Science.gov

Sample records for societal health quality

  1. Societal health and urban sustainability indicators

    SciTech Connect

    Petrich, C.H.; Tonn, B.E.

    1996-08-27

    Without the social will, no city can successfully Undertake the planning and programs necessary for meaningful progress toward sustainability. Social will derives from wellsprings of vital societal health. This paper presents an approach to helping cities in APEC member economies initiate a program for developing indicators of sustainability. Representative indicators of social capital and other aspects of civic engagement, as proxies for societal health, are presented.

  2. Evaluating landscape health: Integrating societal goals and biophysical process

    USGS Publications Warehouse

    Rapport, D.J.; Gaudet, C.; Karr, J.R.; Baron, J. S.; Bohlen, C.; Jackson, W.; Jones, B.; Naiman, R.J.; Norton, B.; Pollock, M. M.

    1998-01-01

    Evaluating landscape change requires the integration of the social and natural sciences. The social sciences contribute to articulating societal values that govern landscape change, while the natural sciences contribute to understanding the biophysical processes that are influenced by human activity and result in ecological change. Building upon Aldo Leopold's criteria for landscape health, the roles of societal values and biophysical processes in shaping the landscape are explored. A framework is developed for indicators of landscape health and integrity. Indicators of integrity are useful in measuring biological condition relative to the condition in landscapes largely unaffected by human activity, while indicators of health are useful in evaluating changes in highly modified landscapes. Integrating societal goals and biophysical processes requires identification of ecological services to be sustained within a given landscape. It also requires the proper choice of temporal and spatial scales. Societal values are based upon inter-generational concerns at regional scales (e.g. soil and ground water quality). Assessing the health and integrity of the environment at the landscape scale over a period of decades best integrates societal values with underlying biophysical processes. These principles are illustrated in two contrasting case studies: (1) the South Platte River study demonstrates the role of complex biophysical processes acting at a distance; and (2) the Kissimmee River study illustrates the critical importance of social, cultural and economic concerns in the design of remedial action plans. In both studies, however, interactions between the social and the biophysical governed the landscape outcomes. The legacy of evolution and the legacy of culture requires integration for the purpose of effectively coping with environmental change.

  3. Societal output and use of research performed by health research groups

    PubMed Central

    2010-01-01

    The last decade has seen the evaluation of health research pay more and more attention to societal use and benefits of research in addition to scientific quality, both in qualitative and quantitative ways. This paper elaborates primarily on a quantitative approach to assess societal output and use of research performed by health research groups (societal quality of research). For this reason, one of the Dutch university medical centres (i.e. the Leiden University Medical Center (LUMC)) was chosen as the subject of a pilot study, because of its mission to integrate top patient care with medical, biomedical and healthcare research and education. All research departments were used as units of evaluation within this university medical centre. The method consisted of a four-step process to reach a societal quality score per department, based on its (research) outreach to relevant societal stakeholders (the general public, healthcare professionals and the private sector). For each of these three types of stakeholders, indicators within four modes of communication were defined (knowledge production, knowledge exchange, knowledge use and earning capacity). These indicators were measured by a bottom-up approach in a qualitative way (i.e. all departments of the LUMC were asked to list all activities they would consider to be of societal relevance), after which they were converted into quantitative scores. These quantitative scores could then be compared to standardised scientific quality scores that are based on scientific publications and citations of peer-reviewed articles. Based on the LUMC pilot study, only a weak correlation was found between societal and scientific quality. This suggests that societal quality needs additional activities to be performed by health research groups and is not simply the consequence of high scientific quality. Therefore we conclude that scientific and societal evaluation should be considered to be synergistic in terms of learning for the

  4. Societal Influences on Health and Life-styles

    PubMed Central

    Ulmer, David D.

    1984-01-01

    Strong sociocultural forces affect individual attitudes toward health and choice of life-style. Economic deprivation fosters negative health behaviors. Positive health habits are reinforced by discrete societal groups. The news media, particularly television, disseminate much useful health information, though the overall educational value is diminished by the content of commercial messages and programming. The automobile is a major societal influence, but neither individual drivers nor the car manufacturers give enough priority to highway safety, leaving that role to governmental regulation. American industry is becoming a positive influence in the encouragement of good health habits, and fashion is lately an important ally in personal health maintenance. PMID:6523860

  5. Air quality management using modern remote sensing and spatial technologies and associated societal costs.

    PubMed

    Uddin, Waheed

    2006-09-01

    This paper presents a study of societal costs related to public health due to the degradation of air quality and the lack of physical activity, both affected by our built environment. The paper further shows road safety as another public health concern. Traffic fatalities are the number one cause of death in the world. Traffic accidents result in huge financial loss to the people involved and the related public health cost is a significant part of the total societal cost. Motor vehicle exhausts and industrial emissions, gasoline vapors, and chemical solvents as well as natural sources emit nitrogen oxides and volatile organic compounds, which are precursors to the formation of ground-level Ozone. High concentration values of ground-level Ozone in hot summer days produce smog and lead to respiratory problems and loss in worker's productivity. These factors and associated economic costs to society are important in establishing public policy and decision-making for sustainable transportation and development of communities in both industrialized and developing countries. This paper presents new science models for predicting ground-level Ozone and related air quality degradation. The models include predictor variables of daily climatological data, traffic volume and mix, speed, aviation data, and emission inventory of point sources. These models have been implemented in the user friendly AQMAN computer program and used for a case study in Northern Mississippi. Lifecycle benefits from reduced societal costs can be used to implement sustainable transportation policies, enhance investment decision-making, and protect public health and the environment.

  6. Air Quality Management Using Modern Remote Sensing and Spatial Technologies and Associated Societal Costs

    PubMed Central

    Uddin, Waheed

    2006-01-01

    This paper presents a study of societal costs related to public health due to the degradation of air quality and the lack of physical activity, both affected by our built environment. The paper further shows road safety as another public health concern. Traffic fatalities are the number one cause of death in the world. Traffic accidents result in huge financial loss to the people involved and the related public health cost is a significant part of the total societal cost. Motor vehicle exhausts and industrial emissions, gasoline vapors, and chemical solvents as well as natural sources emit nitrogen oxides and volatile organic compounds, which are precursors to the formation of ground-level Ozone. High concentration values of ground-level Ozone in hot summer days produce smog and lead to respiratory problems and loss in worker’s productivity. These factors and associated economic costs to society are important in establishing public policy and decision-making for sustainable transportation and development of communities in both industrialized and developing countries. This paper presents new science models for predicting ground-level Ozone and related air quality degradation. The models include predictor variables of daily climatological data, traffic volume and mix, speed, aviation data, and emission inventory of point sources. These models have been implemented in the user friendly AQMAN computer program and used for a case study in Northern Mississippi. Life-cycle benefits from reduced societal costs can be used to implement sustainable transportation policies, enhance investment decision-making, and protect public health and the environment. PMID:16968969

  7. Research and Evaluations of the Health Aspects of Disasters, Part IV: Framework for Societal Structures: the Societal Systems.

    PubMed

    Birnbaum, Marvin L; Daily, Elaine K; O'Rourke, Ann P

    2015-12-01

    For the purposes of research and/or evaluation, a community/society is organized into 13 Societal Systems under the umbrella of an overall Coordination and Control System. This organization facilitates descriptions of a community/society or a component of a community for assessment at any designated time across the Temporal Phases of a disaster. Such assessments provide a picture of the functional status of one or more Systems that comprise a community. Since no system operates in isolation from the other systems, information of the concomitant status of several Societal Systems is crucial to gaining a complete understanding of compromised functions, as well as the effects and side effects of any intervention directed at restoring the functional state of the affected community or risk-reduction interventions of a community-at-risk. The 13 Societal Systems include: (1) Public Health; (2) Medical Care; (3) Water and Sanitation; (4) Shelter and Clothing; (5) Food and Nutrition; (6) Energy Supply; (7) Public Works and Engineering; (8) Social Structures; (9) Logistics and Transportation; (10) Security; (11) Communications; (12) Economy; and (13) Education. Many functions and sub-functions of the Systems overlap, or share some common sub-functions with other systems. For the purposes of research/evaluation, it is necessary to assign functions and sub-functions to only one of the Societal Systems.

  8. Passenger aircraft cabin air quality: trends, effects, societal costs, proposals.

    PubMed

    Hocking, M B

    2000-08-01

    As aircraft operators have sought to substantially reduce propulsion fuel cost by flying at higher altitudes, the energy cost of providing adequate outside air for ventilation has increased. This has lead to a significant decrease in the amount of outside air provided to the passenger cabin, partly compensated for by recirculation of filtered cabin air. The purpose of this review paper is to assemble the available measured air quality data and some calculated estimates of the air quality for aircraft passenger cabins to highlight the trend of the last 25 years. The influence of filter efficiencies on air quality, and a few medically documented and anecdotal cases of illness transmission aboard aircraft are discussed. Cost information has been collected from the perspective of both the airlines and passengers. Suggestions for air quality improvement are given which should help to result in a net, multistakeholder savings and improved passenger comfort.

  9. Good governance and good health: The role of societal structures in the human immunodeficiency virus pandemic.

    PubMed

    Menon-Johansson, Anatole S

    2005-04-25

    BACKGROUND: Only governments sensitive to the demands of their citizens appropriately respond to needs of their nation. Based on Professor Amartya Sen's analysis of the link between famine and democracy, the following null hypothesis was tested: "Human Immunodeficiency Virus (HIV) prevalence is not associated with governance". METHODS: Governance has been divided by a recent World Bank paper into six dimensions. These include Voice and Accountability, Political Stability and Absence of Violence, Government Effectiveness, Regulatory Quality, Rule of Law and the Control of Corruption. The 2002 adult HIV prevalence estimates were obtained from UNAIDS. Additional health and economic variables were collected from multiple sources to illustrate the development needs of countries. RESULTS: The null hypothesis was rejected for each dimension of governance for all 149 countries with UNAIDS HIV prevalence estimates. When these nations were divided into three groups, the median (range) HIV prevalence estimates remained constant at 0.7% (0.05 - 33.7%) and 0.75% (0.05% - 33.4%) for the lower and middle mean governance groups respectively despite improvements in other health and economic indices. The median HIV prevalence estimates in the higher mean governance group was 0.2% (0.05 - 38.8%). CONCLUSION: HIV prevalence is significantly associated with poor governance. International public health programs need to address societal structures in order to create strong foundations upon which effective healthcare interventions can be implemented.

  10. Health and societal effects from exposure to fragranced consumer products.

    PubMed

    Steinemann, Anne

    2017-03-01

    Fragranced consumer products-such as air fresheners, cleaning supplies, and personal care products- pervade society. This study investigated the occurrence and types of adverse effects associated with exposure to fragranced products in Australia, and opportunities for prevention. Data were collected in June 2016 using an on-line survey with a representative national sample (n = 1098). Overall, 33% of Australians report health problems, such as migraine headaches and asthma attacks, when exposed to fragranced products. Of these health effects, more than half (17.1%) could be considered disabling under the Australian Disability Discrimination Act. Additionally, 7.7% of Australians have lost workdays or a job due to illness from fragranced product exposure in the workplace, 16.4% reported health problems when exposed to air fresheners or deodorizers, 15.3% from being in a room after it was cleaned with scented products, and 16.7% would enter but then leave a business as quickly as possible due to fragranced products. About twice as many respondents would prefer that workplaces, health care facilities and professionals, hotels, and airplanes were fragrance-free rather than fragranced. While 73.7% were not aware that fragranced products, even ones called green and organic, emitted hazardous air pollutants, 56.3% would not continue to use a product if they knew it did. This is the first study in Australia to assess the extent of adverse effects associated with exposure to common fragranced products. It provides compelling evidence for the importance and value of reducing fragranced product exposure in order to reduce and prevent adverse health effects and costs.

