teaching persons with intellectual disabilities about their health to promote self-advocacy. This study used a RCT to evaluate a health knowledge training program for adults with intellectual disabilities and verbal skills. Participants were randomly assigned to training (n = 12) or no training control (n = 10) groups. Topics included key body organs, systems, functions, health maintenance and illnesses. Participants played a game answering questions (e.g. 'What does the heart do?'). Instruction involved visuals (e.g., PowerPoint slides), cueing, modelling and feedback. The control group received pre-, post- and follow-up tests as the training group. The training group had significantly higher overall post-test and follow-up health knowledge test scores than the control group. Health knowledge training is one step in promoting health self-advocacy and better health in persons with intellectual disabilities. © 2015 John Wiley & Sons Ltd.

  6. Personalization in the health care system: do personal health budgets have an impact on outcomes and cost?

    PubMed

    Jones, Karen; Forder, Julien; Caiels, James; Welch, Elizabeth; Glendinning, Caroline; Windle, Karen

    2013-10-01

    In England's National Health Service, personal health budgets are part of a growing trend to give patients more choice and control over how health care services are managed and delivered. The personal health budget programme was launched by the Department of Health in 2009, and a three-year independent evaluation was commissioned with the aim of identifying whether the initiative ensured better health- and care-related outcomes and at what cost when compared to conventional service delivery. The evaluation used a pragmatic controlled trial design to compare the outcomes and costs of patients selected to receive a personal health budget with those continuing with conventional support arrangements (control group). Just over 1000 individuals were recruited into the personal health budget group and 1000 into the control group in order to ensure sufficient statistical power, and followed for 12 months. The use of personal health budgets was associated with significant improvement in patients' care-related quality of life and psychological wellbeing at 12 months. Personal health budgets did not appear to have an impact on health status, mortality rates, health-related quality of life or costs over the same period. With net benefits measured in terms of care-related quality of life on the adult social care outcome toolkit measure, personal health budgets were cost-effective: that is, budget holders experienced greater benefits than people receiving conventional services, and the budgets were worth the cost. The evaluation provides support for the planned wider roll-out of personal health budgets in the English NHS after 2014 in so far as the localities in the pilot sample are representative of the whole country.

  7. How to Create a Personal Health Record

    MedlinePlus

    + - START A PHR HEALTH LITERACY TOOLS + RESOURCES BLOG FAQ Accessing Your Health Records Common Privacy Myths Your Privacy Rights What is a PHR? Information ... Create a PHR Choose a PHR What is Health Literacy? Understanding Your Medical Record Glossary of Terms Health ...

  8. Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme

    PubMed Central

    Campbell, Princess Christina; Korie, Patrick Chukwuemeka; Nnaji, Feziechukwu Collins

    2014-01-01

    Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance. PMID:25298605

  9. The military health system's personal health record pilot with Microsoft HealthVault and Google Health.

    PubMed

    Do, Nhan V; Barnhill, Rick; Heermann-Do, Kimberly A; Salzman, Keith L; Gimbel, Ronald W

    2011-01-01

    To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference. A pilot project was conducted in 2008-2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation. The pilot project included 250 beneficiary users. Approximately 73.2% of users were < 65 years of age, and 38.4% were female. Of the users, 169 (67.6%) selected Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n = 60) satisfied with convenience of record access and 91.7% (n = 55) satisfied with overall functionality of PHR. Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider. Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability.

  10. The military health system's personal health record pilot with Microsoft HealthVault and Google Health

    PubMed Central

    Barnhill, Rick; Heermann-Do, Kimberly A; Salzman, Keith L; Gimbel, Ronald W

    2011-01-01

    Objective To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference. Materials and methods A pilot project was conducted in 2008–2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation. Results The pilot project included 250 beneficiary users. Approximately 73.2% of users were <65 years of age, and 38.4% were female. Of the users, 169 (67.6%) selected Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n=60) satisfied with convenience of record access and 91.7% (n=55) satisfied with overall functionality of PHR. Discussion Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider. Conclusion Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability. PMID:21292705

  11. Staying healthy: the salience and meaning of health maintenance behaviors among rural older adults in North Carolina.

    PubMed

    Arcury, T A; Quandt, S A; Bell, R A

    2001-12-01

    Beliefs about what constitutes health promoting behaviors vary by culture and class, and knowing how an older adult interprets a specific health behavior can improve health education and medical compliance. Ethnomedical approaches have investigated how people define disease and the therapies used to return to a state of health. However, little research has addressed how individuals define health, or the behaviors they use to maintain health. We analyze the behaviors elders state are needed to stay healthy, and their meanings for these behaviors. Narratives collected through in-depth interviews with 145 male and female rural North Carolina residents aged 70 and older, including African Americans, Native Americans and European Americans are analyzed using systematic text analysis. The participants' narratives include seven salient health maintenance domains: (1) Eating Right, (2) Drinking Water, (3) "Taking" Exercise, (4) Staying Busy, (5) Being with People, (6) Trusting in God and Participating in Church, and (7) Taking Care of Yourself. Several of these domains are multi-dimensional in the meanings the elders ascribe to them. There is also overlap in the content of some of the domains; they are not discrete in the minds of the elders and a specific health behavior can reflect more than one domain. Four themes cross-cut the domains: "balance and moderation", "the holistic view of health", "social integration", and "personal responsibility". Elders in these rural communities hold a definition of health that overlaps with, but is not synonymous with a biomedical model. These elders' concept of health seamlessly integrates physical, mental, spiritual, and social aspects of health, reflecting how health is embedded in the everyday experience of these elders. Staying healthy is maintaining the ability to function in a community. These results indicate that providers cannot assume that older patients will share their interpretation of general health promotion advice.

  12. A Novel Conceptual Architecture for Person-Centered Health Records

    PubMed Central

    Schleyer, Titus; King, Zachary; Miled, Zina Ben

    2016-01-01

    Personal health records available to patients today suffer from multiple limitations, such as information fragmentation, a one-size-fits-all approach and a focus on data gathered over time and by institution rather than health conditions. This makes it difficult for patients to effectively manage their health, for these data to be enriched with relevant information from external sources and for clinicians to support them in that endeavor. We propose a novel conceptual architecture for person-centered health record information systems that transcends many of these limitations and capitalizes on the emerging trend of socially-driven information systems. Our proposed personal health record system is personalized on demand to the conditions of each individual patient; organized to facilitate the tracking and review of the patient’s conditions; and able to support patient-community interactions, thereby promoting community engagement in scientific studies, facilitating preventive medicine, and accelerating the translation of research findings. PMID:28269906

  13. Personal health records are designed for people like us.

    PubMed

    Showell, Chris; Turner, Paul

    2013-01-01

    Current approaches to designing, implementing and evaluating personal health record systems reflect the attributes and assumptions of well-educated and well to-do users (People like Us: PLUs) rather than the needs of the most disadvantaged in society (the disempowered, disengaged and disconnected: DDDs). These electronic systems for increasing accessibility to personal health information may accentuate rather than mitigate the emerging eHealth divide. Using a PubMed review of literature on personal health record systems, we identified only seven of 73 papers, and one of 29 abstracts which made specific mention of users who were disadvantaged by low literacy levels or difficulties with access to technology. This work is part of a larger study into personal health records and disadvantage.

  14. Personality determinants of health behaviours of merchant navy officers.

    PubMed

    Lipowski, Mariusz; Lipowska, Małgorzata; Peplińska, Aleksandra; Jeżewska, Maria

    2014-01-01

    An individual's health behaviours are highly correlated with selected areas of their personality as well as their values, needs and goals. However, this relationship may be modified by a number of objective factors associated with the individual's functioning, lifestyle or occupational activity. The main objective of the presented study was to investigate the relationship between personality profiles and health behaviours of merchant navy officers. The influences of personality on health behaviours were additionally compared between two groups: mariners and managers. Thirty-two seafarers of an officer rank and 45 managers aged between 29 and 48 took part in the study. Three research tools were used: NEO-Five Factor Inventory, Health Behaviour Inventory and Inventory of Physical Activity Objectives. Results suggest that selected personality variables are significant predictors of individual aspects of health behaviour, however the strength of their influence may differ, depending on the peculiarities of the performed work.

  15. Personal health records: meaningful use, but for whom?

    PubMed

    Kannry, Joseph; Beuria, Pratharna; Wang, Emily; Nissim, Julie

    2012-01-01

    Providers and hospitals have received more than $5 billion from the federal government for meaningfully using electronic health records as of April 2012. Meaningful Use stage 1 makes adoption of the personal health record optional. The proposed Meaningful Use stage 2 regulations make personal health record use mandatory. There is peer-reviewed literature to support a personal health record adoption rate of 10%, which is optional in stage 1 and required in stage 2. The literature also supports the use of secure messaging required in stage 2. However, there is little evidence to support other stage 2 personal health record requirements and dependencies. Further study is urgently needed to ensure that Meaningful Use stage 2 is meaningful for both patients and providers. © 2012 Mount Sinai School of Medicine.

  16. Psychiatric components of a Health Maintenance Facility (HMF) on Space Station

    NASA Technical Reports Server (NTRS)

    Santy, Patricia A.

    1987-01-01

    The operational psychiatric requirements for a comprehensive Health Maintenance Facility (HMF) on a permanently manned Space Station are examined. Consideration is given to the psychological health maintenance program designed for the diagnosis of mental distress in astronauts during flight and for prevention of mental breakdown. The types of mental disorders that can possibly affect the astronauts in flight are discussed, including various organic, psychotic, and affective mental disorders, as well as anxiety, adjustment, and somatoform/dissociative disorders. Special attention is given to therapeutic considerations for psychiatric operations on Space Station, such as restraints, psychopharmacology, psychotherapy, and psychosocial support.

  17. Provision of Personal Healthcare Services by Local Health Departments

    PubMed Central

    Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy

    2016-01-01

    Introduction The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008–2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Methods Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. Results The mean number of personal healthcare services provided by LHDs did not change significantly in 2008–2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services’ share of revenue and per capita expenditures (b=0.57, p<0.001). Conclusions A lower share of revenue from personal healthcare services is associated with lower per capita expenditures. LHDs, especially those serving <25,000 people, are highly dependent on personal healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. PMID:25997902

  18. The economic burden of personality disorders in mental health care.

    PubMed

    Soeteman, Djøra I; Hakkaart-van Roijen, Leona; Verheul, Roel; Busschbach, Jan J V

    2008-02-01

    Some evidence suggests that personality disorders are associated with a high economic burden due to, for example, a high demand on psychiatric, health, and social care services. However, state-of-the-art cost studies for the broad range of personality disorder diagnoses are lacking. The present study examines the direct medical costs, as well as the indirect costs, of patients seeking mental health treatment with DSM-IV personality disorders. The 1740 subjects included in this study were recruited from March 2003 to March 2006 from 6 different mental health care institutes in the Netherlands specializing in the psychotherapeutic treatment of personality disorders. The direct and indirect costs were assessed using the Trimbos and Institute for Medical Technology Assessment Questionnaire on Costs Associated with Psychiatric Illness. Personality disorders were diagnosed using the Structured Interview for DSM-IV Personality. The mean total costs of the personality disorder group in the 12 months prior to treatment were 11,126 euros per patient. Two thirds (66.5%) of these costs consisted of direct medical costs, while the remaining costs were related to productivity losses. Borderline and obsessive-compulsive personality disorders were uniquely associated with increased mean total costs. Treatment-seeking patients with personality disorders pose a high economic burden on society, a burden substantially higher than that found in, for instance, depression or generalized anxiety disorder. These high societal costs present a strong argument in favor of prioritizing effective personality disorder treatments in reimbursement decisions.

  19. 21 CFR 1250.35 - Health of persons handling food.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... SANITATION Food Service Sanitation on Land and Air Conveyances, and Vessels § 1250.35 Health of...

  20. 21 CFR 1250.35 - Health of persons handling food.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... SANITATION Food Service Sanitation on Land and Air Conveyances, and Vessels § 1250.35 Health of...

  1. Health Self-Advocacy Training for Persons with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Feldman, M. A.; Owen, F.; Andrews, A.; Hamelin, J.; Barber, R.; Griffiths, D.

    2012-01-01

    Background: People with intellectual disabilities (ID) have unequal access to health care. While systemic efforts are addressing health inequalities, there remains a need to demonstrate that persons with ID can increase their health self-advocacy skills. Method: A randomised control design with up to 6-month follow-up was used to evaluate the 3Rs…

  2. Health Self-Advocacy Training for Persons with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Feldman, M. A.; Owen, F.; Andrews, A.; Hamelin, J.; Barber, R.; Griffiths, D.

    2012-01-01

    Background: People with intellectual disabilities (ID) have unequal access to health care. While systemic efforts are addressing health inequalities, there remains a need to demonstrate that persons with ID can increase their health self-advocacy skills. Method: A randomised control design with up to 6-month follow-up was used to evaluate the 3Rs…

  3. The association between individual time preferences and health maintenance habits.

    PubMed

    Bradford, W David

    2010-01-01

    Encouraging healthy behaviors, including disease screening, exercise, and tobacco avoidance, has been a significant focus of clinical attention in recent decades. Little is known about the association between individual preferences with respect to time play and preventive health care use and healthy lifestyles. To determine whether rates of these health behaviors are associated with latent time preferences. Interval regression analysis was used to impute individual level discount rates. The difference in means for the rates of health behaviors were assessed for high vs. low to moderate discounting groups using one-factor probit models. The 2004 wave of the Health and Retirement Survey included in a time preferences module (1,039 respondents aged 24 to 65 years). Rates of recent mammograms, breast exams, Pap smears, prostate exams, cholesterol testing, flu shots, and dental visits, and non-smoking status. Respondents in the upper 20th percentile of the distribution have an average imputed annual discount rate of 0.335 (33.5%). High discount rate status is found to have a negative marginal association on the probability that respondents had recent mammogram use (-15.1%; P = 0.001), Pap smear use (-8.3%; P = 0.049), prostate examination use (-20.4%; P =0.003), dental visits (-24.8%; P = 0.001), cholesterol testing (-12.4%; P = 0.001), flu shot usage (-11.1%; P = 0.005), rates of vigorous exercise (-15.1%; P = 0.001), nonsmoking status (-10.4%; P= 0.001), and undertook all measured health habits (-7%; P = 0.001). Differences in underlying preferences for the present over the future may be a substantial barrier for people's propensity to adopt healthy lifestyles.

  4. FastStats: Older Persons' Health

    MedlinePlus

    ... Care Adult Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography ... age 65 years and over Home Health Care Hospice Care Hospitalization, Readmission, and Death Experience of Noninstitutionalized Medicare ...

  5. Disaster mental health services: a personal perspective.

    PubMed

    Weeks, S M

    1999-02-01

    1. Services that may be provided by psychiatric-mental health nurses following a disaster include education, intervention, problem solving, advocacy, and referral. 2. Nurses providing disaster mental health services must be flexible and creative. Strong observational skills and teamwork are also essential characteristics in disaster settings. 3. Psychiatric-mental health nurses who wish to receive training for disaster mental health volunteer opportunities should contact their local chapter of the American Red Cross.

  6. Maintenance of health behavior change in preventive cardiology. Internalization and self-regulation of new behaviors.

    PubMed

    Bellg, Albert J

    2003-01-01

    Long-term health behavior maintenance remains a challenge for patients and health behavior interventionists. Resource-intensive systems of external reinforcement and behavioral cues can support behavior maintenance; an alternative approach is to promote patient internalization and self-regulation of health behaviors. Based in part on organismic internalization theory, self-determination theory, and the experience of patients successful at maintaining health behaviors, the health behavior internalization model (HBIM) is proposed to describe motivational factors associated with internalization processes and hypothesizes that integrated internalization may be associated with long-term health behavior maintenance. The HBIM identifies four self-needs (ownership, self-determination, security, and support) and four behavior-related needs (preference, context, competence, and coping) as motivating health behavior internalization. Behavior change strategies promoting integrated internalization are identified from self-determination theory, motivational interviewing, and transtheoretical model interventions. Other health behavior change constructs are reviewed in relation to internalization processes, and potential limits to the model are discussed.

  7. [Dental health maintenance of military personnel under orthodontic treatment].

    PubMed

    Soldatova, L N; Horoshilkina, F Ya; Iordanishvili, A K

    2017-01-01

    The aim of the study was to estimate dental health of servicemen of young and middle age using PMA index, Schiller-Pisarev assay, iodic number of Svrakov, OHI-S. Hundred and six servicemen were enrolled in the study: control group (n=35) with no orthodontic treatment and groups 2 (n=34) and 3 (n=37) group undergoing orthodontic treatment with bracket-systems. All patients had professional oral hygiene and received standard oral care recommendations. Group 3 participants additionally used dental foam (Splat, Russia) after meal. All patients were examined at baseline and 12 months later. In the presence of orthodontic appliances standard oral care products were not enough to maintain proper oral health. Dental foam improved both periodontal condition and OHI-S.

  8. Use of probiotics and yogurts in maintenance of health.

    PubMed

    Sanders, Mary Ellen

    2008-07-01

    The role of probiotics in treating or preventing diarrheal diseases is well known. Less understood is the impact probiotics may have on maintaining health. Although it can be a challenge to demonstrate improved health of an already healthy population, some recent studies provide evidence that probiotics may reduce the risk of getting sick in populations that are at risk by nature of environmental exposure (eg, children in day care centers), physical status (eg, premature infants or people taking antibiotics), or family history of disease (eg, infants with a primary relative with atopic disease). These benefits may be the result of improved immune status, fewer intestinal infections, or improved intestinal integrity. The live microorganisms mediating these effects may be delivered in different formats, but the role of yogurt as a delivery vehicle for efficacious probiotics is specifically discussed.

  9. A Systematic Review of Personality Disorders and Health Outcomes

    PubMed Central

    Dixon-Gordon, Katherine L.; Whalen, Diana J.; Layden, Brianne K.; Chapman, Alexander L.

    2015-01-01

    Personality disorders have been associated with a wide swath of adverse health outcomes and correspondingly high costs to healthcare systems. To date, however, there has not been a systematic review of the literature on health conditions among individuals with personality disorders. The primary aim of this article is to review research documenting the associations between personality disorders and health conditions. A systematic review of the literature revealed 78 unique empirical English-language peer-reviewed articles examining the association of personality disorders and health outcomes over the past 15 years. Specifically, we reviewed research examining the association of personality disorders with sleep disturbance, obesity, pain conditions, and other chronic health conditions. In addition, we evaluated research on candidate mechanisms underlying health problems in personality disorders and potential treatments for such disorders. Results underscore numerous deleterious health outcomes associated with PD features and PD diagnoses, and suggest potential biological and behavioural factors that may account for these relations. Guidelines for future research in this area are discussed. PMID:26456998

  10. Variations in meanings of the personal core value "health".

    PubMed

    Allicock, Marlyn; Sandelowski, Margarete; DeVellis, Brenda; Campbell, Marci

    2008-11-01

    Preventive health behavior patterns and practices are influenced by many factors. Knowledge about a person's core values may improve the ability to predict decisions related to behaviors such as healthy eating. In this cross-case comparison study, we illuminate the meanings ascribed to the core value "health" in relationship to fruit and vegetable intake for colorectal cancer survivors and for persons with no cancer history. We found that both survivors and non-survivors gave three accounts of how the value "health" influenced having a healthy diet. These were: (1) good health was necessary to fulfill/attain other values; (2) health was a manifestation of God's will; and (3) good health was not possible unless one values responsibility. Understanding a person's core values provides insight about how values may act as motivators for behavior change. Practitioners using motivational interviewing techniques should include a values clarification exercise to improve their assessment of how values influence behaviors.

  11. Issues in Worksite Health Promotion: A Personal Viewpoint.

    ERIC Educational Resources Information Center

    Shephard, Roy J.

    2002-01-01

    Attempts to change employees' personal behavior to promote a healthy workplace raise ethical and professional questions. Needs for successful wellness programs must be balanced against individual rights to remain unhealthy. The paper discusses potential fiscal benefits of wellness programs, ethics of motivation, personal responsibility for health,…

  12. Issues in Worksite Health Promotion: A Personal Viewpoint.

    ERIC Educational Resources Information Center

    Shephard, Roy J.

    2002-01-01

    Attempts to change employees' personal behavior to promote a healthy workplace raise ethical and professional questions. Needs for successful wellness programs must be balanced against individual rights to remain unhealthy. The paper discusses potential fiscal benefits of wellness programs, ethics of motivation, personal responsibility for health,…

  13. Personal Grooming: "Let's Fact It!". Health and the Consumer.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee. Div. of Elementary and Secondary Education.

    Personal grooming is the topic of this learning activity package, which is one part of a consumer education series for secondary students. The module attempts to make students aware of the importance of personal appearance and grooming and to emphasize the direct correlation between maintaining good health and looking good. The learning package…

  14. Personal Grooming: "Let's Fact It!". Health and the Consumer.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee. Div. of Elementary and Secondary Education.

    Personal grooming is the topic of this learning activity package, which is one part of a consumer education series for secondary students. The module attempts to make students aware of the importance of personal appearance and grooming and to emphasize the direct correlation between maintaining good health and looking good. The learning package…

  15. Adolescent health care maintenance in a teen-friendly clinic.

    PubMed

    Chaisson, Nicole; Shore, William B

    2014-09-01

    Adolescence is marked by complex physical, cognitive, social, and emotional development, which can be stressful for families and adolescents. Before the onset of puberty, providers should clearly lay the groundwork for clinical care and office visits during the adolescent years. This article addresses the guidelines and current legal standards for confidentiality in adolescent care, the most frequently used psychosocial screening tools, and current recommendations for preventive health services and immunizations. Through the creation of teen-friendly clinics, primary care providers are well positioned to offer guidance and support to teens and their parents during this time of transition and growth. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Employer-sponsored, personal, and portable health insurance.

    PubMed

    Goodman, John C

    2006-01-01

    Personal and portable health insurance is an idea whose time has come. Despite its stated intent, however, the Health Insurance Portability and Accountability Act (HIPAA) strongly discourages individually owned, portable insurance. Federal tax laws do the same. Some examples of portable benefits exist, such as the TIAA-CREF system. This paper considers three reform models for moving toward personal, portable coverage: the National Center for Policy Analysis-Texas Blue Cross Blue Shield proposal, the Massachusetts health care plan, and a health reimbursement arrangement (HRA) approach. Congress could make the transition smoother by clarifying when and if individually owned insurance can be purchased with pretax dollars.

  17. Using Focus Groups to Identify Factors Affecting Healthful Weight Maintenance in Latino Immigrants

    ERIC Educational Resources Information Center

    Greaney, Mary L.; Lees, Faith D.; Lynch, Breanna; Sebelia, Linda; Greene, Geoffrey W.

    2012-01-01

    Objective: To explore (1) how migration influenced physical activity and dietary behaviors among Latino immigrants and (2) participants' perception of concepts related to a Health at Every Size (HAES) approach to weight maintenance (mindful eating, taking care of oneself). Methods: Four focus groups (n = 35), homogenous by sex, were conducted in…

  18. Using Focus Groups to Identify Factors Affecting Healthful Weight Maintenance in Latino Immigrants

    ERIC Educational Resources Information Center

    Greaney, Mary L.; Lees, Faith D.; Lynch, Breanna; Sebelia, Linda; Greene, Geoffrey W.

    2012-01-01

    Objective: To explore (1) how migration influenced physical activity and dietary behaviors among Latino immigrants and (2) participants' perception of concepts related to a Health at Every Size (HAES) approach to weight maintenance (mindful eating, taking care of oneself). Methods: Four focus groups (n = 35), homogenous by sex, were conducted in…

  19. Integration of Health Maintenance Guidelines into a Clinical Workstation Using Expert System and Relational Database Technology

    PubMed Central

    Jenders, Robert A.; Barnett, G. Octo

    1993-01-01

    We are developing a clinical workstation which integrates access to health maintenance guidelines with a computer-based medical record. We discuss the use of relational database and expert system technology to provide both patient-specific and patient-independent access to clinical guidelines.

  20. Modeling factors that influence personal health records adoption.

    PubMed

    Logue, Melanie D; Effken, Judith A

    2012-07-01

    The purpose of this article was to describe the Personal Health Records Adoption Model and how it was developed. Older adults who often find themselves managing their own care or the care of their families have expressed interest in using electronic personal health records as a management tool, but few are using them. The literature does not provide a comprehensive model of personal health record adoption among older adults with chronic illness; therefore, essential barriers and facilitators were synthesized from existing literature to create the model. The model derivation and synthesis process drew upon candidate theoretical frameworks, including two behavioral theories, an informatics theory, and a self-management theory, while using the Informatics Research Organizing Model as an organizing framework. The Personal Health Records Adoption Model captures important barriers and facilitators that could predict adoption of personal health records among older adults with chronic illness. The long-term goal is to use this explanatory model to develop interventions that will maximize the facilitators and minimize the barriers to personal health record adoption.

  1. Medicare health maintenance organization benefits packages and plan performance measures.

    PubMed

    Cox, Don; Lanyi, Bettina; Strabic, Allison

    2002-01-01

    This article reports the results of an analysis of the relationship between supplemental benefits offered by Medicare+Choice (M+C) plans and their plan performance ratings. We examined two measures of plan performance: (1) plan ratings as reported in the Medicare Managed Care (MMC) Consumer Assessment of Health Care Study (CAHPS), and (2) disenrollment rates. The results of our analysis indicated that variations in plan supplemental offerings have little impact on enrollees' plan performance ratings--both overall ratings and access to care measures. Furthermore, disenrollment rates were found to be more sensitive to the availability of alternative M+C plans, either in general, or for specific benefits than to variations in benefit offerings.

  2. Remember the Person--Infant Mental Health.

    ERIC Educational Resources Information Center

    Texas Child Care, 2003

    2003-01-01

    Highlights the concept of infant mental health and discusses what early care and education professionals can do to boost babies' emotional well-being. Offers steps for the following specific strategies: (1) developing trust; (2) being alert to risk conditions; (3) nurturing children's mental health; (4) creating supportive environments; and (5)…

  3. Michigan Health Care Costs Review. Personal Health Care Expenditures, 1966-1981. Number 1.

    ERIC Educational Resources Information Center

    Michigan State Office of Health and Medical Affairs, Lansing.

    Data are presented describing expenditures for personal health services in Michigan from 1977 to 1981. The rapid growth in expenditures is illustrated, as well as the rates of growth in expenditures, for major categories of health services. Personal health expenditures are defined as payments for care directly provided to patients: specifically,…

  4. Personality traits predict perceived health-related quality of life in persons with multiple sclerosis.

    PubMed

    Zarbo, Ignazio Roberto; Minacapelli, Eleonora; Falautano, Monica; Demontis, Silvia; Carpentras, Giovanni; Pugliatti, Maura

    2016-04-01

    Personality traits can affect health-related quality of life (HRQoL) in different disorders. In multiple sclerosis (MS), personality traits can determine patients' willingness to take on more risky treatment options, predispose to neuropsychiatric symptoms and affect coping strategies. We investigated the role of personality traits as possible predictors of HRQoL in a large cohort of persons with MS (PwMS). In total, 253 consecutively recruited PwMS were screened for intellectual deficits with Raven Colour Progressive Matrices (RCPM), state anxiety with STAI-X1 and major depression on a clinical basis. PwMS' self-perceived mental and physical health status was measured with the 36-Item Short Form Health Survey (SF-36), and the personality profile with the Eysenck Personality Questionnaire (EPQ-R). The correlation between HRQoL and personality traits was investigated by means of analysis of variance, adjusting for possible confounders. Of the 253 MS patients, 195 (F:M=2.75), aged 41.7±10.2 years were included in the analysis. The variance of SF-36 mental and physical composite score was largely explained by extraversion and neuroticism. Our data confirm that PwMS' HRQoL is largely influenced by personality traits, which may therefore act as predictors of perceived quality of life and should be included in clinical and experimental settings focusing on HRQoL. © The Author(s), 2015.

  5. Online and in-person health-seeking for infertility.

    PubMed

    Slauson-Blevins, Kathleen S; McQuillan, Julia; Greil, Arthur L

    2013-12-01

    Using data from Wave 1 (2004-2006) of the National Survey of Fertility Barriers (NSFB), a national probability sample of women ages 25-45, we examine online information-seeking among ever-infertile women. Of the 1352 women who met criteria for infertility, 459 (34%) neither talked to a doctor nor went online for information, 9% went online only for information, 32% talked to a doctor but did not go online, and 25% did both. Guided by Chrisman's Health-Seeking Model and previous research on Internet use to obtain health information, we employ multinomial logistic regression to compare these four groups of ever-infertile women. Findings generally support Chrisman's model. Infertile women tend to seek information online as a complement to, rather than as a substitute for, in-person health-seeking. Greater faith in the ability of medical science to treat infertility and greater perceived stigma were associated with higher odds of using the Internet to obtain information about infertility. In general, women who perceived the symptoms of infertility as more salient had higher odds of using both online and in-person or only in-person health-seeking compared to online health-seeking. Women with greater resources had higher odds of using online sources of information. Strong network encouragement to seek treatment was associated with higher odds of in-person health-seeking and combining in-person and online health-seeking compared to only going online or doing nothing.

  6. Gamification and serious games for personalized health.

    PubMed

    McCallum, Simon

    2012-01-01

    Computer games are no longer just a trivial activity played by children in arcades. Social networking and casual gaming have broadened the market for, and acceptance of, games. This has coincided with a realization of their power to engage and motivate players. Good computer games are excellent examples of modern educational theory [1]. The military, health providers, governments, and educators, all use computer games. This paper focuses on Games for Health, discussing the range of areas and approaches to developing these games. We extend a taxonomy for Games for Health, describe a case study on games for dementia sufferers, and finally, present some challenges and research opportunities in this area.

  7. Challenges in wearable personal health monitoring systems.

    PubMed

    Kim, Insoo; Lai, Po-Hsiang; Lobo, Ryan; Gluckman, Bruce J

    2014-01-01

    Wearable sensors give the users convenience in daily health monitoring, though several challenges in such sensor systems should be overcome. This paper discusses the challenges in wearable health monitoring sensors and solutions for multi-modal and multi-functional wrist-worn devices based on novel circuit design techniques to reject DC offset. This paper also presents a novel sophisticated algorithm to reject motion artifacts. The system has the capability to simultaneously acquire several biomedical signals (i.e. electrocardiogram, PPG, and body-electrode impedance). The system can also help patients who want to monitor their psychological signals to mitigate health risks.

  8. Health Maintenance System (HMS) Hardware Research, Design, and Collaboration

    NASA Technical Reports Server (NTRS)

    Gonzalez, Stefanie M.

    2010-01-01

    The Space Life Sciences division (SLSD) concentrates on optimizing a crew member's health. Developments are translated into innovative engineering solutions, research growth, and community awareness. This internship incorporates all those areas by targeting various projects. The main project focuses on integrating clinical and biomedical engineering principles to design, develop, and test new medical kits scheduled for launch in the Spring of 2011. Additionally, items will be tagged with Radio Frequency Interference Devices (RFID) to keep track of the inventory. The tags will then be tested to optimize Radio Frequency feed and feed placement. Research growth will occur with ground based experiments designed to measure calcium encrusted deposits in the International Space Station (ISS). The tests will assess the urine calcium levels with Portable Clinical Blood Analyzer (PCBA) technology. If effective then a model for urine calcium will be developed and expanded to microgravity environments. To support collaboration amongst the subdivisions of SLSD the architecture of the Crew Healthcare Systems (CHeCS) SharePoint site has been redesigned for maximum efficiency. Community collaboration has also been established with the University of Southern California, Dept. of Aeronautical Engineering and the Food and Drug Administration (FDA). Hardware disbursements will transpire within these communities to support planetary surface exploration and to serve as an educational tool demonstrating how ground based medicine influenced the technological development of space hardware.

  9. Ageing and gut microbes: perspectives for health maintenance and longevity.

    PubMed

    Biagi, Elena; Candela, Marco; Turroni, Silvia; Garagnani, Paolo; Franceschi, Claudio; Brigidi, Patrizia

    2013-03-01

    The ageing process affects the human gut microbiota phylogenetic composition and its interaction with the immune system. Age-related gut microbiota modifications are associated with immunosenescence and inflamm-ageing in a sort of self-sustaining loop, which allows the placement of gut microbiota unbalances among both the causes and the effects of the inflamm-ageing process. Even if, up to now, the link between gut microbiota and the ageing process is only partially understood, the gut ecosystem shows the potential to become a promising target for strategies able to contribute to the health status of older people. In this context, the consumption of pro/prebiotics may be useful in both prevention and treatment of age-related pathophysiological conditions, such as recovery and promotion of immune functions, i.e. adjuvant effect for influenza vaccine, and prevention and/or alleviation of common "winter diseases", as well as constipation and Clostridium difficile-associated diarrhoea. Moreover, being involved in different mechanisms which concur in counteracting inflammation, such as down-regulation of inflammation-associated genes and improvement of colonic mucosa conditions, probiotics have the potentiality to be involved in the promotion of longevity.

  10. What Is a Personal Health Record (PHR)?

    MedlinePlus

    ... want to receive information about you. By insurance companies: After your health information is collected, it is ... those paying your bills, such as your insurance company, although the company may request paper documents in ...

  11. Paradoxes of Personal Responsibility in Mental Health Care.

    PubMed

    Lakeman, Richard

    2016-12-01

    Personal responsibility is widely considered important in mental health recovery as well as in popular models of alcohol and drug treatment. Neo-liberal socio-political rhetoric around consumerism in health care often assumes that people are informed and responsible for their own choices and behaviour. In the mental health care context and especially in emergency or crisis settings, personal responsibility often raises particular paradoxes. People often present whose behaviour does not conform to the ideals of the responsible consumer; they may seek and/or be granted absolution from irresponsible behaviour. This paradox is explored and clinicians are urged to consider the context-bound nature of personal responsibility and how attributions of personal responsibility may conflict with policy and their own professional responsibilities to intervene to protect others.

  12. Implant maintenance treatment and peri-implant health.

    PubMed

    Howe, Mark-Steven

    2017-03-01

    Data sourcesMedline (PubMed), Embase, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases and a manual search of the Journal of Dental Research, Journal of Clinical Periodontology, Journal of Periodontology and the International Journal of Periodontics and Restorative Dentistry from January 2014 to February 2015.Study selectionProspective, retrospective, randomised or not, case-controlled or case series trials showing the incidence or recurrence of peri-implant disease plus or minus PIMT over more than six months.Data extraction and synthesisThree reviewers independently selected studies and abstracted data with two reviewers assessing study quality using the Newcastle-Ottawa Scale (NOS). A multivariate binomial regression was used to examine the data.ResultsThirteen studies were included with ten contributing to the meta-analysis. The average quality assessment score (NOS) was 5.3 out of a possible nine, only one paper achieved eight. At patient level mucositis ranged from 18.5-74.2% and peri-implantitis from 8-28%, with significant effects being seen for treatment (z= -14.36, p<0.001). Mucositis was affected by history of periodontitis and mean PIMT at implant and patient levels, respectively. For peri-implantitis there were also significant effects of treatment (z = -16.63, p<0.001). Increased peri-implantitis was observed for patients with a history of periodontal disease. (z=3.76, p<0.001). Implants under PIMT have 0.958 the incident event compared to those with no PIMT.ConclusionsWithin the limitations of the present systematic review it can be concluded that implant therapy must not be limited to placement and restoration of dental implants, but to the implementation of PIMT to potentially prevent biological complications and heighten the long-term success rate. Although it must be tailored to a patients risk profiling, our findings suggest reason to claim a minimum recall PIMT interval of five to six

  13. Critical advances in bridging personal health informatics and clinical informatics.

    PubMed

    Koch, S; Vimarlund, V

    2012-01-01

    To provide a survey over significant developments in the area of linking personal health informatics and clinical informatics, to give insights into critical advances and to discuss open problems and opportunities in this area. A scoping review over the literature published in scientific journals and relevant conference proceedings in the intersection between personal health informatics and clinical informatics over the years 2010 and 2011 was performed. The publications analyzed are related to two main topics, namely "Sharing information and collaborating through personal health records, portals and social networks" and "Integration of personal health systems with clinical information systems". For the first topic, results are presented according to five different themes: "Patient expectations and attitudes", "Real use experiences", "Changes for care providers", "Barriers to adoption" and "Proposed technical infrastructures". For the second topic, two different themes were found, namely "Technical architectures and interoperability" and "Security, safety and privacy issues". Results show a number of gaps between the information needs of patients and the information care provider organizations provide to them as well as the lack of a trusted technical, ethical and regulatory framework regarding information sharing. Despite recent developments in the areas of personal health informatics and clinical informatics both fields have diverging needs. To support both clinical work processes and empower patients to effectively handle self-care, a number of issues remain unsolved. Open issues include privacy and confidentiality, including trusted sharing of health information and building collaborative environments between patients, their families and care providers. There are further challenges to meet around health and technology literacy as well as to overcome structural and organizational barriers. Frameworks for evaluating personal health informatics applications and

  14. What explains health in persons with visual impairment?

    PubMed

    Leissner, Juliane; Coenen, Michaela; Froehlich, Stephan; Loyola, Danny; Cieza, Alarcos

    2014-05-03

    Visual impairment is associated with important limitations in functioning. The International Classification of Functioning, Disability and Health (ICF) adopted by the World Health Organisation (WHO) relies on a globally accepted framework for classifying problems in functioning and the influence of contextual factors. Its comprehensive perspective, including biological, individual and social aspects of health, enables the ICF to describe the whole health experience of persons with visual impairment. The objectives of this study are (1) to analyze whether the ICF can be used to comprehensively describe the problems in functioning of persons with visual impairment and the environmental factors that influence their lives and (2) to select the ICF categories that best capture self-perceived health of persons with visual impairment. Data from 105 persons with visual impairment were collected, including socio-demographic data, vision-related data, the Extended ICF Checklist and the visual analogue scale of the EuroQoL-5D, to assess self-perceived health. Descriptive statistics and a Group Lasso regression were performed. The main outcome measures were functioning defined as impairments in Body functions and Body structures, limitations in Activities and restrictions in Participation, influencing Environmental factors and self-perceived health. In total, 120 ICF categories covering a broad range of Body functions, Body structures, aspects of Activities and Participation and Environmental factors were identified. Thirteen ICF categories that best capture self-perceived health were selected based on the Group Lasso regression. While Activities-and-Participation categories were selected most frequently, the greatest impact on self-perceived health was found in Body-functions categories. The ICF can be used as a framework to comprehensively describe the problems of persons with visual impairment and the Environmental factors which influence their lives. There are plenty of

  15. Methadone maintenance and the cost and utilization of health care among individuals dependent on opioids in a commercial health plan.