  11. Influence of societal and practice contexts on health professionals’ clinical reasoning: a scoping study protocol

    PubMed Central

    Carrier, Annie; Levasseur, Mélanie; Freeman, Andrew; Mullins, Gary; Quénec'hdu, Suzanne; Lalonde, Louise; Gagnon, Michaël; Lacasse, Francis

    2013-01-01

    Introduction In a context of constrained resources, the efficacy of interventions is a pivotal aim of healthcare systems worldwide. Efficacy of healthcare interventions is highly compromised if clinical reasoning (CR), the process that practitioners use to plan, direct, perform and reflect on client care, is not optimal. The CR process of health professionals is influenced by the institutional dimension (ie, legal, regulatory, administrative and organisational aspects) of their societal and practice contexts. Although several studies have been conducted with respect to the institutional dimension influencing health professionals’ CR, no clear integration of their results is yet available. The aim of this study is to synthesise and disseminate current knowledge on the influence of the institutional dimension of contexts on health professionals’ CR. Methods and analysis A scoping study of the scientific literature from January 1980 to March 2013 will be undertaken to summarise and disseminate research findings about the influence of the institutional dimension on CR. Numerous databases (n=18) from three relevant fields (healthcare, health law and politics and management) will be searched. Extended search strategies will include the manual search of bibliographies, health-related websites, public registries and journals of interest. Data will be collected and analysed using a thematic chart and content analysis. A systematic multidisciplinary team approach will allow optimal identification of relevant studies, as well as effective and valid content analysis and dissemination of the results. Discussion This scoping study will provide a rigorous, accurate and up-to-date synthesis of existing knowledge regarding: (1) those aspects of the institutional dimension of health professionals’ societal and practice contexts that impact their CR and (2) how these aspects influence health professionals’ CR. Through the synergy of a multidisciplinary research team from a

  12. Workers are people too: societal aspects of occupational health disparities--an ecosocial perspective.

    PubMed

    Krieger, Nancy

    2010-02-01

    Workers are people too. What else is new? This seemingly self-evident proposition, however, takes on new meaning when considering the challenging and deeply important issue of occupational health disparities--the topic that is the focus of 12 articles in this special issue of the American Journal of Industrial Medicine. In this commentary, I highlight some of the myriad ways that societal determinants of health intertwine with each and every aspect of occupation-related health inequities, as analyzed from an ecosocial perspective. The engagement extends from basic surveillance to etiologic research, from conceptualization and measurement of variables to analysis and interpretation of data, from causal inference to preventive action, and from the political economy of work to the political economy of health. A basic point is that who is employed (or not) in what kinds of jobs, with what kinds of exposures, what kinds of treatment, and what kinds of job stability, benefits, and pay-as well as what evidence exists about these conditions and what action is taken to address them-depends on societal context. At issue are diverse aspects of people's social location within their societies, in relation to their jointly experienced-and embodied-realities of socioeconomic position, race/ethnicity, nationality, nativity, immigration and citizen status, age, gender, and sexuality, among others. Reviewing the papers' findings, I discuss the scientific and real-world action challenges they pose. Recommendations include better conceptualization and measurement of socioeconomic position and race/ethnicity and also use of the health and human rights framework to further the public health mission of ensuring the conditions that enable people-including workers-to live healthy and dignified lives.

  13. A note on the depreciation of the societal perspective in economic evaluation of health care.

    PubMed

    Johannesson, M

    1995-07-01

    It is common in cost-effectiveness analyses of health care to only include health care costs, with the argument that some fictive 'health care budget' should be used to maximize the health effects. This paper provides a criticism of the 'health care budget' approach to cost-effectiveness analysis of health care. It is argued that the approach is ad hoc and lacks theoretical foundation. The approach is also inconsistent with using a fixed budget as the decision rule for cost-effectiveness analysis. That is the case unless only costs that fall into a single annual actual budget are included in the analysis, which would mean that any cost paid by the patients should be excluded as well as any future cost changes and all costs that fall on other budgets. Furthermore the prices facing the budget holder should be used, rather than opportunity costs. It is concluded that the 'health care budget' perspective should be abandoned and the societal perspective reinstated in economic evaluation of health care.

  14. Morality and the limits of societal values in health care allocation.

    PubMed

    Walker, Rebecca L; Siegel, Andrew W

    2002-04-01

    In this paper, we consider whether there is a clear moral justification for the proposal that societal value preferences (SVPs) should be included in Cost Effectiveness Analyses (CEA) of health care resource allocations. We argue, first, that proponents of the use of SVPs need to be clear about the relationship between these values and moral principles. In particular, once moral principles are accepted as ruling out some SVPs (such as those that are irrational or revealing prejudice), an account is required of why we need to appeal to SVPs rather than moral principles to determine a just division of health care resources. Secondly, we consider whether an independent moral justification might underwrite the use of SVPs. In various places in the literature the notions of representation, presumed consent and democratic decision making appear to be invoked as candidates for fulfilling this justificatory role. We discuss some problems with each of these justifications in the hope of eliciting a more comprehensive proposal from the proponents of SVPs. We conclude that, although a number of interesting proposals have been made, no compelling justification for including SVPs in CEA has yet been systematically articulated.

  15. An Exploratory Analysis of Societal Preferences for Research-Driven Quality of Life Improvements in Canada

    ERIC Educational Resources Information Center

    Rudd, Murray A.

    2011-01-01

    Research in the humanities, arts, and social sciences (HASS) tends to have impacts that enhance quality of life (QOL) but that are not amenable to pricing in established markets. If the economic value of "non-market" research impacts is ignored when making the business case for HASS research, society will under-invest in it. My goal in…

  16. Women's health in a rural setting in societal transition in Ethiopia.

    PubMed

    Berhane, Y; Gossaye, Y; Emmelin, M; Hogberg, U

    2001-12-01

    There are reports indicating a worsening of women's health in transitional rural societies in sub-Saharan Africa in relation to autonomy, workload, illiteracy, nutrition and disease prevalence. Although these problems are rampant, proper documentation is lacking. The objective of this study was to reflect the health situation of women in rural Ethiopia. Furthermore, the study attempts to address the socio-demographic and cultural factors that have potential influence on the health of women in the context of a low-income setting. A combination of qualitative and quantitative research methods was utilised. In-depth interviews and a cross-sectional survey of randomly selected women were the main methods employed. The Butajira Rural Health Program demographic surveillance database provided the sampling frame. Heavy workload, lack of access to health services, poverty, traditional practices, poor social status and decision-making power, and lack of access to education were among the highly prevalent socio-cultural factors that potentially affect the health of women in Butajira. Though the majority of the women use traditional healers younger women show more tendency to use health services. No improvement of women's status was perceived by the younger generation compared to the older generation. Female genital mutilation is universal with a strong motivation to its maintenance. Nail polish has replaced the rite of nail-extraction before marriage in the younger generation. As the factors influencing the health of women are multiple and complex a holistic approach should be adopted with emphasis on improving access to health care and education, enhancing social status, and mechanisms to alleviate poverty.

  17. Medical Education and Societal Expectations: Conflicts at the Clinical Interface.

    ERIC Educational Resources Information Center

    Janeway, Richard

    1986-01-01

    Three factors that will have major effects on the medical cost quality debate are: industrial and governmental policy in regard to health-related expenditures, an aging population, and societal attitudes towards competition in the health care system. Approaches to conflict resolution are offered. (MLW)

  18. Trends that will affect your future … a portrait of American societal health.

    PubMed

    Schwartz, Stephan A

    2011-01-01

    The SchwartzReport tracks emerging trends that will affect the world, particularly the United States. For EXPLORE, it focuses on matters of health in the broadest sense of that term, including medical issues, changes in the biosphere, technology, and policy considerations, all of which will shape our culture and our lives.

  19. Societal values in the allocation of healthcare resources: is it all about the health gain?

    PubMed

    Stafinski, Tania; Menon, Devidas; Marshall, Deborah; Caulfield, Timothy

    2011-01-01

    Over the past decade, public distrust in unavoidable value-laden decisions on the allocation of resources to new health technologies has grown. In response, healthcare organizations have made considerable efforts to improve their acceptability by increasing transparency in decision-making processes. However, the social value judgments (distributive preferences of the public) embedded in them have yet to be defined. While the need to explicate such judgments has become widely recognized, the most appropriate approach to accomplishing this remains unclear. The aims of this review were to identify factors around which distributive preferences of the public have been sought, create a list of social values proposed or used in current resource allocation decision-making processes for new health technologies, and review approaches to eliciting such values from the general public. Social values proposed or used in making resource allocation decisions for new health technologies were identified through three approaches: (i) a comprehensive review of published, peer-reviewed, empirical studies of public preferences for the distribution of healthcare; (ii) an analysis of non-technical factors or social value statements considered by technology funding decision-making processes in Canada and abroad; and (iii) a review of appeals to funding decisions on grounds in part related to social value judgments. A total of 34 empirical studies, 10 technology funding decision-making processes, and 12 appeals to decisions were identified and reviewed. The key factors/patient characteristics addressed through policy statements and around which distributive preferences of the public have been sought included severity of illness, immediate need, age (and its relationship to lifetime health), health gain (amount and final outcome/health state), personal responsibility for illness, caregiving responsibilities, and number of patients who could benefit (rarity). Empirical studies typically

  20. Is Smokeless Tobacco Use an Appropriate Public Health Strategy for Reducing Societal Harm from Cigarette Smoking?

    PubMed Central

    Tomar, Scott L.; Fox, Brion J.; Severson, Herbert H.

    2009-01-01

    Four arguments have been used to support smokeless tobacco (ST) for harm reduction: (1) Switching from cigarettes to ST would reduce health risks; (2) ST is effective for smoking cessation; (3) ST is an effective nicotine maintenance product; and (4) ST is not a “gateway” for cigarette smoking. There is little evidence to support the first three arguments and most evidence suggests that ST is a gateway for cigarette smoking. There are ethical challenges to promoting ST use. Based on the precautionary principle, the burden of proof is on proponents to provide evidence to support their position; such evidence is lacking. PMID:19440266

  1. STAPOL: A Simulation of the Impact of Policy, Values, and Technological and Societal Developments upon the Quality of Life.

    ERIC Educational Resources Information Center

    Little, Dennis; Feller, Richard

    The Institute for the Future has been conducting research in technological and societal forecasting, social indicators, value change, and simulation gaming. This paper describes an effort to bring together parts of that research into a simulation game ("State Policy," or STAPOL) for analysis of the impact of government policy, social values, and…

  2. Ethical, Political and Societal Implications of the Open Access Journal Movement in the Era of Economic Crisis, with Emphasis on Public Health Pharmacogenomics.

    PubMed

    Bragazzi, Nicola Luigi

    2013-12-01

    Publication of the research outputs is a vital step of the research processes and a gateway between the laboratory and the global society. Open Access is revolutionizing the dissemination of scientific ideas, particularly in the field of public health pharmacogenomics that examines the ways in which pharmacogenomics impacts health systems and services at a societal level, rather than a narrow bench to bedside model of translation science. This manuscript argues that despite some limitations and drawbacks, open access has profound ethical, political and societal implications especially on underdeveloped and developing countries, and that it provides opportunities for science to grow in these resource-limited countries, particularly in the era of a severe economic and financial crisis that is imposing cuts and restrictions to research.

  3. Service quality in health care.

    PubMed

    Kenagy, J W; Berwick, D M; Shore, M F

    1999-02-17

    Although US health care is described as "the world's largest service industry," the quality of service--that is, the characteristics that shape the experience of care beyond technical competence--is rarely discussed in the medical literature. This article illustrates service quality principles by analyzing a routine encounter in health care from a service quality point of view. This illustration and a review of related literature from both inside and outside health care has led to the following 2 premises: First, if high-quality service had a greater presence in our practices and institutions, it would improve clinical outcomes and patient and physician satisfaction while reducing cost, and it would create competitive advantage for those who are expert in its application. Second, many other industries in the service sector have taken service quality to a high level, their techniques are readily transferable to health care, and physicians caring for patients can learn from them.

  4. Achieving Quality in Occupational Health

    NASA Technical Reports Server (NTRS)

    O'Donnell, Michele (Editor); Hoffler, G. Wyckliffe (Editor)

    1997-01-01

    The conference convened approximately 100 registered participants of invited guest speakers, NASA presenters, and a broad spectrum of the Occupational Health disciplines representing NASA Headquarters and all NASA Field Centers. Centered on the theme, "Achieving Quality in Occupational Health," conferees heard presentations from award winning occupational health program professionals within the Agency and from private industry; updates on ISO 9000 status, quality assurance, and information technologies; workshops on ergonomics and respiratory protection; an overview from the newly commissioned NASA Occupational Health Assessment Team; and a keynote speech on improving women's health. In addition, NASA occupational health specialists presented 24 poster sessions and oral deliveries on various aspects of current practice at their field centers.

  5. Farmworker Housing Quality and Health.

    PubMed

    Arcury, Thomas A; Jacobs, Ilene J; Ruiz, Virginia

    2015-11-01

    On 11 November 2014, Farmworker Housing Quality and Health: A Transdisciplinary Conference was convened to draw together experts from the variety of disciplines who contribute to research and practice focused on farmworker housing and health in order to delineate current knowledge and propose next steps. The conference addressed three specific aims: (1) to consolidate current knowledge on characteristics and quality of housing provided for farmworkers; (2) to delineate pertinent directions and areas for farmworker housing health and safety research and policy; and (3) to facilitate the development of working groups to support the implementation of research, education, and engineering projects to improve farmworker housing. This article provides an overview of the conference.

  6. Societal determination of usefulness and utilization wishes of community health services: a population-based survey in Wuhan city, China

    PubMed Central

    Zhang, Peipei; Zhao, Lianyi; Liang, Jing; Qiao, Yan; He, Quanyan; Zhang, Liuyi; Wang, Fang; Liang, Yuan

    2015-01-01

    Background As a developing country with the world’s largest population in a state of economic transition, reforms to China’s health system, including community health services (CHS), are very complex and difficult. The aim of this study is to provide evidence and policy recommendations for the sustainable development of CHS for China, which could also be applicable to other developing countries. Methods A cross-sectional survey was conducted door-to-door and face-to-face in Wuhan city, central China with a sample of 1134 individuals aged 15 and older. The independent variables were duration of residence, previous treatment experience, familiarity with health staff, self-reported family economic status and health insurance. The dependent variables were views on the usefulness of CHS and willingness to use them. Sociodemographic variables and health status were used as control variables. Multiple logistic regression analysis was used to analyse the influence of the independent variables on the dependent variables. Findings This study shows that 26.10% of participants reported that the CHSs are not useful and 37.74% reported they did not want to use their CHS. The results found ‘familiarity with health staff’ and ‘previous experience of using services’ had a negative influence on their views on usefulness of and willingness to use CHS. Conclusion The aim of CHS to see ‘minor illnesses treated in the community and serious illness treated in hospital’ is not being fully realized. The key to increasing the use of CHS may be to enhance the quality of services and health staff. A policy pathway of targeting older residents and those with higher education levels as the priority population, and using these groups to encourage the rest of the community to seek minor services at CHS, may be an effective and sustainable development mechanism. PMID:25492032

  7. Helping You Choose Quality Behavioral Health Care

    MedlinePlus

    Helping You Choose Quality Behavioral Health Care Selecting quality behavioral health care services for yourself, a relative or friend requires special thought and attention. The Joint Commission on ...

  8. When "health" is not enough: societal, individual and biomedical assessments of well-being among the Matsigenka of the Peruvian Amazon.

    PubMed

    Izquierdo, Carolina

    2005-08-01

    Although biomedical indicators of health status show that physical health for the Matsigenka of the Peruvian Amazon has significantly improved over the past 20-30 years, the Matsigenka perceive their health and well-being to have severely declined during this period. This discrepancy between empirical measures and local perceptions of health and well-being points to the central tension inherent in measuring and defining "health." While biomedical parameters of health are generally linked to notions of the body free of illness, measurable by physiological means, the Matsigenka define physical health as only one component of what it means to be healthy and to experience well-being. For the Matsigenka, notions of health and well-being are linked fundamentally to ideals about happiness, productivity and goodness, in addition to biomedical health. The Matsigenka attribute the decrease in their well-being to newly instigated sorcery and stressors resulting from outside influences and morality institutionalized by cultural "outsiders", such as missionaries, school teachers, health personnel, oil company employees and government officials. This article explores the relationships between biomedical, societal and personal assessments of health and well-being among the Matsigenka as they seek to preserve their sense of wellness in spite of their rapidly changing social and economic environment. By using longitudinal qualitative and quantitative ethnographic and health data, this paper shows that, for the Matsigenka, increases in acculturation and permanent settlement result in an alarming decrease in their health and well-being.

  9. The Evaluation Scale: Exploring Decisions About Societal Impact in Peer Review Panels.

    PubMed

    Derrick, Gemma E; Samuel, Gabrielle N

    Realising the societal gains from publicly funded health and medical research requires a model for a reflexive evaluation precedent for the societal impact of research. This research explores UK Research Excellence Framework evaluators' values and opinions and assessing societal impact, prior to the assessment taking place. Specifically, we discuss the characteristics of two different impact assessment extremes - the "quality-focused" evaluation and "societal impact-focused" evaluation. We show the wide range of evaluator views about impact, and that these views could be conceptually reflected in a range of different positions along a conceptual evaluation scale. We describe the characteristics of these extremes in detail, and discuss the different beliefs evaluators had which could influence where they positioned themselves along the scale. These decisions, we argue, when considered together, form a dominant definition of societal impact that influences the direction of its evaluation by the panel.

  10. The exodus of health professionals from sub-Saharan Africa: balancing human rights and societal needs in the twenty-first century.

    PubMed

    Ogilvie, Linda; Mill, Judy E; Astle, Barbara; Fanning, Anne; Opare, Mary

    2007-06-01

    Increased international migration of health professionals is weakening healthcare systems in low-income countries, particularly those in sub-Saharan Africa. The migration of nurses, physicians and other health professionals from countries in sub-Saharan Africa poses a major threat to the achievement of health equity in this region. As nurses form the backbone of healthcare systems in many of the affected countries, it is the accelerating migration of nurses that will be most critical over the next few years. In this paper we present a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one's country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to non-discrimination and equality. Creative policy approaches are required to balance these rights and to ensure that the individual rights of health professionals do not compromise the societal right to health.

  11. Does evaluative scientometrics lose its main focus on scientific quality by the new orientation towards societal impact?

    PubMed

    Bornmann, Lutz; Haunschild, Robin

    2017-01-01

    When the meaning of key terms is incompatible in competing taxonomies, a revolution might occur in the field by which the established taxonomy is replaced with another. Since the key term "impact" in scientometrics seems to undergo a taxonomic change, a revolution might be taking place at present: Impact is no longer defined as impact on science alone (measured by citations), but on all sectors of society (e.g. economics, culture, or politics). In this Short Communication, we outline that the current revolution in scientometrics does not only imply a broadening of the impact perspective, but also the devaluation of quality considerations in evaluative contexts. Impact might no longer be seen as a proxy for quality, but in its original sense: the simple resonance in some sectors of society.

  12. Indoor air quality and health

    NASA Astrophysics Data System (ADS)

    Jones, A. P.

    During the last two decades there has been increasing concern within the scientific community over the effects of indoor air quality on health. Changes in building design devised to improve energy efficiency have meant that modern homes and offices are frequently more airtight than older structures. Furthermore, advances in construction technology have caused a much greater use of synthetic building materials. Whilst these improvements have led to more comfortable buildings with lower running costs, they also provide indoor environments in which contaminants are readily produced and may build up to much higher concentrations than are found outside. This article reviews our current understanding of the relationship between indoor air pollution and health. Indoor pollutants can emanate from a range of sources. The health impacts from indoor exposure to combustion products from heating, cooking, and the smoking of tobacco are examined. Also discussed are the symptoms associated with pollutants emitted from building materials. Of particular importance might be substances known as volatile organic compounds (VOCs), which arise from sources including paints, varnishes, solvents, and preservatives. Furthermore, if the structure of a building begins to deteriorate, exposure to asbestos may be an important risk factor for the chronic respiratory disease mesothelioma. The health effects of inhaled biological particles can be significant, as a large variety of biological materials are present in indoor environments. Their role in inducing illness through immune mechanisms, infectious processes, and direct toxicity is considered. Outdoor sources can be the main contributors to indoor concentrations of some contaminants. Of particular significance is Radon, the radioactive gas that arises from outside, yet only presents a serious health risk when found inside buildings. Radon and its decay products are now recognised as important indoor pollutants, and their effects are

  13. The public health implications of United Kingdom offender healthcare policy: a holistic approach to achieve individual and societal gains.

    PubMed

    Senior, Jane; Shaw, Jenny

    2011-01-01

    In 2009, two seminal documents were published by the United Kingdom (UK) government concerning healthcare services for offenders. The Bradley review into diversion for people with mental health problems and learning disabilities emphasised a need to improve offender health, not least because of the high economic costs to society as a whole resulting from unresolved mental illness, physical ill-health and substance abuse problems commonly experienced by offenders. The Bradley review made wide-reaching recommendations for change, requiring strong partnership between health and justice agencies at both central government and local levels. A framework for the delivery of Bradley's recommendations has been set out in Improving health, supporting justice, the Department of Health's offender health strategy which sets out the direction of travel for the next 10 years. This paper discusses the reality of working toward improving health services for this marginalised group in the context of the influence of the current straitened financial climate on the allocation of resources to publically funded healthcare in the UK; it examines the historically based, and widely held, belief in the principle of "less eligibility" within our society, whereby there is much public and media resistance to allocating resources to improving care for offenders when other, more "deserving", groups are perceived to be in continuing need.

  14. Societal assessment overview

    NASA Technical Reports Server (NTRS)

    Bloomquist, C. E.