    PubMed

    McCarty, Dennis; Perrin, Nancy A; Green, Carla A; Polen, Michael R; Leo, Michael C; Lynch, Frances

    2010-10-01

    Few health plans provide maintenance medication for opioid dependence. This study assessed the cost of treating opioid-dependent members in a commercial health plan and the impacts of methadone maintenance on costs of care. Individuals with diagnoses of opioid dependence (two or more diagnoses per year) and at least 9 months of health plan eligibility each year were extracted from electronic health records for the years 2000 through 2004 (1,518 individuals and 2,523 observations across the study period-some individuals were in multiple years). Analyses examined the patterns and costs of health care for three groups of patients: (1) one or more methadone visits during the year (n=1,298; 51%); (2) no methadone visits and 0 or 1 visits in the Addiction Medicine Department (n=370; 15%); (3) no methadone visits and 2 or more visits in addiction medicine (n=855; 34%). Primary care (86%), emergency department (48%) and inpatient (24%) visits were common. Mean total annual costs to the health plan were $11,200 (2004 dollars) per member per year. The health plan's costs for members receiving methadone maintenance were 50% lower ($7,163) when compared to those with two or more outpatient addiction treatment visits but no methadone ($14,157) and 62% lower than those with one or zero outpatient addiction treatment visits and no methadone treatment ($18,694). Use of opioid maintenance services was associated with lower total costs of care for opioid-dependent members in a commercial health plan. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  16. Methadone Maintenance and the Cost and Utilization of Health Care among Individuals Dependent on Opioids in a Commercial Health Plan

    PubMed Central

    McCarty, Dennis; Perrin, Nancy A.; Green, Carla A.; Polen, Michael R.; Leo, Michael C.; Lynch, Frances

    2010-01-01

    Background Few health plans provide maintenance medication for opioid dependence. This study assessed the cost of treating opioid dependent members in a commercial health plan and the impacts of methadone maintenance on costs of care. Methods Individuals with diagnoses of opioid dependence (two or more diagnoses per year) and at least nine months of health plan eligibility each year were extracted from electronic health records for the years 2000 through 2004 (1,518 individuals and 2,523 observations across the study period – some individuals were in multiple years). Analyses examined the patterns and costs of health care for three groups of patients: 1) one or more methadone visits during the year (n = 1,298; 51%); 2) no methadone visits and 0 or 1 visits in the Addiction Medicine Department (n = 370; 15%); and 3) no methadone visits and 2 or more visits in addiction medicine (n = 855; 34%). Results Primary care (86%), emergency department (48%) and inpatient (24%) visits were common. Mean total annual costs to the health plan were $11,200 (2004 dollars) per member per year. The health plan’s costs for members receiving methadone maintenance were 50% lower ($7,163) when compared to those with two or more outpatient addiction treatment visits but no methadone ($14,157) and 62% lower than those with one or zero outpatient addiction treatment visits and no methadone treatment ($18,694). Conclusions Use of opioid maintenance services was associated with lower total costs of care for opioid dependent members in a commercial health plan. PMID:20627427

  17. Preventive, Lifestyle, and Personal Health Behaviors among Physicians

    ERIC Educational Resources Information Center

    Bazargan, Mohsen; Makar, Marian; Bazargan-Hejazi, Shahrzad; Ani, Chizobam; Wolf, Kenneth E.

    2009-01-01

    Objective: This study examines personal health behaviors and wellness, health-related lifestyles, and prevention screening practices among licensed physicians. Methods: An anonymous questionnaire was mailed to a random sample of 1,875 physicians practicing in California. Data from 763 returned questionnaires (41%) were analyzed. Results: Our data…

  18. Personality traits and career satisfaction of health care professionals.

    PubMed

    Richardson, John D; Lounsbury, John W; Bhaskar, Tripti; Gibson, Lucy W; Drost, Adam W

    2009-01-01

    Based on Holland's theorizing that vocational satisfaction arises from a good match between one's personality and career choice, one purpose of the study was to examine broad and narrow personality traits that characterize health care workers in comparison with professionals from other occupations. Also investigated were ways in which characteristic traits of health care workers were related to career satisfaction. Professionals utilizing the services of eCareerfit.com responded to online surveys that have been demonstrated to produce reliable and valid measures of broad and narrow personality traits and levels of career satisfaction. An independent sample t test was used to compare means of health care workers with those from other occupations. Pearson product-moment correlations were then computed to assess relationships between the traits and career satisfaction of health care professionals. Two traits that were particularly strong among health care workers were also significantly correlated with career satisfaction: work drive and conscientiousness. Other traits were found to be significantly related to career satisfaction in health care but were not uniquely high in the sample of health care professionals. To increase career satisfaction of health care professionals and thus to improve retention rates, administrators should consider focusing on recruiting and selecting individuals with higher levels of key personality traits.

  19. 21 CFR 1250.35 - Health of persons handling food.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION INTERSTATE...

  20. 21 CFR 1250.35 - Health of persons handling food.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION INTERSTATE...

  1. Preventive, Lifestyle, and Personal Health Behaviors among Physicians

    ERIC Educational Resources Information Center

    Bazargan, Mohsen; Makar, Marian; Bazargan-Hejazi, Shahrzad; Ani, Chizobam; Wolf, Kenneth E.

    2009-01-01

    Objective: This study examines personal health behaviors and wellness, health-related lifestyles, and prevention screening practices among licensed physicians. Methods: An anonymous questionnaire was mailed to a random sample of 1,875 physicians practicing in California. Data from 763 returned questionnaires (41%) were analyzed. Results: Our data…

  2. An Organizational Framework of Personal Health Records for Social Networks

    ERIC Educational Resources Information Center

    Hasan, Syed Omair

    2009-01-01

    This work proposes an organizational framework for creating a community to share personal health record (PHR) information in the form of a Health Records Social Network (HRSN). The work builds upon existing social network community concepts as well as the existing Systemized Nomenclature of Medicine (SNOMED) model used by the medical community and…

  3. An Organizational Framework of Personal Health Records for Social Networks

    ERIC Educational Resources Information Center

    Hasan, Syed Omair

    2009-01-01

    This work proposes an organizational framework for creating a community to share personal health record (PHR) information in the form of a Health Records Social Network (HRSN). The work builds upon existing social network community concepts as well as the existing Systemized Nomenclature of Medicine (SNOMED) model used by the medical community and…

  4. Personal Health Training Manual. Core Curriculum Resource Material. TR-21.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC. Information Collection and Exchange Div.

    This personal health training manual, intended for all Peace Corps volunteers, presents a series of training sessions dealing with basic health concepts and practices; it is designed to be used by Peace Corps Medical Officers and trainers to help trainees acquire the understanding, skills, and motivation necessary to keep themselves healthy in a…

  5. Laboratory equipment maintenance: a critical bottleneck for strengthening health systems in sub-Saharan Africa?

    PubMed

    Fonjungo, Peter N; Kebede, Yenew; Messele, Tsehaynesh; Ayana, Gonfa; Tibesso, Gudeta; Abebe, Almaz; Nkengasong, John N; Kenyon, Thomas

    2012-02-01

    Properly functioning laboratory equipment is a critical component for strengthening health systems in developing countries. The laboratory can be an entry point to improve population health and care of individuals for targeted diseases - prevention, care, and treatment of TB, HIV/AIDS, and malaria, plus maternal and neonatal health - as well as those lacking specific attention and funding. We review the benefits and persistent challenges associated with sustaining laboratory equipment maintenance. We propose equipment management policies as well as a comprehensive equipment maintenance strategy that would involve equipment manufacturers and strengthen local capacity through pre-service training of biomedical engineers. Strong country leadership and commitment are needed to assure development and sustained implementation of policies and strategies for standardization of equipment, and regulation of its procurement, donation, disposal, and replacement.

  6. A Medical Decision Support System for the Space Station Health Maintenance Facility

    PubMed Central

    Ostler, David V.; Gardner, Reed M.; Logan, James S.

    1988-01-01

    NASA is developing a Health Maintenance Facility (HMF) to provide the equipment and supplies necessary to deliver medical care in the Space Station. An essential part of the Health Maintenance Facility is a computerized Medical Decision Support System (MDSS) that will enhance the ability of the medical officer (“paramedic” or “physician”) to maintain the crew's health, and to provide emergency medical care. The computer system has four major functions: 1) collect and integrate medical information into an electronic medical record from Space Station medical officers, HMF instrumentation, and exercise equipment; 2) provide an integrated medical record and medical reference information management system; 3) manage inventory for logistical support of supplies and secure pharmaceuticals; 4) supply audio and electronic mail communications between the medical officer and ground based flight surgeons. ImagesFigure 1

  7. Socio-environmental exposures and health outcomes among persons with sickle cell disease

    PubMed Central

    Knight Madden, Jennifer; Reid, Marvin; Greene, Lisa-Gaye; Lyew-Ayee, Parris

    2017-01-01

    There is much variability in the expression of sickle cell disease (SCD) and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to clinic. Persons travelled relatively long distances to seek SCD care and those travelling longer had less health maintenance visits. Urban patients had a higher prevalence of significant pain crises (69.4% vs. 55.8%, p value<0.001) and respiratory events (21.2% vs. 14%, p value<0.001). Prevalence of leg ulcers did not vary between rural and urban patients but was higher in males than in females. Females also had lower odds of having respiratory events but there was no sex difference in history of painful crises. Persons with more severe genotypes lived in higher poverty and travelled longer for healthcare services. Persons in areas with higher annual rainfall, higher mean temperatures and living farther from factories had less painful crises and respiratory events. The paper highlights a need for better access to healthcare services for Jamaicans with SCD especially in rural areas of the island. It also reports interesting associations between environmental climatic exposures and health outcomes. PMID:28384224

  8. Personalizing health care: feasibility and future implications

    PubMed Central

    2013-01-01

    Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer’s perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients. PMID:23941275

  9. Personal Health Ontology: towards the interoperation of e-health tools.

    PubMed

    Puustjärvi, Juha; Puustjärvi, Leena

    2011-01-01

    Patient-centred healthcare subscribes to the belief that the patient has strengths, values and experiences that are important in the healthcare experience and relationship between those providing care and the patient. It requires patients to have the ability to obtain and understand health information, and make appropriate health decisions. The main problem here is that though the e-health applications provide patients and consumer with access to health information, each application is still individually used and the used and produced information remains within each system. In this paper, we present our work on developing a Personal Health Server, which allows the interoperation of e-health tools through the shared ontology. The ontology is developed by integrating the ontologies of the e-health tools, which support personal health records, e-health oriented blogs and information therapy. Technically the Personal Health Server is based on knowledge management technologies, and it is easily extensible to capture additional e-health tools.

  10. Health Care and Mortality among Persons with Severe Mental Illness.

    PubMed

    Gal, Gilad; Munitz, Hanan; Levav, Itzhak

    2017-04-01

    Reports show disparities in the health care of persons with severe mental illness (SMI), including in countries with universal health insurance. However, the moderating effect on disparities of specific mental health legislation is yet to be studied. The study aimed to investigate equality of health care for people with SMI in a country with a national health insurance and a comprehensive rehabilitation law for persons with mental disabilities. A case-control epidemiological study compared health services (laboratory tests, visits to specialists, and medications) provided to users with and without a history of schizophrenia and bipolar disorder ( N = 52,131) and with regard to a subgroup of users with diabetes ( n = 16,280). In addition, we examined the mortality rates of the study population. While service users with schizophrenia were somewhat less likely to meet the same indexes of care as controls, those with bipolar disorder did not differ from their counterparts. Yet, mortality risk among service users with schizophrenia and bipolar disorder was 2.4 and 1.7 times higher, respectively. Rates of services to persons with SMI and comorbid diabetes did not differ from their counterparts. In Israel, a country with a national health insurance and a rehabilitation law for persons with mental disabilities, service users with bipolar disorder receive equitable levels of general health care. For users with schizophrenia, the disparities exist in some of the health care measures but to a smaller extent than in other countries with universal health insurance. In contrast, mortality rates are elevated in persons with SMI.

  11. Looking In: Exploring One's Personal Health Values.

    ERIC Educational Resources Information Center

    Read, Donald A.

    This workbook deals with values clarification strategies in the area of health education. It is designed to serve as a tool for expanding self awareness. The underlying assumption is that cognitive knowledge is only half of what is necessary for understanding one's own feelings and making decisions about such potential life problems as drugs, sex,…

  12. Looking In: Exploring One's Personal Health Values.

    ERIC Educational Resources Information Center

    Read, Donald A.

    This workbook deals with values clarification strategies in the area of health education. It is designed to serve as a tool for expanding self awareness. The underlying assumption is that cognitive knowledge is only half of what is necessary for understanding one's own feelings and making decisions about such potential life problems as drugs, sex,…

  13. Frequency and structure of precautionary behavior in the domains of hazard preparedness, crime prevention, vehicular safety, and health maintenance.

    PubMed

    Norris, F H

    1997-11-01

    A sample of 831 adults were interviewed by researchers using a 72-item inventory about their precautionary behaviors and attitudes. Exploratory and confirmatory factor analyses conducted on random halves of the sample provided evidence of consistency and structure in precautionary behavior both within and across domains of concern. Hazard preparedness activities clustered into having basic supplies on hand, advance planning, and hazard alertness. Crime prevention acts organized according to person protection, neighborly cooperation, and professional guidance. Vehicular safety factored into auto care, responsible driving, and seat belt use. Health maintenance activities entailed healthy habits (diet and exercise), risk monitoring, and avoiding tobacco and alcohol. Higher order factor analyses evidenced intra-individual consistency in the use of Disciplined, Vigilant, and Proactive Behaviors across precautionary domains. At all levels, perceptions of the usefulness of precautionary measures were related strongly to the frequency of self-protective acts.

  14. Burmese culture, personality and mental health.

    PubMed

    Way, R T

    1985-09-01

    As Australia, shaped by new policies of immigration and multiculturalism, grows more cosmopolitan, the challenge for psychiatry is to gain greater familiarity with the new ethnic minority groups, including their cultural personalities and backgrounds. The problem faced by the Burmese group in Australia is distinctive and poignant. Some 20,000 Burmese immigrated following World War II, chiefly to Western Australia in the first place, uniting and consolidating their families. Following the military coup and the Revolutionary Council Government of the early 60s, further emigration from Burma was cut off. This meant that the Burmese in Australia, already under stress arising from cultural differences, were prevented from developing the extensive internal social support systems that characterise other major ethnic groups. The author, a Burmese doctor working in a psychiatric setting in Sydney, draws attention to aspects of his country and its people which should be helpful for psychiatric and related professions.

  15. Personal health care expenditures, by State: 1966-82

    PubMed Central

    Levit, Katharine R.

    1985-01-01

    Spending per capita for health care in the United States varies dramatically by State and region. In 1982, personal health care costs per capita ranged from a low of $857 in South Carolina to a high of $1,508 in Massachusetts. The focus of this article is State and regional variation in spending levels and the mix of health care services purchased. Possible causes for these differences are presented. PMID:10311335

  16. A model for enhancing worldwide personal health and wellness.

    PubMed

    Marine, S; Guard, R; Morris, T; Haag, D; Kaya, B; Riep, J; Schick, L; Tsipis, G; Shoemaker, S

    1998-01-01

    Individuals must increasingly take control of managing their own health affairs. This requires access to quality information that is not easily obtained from traditional social institutions. NetWellness is an electronic consumer health information service that provides a model for reaching the goal of enhancing personal health and quality of life. [1] We present a vision of consumer health information delivery in the 21st century, and a model for reaching that vision. Our experience to date, progressing through a five-phase model, is aimed at providing the best health information possible to the widest population possible.

  17. A Scalable Framework to Detect Personal Health Mentions on Twitter

    PubMed Central

    Fabbri, Daniel; Rosenbloom, S Trent

    2015-01-01

    Background Biomedical research has traditionally been conducted via surveys and the analysis of medical records. However, these resources are limited in their content, such that non-traditional domains (eg, online forums and social media) have an opportunity to supplement the view of an individual’s health. Objective The objective of this study was to develop a scalable framework to detect personal health status mentions on Twitter and assess the extent to which such information is disclosed. Methods We collected more than 250 million tweets via the Twitter streaming API over a 2-month period in 2014. The corpus was filtered down to approximately 250,000 tweets, stratified across 34 high-impact health issues, based on guidance from the Medical Expenditure Panel Survey. We created a labeled corpus of several thousand tweets via a survey, administered over Amazon Mechanical Turk, that documents when terms correspond to mentions of personal health issues or an alternative (eg, a metaphor). We engineered a scalable classifier for personal health mentions via feature selection and assessed its potential over the health issues. We further investigated the utility of the tweets by determining the extent to which Twitter users disclose personal health status. Results Our investigation yielded several notable findings. First, we find that tweets from a small subset of the health issues can train a scalable classifier to detect health mentions. Specifically, training on 2000 tweets from four health issues (cancer, depression, hypertension, and leukemia) yielded a classifier with precision of 0.77 on all 34 health issues. Second, Twitter users disclosed personal health status for all health issues. Notably, personal health status was disclosed over 50% of the time for 11 out of 34 (33%) investigated health issues. Third, the disclosure rate was dependent on the health issue in a statistically significant manner (P<.001). For instance, more than 80% of the tweets about

  18. Perceived assistance in pursuing personal goals and personal recovery among mental health consumers across housing services.

    PubMed

    Moran, Galia S; Westman, Kinneret; Weissberg, Esther; Melamed, Samuel

    2017-03-01

    Personal goals/plans play a central role in personal recovery and psychiatric rehabilitation of persons with mental illnesses. Yet, few studies have explored whether perceiving practitioners' assistance towards the pursuit of goals are associated with personal recovery and other favorable rehabilitation outcomes. A total of 2121 mental health consumers, of which 1222 use supported-housing services and 899 use group-home services, completed self-report questionnaires as part of a larger quality-assurance study conducted during the years 2013-2014. Eighty percent of participants living in supported-housing and 72% living in group-homes reported having personal goals/plans for the forthcoming year. Furthermore, their type of goals was different. Irrespective of the type of goal or housing service, participants who reported having goals/plans (compared with those who did not) showed higher levels of personal recovery and more favorable psychosocial outcomes. Regression analyses showed that perceiving professional staff members (but not para-professionals) as assisting in pursuing goals/plans was positively associated with personal recovery. This study empirically validates the value of having personal goals and professionals' assistance in pursuing goals/plans in regards to personal recovery. We propose that recovery-oriented services should seek to enhance goal setting and goal-pursuit, and to train practitioners in these areas. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  19. Evolving health care through personal genomics.

    PubMed

    Rehm, Heidi L

    2017-04-01

    With the rapid evolution of next-generation DNA sequencing technologies, the cost of sequencing a human genome has plummeted, and genomics has started to pervade health care across all stages of life - from preconception to adult medicine. Challenges to fully embracing genomics in a clinical setting remain, but some approaches are starting to overcome these barriers, such as community-driven data sharing to improve the accuracy and efficiency of applying genomics to patient care.

  20. Tracing personalized health curves during infections.

    PubMed

    Schneider, David S

    2011-09-01

    It is difficult to describe host-microbe interactions in a manner that deals well with both pathogens and mutualists. Perhaps a way can be found using an ecological definition of tolerance, where tolerance is defined as the dose response curve of health versus parasite load. To plot tolerance, individual infections are summarized by reporting the maximum parasite load and the minimum health for a population of infected individuals and the slope of the resulting curve defines the tolerance of the population. We can borrow this method of plotting health versus microbe load in a population and make it apply to individuals; instead of plotting just one point that summarizes an infection in an individual, we can plot the values at many time points over the course of an infection for one individual. This produces curves that trace the course of an infection through phase space rather than over a more typical timeline. These curves highlight relationships like recovery and point out bifurcations that are difficult to visualize with standard plotting techniques. Only nine archetypical curves are needed to describe most pathogenic and mutualistic host-microbe interactions. The technique holds promise as both a qualitative and quantitative approach to dissect host-microbe interactions of all kinds.

  1. Tracing Personalized Health Curves during Infections

    PubMed Central

    Schneider, David S.

    2011-01-01

    It is difficult to describe host–microbe interactions in a manner that deals well with both pathogens and mutualists. Perhaps a way can be found using an ecological definition of tolerance, where tolerance is defined as the dose response curve of health versus parasite load. To plot tolerance, individual infections are summarized by reporting the maximum parasite load and the minimum health for a population of infected individuals and the slope of the resulting curve defines the tolerance of the population. We can borrow this method of plotting health versus microbe load in a population and make it apply to individuals; instead of plotting just one point that summarizes an infection in an individual, we can plot the values at many time points over the course of an infection for one individual. This produces curves that trace the course of an infection through phase space rather than over a more typical timeline. These curves highlight relationships like recovery and point out bifurcations that are difficult to visualize with standard plotting techniques. Only nine archetypical curves are needed to describe most pathogenic and mutualistic host–microbe interactions. The technique holds promise as both a qualitative and quantitative approach to dissect host–microbe interactions of all kinds. PMID:21957398

  2. Is Personality Associated with Health Care Use by Older Adults?

    PubMed Central

    Friedman, Bruce; Veazie, Peter J; Chapman, Benjamin P; Manning, Willard G; Duberstein, Paul R

    2013-01-01

    Context The patterns of health care utilization in the United States pose well-established challenges for public policy. Although economic and sociological research has resulted in considerable knowledge about what influences the use of health services, the psychological literature in this area is underdeveloped. Importantly, it is not known whether personality traits are associated with older adults’ use of acute and long-term care services. Methods Data were collected from 1,074 community-dwelling seniors participating in a Medicare demonstration. First they completed a self-report questionnaire measuring the “Big Five” personality traits: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. During the next two years, the participants maintained daily journals of their use of health care services. We used regression models based on the Andersen behavioral model of health care utilization to test for associations. Findings Our hypothesis that higher Neuroticism would be associated with greater health care use was confirmed for three services—probability of any emergency department (ED) use, likelihood of any custodial nursing home use, and more skilled nursing facility (SNF) days for SNF users—but was disconfirmed for hospital days for those hospitalized. Higher Openness to Experience was associated with a greater likelihood of custodial home care use, and higher Agreeableness and lower Conscientiousness with a higher probability of custodial nursing home use. For users, lower Openness was associated with more ED visits and SNF days, and lower Conscientiousness with more ED visits. For many traits with significant associations, the predicted use was 16 to 30 percent greater for people high (low) versus low (high) in specific traits. Conclusions Personality traits are associated with Medicare beneficiaries’ use of many expensive health care services, findings that have implications for health services research and

  3. Is personality associated with health care use by older adults?

    PubMed

    Friedman, Bruce; Veazie, Peter J; Chapman, Benjamin P; Manning, Willard G; Duberstein, Paul R

    2013-09-01

    The patterns of health care utilization in the United States pose well-established challenges for public policy. Although economic and sociological research has resulted in considerable knowledge about what influences the use of health services, the psychological literature in this area is underdeveloped. Importantly, it is not known whether personality traits are associated with older adults' use of acute and long-term care services. Data were collected from 1,074 community-dwelling seniors participating in a Medicare demonstration. First they completed a self-report questionnaire measuring the "Big Five" personality traits: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. During the next two years, the participants maintained daily journals of their use of health care services. We used regression models based on the Andersen behavioral model of health care utilization to test for associations. Our hypothesis that higher Neuroticism would be associated with greater health care use was confirmed for three services-probability of any emergency department (ED) use, likelihood of any custodial nursing home use, and more skilled nursing facility (SNF) days for SNF users-but was disconfirmed for hospital days for those hospitalized. Higher Openness to Experience was associated with a greater likelihood of custodial home care use, and higher Agreeableness and lower Conscientiousness with a higher probability of custodial nursing home use. For users, lower Openness was associated with more ED visits and SNF days, and lower Conscientiousness with more ED visits. For many traits with significant associations, the predicted use was 16 to 30 percent greater for people high (low) versus low (high) in specific traits. Personality traits are associated with Medicare beneficiaries' use of many expensive health care services, findings that have implications for health services research and policy. Accordingly, person-centered interventions

  4. Clinical Preventive Services for Older Adults: The Interface Between Personal Health Care and Public Health Services

    PubMed Central

    Richards, Chesley L.; Shenson, Douglas

    2012-01-01

    Healthy aging must become a priority objective for both population and personal health services, and will require innovative prevention programming to span those systems. Uptake of essential clinical preventive services is currently suboptimal among adults, owing to a number of system- and office-based care barriers. To achieve maximum health results, prevention must be integrated across community and clinical settings. Many preventive services are portable, deliverable in either clinical or community settings. Capitalizing on that flexibility can improve uptake and health outcomes. Significant reductions in health disparities, mortality, and morbidity, along with decreases in health spending, are achievable through improved collaboration and synergy between population health and personal health systems. PMID:22390505

  5. Moving toward Personalized Medicine in the Methadone Maintenance Treatment Program: A Pilot Study on the Evaluation of Treatment Responses in Taiwan

    PubMed Central

    Lee, Hsin-Ya; Li, Jih-Heng; Sheu, Yuh-Ling; Tang, Hsin-Pei; Chang, Wei-Chiao; Tang, Tze-Chun; Yeh, Yi-Chun; Wang, Shing-Yaw; Liu, Ray-H.

    2013-01-01

    This pilot study simultaneously evaluated the effects of various factors, including genetic variations of CYP2B6, CYP2C19, and ABCB1, demographic characteristics, disease states, methadone-drug interactions (MDIs), and poly-substance use, on the treatment responses among non-HIV patients in the methadone maintenance treatment program (MMTP) in Taiwan. A total of 178 patients were recruited from two major hospitals that provided MMTP services in southern Taiwan, and information regarding concomitant medications and diseases was acquired from the National Health Insurance (NHI) program. The results demonstrated that the methadone maintenance dose, CYP2B6 785G allele, and ABCB1 2677T allele have positive effects on the methadone plasma concentration. In contrast, patients with HCV coinfection, alcohol problems, and psychiatric diseases may have a negative response to treatment. Thus, a comprehensive evaluation of treatment responses in the MMTP should include not only genetic polymorphisms in methadone metabolism and transporter proteins, but also concomitant diseases, MDIs, and poly-substance use. The results also suggest that personalized medicine may be indispensable for a better outcome of the MMTP. PMID:24455721

  6. Moving toward personalized medicine in the methadone maintenance treatment program: a pilot study on the evaluation of treatment responses in Taiwan.

    PubMed

    Lee, Hsin-Ya; Li, Jih-Heng; Sheu, Yuh-Ling; Tang, Hsin-Pei; Chang, Wei-Chiao; Tang, Tze-Chun; Yeh, Yi-Chun; Wang, Shing-Yaw; Liu, Ray-H

    2013-01-01

    This pilot study simultaneously evaluated the effects of various factors, including genetic variations of CYP2B6, CYP2C19, and ABCB1, demographic characteristics, disease states, methadone-drug interactions (MDIs), and poly-substance use, on the treatment responses among non-HIV patients in the methadone maintenance treatment program (MMTP) in Taiwan. A total of 178 patients were recruited from two major hospitals that provided MMTP services in southern Taiwan, and information regarding concomitant medications and diseases was acquired from the National Health Insurance (NHI) program. The results demonstrated that the methadone maintenance dose, CYP2B6 785G allele, and ABCB1 2677T allele have positive effects on the methadone plasma concentration. In contrast, patients with HCV coinfection, alcohol problems, and psychiatric diseases may have a negative response to treatment. Thus, a comprehensive evaluation of treatment responses in the MMTP should include not only genetic polymorphisms in methadone metabolism and transporter proteins, but also concomitant diseases, MDIs, and poly-substance use. The results also suggest that personalized medicine may be indispensable for a better outcome of the MMTP.

  7. Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine

    PubMed Central

    Chapman, Benjamin P.; Roberts, Brent; Duberstein, Paul

    2011-01-01

    We review evidence for links between personality traits and longevity. We provide an overview of personality for health scientists, using the primary organizing framework used in the study of personality and longevity. We then review data on various aspects of personality linked to longevity. In general, there is good evidence that higher level of conscientiousness and lower levels of hostility and Type D or “distressed” personality are associated with greater longevity. Limited evidence suggests that extraversion, openness, perceived control, and low levels of emotional suppression may be associated with longer lifespan. Findings regarding neuroticism are mixed, supporting the notion that many component(s) of neuroticism detract from life expectancy, but some components at some levels may be healthy or protective. Overall, evidence suggests various personality traits are significant predictors of longevity and points to several promising directions for further study. We conclude by discussing the implications of these links for epidemiologic research and personalized medicine and lay out a translational research agenda for integrating the psychology of individual differences into public health and medicine. PMID:21766032

  8. Movement Advocacy, Personal Relationships, and Ending Health Care Disparities.

    PubMed

    Chin, Marshall H

    2017-01-01

    Deep-rooted structural problems drive health care disparities. Compounding the difficulty of attaining health equity, solutions in clinics and hospitals require the cooperation of clinicians, administrators, patients, and the community. Recent protests over police brutality and racism on campuses across America have opened fresh wounds over how best to end racism, with lessons for achieving health equity. Movement advocacy, the mobilizing of the people to raise awareness of an injustice and to advocate for reform, can break down ingrained structural barriers and policies that impede health equity. However, simultaneously advocates, clinicians, and health care organizations must build trusting relationships and resolve conflict with mutual respect and honesty. Tension is inherent in discussions about racial and ethnic disparities. Yet, tension can be constructive if it forces self-examination and spurs systems change and personal growth. We must simultaneously advocate for policy reform, build personal relationships across diverse groups, and honestly examine our biases.

  9. How to enhance integrated care towards the personal health paradigm?

    PubMed

    Blobel, Bernd G M E; Pharow, Peter; Norgall, Thomas

    2007-01-01

    For improving quality and efficiency of health delivery under the well-known burdens, the health service paradigm has to change from organization-centered over process-controlled to personal health. The growing complexity of highly distributed and fully integrated healthcare settings can only be managed through an advanced architectural approach, which has to include all dimensions of personal health. Here, ICT, medicine, biomedical engineering, bioinformatics and genomics, legal and administrative aspects, terminology and ontology have to be mentioned. The Generic Component Model allows for different domains' concept representation and aggregation. Framework, requirements, methodology and process design possibilities for such a future-proof and meanwhile practically demonstrated approach are discussed in detail. The deployment of the Generic Component Model and the concept representation to biomedical engineering aspects of eHealth are touched upon as essential issues.

  10. Role of sport and exercise in the maintenance of female bone health.

    PubMed

    Iwamoto, Jun; Sato, Yoshihiro; Takeda, Tsuyoshi; Matsumoto, Hideo

    2009-01-01

    Osteoporosis most commonly affects postmenopausal women, placing them at a significant risk for fractures. The strategies for preventing osteoporotic fractures are maximizing peak bone mass, counteracting age- and menopause-related bone loss, minimizing the increase in spinal kyphosis, and preventing falls. Thus, the aim of sport and exercise appears to differ among ages in the maintenance of bone health in females. Given that maximizing peak bone mass is the most important strategy for preventing fractures in later life, interventions may therefore be needed before the menarche (during the growth spurt) in children. The efficacy of sport activity and exercise in all strategies has been established, although there is no evidence that sport and exercise are able to prevent hip fractures. However, sport activity and exercise across the life span of the average female should be encouraged in the maintenance of bone health.

  11. The usability of electronic personal health record systems for an underserved adult population.

    PubMed

    Czaja, Sara J; Zarcadoolas, Christina; Vaughon, Wendy L; Lee, Chin Chin; Rockoff, Maxine L; Levy, Joslyn

    2015-05-01

    The goals of this study were to identify the demands associated with using electronic personal health records (PHRs) and to evaluate the ability of adults of lower socioeconomic status and low health literacy to use PHRs to perform health management activities. PHRs are proliferating in clinical practices and health care organizations. These systems offer the potential of increasing the active involvement of patients in health self-management. However, little is known about the actual usability of these tools for health consumers. We used task analysis and health literacy load analysis to identify the cognitive and literacy demands inherent in the use of PHRs and evaluated the usability of three currently available PHR systems with a sample of 54 adults. Participants used the systems to perform tasks related to medication management, interpretation of lab/test results, and health maintenance. Data were also gathered on the participants' perception of the potential value of using a PHR. The results indicated that a majority of the participants had difficulty completing the tasks and needed assistance. There was some variability according to task and PHR system. However, most participants perceived the use of PHRs as valuable. Although considered a valuable tool by consumers, the use of PHR systems may be challenging for many people. Strategies are needed to enhance the usability of these systems, especially for people with low literacy, low health literacy, or limited technology skills. The data from this study have implications for the design of PHRs. © 2014, Human Factors and Ergonomics Society.

  12. The Usability of Electronic Personal Health Record Systems for an Underserved Adult Population

    PubMed Central

    Czaja, Sara J.; Zarcadoolas, Christina; Vaughon, Wendy L.; Lee, Chin Chin; Rockoff, Maxine L.; Levy, Joslyn

    2015-01-01

    Objective The goals of this study were to identify the demands associated with using electronic personal health records (PHRs) and to evaluate the ability of adults of lower socioeconomic status and low health literacy to use PHRs to perform health management activities. Background PHRs are proliferating in clinical practices and health care organizations. These systems offer the potential of increasing the active involvement of patients in health self-management. However, little is known about the actual usability of these tools for health consumers. Method We used task analysis and health literacy load analysis to identify the cognitive and literacy demands inherent in the use of PHRs and evaluated the usability of three currently available PHR systems with a sample of 54 adults. Participants used the systems to perform tasks related to medication management, interpretation of lab/test results, and health maintenance. Data were also gathered on the participants’ perception of the potential value of using a PHR. Results The results indicated that a majority of the participants had difficulty completing the tasks and needed assistance. There was some variability according to task and PHR system. However, most participants perceived the use of PHRs as valuable. Conclusions Although considered a valuable tool by consumers, the use of PHR systems may be challenging for many people. Strategies are needed to enhance the usability of these systems, especially for people with low literacy, low health literacy, or limited technology skills. Application The data from this study have implications for the design of PHRs. PMID:25875437

  13. Prevalence and demographic and clinical associations of health literacy in patients on maintenance hemodialysis.

    PubMed

    Green, Jamie A; Mor, Maria K; Shields, Anne Marie; Sevick, Mary Ann; Palevsky, Paul M; Fine, Michael J; Arnold, Robert M; Weisbord, Steven D

    2011-06-01

    Although limited health literacy is estimated to affect over 90 million Americans and is recognized as an important public health concern, there have been few studies examining this issue in patients with chronic kidney disease. We sought to characterize the prevalence of and associations of demographic and clinical characteristics with limited health literacy in patients receiving maintenance hemodialysis. As part of a prospective clinical trial of symptom management strategies in 288 patients treated with chronic hemodialysis, we assessed health literacy using the Rapid Estimate of Adult Literacy in Medicine (REALM). We defined limited health literacy as a REALM score ≤60 and evaluated independent associations of demographic and baseline clinical characteristics with limited health literacy using multivariable logistic regression. Of the 260 patients who completed the REALM, 41 demonstrated limited health literacy. African-American race, lower educational level, and veteran status were independently associated with limited health literacy. There was no association of limited health literacy with age, gender, serologic values, dialysis adequacy, overall symptom burden, quality of life, or depression. Limited health literacy is common among patients receiving chronic hemodialysis. African-American race and socioeconomic factors are strong independent predictors of limited health literacy. These findings can help inform the design and implementation of interventions to improve health literacy in the hemodialysis population.

  14. Prospective Care of Elderly Patients in Family Practice Part 1: Health Maintenance for the Elderly

    PubMed Central

    Hay, W. Ian

    1990-01-01

    The author examines Canadian demographic data that underline the urgency of planning future services for the elderly. “Health” of the elderly is defined as not simply the absence of infirmity, but rather the ability to function and maintain quality of life. The components of a health maintenance plan are discussed, as well as some of the practical and political issues that must be dealt with for such a program to be fully effective. PMID:21233960

  15. The future of highly personalized health care.

    PubMed

    Robson, Barry; Garnier, Jean

    2002-01-01

    We can surely lean well towards the optimistic in envisioning health care. In the world 10-25 years ahead of us. This optimism is based on rapid developments in genomics, the essential basis of molecular medicine, and on advances in computer power. At the time of writing this paper, the Human Genome Project was planned to have a working draft by 2000 and indeed completion was announced on June 26th from Washington. This paper describes the situation and vision at that time. Though there has been much subsequent more thought about the influence of genomics on healthcare, the aspirations and visions have not fundamentally changed from those of 2000, except for the greater attention to practical details that comes from increased confidence in the practicality of the vision.

  16. Health maintenance organizations; MetroCare Inc.; revocation of federal qualification--Public Health Service. Notice, continued regulation of health maintenance organizations: determination of noncompliance and revocation of federal qualification.

    PubMed

    1982-05-19

    On September 19, 1980, the Office of Health Maintenance Organizations (OHMO) determined that MetroCare, Inc., (MetroCare), 1701 West Euless Boulevard, Euless, Texas 76039, a federally qualified health maintenance organization (HMO), was not in compliance with the assurances it has provided to the Secretary that it would (1) maintain a fiscally sound operation and (2) maintain satisfactory administrative and managerial arrangements. On April 26, 1982, the Director of OHMO notified MetroCare that he was revoking MetroCare's Federal qualification and this revocation would become effective the fifth working day after receipt of this letter. Accordingly, MetroCare is no longer a federally qualified HMO.