    1980-01-01

    The decision to proceed with SPS depends on a political determination that commitment of the economic, institutional, and social energies required for its implementation is a worthwhile investment. This determination is national (and international) in scope and is based on knowledge of the environmental and societal impacts of the SPS, its projected economics and technological risks, expressed through the influence of contending segments of society. To assist the decision makers, an assessment of societal issues associated with the SPS was undertaken as part of the Concept Development and Evaluation Program. Results of the assessment are reported. The primary societal assessment objectives are to determine if the societal ramifications of an SPS might significantly impede its development, and to establish an information base regarding these issues. Estimates regarding SPS impacts commensurate with its stage of development and the needs of the decision makers are provided.

  15. Societal Duty and Resource Allocation for Persons with Severe Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    DeJong, Gerben; Batavia, Andrew I.

    1989-01-01

    The article considers eight values and factors that enter into decisions regarding resource allocation for persons with brain injury including the quality of life, moral culpability of the brain-injured person, the social contribution of the person, allocation of family and societal responsibilities, justice, the nature of health care, and…

  16. The impact of non-adherence to medication in patients with schizophrenia on health, social care and societal costs. Analysis of the QUATRO study.

    PubMed

    King, D; Knapp, M; Patel, A; Amaddeo, F; Tansella, M; Schene, A; Koeter, M; Angermeyer, M; Becker, T

    2014-03-01

    Aims. For people with schizophrenia, non-adherence to antipsychotic medications may result in high use of health and other services. The objective of our research was to examine the economic consequences of non-adherence in patients with schizophrenia taking antipsychotic medication. Methods. Data were taken from QUATRO, a randomized controlled trial that drew a sample of adults with schizophrenia receiving psychiatric services in four European cities: Amsterdam, Leipzig, London and Verona. Trial inclusion criteria were a clinical diagnosis of schizophrenia, requiring on-going antipsychotic medication for at least 1-year following baseline assessment, and exhibiting evidence of clinical instability in the year prior to baseline. The patient-completed Medication Adherence Questionnaire (MAQ) was used to calculate the 5-point Morisky index of adherence. Generalized linear models (GLM) were developed to determine the effect of adherence on (i) health and social care and (ii) societal costs before and after treatment, taking into account other potential cost-influencing factors. Results. The effect of non-adherence on costs was mixed. For different groups of services, and according to treatment group assignment, non-adherence was both negatively and positively associated with costs. Conclusions. The impact of non-adherence on costs varies across the types of services used by individuals with schizophrenia.

  17. Improving Health and Quality of Life

    MedlinePlus

    ... Supplements Managing Activities and Exercise Improving Health and Quality of Life Pediatric Definition and Diagnosis Management and Treatment Factsheets Healthcare Professionals Parents Education Professionals ...

  18. The Societal Importance of Embracing Counterintuitive Thought in Science: Assisted Exercise in Preterm Infants for Long-term Health Outcomes.

    PubMed

    Olshansky, Ellen; Vaughan, Jessica; Sando, Kelsi; Rich, Julia; Lakes, Kimberley; Cooper, Daniel

    For research to lead to progressive change, scientists and society must embrace what may seem counterintuitive. While there is often resistance to changing views of what we presume to already understand, we must be open to evolving knowledge and evidence. Our research is examining the effect of a novel intervention designed to increase physical activity of premature babies in their first year of life on: (1) body composition, (2) associated biochemical and cellular mechanisms of growth and inflammation, and (3) quality of maternal care. This study is novel because it is counterintuitive to prevailing knowledge of the care and treatment of infants born prematurely. Traditionally, we swaddle infants and restrict their movement in order to minimize energy expenditure. We are proposing the opposite: to increase energy expenditure in a systematic, controlled way in order to increase muscle mass and bone density, with the ultimate goal of preventing diseases associated with lack of muscle mass or bone density. Our research actively engages the mothers in the study by learning about their perceptions and their experiences of doing the exercise with their infants because the mothers, too, are aware of the prevailing views that are counter to what they are being asked to do. The mothers have taught us, however, that they are willing to participate in this exercise study, while paradoxically also viewing their infants as "fragile" and are fearful of hurting their infants. Our thesis in this research-based paper is that science and society must work in tandem to be effective.

  19. Cambodian boys' transitions into young adulthood: exploring the influence of societal and masculinity norms on young men's health.

    PubMed

    Scandurra, Leah; Khorn, Daro; Charles, Thana-Ashley; Sommer, Marni

    2016-11-24

    A growing body of evidence focuses on the experiences of young men in low-income countries, including their health vulnerabilities. Much of this research has been conducted in sub-Saharan Africa, Asia and Latin America. Limited evidence exists on the norms influencing boys' transitions into young adulthood in Southeast Asia, and in Cambodia in particular. To help fill this gap, we conducted a comparative case study using participatory methods with 16-19-year-old young men in rural and urban Cambodia, and with the adults who intersect in their lives. Findings suggest that in line with their counterparts growing up elsewhere, Cambodian boys welcome becoming young men as a time of newly acquired adult roles and responsibilities, while some may experience growing up as a time of bodily change, burgeoning sexual feelings and limited sources of support and guidance. As a result, some may strive more intensely to conform to the alcohol use and violence modelled by the older men in their environments. Additional research is needed to better understand the vulnerabilities of boys' transition into young adulthood in Cambodia today, and how to prevent or reduce engagement with these more negative practices.

  20. Quality and Electronic Health Records in Community Health Centers

    ERIC Educational Resources Information Center

    Lesh, Kathryn A.

    2014-01-01

    Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of…

  1. Organisational Learning for School Quality and Health

    ERIC Educational Resources Information Center

    Lagrosen, Yvonne; Lagrosen, Stefan

    2012-01-01

    Purpose: The purpose of this paper is to shed light upon the connections between quality management, employee health and organisational learning in a school setting. Design/methodology/approach: The study is based on a quantitative survey. Items measuring health status and values of quality management were included in a questionnaire addressed to…

  2. Quality improvement in public health institutions.

    PubMed

    Sanadia, Bharti N

    2005-02-01

    Quality issues are integral to providing primary health care. The delivery of health care is a complex process that involves a number of factors such as interpersonal skill, culture, technology and available resources. In general, quality is defined as customer satisfaction at competitive cost. As per John Guaspari, "Quality should not be positioned as the absence of problems as defined by us. It should be positioned as the presence of Value and satisfaction as defined by the customers/clients."

  3. Health care quality and safety issues.

    PubMed

    Cornett, Becky Sutherland

    2006-05-01

    Our health-care system is burdened with high costs, health-care disparities, overtreatment, undertreatment, high error rates, and fraud and abuse. At the same time, the United States has achieved spectacular medical advances using the latest technology. As a result, health-care quality measurement, publicly reported patient safety and quality indicators, and evaluation of patients' experience of care are watchwords of a new era of accountability for health-care professionals and organizations. The health-care industry is subject to increasing regulation, private sector challenges, and public demand to make significant improvements in all three components of the quality triad: structure, process, and outcome. This article examines regulatory initiatives and industry trends pertaining to patient safety and quality measurement and concludes with specific suggestions for the professions of speech-language pathology and audiology.

  4. [Health care quality assurance in the Netherlands].

    PubMed

    Reerink, E

    1990-01-01

    In this paper the main structural features of the dutch health system are described, together with a historical survey of its development in recent years. The basic elements of quality assurance in the country are also discussed.

  5. Total quality management in health care.

    PubMed

    McDonald, S C

    1994-01-01

    Total quality management (TQM), continuous quality improvement (CQI) and quality control are terms that are becoming very familiar to workers in the health care environment. The purpose of this article is to discuss these terms and the concepts they describe. The origins of TQM and the keen interest in its application to the health care environment today are addressed. In other environments, TQM has shown significant increases in productivity while increasing effectiveness. Its application to the health care environment is the provision of the best possible care through continuously improving service to meet or exceed the needs and expectations of the customer. The customer in the health care environment could be the patient, staff, physician and community serviced by the hospital. Characteristics of the new organizational structure are reviewed. Established techniques and processes are commonly used to identify process-improvement opportunities to assist the manager in continuously evaluating quality trends.

  6. Measuring Physical Neighborhood Quality Related to Health

    PubMed Central

    Rollings, Kimberly A.; Wells, Nancy M.; Evans, Gary W.

    2015-01-01

    Although sociodemographic factors are one aspect of understanding the effects of neighborhood environments on health, equating neighborhood quality with socioeconomic status ignores the important role of physical neighborhood attributes. Prior work on neighborhood environments and health has relied primarily on level of socioeconomic disadvantage as the indicator of neighborhood quality without attention to physical neighborhood quality. A small but increasing number of studies have assessed neighborhood physical characteristics. Findings generally indicate that there is an association between living in deprived neighborhoods and poor health outcomes, but rigorous evidence linking specific physical neighborhood attributes to particular health outcomes is lacking. This paper discusses the methodological challenges and limitations of measuring physical neighborhood environments relevant to health and concludes with proposed directions for future work. PMID:25938692

  7. Systemic vasculitis: how little we know about their societal and economic burden.

    PubMed

    Trieste, Leopoldo; Palla, Ilaria; Baldini, Chiara; Talarico, Rosaria; D'Angiolella, Lucia; Mosca, Marta; Turchetti, Giuseppe

    2012-01-01

    This article attempts to perform an evaluation of the state of the art of the economic and societal burden of systemic vasculitis (VAs). Due to the rarity of these diseases and their variable clinical picture, few data are available in the literature on their health economic issues, and only some papers have been published that marginally examine the problem. Since VAs are severe conditions with a high medical and societal impact and determine high healthcare resource consumption, studies able to define societal, quality of life and economic burden of these pathologies are needed. Policy makers, private and public organisations involved in the care of VAs need data to programme future investment or make cost-effectiveness analysis for introducing new drugs or protocols.

  8. Quality of health care for the disadvantaged.

    PubMed

    Brook, R H; Williams, K N

    1975-01-01

    Literature review points out that: (a) differentials in health status between the disadvantaged and the nondisadvantaged persist, often to a large degree; (b) differentials in the overall amount of care received are less striking now than heretofore, but standardization by level of need demonstrates measurable discrepancies in health services provided to the disadvantaged compared with the nondisadvantaged; (c) the quality of health care for the disadvantaged is not strikingly poorer than care for the nondisadvantaged, but, in view of demonstrable shortcomings in the quality of health care in general, this is not viewed as a positive statement; and (d) attempts to improve quality of care for the disadvantaged have not had the hoped-for impact. Four new avenues are suggested for possible further research; increased patient responsibility, increased consumer knowledge, financial accountability, and quality assurance activities. Because of the likelihood of only marginal changes in health status, rigorous evaluation of any experimental program is emphasized. During the last decade, many attempts have been made by private and governmental bodies to improve the health of the American people. In general, these efforts have focused on improving the health of members of disadvantaged groups and have included such diverse activities as building OEO health centers, developing maternal and infant care programs, and financing care for the elderly. During the last few years, a different movement, concerned with assuring high quality care for all people, has produced efforts such as quality assurance activities in health maintenance organizations, the Professional Standards Review Organization program, and the medical care evaluation program of the Joint Commission on the Accreditation of Hospitals. Consideration of these two issues, i.e., improving the health of disadvantaged groups and improving the quality of care for all people, has led to two policy-relevant questions: "Can

  9. Quality assurance guides health reform in Jordan.

    PubMed

    Abubaker, W; Abdulrahman, M

    1996-01-01

    In November 1995, a World Bank mission went to Jordan to conduct a study of the health sector. The study recommended three strategies to reform the health sector: decentralization of Ministry of Health (MOH) management; improvement of clinical practices, quality of care, and consumer satisfaction; and adoption of treatment protocols and standards. The MOH chose quality assurance (QA) methods and quality management (QM) techniques to accomplish these reforms. The Monitoring and QA Directorate oversees QA applications within MOH. It also institutes and develops the capacity of local QA units in the 12 governorates. The QA units implement and monitor day-to-day QA activities. The QM approach encompasses quality principles: establish objectives; use a systematic approach; teach lessons learned and applicable research; use QA training to teach quality care, quality improvement, and patient satisfaction; educate health personnel about QM approaches; use assessment tools and interviews; measure the needs and expectations of local health providers and patients; ensure feedback on QA improvement projects; ensure valid and reliable data; monitor quality improvement efforts; standardize systemic data collection and outcomes; and establish and disseminate QA standards and performance improvement efforts. The Jordan QA Project has helped with the successful institutionalization of a QA system at both the central and local levels. The bylaws of the QA councils and committees require team participation in the decision-making process. Over the last two years, the M&QA Project has adopted 21 standards for nursing, maternal and child health care centers, pharmacies, and medications. The Balqa pilot project has developed 44 such protocols. Quality improvement (COUGH) studies have examined hyper-allergy, analysis of patient flow rate, redistribution of nurses, vaccine waste, and anemic pregnant women. There are a considerable number of on-going clinical and non-clinical COUGH studies

  10. Patient and Societal Value Functions for the Testing Morbidities Index

    PubMed Central

    Swan, John Shannon; Kong, Chung Yin; Lee, Janie M.; Akinyemi, Omosalewa; Halpern, Elkan F.; Lee, Pablo; Vavinskiy, Sergey; Williams, Olubunmi; Zoltick, Emilie S.; Donelan, Karen

    2013-01-01

    Background We developed preference-based and summated scale scoring for the Testing Morbidities Index (TMI) classification, which addresses short-term effects on quality of life from diagnostic testing before, during and after a testing procedure. Methods The two TMI value functions utilize multiattribute value techniques; one is patient-based and the other has a societal perspective. 206 breast biopsy patients and 466 (societal) subjects informed the models. Due to a lack of standard short-term methods for this application, we utilized the visual analog scale (VAS). Waiting trade-off (WTO) tolls provided an additional option for linear transformation of the TMI. We randomized participants to one of three surveys: the first derived weights for generic testing morbidity attributes and levels of severity with the VAS; a second developed VAS values and WTO tolls for linear transformation of the TMI to a death-healthy scale; the third addressed initial validation in a specific test (breast biopsy). 188 patients and 425 community subjects participated in initial validation, comparing direct VAS and WTO values to the TMI. Alternative TMI scoring as a non-preference summated scale was included, given evidence of construct and content validity. Results The patient model can use an additive function, while the societal model is multiplicative. Direct VAS and the VAS-scaled TMI were correlated across modeling groups (r=0.45 to 0.62) and agreement was comparable to the value function validation of the Health Utilities Index 2. Mean Absolute Difference (MAD) calculations showed a range of 0.07–0.10 in patients and 0.11–0.17 in subjects. MAD for direct WTO tolls compared to the WTO-scaled TMI varied closely around one quality-adjusted life day. Conclusions The TMI shows initial promise in measuring short-term testing-related health states. PMID:23689044

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

    PubMed Central

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

    2007-01-01

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

  12. Insomnia risks and costs: health, safety, and quality of life.

    PubMed

    Rosekind, Mark R; Gregory, Kevin B

    2010-08-01

    The effect of insomnia on next-day functioning, health, safety, and quality of life results in a substantial societal burden and economic cost. The annual direct cost of insomnia has been estimated in the billions of US dollars and is attributed to the association of insomnia with the increased risk of certain psychiatric and medical comorbidities that result in increased healthcare service utilization. It is well known that psychiatric conditions, anxiety and depression in particular, are comorbid with insomnia. However, emerging data have shown links with several common and costly medical conditions such as heart disease and diabetes. Furthermore, studies show that patients who have insomnia have more emergency department and physician visits, laboratory tests, and prescription drug use than those who do not have insomnia, increasing direct and indirect consumption of healthcare resources. Insomnia also has been shown to negatively affect daytime functioning, including workplace productivity, as well as workplace and public safety. These daytime effects of insomnia are translated into indirect costs that are reportedly higher than the direct costs of this disorder. These observations have significant implications for managed care organizations and healthcare providers. Improvements in diagnosing and treating insomnia can significantly reduce the healthcare cost of insomnia and its comorbid disorders, while providing additional economic benefits from improved daytime functioning and from increased productivity.

  13. Quality measurement indicators for Iranian Health Centers

    PubMed Central

    Moslehi, Shandiz; Atefi Manesh, Pezhman; Sarabi Asiabar, Ali

    2015-01-01

    Background: Recently, quality is a serious concern in development of organizations. There are various indicators to assess quality and the purpose of this study was to identify the main indicators for quality measurement of Iranian health centers. Methods: This qualitative study was conducted in three stages: first, review of the literature was performed to identify different indicators for quality measurement in health centers; second, a tworound Delphi process was used with participation of 18 experts in both rounds; third, Analytical Hierarchy Process (AHP) method was applied to give weights to each indicator. Results: Twenty-seven indicators were identified from the literature review stage. The Delphi method reduced the list to 4 indicators. Developing a quality plan in the health center had the highest weight (38%) and percentage of followed complaints the lowest (12%). The consistency rate was 7.2% indicating appropriateness of the data. Conclusion: This list of indicators can be used as a template for measuring quality of health centers in Iran and possibly in other developing countries. PMID:26034730

  14. Data Quality in Electronic Health Records Research.

    PubMed

    Feder, Shelli L

    2017-01-01

    The proliferation of the electronic health record (EHR) has led to increasing interest and opportunities for nurse scientists to use EHR data in a variety of research designs. However, methodological problems pertaining to data quality may arise when EHR data are used for nonclinical purposes. Therefore, this article describes common domains of data quality and approaches for quality appraisal in EHR research. Common data quality domains include data accuracy, completeness, consistency, credibility, and timeliness. Approaches for quality appraisal include data validation with data rules, evaluation and verification of data abstraction methods with statistical measures, data comparisons with manual chart review, management of missing data using statistical methods, and data triangulation between multiple EHR databases. Quality data enhance the validity and reliability of research findings, form the basis for conclusions derived from the data, and are, thus, an integral component in EHR-based study design and implementation.

  15. [Quality assurance in occupational health services].

    PubMed

    Michalak, J

    1996-01-01

    The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.

  16. Quality and Certification of Electronic Health Records

    PubMed Central

    Hoerbst, A.; Ammenwerth, E.

    2010-01-01

    Background Numerous projects, initiatives, and programs are dedicated to the development of Electronic Health Records (EHR) worldwide. Increasingly more of these plans have recently been brought from a scientific environment to real life applications. In this context, quality is a crucial factor with regard to the acceptance and utility of Electronic Health Records. However, the dissemination of the existing quality approaches is often rather limited. Objectives The present paper aims at the description and comparison of the current major quality certification approaches to EHRs. Methods A literature analysis was carried out in order to identify the relevant publications with regard to EHR quality certification. PubMed, ACM Digital Library, IEEExplore, CiteSeer, and Google (Scholar) were used to collect relevant sources. The documents that were obtained were analyzed using techniques of qualitative content analysis. Results The analysis discusses and compares the quality approaches of CCHIT, EuroRec, IHE, openEHR, and EN13606. These approaches differ with regard to their focus, support of service-oriented EHRs, process of (re-)certification and testing, number of systems certified and tested, supporting organizations, and regional relevance. Discussion The analyzed approaches show differences with regard to their structure and processes. System vendors can exploit these approaches in order to improve and certify their information systems. Health care organizations can use these approaches to support selection processes or to assess the quality of their own information systems. PMID:23616834

  17. Indoor air quality and human health

    SciTech Connect

    Turiel, I.

    1985-01-01

    The air inside buildings can contain various threats to human health: cigarette smoke, fumes from fires and cookers, microbes, gases, allergens and fumes produced by household products or building materials. Higher standards of insulation and draught-proofing and more use of air conditioning can increase the problems. This book provides a summary of indoor air quality problems in homes, offices and public buildings. Contents: Preface; Introduction; Formaledhyde and other household contaminants; Radon; Particulates; Combustion products; Involuntary smoking; Energy-efficient buildings and indoor air quality; Control of indoor air pollutants; Indoor air quality problems in office buildings; Legal and regulatory issues; Appendices; Sources and suggested reading; Glossary; Index.

  18. The societal impact value of risk

    SciTech Connect

    Simpson, D.E.

    1995-04-01

    A key ill-defined issue in the management and regulation of potentially hazardous conditions is that of the value to be associated with a reduction (or existence) of human health risks, such as radiation exposure or hazardous substance ingestion. Empirical observations of societal behavior patterns lead to a relationship for the quantitative value of societal risk impact which is consistent with general societal risk acceptance, is not inconsistent with ``de facto`` risk regulation, and is suitable and appropriate as a specification or guide for risk management and risk regulation. This societal risk impact expression is: Impact ($/year) = (8 {times} 10{sup 7}) NR{sub i}{sup 4/3} where Ri = individual annual mortality risk; N = number of persons in the population sharing the risk and benefits. The change in Impact which can be derived from a regulation or risk management activity is the value of annual benefit which society would expect to forego (or annual equivalent cost to incur) in consideration of the activity.

  19. 'Are you still on that stupid diet?': women's experiences of societal pressure and support regarding weight loss, and attitudes towards health policy intervention.

    PubMed

    Whale, Katie; Gillison, Fiona B; Smith, Paula C

    2014-12-01

    This study investigated how people's attitudes and motivations towards losing weight are influenced by societal pressures surrounding weight loss, their interaction with the obesogenic environment and individuals' attitudes and motivations towards weight. Semi-structured qualitative interviews were conducted with 10 women currently attending commercial weight-loss programmes. Participants experienced conflicting messages regarding weight norms, with the media portraying powerful social norms relating to thinness and beauty, and changes to the food environment and interactions with family and friends commonly undermining weight-loss activities and promoting increased consumption. Providing social and environmental support for the behaviours needed to produce weight loss may need to be a primary focus for obesity policy.

  20. Towards medicines regulatory authorities' quality performance improvement: value for public health.

    PubMed

    Pejović, Gordana; Filipović, Jovan; Tasić, Ljiljana; Marinković, Valentina

    2016-01-01

    The purpose of this article is to explore the possibility of implementing total quality management (TQM) principles in national medicines regulatory authorities in Europe to achieve all public health objectives. Bearing in mind that medicines regulation is a governmental function that serves societal objectives to protect and promote public health, measuring the effective achievement of quality objectives related to public health is of utmost importance. A generic TQM model for meeting public health objectives was developed and was tested on 10 European national medicines regulatory authorities with different regulatory performances. Participating national medicines regulatory authorities recognised all TQM factors of the proposed model in implemented systems with different degrees of understanding. An analysis of responses was performed within the framework of two established criteria-the regulatory authority's category and size. The value of the paper is twofold. First, the new generic TQM model proposes to integrate four public health objectives with six TQM factors. Second, national medicines regulatory authorities were analysed as public organisations and health authorities to develop a proper tool for assessing their regulatory performance. The paper emphasises the importance of designing an adequate approach to performance measurement of quality management systems in medicines regulatory authorities that will support their public service missions.