  17. Building a science of personalized intervention for youth mental health

    PubMed Central

    Ng, Mei Yi; Weisz, John R.

    2015-01-01

    Background Within the past decade, healthcare service and research priorities have shifted from evidence-based medicine to personalized medicine. In mental healthcare, a similar shift to personalized intervention may boost the effectiveness and clinical utility of empirically supported therapies (ESTs). Aims and Scope The emerging science of personalized intervention will need to encompass evidence-based methods for determining which problems to target and in which order, selecting treatments and deciding whether and how to combine them, and informing ongoing clinical decision-making through monitoring of treatment response throughout episodes of care. We review efforts to develop these methods, drawing primarily from psychotherapy research with youths. Then we propose strategies for building a science of personalized intervention in youth mental health. Findings The growing evidence base for personalizing interventions includes research on therapies adapted for specific subgroups; treatments targeting youths’ environments; modular therapies; sequential, multiple assignment, randomized trials; measurement feedback systems; meta-analyses comparing treatments for specific patient characteristics; data-mining decision trees; and individualized metrics. Conclusion The science of personalized intervention presents questions that can be addressed in several ways. First, to evaluate and organize personalized interventions, we propose modifying the system used to evaluate and organize ESTs. Second, to help personalizing research keep pace with practice needs, we propose exploiting existing randomized trial data to inform personalizing approaches, prioritizing the personalizing approaches likely to have the greatest impact, conducting more idiographic research, and studying tailoring strategies in usual care. Third, to encourage clinicians’ use of personalized intervention research to inform their practice, we propose expanding outlets for research summaries and case

  18. Gender: shaping personality, lives and health of women in Pakistan

    PubMed Central

    2014-01-01

    Background Gender norms determine the status of Pakistani women that influence their life including health. In Pakistan, the relationship between gender norms and health of women is crucial yet complex demanding further analysis. This paper: determines the reasons for reiteration of gender roles; describes the societal processes and mechanisms that reproduce and reinforce them; and identifies their repercussions on women’s personality, lives and health especially reproductive health. Methods As part of a six-country study titled ‘Women’s Empowerment in Muslim Contexts’, semi-structured group discussions (n = 30) were conducted with women (n = 250) who were selected through snowballing from different age, ethnic and socio-economic categories. Discussion guidelines were used to collect participant’s perceptions about Pakistani women’s: characteristics, powers, aspirations, needs and responsibilities; circumstances these women live in such as opportunities, constraints and risks; and influence of these circumstances on their personality, lifestyle and health. Results The society studied has constructed a ‘Model’ for women that consider them ‘Objects’ without rights and autonomy. Women’s subordination, a prerequisite to ensure compliance to the constructed model, is maintained through allocation of lesser resources, restrictions on mobility, seclusion norms and even violence in cases of resistance. The model determines women’s traits and responsibilities, and establishes parameters for what is legitimate for women, and these have implications for their personality, lifestyle and health, including their reproductive behaviours. Conclusion There is a strong link between women’s autonomy, rights, and health. This demands a gender sensitive and a, right-based approach towards health. In addition to service delivery interventions, strategies are required to counter factors influencing health status and restricting access to and utilization

  19. Gender: shaping personality, lives and health of women in Pakistan.

    PubMed

    Rizvi, Narjis; S Khan, Kausar; Shaikh, Babar T

    2014-04-01

    Gender norms determine the status of Pakistani women that influence their life including health. In Pakistan, the relationship between gender norms and health of women is crucial yet complex demanding further analysis. This paper: determines the reasons for reiteration of gender roles; describes the societal processes and mechanisms that reproduce and reinforce them; and identifies their repercussions on women's personality, lives and health especially reproductive health. As part of a six-country study titled 'Women's Empowerment in Muslim Contexts', semi-structured group discussions (n = 30) were conducted with women (n = 250) who were selected through snowballing from different age, ethnic and socio-economic categories. Discussion guidelines were used to collect participant's perceptions about Pakistani women's: characteristics, powers, aspirations, needs and responsibilities; circumstances these women live in such as opportunities, constraints and risks; and influence of these circumstances on their personality, lifestyle and health. The society studied has constructed a 'Model' for women that consider them 'Objects' without rights and autonomy. Women's subordination, a prerequisite to ensure compliance to the constructed model, is maintained through allocation of lesser resources, restrictions on mobility, seclusion norms and even violence in cases of resistance. The model determines women's traits and responsibilities, and establishes parameters for what is legitimate for women, and these have implications for their personality, lifestyle and health, including their reproductive behaviours. There is a strong link between women's autonomy, rights, and health. This demands a gender sensitive and a, right-based approach towards health. In addition to service delivery interventions, strategies are required to counter factors influencing health status and restricting access to and utilization of services. Improvement in women's health is bound to have

  20. Structural health and prognostics management for the enhancement of offshore wind turbine operations and maintenance strategies

    DOE PAGES

    Griffith, D. Todd; Yoder, Nathanael C.; Resor, Brian; ...

    2013-09-19

    Offshore wind turbines are an attractive source for clean and renewable energy for reasons including their proximity to population centers and higher capacity factors. One obstacle to the more widespread installation of offshore wind turbines in the USA, however, is that recent projections of offshore operations and maintenance costs vary from two to five times the land-based costs. One way in which these costs could be reduced is through use of a structural health and prognostics management (SHPM) system as part of a condition-based maintenance paradigm with smart loads management. Our paper contributes to the development of such strategies bymore » developing an initial roadmap for SHPM, with application to the blades. One of the key elements of the approach is a multiscale simulation approach developed to identify how the underlying physics of the system are affected by the presence of damage and how these changes manifest themselves in the operational response of a full turbine. A case study of a trailing edge disbond is analysed to demonstrate the multiscale sensitivity of damage approach and to show the potential life extension and increased energy capture that can be achieved using simple changes in the overall turbine control and loads management strategy. Finally, the integration of health monitoring information, economic considerations such as repair costs versus state of health, and a smart loads management methodology provides an initial roadmap for reducing operations and maintenance costs for offshore wind farms while increasing turbine availability and overall profit.« less

  1. Structural health and prognostics management for the enhancement of offshore wind turbine operations and maintenance strategies

    SciTech Connect

    Griffith, D. Todd; Yoder, Nathanael C.; Resor, Brian; White, Jonathan; Paquette, Joshua

    2013-09-19

    Offshore wind turbines are an attractive source for clean and renewable energy for reasons including their proximity to population centers and higher capacity factors. One obstacle to the more widespread installation of offshore wind turbines in the USA, however, is that recent projections of offshore operations and maintenance costs vary from two to five times the land-based costs. One way in which these costs could be reduced is through use of a structural health and prognostics management (SHPM) system as part of a condition-based maintenance paradigm with smart loads management. Our paper contributes to the development of such strategies by developing an initial roadmap for SHPM, with application to the blades. One of the key elements of the approach is a multiscale simulation approach developed to identify how the underlying physics of the system are affected by the presence of damage and how these changes manifest themselves in the operational response of a full turbine. A case study of a trailing edge disbond is analysed to demonstrate the multiscale sensitivity of damage approach and to show the potential life extension and increased energy capture that can be achieved using simple changes in the overall turbine control and loads management strategy. Finally, the integration of health monitoring information, economic considerations such as repair costs versus state of health, and a smart loads management methodology provides an initial roadmap for reducing operations and maintenance costs for offshore wind farms while increasing turbine availability and overall profit.

  2. Maintenance of the classroom health education curricula: results from the CATCH-ON study.

    PubMed

    Johnson, Carolyn C; Li, Donglin; Galati, Todd; Pedersen, Sheryl; Smyth, Mary; Parcel, Guy S

    2003-08-01

    Maintenance of the interactive Child and Adolescent Trial for Cardiovascular Health (CATCH) third- to fifth-grade curricula was studied in the 56 original intervention schools and 20 of the original control schools 5 years postintervention in four regions of the United States. Target grade teachers completed a self-administered survey that included questions regarding use of the CATCH materials, training in CATCH or other health education, barriers and perceived support for health education, and amount of health education currently taught. Percentage of teachers who continued to teach CATCH in the classroom was low; however, percentages were significantly higher in former intervention compared with control schools, even though control schools received training and materials following the main field trial. The results of this study can provide useful information for future development of classroom health promotion materials with a higher level of sustainability.

  3. 42 CFR 476.72 - Review of the quality of care of risk-basis health maintenance organizations and competitive...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... sanctions on health care practitioners and providers. ... 42 Public Health 4 2010-10-01 2010-10-01 false Review of the quality of care of risk-basis health maintenance organizations and competitive medical plans. 476.72 Section 476.72 Public Health CENTERS...

  4. Universal Health Insurance and Health Care Access for Homeless Persons

    PubMed Central

    Ueng, Joanna J. M.; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A.

    2010-01-01

    Objectives. We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. Methods. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Results. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Conclusions. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored. PMID:20558789

  5. Universal health insurance and health care access for homeless persons.

    PubMed

    Hwang, Stephen W; Ueng, Joanna J M; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A

    2010-08-01

    We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored.

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

    ERIC Educational Resources Information Center

    Nutting, Paul A.; And Others

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

  7. Personality disorders and the DSM-5: Scientific and extra-scientific factors in the maintenance of the status quo.

    PubMed

    Gøtzsche-Astrup, Oluf; Moskowitz, Andrew

    2016-02-01

    The aim of this study was to review and discuss the evidence for dimensional classification of personality disorders and the historical and sociological bases of psychiatric nosology and research. Categorical and dimensional conceptualisations of personality disorder are reviewed, with a focus on the Diagnostic and Statistical Manual of Mental Disorders-system's categorisation and the Five-Factor Model of personality. This frames the events leading up to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, personality disorder debacle, where the implementation of a hybrid model was blocked in a last-minute intervention by the American Psychiatric Association Board of Trustees. Explanations for these events are discussed, including the existence of invisible colleges of researchers and the fear of risking a 'scientific revolution' in psychiatry. A failure to recognise extra-scientific factors at work in classification of mental illness can have a profound and long-lasting influence on psychiatric nosology. In the end it was not scientific factors that led to the failure of the hybrid model of personality disorders, but opposing forces within the mental health community in general and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Task Force in particular. Substantial evidence has accrued over the past decades in support of a dimensional model of personality disorders. The events surrounding the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Personality and Personality Disorders Work Group show the difficulties in reconciling two different worldviews with a hybrid model. They also indicate the future of a psychiatric nosology that will be increasingly concerned with dimensional classification of mental illness. As such, the road is paved for more substantial changes to personality disorder classification in the International Classification of Diseases, 11th Revision, in 2017. © The Royal Australian and

  8. Project HealthDesign: stimulating the next generation of personal health records.

    PubMed

    Brennan, Patricia Flatley; Downs, Stephen; Casper, Gail; Kenron, Daniel

    2007-10-11

    Project HealthDesign is a national program designed to rethink the power and potential of personal health to rethink the power and potential of personal health records. It intends to stimulate development of new personal health management tools by harnessing the content of the personal health record and making advice, recommendations, and data-tracking tools available to lay people. The program goals include creating a set of prototype personal health records applications, deriving the core functions needed to support interoperable 'plug-and-play' resources for managing health challenges, and addressing the ethical, legal, and social issues that confront the development of computer tools to promote health actions. Response to the call for proposals was tremendous; from the over 160 groups who submitted proposals, 9 teams were selected to design and create prototypes of innovative personal health management tools. This paper summarizes the full set of proposals, their populations of interest, and the technical challenges that await full implementation of the PHR-based applications designed to promote health.

  9. Institutional profile: University of Florida Health Personalized Medicine Program.

    PubMed

    Cavallari, Larisa H; Weitzel, Kristin W; Elsey, Amanda R; Liu, Xinyue; Mosley, Scott A; Smith, Donald M; Staley, Benjamin J; Winterstein, Almut G; Mathews, Carol A; Franchi, Francesco; Rollini, Fabiana; Angiolillo, Dominick J; Starostik, Petr; Clare-Salzler, Michael J; Nelson, David R; Johnson, Julie A

    2017-04-01

    The University of Florida (UF) Health Personalized Medicine Program launched in 2012 with CYP2C19 genotyping for clopidogrel response at UF Health Shands Hospital. We have since expanded CYP2C19 genotyping to UF Health Jacksonville and established the infrastructure at UF Health to support clinical implementation for five additional gene-drug pairs: TPMT-thiopurines, IFNL3 (IL28B)-PEG IFN-α-based regimens, CYP2D6-opioids, CYP2D6/CYP2C19-antidepressants and CYP2C19-proton pump inhibitors. We are contributing to the evidence based on outcomes with genotype-guided therapy through pragmatic studies of our clinical implementations. In addition, we have developed a broad array of educational programs for providers, trainees and students that incorporate personal genotype evaluation to enhance participant learning.

  10. Social health maintenance organizations' service use and costs, 1985-89

    PubMed Central

    Harrington, Charlene; Newcomer, Robert J.

    1991-01-01

    Presented in this article are aggregate utilization and financial data from the four social health maintenance organization (SIHMO) demonstrations that were collected and analyzed as a part of the national evaluation of the SIHMO demonstration project conducted for the Health Care Financing Administration. The S/HMOs, in offering a $6,500 to $12,000 chronic care benefit in addition to the basic HMO benefit package, had higher startup costs and financial losses over the first 5 years than expected, and controlling costs continues to be a challenge to the sites and their sponsors. PMID:10113612

  11. Financial performance in the social health maintenance organization, 1985-88

    PubMed Central

    Leutz, Walter; Malone, Joelyn; Kistner, Marlin; O'Bar, Tim; Ripley, Jeanne M.; Sandhaus, Martin

    1990-01-01

    Since early 1985, four social health maintenance organizations have delivered integrated health and long-term care services to Medicare beneficiaries under congressionally mandated waivers that included shared public-program risk for losses. Three of four sites had substantial losses in the first 3 years, primarily because of slow enrollment and resultant high marketing and administrative costs. After assuming full risk, two of the three showed surpluses in 1988. Service and management costs for expanded long-term care were similar across sites and were affordable within the framework of Medicare and Medicaid reimbursement and private premiums. PMID:10113466

  12. [Concept of personal data relating to health in the law of personal data protection].

    PubMed

    Navarrete, Jesús Rubí

    2006-01-01

    The Law on the Protection of Data states that health data are sensible data and therefore subject to a strengthened system of guarantees. In order to apply this, the information must make reference to physical persons and must be susceptible of being included within the concept of health data. The resolutions of the Spanish Agency for Data Protection and the rulings of the Courts provide very valuable elements to clarify both concepts.

  13. Consumer support for health information exchange and personal health records: a regional health information organization survey.

    PubMed

    Patel, Vaishali N; Dhopeshwarkar, Rina V; Edwards, Alison; Barrón, Yolanda; Sparenborg, Jeffrey; Kaushal, Rainu

    2012-06-01

    In order to characterize consumer support for electronic health information exchange (HIE) and personal health records (PHRs) in a community where HIE is underway, we conducted a survey of English speaking adults who visited primary care practices participating in a regional community-wide clinical data exchange, during August, 2008. Amongst the 117 respondents, a majority supported physicians' use of HIE (83%) or expressed interest in potentially using PHRs (76%). Consumers' comfort sending personal information electronically over the Internet and their perceptions regarding the potential benefits of HIE were independently associated with their support for HIE. Consumers' prior experience using the Internet to manage their healthcare, perceptions regarding the potential benefits of PHRs and college education were independently associated with potential PHR use. Bolstering consumer support for HIE and PHRs will require addressing privacy and security concerns, demonstrating clinical benefits, and reaching out to those who are less educated and computer literate.

  14. Persons with Alzheimer's disease perform daily activities using verbal-instruction technology: a maintenance assessment.

    PubMed

    Lancioni, Giulio; Singh, Nirbhay; O'Reilly, Mark; Zonno, Nadia; Cassano, Germana; De Vanna, Floriana; De Bari, Anna Laura; Pinto, Katia; Minervini, Mauro

    2010-01-01

    To assess whether verbal-instruction technology could help persons with mild and moderate Alzheimer's disease maintain their recaptured performance of daily activities. This study followed nine patients who had participated in previous studies aimed at helping them recapture one or more functional daily activities (i.e. table setting, coffee, tea or snack preparation, use of make-up and shaving). The plan was to follow each patient for at least 6 months after the intervention, unless his/her condition called for an earlier end of the study. The study was interrupted after 5 months for two patients who developed serious behavioural problems and continued for 6-14 months for the other seven patients who had largely accurate performance with some adaptations of instructions/steps. Most patients also showed mood improvement during activity. Verbal-instruction technology might be considered a critical tool to help persons with Alzheimer's disease enhance their activity and mood.

  15. Personality traits, motivation and bone health in vegetarians.

    PubMed

    Bobić, Jasminka; Cvijetić, Selma; Barić, Irena Colić; Satalić, Zvonimir

    2012-09-01

    Vegetarian diets attract more and more attention due to growing concerns about health, ecology and/or animal welfare in general population. The main purpose of this paper was to examine whether vegetarianism could be associated with some specific personality characteristics, with the emphasis on the main motivational factors which determined acquiring the diet. Since the nutrition is also an important determinant of bone health we additionally analyzed the association between personal characteristics and bone density. On a sample of 109 adult vegetarians of both sexes we applied Eysenck Personality Questionnaire (including Psychoticism, Extraversion, Neuroticism and Lie scale), bone densitometry and questionnaire on dominant motives for dietary choices. The results on overall personality characteristics, bone density and basic anthropometric measures were within expected values for age. Vegetarian men had significantly more fractures during lifetime and lower neuroticism scores than women. Dominant motivational factors for acquiring vegetarianism were moral values. In addition "moral vegetarians" showed more pronounced introversion compared to "health vegetarians", lending further support to the argument that personality plays an important role in the structure of motivation.

  16. Associations between Major Domains of Personality and Health Behavior

    DTIC Science & Technology

    1991-11-01

    lead to more effective, efficient health behavior modification programs. Aeoesson 7or ITI GRA&I DTIC TAB5 Unnnnoanced 5 SJu~ti:Icrti or D31tt ’bu𔃿iOn...further study, however, these barriers might be overcome by designing health behavior modification programs in which participants were assigned to... behavior modification programs matched to their personality predispositions. References Aho, W. R. (1979a). Participation of senior citizens in the

  17. Summary of personal monitoring data for asbestos-related maintenance work at the Lawrence Livermore National Laboratory

    SciTech Connect

    Franaszek, S.M.; Kelly, R.J.

    1996-05-01

    The Lawrence Livermore National Laboratory (LLNL) consists of 665 structures with approximately 6 million square feet of space. Many of the buildings date from the 1940`s to 1980`s and contain asbestos-containing materials (ACM). Maintenance and Operation activities, as well as full scale asbestos abatement and repair, has been conducted for many years. One result of all this activity is that a substantial database of personal monitoring data has been collected. This database is a collection of reported (Fed OSHA) Permissible Exposure Limit (PEL) information, including 8-hour Time Weighted Averages (TWA) and 30-minute Excursion Limit (EL) samples. Because this data represented a wide variety of asbestos removal techniques, materials and sampling strategies and industrial hygienists, a rigorous statistical comparison is of limited value. By summarizing the data by procedure category, procedures likely to result in significant exposures can be identified.

  18. MyHealtheVet (VA's personal health record)

    MedlinePlus

    ... Case of Emergency Profiles Download My Data Account Pharmacy RX Refill Medications + Supplements Research Health Healthy Living ... Case of Emergency Profiles Download My Data Account Pharmacy Pharmacy Pharmacy Home RX Refill Medications + Supplements Research ...

  19. Personality and Health Care Decision-Making Style

    PubMed Central

    Flynn, Kathryn E.; Smith, Maureen A.

    2008-01-01

    Using the Wisconsin Longitudinal Study Graduate Survey (N = 5,830), a population-based cohort of older adults (most aged 63–66 years), we explored relationships between five factors of personality and four preference types that account for multiple components of the health care decision-making process (information exchange, deliberation, and selection of treatment choice). After adjustment for personal, health, social, and economic factors, we found that increased conscientiousness and openness to experience and decreased agreeableness and neuroticism corresponded to preferring the most active decision-making style compared with the least active. A better understanding of how personality traits relate to patient decision-making styles may help clinicians tailor treatment discussions to the needs and preferences of individual patients. PMID:17906167

  20. Health, Supportive Environments, and the Reasonable Person Model

    Treesearch

    Stephen Kaplan; Rachel Kaplan

    2003-01-01

    The Reasonable Person Model is a conceptual framework that links environmental factors with human behavior. People are more reasonable, cooperative, helpful, and satisfied when the environment supports their basic informational needs. The same environmental supports are important factors in enhancing human health. We use this framework to identify the informational...

  1. Increasing incidence of multiple sclerosis among women in Buenos Aires: a 22 year health maintenance organization based study.

    PubMed

    Cristiano, E; Patrucco, L; Miguez, J; Giunta, D; Peroni, J; Rojas, J I

    2016-10-01

    Studies in multiple sclerosis (MS) suggest a trend of increasing disease prevalence and incidence, and especially, a disproportional increase in the incidence of multiple sclerosis in women. The objective of this study was to evaluate the incidence of MS over 22 years and to determine the ratio in incidence of men to women in a health maintenance organization from Buenos Aires, Argentina. The population was made up of all members of a hospital-based HMO affiliated between January 1992 and December 2013. Each person was followed contributing time at risk. Cases with definite diagnosis of MS were included. Incidence density was calculated with 95 % confidence intervals and compared between women and men. 165,456 subjects were followed for a total of 1,488,575 person-years, of whom 42 developed MS. Incidence density was 3/100,000 person-years (95 % CI 2.1-3.5/100,000 person-years). During this period (1992-2013), the incidence rate in women increased from 1/100,000 (95 % CI 0.8-1.6) to 4.9/100,000 (95 % CI 4.1-5.4) (p < 0.001), while in men the incidence ranged from 1.4/100,000 (95 % CI 1-1.7) to 1.8 (1.3-2.1) (p = 0.16). Incidence density during the study period increased significantly in women but not in men. This is the first report of this phenomenon in Latin America region.

  2. What explains health in persons with visual impairment?

    PubMed Central

    2014-01-01

    Background Visual impairment is associated with important limitations in functioning. The International Classification of Functioning, Disability and Health (ICF) adopted by the World Health Organisation (WHO) relies on a globally accepted framework for classifying problems in functioning and the influence of contextual factors. Its comprehensive perspective, including biological, individual and social aspects of health, enables the ICF to describe the whole health experience of persons with visual impairment. The objectives of this study are (1) to analyze whether the ICF can be used to comprehensively describe the problems in functioning of persons with visual impairment and the environmental factors that influence their lives and (2) to select the ICF categories that best capture self-perceived health of persons with visual impairment. Methods Data from 105 persons with visual impairment were collected, including socio-demographic data, vision-related data, the Extended ICF Checklist and the visual analogue scale of the EuroQoL-5D, to assess self-perceived health. Descriptive statistics and a Group Lasso regression were performed. The main outcome measures were functioning defined as impairments in Body functions and Body structures, limitations in Activities and restrictions in Participation, influencing Environmental factors and self-perceived health. Results In total, 120 ICF categories covering a broad range of Body functions, Body structures, aspects of Activities and Participation and Environmental factors were identified. Thirteen ICF categories that best capture self-perceived health were selected based on the Group Lasso regression. While Activities-and-Participation categories were selected most frequently, the greatest impact on self-perceived health was found in Body-functions categories. The ICF can be used as a framework to comprehensively describe the problems of persons with visual impairment and the Environmental factors which influence their

  3. Establishment and maintenance of records under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. Final rule.

    PubMed

    2004-12-09

    The Food and Drug Administration (FDA) is issuing a final regulation that requires the establishment and maintenance of records by persons who manufacture, process, pack, transport, distribute, receive, hold, or import food in the United States. Such records are to allow for the identification of the immediate previous sources and immediate subsequent recipients of food. The final rule implements the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act), and is necessary to help address credible threats of serious adverse health consequences or death to humans or animals. The requirement to establish and maintain records is one of several tools that will help improve FDA's ability to respond to, and further contain, threats of serious adverse health consequences or death to humans or animals from accidental or deliberate contamination of food. In the event of an outbreak of foodborne illness, such information will help FDA and other authorities determine the source and cause of the event. In addition, the information will improve FDA's ability to quickly notify the consumers and/or facilities that might be affected by the outbreak.

  4. Investigating the over-representation of older persons in do-it-yourself home maintenance injury and barriers to prevention.

    PubMed

    Ashby, K; Ozanne-Smith, J; Fox, B

    2007-10-01

    To examine why older persons undertake high-risk do-it-yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low-risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Exploratory qualitative study using focus-group methodology. Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost-effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. This research is an important first step in understanding issues facing community-dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs.

  5. Investigating the over‐representation of older persons in do‐it‐yourself home maintenance injury and barriers to prevention

    PubMed Central

    Ashby, K; Ozanne‐Smith, J; Fox, B

    2007-01-01

    Objective To examine why older persons undertake high‐risk do‐it‐yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low‐risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Design Exploratory qualitative study using focus‐group methodology. Setting and subjects Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Results Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost‐effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. Conclusions This research is an important first step in understanding issues facing community‐dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs. PMID:17916890

  6. Functional maintenance of differentiated embryoid bodies in microfluidic systems: a platform for personalized medicine.

    PubMed

    Guven, Sinan; Lindsey, Jennifer S; Poudel, Ishwari; Chinthala, Sireesha; Nickerson, Michael D; Gerami-Naini, Behzad; Gurkan, Umut A; Anchan, Raymond M; Demirci, Utkan

    2015-03-01

    Hormone replacement therapies have become important for treating diseases such as premature ovarian failure or menopausal complications. The clinical use of bioidentical hormones might significantly reduce some of the potential risks reportedly associated with the use of synthetic hormones. In the present study, we demonstrate the utility and advantage of a microfluidic chip culture system to enhance the development of personalized, on-demand, treatment modules using embryoid bodies (EBs). Functional EBs cultured on microfluidic chips represent a platform for personalized, patient-specific treatment cassettes that can be cryopreserved until required for treatment. We assessed the viability, differentiation, and functionality of EBs cultured and cryopreserved in this system. During extended microfluidic culture, estradiol, progesterone, testosterone, and anti-müllerian hormone levels were measured, and the expression of differentiated steroidogenic cells was confirmed by immunocytochemistry assay for the ovarian tissue markers anti-müllerian hormone receptor type II, follicle-stimulating hormone receptor, and inhibin β-A and the estrogen biosynthesis enzyme aromatase. Our studies showed that under microfluidic conditions, differentiated steroidogenic EBs continued to secrete estradiol and progesterone at physiologically relevant concentrations (30-120 pg/ml and 150-450 pg/ml, respectively) for up to 21 days. Collectively, we have demonstrated for the first time the feasibility of using a microfluidic chip system with continuous flow for the differentiation and extended culture of functional steroidogenic stem cell-derived EBs, the differentiation of EBs into cells expressing ovarian antigens in a microfluidic system, and the ability to cryopreserve this system with restoration of growth and functionality on thawing. These results present a platform for the development of a new therapeutic system for personalized medicine. ©AlphaMed Press.

  7. The Role of Communications, Socio-Psychological, and Personality Factors in the Maintenance of Crew Coordination

    NASA Technical Reports Server (NTRS)

    Foushee, H. Clayton

    1982-01-01

    There is increasing evidence that many air transport incidents and accidents are the result of the improper or inadequate utilization of the resources accessible to flight dock crew members. These resources obviously include the hardware and technical information necessary for the safe and efficient conduct of the flight, but they also Include the human resources which must be coordinated effectively. The focus of this paper is upon the human resources, and how communication styles, socio-psychological factors, and personality characteristics can affect crew coordination.

  8. Acquisition and maintenance of health-care routines as a function of feedback density.

    PubMed Central

    Alavosius, M P; Sulzer-Azaroff, B

    1990-01-01

    Two schedules of feedback were examined to determine their relative effects on the acquisition and maintenance of three health-care routines: feeding, positioning, and transferring physically disabled patients. Four direct service providers' performances in the natural environment were measured weekly. Concurrent schedules and multiple baselines across subjects and response classes were used to evaluate the effects of written instructions combined with either continuous, intermittent, or nofeedback schedules. Results showed that instructions alone led to slight and usually brief changes. Marked improvements were noted after feedback was introduced, with the continuous schedule producing more rapid acquisition. Follow-up measures indicated performance maintenance for both schedules. Subjects rated the feedback programs favorably and recommended provision of this service to co-workers. Cost estimates indicated that, although considerable time was spent developing the observational system, the feedback procedure was relatively inexpensive, easy to use, and did not interfere with patient care. PMID:2373652

  9. Blurring personal health and public priorities: an analysis of celebrity health narratives in the public sphere.

    PubMed

    Beck, Christina S; Aubuchon, Stellina M; McKenna, Timothy P; Ruhl, Stephanie; Simmons, Nathaniel

    2014-01-01

    This article explores the functions of personal celebrity health narratives in the public sphere. This study examines data about 157 celebrities, including athletes, actors, musicians, and politicians, who have shared private information regarding a personal health situation (or that of a loved one) with others in the public domain. Part of a larger project on celebrity health narratives, this article highlights three key functions that celebrity health narratives perform--education, inspiration, and activism--and discusses the implications for celebrities and for public conversations about health-related issues.

  10. Personalization of health care in England: have the wrong lessons been drawn from the personal health budget pilots?

    PubMed

    Slasberg, Colin; Watson, Nick; Beresford, Peter; Schofield, Peter

    2014-07-01

    The Government has introduced personal health budgets in England's National Health Service (NHS). A three-year programme of pilots has shown that personal health budgets have improved outcomes and are generally cost-effective. They are seen as a key step toward creating a personalized service. However, the Government is attributing the success of the pilots to entirely the wrong factors. It believes that a process similar to the one introduced in social care - where it is called self-directed support - based on the person being given a sum of money 'up-front' with which to plan their own care - is responsible for the better outcomes. However, this is not supported by the evidence from the pilots which points to quite different factors being at play. The consequences are potentially very serious. The success of the pilots will not be repeated in roll out. Further, there is the potential to greatly weaken the service by creating confused process and practice, and additional dysfunctional bureaucracy. The practice and process implications from a correct reading of the reasons for success within the pilots centre on replacing the consumerist concepts underpinning self-directed support with what we have called 'flexibility through partnership'. This will require freeing up the resource base as cash and creating a policy framework to enable decisions about how much resource each person should get within a cash-limited budget that will almost certainly be less than would be required to meet all assessed need.

  11. Sharing sensitive personal health information through Facebook: the unintended consequences.

    PubMed

    Househ, Mowafa

    2011-01-01

    The purpose of this paper was to explore the types of sensitive health information posted by individuals through social network media sites such as Facebook. The researcher found several instances in which individuals, who could be identified by their user profiles, posted personal and sensitive health information related to mental and genetic disorders and sexually transmitted diseases. The data suggest that Facebook users should be made aware of the potential harm that may occur when sharing sensitive health information publicly through Facebook. Ethical considerations in undertaking such research are also examined.

  12. Electronic Health Record in Italy and Personal Data Protection.

    PubMed

    Bologna, Silvio; Bellavista, Alessandro; Corso, Pietro Paolo; Zangara, Gianluca

    2016-06-01

    The present article deals with the Italian Electronic Health Record (hereinafter EHR), recently introduced by Act 221/2012, with a specific focus on personal data protection. Privacy issues--e.g., informed consent, data processing, patients' rights and minors' will--are discussed within the framework of recent e-Health legislation, national Data Protection Code, the related Data Protection Authority pronouncements and EU law. The paper is aimed at discussing the problems arising from a complex, fragmentary and sometimes uncertain legal framework on e-Health.

  13. Conscientiousness, health, and aging: the life course of personality model.

    PubMed

    Shanahan, Michael J; Hill, Patrick L; Roberts, Brent W; Eccles, Jacquelynne; Friedman, Howard S

    2014-05-01

    The Conscientiousness (C) of the self and significant others influences health by way of mediational chains involving socioeconomic attainment, the avoidance and neutralization of stressors, the promotion of health behaviors and the minimization of risk behaviors, and the management of symptoms and diseases. Yet, meta-analyses reveal that these associations are moderated by factors that are not well understood. We propose the Life Course of Personality Model (LCP Model), which comprises a series of hypotheses that suggest how such mediational chains are subject to 2 sources of contingency. First, the mechanisms by which C translates into health and the avoidance of risk change from early childhood to late adulthood, involving processes that are specific to phases of the life course; also, however, C influences health by way of continuous processes extending over many decades of life. Second, C may be more consequential in some social contexts than in others, and when accompanied by some constellations of personality characteristics than by others. That is, the mediational processes by which C translates into health and the avoidance of disease are likely moderated by timing, social context (including the C of others), and other aspects of the individual's personality. We consider methodological implications of the LCP Model.

  14. Computer-based documentation: effects on parent-provider communication during pediatric health maintenance encounters.

    PubMed

    Johnson, Kevin B; Serwint, Janet R; Fagan, Lawrence A; Thompson, Richard E; Wilson, Modena E H; Roter, Debra

    2008-09-01

    The goal was to investigate the impact of a computer-based documentation tool on parent-health care provider communication during a pediatric health maintenance encounter. We used a quasiexperimental study design to compare communication dynamics between clinicians and parents/children in health maintenance visits before and after implementation of the ClicTate system. Before ClicTate use, paper forms were used to create visit notes. The children examined were health maintenance encounter positively affected several aspects of parent-clinician communication in a pediatric clinic setting. These results support the integration of computer-based documentation into primary care pediatric visits.

  15. Aspirin treatment after myocardial infarction: are health maintenance organization members, women, and the elderly undertreated?

    PubMed

    Hill, J W; Roglieri, J L; Warburton, S W

    1998-01-01

    In April 1996, we surveyed 539 patients who had suffered a myocardial infarction in 1995 to determine whether the prescription and use of aspirin after myocardial infarction differs by patient age, sex, and type of health insurance. Patients who were insured through one of four health maintenance organizations in major metropolitan areas or by an indemnity plan in 40 states completed the survey. Among the 502 patients with no contraindications to use, 93.8% were prescribed aspirin. Among patients with a prescription and no subsequent contraindications to use, 96.4% were taking aspirin when surveyed. Among aspirin users, 96.5% reported taking aspirin daily. Controlling for other characteristics, 75-year-old patients were 5 percentage points less likely to receive a prescription for aspirin than were 50-year-old patients (P = 0.05). Although not significant at conventional levels, point estimates revealed a prescription rate for women that was 6 percentage points higher than that for men (P = 0.054) and a rate for health maintenance organization members that was 4 percentage points lower than that for patients with indemnity insurance (P = 0.10). Aspirin use was lower among older patients (P = 0.02) but did not differ by gender or type of insurance plan. Health maintenance organization members were just as likely to receive a prescription from a specialist as were those with indemnity insurance (P = 0.92). Based on these results, the rate of aspirin treatment after myocardial infarction may be much higher than previous studies indicate. Concerns that managed care patients and women may be undertreated are not supported by our findings. Although older patients are at risk for undertreatment, this risk is low. Once aspirin is prescribed, selfreported patient compliance with a daily regimen of aspirin is high.

  16. Personality and mental health: Arabic Scale of Mental Health, Eysenck Personality Questionnaire, and Neo Five Factor Inventory.

    PubMed

    Abdel-Khalek, Ahmed M

    2012-08-01

    The aim of this research was to explore associations of mental health and personality factors through two studies. Two separate convenience samples of volunteer Kuwaiti college students took part in the study (n1 = 193, n2 = 128). Their ages ranged between 18 and 32 years. They responded, in small group sessions, to the Eysenck Personality Questionnaire and to Costa and McCrae's Five Personality Factors in their Arabic forms. In addition, both samples responded to the Arabic Scale of Mental Health (ASMH). In the first study, scorers on the ASMH were significantly correlated (r) with Neuroticism (-.63), Extraversion (.57), and Lie (.22) scores. Two orthogonal components were retained and labeled "Mental health and Extraversion versus Neuroticism," and "Psychoticism versus Lie." In Study 2, mental health scores were significantly positively correlated with Conscientiousness (.62), Extraversion (.59), Agreeableness (.34), and Openness (.26) scores, and negatively with Neuroticism (-.62) scores. Two orthogonal components were retained and labeled "Mental health, Agreeableness, Extraversion versus Neuroticism," and "Openness, Conscientiousness, and Mental health." It was concluded that the salient associations of the ASMH were with positive traits and scores on Extraversion, Conscientiousness (positive), and with Neuroticism (negative), indicating good construct validity of the ASMH.

  17. Costs and survival of patients with colorectal cancer in a health maintenance organization and a preferred provider organization.