  1. The Evaluation Scale: Exploring Decisions about Societal Impact in Peer Review Panels

    ERIC Educational Resources Information Center

    Derrick, Gemma E.; Samuel, Gabrielle N.

    2016-01-01

    Realising the societal gains from publicly funded health and medical research requires a model for a reflexive evaluation precedent for the societal impact of research. This research explores UK Research Excellence Framework evaluators' values and opinions and assessing societal impact, prior to the assessment taking place. Specifically, we…

  2. Inflammation, Oxidative Stress, and Antioxidants Contribute to Selected Sleep Quality and Cardiometabolic Health Relationships: A Cross-Sectional Study

    PubMed Central

    Kanagasabai, Thirumagal; Ardern, Chris I.

    2015-01-01

    Sleep is vital for cardiometabolic health, but a societal shift toward poor sleep is a prominent feature of many modern cultures. Concurrently, factors such as diet and lifestyle have also changed and may mediate the relationship between sleep quality and cardiometabolic health. Objectives were to explore (1) the interrelationship and (2) mediating effect of inflammation, oxidative stress, and antioxidants on sleep quality and cardiometabolic health. Cross-sectional data from the US National Health and Nutritional Examination Survey 2005-06 (≥20 y; N = 2,072) was used. Cardiometabolic health was defined as per the Joint Interim Statement; overall sleep quality was determined from six sleep habits and categorized as good, fair, poor, and very poor. Fair quality sleepers had optimal inflammation, oxidative stress, and antioxidant levels. Inflammation was above the current clinical reference range across all sleep quality categories, while oxidative stress was only within the clinical reference range for fair sleep quality. Selected sleep quality-cardiometabolic health relationships were mediated by inflammation, oxidative stress, and antioxidants and were moderated by sex. Our results provide initial evidence of a potential role for inflammation, oxidative stress, and antioxidants in the pathway between poor sleep quality-cardiometabolic decline. Further prospective research is needed to confirm our results. PMID:26568665

  3. Inflammation, Oxidative Stress, and Antioxidants Contribute to Selected Sleep Quality and Cardiometabolic Health Relationships: A Cross-Sectional Study.

    PubMed

    Kanagasabai, Thirumagal; Ardern, Chris I

    2015-01-01

    Sleep is vital for cardiometabolic health, but a societal shift toward poor sleep is a prominent feature of many modern cultures. Concurrently, factors such as diet and lifestyle have also changed and may mediate the relationship between sleep quality and cardiometabolic health. Objectives were to explore (1) the interrelationship and (2) mediating effect of inflammation, oxidative stress, and antioxidants on sleep quality and cardiometabolic health. Cross-sectional data from the US National Health and Nutritional Examination Survey 2005-06 (≥20 y; N = 2,072) was used. Cardiometabolic health was defined as per the Joint Interim Statement; overall sleep quality was determined from six sleep habits and categorized as good, fair, poor, and very poor. Fair quality sleepers had optimal inflammation, oxidative stress, and antioxidant levels. Inflammation was above the current clinical reference range across all sleep quality categories, while oxidative stress was only within the clinical reference range for fair sleep quality. Selected sleep quality-cardiometabolic health relationships were mediated by inflammation, oxidative stress, and antioxidants and were moderated by sex. Our results provide initial evidence of a potential role for inflammation, oxidative stress, and antioxidants in the pathway between poor sleep quality-cardiometabolic decline. Further prospective research is needed to confirm our results.

  4. [Quality management in a public health agency].

    PubMed

    Villalbí, Joan R; Ballestín, Manuela; Casas, Conrad; Subirana, Teresa

    2012-01-01

    This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users' opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification.

  5. Health care quality improvement publication trends.

    PubMed

    Sun, Gordon H; MacEachern, Mark P; Perla, Rocco J; Gaines, Jean M; Davis, Matthew M; Shrank, William H

    2014-01-01

    To analyze the extent of academic interest in quality improvement (QI) initiatives in medical practice, annual publication trends for the most well-known QI methodologies being used in health care settings were analyzed. A total of 10 key medical- and business-oriented library databases were examined: PubMed, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, Scopus, the Cochrane Central Register of Controlled Trials, ABI/INFORM, and Business Source Complete. A total of 13 057 articles were identified that discuss at least 1 of 10 well-known QI concepts used in health care contexts, 8645 (66.2%) of which were classified as original research. "Total quality management" was the only methodology to demonstrate a significant decline in publication over time. "Continuous quality improvement" was the most common topic of study across all publication years, whereas articles discussing Lean methodology demonstrated the largest growth in publication volume over the past 2 decades. Health care QI publication volume increased substantially beginning in 1991.

  6. Making Quality Health Websites a National Public Health Priority: Toward Quality Standards

    PubMed Central

    2016-01-01

    Background Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. Objective The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. Methods The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. Results This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out

  7. Hydroelectric power provides a cheap source of electricity with few carbon emissions. Yet, reservoirs are not operated sustainably, which we define as meeting societal needs for water and power while protecting long-term health of the river ecosystem. Reservoirs that generate hydropower are typically operated with the goal of maximizing energy reve

    SciTech Connect

    Jager, Yetta; Smith, Brennan T

    2008-02-01

    Hydroelectric power provides a cheap source of electricity with few carbon emissions. Yet, reservoirs are not operated sustainably, which we define as meeting societal needs for water and power while protecting long-term health of the river ecosystem. Reservoirs that generate hydropower are typically operated with the goal of maximizing energy revenue, while meeting other legal water requirements. Reservoir optimization schemes used in practice do not seek flow regimes that maximize aquatic ecosystem health. Here, we review optimization studies that considered environmental goals in one of three approaches. The first approach seeks flow regimes that maximize hydropower generation, while satisfying legal requirements, including environmental (or minimum) flows. Solutions from this approach are often used in practice to operate hydropower projects. In the second approach, flow releases from a dam are timed to meet water quality constraints on dissolved oxygen (DO), temperature and nutrients. In the third approach, flow releases are timed to improve the health of fish populations. We conclude by suggesting three steps for bringing multi-objective reservoir operation closer to the goal of ecological sustainability: (1) conduct research to identify which features of flow variation are essential for river health and to quantify these relationships, (2) develop valuation methods to assess the total value of river health and (3) develop optimal control softwares that combine water balance modelling with models that predict ecosystem responses to flow.

  8. Quality of Life, Health Status, and Depression

    PubMed Central

    Pike, Nancy A.; Evangelista, Lorraine S.; Doering, Lynn V.; Eastwood, Jo-Ann; Lewis, Alan B.; Child, John S.

    2012-01-01

    Background Quality of life (QOL) in adolescents and adults who have undergone the Fontan procedure and are living with only 1 ventricle is presumed to be diminished. Objectives This study aimed to compare QOL, health status, and prevalence of depression in adolescents/adults after the Fontan procedure with healthy counterparts and to identify predictors of QOL in the Fontan group. Methods Using a comparative, cross-sectional design, 54 adolescents and adults with single ventricle congenital heart disease who have undergone the Fontan procedure were compared with 66 age-matched healthy counterparts. Quality of life, health status, depression, and social support were measured using the Satisfaction With Life Scale, Short Form Survey Version 2, Patient Health Questionnaire Depression Module, and Multidimensional Scale of Perceived Social Support. Clinical variables were abstracted from medical records. Predictors of QOL were determined using multiple linear regression. Results Adolescents and adults in the Fontan group reported lower physical health status (mean [SD] = 46.5 [9.3] vs mean [SD] = 55.9 [5.1], P < .001) and were more depressed (mean [SD] = 7.3 [5.9] vs mean [SD] = 4.5 [4.3], P < .004) than their healthy counterparts. There were no differences in QOL, mental health status, or social support between the 2 groups. Functional status (New York Heart Association class), depression, and social support accounted for 55% of the variance in QOL in the Fontan group. Conclusions Despite lower levels of physical health, the QOL of Fontan patients was comparable with that of their healthy counterparts; this finding contradicts previous proxy reports, self-reports, and assumptions that QOL is lower in patients with complex single ventricle congenital heart disease. However, because Fontan patients were more depressed than their healthy counterparts, the need for early screening and detection is warranted. PMID:21912272

  9. Utilizing Earth Observations for Societal Issues

    NASA Technical Reports Server (NTRS)

    Habib, Shahid

    2010-01-01

    Over the last four decades a tremendous progress has been made in the Earth science space-based remote sensing observations, technologies and algorithms. Such advancements have improved the predictability by providing lead-time and accuracy of forecast in weather, climate, natural hazards, and natural resources. It has further reduced or bounded the overall uncertainties by partially improving our understanding of planet Earth as an integrated system that is governed by non-linear and chaotic behavior. Many countries such as the US, European Community, Japan, China, Russia, India has and others have invested billions of dollars in developing and launching space-based assets in the low earth (LEO) and geostationary (GEO) orbits. However, the wealth of this scientific knowledge that has potential of extracting monumental socio-economic benefits from such large investments have been slow in reaching the public and decision makers. For instance, there are a number of areas such as water resources and availability, energy forecasting, aviation safety, agricultural competitiveness, disaster management, air quality and public health, which can directly take advantage. Nevertheless, we all live in a global economy that depends on access to the best available Earth Science information for all inhabitants of this planet. This presentation discusses a process to transition Earth science data and products for societal needs including NASA's experience in achieving such objectives. It is important to mention that there are many challenges and issues that pertain to a number of areas such as: (1) difficulties in making a speedy transition of data and information from observations and models to relevant Decision Support Systems (DSS) or tools, (2) data and models inter-operability issues, (3) limitations of spatial, spectral and temporal resolution, (4) communication limitations as dictated by the availability of image processing and data compression techniques. Additionally, the

  10. Silver Nanoparticles: Technological Advances, Societal Impacts, and Metrological Challenges

    PubMed Central

    Calderón-Jiménez, Bryan; Johnson, Monique E.; Montoro Bustos, Antonio R.; Murphy, Karen E.; Winchester, Michael R.; Vega Baudrit, José R.

    2017-01-01

    Silver nanoparticles (AgNPs) show different physical and chemical properties compared to their macroscale analogs. This is primarily due to their small size and, consequently, the exceptional surface area of these materials. Presently, advances in the synthesis, stabilization, and production of AgNPs have fostered a new generation of commercial products and intensified scientific investigation within the nanotechnology field. The use of AgNPs in commercial products is increasing and impacts on the environment and human health are largely unknown. This article discusses advances in AgNP production and presents an overview of the commercial, societal, and environmental impacts of this emerging nanoparticle (NP), and nanomaterials in general. Finally, we examine the challenges associated with AgNP characterization, discuss the importance of the development of NP reference materials (RMs) and explore their role as a metrological mechanism to improve the quality and comparability of NP measurements. PMID:28271059

  11. Assuring quality health care outcomes: lessons learned from car dealers?

    PubMed Central

    Dimsdale, Joel E

    2017-01-01

    Health care systems want quality but struggle to find the right tools because, typically, they track quality in only one or two ways. Because of the complexity of health care, high quality will emerge only when health care systems employ multiple approaches, including, importantly, patient-reported outcome perspectives. Sustained changes are unlikely to emerge in the absence of such multipronged interventions. PMID:28123314

  12. [Quality management is associated with high quality services in health care].

    PubMed

    Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

    2013-12-09

    In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

  13. Water Quality and Sustainable Environmental Health

    NASA Astrophysics Data System (ADS)

    Setegn, S. G.

    2014-12-01

    Lack of adequate safe water, the pollution of the aquatic environment and the mismanagement of resources are major causes of ill-health and mortality, particularly in the developing countries. In order to accommodate more growth, sustainable fresh water resource management will need to be included in future development plans. One of the major environmental issues of concern to policy-makers is the increased vulnerability of ground water quality. The main challenge for the sustainability of water resources is the control of water pollution. To understand the sustainability of the water resources, one needs to understand the impact of future land use and climate changes on the natural resources. Providing safe water and basic sanitation to meet the Millennium Development Goals will require substantial economic resources, sustainable technological solutions and courageous political will. A balanced approach to water resources exploitation for development, on the one hand, and controls for the protection of health, on the other, is required if the benefits of both are to be realized without avoidable detrimental effects manifesting themselves. Meeting the millennium development goals for water and sanitation in the next decade will require substantial economic resources, sustainable technological solutions and courageous political will. In addition to providing "improved" water and "basic" sanitation services, we must ensure that these services provide: safe drinking water, adequate quantities of water for health, hygiene, agriculture and development and sustainable sanitation approaches to protect health and the environment.

  14. [Influence of stomatological health upon the quality of life].

    PubMed

    Simanovskaia, O E

    2008-01-01

    The parameters of quality of life of 58 stomatological patients were investigated. 3 groups of dentist health were allocated. On the basis of correlation dependence was proved that stomatological diseases sharply reduced the quality of life and health. The application for the invention quality of a life on indexes of stomatologic health> is issued, allowing to define individual volume of treatment-and-prophylactic actions depending the parameters of quality of life.

  15. [Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

    PubMed

    Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

    2010-12-01

    Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance

  16. Broader Societal Issues of Nanotechnology

    NASA Astrophysics Data System (ADS)

    Roco, M. C.

    2003-08-01

    Nanoscale science and engineering are providing unprecedented understanding and control over the basic building blocks of matter, leading to increased coherence in knowledge, technology, and education. The main reason for developing nanotechnology is to advance broad societal goals such as improved comprehension of nature, increased productivity, better healthcare, and extending the limits of sustainable development and of human potential. This paper outlines societal implication activities in nanotechnology R&D programs. The US National Nanotechnology Initiative annual investment in research with educational and societal implications is estimated at about 30 million (of which National Science Foundation (NSF) awards about 23 million including contributions to student fellowships), and in nanoscale research with relevance to environment at about 50 million (of which NSF awards about 30 million and EPA about 6 million). An appeal is made to researchers and funding organizations worldwide to take timely and responsible advantage of the new technology for economic and sustainable development, to initiate societal implications studies from the beginning of the nanotechnology programs, and to communicate effectively the goals and potential risks with research users and the public.

  17. Societal Development and Social Change

    ERIC Educational Resources Information Center

    Nderu-Boddington, Eulalee

    2008-01-01

    This article compares and contrasts the theories of three major writers on societal change: Chirot discusses the economic power struggles within and among core, peripheral, and semiperipheral societies, Toffler exposes a future in which major power shifts could have cataclysmic results, and Bruner emphasizes the importance of education to temper…

  18. United States societal experiments via the Communications Technology Satellite

    NASA Technical Reports Server (NTRS)

    Donoughe, P. L.

    1976-01-01

    After a brief description of the Communication Technology Satellite and its U.S. coverage, the U.S. societal experiments via the CTS are discussed. These include education (college curriculum sharing, and project interchange), health care (biomedical communications, health communications, and communication support for decentralized education), and community and special experiments (satellite library information network, and transportable earth terminal).

  19. Theory and practice for measuring health care quality

    PubMed Central

    Berwick, Donald M.; Knapp, Marian Gilbert

    1987-01-01

    As competition, cost control, and new modes of delivery emerge in health care, there is a need to reexamine both the traditional definitions of health care quality and the methods by which it is measured. Industries other than health care have much to teach regarding the methods for obtaining, analyzing, and displaying data; techniques for problem identification, problem solving, and reassessment; and ideas about organizational factors that produce a high quality product or service. The Quality-of-Care Measurement Department at the Harvard Community Health Plan has built a program that draws from a distinguished health care quality assurance tradition and incorporates techniques that have been successful in other industries. PMID:10312319

  20. The Effects of School Quality on Long-Term Health

    ERIC Educational Resources Information Center

    Sansani, Shahar

    2011-01-01

    In this paper I estimate the relationship between school quality and mortality. Although many studies have linked the quantity of education to health outcomes, the effect of school quality on health has yet to be examined. I construct synthetic birth cohorts and relate the quality of education they attained to their mortality rates. I find that…

  1. Quality assurance in health care: past, present and future.

    PubMed

    Bilawka, E; Craig, B J

    2003-08-01

    Quality of health care delivery is a growing concern globally given current budget restraints and increasing demands on health care providers. The variety of quality assurance and quality management activities equals the numerous ways health care practitioners of all genres provide health care. Dental hygienists around the world must be knowledgeable about quality assurance and management in health care as it is a significant factor in the evolution of the dental hygiene profession and the quality of oral health care provided by dental hygienists. The objective of this research was to conduct a literature review on quality assurance and quality management. A MEDLINE search from 1966 to 2002 was conducted. The search resulted in approximately 145 articles. Additional references from works generated by the search were also obtained. The literature revealed information on the background and history of quality assurance and quality management. Much of the literature was devoted to discussions of the validity, reliability and effectiveness of most prominent quality management activities being utilised in health care today. The investigation revealed numerous issues and barriers surrounding quality management. This article concludes with suggestions for future directions of quality assurance and quality management.

  2. Improving the quality of health care through contracting: a study of health authority practice.

    PubMed Central

    Gray, J D; Donaldson, L J

    1996-01-01

    OBJECTIVES: To investigate approaches of district health authorities to quality in contracting. DESIGN: Descriptive survey. SETTING: All district health authorities in one health region of England in a National Health Service accounting year. MATERIAL: 129 quality specifications used in contracting for services in six specialties (eight general quality specifications and 121 service specific quality specifications) MAIN MEASURES: Evaluation of the use of quality specifications; their scope and content in relation to established criteria of healthcare quality. RESULTS: Most district health authorities developed quality specifications which would be applicable to their local hospital. When purchasing care outside their boundaries they adopted the quality specifications developed by other health authorities. The service specific quality specifications were more limited in scope than the general quality specifications. The quality of clinical care was referred to in 75% of general and 43% of service specific quality specifications. Both types of specification considered quality issues in superficial and broad terms only. Established features of quality improvement were rarely included. Prerequisites to ensure provider accountability and satisfactory delivery of service specifications were not routinely included in contracts. CONCLUSION: Quality specifications within service contracts are commonly used by health authorities. This study shows that their use of this approach to quality improvement is inconsistent and unlikely to achieve desired quality goals. Continued reliance on the current approach is holding back a more fundamental debate on how to create effective management of quality improvement through the interaction between purchasers and providers of health care. PMID:10164143

  3. Afghanistan's national strategy for improving quality in health care

    PubMed Central

    Rahimzai, Mirwais; Amiri, Mirwais; Burhani, Nadera Hayat; Leatherman, Sheila; Hiltebeitel, Simon; Rahmanzai, Ahmed Javed

    2013-01-01

    Quality problem or issue When the Ministry of Public Health (MoPH) of the Islamic Republic of Afghanistan began reconstructing the health system in 2003, it faced serious challenges. Decades of war had severely damaged the health infrastructure and the country's ability to deliver health services. Initial assessment A national health resources assessment in 2002 revealed huge structural and resource disparities fundamental to improving health care. For example, only 9% of the population was able to access basic health services, and about 40% of health facilities had no female health providers, severely constraining access of women to health care. Multiple donor programs and the MoPH had some success in improving quality, but questions about sustainability, as well as fragmentation and poor coordination, existed. Plan of action In 2009, MoPH resolved to align and accelerate quality improvement efforts as well as build structural and skill capacity. Implementation The MoPH established a new quality unit within the ministry and undertook a year-long consultative process that drew on international evidence and inputs from all levels of the health system to developed a National Strategy for Improving Quality in Health Care consisting of a strategy implementation framework and a five-year operational plan. Lessons Learned Even in resource-restrained countries, under the most adverse circumstances, quality of health care can be improved at the front-lines and a consensual and coherent national quality strategy developed and implemented. PMID:23485422

  4. Indoor air quality and health in schools*

    PubMed Central

    Ferreira, Ana Maria da Conceição; Cardoso, Massano

    2014-01-01

    Objective: To determine whether indoor air quality in schools is associated with the prevalence of allergic and respiratory diseases in children. Methods: We evaluated 1,019 students at 51 elementary schools in the city of Coimbra, Portugal. We applied a questionnaire that included questions regarding the demographic, social, and behavioral characteristics of students, as well as the presence of smoking in the family. We also evaluated the indoor air quality in the schools. Results: In the indoor air of the schools evaluated, we identified mean concentrations of carbon dioxide (CO2) above the maximum reference value, especially during the fall and winter. The CO2 concentration was sometimes as high as 1,942 ppm, implying a considerable health risk for the children. The most prevalent symptoms and respiratory diseases identified in the children were sneezing, rales, wheezing, rhinitis, and asthma. Other signs and symptoms, such as poor concentration, cough, headache, and irritation of mucous membranes, were identified. Lack of concentration was associated with CO2 concentrations above the maximum recommended level in indoor air (p = 0.002). There were no other significant associations. Conclusions: Most of the schools evaluated presented with reasonable air quality and thermal comfort. However, the concentrations of various pollutants, especially CO2, suggest the need for corrective interventions, such as reducing air pollutant sources and improving ventilation. There was a statistically significant association between lack of concentration in the children and exposure to high levels of CO2. The overall low level of pollution in the city of Coimbra might explain the lack of other significant associations. PMID:25029649

  5. Quality Enhancement Research Initiative in Mental Health.

    PubMed

    Fischer, E P; Marder, S R; Smith, G R; Owen, R R; Rubenstein, L; Hedrick, S C; Curran, G M

    2000-06-01

    The Veterans Administration (VA) recently introduced its Quality Enhancement Research Initiative (QUERI) to facilitate the translation of best practices into usual clinical care. The Mental Health QUERI (MHQ) was charged with developing strategic plans for major depressive disorder (MDD) and schizophrenia. Twenty percent or more of VA service users are affected by 1 of these 2 disorders, disorders that often have a devastating impact on affected individuals. Despite the increasing availability of efficacious treatments for each disorder, substantial gaps remain between best practices and routine care. In this context, the MHQ identified steps critical to the success of a sustained process of rapid-cycle health care improvement for MDD and schizophrenia, including research initiatives to close gaps in knowledge of best treatment practices, demonstration projects to close gaps in practice and to expand understanding of effective strategies for implementing clinical guidelines, targeted enhancements of the VA information system, and research and dissemination initiatives to increase the availability of resources to support the accelerated incorporation of best practices into routine care. This article presents an overview of the elements in the initial MHQ strategic plans and the rationale behind them.