    PubMed

    Kerrigan, Matthew; Howlader, Nadia; Mandelson, Margaret T; Harrison, Robert; Mansley, Edward C; Ramsey, Scott D

    2005-10-01

    Colorectal cancer is relatively frequent among adults of working age, yet few studies have examined treatment, outcomes, and costs for people under 65 years of age with this disease. The objective of this study was to compare the initial treatments, survival, cancer-related medical costs, and overall medical costs for working-aged persons with colorectal cancer in 2 large health insurance plans in Washington State, one a preferred provider organization (PPO) and the other a group model health maintenance organization (HMO). This study consisted of patients, aged 20-64 years, diagnosed with colorectal cancer in both health plans from 1996 to 1998. For each cancer case, up to 5 control subjects, matched on age and sex, were selected for the analysis. We calculated unadjusted, attributable, and overall medical costs using the Kaplan-Meier sample average estimator. We calculated relative mortality rates using Cox regression. We used propensity scores to adjust overall costs and survival for potential confounding factors. Two hundred ten persons in the PPO and 136 persons in the HMO, aged 20-64 years, were diagnosed with cancer over the observation period and included in this study. Patients in the PPO were more likely to have local excision of their tumor (16% compared with 11%) and were less likely to receive chemotherapy (48% compared with 60%). The overall medical costs for the cancer cases were $46,000 in the HMO and $46,400 in the PPO (95% confidence interval for the difference: -$19,300 to 20,100). The cancer-attributable medical costs over 2 years were $40,400 in the HMO and $44,300 in the PPO (95% confidence interval for the difference: -$17,400 to 25,200). Survival was similar in the 2 health plans: the hazard ratio was 0.89 for those enrolled in the PPO (95% confidence interval: 0.50 to 1.59). Adjustment for potential confounding factors altered the results little. There were differences in the initial treatment of the patients in each health plan, but costs

  18. Personal responsibility within health policy: unethical and ineffective.

    PubMed

    Friesen, Phoebe

    2016-09-22

    This paper argues against incorporating assessments of individual responsibility into healthcare policies by expanding an existing argument and offering a rebuttal to an argument in favour of such policies. First, it is argued that what primarily underlies discussions surrounding personal responsibility and healthcare is not causal responsibility, moral responsibility or culpability, as one might expect, but biases towards particular highly stigmatised behaviours. A challenge is posed for proponents of taking personal responsibility into account within health policy to either expand the debate to also include socially accepted behaviours or to provide an alternative explanation of the narrowly focused discussion. Second, a critical response is offered to arguments that claim that policies based on personal responsibility would lead to several positive outcomes including healthy behaviour change, better health outcomes and decreases in healthcare spending. It is argued that using individual responsibility as a basis for resource allocation in healthcare is unlikely to motivate positive behaviour changes, and is likely to increase inequality which may lead to worse health outcomes overall. Finally, the case of West Virginia's Medicaid reform is examined, which raises a worry that policies focused on personal responsibility have the potential to lead to increases in medical spending overall.

  19. Understanding persons with psychological distress in primary health care.

    PubMed

    Arvidsdotter, Tina; Marklund, Bertil; Kylén, Sven; Taft, Charles; Ekman, Inger

    2016-12-01

    The purpose of this study was to gain more knowledge and a deeper understanding of experiences of persons living with psychological distress who seek help in primary care. Psychological distress is a state of emotional suffering associated with stressors and demands that are difficult to cope with in daily life. The lack of effective care for and difficulty in identifying psychological distress is frustrating for patients and health professionals alike. The aim was therefore to gain more knowledge about the experience of living with psychological distress. Twelve persons (nine women and three men) aged 23-51 years were interviewed. Analyses were based on a phenomenological hermeneutic method and indicated that psychological distress may be seen as an imbalance (incongruence) between the self and the ideal self, which slowly breaks down a person's self-esteem. This imbalance was described in three dimensions: Struggling to cope with everyday life, Feeling inferior to others and Losing one's grip on life. It seems to be associated with a gradual depletion of existential capacities and lead to dissatisfaction, suffering, poor self-esteem and lack of control. As psychological distress may be a forerunner to mental, physical and emotional exhaustion, there is a need to initiate preventive or early interventions to avoid mental, physical and emotional chaos in such patients. Patients' with psychological distress need to be involved in a person-centred salutogenic dialogue with health professionals to become aware of and strengthen their own capacities to regain health and well-being.

  20. A personally controlled electronic health record for Australia

    PubMed Central

    Pearce, Christopher; Bainbridge, Michael

    2014-01-01

    Objective On July 1, 2012 Australia launched a personally controlled electronic health record (PCEHR) designed around the needs of consumers. Using a distributed model and leveraging key component national eHealth infrastructure, the PCEHR is designed to enable sharing of any health information about a patient with them and any other health practitioner involved in their care to whom the patient allows access. This paper discusses the consumer-facing part of the program. Method Design of the system was through stakeholder consultation and the development of detailed requirements, followed by clinical design assurance. Results Patients are able to access any posted information through a web-accessible ‘consumer portal.’ Within the portal they are able to assert access controls on all or part of their record. The portal includes areas for consumers to record their own personal information. Discussion The PCEHR has the potential to transform the ability of patients to actively engage in their own healthcare, and to enable the emerging partnership model of health and healthcare in medicine. The ability to access health information traditionally kept within the closed walls of institutions also raises challenges for the profession, both in the language clinicians choose and the ethical issues raised by the changed roles and responsibilities. Conclusions The PCEHR is aimed at connecting all participants and their interventions, and is intended to become a system-wide activity. PMID:24650635

  1. Investigating personality and conceptualising allied health as person or technique oriented.

    PubMed

    Campbell, Narelle; Eley, Diann S; McAllister, Lindy

    2014-02-01

    Allied health (AH) includes many diverse professions, each with a unique contribution to healthcare, making it possible to consider these professions as person oriented (PO) or technique oriented (TO). This paper explored the personality traits of AH professionals from the perspective of both the PO or TO orientation and the individual professions. AH professionals (n=562) provided demographic data and completed the Temperament and Character Inventory. Examination of the literature and a consultation process resulted in nine professions classified as PO and 10 classified as TO. Multivariate analyses compared levels of personality traits and demographic variables between the PO (n=492) and TO (n=70) groups, and the professions within the groups. Professionals in the PO group showed significantly higher levels of traits that emphasise person orientation attributes, such as being sociable, empathic and cooperative, compared with AH professionals in professions with an emphasis on TO. Trends in personality traits among AH professionals were congruent with the PO and TO aspects of their chosen profession. This supports the usefulness of the PO and TO concepts in describing AH professions and may provide new clues for policy aiming to enhance job satisfaction, retention and career development. WHAT IS KNOWN ABOUT THE TOPIC? The literature suggests that certain medical specialities can be classified as person (PO) or technique oriented (TO) and that individuals attracted to those specialties display traits that are similar to that orientation. There is scant information on the AH professions regarding similar person or technique orientations. WHAT DOES THIS PAPER ADD? The diversity of professions within AH allows a new approach to describing each profession as either PO (socially dependent, cooperative and relationship focused), or TO (focused on skills and procedures). The trend in personality traits of individuals in certain AH professions is compatible with the

  2. An assessment of clinical chemical sensing technology for potential use in space station health maintenance facility

    NASA Technical Reports Server (NTRS)

    1987-01-01

    A Health Maintenance Facility is currently under development for space station application which will provide capabilities equivalent to those found on Earth. This final report addresses the study of alternate means of diagnosis and evaluation of impaired tissue perfusion in a microgravity environment. Chemical data variables related to the dysfunction and the sensors required to measure these variables are reviewed. A technology survey outlines the ability of existing systems to meet these requirements. How the candidate sensing system was subjected to rigorous testing is explored to determine its suitability. Recommendations for follow-on activities are included that would make the commercial system more appropriate for space station applications.

  3. Pricing and performance in health maintenance organizations: a strategic management perspective.

    PubMed

    Conant, J S; Mokwa, M P; Burnett, J J

    1989-03-01

    Innovative, consumer-oriented pricing strategies have contributed to the impressive growth of health maintenance organizations (HMOs). In a national study of HMO marketing directors, the relationships between strategic management style and (1) the relative importance of pricing in competitive marketing strategy, (2) the effectiveness of price strategy planning, and (3) financial performance are examined. The findings indicate that HMOs practicing effective price planning also perform well on an overall basis. Insight into the content and substance of HMO pricing strategies is also provided.

  4. Information gap: can health insurer personal health records meet patients' and physicians' needs?

    PubMed

    Grossman, Joy M; Zayas-Cabán, Teresa; Kemper, Nicole

    2009-01-01

    Personal health records (PHRs), centralized places for people to electronically store and organize their health information, can benefit both patients and doctors. This qualitative study of health insurers' PHRs for enrollees reveals potential benefits and challenges. Insurers' ability to put claims-based data into the PHR offers an advantage. However, consumers are concerned about sharing personal health information with insurers and about Internet security. Physicians question (1) the validity of claims data in making treatment decisions and (2) whether accessing these PHRs is worth the disruptions to their workflow. This paper offers possible solutions that may lead to more widespread adoption of insurer PHRs.

  5. Personalized medicine: risk prediction, targeted therapies and mobile health technology.

    PubMed

    Hayes, Daniel F; Markus, Hugh S; Leslie, R David; Topol, Eric J

    2014-02-28

    Personalized medicine is increasingly being employed across many areas of clinical practice, as genes associated with specific diseases are discovered and targeted therapies are developed. Mobile apps are also beginning to be used in medicine with the aim of providing a personalized approach to disease management. In some areas of medicine, patient-tailored risk prediction and treatment are applied routinely in the clinic, whereas in other fields, more work is required to translate scientific advances into individualized treatment. In this forum article, we asked specialists in oncology, neurology, endocrinology and mobile health technology to discuss where we are in terms of personalized medicine, and address their visions for the future and the challenges that remain in their respective fields.

  6. Personalized medicine: risk prediction, targeted therapies and mobile health technology

    PubMed Central

    2014-01-01

    Personalized medicine is increasingly being employed across many areas of clinical practice, as genes associated with specific diseases are discovered and targeted therapies are developed. Mobile apps are also beginning to be used in medicine with the aim of providing a personalized approach to disease management. In some areas of medicine, patient-tailored risk prediction and treatment are applied routinely in the clinic, whereas in other fields, more work is required to translate scientific advances into individualized treatment. In this forum article, we asked specialists in oncology, neurology, endocrinology and mobile health technology to discuss where we are in terms of personalized medicine, and address their visions for the future and the challenges that remain in their respective fields. PMID:24580858

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

    PubMed

    Merecz, Dorota; Andysz, Aleksandra

    2012-06-01

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

  8. Personality is of central concern to understand health: towards a theoretical model for health psychology

    PubMed Central

    Ferguson, Eamonn

    2013-01-01

    This paper sets out the case that personality traits are central to health psychology. To achieve this, three aims need to be addressed. First, it is necessary to show that personality influences a broad range of health outcomes and mechanisms. Second, the simple descriptive account of Aim 1 is not sufficient, and a theoretical specification needs to be developed to explain the personality-health link and allow for future hypothesis generation. Third, once Aims 1 and 2 are met, it is necessary to demonstrate the clinical utility of personality. In this review I make the case that all three Aims are met. I develop a theoretical framework to understand the links between personality and health drawing on current theorising in the biology, evolution, and neuroscience of personality. I identify traits (i.e., alexithymia, Type D, hypochondriasis, and empathy) that are of particular concern to health psychology and set these within evolutionary cost-benefit analysis. The literature is reviewed within a three-level hierarchical model (individual, group, and organisational) and it is argued that health psychology needs to move from its traditional focus on the individual level to engage group and organisational levels. PMID:23772230

  9. Project HealthDesign: rethinking the power and potential of personal health records.

    PubMed

    Brennan, Patricia Flatley; Downs, Stephen; Casper, Gail

    2010-10-01

    Project HealthDesign, a multi-year, multi-site project sponsored by the Robert Wood Johnson Foundation with additional support from the California HealthCare Foundation, is designed to stimulate innovation in personal health records (PHRs). Project HealthDesign teams employed user-centered design processes to create designs and prototypes of computer-based applications to support and enhance human health for a wide range of patients, from children with chronic health conditions to elders transitioning from hospital to home. A program design philosophy encouraged designers to envision PHRs as a suite of personal health information management tools, or applications, separate from, but drawing upon, personal health data from a variety of sources. In addition to information contained in one's medical record, these personal health data included patient-supplied clinical parameters such as blood glucose and daily weights; as well as patient-generated observations of daily living (ODLs) - the unique, idiosyncratic cues, such as sleep adequacy or confidence in self care, that inform patients about their abilities to manage health challenges and take healthy action. A common technical platform provided infrastructure services such as data standards and identity-management protocols, and helped to demonstrate a scalable, efficient approach to user-centered design of personal health information management systems. The program's ethical, legal and social issues consultancy identified challenges to acceleration of action-focused PHRs: personal control of privacy choices, management of privacy in home conditions, and rebalancing power structures in shared decision making. Copyright © 2010 Elsevier Inc. All rights reserved.

  10. Transfer of information from personal health records: a survey of veterans using My HealtheVet.

    PubMed

    Turvey, Carolyn L; Zulman, Donna M; Nazi, Kim M; Wakefield, Bonnie J; Woods, Susan S; Hogan, Timothy P; Weaver, Frances M; McInnes, Keith

    2012-03-01

    Personal health records provide patients with ownership of their health information and allow them to share information with multiple healthcare providers. However, the usefulness of these records relies on patients understanding and using their records appropriately. My HealtheVet is a Web-based patient portal containing a personal health record administered by the Veterans Health Administration. The goal of this study was to explore veterans' interest and use of My HealtheVet to transfer and share information as well as to identify opportunities to increase veteran use of the My HealtheVet functions. Two waves of data were collected in 2010 through an American Customer Satisfaction Index Web-based survey. A random sample of veterans using My HealtheVet was invited to participate in the survey conducted on the My HealtheVet portal through a Web-based pop-up browser window. Wave One results (n=25,898) found that 41% of veterans reported printing information, 21% reported saving information electronically, and only 4% ever sent information from My HealtheVet to another person. In Wave Two (n=18,471), 30% reported self-entering medication information, with 18% sharing this information with their Veterans Affairs (VA) provider and 9.6% sharing with their non-VA provider. Although veterans are transferring important medical information from their personal health records, increased education and awareness are needed to increase use. Personal health records have the potential to improve continuity of care. However, more research is needed on both the barriers to adoption as well as the actual impact on patient health outcomes and well-being.

  11. A conceptual security framework for personal health records (PHRs).

    PubMed

    Poulymenopoulou, Mikaela; Papakonstantinou, Despina; Malamateniou, Flora; Prentza, Andriana; Vassilacopoulos, George

    2013-01-01

    Electronic personal health record (PHR) is a citizen-centric information tool that allows citizens to control their personal information. However, an ideal PHR should also allow citizens to connect with their formal and informal caregivers (e.g. a family member, a caregiver) and together manage citizen health and social information. This introduces specific challenges in terms of security since multiple parties make entries and require access to PHR data. Since citizens are typically non-security and non-domain experts is considered impossible to control all this information. To this end, this paper presents a conceptual security framework for the employment of an attribute-based PHR access control policy that is continually updated according to providers' local security policies and individual professionals and citizen sharing preferences.

  12. Intelligent personal health record: experience and open issues.

    PubMed

    Luo, Gang; Tang, Chunqiang; Thomas, Selena B

    2012-08-01

    Web-based personal health records (PHRs) are under massive deployment. To improve PHR's capability and usability, we previously proposed the concept of intelligent PHR (iPHR). By introducing and extending expert system technology and Web search technology into the PHR domain, iPHR can automatically provide users with personalized healthcare information to facilitate their daily activities of living. Our iPHR system currently provides three functions: guided search for disease information, recommendation of home nursing activities, and recommendation of home medical products. This paper discusses our experience with iPHR as well as the open issues, including both enhancements to the existing functions and potential new functions. We outline some preliminary solutions, whereas a main purpose of this paper is to stimulate future research work in the area of consumer health informatics.

  13. Personal and workgroup incivility: impact on work and health outcomes.

    PubMed

    Lim, Sandy; Cortina, Lilia M; Magley, Vicki J

    2008-01-01

    This article develops a theoretical model of the impact of workplace incivility on employees' occupational and psychological well-being. In Study 1, the authors tested the model on 1,158 employees, finding that satisfaction with work and supervisors, as well as mental health, partially mediated effects of personal incivility on turnover intentions and physical health; this process did not vary by gender. Study 2 cross-validated and extended these results on an independent sample of 271 employees, showing negative effects of workgroup incivility that emerged over and above the impact of personal incivility. In both studies, all results held while controlling for general job stress. Implications for organizational science and practice are discussed. 2008 APA

  14. Impaired Maintenance of Interpersonal Synchronization in Musical Improvisations of Patients with Borderline Personality Disorder

    PubMed Central

    Foubert, Katrien; Collins, Tom; De Backer, Jos

    2017-01-01

    Borderline personality disorder (BPD) is a serious and complex mental disorder with a lifetime prevalence of 5.9%, characterized by pervasive difficulties with emotion regulation, impulse control, and instability in interpersonal relationships and self-image. Impairments in interpersonal functioning have always been a prominent characteristic of BPD, indicating a need for research to identify the specific interpersonal processes that are problematic for diagnosed individuals. Previous research has concentrated on self-report questionnaires, unidirectional tests, and experimental paradigms wherein the exchange of social signals between individuals was not the focus. We propose joint musical improvisation as an alternative method to investigate interpersonal processes. Using a novel, carefully planned, ABA′ accompaniment paradigm, and taking into account the possible influences of mood, psychotropic medication, general attachment, and musical sophistication, we recorded piano improvisations of 16 BPD patients and 12 matched healthy controls. We hypothesized that the insecure attachment system associated with BPD would be activated in the joint improvisation and manifest in measures of timing behavior. Results indicated that a logistic regression model, built on differences in timing deviations, predicted diagnosis with 82% success. More specifically, over the course of the improvisation B section (freer improvisation), controls' timing deviations decreased (temporal synchrony became more precise) whereas that of the patients with BPD did not, confirming our hypothesis. These findings are in accordance with previous research, where BPD is characterized by difficulties in attachment relationships such as maintaining strong attachment with others, but it is novel to find empirical evidence of such issues in joint musical improvisation. We suggest further longitudinal research within the field of music therapy, to study how recovery of these timing habits are related

  15. Making Personalized Health Care Even More Personalized: Insights From Activities of the IOM Genomics Roundtable.

    PubMed

    David, Sean P; Johnson, Samuel G; Berger, Adam C; Feero, W Gregory; Terry, Sharon F; Green, Larry A; Phillips, Robert L; Ginsburg, Geoffrey S

    2015-01-01

    Genomic research has generated much new knowledge into mechanisms of human disease, with the potential to catalyze novel drug discovery and development, prenatal and neonatal screening, clinical pharmacogenomics, more sensitive risk prediction, and enhanced diagnostics. Genomic medicine, however, has been limited by critical evidence gaps, especially those related to clinical utility and applicability to diverse populations. Genomic medicine may have the greatest impact on health care if it is integrated into primary care, where most health care is received and where evidence supports the value of personalized medicine grounded in continuous healing relationships. Redesigned primary care is the most relevant setting for clinically useful genomic medicine research. Taking insights gained from the activities of the Institute of Medicine (IOM) Roundtable on Translating Genomic-Based Research for Health, we apply lessons learned from the patient-centered medical home national experience to implement genomic medicine in a patient-centered, learning health care system.

  16. Making Personalized Health Care Even More Personalized: Insights From Activities of the IOM Genomics Roundtable

    PubMed Central

    David, Sean P.; Johnson, Samuel G.; Berger, Adam C.; Feero, W. Gregory; Terry, Sharon F.; Green, Larry A.; Phillips, Robert L.; Ginsburg, Geoffrey S.

    2015-01-01

    Genomic research has generated much new knowledge into mechanisms of human disease, with the potential to catalyze novel drug discovery and development, prenatal and neonatal screening, clinical pharmacogenomics, more sensitive risk prediction, and enhanced diagnostics. Genomic medicine, however, has been limited by critical evidence gaps, especially those related to clinical utility and applicability to diverse populations. Genomic medicine may have the greatest impact on health care if it is integrated into primary care, where most health care is received and where evidence supports the value of personalized medicine grounded in continuous healing relationships. Redesigned primary care is the most relevant setting for clinically useful genomic medicine research. Taking insights gained from the activities of the Institute of Medicine (IOM) Roundtable on Translating Genomic-Based Research for Health, we apply lessons learned from the patient-centered medical home national experience to implement genomic medicine in a patient-centered, learning health care system. PMID:26195686

  17. Geographic access to health care services: the case of maintenance hemodialysis.

    PubMed

    Smith, M D; Robson, A M; Woodward, R S; Michelman, J E; Valerius, T J; Hong, B A

    1985-01-01

    A longitudinal study of the system for delivering maintenance hemodialysis services in St Louis, Missouri was conducted to determine the significance of geographic access in the selection and continued utilization of a treatment facility. Historically, center hemodialysis patients in this metropolitan area received care at four centrally located facilities. In 1981, two new, independent facilities were constructed; a satellite of an existing unit was opened in 1983. The data obtained in this study demonstrated that end-stage renal disease (ESRD) patients generally did not change their mode of maintenance therapy, their treatment facility, or the location of their personal residence. When such changes occurred, they were rarely precipitated by a desire to reduce travel time to treatment. Furthermore, the opportunity to improve geographic access by transferring to a closer unit was perceived by patients to be viable only if they could retain their physician. It was concluded, therefore, that travel time to treatment is a relatively unimportant aspect of the chronic care of center hemodialysis patients in a metropolitan area.

  18. Can health care providers recognise a fibromyalgia personality?

    PubMed

    Da Silva, José A P; Jacobs, Johannes W G; Branco, Jaime C; Canaipa, Rita; Gaspar, M Filomena; Griep, Ed N; van Helmond, Toon; Oliveira, Paula J; Zijlstra, Theo J; Geenen, Rinie

    2017-01-01

    To determine if experienced health care providers (HCPs) can recognise patients with fibromyalgia (FM) based on a limited set of personality items, exploring the existence of a FM personality. From the 240-item NEO-PI-R personality questionnaire, 8 HCPs from two different countries each selected 20 items they considered most discriminative of FM personality. Then, evaluating the scores on these items of 129 female patients with FM and 127 female controls, each HCP rated the probability of FM for each individual on a 0-10 scale. Personality characteristics (domains and facets) of selected items were determined. Scores of patients with FM and controls on the eight 20-item sets, and HCPs' estimates of each individual's probability of FM were analysed for their discriminative value. The eight 20-item sets discriminated for FM, with areas under the receiver operating characteristic curve ranging from 0.71-0.81. The estimated probabilities for FM showed, in general, percentages of correct classifications above 50%, with rising correct percentages for higher estimated probabilities. The most often chosen and discriminatory items were predominantly of the domain neuroticism (all with higher scores in FM), followed by some items of the facet trust (lower scores in FM). HCPs can, based on a limited set of items from a personality questionnaire, distinguish patients with FM from controls with a statistically significant probability. The HCPs' expectation that personality in FM patients is associated with higher levels for aspects of neuroticism (proneness to psychological distress) and lower scores for aspects of trust, proved to be correct.

  19. Disclosing personal health information relating to adults who lack capacity.

    PubMed

    Griffith, Richard

    2014-03-01

    The need to share information about patients is vital to effective care and protection, especially where it relates to adults who lack decision-making capacity but it has to be balanced against the right to confidentiality. Like other health professionals, district nurses have a duty to maintain the confidentiality of patient information, and incapable adults have the right to expect their personal health information to be kept private. This right is guaranteed by the common-law duty of confidence, the Data Protection Act 1998 and the NHS Care Record Guarantee and confidentiality policy. This article discusses the district nurse's legal obligations when considering sharing information in relation to an incapable adult

  20. [Vulnerability to environmental heat among persons with mental health problems].

    PubMed

    Vida, Stephen

    2011-01-01

    This review is intended to alert health professionals to the particular vulnerability of persons with mental health problems or taking certain medications to heat-related illness, a threat that is increasing due to climate change. It reviews epidemiology, physiology and clinical features of heat-related illness. For acute medical management, it refers readers to existing guidelines and recommendations. It reviews risk and protective factors. Finally, it presents preventive strategies that may help reduce the impact of heat-related illness in this population.

  1. Assessing the privacy policies in mobile personal health records.

    PubMed

    Zapata, Belén Cruz; Hernández Niñirola, Antonio; Fernández-Alemán, José Luis; Toval, Ambrosio

    2014-01-01

    The huge increase in the number and use of smartphones and tablets has led health service providers to take an interest in mHealth. Popular mobile app markets like Apple App Store or Google Play contain thousands of health applications. Although mobile personal health records (mPHRs) have a number of benefits, important challenges appear in the form of adoption barriers. Security and privacy have been identified as part of these barriers and should be addressed. This paper analyzes and assesses a total of 24 free mPHRs for Android and iOS. Characteristics regarding privacy and security were extracted from the HIPAA. The results show important differences in both the mPHRs and the characteristics analyzed. A questionnaire containing six questions concerning privacy policies was defined. Our questionnaire may assist developers and stakeholders to evaluate the security and privacy of their mPHRs.

  2. Commercial products that convey personal health information in emergencies.

    PubMed

    Potini, Vishnu C; Weerasuriya, Dilani N; Lowery-North, Douglas W; Kellermann, Arthur L

    2011-12-01

    Describe commercially available products and services designed to convey personal health information in emergencies. The search engine Google®, supplemented by print ads, was used to identify companies and organizations that offer relevant products and services to the general market. Disease-specific, health system, and health plan-specific offerings were excluded. Vendor web sites were the primary sources of information, supplemented by telephone and e-mail queries to sales representatives. Perfect inter-rater agreement was achieved. Thirty-nine unique vendors were identified. Eight sell engraved jewelry. Three offer an embossed card or pamphlet. Twelve supply USB drives with various features. Eleven support password-protected web sites. Five maintain national call centers. Available media differed markedly with respect to capacity and accessibility. Quoted prices ranged from a one-time expenditure of $3.50 to an annual fee of $200. Associated features and annual fees varied widely. A wide range of products and services exist to help patients convey personal health information. Health care providers should be familiar with their features, so they can access the information in a disaster or emergency.

  3. Unmet oral health needs among persons with intellectual disability.

    PubMed

    Petrovic, Bojan B; Peric, Tamara O; Markovic, Dejan L J; Bajkin, Branislav B; Petrovic, Djorde; Blagojevic, Duska B; Vujkov, Sanja

    2016-12-01

    The aim of this study was to examine the factors affecting oral health status among intellectually disabled individuals in Serbia. The sample population was categorized according to age, sex, living arrangements, general health and the level of intellectual disability (ID). The diagnosis of dental caries was performed using the DMFT/dmft criteria. The oral hygiene and gingival health were assessed with the plaque index (Silness&Löe) and gingival index (Löe&Silness), respectively. Descriptive analysis, step-wise and logistic regression were performed to analyze related influential factors for caries presence, number of extracted teeth, teeth restored, the oral hygiene level and the extent of gingival inflammation. Odds ratios for caries were significantly higher among adult persons with ID, in persons with co-occurring developmental disorders (DDS) and increased with the level of ID. Group with DDS was associated with a 1.6 times greater odds of untreated decay, while the institutionalization was associated with 2.4 times greater odds of untreated decay. Institutionalization and co-occurring disabilities have been found to be significantly associated with a higher probability of developing gingivitis. Targeting oral health services to individuals with ID are encouraged and may help to reduce overall negative effect on oral and general health associated with delayed treatments, chronic dental pain, emergency dental care, tooth loss and advanced periodontal disease.

  4. [Personalized medicine, privatized medicine? legal and public health stakes].

    PubMed

    Rial-Sebbag, Emmanuelle

    2014-11-01

    Personalized medicine is booming. It tends to provide a medical management "tailored" for groups of patients, or for one unique patient, but also to identify risk groups to develop public health strategies. In this context, some radicalization phenomenon can emerge, leading to not only personalized medicine but also privatized medicine, which can lead to a capture of the medical public resource. If the "privatization" of medicine is not limited to producing adverse effects, several potentially destabilizing phenomena for patients still remain. First, some objective factors, like the adjustment of scientific prerequisites, are emerging from personalized medicine practices (clinical trial, public health policy) and are interfering with the medical doctor/patient relationship. Another risk emerges for patients concomitantly to their demand for controlling their own health, in terms of patients' security although these risks are not clearly identified and not effectively communicated. These practices, related to a privatized medicine, develop within the healthcare system but also outside, and the government and legislators will have to take into account these new dimensions in drafting their future regulations and policies.

  5. Health behaviors and personality in burnout: a third dimension

    PubMed Central

    Mustafa, Osama M.

    2015-01-01

    The high prevalence of burnout among healthcare professionals warrants a thorough examination aimed at improving the current understanding of its predictors and preventive measures. Cecil et al. have underscored the alarming prevalence of burnout among medical students and assessed its association with demographic, lifestyle, and behavioral factors. Of interest, health behaviors were found to be predictive of burnout. The study suggests certain behaviors (such as high physical activity) to be protective, and thus, calls for their establishment early in college life to prevent the development of this professionally-disabling mental state. Although the adoption of advisable health behaviors may independently reduce the risk of burnout, recognition of the existence and influence of closely related factors allows for an enhanced understanding and a greater precision for any conclusions to be made. Personality, through deductive and inductive reasoning, is likely to exert significant influence on both the student's behavior and his/her susceptibility to burnout. Thus, with personality representing – in and of itself – a principal model for prediction of burnout risk, controlling for personality traits when addressing health behaviors’ influence per se on burnout is essential. PMID:26365101

  6. Health Maintenance Deficits in a Fully Insured Population of Adolescents With Chronic Medical Conditions.

    PubMed

    Sainato, Rebecca; Flores, Michelle; Malloy, Allison; Geaney, Casey; Rajnik, Michael; Ottolini, Martin; Weisse, Martin

    2017-06-01

    The current national monitoring of routine wellness care and vaccine uptake does not provide data on health maintenance among pediatric populations with chronic medical conditions. In this case-control study that analyzes wellness visits and vaccine uptake among adolescents, ages 16 to 18 years, we identified 938 without (controls) and 74 with (cases) 1 of 12 specific chronic medical conditions. The PPSV23 (23-valent pneumococcal polysaccharide vaccine) is recommended by the Advisory Committee on Immunization Practices for these 12 conditions and served as a measure of uptake for medically indicated vaccines. Our controls were twice as likely as cases to have a documented well visit in the past year, and there was a significantly higher proportion of controls than cases vaccinated with Tdap (tetanus toxoid, reduced diphtheria toxoid, acellular pertussis), MCV-4 (quadrivalent meningococcal conjugate), and HPV (human papillomavirus), all P < .05. More than 60% of cases failed to receive PPSV23. Adolescents with chronic medical conditions are at high risk of neglecting routine health maintenance.

  7. Carotenoid maintenance handicap and the physiology of carotenoid-based signalisation of health.

    PubMed

    Vinkler, Michal; Albrecht, Tomás

    2010-01-01

    Despite a reasonable scientific interest in sexual selection, the general principles of health signalisation via ornamental traits remain still unresolved in many aspects. This is also true for the mechanism preserving honesty of carotenoid-based signals. Although it is widely accepted that this type of ornamentation reflects an allocation trade-off between the physiological utilisation of carotenoids (mainly in antioxidative processes) and their deposition in ornaments, some recent evidence suggests more complex interactions. Here, we further develop the models currently proposed to explain the honesty of carotenoid-based signalisation of heath status by adding the handicap principle concept regulated by testosterone. We propose that under certain circumstances carotenoids may be dangerous for the organism because they easily transform into toxic cleavage products. When reserves of other protective antioxidants are insufficient, physiological trade-offs may exist between maintenance of carotenoids for ornament expression and their removal from the body. Furthermore, we suggest that testosterone which enhances ornamentation by increasing carotenoid bioavailability may also promote oxidative stress and hence lower antioxidant reserves. The presence of high levels of carotenoids required for high-quality ornament expression may therefore represent a handicap and only individuals in prime health could afford to produce elaborate colourful ornaments. Although further testing is needed, this 'carotenoid maintenance handicap' hypothesis may offer a new insight into the physiological aspects of the relationship between carotenoid function, immunity and ornamentation.

  8. Carotenoid maintenance handicap and the physiology of carotenoid-based signalisation of health

    NASA Astrophysics Data System (ADS)

    Vinkler, Michal; Albrecht, Tomáš

    2010-01-01

    Despite a reasonable scientific interest in sexual selection, the general principles of health signalisation via ornamental traits remain still unresolved in many aspects. This is also true for the mechanism preserving honesty of carotenoid-based signals. Although it is widely accepted that this type of ornamentation reflects an allocation trade-off between the physiological utilisation of carotenoids (mainly in antioxidative processes) and their deposition in ornaments, some recent evidence suggests more complex interactions. Here, we further develop the models currently proposed to explain the honesty of carotenoid-based signalisation of heath status by adding the handicap principle concept regulated by testosterone. We propose that under certain circumstances carotenoids may be dangerous for the organism because they easily transform into toxic cleavage products. When reserves of other protective antioxidants are insufficient, physiological trade-offs may exist between maintenance of carotenoids for ornament expression and their removal from the body. Furthermore, we suggest that testosterone which enhances ornamentation by increasing carotenoid bioavailability may also promote oxidative stress and hence lower antioxidant reserves. The presence of high levels of carotenoids required for high-quality ornament expression may therefore represent a handicap and only individuals in prime health could afford to produce elaborate colourful ornaments. Although further testing is needed, this ‘carotenoid maintenance handicap’ hypothesis may offer a new insight into the physiological aspects of the relationship between carotenoid function, immunity and ornamentation.

  9. Relationship of personal health experiences with interest in health careers among youth from an underserved area.

    PubMed

    Brooks, Alyssa T; Washington, Shakira; Boekeloo, Bradley O; Gilchrist, Brian; Wang, Min Q

    2013-01-01

    Only 10% of health professionals are from racial/ethnic minority groups, and much research has been focused on encouraging minorities to enter a health career. The lack of health workforce diversity has many implications for the effective delivery of care to an increasingly diverse US population. The goal of this analysis is to examine the influence of personal health experiences on interest in a health career. "Personal Health Experiences" is a newly created scaled variable that assesses the influence of direct and indirect health experiences of respondents. In a sample of 134 predominantly minority 10th graders from underprivileged neighborhoods, the scale had adequate psychometric properties (range 1-7; mean 4.44, SD 1.46, median 4.60, Cronbach's alpha 0.72), and multivariate regression modeling revealed that it predicted increased "Interest in Health Careers" (B=0.46, SE 0.10, p<0.01). Future research is needed to determine the role that personal health experiences play in career choices and one's success in health career decisions. Such information could, for example, help to refine health profession recruitment strategies.

  10. Bridging human and animal research: a comparative approach to studies of personality and health.

    PubMed

    Mehta, Pranjal H; Gosling, Samuel D

    2008-07-01

    This article evaluates a comparative approach to personality and health research. We (1) review evidence showing that personality exists and can be measured in animals, (2) illustrate the benefits of animal studies for human personality research, (3) illustrate the benefits of human studies for animal personality research, and (4) provide guidelines for making cross-species comparisons. We conclude that a comparative approach can provide unique insights into personality psychology, especially into research on personality, immunity, and health.

  11. When a solution is not a solution: Medicaid and Health Maintenance Organizations.

    PubMed

    Spitz, B

    1979-01-01

    Health Maintenance Organization (HMOs) are repeatedly described as a general solution to the health care crisis and a specific solution to the problems confronting Medicare and Medicaid. The potential incorporation of HMOs into Medicaid has promised to improve the states' ability to accurately budget program expenditures, simplify management, eliminate abusive practices directly linked to fee-for-service (e.g., billing for undelivered services for providing unnecessary care) and, most important, contain costs. At the same time it has promised to increase access to mainstream medicine. Experience has shown, however, that the promise has often been severely compromised by unethical HMO marketing practices, inadequacy of services and excessive administrative costs. This article examines some of the reasons: the political process which created HMOs, the rhetorical claims which exaggerated the strengths of prepaid group practice and distorted the formulation of policy, and the peculiar characteristics of the Medicaid program which have caused Medicaid HMOs to deviate considerably from theoretical expectations.

  12. The Russian experience in medical care and health maintenance of the International Space Station crews

    NASA Astrophysics Data System (ADS)

    Bogomolov, V. V.; Grigoriev, A. I.; Kozlovskaya, I. B.

    2007-02-01

    The main purpose of the medical support system aboard International Space Station (ISS) is crew health maintenance and high level of work capability assurance prior to during and after in space flights. In the present communication the Russian point of view dealing with the problems and achievements in this branch is presented. An overview on medical operations during flight and after finalization of the space missions based on Russian data of crew health and environment state monitoring, as well as data on the inflight countermeasures (prophylaxis) jointly with data on operational problems that are specific to ISS is presented. The report summarizes results of the medical examination of Russian members of the ISS and taxi crews during and after visits to the ISS.

  13. CNS development of health maintenance programs: quality improvement and cost reduction.

    PubMed

    Mullin, M H; Opperwall, B C; White, S L

    1995-01-01

    Several outpatient health maintenance programs were developed by CNSs that resulted in quality improvement and cost savings. Common implementation strategies, barriers to implementation, marketing issues and techniques, and revenue generation issues were found. An outpatient consultation model was used to expand enterostomal therapy and diabetic teaching services. Education and support programs include a cardiac support group and community education classes on aging. Preadmission programs include physical therapy consultation for patients scheduled for elective orthopedic surgery. Outpatient programs facilitate continuity of care in a managed care format, promote cost savings, and provide unique services that encourage patients to return to our hospital, thereby increasing market share. Key barriers encountered include inconsistent or ambiguous administrative support, budgetary constraints, lack of collaboration, communication problems, facility limitations, funding considerations, resource allocation, and territoriality. The programs are consistent with the change in focus of health care from treatment to prevention.

  14. [Involuntary placement and treatment of persons with mental health problems].

    PubMed

    Ikehara, Yoshikazu

    2013-01-01

    Involuntary placement and treatment of persons with mental health problems were initially discussed from the perspective of personal liberty. However, the autonomy of persons with mental health problems has been growing in importance as an issue of involuntary placement and treatment since the last part of the twentieth century, because the purpose of involuntary placement is not the deprivation of liberty but to provide adequate treatment under medical supervision. The UN Convention on the Rights of Persons with Disabilities (CRPD) adds a new perspective from non-discrimination and equality. Article 14 of CRPD states that "the existence of a disability shall in no case justify a deprivation of liberty." This provision should be construed from a perspective of non-discrimination. Conventional types of involuntary placement mainly based on dangerousness (UN-MI Principle 16-1a) and incompetency (UN-MI Principle16-1b) are not allowed by Article 14. There is a discussion on the difference between "mental disability" and "mental illness". Some people argue that CRPD should apply not to persons with mental illness, but to those with mental disabilities. However, CRPD does not provide a definition of "disability". It states that its definition is developing. ICF also mentions that ICD-10 and ICF should complement each other. Thus, CRPD should apply to the involuntary placement and treatment of persons with mental illness as well. It is clear that Article 14 intends to change the situation whereby persons who have been described using various terms, such as madness, lunacy, insanity, mental illness, mental disability, mental health problems, and users, are involuntarily hospitalized/placed. The significance of Article 14 will be lost if it cannot be applied to psychiatric hospitalization. From the perspective of non-discrimination, we have to universalize involuntary placement and treatment or completely abolish them. We cannot tolerate a situation where a type of

  15. PERSONAL HEALTH BUDGETS IN ENGLAND: MOOD MUSIC OR DEATH KNELL FOR THE NATIONAL HEALTH SERVICE?

    PubMed

    Scott-Samuel, Alex

    2015-01-01

    Personal health budgets in England are National Health Service (NHS) funds that can be allocated to certain groups of patients to allow them, together with their NHS support staff, to purchase services or equipment that they believe will enhance their health and well-being. Some see this as a welcome personalization of health care that increases people's control over their health. However, personal health budgets are being introduced at a time when rapid privatization of the English NHS is taking place and when restrictions are being placed on people's access to health care. As a result, many view their introduction as a diversionary gimmick designed to help pave the way for the conversion of the NHS into the insurance-based system, which many believe is the intention of the U.K. government. This article describes the research and policy context in which this controversial intervention is being introduced and presents recent expert debate between proponents and opponents of personal health budgets, from e-mail discussion lists.

  16. Personal Reflection: Reflections on a Family Health History Assignment for Undergraduate Public Health and Nursing Students

    ERIC Educational Resources Information Center

    Rooks, Ronica N.; Ford, Cassandra

    2013-01-01

    This personal reflection describes our experiences with incorporating the scholarship of teaching and learning and problem-based techniques to facilitate undergraduate student learning and their professional development in the health sciences. We created a family health history assignment to discuss key concepts in our courses, such as health…

  17. Choosing health: qualitative evidence from the experiences of personal health budget holders.

    PubMed

    Davidson, Jacqueline; Baxter, Kate; Glendinning, Caroline; Irvine, Annie

    2013-10-01

    Personal health budgets were piloted in the English National Health Service between 2009 and 2012. Semi-structured interviews with a sub-sample of early budget holders aimed to explore their experiences of receiving and using a budget. Over 2000 people from 20 pilot sites were recruited to a multi-method evaluation of the personal health budget pilots. A sub-sample of 58 people was selected for qualitative interviews three months after the offer of a budget; 52 were re-interviewed six months later. The purposively selected sample reflected a range of health conditions, locality, age and gender. Personal health budgets were reported to have positive impacts on health, health care and relatives/family. Benefits often extended beyond the condition for which the budget had been awarded. However, interviewees rarely knew the level of their budget; some reported difficulty in agreeing acceptable uses for their budget; and delays could occur in procuring chosen services or equipment. Patients' experiences offer valuable insights for the roll-out of personal health budgets beyond the pilot phase. Flexibility in how budgets are used may allow maximum benefits to be derived. Clear information about what budgets can and cannot be used for, with suggestions offered, will be useful. People with newly diagnosed or recent sudden onset conditions may need more help to plan their support, but all budget holders are likely to benefit from regular contact with staff for reassurance and continued motivation.

  18. Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities

    ERIC Educational Resources Information Center

    Chen, Jie; Mullins, C. Daniel; Novak, Priscilla; Thomas, Stephen B.

    2016-01-01

    Designing culturally sensitive personalized interventions is essential to sustain patients' involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and…

  19. Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities

    ERIC Educational Resources Information Center

    Chen, Jie; Mullins, C. Daniel; Novak, Priscilla; Thomas, Stephen B.

    2016-01-01

    Designing culturally sensitive personalized interventions is essential to sustain patients' involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and…

  20. Risk-Accepting Personality and Personal Protective Equipment Use within the Agricultural Health Study

    PubMed Central

    DellaValle, Curt T.; Hoppin, Jane A.; Hines, Cynthia J.; Andreotti, Gabriella; Alavanja, Michael C.R.

    2012-01-01

    Pesticide exposures can be reduced by use of personal protective equipment as well as proper mixing and application practices. We examined the effects of risk-accepting personality on personal protective equipment (PPE) use and mixing and application practices among private pesticide applicators and their spouses within the Agricultural Health Study (AHS) in Iowa and North Carolina and commercial applicators in Iowa. The AHS follow-up questionnaire included four questions designed to assess attitudes toward risk. Analysis was limited to those who were currently working on a farm or registered as a commercial applicator and indicated current pesticide use (n=25,166). Respondents who answered three or more questions in the affirmative (private applicators: n=4,160 (21%); commercial applicators: n=199 (14%); spouses: n=829 (23%)) were classified as having a risk-accepting personality. Logistic regression was used to evaluate specific work practices associated with risk-accepting attitudes. Among private applicators, the likelihood of using any PPE when mixing or loading pesticides was lower among risk-acceptors compared to risk-averse individuals (odds ratio (OR) = 0.72; 95% Confidence Interval (CI): 0.65 – 0.79). A similar relationship was observed among commercial applicators (OR = 0.77, 95% CI: 0.34 – 1.77) but not among spouses (OR = 1.09, 95% CI: 0.90 – 1.33). Among private applicators, risk-acceptors were more likely than the risk-averse to apply pesticides within 50 ft of the home (OR=1.21; 95% CI: 1.01 – 1.44), compared to further than ¼ mile. Our findings suggest that the decisions to use personal protective equipment and properly handle/apply pesticides may be driven by risk-accepting personality traits. PMID:22732067

  1. Personal health technology: A new era in cardiovascular disease prevention.

    PubMed

    Franklin, Nina C; Lavie, Carl J; Arena, Ross A

    2015-03-01

    Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide yet the majority of related risk factors are largely preventable (primary prevention [PP]) and effectively treatable (secondary prevention [SP]) with healthy lifestyle behaviors. The use of information and communication technology (ICT) offers a unique approach to personal health and CVD prevention, as these mediums are relatively affordable, approachable, and accessible. The purpose of this review is to provide an overview of ICT-driven personal health technologies and their potential role in promoting and supporting self-care behaviors for PP and SP of CVD. In this review, we focus on technological interventions that have been successful at supporting positive behavior change in order to determine which tools, resources, and methods are most appropriate for delivering interventions geared towards CVD prevention. We conducted a literature search from a range of sources including scholarly, peer-reviewed journal articles indexed in PubMed and CINAHL, gray literature, and reputable websites and other Internet-based media. A synthesis of existing literature indicates that the overall efficacy of ICT-driven personal health technologies is largely determined by: 1) the educational resources provided and the extent to which the relayed information is customized or individually tailored; and 2) the degree of self-monitoring and levels of personalized feedback or other interactions (e.g. interpersonal communications). We conclude that virtually all the technological tools and resources identified (e.g. Internet-based communications including websites, weblogs and wikis, mobile devices and applications, social media, and wearable monitors) can be strategically leveraged to enhance self-care behaviors for CVD risk reduction and SP but further research is needed to evaluate their efficacy, cost-effectiveness, and long-term maintainability.

  2. Personal, Electronic, Secure National Library of Medicine Hosts Health Records Conference

    MedlinePlus

    ... Bar Home Current Issue Past Issues EHR Personal, Electronic, Secure: National Library of Medicine Hosts Health Records ... One suggestion for saving money is to implement electronic personal health records. With this in mind, the ...

  3. Integrated system health management-oriented maintenance decision-making for multi-state system based on data mining

    NASA Astrophysics Data System (ADS)

    Xu, Jiuping; Sun, Kai; Xu, Lei

    2016-10-01

    To ensure a series of missions can be completed with only finite breaks, many systems are required to guarantee system safety and mission success. Of these, maintenance decision support is vital. One widely used maintenance strategy has been selective maintenance. Most traditional selective maintenance optimisation research has focused on binary state systems, which are subject to distribution deterioration or failure. However, a majority of systems used in aerospace or industrial applications are multi-state systems with more than two states deteriorating at the same time, meaning that real-time state distribution is needed to provide more timely and effective maintenance. This paper presents a novel integrated system health management-oriented maintenance decision support methodology and framework for a multi-state system based on data mining. An aero-engine system numerical example is given to illustrate the methodology, the results of which demonstrate the significant advantages of using data mining to efficiently obtain state distribution information, and the benefits of using a robust optimal model to choose suitable strategies. This methodology, which is applicable to multi-state systems of varying sizes, has the ability to solve maintenance problems when imperfect maintenance quality is considered.

  4. Designing smart analytical data services for a personal health framework.

    PubMed

    Koumakis, Lefteris; Kondylakis, Haridimos; Chatzimina, Maria; Iatraki, Galatia; Argyropaidas, Panagiotis; Kazantzaki, Eleni; Tsiknakis, Manolis; Kiefer, Stephan; Marias, Kostas

    2016-01-01

    Information in the healthcare domain and in particular personal health record information is heterogeneous by nature. Clinical, lifestyle, environmental data and personal preferences are stored and managed within such platforms. As a result, significant information from such diverse data is difficult to be delivered, especially to non-IT users like patients, physicians or managers. Another issue related to the management and analysis is the volume, which increases more and more making the need for efficient data visualization and analysis methods mandatory. The objective of this work is to present the architectural design for seamless integration and intelligent analysis of distributed and heterogeneous clinical information in the PHR context, as a result of a requirements elicitation process in iManageCancer project. This systemic approach aims to assist health-care professionals to orient themselves in the disperse information space and enhance their decision-making capabilities, to encourage patients to have an active role by managing their health information and interacting with health-care professionals.

  5. Satisfaction with access to and quality of health care among Medicare enrollees in a health maintenance organization.

    PubMed Central

    Meng, Y Y; Jatulis, D E; McDonald, J P; Legorreta, A P

    1997-01-01

    This study was designed to determine the levels and predictors of Medicare enrollees' satisfaction with access to medical care and quality of health care in a health maintenance organization. Data collected by an instrument adapted from the Group Health Association of America's Consumer Satisfaction Survey were analyzed after being linked with administrative data. In general, Medicare enrollees reported high satisfaction with both access to and quality of health care. Most members (96%) rated skill, experience, and training of physicians and the friendliness and courtesy of the staff favorably. A lower percentage of members (77%) rated favorably the ability to contact a physician after hours. Levels of satisfaction were essentially not explained by patient characteristics such as age, sex, geographic region, medications, or utilization. Stepwise regression identified the ease of arranging appointments as the strongest predictor of satisfaction, with access to care and outcomes of medical care as the strongest predictor of overall satisfaction with quality of health care. These findings indicate that items that members rated least favorably, such as ability to contact a physician after hours, added little to the prediction of satisfaction with access to and quality of health care. PMID:9168681

  6. Satisfaction with access to and quality of health care among Medicare enrollees in a health maintenance organization.

    PubMed

    Meng, Y Y; Jatulis, D E; McDonald, J P; Legorreta, A P

    1997-04-01

    This study was designed to determine the levels and predictors of Medicare enrollees' satisfaction with access to medical care and quality of health care in a health maintenance organization. Data collected by an instrument adapted from the Group Health Association of America's Consumer Satisfaction Survey were analyzed after being linked with administrative data. In general, Medicare enrollees reported high satisfaction with both access to and quality of health care. Most members (96%) rated skill, experience, and training of physicians and the friendliness and courtesy of the staff favorably. A lower percentage of members (77%) rated favorably the ability to contact a physician after hours. Levels of satisfaction were essentially not explained by patient characteristics such as age, sex, geographic region, medications, or utilization. Stepwise regression identified the ease of arranging appointments as the strongest predictor of satisfaction, with access to care and outcomes of medical care as the strongest predictor of overall satisfaction with quality of health care. These findings indicate that items that members rated least favorably, such as ability to contact a physician after hours, added little to the prediction of satisfaction with access to and quality of health care.

  7. Self-maintenance Habits and Preferences in Elderly (SHAPE): reliability of reports of self-care preferences in older persons.

    PubMed

    Cohen-Mansfield, Jiska; Jensen, Barbara

    2007-02-01

    Self-care preferences can be used in designing programs of care. Yet little has been documented concerning the self-care habits and preferences of older adults. This study assessed the reliability of reports of self-care preferences and their importance among older adults using the Self-maintenance Habits and Preferences in Elderly (SHAPE) instrument. Twenty community-dwelling seniors completed the SHAPE questionnaire twice within a one- to two-week interval. Percent agreement, both exact and close/partial, was computed to assess the reliability of preference content, and intra-class correlations (ICCs) were used for preference importance. Test and subject factors affecting reliability were also investigated. Exact agreement rate for item content was 73%, and that for close/partial agreement was 93%. Mean ICC for item importance was 0.72. Reliability was greater for dichotomous items than for either ordinal or categorical questions. Reliability of item content varied with number of response options and importance reliability varied with age and IADL status. Information from SHAPE about self-care preferences can be used to plan services for seniors and to individualize care for older persons, especially those transitioning to new living environments or those receiving home care.

  8. A cautionary note for population health: disproportionate emphasis on personal responsibility for health and wellbeing.

    PubMed

    Naumova, Elena N

    2014-08-01

    By investing in healthy human life we are investing in our social capital, the primary treasure of a modern technologically advanced society. In rethinking the definition of health from a new interdisciplinary viewpoint, I argue that health can be measured by satisfaction with life fulfillment and by abilities that permit an individual to perform tasks demanded by a society. While considering health as a property of a dynamic system governed by social and environmental determinants, a balance between societal and personal responsibility for health and wellbeing has to be maintained to protect those who have limited opportunities to "use their biologically given and personally acquired potentials" or to entertain their rights of healthy living standards. Instead of separating the biologically given and personally acquired potentials, I suggest capitalizing on emerging information, technologies, and materials aiming to enhance human potentials, both physical and intellectual.

  9. Compliance with national asthma management guidelines and specialty care: a health maintenance organization experience.

    PubMed

    Legorreta, A P; Christian-Herman, J; O'Connor, R D; Hasan, M M; Evans, R; Leung, K M

    1998-03-09

    To improve asthma disease management, the National Asthma Education Program (NAEP) Expert Panel published Guidelines for the Diagnosis and Management of Asthma in 1991. To compare the current status of asthma disease management among patients in a large health maintenance organization with the NAEP guidelines and to identify the factors that may be associated with medical care (eg, emergency department visits and hospital admissions) and adherence to the guidelines. Analyses of 1996 survey data from 5580 members with asthma (age range, 14 to 65 years) covered by a major health maintenance organization in California (Health Net). In general, adherence to NAEP guidelines was poor. Seventy-two percent of respondents with severe asthma reported having a steroid inhaler, and of those, only 54% used it daily. Only 26% of respondents reported having a peak flowmeter, and of those, only 16% used it daily. Age (older), duration of asthma (longer), increasing current severity of disease, and treatment by an asthma specialist correlated with daily use of inhaled steroids. Ethnicity (African American and Hispanic) correlated negatively with inhaled steroid use but positively with emergency department visits and hospital admissions for asthma. Increasing age and treatment by an asthma specialist were also identified as common factors significantly related to the daily use of a peak flowmeter and, interestingly, to overuse of beta2-agonist metered-dose inhalers. Although the NAEP guidelines were published 7 years ago, compliance with the guidelines was low. It was especially poor for use of preventive medication and routine peak-flow measurement. Furthermore, the results showed that asthma specialists provided more thorough care than did primary care physicians in treating patients with asthma. Combining the results of the regression analyses revealed that some of the variation in rates of emergency department visits and hospitalizations among some subpopulations can be

  10. Pronounced gender and age differences are evident in personal health care spending per person.

    PubMed

    Cylus, Jonathan; Hartman, Micah; Washington, Benjamin; Andrews, Kimberly; Catlin, Aaron

    2011-01-01

    This paper examines differences in national health care spending by gender and age. Our research found significant variations in per person spending by gender across age groups, health services, and types of payers. For example, in 2004 per capita health care spending for females was 32 percent more than for males. Per capita differences were most pronounced among the working-age population, largely because of spending for maternity care. Except for children, total spending for and by females was greater than that for and by males, for most services and payers. The gender difference in total spending was most pronounced in the elderly, as a result of the longer life expectancy of women.

  11. An Educational Program for Sub-Professional Personnel to be Employed in Health Maintenance Organizations. Final Report.

    ERIC Educational Resources Information Center

    HMO Management, Inc., Los Angeles, CA.

    Through Medicaid, the Health Maintenance Organization Act (HMO), and Prepaid Health Programs (PHP) approaches were established whereby the government can help alleviate the medical problems of the needy. A program to educate and train students in California in the philosophy, administration, and development of PHP was developed in response to…

  12. Integrating Public Health and Personal Care in a Reformed US Health Care System

    PubMed Central

    Chernichovsky, Dov

    2010-01-01

    Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access. Inefficiency is increased by the lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. We advocate a health trust system to provide core medical benefits to every American, while improving efficiency and reducing redundancy. The major innovation of this plan would be to incorporate existing private health insurance plans in a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns. PMID:20019310

  13. Personalized health applications in the Web 2.0: the emergence of a new approach.

    PubMed

    Fernandez-Luque, Luis; Karlsen, Randi; Krogstad, Trine; Burkow, Tatjana M; Vognild, Lars K

    2010-01-01

    Health consumers have embraced the web to obtain access to health information and to socialize and share knowledge with peers. Additionally, the web has become a more interactive and rich platform with the integration of health applications and services, such as Personal Health Records. Some of these applications provide personalized interactions based on user specific characteristics. In this paper we provide an overview of Personalized Health Applications in the Web 2.0. We reviewed the health applications integrated in Google Health, Microsoft HealthVault and Facebook. We studied the goals of the applications and also the personalized feedback they provided.

  14. Marital Conflict in Older Couples: Positivity, Personality, and Health

    PubMed Central

    Iveniuk, James; Waite, Linda J.; McClintock, Martha K.; Teidt, Andrew D.

    2016-01-01

    We examine the implications of health and personality characteristics for late-life marital conflict, using data from the 2010–11 wave of the National Social Life Health and Aging Project (NSHAP), a nationally representative study with data on both partners in 955 marital and cohabitational dyads. Using these data, we relate characteristics of husbands to characteristics of their wives, and vice versa. Wives with husbands in fair or poor physical health are more likely to report high levels of marital conflict, but the reverse is not true. Similarly, wives report more conflict when their husbands are high on Neuroticism, high on Extraversion, and low on a new measure we call Positivity. Our findings point to noteworthy gender differences between men and women in the associations between individual characteristics and levels of marital conflict. We point to differences between husbands’ and wives’ marital roles as a contributor to these differences. PMID:27274569

  15. Marital Conflict in Older Couples: Positivity, Personality, and Health.

    PubMed

    Iveniuk, James; Waite, Linda J; McClintock, Martha K; Teidt, Andrew D

    2014-02-01

    We examine the implications of health and personality characteristics for late-life marital conflict, using data from the 2010-11 wave of the National Social Life Health and Aging Project (NSHAP), a nationally representative study with data on both partners in 955 marital and cohabitational dyads. Using these data, we relate characteristics of husbands to characteristics of their wives, and vice versa. Wives with husbands in fair or poor physical health are more likely to report high levels of marital conflict, but the reverse is not true. Similarly, wives report more conflict when their husbands are high on Neuroticism, high on Extraversion, and low on a new measure we call Positivity. Our findings point to noteworthy gender differences between men and women in the associations between individual characteristics and levels of marital conflict. We point to differences between husbands' and wives' marital roles as a contributor to these differences.

  16. Personal Benefits of a Health Evaluation and Enhancement Program

    NASA Technical Reports Server (NTRS)

    Heinzelmann, F.; Durbeck, D. C.

    1970-01-01

    A study was made of the benefits reported by participants in a health evaluation and enhancement program dealing with physical activity. Program benefits were identified and defined in regard to three major areas: program effects on work; program effects on health; and program effects on habits and behavior. A strong positive and consistent relationship was found between reported benefits in each of these areas and measures of improvement in cardiovascular functioning based on treadmill performance. Significant differences in these measures of improvement were also found between participants who reported program benefits and those persons who did not. These findings provide a meaningful profile of the pattern of benefits generated by this kind of health program.

  17. Education and personalized genomics: deciphering the public's genetic health report

    PubMed Central

    Lamb, Neil E; Myers, Richard M; Gunter, Chris

    2010-01-01

    Where do members of the public turn to understand what genetic tests mean in terms of their own health? Now that genome-wide association studies and complete genome sequencing are widely available, the importance of education in personalized genomics cannot be overstated. Although some media have introduced the concept of genetic testing to better understand health and disease, the public's understanding of the scope and impact of genetic variation has not kept up with the pace of the science or technology. Unfortunately, the likely sources to which the public turn to for guidance – their physician and the media – are often no better prepared. We examine several venues for information, including print and online guides for both lay and health-oriented audiences, and summarize selected resources in multiple formats. We also note on the roadblocks to progress and discuss ways to remove them, as urgent action is needed to connect people with their genomes in a meaningful way. PMID:20161675

  18. Personal Benefits of a Health Evaluation and Enhancement Program

    NASA Technical Reports Server (NTRS)

    Heinzelmann, F.; Durbeck, D. C.

    1970-01-01

    A study was made of the benefits reported by participants in a health evaluation and enhancement program dealing with physical activity. Program benefits were identified and defined in regard to three major areas: program effects on work; program effects on health; and program effects on habits and behavior. A strong positive and consistent relationship was found between reported benefits in each of these areas and measures of improvement in cardiovascular functioning based on treadmill performance. Significant differences in these measures of improvement were also found between participants who reported program benefits and those persons who did not. These findings provide a meaningful profile of the pattern of benefits generated by this kind of health program.

  19. Banking on health: Personal records and information exchange.

    PubMed

    Ball, Marion J; Gold, Jonathan

    2006-01-01

    Consumer demand for personal health records (PHRs) and the capabilities provided by regional health information organizations (RHIOs) will change healthcare, just as automatic teller machines have changed banking. The PHR is predicated on the existence of electronic medical records (EMRs) and electronic health records (EHRs). Patient and consumer principles guiding the development of the PHR reflect issues of access, control, privacy, and security. Working models illustrate the variations of RHIOs and PHRs possible and suggest the benefits that electronic information exchange can accrue for healthcare and healthcare consumers. Today both the private and public sectors are working to define the issues involved in efforts that are now taking place and that will transform healthcare. Consumers are ready for the type of changes that will improve healthcare quality.

  20. Web-browser encryption of personal health information

    PubMed Central

    2011-01-01

    Background Electronic health records provide access to an unprecedented amount of clinical data for research that can accelerate the development of effective medical practices. However it is important to protect patient confidentiality, as many medical conditions are stigmatized and disclosure could result in personal and/or financial loss. Results We describe a system for remote data entry that allows the data that would identify the patient to be encrypted in the web browser of the person entering the data. These data cannot be decrypted on the server by the staff at the data center but can be decrypted by the person entering the data or their delegate. We developed this system to solve a problem that arose in the context of clinical research, but it is applicable in a range of situations where sensitive information is stored and updated in a database and it is necessary to ensure that it cannot be viewed by any except those intentionally given access. Conclusion By developing this system, we are able to centralize the collection of some patient data while minimizing the risk that protected health information be made available to study personnel who are not authorized to use it. PMID:22073940

  1. Screening for and Diagnosis of Depression Among Adolescents in a Large Health Maintenance Organization.

    PubMed

    Lewandowski, R Eric; O'Connor, Briannon; Bertagnolli, Andrew; Beck, Arne; Tinoco, Aldo; Gardner, William P; Jelinek-Berents, Christine X; Newton, Douglas A; Wain, Kris F; Boggs, Jennifer M; Brace, Nancy E; deSa, Patricia; Scholle, Sarah Hudson; Hoagwood, Kimberly; Horwitz, Sarah McCue

    2016-06-01

    The aim of this analysis was to determine changes in patterns of depression screening and diagnosis over three years in primary and specialty mental health care in a large health maintenance organization (HMO) as part of a project to develop quality measures for adolescent depression treatment. Two series of aggregate data (2010-2012) were gathered from the electronic health records of the HMO for 44,342 unique adolescents (ages 12 to 21) who had visits in primary and mental health care. Chi square tests assessed the significance of changes in frequency and departmental location of Patient Health Questionnaire-9 (PHQ-9) administration, incidence of depression symptoms, and depression diagnoses. There was a significant increase in PHQ-9 use, predominantly in primary care, consistent with internally generated organizational recommendations to increase screening with the PHQ-9. The increase in PHQ-9 use led to an increase in depression diagnoses in primary care and a shift in the location of some diagnoses from specialty mental health care to primary care. The increase in PHQ-9 use was also linked to a decrease in the proportion of positive PHQ-9 results that led to formal depression diagnoses. The rate of depression screening in primary care increased over the study period. This increase corresponded to an increase in the number of depression diagnoses made in primary care and a shift in the location in which depression diagnoses were made, from the mental health department to primary care. The frequency of positive PHQ-9 administrations not associated with depression diagnoses also increased.

  2. Are Personal Health Records Safe? A Review of Free Web-Accessible Personal Health Record Privacy Policies

    PubMed Central

    Fernández-Alemán, José Luis; Toval, Ambrosio

    2012-01-01

    Background Several obstacles prevent the adoption and use of personal health record (PHR) systems, including users’ concerns regarding the privacy and security of their personal health information. Objective To analyze the privacy and security characteristics of PHR privacy policies. It is hoped that identification of the strengths and weaknesses of the PHR systems will be useful for PHR users, health care professionals, decision makers, and designers. Methods We conducted a systematic review using the principal databases related to health and computer science to discover the Web-based and free PHR systems mentioned in published articles. The privacy policy of each PHR system selected was reviewed to extract its main privacy and security characteristics. Results The search of databases and the myPHR website provided a total of 52 PHR systems, of which 24 met our inclusion criteria. Of these, 17 (71%) allowed users to manage their data and to control access to their health care information. Only 9 (38%) PHR systems permitted users to check who had accessed their data. The majority of PHR systems used information related to the users’ accesses to monitor and analyze system use, 12 (50%) of them aggregated user information to publish trends, and 20 (83%) used diverse types of security measures. Finally, 15 (63%) PHR systems were based on regulations or principles such as the US Health Insurance Portability and Accountability Act (HIPAA) and the Health on the Net Foundation Code of Conduct (HONcode). Conclusions Most privacy policies of PHR systems do not provide an in-depth description of the security measures that they use. Moreover, compliance with standards and regulations in PHR systems is still low. PMID:22917868

  3. Are personal health records safe? A review of free web-accessible personal health record privacy policies.

    PubMed

    Carrión Señor, Inmaculada; Fernández-Alemán, José Luis; Toval, Ambrosio

    2012-08-23

    Several obstacles prevent the adoption and use of personal health record (PHR) systems, including users' concerns regarding the privacy and security of their personal health information. To analyze the privacy and security characteristics of PHR privacy policies. It is hoped that identification of the strengths and weaknesses of the PHR systems will be useful for PHR users, health care professionals, decision makers, and designers. We conducted a systematic review using the principal databases related to health and computer science to discover the Web-based and free PHR systems mentioned in published articles. The privacy policy of each PHR system selected was reviewed to extract its main privacy and security characteristics. The search of databases and the myPHR website provided a total of 52 PHR systems, of which 24 met our inclusion criteria. Of these, 17 (71%) allowed users to manage their data and to control access to their health care information. Only 9 (38%) PHR systems permitted users to check who had accessed their data. The majority of PHR systems used information related to the users' accesses to monitor and analyze system use, 12 (50%) of them aggregated user information to publish trends, and 20 (83%) used diverse types of security measures. Finally, 15 (63%) PHR systems were based on regulations or principles such as the US Health Insurance Portability and Accountability Act (HIPAA) and the Health on the Net Foundation Code of Conduct (HONcode). Most privacy policies of PHR systems do not provide an in-depth description of the security measures that they use. Moreover, compliance with standards and regulations in PHR systems is still low.

  4. Combining iGoogle and personal health records to create a prototype personal health application for diabetes self-management.

    PubMed

    Fonda, Stephanie J; Kedziora, Richard J; Vigersky, Robert A; Bursell, Sven-Erik

    2010-05-01

    The aim of this project is to create a prototype for a personal health application (PHA) for patients (i.e., consumers) with diabetes by employing a user-centered design process. This article describes the design process for and resulting architecture, workflow, and functionality of such a PHA. For the design process, we conducted focus groups with people who have diabetes (n = 21) to ascertain their needs for a PHA. We then developed a prototype in response to these needs, and through additional focus groups and step-by-step demonstrations for people with diabetes as well as healthcare providers, we obtained feedback about the prototype. The feedback led to changes in the PHA's presentation and function. Focus group participants said they wanted a tool that could give them timely, readily available information on how diabetes-related domains interact, how their behaviors affect them, and what to do next. Thus, the prototype PHA is Internet-based, retrieves data for diabetes self-management from a personal health record, displays those data using gadgets in the consumer's iGoogle page, and makes the data available to a decision-support component that provides lifestyle-oriented advice. Manipulation of the data enables consumers to anticipate the results of future actions and to see interrelationships. A user-centered design process resulted in a PHA that uses technology that is publicly available, employs a personal health record, and is Internet based. This PHA can provide the backbone for a decision support system that can bring together the cornerstones of diabetes self-management and integrate them into the life of the person with diabetes.

  5. An Evaluation of Personal Health Information Remnants in Second-Hand Personal Computer Disk Drives

    PubMed Central

    Neri, Emilio; Jonker, Elizabeth

    2007-01-01

    Background The public is concerned about the privacy of their health information, especially as more of it is collected, stored, and exchanged electronically. But we do not know the extent of leakage of personal health information (PHI) from data custodians. One form of data leakage is through computer equipment that is sold, donated, lost, or stolen from health care facilities or individuals who work at these facilities. Previous studies have shown that it is possible to get sensitive personal information (PI) from second-hand disk drives. However, there have been no studies investigating the leakage of PHI in this way. Objectives The aim of the study was to determine the extent to which PHI can be obtained from second-hand computer disk drives. Methods A list of Canadian vendors selling second-hand computer equipment was constructed, and we systematically went through the shuffled list and attempted to purchase used disk drives from the vendors. Sixty functional disk drives were purchased and analyzed for data remnants containing PHI using computer forensic tools. Results It was possible to recover PI from 65% (95% CI: 52%-76%) of the drives. In total, 10% (95% CI: 5%-20%) had PHI on people other than the owner(s) of the drive, and 8% (95% CI: 7%-24%) had PHI on the owner(s) of the drive. Some of the PHI included very sensitive mental health information on a large number of people. Conclusions There is a strong need for health care data custodians to either encrypt all computers that can hold PHI on their clients or patients, including those used by employees and subcontractors in their homes, or to ensure that their computers are destroyed rather than finding a second life in the used computer market. PMID:17942386

  6. Including a measure of health status in Medicare's health maintenance organization capitation formula: reliability issues.

    PubMed

    Lichtenstein, R; Thomas, J W

    1987-02-01

    Medicare's formula for determining capitation levels for risk-based HMOs, the Adjusted Average Per Capita Cost (AAPCC), has been criticized as a poor basis for establishing payments. Among new adjusting factors suggested for the formula is a measure of beneficiaries' functional health status. The ability of such a measure to improve predictions of Medicare costs has been demonstrated in several studies. In addition to possessing predictive validity, a measure considered for inclusion in the AAPCC must also be reliable. In this paper, the authors examine a measure of functional health status for intrarater reliability or, equivalently, stability over time. A sample of 1,616 Medicare beneficiaries was surveyed twice--in late 1982 and in January 1984. Using a five-point scale, functional health status scores were calculated for each of the beneficiaries at two points in time. For 68.4% of the sample, functional health scores were unchanged over the year, and second-year scores were within one point of first-year scores for 94.3% of the sample. Based on the intraclass correlation coefficient, the scores on this functional health scale demonstrated substantial to "almost perfect" agreement over the 1-year period.

  7. Effect of Integrated Personalized Health Care System on Middle-Aged and Elderly Women's Health

    PubMed Central

    Lee, Hiye-Ja; Park, Seung-Hun; Ju, Se-Jin; Jin, Mi-Hwa; Park, Boc-Nam

    2012-01-01

    Objectives Body weight, body mass index (BMI), body fat, and blood pressure are important indicators of a person's health. In this experimental study, we evaluated the effectiveness of an integrated personalized health care system, Health Improvement and Management System (HIMS)-everyday, which instantly provides subjects with biofeedback on their measured body weight, BMI, body fat and blood pressure using a database that stores subjects-customized information. Methods The subjects of this study used the system once or twice a week for 8 weeks. We analyzed the changes in their body weight, BMI, body fat, and blood pressure according to their respective usage of the system, and analyzed the changes in their perceived health status and health promoting behavior accordingly. Results Subjects' body weight, BMI, and blood pressure decreased significantly with respect to their individual usage of the system. Subjects who used the system more frequently showed significant improvement in their body weight, BMI, and body fat. However, subjects' perceived health status and health promoting behavior did not improve significantly. Conclusions The study showed that the biofeedback-based personalized health care system was effective in controlling middle-aged and elderly women' body weight, BMI, body fat, and blood pressure. PMID:23115743

  8. Resilience associated with mental health problems among methadone maintenance treatment patients in Guangzhou, China.

    PubMed

    Jiao, Mingxu; Gu, Jing; Xu, Huifang; Hao, Chun; Lau, Joseph T F; Mo, Phoenix; Liu, Di; Zhao, Yuteng; Zhang, Xiao; Babbitt, Andrew; Hao, Yuantao

    2017-05-01

    A considerable proportion of methadone maintenance treatment (MMT) clients have experienced mental health problems (e.g., depression and anxiety), and poor mental health status is associated with HIV-related risk behaviors and treatment drop-out. Resilience is known to be a protective factor for mental health problems but is not studied among MMT clients in China. This study aimed to explore the relationship between resilience and mental health problems (depression, anxiety and stress) among clients of community-based MMT clinics in China. A total of 208 MMT clients completed the face-to-face interview conducted at 4 of 11 MMT clinics in Guangzhou. The Chinese short version of Depression Anxiety Stress Scale (DASS-21) was used to assess the presence of depressive, anxiety and stress symptoms, and the Connor-Davidson Resilience Scale (CD-RISC) was used to measure resilience. Logistic regression models were fit in data analyses. Of all participants, 12.8%, 19.5% and 8.3% had depression, anxiety and stress, respectively. The mean resilience score was 57.6 (SD = 15.9). In the univariate analyses, resilience was negatively associated with two studied mental health problems (depression and anxiety, ORu = 0.96 and 0.96, p < .01). In multivariate models adjusting for both background and other psycho-social factors, resilience was independently associated with probable depression (ORa = 0.97, 95% CI: 0.93-0.99) and anxiety (ORa = 0.96, 95% CI: 0.94-0.99). Resilience was independently associated with depression and anxiety. As resilience is changeable, interventions targeting mental health problems of MMT users should consider resilience as an important part in the designing of such interventions.

  9. A Patient-Centric Taxonomy for Personal Health Records (PHRs)

    PubMed Central

    Vincent, Adam; Kaelber, David C.; Pan, Eric; Shah, Sapna; Johnston, Douglas; Middleton, Blackford

    2008-01-01

    Today, the nascent field of personal health records (PHRs) lacks a comprehensive taxonomy that encompasses the full range of PHRs currently in existence and what may be possible. The Center for Information Technology Leadership (CITL) has created a taxonomy that broadly defines a PHR as having both an infrastructure component, which allows for data viewing and sharing, and an application component, allowing for selfmanagement and information exchange. The taxonomy also accounts for different PHR architectures – provider, payer, third-party, or interoperable. This comprehensive taxonomy may help to define the field of PHRs and provide a framework for assessing PHR value. PMID:18998912

  10. The check is in the mail: determinants of claims payable timing among health maintenance organizations.

    PubMed

    Connor, Robert; Wholey, Douglas R; Feldman, Roger; Riley, William

    2004-01-01

    This paper used financial data from health maintenance organizations (HMOs) in the United States from the period 1985 to 2001 to examine the determinants of claims payable--the dollar amount of services rendered to enrollees but for which the HMO has not yet paid providers, such as physicians and hospitals. Claims payable management is important because delaying payments to providers can jeopardize provider operations and reduce HMO operational flexibility. The results show that HMOs manage claims payable with a multi-period perspective designed to evoke favorable responses and to avoid unfavorable ones from external parties, and to maintain flexibility for unexpected conditions. Higher HMO profitability, quicker receipt of premiums by the HMO, increased provider involvement, and greater local control of the HMO lead to faster payment to providers. Implications for HMO managers, providers, employers, and regulators are discussed.

  11. Evaluation of prototype air/fluid separator for Space Station Freedom Health Maintenance Facility

    NASA Technical Reports Server (NTRS)

    Billica, Roger; Smith, Maureen; Murphy, Linda; Kizzee, Victor D.

    1991-01-01

    A prototype air/fluid separator suction apparatus proposed as a possible design for use with the Health Maintenance Facility aboard Space Station Freedom (SSF) was evaluated. A KC-135 parabolic flight test was performed for this purpose. The flights followed the standard 40 parabola profile with 20 to 25 seconds of near-zero gravity in each parabola. A protocol was prepared to evaluate the prototype device in several regulator modes (or suction force), using three fluids of varying viscosity, and using either continuous or intermittent suction. It was felt that a matrixed approach would best approximate the range of utilization anticipated for medical suction on SSF. The protocols were performed in one-gravity in a lab setting to familiarize the team with procedures and techniques. Identical steps were performed aboard the KC-135 during parabolic flight.

  12. Sexual health care in persons with intellectual disabilities.

    PubMed

    Servais, Laurent

    2006-01-01

    In the past, preventive health concerning sexuality of people with intellectual disabilities was addressed through surgical sterilization as part of nationwide eugenic programs in many countries. For more than 30 years now, it has come progressively to light in the scientific literature that, besides major ethical and legal problems, these programs also failed to assess many of the individual's needs in sexual health. The fact that an increasing number of people with intellectual disabilities live in the community rather than in institutions has heightened public awareness that these individuals have sexual expectancies, desires, and needs that must be supported through both education and health services. The emergence of AIDS, including descriptions of cases among people with intellectual disabilities, has further demonstrated that surgical sterilization cannot be considered a global option to achieve preventive sexual health. The aim of this paper is to review scientific studies that have assessed the expectancies and support needs of persons with intellectual disabilities in terms of sexual health. These needs vary widely from one individual to another, according to life milieu, level of disability, and potential comorbidity. From this review, it appears that hygiene management, global gynecological care, and prevention of unplanned pregnancy, sexually transmitted diseases, and abuse have been frequently identified as areas in which the presence of intellectual disability dictates specific support needs. Different approaches that have been evaluated to address these issues will also be discussed.

  13. Infrastructure for Personalized Medicine at Partners HealthCare

    PubMed Central

    Weiss, Scott T.; Shin, Meini Sumbada

    2016-01-01

    Partners HealthCare Personalized Medicine (PPM) is a center within the Partners HealthCare system (founded by Massachusetts General Hospital and Brigham and Women’s Hospital) whose mission is to utilize genetics and genomics to improve the care of patients in a cost effective manner. PPM consists of five interconnected components: (1) Laboratory for Molecular Medicine (LMM), a CLIA laboratory performing genetic testing for patients world-wide; (2) Translational Genomics Core (TGC), a core laboratory providing genomic platforms for Partners investigators; (3) Partners Biobank, a biobank of samples (DNA, plasma and serum) for 50,000 Consented Partners patients; (4) Biobank Portal, an IT infrastructure and viewer to bring together genotypes, samples, phenotypes (validated diagnoses, radiology, and clinical chemistry) from the electronic medical record to Partners investigators. These components are united by (5) a common IT system that brings researchers, clinicians, and patients together for optimal research and patient care. PMID:26927187

  14. The Cradle Coast personally controlled electronic health record evaluation research.

    PubMed

    Cummings, Elizabeth; Cheek, Colleen; Van Der Ploeg, Winifred; Orpin, Peter; Behrens, Heidi; Condon, Sharon; Jaffray, Linda; Ellis, Isabelle; Ringeisen Arnold, Barbara; Brogan, Robyn; Skinner, Timothy

    2012-01-01

    In 2010 the Federal Government announced funding over two years to create a Personally Controlled Electronic Health Record (PCEHR) for Australians. One of the wave 2 implementation sites is the Cradle Coast in Tasmania. A PCEHR Program Benefits and Evaluation Partner (BEP) has been appointed to undertake evaluation activities with the e-health lead implementation sites. In addition to this implementation a comprehensive research plan has been developed and commenced through the Rural Clinical School at the University of Tasmania. The overarching aim of the research agenda is to evaluate the outcomes of various elements of the 4C project as it evolves and is implemented, from multiple perspectives. The research agenda is important as it expands upon the NEHTA mandated evaluation and provides an holistic overview of the PCEHR implementation process and outcomes for clinicians, patients and family members. This paper will detail the planned evaluation and its progress to date.

  15. Motion aware clothing for the personal health assistant.

    PubMed

    Tröster, Gerhard; Kirstein, Tünde; Lukowicz, Paul

    2005-01-01

    This paper sketches the vision and first results of a 'Personal Health Assistant' PHA, opening up new vistas in patient centred healthcare. The PHA is comprised of a wearable sensing and communicating system, seamlessly embedded in daily clothing. Several on-body sensors monitor the biometric and contextual status of the wearer continuously. The embedded computer fuses the vital and physiological data with activity patterns of the wearer and with the social environment; based on these data the on-body computer generates the 'Life Balance Factor' LBF as an individual feedback to the user and to the surroundings afford-ing effective disease prevention, management and rehabilitation, the last also involving telemedicine. The state-of-the-art enabling technologies: smart textile technology and miniaturization of electronics combined with wireless communication, along with recent developments in wearable computing are presented and assessed in the context of multiparameter health monitoring.

  16. Nuadu concept for personal management of lifestyle related health risks.

    PubMed

    Mattila, E; Korhonen, I; Lappalainen, R; Ahtinen, A; Hopsu, L; Leino, T

    2008-01-01

    Majority of the health risks and diseases in the modern world are related to lifestyles, e.g., overweight, unhealthy diet, physical inactivity, sleep deprivation, and stress. Behavioral change towards healthy lifestyles is the key to the prevention and management of these risks, but early and efficient interventions are scarcely available. We present the Nuadu Concept, an ICT (Information and Communication Technologies) assisted wellness toolbox for the management of multiple, behavior-originated health risks. The concept is based on psychological models, which provide methods and motivation for behavior change. The individual is considered as the best expert of his/her own wellness. Thus, the Nuadu Concept provides a variety of personal wellness technologies and services, among which the user may freely choose the best tools for him/herself. We believe this approach has the potential to provide efficient, acceptable, available, and affordable wellness management support for a significant number of people.

  17. [Mental health service utilization among borderline personality disorder patients inpatient].

    PubMed

    Cailhol, L; Thalamas, C; Garrido, C; Birmes, P; Lapeyre-Mestre, M

    2015-04-01

    Borderline personality disorder (BPD) is characterized by a pervasive pattern of instability and impulsivity. Several North American prospective studies support the high level of mental health care utilization in this population. There is little data in other systems of health organization, such as France. Furthermore, little is known on the variables associated with the mental health service utilization among BPD patients. The main objective was to compare the utilization of mental health care among BPD patients, to the general population and patients with another personality disorder (PD) and to describe the demographic and clinical factors associated with the group of patients who use the most health care. A multi-center (5 public and private centers), epidemiological study. Data were collected prospectively (database of an insurance fund covering 80% of the population) and viewed, retrospectively. We used the data collected during the five years previously to the inclusion. Inclusion criteria were age (18-60 years) and membership in the health insurance fund targeted. Patients on legal protection, forced hospitalization, with a chronic psychotic disorder, manic, mental retardation, or not reading French were excluded. First, four groups were composed: BPD, other PD, control groups for PD and other PD. The first two groups were recruited from a screening of inpatients including a self-administered questionnaire (Personality Disorder Questionnaire 4+). Assessment by a psychologist including the Structured Interview for DSM-IV Personality Disorders (SIDP-IV) was given straight to those who had a score above 28. This questionnaire allowed us to distinguish one group of subjects with BPD and a group with other PD (without BPD). Clinical evaluation included Axis I (MINI), Axis II (SIDP-IV), psychopathological features (YSQ-I, DSQ-40), demographic variables and therapeutic alliance (Haq-II). Matched controls (age, sex) composed the 3rd and 4th group (BPD control and

  18. The value of personal health record (PHR) systems.

    PubMed

    Kaelber, David; Pan, Eric C

    2008-11-06

    Personal health records (PHRs) are a rapidly growing area of health information technology despite a lack of significant value-based assessment.Here we present an assessment of the potential value of PHR systems, looking at both costs and benefits.We examine provider-tethered, payer-tethered, and third-party PHRs, as well as idealized interoperable PHRs. An analytical model was developed that considered eight PHR application and infrastructure functions. Our analysis projects the initial and annual costs and annual benefits of PHRs to the entire US over the next 10 years.This PHR analysis shows that all forms of PHRs have initial net negative value. However, at the end of 10 years, steady state annual net value ranging from$13 billion to -$29 billion. Interoperable PHRs provide the most value, followed by third-party PHRs and payer-tethered PHRs also showing positive net value. Provider-tethered PHRs constantly demonstrating negative net value.

  19. Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities.

    PubMed

    Chen, Jie; Mullins, C Daniel; Novak, Priscilla; Thomas, Stephen B

    2016-02-01

    Designing culturally sensitive personalized interventions is essential to sustain patients' involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and self-determination for their own health and health care. We propose a patient-centered, multilevel activation and empowerment framework (individual-, health care professional-, community-, and health care delivery system-level) to inform the development of culturally informed personalized patient activation and empowerment (P-PAE) interventions to improve population health and reduce racial and ethnic disparities. We discuss relevant Affordable Care Act payment and delivery policy reforms and how they affect patient activation and empowerment. Such policies include Accountable Care Organizations and value-based purchasing, patient-centered medical homes, and the community health benefit. Challenges and possible solutions to implementing the P-PAE are discussed. Comprehensive and longitudinal data sets with consistent P-PAE measures are needed to conduct comparative effectiveness analyses to evaluate the optimal P-PAE model. We believe the P-PAE model is timely and sustainable and will be critical to engaging patients in their treatment, developing patients' abilities to manage their health, helping patients express concerns and preferences regarding treatment, empowering patients to ask questions about treatment options, and building up strategic patient-provider partnerships through shared decision making. © 2015 Society for Public Health Education.

  20. Personal Health Records for Patients with Chronic Disease

    PubMed Central

    Rozenblum, R.; Park, A.; Dunn, M.; Bates, D.W.

    2014-01-01

    Summary Background Personal health records (PHRs) connected to a physician’s electronic health record system hold substantial promise for supporting and engaging patients with chronic disease. Objectives: To explore how U.S. health care organizations are currently utilizing PHRs for chronic disease populations. Methods A mixed methods study including semi-structured interviews and a questionnaire was conducted. A purposive sample was developed of health care organizations which were recognized as exemplars for PHRs and were high performers in national patient satisfaction surveys (H-CAHPS or CAHPS). Within each organization, participants were health IT leaders or those managing high-risk or chronic disease populations. Results Interviews were conducted with 30 informants and completed questionnaires were received from 16 organizations (84% response rate). Most PHRs allowed patients to access health records and educational material, message their provider, renew prescriptions and request appointments. Patient generated data was increasingly being sought and combined with messaging, resulted in greater understanding of patient health and functioning outside of the clinic visit. However for chronic disease populations, there was little targeted involvement in PHR design and few tools to help interpret and manage their conditions beyond those offered for all. The PHR was largely uncoupled from high risk population management interventions and no clear framework for future PHR development emerged. Conclusion This technology is currently underutilized and represents a major opportunity given the potential benefits of patient engagement and shared decision making. A coherent patient-centric PHR design and evaluation strategy is required to realize its potential and maximize this natural hub for multidisciplinary care co-ordination. PMID:25024758

  1. The implications of electronic health record for personalized medicine.

    PubMed

    Shabo, Amnon

    2005-12-01

    The emerging concept of an electronic health record (EHR) targeted at a patient centric, cross-institutional and longitudinal information entity (possibly spanning the individuals lifetime) has great promise for personalized medicine. In fact, it is probably the only vehicle through which we may truly realize the personalization of medicine beyond population-based genetic profiles that are expected to become part of medication and treatment indications in the near future. The new EHR standards include mechanisms that integrate clinical data with genomic testing results obtained through applying research-type procedures, such as full DNA sequencing, to an individual patient. Although the most optimal process for the utilization of integrated clinical-genomic data in the EHR framework is still unclear, the new Health Level Seven (HL7) Clinical Genomics Draft Standard for Trial Use suggests using the 'encapsulate & bubble-up' approach, which includes two main phases: the encapsulation of raw genomic data and bubbling-up the most clinically significant portions of that data, while associating it with clinical phenotypes residing in the individual's EHR.

  2. Personality, Aging Self-Perceptions, and Subjective Health: A Mediation Model

    ERIC Educational Resources Information Center

    Moor, Caroline; Zimprich, Daniel; Schmitt, Marina; Kliegel, Matthias

    2006-01-01

    Since the global item of subjective health has emerged as a strong predictor of important health outcomes such as mortality, there have been many attempts to uncover its correlates. In this study, we tested whether personality as assessed via the five-factor model of personality predicted subjective health when physician-rated health and…

  3. Personality, Aging Self-Perceptions, and Subjective Health: A Mediation Model

    ERIC Educational Resources Information Center

    Moor, Caroline; Zimprich, Daniel; Schmitt, Marina; Kliegel, Matthias

    2006-01-01

    Since the global item of subjective health has emerged as a strong predictor of important health outcomes such as mortality, there have been many attempts to uncover its correlates. In this study, we tested whether personality as assessed via the five-factor model of personality predicted subjective health when physician-rated health and…

  4. An Exploratory Study into Health Care Policy for Persons with Intellectual Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Lin, J. D.; Wu, J. L.; Yen, C. F.

    2004-01-01

    Although Taiwan has already had a higher quality of health care compared with other countries, there still is a need to review the quality and effectiveness of services provided. The lack of health care policy for persons with disabilities is a reflection of health care provision in Taiwan. Health care provision problems will limit persons with…

  5. Core Self-Evaluations as Personal Factors in the World Health Organization's International Classification of Functioning, Disability and Health Model: An Application in Persons with Spinal Cord Injury

    ERIC Educational Resources Information Center

    Yaghmanian, Rana; Smedema, Susan Miller; Thompson, Kerry

    2017-01-01

    Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu's (2009) revised World Health Organization's International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI). Method: One hundred eighty-seven adults with SCI were…

  6. The shape of health: A comparison of five alternative ways of visualizing personal health and wellbeing.

    PubMed

    Ledesma, Andres; Nieminen, Hannu; Valve, Paivi; Ermes, Miikka; Jimison, Holly; Pavel, Misha

    2015-01-01

    The combination of clinical and personal health and wellbeing data can tell us much about our behaviors, risks and overall status. The way this data is visualized may affect our understanding of our own health. To study this effect, we conducted a small experiment with 30 participants in which we presented a holistic overview of the health and wellbeing of two modeled individuals, one of them with metabolic syndrome. We used an insight-based methodology to assess the effectiveness of the visualizations. The results show that adequate visualization of holistic health data helps users without medical background to better understand the overall health situation and possible health risks related to lifestyles. Furthermore, we found that the application of insight-based methodology in the health and wellbeing domain remains unexplored and additional research and methodology development are needed.

  7. Ethics of patient activation: exploring its relation to personal responsibility, autonomy and health disparities.

    PubMed

    Gibert, Sophia H; DeGrazia, David; Danis, Marion

    2017-10-01

    Discussions of patient-centred care and patient autonomy in bioethics have tended to focus on the decision-making context and the process of obtaining informed consent, leaving open the question of how patients ought to be counselled in the daily maintenance of their health and management of chronic disease. Patient activation is an increasingly prominent counselling approach and measurement tool that aims to improve patients' confidence and skills in managing their own health conditions. The strategy, which has received little conceptual or ethical analysis, raises important questions about how clinicians ought to foster confidence and a sense of control in their patients without exposing them to blame, stigma and other harms. In this paper, we describe patient activation, discuss its relationship to personal responsibility, autonomy and health disparities, and make recommendations regarding its use and measurement. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities

    PubMed Central

    Chen, Jie; Mullins, C. Daniel; Novak, Priscilla; Thomas, Stephen B.

    2015-01-01

    Designing culturally-sensitive personalized interventions is essential to sustain patients’ involvement in their treatment, and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and self-determination for their own health and health care. We propose a patient-centered, multi-level activation and empowerment framework (individual-, health care professional-, community-, and health care delivery system-level) to inform the development of culturally informed personalized patient activation and empowerment (P-PAE) interventions to improve population health, and reduce racial and ethnic disparities. We discuss relevant Affordable Care Act payment and delivery policy reforms, and how they impact patient activation and empowerment. Such policies include Accountable Care Organizations and Value Based Purchasing, Patient Centered Medical Homes, and the Community Health Benefit. Challenges and possible solutions to implementing the P-PAE are discussed. Comprehensive and longitudinal data sets with consistent P-PAE measures are needed to conduct comparative effectiveness analyses to evaluate the optimal P-PAE model. We believe the P-PAE model is timely and sustainable, and will be critical to engaging patients in their treatment, developing patients’ abilities to manage their health, helping patients to express concerns and preferences regarding treatment, empowering patients to ask questions about treatment options, and building up strategic patient-provider partnerships through shared decision making. PMID:25845376

  9. Health Insurance Exchanges: Health Insurance Navigators and In-Person Assistance

    DTIC Science & Technology

    2013-09-25

    they may not accept compensation from health insurance companies in that role. Consumers may also purchase policies directly from health insurers...and In-Person Assistance Congressional Research Service 2 businesses, and issuers are not required to use the exchanges to purchase insurance...apply for coverage through the exchanges may be eligible for small business tax credits.5 Consumers may apply for coverage over the phone, online , via

  10. Personal Health Management: Be Your Body's Best Friend. Retirement Preparation Guide No. 7.

    ERIC Educational Resources Information Center

    Page, Frances I.

    This article examines the issues at the center of positive health maintenance in later life. Included are helpful planning aids, as well as references for further reading on such subjects as exercise and nutrition. (Author/MLF)

  11. A Quantitative Exploration of the Relationship between Patient Health and Electronic Personal Health Records

    ERIC Educational Resources Information Center

    Hines, Denise Williams

    2009-01-01

    The use of electronic personal health records is becoming increasingly more popular as healthcare providers, healthcare and government leaders, and patients are seeking ways to improve healthcare quality and to decrease costs (Abrahamsen, 2007). This quantitative, descriptive correlational study examined the relationship between the degree of…

  12. A Quantitative Exploration of the Relationship between Patient Health and Electronic Personal Health Records

    ERIC Educational Resources Information Center

    Hines, Denise Williams

    2009-01-01

    The use of electronic personal health records is becoming increasingly more popular as healthcare providers, healthcare and government leaders, and patients are seeking ways to improve healthcare quality and to decrease costs (Abrahamsen, 2007). This quantitative, descriptive correlational study examined the relationship between the degree of…

  13. Review of Extracting Information From the Social Web for Health Personalization

    PubMed Central

    Karlsen, Randi; Bonander, Jason

    2011-01-01

    In recent years the Web has come into its own as a social platform where health consumers are actively creating and consuming Web content. Moreover, as the Web matures, consumers are gaining access to personalized applications adapted to their health needs and interests. The creation of personalized Web applications relies on extracted information about the users and the content to personalize. The Social Web itself provides many sources of information that can be used to extract information for personalization apart from traditional Web forms and questionnaires. This paper provides a review of different approaches for extracting information from the Social Web for health personalization. We reviewed research literature across different fields addressing the disclosure of health information in the Social Web, techniques to extract that information, and examples of personalized health applications. In addition, the paper includes a discussion of technical and socioethical challenges related to the extraction of information for health personalization. PMID:21278049

  14. Somatic health among heroin addicts before and during opioid maintenance treatment: a retrospective cohort study

    PubMed Central

    Skeie, Ivar; Brekke, Mette; Lindbæk, Morten; Waal, Helge

    2008-01-01

    Background The long-term impact of opioid maintenance treatment (OMT) on morbidity and health care utilization among heroin addicts has been insufficiently studied. The objective of this study was to investigate whether health care utilization due to somatic disease decreased during OMT, and if so, whether the reduction included all kinds of diseases and whether a reduction was related to abstinence from drug use. Methods Cohort study with retrospective registration of somatic disease incidents (health problems, acute or sub-acute, or acute problems related to chronic disease, resulting in a health care contact). Medical record data were collected from hospitals, Outpatients' Departments, emergency wards and from general practitioners (GPs) and prospective data on substance use during OMT were available from 2001 onwards. The observation period was five years before and up to five years during OMT. The cohort consisted of 35 out of 40 patients who received OMT between April 1999 and January 2005 in a Norwegian district town. Statistical significance concerning changes in number of incidents and inpatient and outpatient days during OMT compared with the pre OMT period was calculated according to Wilcoxon signed rank test. Significance concerning pre/during OMT changes in disease incidents by relation to the type of health service contacts, as well as the impact of ongoing substance use during OMT on the volume of contacts, was calculated according to Pearson chi-square and Fisher's exact tests. Results 278 disease incidents were registered. There was a reduction in all incidents by 35% (p = 0.004), in substance-related incidents by 62% (p < 0.001) and in injection-related incidents by 70% (p < 0.001). There was an insignificant reduction in non-fatal overdose incidents by 44% (p = 0.127) and an insignificant increase in non-substance-related incidents by 13% (p = 0.741). Inpatient and outpatient days were reduced by 76% (p = 0.003) and 46% (p = 0.060), respectively

  15. Examining the Role of Anxiety and Apathy in Health Consumers' Intentions to Use Patient Health Portals for Personal Health Information Management

    ERIC Educational Resources Information Center

    Torres, Carlos A.

    2011-01-01

    This study investigated college students' attitudes toward and intentions to use personal health portals (PHPs) for managing their personal health information using a survey method. The study also aimed to examine the roles electronic Personal Health Information Management (PHIM) anxiety and apathy play in influencing students' attitudes toward…

  16. Examining the Role of Anxiety and Apathy in Health Consumers' Intentions to Use Patient Health Portals for Personal Health Information Management

    ERIC Educational Resources Information Center

    Torres, Carlos A.

    2011-01-01

    This study investigated college students' attitudes toward and intentions to use personal health portals (PHPs) for managing their personal health information using a survey method. The study also aimed to examine the roles electronic Personal Health Information Management (PHIM) anxiety and apathy play in influencing students' attitudes toward…

  17. Co-production of Health enabled by next generation personal health systems.

    PubMed

    Boye, Niels

    2012-01-01

    This paper describes the theoretical principles for the establishment of a parallel and complementary modality of healthcare delivery - named Coproduction of Health (CpH). This service-model activates digital data, information, and knowledge about health, healthy choices, and the individuals' health-state and computes through personalized models context-aware communication and advice. "Lightweight technologies" (smartphones, tablets, application stores) would serve as the technology close to the end-users (citizens, patients, clients, customers), connecting them with "big data" in conventionally and non-conventionally organized data repositories. The CpH modality aims at providing synergies between professional healthcare, selfcare, informal care and provides data-fusion from several sources such as health characteristics of consumer goods, from sensors, actuators, and health related data-repositories, and turns this into "health added value" for the individual. A theoretical business model respecting healthcare values, ethics, and legal foundation is also sketched out.

  18. Consumer attitudes toward personal health records in a beacon community.

    PubMed

    Patel, Vaishali N; Abramson, Erika; Edwards, Alison M; Cheung, Melissa A; Dhopeshwarkar, Rina V; Kaushal, Rainu

    2011-04-01

    To characterize consumers' attitudes about personal health records (PHRs), electronic tools that enable consumers to securely access, manage, and share their health information, in a community participating in health information technology initiatives. Cross-sectional study. A random-digit-dial telephone survey about PHRs was conducted among adult residents of New York State's greater Buffalo region. Multivariate regression analyses identified factors associated with potential PHR use. We obtained a 79% (n = 200) response rate. Many respondents (70%) would potentially use PHRs. Consumers wanted PHRs to incorporate an array of information, including immunization records (89%) and providers visited (88%). They expressed interest in several online activities, including accessing their family members' healthcare information (71%). Potential PHR use was associated with perceptions that PHRs would improve privacy and security of medical information (odds ratio [OR] 4.7; 95% confidence interval [CI] 1.1, 20.1), understanding regarding health (OR 3.7; 95% CI 1.3, 11.1), and overall quality of care (OR 3.6; 95% CI 1.2, 10.6). Potential PHR use was associated with annual household income of more than $30,000 (OR 3.9; 95% CI 1.3, 11.9) and experience looking up health information online (OR 3.0; 95% CI 1.1, 8.1). Consumers expressed great interest in using PHRs and wanted comprehensive PHRs. However, the "digital divide" between those with varying levels of Internet experience and concerns about PHRs’ effect on privacy and security of medical information may limit use. Designing PHRs that incorporate consumer preferences and developing policies that address these barriers may increase consumers' PHR use.

  19. Health Maintenance Organizations and Academic Medical Centers. Proceedings of a National Conference (Colorado Springs, Colorado, October 1980).

    ERIC Educational Resources Information Center

    Hudson, James I., Ed.; Nevins, Madeline M., Ed.

    In October 1980 a national conference on health maintenance organizations (HMOs) and Academic Medical Centers (AMCs) was held by the Association of American Medical Colleges and supported by the Henry J. Kaiser Family Foundation, in response to inquiries about the advantages and disadvantages of AMC affiliation with or sponsorship of HMOs.…

  20. 26 CFR 1.420-1 - Significant reduction in retiree health coverage during the cost maintenance period.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 5 2014-04-01 2014-04-01 false Significant reduction in retiree health coverage during the cost maintenance period. 1.420-1 Section 1.420-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.420-1...

  1. 26 CFR 1.420-1 - Significant reduction in retiree health coverage during the cost maintenance period.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Significant reduction in retiree health coverage during the cost maintenance period. 1.420-1 Section 1.420-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.420-1...

  2. 26 CFR 1.420-1 - Significant reduction in retiree health coverage during the cost maintenance period.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Significant reduction in retiree health coverage during the cost maintenance period. 1.420-1 Section 1.420-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.420-1...

  3. Primary Care Education in Health Maintenance Organizations: Curriculum Content, Evaluation and Costs. A Collaborative Study. Final Report.

    ERIC Educational Resources Information Center

    Infeld, Marcel D.

    The report is an effort to summarize and synthesize the work of six academic medical centers and affiliated health maintenance organizations that participated in the project for the development and implementation of curricula for physician training in HMO's. The selected works of the participating institutions constitute the bulk of the report.…

  4. Personality, self-rated health, and cognition in centenarians: Do personality and self-rated health relate to cognitive function in advanced age?

    PubMed Central

    Kato, Kaori; Zweig, Richard; Schechter, Clyde B.; Verghese, Joe; Barzilai, Nir; Atzmon, Gil

    2013-01-01

    Personality and self-rated health have been linked previously to cognitive outcome in late life. However, these associations have not been shown among the oldest old. This study examined relationships between personality, self-rated health, and cognitive function in a selected sample of Ashkenazi Jewish centenarians (n = 68, 59% female) aged 95 to 106 who lived independently in the community. Personality was measured using the Personality Outlook Profile Scale (POPS), a brief measure that was validated in this population. Self-rated health was assessed by participants’ subjective rating of their present health, and Mini-Mental Status Examination was used to determine cognitive function. Results showed positive associations of the Positive Attitude Towards Life domain of the POPS and self-rated health with participants’ current cognitive function. These associations remained significant even after adjusting for the effects of participants'age, gender, marital status, education, and history of medical illnesses. Further exploratory analysis using structural equations modeling showed significant associations among the three variables, but demonstrated a borderline significant level of mediating effect of personality on the relationship between self-rated health and cognition. These results reemphasized the independent roles of personality and self-rated health on centenarians’ cognitive outcomes. Future studies will further elucidate the impact of personality and self-rated health on cognitive outcomes in the oldest old. PMID:23524310

  5. Defining personal nutrition and metabolic health through metabonomics.

    PubMed

    Rezzi, S; Martin, F-P J; Kochhar, S

    2007-01-01

    A major charter for modern nutrition is to provide a molecular basis for health outcome resulting from different food choices and how this could be designed to maintain individual health free of disease. Nutrigenomic techniques have been developed to generate information at various levels of biological organization, i.e. genes, proteins, and metabolites. Within this frame, metabonomics targets the molecular characterization of a living system through metabolic profiling. The metabolic profiles are explored with sophisticated data mining techniques mainly based on multivariate statistics, which can recover key metabolic information to be further linked to biochemical processes and physiological events. The power of metabonomics relies on its unique ability to assess functional changes in the metabolism of complex organisms stemming from multiple influences such as lifestyle and environmental factors. In particular, metabolic profiles encapsulate information on the metabolic activity of symbiotic partners, i.e. gut microflora, in complex organisms, which represent major determinant in nutrition and health. Therefore, applications of metabonomics to nutrition sciences led to the nutrimetabonomics approach for the classification of dietary responses in populations and the possibility of optimized or personalized nutritional management.

  6. Personal factors related to compassion fatigue in health professionals.

    PubMed

    Zeidner, Moshe; Hadar, Dafna; Matthews, Gerald; Roberts, Richard D

    2013-01-01

    This study examines the role of some personal and professional factors in compassion fatigue among health-care professionals. Research participants included 182 (89 mental and 93 medical) health-care professionals who completed an assessment battery measuring compassion fatigue, emotion management, trait emotional intelligence, situation-specific coping strategies, and negative affect. Major findings indicate that both self-report "trait" emotional intelligence and ability-based emotion management are inversely associated with compassion fatigue; adaptive coping is inversely related to compassion fatigue; and differences exist between mental and medical professions in emotional intelligence, coping strategies, and negative affect. Furthermore, problem-focused coping appears to mediate the association between trait emotional intelligence and compassion fatigue. These findings shed light on the role of emotional factors in compassion fatigue among health-care professionals. Beyond enhancing our knowledge of practitioners' professional quality of life, the current study serves as a basis for the early identification of groups of practitioners at risk for compassion fatigue.

  7. Emergency access authorization for personally controlled online health care data.

    PubMed

    Chen, Tingting; Zhong, Sheng

    2012-02-01

    Personally controlled health records (PCHR) systems have emerged to allow patients to control their own medical data. In a PCHR system, all the access privileges to a patient's data are granted by the patient. However, in many emergency cases, it is impossible for the patient to participate in access authorization on site when immediate medical treatment is needed. To solve the emergency access authorization problem in the absence of patients, we consider two cases: a) the requester is already in the PCHR system but has not obtained the access privilege of the patient's health records, and b) the requester does not even have an account in the PCHR system to submit its request. For each of the two cases, we present a method for emergency access authorization, utilizing the weighted voting and source authentication cryptographic techniques. Our methods provide an effective, secure and private solution for emergency access authorization, that makes the existing PCHR system frameworks more practical and thus improves the patients' experiences of health care when using PCHR systems. We have implemented a prototype system as a proof of concept.

  8. Personal health systems and value creation mechanisms in occupational health care.

    PubMed

    Auvinen, Ari-Matti

    2007-01-01

    Personal Health Systems are believed to have great business potential among citizens, but they might reach also an important market in occupational health care. However, in reaching the occupational health care market, it is important to understand the value creation and value configuration mechanisms of this particular market. This paper also claims that in such a business-to-business market service integrators are needed to compose for the various customers specific offerings combing a tailored variety of products and services to suit their specific needs.

  9. Semantic Web, Reusable Learning Objects, Personal Learning Networks in Health: Key Pieces for Digital Health Literacy.

    PubMed

    Konstantinidis, Stathis Th; Wharrad, Heather; Windle, Richard; Bamidis, Panagiotis D

    2017-01-01

    The knowledge existing in the World Wide Web is exponentially expanding, while continuous advancements in health sciences contribute to the creation of new knowledge. There are a lot of efforts trying to identify how the social connectivity can endorse patients' empowerment, while other studies look at the identification and the quality of online materials. However, emphasis has not been put on the big picture of connecting the existing resources with the patients "new habits" of learning through their own Personal Learning Networks. In this paper we propose a framework for empowering patients' digital health literacy adjusted to patients' currents needs by utilizing the contemporary way of learning through Personal Learning Networks, existing high quality learning resources and semantics technologies for interconnecting knowledge pieces. The framework based on the concept of knowledge maps for health as defined in this paper. Health Digital Literacy needs definitely further enhancement and the use of the proposed concept might lead to useful tools which enable use of understandable health trusted resources tailored to each person needs.

  10. Health professionals’ experiences of person-centered collaboration in mental health care

    PubMed Central

    Sommerseth, Rita; Dysvik, Elin

    2008-01-01

    Objective The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation. Method The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semi-structured in-depth interview to judge validity. Results Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care. Conclusion Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness. PMID:19920972

  11. Religious leaders' opinions and guidance towards oral health maintenance and promotion: a qualitative study.

    PubMed

    Zini, Avraham; Sgan-Cohen, Harold D; Feder-Bubis, Paula

    2015-04-01

    Religions emphasize the supreme value of life. However, potential or concrete conflicts of perception between dictates of faith and science often present an inescapable dilemma. The aim of this qualitative research was to examine the views of spiritual and religious leaders towards general and oral health issues. A total of 11 eminent Jewish spiritual and religious community leaders were purposively chosen. They were interviewed using a semi-structured questionnaire. The verbatim transcriptions of the interviews were analysed in the spirit of grounded theory, using qualitative data analysis software. Open, axial, and thematic coding served to build categories and themes. Analysis of participants' perspectives reflected that they, based upon Jewish theology, attributed high importance to primary prevention at both personal and community levels. Religious and orthodox people were depicted as being motivated towards maintaining oral health behaviours due to a sense of obligation to follow religious edicts, strong social support, and elevated perceived spiritual levels. We offer a theoretical model that can explain the potential high motivation among these communities towards implementing positive general and oral health behaviours. Religiosity may be regarded as an example of a psycho-social health determinant, encompassing spiritual belief ("psycho") and social support ("social") components.

  12. Interoperability of electronic health records and personal health records: key interoperability issues associated with information exchange.

    PubMed

    Pringle, Simone; Lippitt, Alex

    2009-01-01

    As patients receive medical care, their clinical history may be tracked and recorded by multiple electronic systems developed by independent vendors. Medical providers might use electronic health record (EHR) software tailored to the needs of trained medical personnel, whereas patients may interact with personal health records (PHR). The purpose of this essay is to identify the key interoperability issues associated with the information exchange between these two types of systems and offer an approach for enhancing interoperability. This article is part of a series of unpublished essays titled A Community View on How Personal Health Records Can Improve Patient Care and Outcomes in Many Healthcare Settings, a collaborative project of Northern Illinois Physicians For Connectivity and the Coalition for Quality and Patient Safety of Chicagoland. For further information on how you can obtain copies of the complete work, contact the principle Dr. Stasia Kahn at Stash5@sbcglobal.net.

  13. 42 CFR 136a.12 - Persons to whom health services will be provided.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....111 of the regulations; (2) To Public Health Service and other Federal beneficiaries under Economy Act... 42 Public Health 1 2011-10-01 2011-10-01 false Persons to whom health services will be provided. 136a.12 Section 136a.12 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN...

  14. 42 CFR 136a.12 - Persons to whom health services will be provided.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....111 of the regulations; (2) To Public Health Service and other Federal beneficiaries under Economy Act... 42 Public Health 1 2010-10-01 2010-10-01 false Persons to whom health services will be provided. 136a.12 Section 136a.12 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN...

  15. Quality of outpatient care provided to diabetic patients. A health maintenance organization experience.

    PubMed

    Peters, A L; Legorreta, A P; Ossorio, R C; Davidson, M B

    1996-06-01

    To document the quality of diabetes care provided to patients in a large health maintenance organization (HMO) from 1 January 1993 to 1 January 1994 and compare it to the standards of the American Diabetes Association (ADA). To meet a Health Plan and Employer Data Information Set (HEDIS) requirement, a major HMO in California identified 14,539 members with diabetes and randomly selected 384 individuals for review. Charts were available on 353 of these patients, and after obtaining the information for the HEDIS review, additional information was extracted from the charts by an outside chart reviewer. This data set was used for an analysis of the quality of diabetic care provided by the participating medical groups to these HMO members during 1 year. Documentation of follow-up and measures of glycemic and lipid control was examined both for absolute values and for the frequency of measurement over the year. These results were compared to the ADA standards of care. Although patients averaged 4.5 visits to their primary care physicians (PCPs) over the year, 21% had one or fewer visits per year. Glycated hemoglobin levels were not documented in 56% of patients (ADA recommends two to four measurements per year), and of those with a glycated hemoglobin level measured. 39% had at least one value > or = 10%. Fasting plasma glucose concentrations were not documented in 65% of patients (four to six per year recommended). Foot exams (which should be performed at each regular visit) were not documented for 94% of patients. Urine protein measurements were not performed in 52% of patients. Additionally, many patients had elevated and untreated lipid abnormalities. In spite of the frequency of PCP visits during the year for many of these patients, diabetes management was inadequate. This lack of adequate preventive care will lead to an increased risk of the development of the acute and chronic complications of diabetes, creating an even greater future burden on the health care

  16. Adherence to standards of care by health maintenance organizations in Israel and the USA.

    PubMed

    Rosen, Bruce; Porath, Avi; Pawlson, L Gregory; Chassin, Mark R; Benbassat, Jochanan

    2011-02-01

    The health-care systems in the USA and Israel differ in organization, financing and expenditure levels. However, managed care organizations play an important role in both countries, and a comparison of the performance of their community-based health plans could inform policymakers about ways to improve the quality of care. To compare the adherence to standards of care in Israel and in the USA. An observational study comparing trends in performance using data from reports of the National Quality Measures Program in Israel and of the National Committee for Quality Assurance in the USA. Differences in specifications preclude a comparison between most measures in the two reports. However, the comparison of 11 similar measures in the 2007 reports indicates that performance was higher in the USA by 10 or more percentage points on four measures (flu immunization, medication for asthma, screening for colorectal cancer and monitoring for diabetic nephropathy). Performance was higher in Israel on three measures in patients with diabetes (blood pressure, low-density lipoprotein (LDL) cholesterol and glycemic control), and similar on the remaining four measures. Between 2005 and 2007, quality of care improved in both countries. However, improvement was slower in the USA than in Israel. In comparison with the USA, Israel achieves comparable health maintenance organization (HMO) quality on several primary care indicators and more rapid quality improvement, despite its substantially lower level of expenditure. Considering the differences between the two countries in settings and populations, further research is needed to assess the causes, generalizability and policy implications of these findings.

  17. Mobile Personal Health System for Ambulatory Blood Pressure Monitoring

    PubMed Central

    Felix, Vanessa G.; Ostos, Rodolfo; Gonzalez, Jesus A.; Cervantes, Armando; Ochoa, Armando; Ruiz, Carlos; Ramos, Roberto; Maestre, Gladys E.

    2013-01-01

    The ARVmobile v1.0 is a multiplatform mobile personal health monitor (PHM) application for ambulatory blood pressure (ABP) monitoring that has the potential to aid in the acquisition and analysis of detailed profile of ABP and heart rate (HR), improve the early detection and intervention of hypertension, and detect potential abnormal BP and HR levels for timely medical feedback. The PHM system consisted of ABP sensor to detect BP and HR signals and smartphone as receiver to collect the transmitted digital data and process them to provide immediate personalized information to the user. Android and Blackberry platforms were developed to detect and alert of potential abnormal values, offer friendly graphical user interface for elderly people, and provide feedback to professional healthcare providers via e-mail. ABP data were obtained from twenty-one healthy individuals (>51 years) to test the utility of the PHM application. The ARVmobile v1.0 was able to reliably receive and process the ABP readings from the volunteers. The preliminary results demonstrate that the ARVmobile 1.0 application could be used to perform a detailed profile of ABP and HR in an ordinary daily life environment, bedsides of estimating potential diagnostic thresholds of abnormal BP variability measured as average real variability. PMID:23762189

  18. A cost model for personal health records (PHRs).

    PubMed

    Shah, Sapna; Shah, Sapna S; Kaelber, David C; Kaelber, David Charles; Vincent, Adam; Pan, Eric C; Pan, Eric; Johnston, Douglas; Middleton, Blackford

    2008-11-06

    Personal health records (PHRs) are a rapidly expanding area in medical informatics due to the belief that they may improve healthcare delivery and control costs of care. To truly understand the full potential value of a technology, a cost analysis is critical.However, little evidence exists on the value potential of PHRs, and a cost model for PHRs does not currently exist in the literature.This paper presents a sample cost model for PHR systems, which include PHR infrastructure and applications. We used this model to examine the costs of provider-tethered, payer-tethered, third-party, and interoperable PHRs. Our model projects that on a per-person basis, third-party PHRs will be the most expensive followed by inter operable PHRs, and then provider-tethered PHRs and payer-tethered PHRs are the least expensive. Data interfaces are a major cost driver, thus these findings underscore the need for standards development and use in the implementation ofPHR systems.

  19. The SADI Personal Health Lens: A Web Browser-Based System for Identifying Personally Relevant Drug Interactions.

    PubMed

    Vandervalk, Ben; McCarthy, E Luke; Cruz-Toledo, José; Klein, Artjom; Baker, Christopher J O; Dumontier, Michel; Wilkinson, Mark D

    2013-04-05

    The Web provides widespread access to vast quantities of health-related information that can improve quality-of-life through better understanding of personal symptoms, medical conditions, and available treatments. Unfortunately, identifying a credible and personally relevant subset of information can be a time-consuming and challenging task for users without a medical background. The objective of the Personal Health Lens system is to aid users when reading health-related webpages by providing warnings about personally relevant drug interactions. More broadly, we wish to present a prototype for a novel, generalizable approach to facilitating interactions between a patient, their practitioner(s), and the Web. We utilized a distributed, Semantic Web-based architecture for recognizing personally dangerous drugs consisting of: (1) a private, local triple store of personal health information, (2) Semantic Web services, following the Semantic Automated Discovery and Integration (SADI) design pattern, for text mining and identifying substance interactions, (3) a bookmarklet to trigger analysis of a webpage and annotate it with personalized warnings, and (4) a semantic query that acts as an abstract template of the analytical workflow to be enacted by the system. A prototype implementation of the system is provided in the form of a Java standalone executable JAR file. The JAR file bundles all components of the system: the personal health database, locally-running versions of the SADI services, and a javascript bookmarklet that triggers analysis of a webpage. In addition, the demonstration includes a hypothetical personal health profile, allowing the system to be used immediately without configuration. Usage instructions are provided. The main strength of the Personal Health Lens system is its ability to organize medical information and to present it to the user in a personalized and contextually relevant manner. While this prototype was limited to a single knowledge domain

  20. The SADI Personal Health Lens: A Web Browser-Based System for Identifying Personally Relevant Drug Interactions

    PubMed Central

    Vandervalk, Ben; McCarthy, E Luke; Cruz-Toledo, José; Klein, Artjom; Baker, Christopher J O; Dumontier, Michel

    2013-01-01

    Background The Web provides widespread access to vast quantities of health-related information that can improve quality-of-life through better understanding of personal symptoms, medical conditions, and available treatments. Unfortunately, identifying a credible and personally relevant subset of information can be a time-consuming and challenging task for users without a medical background. Objective The objective of the Personal Health Lens system is to aid users when reading health-related webpages by providing warnings about personally relevant drug interactions. More broadly, we wish to present a prototype for a novel, generalizable approach to facilitating interactions between a patient, their practitioner(s), and the Web. Methods We utilized a distributed, Semantic Web-based architecture for recognizing personally dangerous drugs consisting of: (1) a private, local triple store of personal health information, (2) Semantic Web services, following the Semantic Automated Discovery and Integration (SADI) design pattern, for text mining and identifying substance interactions, (3) a bookmarklet to trigger analysis of a webpage and annotate it with personalized warnings, and (4) a semantic query that acts as an abstract template of the analytical workflow to be enacted by the system. Results A prototype implementation of the system is provided in the form of a Java standalone executable JAR file. The JAR file bundles all components of the system: the personal health database, locally-running versions of the SADI services, and a javascript bookmarklet that triggers analysis of a webpage. In addition, the demonstration includes a hypothetical personal health profile, allowing the system to be used immediately without configuration. Usage instructions are provided. Conclusions The main strength of the Personal Health Lens system is its ability to organize medical information and to present it to the user in a personalized and contextually relevant manner. While this

  1. Electronic Personal Health Record Use Among Nurses in the Nursing Informatics Community.

    PubMed

    Gartrell, Kyungsook; Trinkoff, Alison M; Storr, Carla L; Wilson, Marisa L

    2015-07-01

    An electronic personal health record is a patient-centric tool that enables patients to securely access, manage, and share their health information with healthcare providers. It is presumed the nursing informatics community would be early adopters of electronic personal health record, yet no studies have been identified that examine the personal adoption of electronic personal health record's for their own healthcare. For this study, we sampled nurse members of the American Medical Informatics Association and the Healthcare Information and Management Systems Society with 183 responding. Multiple logistic regression analysis was used to identify those factors associated with electronic personal health record use. Overall, 72% were electronic personal health record users. Users tended to be older (aged >50 years), be more highly educated (72% master's or doctoral degrees), and hold positions as clinical informatics specialists or chief nursing informatics officers. Those whose healthcare providers used electronic health records were significantly more likely to use electronic personal health records (odds ratio, 5.99; 95% confidence interval, 1.40-25.61). Electronic personal health record users were significantly less concerned about privacy of health information online than nonusers (odds ratio, 0.32; 95% confidence interval, 0.14-0.70) adjusted for ethnicity, race, and practice region. Informatics nurses, with their patient-centered view of technology, are in prime position to influence development of electronic personal health records. Our findings can inform policy efforts to encourage informatics and other professional nursing groups to become leaders and users of electronic personal health record; such use could help them endorse and engage patients to use electronic personal health records. Having champions with expertise in and enthusiasm for the new technology can promote the adoptionof electronic personal health records among healthcare providers as well as

  2. Refugees and displaced persons. War, hunger, and public health.

    PubMed

    Toole, M J; Waldman, R J

    1993-08-04

    The number of refugees and internally displaced persons in need of protection and assistance has increased from 30 million in 1990 to more than 43 million today. War and civil strife have been largely responsible for this epidemic of mass migration that has affected almost every region of the world, including Europe. Since 1990, crude death rates (CDRs) during the early influx of refugees who crossed international borders have been somewhat lower than CDRs reported earlier among Cambodian and Ethiopian refugees. Nevertheless, CDRs among refugees arriving in Ethiopia, Kenya, Nepal, Malawi, and Zimbabwe since 1990 ranged from five to 12 times the baseline CDRs in the countries of origin. Among internally displaced populations in northern Iraq, Somalia, and Sudan, CDRs were extremely high, ranging from 12 to 25 times the baseline CDRs for the nondisplaced. Among both refugees and internally displaced persons, death rates among children less than 5 years of age were far higher than among older children and adults. In Bangladesh, the death rate in female Rohingya refugees was several times higher than in males. Preventable conditions such as diarrheal disease, measles, and acute respiratory infections, exacerbated often by malnutrition, caused most deaths. Although relief programs for refugees have improved since 1990, the situation among the internally displaced may have worsened. The international community should intervene earlier in the evolution of complex disasters involving civil war, human rights abuses, food shortages, and mass displacement. Relief programs need to be based on sound health and nutrition information and should focus on the provision of adequate shelter, food, water, sanitation, and public health programs that prevent mortality from diarrhea, measles, and other communicable diseases, especially among young children and women.

  3. [Personal satisfaction of adolescent drug addicts in the family environment during treatment at a mental health institute].

    PubMed

    Velásquez Carranza, Doris Violeta; Pedrão, Luiz Jorge

    2005-01-01

    This study aimed at analyzing the level of personal satisfaction of adolescents addicted to drugs in family environment during the treatment stage at a mental health institute. Authors used the Family Satisfaction Scale with Adjectives adapted, validated and applied to a sample of 34 patients selected according to established inclusion and exclusion criteria. A significant relationship between the level of satisfaction and parents' good relationship in their marriage was found. 61% of adolescents presented an average personal satisfaction level and 41.18% of them were from families whose maintenance is provided by both parents. There are no similar studies, thus, this research aims at contributing to improve rehabilitation programs based on the nursing perspective and facilitating the relationship between the family and the addicted in treatment.

  4. Associations between the Five-Factor Model of Personality and Health Behaviors among College Students

    ERIC Educational Resources Information Center

    Raynor, Douglas A.; Levine, Heidi

    2009-01-01

    Objective: In fall 2006, the authors examined associations between the five-factor model of personality and several key health behaviors. Methods: College students (N = 583) completed the American College Health Association-National College Health Assessment and the International Personality Item Pool Big Five short-form questionnaire. Results:…

  5. Randomized Control Trial of the 3Rs Health Knowledge Training Program for Persons with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Feldman, Maurice A.; Owen, Frances; Andrews, Amy E.; Tahir, Munazza; Barber, Rachel; Griffiths, Dorothy

    2016-01-01

    Background: Persons with intellectual disabilities (ID) experience a wide range of health problems. Research is needed on teaching persons with intellectual disabilities about their health to promote self-advocacy. This study used a RCT to evaluate a health knowledge training program for adults with intellectual disabilities and verbal skills.…

  6. Randomized Control Trial of the 3Rs Health Knowledge Training Program for Persons with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Feldman, Maurice A.; Owen, Frances; Andrews, Amy E.; Tahir, Munazza; Barber, Rachel; Griffiths, Dorothy

    2016-01-01

    Background: Persons with intellectual disabilities (ID) experience a wide range of health problems. Research is needed on teaching persons with intellectual disabilities about their health to promote self-advocacy. This study used a RCT to evaluate a health knowledge training program for adults with intellectual disabilities and verbal skills.…

  7. Associations between the Five-Factor Model of Personality and Health Behaviors among College Students

    ERIC Educational Resources Information Center

    Raynor, Douglas A.; Levine, Heidi

    2009-01-01

    Objective: In fall 2006, the authors examined associations between the five-factor model of personality and several key health behaviors. Methods: College students (N = 583) completed the American College Health Association-National College Health Assessment and the International Personality Item Pool Big Five short-form questionnaire. Results:…

  8. The impact of health literacy on a patient's decision to adopt a personal health record.

    PubMed

    Noblin, Alice M; Wan, Thomas T H; Fottler, Myron

    2012-01-01

    Health literacy is a concept that describes a patient's ability to understand materials provided by physicians or other providers. Several factors, including education level, income, and age, can influence health literacy. Research conducted at one medical practice in Florida indicated that in spite of the patients' relatively low education level, the majority indicated a broad acceptance of personal health record (PHR) technology. The key variable explaining patient willingness to adopt a PHR was the patient's health literacy as measured by the eHealth Literacy Scale (eHEALS). Adoption and use rates may also depend on the availability of office staff for hands-on training as well as assistance with interpretation of medical information. It is hoped that technology barriers will disappear over time, and usefulness of the information will promote increased utilization of PHRs. Patient understanding of the information remains a challenge that must be overcome to realize the full potential of PHRs.

  9. Cocaine users with comorbid Cluster B personality disorders show dysfunctional brain activation and connectivity in the emotional regulation networks during negative emotion maintenance and reappraisal.

    PubMed

    Albein-Urios, Natalia; Verdejo-Román, Juan; Soriano-Mas, Carles; Asensio, Samuel; Martínez-González, José Miguel; Verdejo-García, Antonio

    2013-12-01

    Cocaine dependence often co-occurs with Cluster B personality disorders. Since both disorders are characterized by emotion regulation deficits, we predicted that cocaine comorbid patients would exhibit dysfunctional patterns of brain activation and connectivity during reappraisal of negative emotions. We recruited 18 cocaine users with comorbid Cluster B personality disorders, 17 cocaine users without comorbidities and 21 controls to be scanned using functional magnetic resonance imaging (fMRI) during performance on a reappraisal task in which they had to maintain or suppress the emotions induced by negative affective stimuli. We followed region of interest (ROI) and whole-brain approaches to investigate brain activations and connectivity associated with negative emotion experience and reappraisal. Results showed that cocaine users with comorbid personality disorders had reduced activation of the subgenual anterior cingulate cortex during negative emotion maintenance and increased activation of the lateral orbitofrontal cortex and the amygdala during reappraisal. Amygdala activation correlated with impulsivity and antisocial beliefs in the comorbid group. Connectivity analyses showed that in the cocaine comorbid group the subgenual cingulate was less efficiently connected with the amygdala and the fusiform gyri and more efficiently connected with the anterior insula during maintenance, whereas during reappraisal the left orbitofrontal cortex was more efficiently connected with the amygdala and the right orbitofrontal cortex was less efficiently connected with the dorsal striatum. We conclude that cocaine users with comorbid Cluster B personality disorders have distinctive patterns of brain activation and connectivity during maintenance and reappraisal of negative emotions, which correlate with impulsivity and dysfunctional beliefs. Copyright © 2013 Elsevier B.V. and ECNP. All rights reserved.

  10. Personality Change at Mid-Life is Associated with Changes in Self-Rated Health: Evidence from the Hawaii Personality and Health Cohort.

    PubMed

    Letzring, Tera D; Edmonds, Grant W; Hampson, Sarah E

    2014-02-01

    Personality traits change across the lifespan, and trait change, in addition to trait level, may be related to health. Longitudinal data from the Hawaii Personality and Health Cohort were used to investigate associations between changes in traits and self-rated health (SRH). Participants (N = 733, Mage = 44.4) completed measures of the Big Five personality traits and SRH twice approximately 3 years apart. Personality trait changes were associated with SRH change. Additionally, increases on Agreeableness, Conscientiousness, and Openness, and decreases on Neuroticism, predicted increases in SRH, even when controlling for gender and education. Relating correlated trait change at mid-life, when traits reach peak stability, to a consequential health outcome such as SRH change, demonstrates the value of treating both traits and health indicators as dynamic variables.

  11. 14 CFR 91.1423 - CAMP: Maintenance organization.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... required inspections), preventive maintenance, or alterations, and each person with whom it arranges for... that work. (c) Each person performing required inspections in addition to other maintenance, preventive... inspection functions from the other maintenance, preventive maintenance, or alteration functions....

  12. 14 CFR 91.1423 - CAMP: Maintenance organization.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... required inspections), preventive maintenance, or alterations, and each person with whom it arranges for... that work. (c) Each person performing required inspections in addition to other maintenance, preventive... inspection functions from the other maintenance, preventive maintenance, or alteration functions....

  13. 14 CFR 91.1423 - CAMP: Maintenance organization.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... required inspections), preventive maintenance, or alterations, and each person with whom it arranges for... that work. (c) Each person performing required inspections in addition to other maintenance, preventive... inspection functions from the other maintenance, preventive maintenance, or alteration functions....

  14. Creating a paper-based personal health record for HIV-infected persons.

    PubMed

    Nokes, Kathleen M; Hughes, Valery; Santos, Ryan; Bang, Heejung

    2012-01-01

    A personal health record (PHR) contains information that a client believes is important to his/her health status; it can be either paper or Internet-based. The purposes of this action research were to determine the length of time an expert HIV nurse clinician needed to create a comprehensive PHR and to determine how hard it was for the patient to understand different components of a PHR. The average respondent (N = 9) was older, female, completed high school, African American, diagnosed with AIDS, and taking HIV medications for 11 years. The HIV nurse expert spent an average of 79 minutes preparing the PHR. Clients had the greatest difficulty understanding laboratory tests, medications, medical history, and immunizations. PHRs are evolving through the consumer-empowerment movement, technology, and a growing awareness of the consequences of medical errors. Nurses need to assist clients to create and use the PHR as an important tool in self-care management. Copyright © 2012 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  15. The smoker's health project: a self-determination theory intervention to facilitate maintenance of tobacco abstinence.

    PubMed

    Williams, Geoffrey C; Patrick, Heather; Niemiec, Christopher P; Ryan, Richard M; Deci, Edward L; Lavigne, Holly McGregor

    2011-07-01

    A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence, which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of the three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6 month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6 month SDT-based intervention to 12 months and trains an important other to provide support for smokers' basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30 days but who are willing to reduce their cigarette use by half. The primary outcome is 12 month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30 day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others.

  16. Intrusive imagery in severe health anxiety: Prevalence, nature and links with memories and maintenance cycles.

    PubMed

    Muse, Kate; McManus, Freda; Hackmann, Ann; Williams, Matthew; Williams, Mark

    2010-08-01

    Increased understanding of the nature and role of intrusive imagery has contributed to the development of effective treatment protocols for some anxiety disorders. However, intrusive imagery in severe health anxiety (hypochondriasis) has been comparatively neglected. Hence, the current study investigates the prevalence, nature and content of intrusive imagery in 55 patients who met DSM-IV-TR (APA, 2000) criteria for the diagnosis of hypochondriasis. A semi-structured interview was used to assess the prevalence, nature and possible role of intrusive imagery in this disorder. Over 78% of participants reported experiencing recurrent, distressing intrusive images, the majority (72%) of which either were a memory of an earlier event or were strongly associated with a memory. The images tended to be future orientated, and were reliably categorised into four themes: i) being told 'the bad news' that you have a serious/life threatening-illness (6.9%), ii) suffering from a serious or life-threatening illness (34.5%), iii) death and dying due to illness (22.4%) and iv) impact of own death or serious illness on loved ones (36.2%). Participants reported responding to experiencing intrusive images by engaging in avoidance, checking, reassurance seeking, distraction and rumination. Potential treatment implications and links to maintenance cycles are considered.

  17. Sleep quality, daytime sleepiness and health-related quality-of-life in maintenance haemodialysis patients.

    PubMed

    Shen, Quanquan; Huang, Xiaohong; Luo, Zhaofen; Xu, Xiujun; Zhao, Xiang; He, Qiang

    2016-06-01

    To assess the relationship between sleep quality, daytime sleepiness and health-related quality-of-life (HRQoL) in Chinese patients undergoing maintenance haemodialysis (MHD). This cross-sectional study enrolled patients undergoing MHD. Self-reported sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]) and HRQoL (36-item Short Form [SF-36]) were recorded for all patients. Sixty eight patients (mean ± SD age = 61.75 ± 16.56 years; 43 male/25 female) who regularly received MHD were included. The prevalence of poor sleepers was 69.1% (47/68) and daytime sleepiness was 11.8% (eight of 68). Poor sleepers had a significantly lower Physical Component Scale (PCS) score, Mental Component Scale (MCS) score and total SF-36 score than good sleepers. The PSQI score correlated inversely with both the PCS and MCS scores and correlated positively with age. Independent variables associated with total SF-36 score were duration of MHD, ESS score and PSQI score. Poor sleep quality is a common and severe issue for MHD patients in east China. Both sleep quality and daytime sleepiness were associated with lower HRQoL scores. © The Author(s) 2016.

  18. Personal health records: is rapid adoption hindering interoperability?

    PubMed

    Studeny, Jana; Coustasse, Alberto

    2014-01-01

    The establishment of the Meaningful Use criteria has created a critical need for robust interoperability of health records. A universal definition of a personal health record (PHR) has not been agreed upon. Standardized code sets have been built for specific entities, but integration between them has not been supported. The purpose of this research study was to explore the hindrance and promotion of interoperability standards in relationship to PHRs to describe interoperability progress in this area. The study was conducted following the basic principles of a systematic review, with 61 articles used in the study. Lagging interoperability has stemmed from slow adoption by patients, creation of disparate systems due to rapid development to meet requirements for the Meaningful Use stages, and rapid early development of PHRs prior to the mandate for integration among multiple systems. Findings of this study suggest that deadlines for implementation to capture Meaningful Use incentive payments are supporting the creation of PHR data silos, thereby hindering the goal of high-level interoperability.

  19. Disadvantaged persons' participation in health promotion projects: some structural dimensions.

    PubMed

    Boyce, W F

    2001-05-01

    A structural perspective was used in studying community participation of disadvantaged groups (poor women, street youth, and disabled persons) in health promotion projects. Five community projects in the Canadian Health Promotion Contribution Program were examined in a comparative case study utilizing in-depth interviews, documents, and secondary sources. Analysis revealed relatively low numbers and restricted range of participants, difficulties in recruiting and maintaining participants, declining rates of active participation over time, and limited target group influence and power. This paper reports on the relationship between various dimensions of structure (social-cultural, organizational, political-legal-economic) and the community participation process. Participation was influenced by structural factors such as bureaucratic rules and regulators, perceived minority group rights and relations, agency reputations and responsibilities, available resources, and organizational roles. Control of projects by target group members, rather than by service agencies, was an important overall organizational structural factor which allowed community members to achieve influence in projects. The study concludes that a conceptual model based on structural factors is useful in explaining how key factors from federal and local levels can restrict or facilitate the community participation process.

  20. Personal Health Records: Is Rapid Adoption Hindering Interoperability?

    PubMed Central

    Studeny, Jana; Coustasse, Alberto

    2014-01-01

    The establishment of the Meaningful Use criteria has created a critical need for robust interoperability of health records. A universal definition of a personal health record (PHR) has not been agreed upon. Standardized code sets have been built for specific entities, but integration between them has not been supported. The purpose of this research study was to explore the hindrance and promotion of interoperability standards in relationship to PHRs to describe interoperability progress in this area. The study was conducted following the basic principles of a systematic review, with 61 articles used in the study. Lagging interoperability has stemmed from slow adoption by patients, creation of disparate systems due to rapid development to meet requirements for the Meaningful Use stages, and rapid early development of PHRs prior to the mandate for integration among multiple systems. Findings of this study suggest that deadlines for implementation to capture Meaningful Use incentive payments are supporting the creation of PHR data silos, thereby hindering the goal of high-level interoperability. PMID:25214822

  1. Personal health records: key adoption issues and implications for management.

    PubMed

    Raisinghani, Mahesh S; Young, Erika

    2008-01-01

    Electronic Personal Health Records (PHRs) has been perceived as the tool to empower consumers to become active decision-makers of their healthcare instead of leaving the decision to providers. However, there has been the lack of enthusiasm and adoption of PHRs. This paper examines the current healthcare climate and attempts to understand the major challenges associated with PHRs adoption. The paper-based and fragmented healthcare system is no longer appropriate for the digital economy of the 21st century. The integrated health information technology system is the solution to transform clinical practice to consumer centric and information driven. Tools such as PHRs are means to an end that provide better, safer and more affordable healthcare for consumers. However, there has been little research conducted to demonstrate PHR's tangible value, despite the widespread perceived value of these technologies. Although survey data reveals that there is a lack of awareness among the public, consumers are receptive to this concept, especially when a physician recommends it. Key issues in adopting PHRs and strategies for successful implementation of PHRs are discussed.

  2. Going mobile: how mobile personal health records can improve health care during emergencies.

    PubMed

    Bouri, Nidhi; Ravi, Sanjana

    2014-03-05

    Personal health records (PHRs), in contrast to electronic health records (EHRs) or electronic medical records (EMRs), are health records in which data are accessible to patients and not just providers. In recent years, many systems have enabled PHRs to be available in a mobile format. Mobile PHRs (mPHRs) allow patients to access health information via the Internet or telecommunication devices, such as mobile phones, personal digital assistants, and tablet computers. mPHRs have the potential to help patients and providers identify medical conditions and prescriptions from numerous locations, which may minimize medical errors and identify improvements to health behaviors during emergencies, when patients present to a new provider, or EHRs are not accessible. Despite their benefits, numerous challenges inhibit the adoption and further development of mPHRs, including integration into overall health technology infrastructure and legal and security concerns. This paper identifies the benefits of mPHRs during emergencies and the remaining challenges impeding full adoption and use, and provides recommendations to federal agencies to enhance support and use of mPHRs.

  3. Going Mobile: How Mobile Personal Health Records Can Improve Health Care During Emergencies

    PubMed Central

    Ravi, Sanjana

    2014-01-01

    Personal health records (PHRs), in contrast to electronic health records (EHRs) or electronic medical records (EMRs), are health records in which data are accessible to patients and not just providers. In recent years, many systems have enabled PHRs to be available in a mobile format. Mobile PHRs (mPHRs) allow patients to access health information via the Internet or telecommunication devices, such as mobile phones, personal digital assistants, and tablet computers. mPHRs have the potential to help patients and providers identify medical conditions and prescriptions from numerous locations, which may minimize medical errors and identify improvements to health behaviors during emergencies, when patients present to a new provider, or EHRs are not accessible. Despite their benefits, numerous challenges inhibit the adoption and further development of mPHRs, including integration into overall health technology infrastructure and legal and security concerns. This paper identifies the benefits of mPHRs during emergencies and the remaining challenges impeding full adoption and use, and provides recommendations to federal agencies to enhance support and use of mPHRs. PMID:25098942

  4. Health Center Sustainment Contract Resulted in Some Repairs, but Iraqi Maintenance Capability Was Not Achieved

    DTIC Science & Technology

    2010-04-29

    GRD did provide the MoH with some limited maintenance management materials at 17 PHCs, including Arabic language maintenance manuals for medical...personnel. ____________________ 12 An SBH official stated it used Maximo, Primavera , and VFA software for this requirement. 13 For the 40 PHC assessments

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

    PubMed

    Kneale, Laura; Choi, Yong; Demiris, George

    2016-01-01

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

  6. What do patients with glaucoma think about personal health records?

    PubMed

    Somner, John E A; Sii, Freda; Bourne, Rupert; Cross, Vinette; Shah, Peter

    2013-11-01

    Putting patients in control of their records is one way of promoting patient centred care and patients with chronic health problems may benefit most from personal health records (PHRs). Glaucoma management is often complicated by incomplete understanding and poor adherence to treatment, two areas which a PHR may help to address. This study aimed to discover what patients with glaucoma think about PHRs and what type of information a glaucoma PHR should contain. A consultation exercise using a focus group approach involving 71 participants was undertaken to discuss if a PHR would be useful and what it would be like. Narrative data were collected through written notes and an online forum in addition to transcripts of the focus group feedback session and individual interviews. Recordings were transcribed and analysed with simple thematic analysis facilitated by NVivo software (www.qsrinternational.com). The consultation exercise indicated enthusiasm for PHRs. Views varied on the best format, some participants strongly favoured electronic records and others preferred a low-tech, paper based format. A comprehensive dataset of 24 items was developed which highlighted areas which are not covered by existing guidance to developers. A model for how PHRs may be useful as an education tool in clinical practice was devised. Asking patients what they thought about a glaucoma PHR raised challenging questions and adds perspective to predominantly clinician led development. Listening and responding to such viewpoints is fundamental to developing more patient centred PHRs which may act both as health record and self-care educational tool to promote more holistic, efficient glaucoma care. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

  7. Mobile personal health records: an evaluation of features and functionality.

    PubMed

    Kharrazi, Hadi; Chisholm, Robin; VanNasdale, Dean; Thompson, Benjamin

    2012-09-01

    To evaluate stand-alone mobile personal health record (mPHR) applications for the three leading cellular phone platforms (iOS, BlackBerry, and Android), assessing each for content, function, security, and marketing characteristics. Nineteen stand-alone mPHR applications (8 for iOS, 5 for BlackBerry, and 6 for Android) were identified and evaluated. Main criteria used to include mPHRs were: operating standalone on a mobile platform; not requiring external connectivity; and covering a wide range of health topics. Selected mPHRs were analyzed considering product characteristics, data elements, and application features. We also reviewed additional features such as marketing tactics. Within and between the different mobile platforms attributes for the mPHR were highly variable. None of the mPHRs contained all attributes included in our evaluation. The top four mPHRs contained 13 of the 14 features omitting only the in-case-of emergency feature. Surprisingly, seven mPHRs lacked basic security measures as important as password protection. The mPHRs were relatively inexpensive: ranging from no cost to $9.99. The mPHR application cost varied in some instances based on whether it supported single or multiple users. Ten mPHRs supported multiple user profiles. Notably, eight mPHRs used scare tactics as marketing strategy. mPHR is an emerging health care technology. The majority of existing mPHR apps is limited by at least one of the attributes considered for this study; however, as the mobile market continues to expand it is likely that more comprehensive mPHRs will be developed in the near future. New advancements in mobile technology can be utilized to enhance mPHRs by long-term patient empowerment features. Marketing strategies for mPHRs should target specific subpopulations and avoid scare tactics. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

    PubMed

    Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

    2017-04-01

    Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current

  9. [The care of homeless person: reviewing the meanings of health-disease process].

    PubMed

    Rosa, Anderson da Silva; Secco, Maria Garbriela; Brêtas, Ana Cristina Passarela

    2006-01-01

    This qualitative research had the objective of knowing the significance of the health-sickness-care process to homeless person and workers of a community center to homeless people on Sio Paulo city. The dates were collected by the interview with four homeless person and four workers. The interviews were separated in three categories: (1) the apprehension of the health - sickness-care process, (2) the caring of health in the street, (3) advices to survive in the street. The results showed that even with the difference of the homeless person, the street have a specific culture relative of the health-sickness-care person that need to be comprehend by nurses.

  10. The relationship between burnout symptoms and Type D personality among health care professionals in Turkey.

    PubMed

    Tekin, Atilla; Karadağ, Hekim; Yayla, Sinan

    2016-04-27

    The aim of this study was to investigate the relationship between burnout and Type D personality in health care professionals. The study randomly included 120 health care professionals (73 nurses, 47 doctors). Sociodemographic data form, Maslach Burnout Inventory, and Type D Personality Scale were applied to each participant; 38.3% of the health care professionals (n = 46) had the Type D personality. Emotional exhaustion and depersonalization of health care professionals with Type D personality were higher than of those without Type D personality (p = .006 and p = .005). Stepwise regression analysis indicated that Type D personality was a predictor of emotional exhaustion and depersonalization (p = .005 and p = .001, respectively). Our results suggest that Type D personality is associated with higher burnout levels.

  11. Using personal health records to scaffold perceived self-efficacy for health promotion.

    PubMed

    Monkman, Helen; Kushniruk, Andre W

    2015-01-01

    According to Bandura (1977), believing in one's ability to achieve a goal is one of the best predictors that a goal will be accomplished. Given its predictive power, the concept of belief in one's ability to succeed, or perceived self-efficacy, is well researched for its influence on health promotion. It has been argued that a paradigm shift must occur away from illness treatment towards illness prevention and health promotion, for healthcare to accommodate the needs of the population. Personal Health Records (PHRs) may be a tool to help facilitate this paradigm shift. PHRs are repositories of information that individuals can use to access, manage, and share their personal health information. An extension of Bandura's model of self-efficacy will be presented here which identifies opportunities for PHRs to enhance perceived self-efficacy through mastery, social modeling, social persuasion, and physiological state. Bolstering self-efficacy through PHR tools will expand the utility of PHRs beyond self-management to also facilitate health promotion and illness prevention and gains in self-efficacy are also likely to transcend into other areas of consumers' lives.

  12. '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

  13. How applicable are results of systematic reviews and meta-analyses of health behaviour maintenance? A critical evaluation.

    PubMed

    Loef, M; Walach, H

    2015-04-01

    To evaluate the practical applicability of systematic reviews and meta-analyses to the maintenance of physical activity or weight loss by assessing methodological and reporting aspects. To identify relevant studies a literature search was conducted in MEDLINE, EMBASE, Cochrane Library, PsycINFO, PSYNDEX, Google scholar, and reference lists. Each article was evaluated for methodological quality, operationalization of maintenance, and practicability following the RE-AIM framework and the PRISMA statement. Twenty-four systematic reviews and meta-analyses were included of which 14 were published in the last four years. There were multiple definitions of maintenance. In addition the instances of redundancy, and neglect of thematic fields are identified. Eighty-seven percent of the reviews showed methodological flaws. The potential practical use of the outcomes was limited. The applicability of systematic reviews and meta-analyses regarding health behaviour maintenance is limited with regard to reporting, methodology and thematic coverage. For practitioners, synthesis of quantitative and qualitative evidence with theoretical models is lacking. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. Personality and the education-health gradient: a note on "understanding differences in health behaviors by education".

    PubMed

    Conti, Gabriella; Hansman, Christopher

    2013-03-01

    We test the robustness of the results of Cutler and Lleras-Muney (2010) on the role of personality in explaining the education-health gradient by using alternative measures of child personality available in the National Child Development Study. We show that, alternatively to the authors, conclusions, personality contributes to the education-health gradient to an extent nearly as large as that of cognition.

  15. Genome-health nutrigenomics and nutrigenetics: nutritional requirements or 'nutriomes' for chromosomal stability and telomere maintenance at the individual level.

    PubMed

    Bull, Caroline; Fenech, Michael

    2008-05-01

    It is becoming increasingly evident that (a) risk for developmental and degenerative disease increases with more DNA damage, which in turn is dependent on nutritional status, and (b) the optimal concentration of micronutrients for prevention of genome damage is also dependent on genetic polymorphisms that alter the function of genes involved directly or indirectly in the uptake and metabolism of micronutrients required for DNA repair and DNA replication. The development of dietary patterns, functional foods and supplements that are designed to improve genome-health maintenance in individuals with specific genetic backgrounds may provide an important contribution to an optimum health strategy based on the diagnosis and individualised nutritional prevention of genome damage, i.e. genome health clinics. The present review summarises some of the recent knowledge relating to micronutrients that are associated with chromosomal stability and provides some initial insights into the likely nutritional factors that may be expected to have an impact on the maintenance of telomeres. It is evident that developing effective strategies for defining nutrient doses and combinations or 'nutriomes' for genome-health maintenance at the individual level is essential for further progress in this research field.

  16. Person-centered osteopathic practice: patients' personality (body, mind, and soul) and health (ill-being and well-being).

    PubMed

    Fahlgren, Elin; Nima, Ali A; Archer, Trevor; Garcia, Danilo

    2015-01-01

    Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient's personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger's personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients' personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients' health in relation to their presenting problem and gender. Results. The patients' personality explained the variance of all of the well-being (R (2) between .19 and .54) and four of the ill-being (R (2) between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and

  17. 14 CFR 135.433 - Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance and preventive maintenance... SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.433 Maintenance and preventive maintenance training program. Each certificate holder or a person performing maintenance or...

  18. Personal health record reach in the Veterans Health Administration: a cross-sectional analysis.

    PubMed

    Shimada, Stephanie Leah; Brandt, Cynthia A; Feng, Hua; McInnes, D Keith; Rao, Sowmya R; Rothendler, James A; Haggstrom, David A; Abel, Erica A; Cioffari, Lisa S; Houston, Thomas K

    2014-12-12

    My HealtheVet (MHV) is the personal health record and patient portal developed by the United States Veterans Health Administration (VA). While millions of American veterans have registered for MHV, little is known about how a patient's health status may affect adoption and use of the personal health record. Our aim was to characterize the reach of the VA personal health record by clinical condition. This was a cross-sectional analysis of all veterans nationwide with at least one inpatient admission or two outpatient visits between April 2010 and March 2012. We compared adoption (registration, authentication, opt-in to use secure messaging) and use (prescription refill and secure messaging) of MHV in April 2012 across 18 specific clinical conditions prevalent in and of high priority to the VA. We calculated predicted probabilities of adoption by condition using multivariable logistic regression models adjusting for sociodemographics, comorbidities, and clustering of patients within facilities. Among 6,012,875 veterans, 6.20% were women, 61.45% were Caucasian, and 26.31% resided in rural areas. The mean age was 63.3 years. Nationwide, 18.64% had registered for MHV, 11.06% refilled prescriptions via MHV, and 1.91% used secure messaging with their clinical providers. Results from the multivariable regression suggest that patients with HIV, hyperlipidemia, and spinal cord injury had the highest predicted probabilities of adoption, whereas those with schizophrenia/schizoaffective disorder, alcohol or drug abuse, and stroke had the lowest. Variation was observed across diagnoses in actual (unadjusted) adoption and use, with registration rates ranging from 29.19% of patients with traumatic brain injury to 14.18% of those with schizophrenia/schizoaffective disorder. Some of the variation in actual reach can be explained by facility-level differences in MHV adoption and by differences in patients' sociodemographic characteristics (eg, age, race, income) by diagnosis. In this

  19. Factored Scales for the Personal Health Survey with Schizophrenics, Alcoholics, Felons, Unmarried Mothers, and College Students

    ERIC Educational Resources Information Center

    Pishkin, Vladimir; Thorne, Frederick C.

    1978-01-01

    Employed the Personal Health Survey (PHS) to study patterns of symptomology related to physical and mental health in a population of 730 Ss, which consisted of five groups: felons, hospitalized alcoholics, unmarried mothers, college students and institutionalized schizophrenics. (Editor)

  20. Health Care Finance Executive Personalities Revisited: A 10-Year Follow-up Study.

    PubMed

    Lieneck, Cristian; Nowicki, Michael

    2015-01-01

    A dynamic health care industry continues to call upon health care leaders to possess not one but multiple competencies. Inherent personality characteristics of leaders often play a major role in personal as well as organizational success to include those in health care finance positions of responsibility. A replication study was conducted to determine the Myers-Briggs personality-type differences between practicing health care finance professionals in 2014, as compared with a previous 2003 study. Results indicate a significant shift between both independent samples of health care finance professionals over the 10-year period from original high levels of introversion to that of extraversion, as well as higher sensing personality preferences, as compared with the original sample's high level of intuition preferences. Further investigation into the evolving role of the health care finance manager is suggested, while continued alignment of inherent, personal characteristics is suggested to meet ongoing changes in the industry.

  1. Personal health records and hypertension control: a randomized trial.

    PubMed

    Wagner, Peggy J; Dias, James; Howard, Shalon; Kintziger, Kristina W; Hudson, Matthew F; Seol, Yoon-Ho; Sodomka, Pat

    2012-01-01

    To examine the impact of a personal health record (PHR) in patients with hypertension measured by changes in biological outcomes, patient empowerment, patient perception of quality of care, and use of medical services. A cluster-randomized effectiveness trial with PHR and no PHR groups was conducted in two ambulatory clinics. 453 of 1686 (26.4%) patients approached were included in the analyses. A PHR tethered to the patient's electronic medical record (EMR) was the primary intervention and included security measures, patient control of access, limited transmission of EMR data, blood pressure (BP) tracking, and appointment assistance. BP was the main outcome measure. Patient empowerment was assessed using the Patient Activation Measure and Patient Empowerment Scale. Quality of care was assessed using the Clinician and Group Assessment Score (CAHPS) and the Patient Assessment of Chronic Illness Care. Frequency of use of medical services was self-reported. No impact of the PHR was observed on BP, patient activation, patient perceived quality, or medical utilization in the intention-to-treat analysis. Sub-analysis of intervention patients self-identified as active PHR users (25.7% of those with available information) showed a 5.25-point reduction in diastolic BP. Younger age, self-reported computer skills, and more positive provider communication ratings were associated with frequency of PHR use. Few patients provided with a PHR actually used the PHR with any frequency. Thus simply providing a PHR may have limited impact on patient BP, empowerment, satisfaction with care, or use of health services without additional education or clinical intervention designed to increase PHR use. http://ClinicalTrials.gov Identifier: NCT01317537.

  2. Consumer perspectives on personal health records: a 4-community study.

    PubMed

    Abramson, Erika L; Patel, Vaishali; Edwards, Alison; Kaushal, Rainu

    2014-04-01

    To characterize consumer attitudes toward personal health records (PHRs) in 4 diverse communities across New York state (NYS). Combined analysis from four separate cross-sectional studies. We analyzed pooled data from surveys separately administered to 4 NYS communities. Results from individual communities have been previously published. However, pooling the data allowed us to conduct multivariable regression analyses that identified key factors associated with potential usage among a broad group of consumers. We received responses from 701 consumers. A majority (74%) of respondents (n = 494) reported that they would use a PHR and the majority wanted a broad array of functionalities available. We found that potential PHR use was significantly associated with Internet use at least monthly (odds ratio [OR] = 5.8, 95% confidence interval [CI] = 3.3-10.2), a belief that PHRs may improve the security of health information (OR = 2.6, 95% CI = 1.5-4.7), and a belief that PHRs may improve quality of care (OR = 4.1, 95% CI = 2.6-6.6). As federal initiatives aim to improve healthcare, which includes making care more patient centered, PHRs will likely play an increasing role. Our results provide critical information to inform policy efforts, suggesting that PHRs must offer a broad range of patient-centered functionalities while maintaining high privacy and security standards to narrow the gap between reported interest and actual use. Ensuring widespread access to and frequent use of the internet among consumers will also be critical to avoid creating healthcare disparities through PHR use.

  3. Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health

    PubMed Central

    Trinkoff, A.M.; Storr, C.L.; Wilson, M.L.; Gurses, A.P.

    2015-01-01

    Summary Background To our knowledge, no evidence is available on health care professionals’ use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses’ personal use of ePHRs using a modified technology acceptance model. Objectives To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses’ own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers’ use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use. Methods A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect. Results Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses’ own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses. Conclusions Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their

  4. Personal needs versus national needs: public attitudes regarding health care priorities at the personal and national levels.

    PubMed

    Kaplan, Giora; Baron-Epel, Orna

    2015-01-01

    Many stakeholders have little or no confidence in the ability of the public to express their opinions on health policy issues. The claim often arises that lay people prioritize according to their own personal experiences and may lack the broad perspective necessary to understand the needs of the population at large. In order to test this claim empirically, this study compares the public's priorities regarding personal insurance to their priorities regarding allocation of national health resources. Thus, the study should shed light on the extent to which the public's priorities at the national level are a reflection of their priorities at the personal level. A telephone survey was conducted with a representative sample of the Israeli adult population aged 18 and over (n = 1,225). The public's priorities were assessed by asking interviewees to assume that they were the Minister of Health and from this point of view allocate an additional budget among various health areas. Their priorities at the personal level were assessed by asking interviewees to choose preferred items for inclusion in their personal supplementary health insurance. Over half of the respondents (54%) expressed different personal and national priorities. In multivariable logistic analysis, "population group" was the only variable found to be statistically significant; Jews were 1.8 times more likely than Arabs to give a similar response to both questions. Income level was of borderline significance. At least half of the population was able to differentiate between their personal needs and national policy needs. We do not advocate a decision-making process based on polls or referendums. However, we believe that people should be allowed to express their priorities regarding national policy issues, and that decision-makers should consider these as one of the factors used to determine policy decisions.

  5. General Healthcare Maintenance of IBD

    MedlinePlus

    ... Resources > General Healthcare Maintenance Go Back General Healthcare Maintenance Email Print + Share It is important to continue ... Bowel Diseases. September 2009, 1399-1409 Health Care Maintenance Chart YEAR PPD (Tuberculosis skin test) Vaccinations Hepatitis ...

  6. Signals of Personality and Health: The Contributions of Facial Shape, Skin Texture, and Viewing Angle

    ERIC Educational Resources Information Center

    Jones, Alex L.; Kramer, Robin S. S.; Ward, Robert

    2012-01-01

    To what extent does information in a person's face predict their likely behavior? There is increasing evidence for association between relatively neutral, static facial appearance and personality traits. By using composite images rendered from three dimensional (3D) scans of women scoring high and low on health and personality dimensions, we aimed…

  7. Signals of Personality and Health: The Contributions of Facial Shape, Skin Texture, and Viewing Angle

    ERIC Educational Resources Information Center

    Jones, Alex L.; Kramer, Robin S. S.; Ward, Robert

    2012-01-01

    To what extent does information in a person's face predict their likely behavior? There is increasing evidence for association between relatively neutral, static facial appearance and personality traits. By using composite images rendered from three dimensional (3D) scans of women scoring high and low on health and personality dimensions, we aimed…

  8. Diagnosis, Comorbidities and Management of Irritable Bowel Syndrome in Patients in a Large Health Maintenance Organization

    PubMed Central

    Ladabaum, Uri; Boyd, Erin; Zhao, Wei K.; Mannalithara, Ajitha; Sharabidze, Annie; Singh, Gurkirpal; Chung, Elaine; Levin, Theodore R.

    2011-01-01

    Background Irritable bowel syndrome (IBS) imposes significant clinical and economic burdens. We aimed to characterize patterns of practice for patients with IBS who were members of a large health maintenance organization, analyzing point of diagnosis, testing, comorbidities and treatment. Methods Members of Kaiser Permanente Northern California who were diagnosed with IBS were matched to controls by age, sex, and period of enrollment. We compared rates of testing, comorbidities and interventions. Results From 1995 to 2005, IBS was diagnosed in 141,295 patients (mean age 46, SD 17 years; 74% female). Internists made 68% of diagnoses, gastroenterologists 13%, and others 19%. Lower endoscopy did not usually precede IBS diagnosis. Patients with IBS were more likely than controls to have blood, stool, endoscopic and radiologic tests, and to undergo abdominal or pelvic operations (ORs 1.5–10.7, all P<0.0001). Only 2.7% were tested for celiac disease and only 1.8% were eventually diagnosed with inflammatory bowel disease. Chronic pain syndromes, anxiety and depression were more common among IBS patients than controls (ORs 2.7–4.6, all P<0.0001). Many patients with IBS were treated with anxiolytics (61%) and antidepressants (55%). Endoscopic and radiologic testing were most strongly associated with having IBS diagnosed by a gastroenterologist. Psychotropic medication use was most strongly associated with female sex. Conclusions In a large, managed care cohort, most diagnoses of IBS were made by generalists, often without endoscopic evaluation. Patients with IBS had consistently higher rates of testing, chronic pain syndromes, psychiatric comorbidity and operations than controls. Most patients with IBS were treated with psychiatric medications. PMID:21871250

  9. Diagnosis, comorbidities, and management of irritable bowel syndrome in patients in a large health maintenance organization.

    PubMed

    Ladabaum, Uri; Boyd, Erin; Zhao, Wei K; Mannalithara, Ajitha; Sharabidze, Annie; Singh, Gurkirpal; Chung, Elaine; Levin, Theodore R

    2012-01-01

    Irritable bowel syndrome (IBS) imposes significant clinical and economic burdens. We aimed to characterize practice patterns for patients with IBS in a large health maintenance organization, analyzing point of diagnosis, testing, comorbidities, and treatment. Members of Kaiser Permanente Northern California who were diagnosed with IBS were matched to controls by age, sex, and period of enrollment. We compared rates of testing, comorbidities, and interventions. From 1995-2005, IBS was diagnosed in 141,295 patients (mean age, 46 years; standard deviation, 17 years; 74% female). Internists made 68% of diagnoses, gastroenterologists 13%, and others 19%. Lower endoscopy did not usually precede IBS diagnosis. Patients with IBS were more likely than controls to have blood, stool, endoscopic, and radiologic tests and to undergo abdominal or pelvic operations (odds ratios, 1.5-10.7; all P < .0001). Only 2.7% were tested for celiac disease, and only 1.8% were eventually diagnosed with inflammatory bowel disease. Chronic pain syndromes, anxiety, and depression were more common among IBS patients than among controls (odds ratios, 2.7-4.6; all P < .0001). Many patients with IBS were treated with anxiolytics (61%) and antidepressants (55%). Endoscopic and radiologic testing was most strongly associated with having IBS diagnosed by a gastroenterologist. Psychotropic medication use was most strongly associated with female sex. In a large, managed care cohort, most diagnoses of IBS were made by generalists, often without endoscopic evaluation. Patients with IBS had consistently higher rates of testing, chronic pain syndromes, psychiatric comorbidity, and operations than controls. Most patients with IBS were treated with psychiatric medications. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

  10. Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records

    PubMed Central

    Cochran, Gary L.; Lander, Lina; Morien, Marsha; Lomelin, Daniel E.; Brittin, Jeri; Reker, Celeste; Klepser, Donald G.

    2015-01-01

    Background Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. Objective The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Methods Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10–12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. Results The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Conclusion Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the

  11. Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records.

    PubMed

    Cochran, Gary L; Lander, Lina; Morien, Marsha; Lomelin, Daniel E; Brittin, Jeri; Reker, Celeste; Klepser, Donald G

    2015-01-01

    Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10-12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the

  12. Relationships between activities, participation, personal factors, mental health, and life satisfaction in persons with spinal cord injury.

    PubMed

    van Leeuwen, Christel M; Post, Marcel W; Westers, Paul; van der Woude, Lucas H; de Groot, Sonja; Sluis, Tebbe; Slootman, Hans; Lindeman, Eline

    2012-01-01

    To clarify relationships between activities, participation, mental health, and life satisfaction in persons with spinal cord injury (SCI) and specify how personal factors (self-efficacy, neuroticism, appraisals) interact with these components. We hypothesized that (1) activities are related directly to participation, participation is related directly to mental health and life satisfaction, and mental health and life satisfaction are 2 interrelated outcome variables; and (2) appraisals are mediators between participation and mental health and life satisfaction, and self-efficacy and neuroticism are related directly to mental health and life satisfaction and indirectly through appraisals. Follow-up measurement of a multicenter prospective cohort study 5 years after discharge from inpatient rehabilitation. Eight Dutch rehabilitation centers with specialized SCI units. Persons (N=143) aged 18 to 65 years at the onset of SCI. Not applicable. Mental health was measured by using the Mental Health subscale of the 36-Item Short Form Health Survey and life satisfaction with the sum score of "current life satisfaction" and "current life satisfaction compared with life satisfaction before SCI." Structural equation modeling showed that activities and neuroticism were related to participation and explained 49% of the variance in participation. Self-efficacy, neuroticism, and 2 appraisals were related to mental health and explained 35% of the variance in mental health. Participation, 3 appraisals, and mental health were related to life satisfaction and together explained 50% of the total variance in life satisfaction. Mental health and life satisfaction can be seen as 2 separate but interrelated outcome variables. Self-efficacy and neuroticism are related directly to mental health and indirectly to life satisfaction through the mediating role of appraisals. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Person: centre both of clinical ethics and of public health ethics. Commentary.

    PubMed

    Petrini, Carlo

    2012-01-01

    The "public health" perspective is different from the ″patient-centred″ clinical perspective for various reasons. Tensions between collective and individual interests are unavoidable in public health. Intersections between public health ethics and clinical bioethics can be traced to a set of duties which derive from respect of the person. Human rights and solidarity are "person-centred" cornerstones of both clinical and public health ethics.

  14. Modeling the mental health effects of victimization among homeless persons

    PubMed Central

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F.; Pollio, David

    2014-01-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults. PMID:18703266

  15. Modeling the mental health effects of victimization among homeless persons.

    PubMed

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F; Pollio, David

    2008-11-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults.

  16. Personal health records as portal to the electronic medical record.

    PubMed

    Cahill, Jennifer E; Gilbert, Mark R; Armstrong, Terri S

    2014-03-01

    This topic review discusses the evolving clinical challenges associated with the implementation of electronic personal health records (PHR) that are fully integrated with electronic medical records (EMR). The benefits of facilitating patient access to the EMR through web-based, PHR-portals may be substantial; foremost is the potential to enhance the flow of information between patient and healthcare practitioner. The benefits of improved communication and transparency of care are presumed to be a reduction in clinical errors, increased quality of care, better patient-management of disease, and better disease and symptom comprehension. Yet PHR databases allow patients open access to newly-acquired clinical data without the benefit of concurrent expert clinical interpretation, and therefore may create the potential for greater patient distress and uncertainty. With specific attention to neuro-oncology patients, this review focuses on the developing conflicts and consequences associated with the use of a PHR that parallels data acquisition of the EMR in real-time. We conclude with a discussion of recommendations for implementing fully-integrated PHR for neuro-oncology patients.

  17. Sociotechnical Challenges of Developing an Interoperable Personal Health Record

    PubMed Central

    Gaskin, G.L.; Longhurst, C.A.; Slayton, R.; Das, A.K.

    2011-01-01

    Objectives To analyze sociotechnical issues involved in the process of developing an interoperable commercial Personal Health Record (PHR) in a hospital setting, and to create guidelines for future PHR implementations. Methods This qualitative study utilized observational research and semi-structured interviews with 8 members of the hospital team, as gathered over a 28 week period of developing and adapting a vendor-based PHR at Lucile Packard Children’s Hospital at Stanford University. A grounded theory approach was utilized to code and analyze over 100 pages of typewritten field notes and interview transcripts. This grounded analysis allowed themes to surface during the data collection process which were subsequently explored in greater detail in the observations and interviews. Results Four major themes emerged: (1) Multidisciplinary teamwork helped team members identify crucial features of the PHR; (2) Divergent goals for the PHR existed even within the hospital team; (3) Differing organizational conceptions of the end-user between the hospital and software company differentially shaped expectations for the final product; (4) Difficulties with coordination and accountability between the hospital and software company caused major delays and expenses and strained the relationship between hospital and software vendor. Conclusions Though commercial interoperable PHRs have great potential to improve healthcare, the process of designing and developing such systems is an inherently sociotechnical process with many complex issues and barriers. This paper offers recommendations based on the lessons learned to guide future development of such PHRs. PMID:22003373

  18. Lifetime trauma, personality traits, and health: A pathway to midlife health status.

    PubMed

    Hampson, Sarah E; Edmonds, Grant W; Goldberg, Lewis R; Barckley, Maureen; Klest, Bridget; Dubanoski, Joan P; Hillier, Teresa A

    2016-07-01

    This study investigated whether lifetime experience of trauma is related to personality through instrumental and reactive trait processes, and whether lifetime trauma is a mechanism underlying the association between childhood conscientiousness and objectively assessed adult physical health. Participants (N = 831) were 442 women and 389 men from the Hawaii longitudinal study of personality and health. Teacher assessments of personality were obtained when the participants were in elementary school. Self-reported adult personality assessments, lifetime histories of trauma experience, and objectively assessed physiological dysregulation were obtained between ages 45-55. Women tended to report more high-betrayal trauma than men, whereas men reported more low-betrayal trauma than women. Women who were judged by their teachers to be less agreeable and less conscientious in childhood reported more lifetime trauma, suggesting instrumental trait processes. For both genders, neuroticism and openness/intellect/imagination in adulthood, but not in childhood, were associated with lifetime trauma, suggesting reactive trait processes. For both genders, trauma experience was correlated with dysregulation and with Body Mass Index (BMI). The indirect paths from childhood conscientiousness to adult dysregulation and BMI through total teen and adult trauma were significant for women, but not for men (indirect effect for women's dysregulation = -.025, p = .040, 95% confidence interval [CI] = -.048, -.001; indirect effect for women's BMI = -.037, p = .009, 95% CI = -.067, -.008). Teen and adult trauma experience appears to be a hitherto unidentified mechanism in women underlying the association between conscientiousness and health. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. Person-centered osteopathic practice: patients’ personality (body, mind, and soul) and health (ill-being and well-being)

    PubMed Central

    Nima, Ali A.; Archer, Trevor

    2015-01-01

    Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient’s personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger’s personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients’ personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients’ health in relation to their presenting problem and gender. Results. The patients’ personality explained the variance of all of the well-being (R2 between .19 and .54) and four of the ill-being (R2 between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and

  20. Interest in use of mHealth technology in HIV prevention and associated factors among high-risk drug users enrolled in methadone maintenance program.

    PubMed

    Shrestha, Roman; Karki, Pramila; Copenhaver, Michael

    2017-09-01

    The adoption of mobile technologies for health (mHealth) in healthcare has grown considerably in recent years, but systematic assessment of interest in the use of mHealth in HIV prevention efforts among people who use drugs (PWUD) is lacking. We therefore examined interest in use of mHealth technology in HIV prevention and associated individual-level factors among high-risk PWUD enrolled in methadone maintenance program. A total of 400 HIV-negative PWUD, who reported drug- and/or sex-related risk behaviors completed a standardized assessment using audio computer assisted self-interview (ACASI). Results revealed significant interest in using mHealth-based approaches for specific purposes, including: to receive medication reminders (72.3%), to receive information about HIV risk reduction (65.8%), and to assess HIV risk behaviors (76.5%). Multivariate analysis showed that interest in receiving medication reminders was associated with currently taking medication and being neurocognitively impaired, whereas interest in receiving HIV-risk reduction information was associated with being non-white, married, and perceiving the person was at high-risk for contracting HIV. Similarly, participants' interested in using mHealth for HIV risk behavior assessment was associated with having recently visited a healthcare provider and exhibiting depressive symptoms. Overall, this study demonstrated that high-risk PWUD are interested in using mHealth-based tools as a key part of an HIV prevention approach within a common type of drug treatment settings. Thus, formative research on preferences for design and functionality of mHealth-based HIV prevention tools are now needed, followed by practical development, implementation, and evaluation of these new intervention strategies.

  1. Hearing impairment in F-111 maintenance workers: the study of health outcomes in aircraft maintenance personnel (SHOAMP) general health and medical study.

    PubMed

    Guest, Maya; Boggess, May; Attia, John; D'Este, Catherine; Brown, Anthony; Gibson, Richard; Tavener, Meredith; Gardner, Ian; Harrex, Warren; Horsley, Keith; Ross, James

    2010-11-01

    We sought to examine hearing loss in a group from the Royal Australian Air Force who undertook fuel tank maintenance on F-111 aircraft, with exposure to formulations containing ototoxins, relative to two different comparison groups. Using pure-tone audiometry, hearing thresholds were assessed in 614 exposed personnel, 513 technical-trade comparisons (different base, same job), and 403 non-technical comparisons (same base, different job). We calculated percentage loss of hearing (PLH) and used regression models to examine whether there was an association between PLH and F-111 fuel tank maintenance, adjusting for possible confounders. In addition, the difference between the observed hearing thresholds and the expected thresholds based on an otologically normal population (ISO-7029-2003) was determined. The PLH ranged from nil to 96 (median 1.5, quartiles 0.3, 5.5). A logistic regression model showed no statistically significant difference in PLH among the three exposure groups (exposed vs. non-technical controls 1.1: 95% CI 0.7, 2.0 and exposed vs. technical OR 0.9: 95% CI 0.6, 1.3). The model also highlighted a number of other risk factors for PLH including age, tinnitus, smoking, depression, and use of depression medications. However, at all eight frequencies measured, all populations had lower than expected hearing thresholds based on published ISO-7029 medians. Although there was no difference in PLH between the three exposure groups, the study did reveal a high degree of hearing loss between the 3 groups and a normal population. © 2010 Wiley-Liss, Inc.

  2. Personal recognition using head-top image for health-monitoring system in the home.

    PubMed

    Nakajima, K; Sasaki, K

    2004-01-01

    Automatic health-monitoring systems for the smart house are being developed for the elderly. An automatic health-monitoring system needs a way of personal recognition when two or more aged persons live together. We propose a personal recognition method based on the space spectrum of the head-top image. We examined 33 head-top images from eleven subjects and achieved a personal recognition rate of 86.4 percent. When one subject with thinning hair was excluded, the personal recognition rate was 90.0 percent in 30 head-top images from ten subjects.

  3. A global travelers' electronic health record template standard for personal health records.

    PubMed

    Li, Yu-Chuan; Detmer, Don E; Shabbir, Syed-Abdul; Nguyen, Phung Anh; Jian, Wen-Shan; Mihalas, George I; Shortliffe, Edward H; Tang, Paul; Haux, Reinhold; Kimura, Michio

    2012-01-01

    Tourism as well as international business travel creates health risks for individuals and populations both in host societies and home countries. One strategy to reduce health-related risks to travelers is to provide travelers and relevant caregivers timely, ongoing access to their own health information. Many websites offer health advice for travelers. For example, the WHO and US Department of State offer up-to-date health information about countries relevant to travel. However, little has been done to assure travelers that their medical information is available at the right place and time when the need might arise. Applications of Information and Communication Technology (ICT) utilizing mobile phones for health management are promising tools both for the delivery of healthcare services and the promotion of personal health. This paper describes the project developed by international informaticians under the umbrella of the International Medical Informatics Association. A template capable of becoming an international standard is proposed. This application is available free to anyone who is interested. Furthermore, its source code is made open.

  4. US Spending on Personal Health Care and Public Health, 1996-2013.

    PubMed

    Dieleman, Joseph L; Baral, Ranju; Birger, Maxwell; Bui, Anthony L; Bulchis, Anne; Chapin, Abigail; Hamavid, Hannah; Horst, Cody; Johnson, Elizabeth K; Joseph, Jonathan; Lavado, Rouselle; Lomsadze, Liya; Reynolds, Alex; Squires, Ellen; Campbell, Madeline; DeCenso, Brendan; Dicker, Daniel; Flaxman, Abraham D; Gabert, Rose; Highfill, Tina; Naghavi, Mohsen; Nightingale, Noelle; Templin, Tara; Tobias, Martin I; Vos, Theo; Murray, Christopher J L

    2016-12-27

    US health care spending has continued to increase, and now accounts for more than 17% of the US economy. Despite the size and growth of this spending, little is known about how spending on each condition varies by age and across time. To systematically and comprehensively estimate US spending on personal health care and public health, according to condition, age and sex group, and type of care. Government budgets, insurance claims, facility surveys, household surveys, and official US records from 1996 through 2013 were collected and combined. In total, 183 sources of data were used to estimate spending for 155 conditions (including cancer, which was disaggregated into 29 conditions). For each record, spending was extracted, along with the age and sex of the patient, and the type of care. Spending was adjusted to reflect the health condition treated, rather than the primary diagnosis. Encounter with US health care system. National spending estimates stratified by condition, age and sex group, and type of care. From 1996 through 2013, $30.1 trillion of personal health care spending was disaggregated by 155 conditions, age and sex group, and type of care. Among these 155 conditions, diabetes had the highest health care spending in 2013, with an estimated $101.4 billion (uncertainty interval [UI], $96.7 billion-$106.5 billion) in spending, including 57.6% (UI, 53.8%-62.1%) spent on pharmaceuticals and 23.5% (UI, 21.7%-25.7%) spent on ambulatory care. Ischemic heart disease accounted for the second-highest amount of health care spending in 2013, with estimated spending of $88.1 billion (UI, $82.7 billion-$92.9 billion), and low back and neck pain accounted for the third-highest amount, with estimated health care spending of $87.6 billion (UI, $67.5 billion-$94.1 billion). The conditions with the highest spending levels varied by age, sex, type of care, and year. Personal health care spending increased for 143 of the 155 conditions from 1996 through 2013. Spending on low

  5. US Spending on Personal Health Care and Public Health, 1996–2013

    PubMed Central

    Dieleman, Joseph L.; Baral, Ranju; Birger, Maxwell; Bui, Anthony L.; Bulchis, Anne; Chapin, Abigail; Hamavid, Hannah; Horst, Cody; Johnson, Elizabeth K.; Joseph, Jonathan; Lavado, Rouselle; Lomsadze, Liya; Reynolds, Alex; Squires, Ellen; Campbell, Madeline; DeCenso, Brendan; Dicker, Daniel; Flaxman, Abraham D.; Gabert, Rose; Highfill, Tina; Naghavi, Mohsen; Nightingale, Noelle; Templin, Tara; Tobias, Martin I.; Vos, Theo; Murray, Christopher J. L.

    2017-01-01

    IMPORTANCE US health care spending has continued to increase, and now accounts for more than 17% of the US economy. Despite the size and growth of this spending, little is known about how spending on each condition varies by age and across time. OBJECTIVE To systematically and comprehensively estimate US spending on personal health care and public health, according to condition, age and sex group, and type of care. DESIGN AND SETTING Government budgets, insurance claims, facility surveys, household surveys, and official US records from 1996 through 2013 were collected and combined. In total, 183 sources of data were used to estimate spending for 155 conditions (including cancer, which was disaggregated into 29 conditions). For each record, spending was extracted, along with the age and sex of the patient, and the type of care. Spending was adjusted to reflect the health condition treated, rather than the primary diagnosis. EXPOSURES Encounter with US health care system. MAIN OUTCOMES AND MEASURES National spending estimates stratified by condition, age and sex group, and type of care. RESULTS From 1996 through 2013, $30.1 trillion of personal health care spending was disaggregated by 155 conditions, age and sex group, and type of care. Among these 155 conditions, diabetes had the highest health care spending in 2013, with an estimated $101.4 billion (uncertainty interval [UI], $96.7 billion–$106.5 billion) in spending, including 57.6% (UI, 53.8%–62.1%) spent on pharmaceuticals and 23.5% (UI, 21.7%–25.7%) spent on ambulatory care. Ischemic heart disease accounted for the second-highest amount of health care spending in 2013, with estimated spending of $88.1 billion (UI, $82.7 billion–$92.9 billion), and low back and neck pain accounted for the third-highest amount, with estimated health care spending of $87.6 billion (UI, $67.5 billion–$94.1 billion). The conditions with the highest spending levels varied by age, sex, type of care, and year. Personal

  6. Personality and coping: a context for examining celebrity worship and mental health.

    PubMed

    Maltby, John; Day, Liza; McCutcheon, Lynn E; Gillett, Raphael; Houran, James; Ashe, Diane D

    2004-11-01

    The adaptational-continuum model of personality and coping suggests a useful context for research areas that emphasize both personality and coping. The present paper used Ferguson's (2001) model integrating personality and coping factors to further conceptualize findings around celebrity worship. Three hundred and seventy-two respondents completed measures of celebrity worship, personality, coping style, general health, stress, positive and negative affect and life satisfaction. Celebrity worship for intense-personal reasons is associated with poorer mental heath and this relationship can be understood within the dimensions of neuroticism and a coping style that suggests disengagement. Such findings suggest the utility of examining the relationship between celebrity worship and mental health within both personality and coping variables, which have practical implications for understanding and addressing mental health problems that may occur as the result of engaging in celebrity worship for intense-personal reasons.

  7. A Qualitative Systematic Review of Older Persons' Perceptions of Health, Ill Health, and Their Community Health Care Needs

    PubMed Central

    Holm, Anne Lise; Severinsson, Elisabeth

    2013-01-01

    The aim of this qualitative systematic review was to report a synthesis of older persons' perceptions of health, ill health, and their community health care needs. The review questions were what characterizes older persons' perceptions of health and ill health? and what are their community health care needs? Ten studies were identified in a systematic search for relevant qualitative papers published between January 2000 and January 2013 in the following electronic databases: PubMed, EBSCOhost/Academic Search Premier, and CINAHL. Publications were evaluated for quality, and a thematic analysis was performed. Two main themes were interpreted on a higher level: reconciliation with how life has become: and desire to regain their identity and sense of self-worth despite disability. Two themes emerged: creating meaning led to the experience of being valued in health care and society and a mental struggle to regain independence with the help of caregivers. Of special interest is the finding of perceptions related to the fear of becoming dependent on caregivers as well as the sorrow and pain caused by encountering caregivers who did not understand their desire to create meaning in their lives or their struggle for autonomy and independency. PMID:23738062

  8. Health insurance coverage among persons with AIDS: results from a multistate surveillance project.

    PubMed Central

    Diaz, T; Chu, S Y; Conti, L; Nahlen, B L; Whyte, B; Mokotoff, E; Shields, A; Checko, P J; Herr, M; Mukhtar, Q

    1994-01-01

    To determine factors associated with health insurance coverage among persons with acquired immunodeficiency syndrome (AIDS), we interviewed 1958 persons 18 years of age or older who were reported to have AIDS in 11 states and cities. Overall, 25% had no insurance, 55% had public insurance, and 20% had private insurance. Factors associated with lack of insurance varied by current employment status. Employed persons with an annual household income of less than $10,000 were 3.6 times more likely to lack insurance than employed persons with a higher income. Unemployed persons diagnosed with AIDS for less than 1 year were two times more likely to lack health insurance than unemployed persons diagnosed for a longer time. Making insurance available to persons identified as most likely to lack insurance should improve access to care for persons with AIDS. PMID:8203668

  9. Rapid progress or lengthy process? electronic personal health records in mental health

    PubMed Central

    2011-01-01

    A major objective of many healthcare providers is to increase patients' participation in their own care. The introduction of electronic personal health records (ePHRs) may help to achieve this. An ePHR is an electronic database of an individual's health information, accessible to and maintained by the patient. ePHRs are very much in vogue, with an increasing number of studies reporting their potential utility as well as cost. However, the vast majority of these studies focus on general healthcare. Little attempt has been made to document the specific problems which might occur throughout the implementation of ePHRs in mental health. This review identifies such concerns through an electronic search of the literature. Several potential difficulties are highlighted and addressed, including access to information technology, identifying relevant populations and the handling of sensitive information. Special attention is paid to the concept of 'empowerment' and what this means in relation to ePHRs. PMID:21791069

  10. Rapid progress or lengthy process? Electronic personal health records in mental health.

    PubMed

    Ennis, Liam; Rose, Diana; Callard, Felicity; Denis, Mike; Wykes, Til

    2011-07-26

    A major objective of many healthcare providers is to increase patients' participation in their own care. The introduction of electronic personal health records (ePHRs) may help to achieve this. An ePHR is an electronic database of an individual's health information, accessible to and maintained by the patient. ePHRs are very much in vogue, with an increasing number of studies reporting their potential utility as well as cost. However, the vast majority of these studies focus on general healthcare. Little attempt has been made to document the specific problems which might occur throughout the implementation of ePHRs in mental health. This review identifies such concerns through an electronic search of the literature. Several potential difficulties are highlighted and addressed, including access to information technology, identifying relevant populations and the handling of sensitive information. Special attention is paid to the concept of 'empowerment' and what this means in relation to ePHRs.

  11. Health Co-Morbidities in Ageing Persons with Down Syndrome and Alzheimer's Dementia

    ERIC Educational Resources Information Center

    McCarron, M.; Gill, M.; McCallion, P.; Begley, C.

    2005-01-01

    Consideration of the relationship between physical and mental health co-morbidities in ageing persons with Down syndrome (DS) and Alzheimer's dementia (AD) is of clinical importance both from a care and resource perspective. To investigate and measure health co-morbidities in ageing persons with Down syndrome with and without AD. Recorded physical…

  12. Does a Personalized Health Portal for Diabetes Retinal Imaging Positively Affect Motivational Readiness to Change

    DTIC Science & Technology

    2010-11-01

    term complications related to diabetes include diabetic eye disease, nerve damage ( neuropathy ), heart disease, stroke, kidney failure, and peripheral ...TITLE: Does a Personalized Health Portal for Diabetes Retinal Imaging Positively Affect Motivational Readiness to Change PRINCIPAL...SUBTITLE Does a Personalized Health Portal for Diabetes Retinal Imaging 5a. CONTRACT NUMBER W81XWH-09-2-0166 Positively Affect Motivational

  13. Integrating a Stress Management Mini-Course into a Personal Health Course.

    ERIC Educational Resources Information Center

    Lang, Darrel

    A study investigated whether stress management could be enhanced among college students after the completion of a three credit personal health course. The subjects were 20 randomly selected male and female students enrolled in a personal health course at Emporia State University (Kansas). The 20 experimental subjects and the 15 members of a…

  14. Health Co-Morbidities in Ageing Persons with Down Syndrome and Alzheimer's Dementia

    ERIC Educational Resources Information Center

    McCarron, M.; Gill, M.; McCallion, P.; Begley, C.

    2005-01-01

    Consideration of the relationship between physical and mental health co-morbidities in ageing persons with Down syndrome (DS) and Alzheimer's dementia (AD) is of clinical importance both from a care and resource perspective. To investigate and measure health co-morbidities in ageing persons with Down syndrome with and without AD. Recorded physical…

  15. Health of Spouse Caregivers of Dementia Patients: The Role of Personality and Social Support.

    ERIC Educational Resources Information Center

    Monahan, Deborah J.; Hooker, Karen

    1995-01-01

    Examined measures of social support and personality to determine their influence on health outcomes of 51 spouse caregivers of dementia patients. Results indicated a relationship between health outcomes and personality and social support. This finding may help practitioners target and improve interventions with dementia patients and their…

  16. Influence of personality on depression, burden, and health-related quality of life in family caregivers of persons with dementia.

    PubMed

    Kim, Sun Kyung; Park, Myonghwa; Lee, Yunhwan; Choi, Seong Hye; Moon, So Young; Seo, Sang Won; Park, Kyung Won; Ku, Bon D; Han, Hyun Jeong; Park, Kee Hyung; Han, Seol-Heui; Kim, Eun-Joo; Lee, Jae-Hong; Park, Sun A; Shim, Yong S; Kim, Jong Hun; Hong, Chang Hyung; Na, Duk L; Ye, Byoung Seok; Kim, Hee Jin; Moon, Yeonsil

    2017-02-01

    Personality may predispose family caregivers to experience caregiving differently in similar situations and influence the outcomes of caregiving. A limited body of research has examined the role of some personality traits for health-related quality of life (HRQoL) among family caregivers of persons with dementia (PWD) in relation to burden and depression. Data from a large clinic-based national study in South Korea, the Caregivers of Alzheimer's Disease Research (CARE), were analyzed (N = 476). Path analysis was performed to explore the association between family caregivers' personality traits and HRQoL. With depression and burden as mediating factors, direct and indirect associations between five personality traits and HRQoL of family caregivers were examined. Results demonstrated the mediating role of caregiver burden and depression in linking two personality traits (neuroticism and extraversion) and HRQoL. Neuroticism and extraversion directly and indirectly influenced the mental HRQoL of caregivers. Neuroticism and extraversion only indirectly influenced their physical HRQoL. Neuroticism increased the caregiver's depression, whereas extraversion decreased it. Neuroticism only was mediated by burden to influence depression and mental and physical HRQoL. Personality traits can influence caregiving outcomes and be viewed as an individual resource of the caregiver. A family caregiver's personality characteristics need to be assessed for tailoring support programs to get the optimal benefits from caregiver interventions.

  17. Personality is associated with perceived health and functional status in older primary care patients.

    PubMed

    Duberstein, Paul R; Sörensen, Silvia; Lyness, Jeffrey M; King, Deborah A; Conwell, Yeates; Seidlitz, Larry; Caine, Eric D

    2003-03-01

    Using data collected on 265 primary care medical patients 60 years of age and older, the authors examined the personality bases of subjective health (perceived health, functional status) after controlling for observer-rated depression and medical burden. Four hypotheses were tested: High Neuroticism is associated with poorer perceived health, low Extraversion is associated with poorer perceived health, low Openness to Experience is associated with worse functional status, and age moderates the relationships between personality and subjective health. Findings supported the notion that personality is associated with subjective health; moreover, this effect appeared to grow more pronounced with increasing age. This study underscores the conceptual and heuristic value of examining moderators of the links between personality variables and health.

  18. School Experiences Influence Personal Health and Interpersonal Relationships of Adolescents: The Canadian Case

    ERIC Educational Resources Information Center

    Ma, Xin

    2007-01-01

    Canadian data from the 1998 Cross-National Survey on Health Behaviors in School-Aged Children were analyzed to examine the effects of school experiences on personal health (physical health, mental health, self-esteem, helplessness, and body image) and interpersonal relationships (number of close friends and making friends) among adolescents.…

  19. School Experiences Influence Personal Health and Interpersonal Relationships of Adolescents: The Canadian Case

    ERIC Educational Resources Information Center

    Ma, Xin

    2007-01-01

    Canadian data from the 1998 Cross-National Survey on Health Behaviors in School-Aged Children were analyzed to examine the effects of school experiences on personal health (physical health, mental health, self-esteem, helplessness, and body image) and interpersonal relationships (number of close friends and making friends) among adolescents.…

  20. It's "Supposed" to Be Personal: Personal and Educational Factors Associated with Sexual Health Attitudes, Knowledge, Comfort and Skill in Health Profession Students

    ERIC Educational Resources Information Center

    West, Lindsey M.; Stepleman, Lara M.; Wilson, Christina K.; Campbell, Jeff; Villarosa, Margo; Bodie, Brittany; Decker, Matthew

    2012-01-01

    The health professional and the patient are cultural beings with beliefs and attitudes that are shaped by family traditions, social development, and exposure to novel experiences. As such, it is especially important for health profession students to gain awareness about the personal and educational factors that likely inform their practice and…