  6. Air quality standards must protect public health

    SciTech Connect

    Norman Edelman

    2006-06-15

    Leading medical and public health organizations are deeply concerned about the proposed revisions to the National Ambient Air Quality Standard (NAAQS) that the US Environmental Protection Agency (EPA) announced in December 2005. Led by the American Lung Association (ALA), these groups are fighting to force EPA to finalize stricter standards for fine and coarse particles when the final decision is announced in September 2006. The ALA disagrees strongly with the proposal to exempt coarse particles from agriculture and mining sources, and to exclude communities with populations fewer than 100,000 from protection and monitoring requirements. ALA urges EPA to set the following health-based NAAQS for PM: Annual average PM2.5 standard of 12 {mu}mg/m{sup 3}; 24 hour average PM2.5 standard of 25 {mu}mg.m{sup 3} (99th percentile); 24-hour average PM10-2.5 standard of 25-30 {mu}g/m{sup 3} (99th percentile), applied equally to all areas of the country and to all types of particles. 72 refs., 2 figs., 1 tab.

  7. Understanding the relationships between air quality and human health

    SciTech Connect

    S.T. Rao

    2006-09-15

    Although there has been substantial progress in improving ambient air quality in the United States, atmospheric concentrations of ozone and fine particulate matter (PM2.5) continue to exceed the National Ambient Air Quality Standards in many locations. Consequently, a large portion of the U.S. population continues to be exposed to unhealthful levels of ozone and fine particles. This issue of EM, entitled 'Understanding the relationships between air quality and human health' presents a series of articles that focus on the relationships between air quality and human health - what we know so far and the challenges that remain. Their titles are: Understanding the effects of air pollution on human health; Assessing population exposures in studies of human health effects of PM2.5; Establishing a national environmental public health tracking network; Linking air quality and exposure models; and On alert: air quality forecasting and health advisory warnings.

  8. [Quality of life and oral health in children].

    PubMed

    Versloot, J; Klaassen, M A

    2011-03-01

    In recent years, research on the influence of oral health on quality of life among children has become increasingly popular Half of the children and adolescents will have had moments of diminished oral health and that can lead to functional problems, pain and decreased quality of life. While measuring oral health-related quality of life of children, reports of parents are frequently used as a proxy. Diminished oral health not only has an impact on the child's quality of life, but also on that of his family members. Results from studies on oral health-related quality of life in children may be used as the basis for useful guidance for parents and children on improving oral health and quality of life.

  9. Attributes of Quality in Audiovisual Materials for Health Professionals.

    ERIC Educational Resources Information Center

    Suter, Emanuel; Waddell, Wendy H.

    1981-01-01

    Defines attributes of quality in content, instructional design, technical production, and packaging of audiovisual materials used in the education of health professionals. Seven references are listed. (FM)

  10. Research on Health and Environmental Effects of Air Quality

    EPA Pesticide Factsheets

    Research has linked regulated air pollutants such as ozone and particulate matter, to lung, heart disease and other health problems. Further investigation is needed to understand the role poor air quality plays on health and disease

  11. AIR QUALITY CHARACTERIZATION OF ENVIRONMENTAL PUBLIC HEALTH TRACKING

    EPA Science Inventory

    The EPA and the CDC have conducted a collaborative effort entitled the Public Health Air Surveillance Evaluation (PHASE) to pilot the development of integrated air quality data sets, from routinely available sources, for specific use by public health officials.

  12. Creating Quality Improvement Culture in Public Health Agencies

    PubMed Central

    Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

    2014-01-01

    Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680

  13. INTEGRATING AIR QUALITY DATA TO INFORM HUMAN HEALTH DECISIONS

    EPA Science Inventory

    The August 1-2, 2005 EPA-NIEHS workshop is addressing the linkages between air quality and human health. My presentation will discuss the strengths and limitations of various databases for relating air quality to health impacts. Specifically, the need for fusing ground-based, s...

  14. Quality and Evaluation in a Comprehensive Health Organization.

    ERIC Educational Resources Information Center

    Anderson, Malcolm; Brazil, Kevin

    1995-01-01

    An innovative approach to delivering health care is being developed in several Ontario (Canada) communities. This report describes the initial framework for quality and evaluation for a comprehensive health organization (CHO). As CHOs become operational, there is great opportunity to develop a comprehensive approach to quality and evaluation. (SLD)

  15. The Unique Impact of Abolition of Jim Crow Laws on Reducing Inequities in Infant Death Rates and Implications for Choice of Comparison Groups in Analyzing Societal Determinants of Health

    PubMed Central

    Chen, Jarvis T.; Coull, Brent; Waterman, Pamela D.; Beckfield, Jason

    2013-01-01

    Objectives. We explored associations between the abolition of Jim Crow laws (i.e., state laws legalizing racial discrimination overturned by the 1964 US Civil Rights Act) and birth cohort trends in infant death rates. Methods. We analyzed 1959 to 2006 US Black and White infant death rates within and across sets of states (polities) with and without Jim Crow laws. Results. Between 1965 and 1969, a unique convergence of Black infant death rates occurred across polities; in 1960 to 1964, the Black infant death rate was 1.19 times higher (95% confidence interval [CI] = 1.18, 1.20) in the Jim Crow polity than in the non–Jim Crow polity, whereas in 1970 to 1974 the rate ratio shrank to and remained at approximately 1 (with the 95% CI including 1) until 2000, when it rose to 1.10 (95% CI = 1.08, 1.12). No such convergence occurred for Black–White differences in infant death rates or for White infants. Conclusions. Our results suggest that abolition of Jim Crow laws affected US Black infant death rates and that valid analysis of societal determinants of health requires appropriate comparison groups. PMID:24134378

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

    PubMed

    Hartley, R

    1995-12-01

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

  17. Societal responses to the Anthropocene.

    PubMed

    Tickell, Crispin

    2011-03-13

    This article discusses the societal responses to the Anthropocene. First we need to confront the effects of our own population proliferation in all its aspects; next to look again at economics and replace consumerism as a goal; then to work out new ways of generating energy; to manage and adapt to what is in effect climate destabilization; to give higher priority to conservation of the natural world; and last to create the necessary institutional means of coping with global problems in a world in which society is more integrated than ever before.

  18. Financial Health of Child Care Facilities Affects Quality of Care.

    ERIC Educational Resources Information Center

    Brower, Mary R.; Sull, Theresa M.

    2003-01-01

    Contends that child care facility owners, boards of directors, staff, and parents need to focus on financial management, as poor financial health compromises the quality of care for children. Specifically addresses the issues of: (1) concern for providing high quality child care; (2) the connection between quality and money; and (3) strengthening…

  19. The role of academic medicine in improving health care quality.

    PubMed

    Brindis, Ralph G; Spertus, John

    2006-09-01

    Academic medicine, often entrenched in biomedical and clinical research, has largely ignored the development and application of quality metrics to ensure the delivery of high-quality health care. Nevertheless, academic medicine has substantial opportunities to lead the charge in building a quality infrastructure with the goal of delivering high-quality and cost-efficient health care to all Americans. The American College of Cardiology (ACC) and American Heart Association (AHA) have worked jointly to measure and improve the quality of cardiovascular care. This effort has led to the development of clinical practice guidelines, performance measures, data standards, national registries, and appropriateness criteria for cardiovascular care. Academic medicine should actively embrace and promote the type of quality metrics and criteria developed by ACC and AHA and apply this model across the entire academic medicine community. Academic medicine, with its many resources, could lead the way in the expanding field of quality science by supporting fundamental research in quality improvement, supporting academicians to improve quality at their own institutions, developing educational models for quality assessment and improvement, creating and implementing data registries, and serving as a conduit for developing the emerging science of quality assessment. In this and many other ways, academic medicine must offer the health care community leadership for improving our nation's health care quality with the same fervor presently exhibited for the advancement of basic science, the development of specialized and experimental therapy, and as centers for tertiary and quaternary patient care.

  20. Insights into the Societal Risk of Nuclear Power Plant Accidents.

    PubMed

    Denning, Richard; Mubayi, Vinod

    2017-01-01

    The elements of societal risk from a nuclear power plant accident are clearly illustrated by the Fukushima accident: land contamination, long-term relocation of large numbers of people, loss of productive farm area, loss of industrial production, and significant loss of electric capacity. NUREG-1150 and other studies have provided compelling evidence that the individual health risk of nuclear power plant accidents is effectively negligible relative to other comparable risks, even for people living in close proximity to a plant. The objective of this study is to compare the societal risk of nuclear power plant accidents to that of other events to which the public is exposed. We have characterized the monetized societal risk in the United States from major societally disruptive events, such as hurricanes, in the form of a complementary cumulative distribution function. These risks are compared with nuclear power plant risks, based on NUREG-1150 analyses and new MACCS code calculations to account for differences in source terms determined in the more recent SOARCA study. A candidate quantitative societal objective is discussed for potential adoption by the NRC. The results are also interpreted with regard to the acceptability of nuclear power as a major source of future energy supply.

  1. Sexual Activity and Psychological Health As Mediators of the Relationship Between Physical Health and Marital Quality

    PubMed Central

    2014-01-01

    Objectives. The pathways linking spousal health to marital quality in later life have been little examined at the population level. We develop a conceptual model that links married older adults’ physical health and that of their spouse to positive and negative dimensions of marital quality via psychological well-being of both partners and their sexual activity. Methods. We use data from 1,464 older adults in 732 marital dyads in the 2010–2011 wave of the National Social Life Health and Aging Project. Results. We find that own fair or poor physical health is linked to lower positive and higher negative marital quality, spouse’s health to positive quality, and that own and spouse’s mental health and more frequent sex are associated with higher positive and lower negative marital quality. Further, we find that (a) sexual activity mediates the association between own and partner’s physical health and positive marital quality, (b) own mental health mediates the association between one’s own physical health and both positive and negative marital quality, and (c) partner’s mental health mediates the associations of spouse’s physical health with positive marital quality. These results are robust to alternative specifications of the model. Discussion. The results suggest ways to protect marital quality among older adults who are struggling with physical illness in themselves or their partners. PMID:24470175

  2. Health-Related Quality of Life in Cardiovascular Disease.

    ERIC Educational Resources Information Center

    Kaplan, Robert M.

    1988-01-01

    Reviews several current approaches to the assessment of health outcomes in cardiovascular disease, including health-related quality of life. Offers a general health policy model as a method for comparing program options in cardiovascular disease that may have very different objectives. Uses examples from hypertension screening and treatment, heart…

  3. Health-Related Quality of Life in HIV Disease.

    ERIC Educational Resources Information Center

    Hays, Ron D.; And Others

    1995-01-01

    The structure of health-related quality of life (HRQOL) in persons with human immunodeficiency virus (HIV) was studied in 205 symptomatic adults. Confirmatory factor analysis supported a two-factor model of HRQOL, with physical and mental health dimensions. Correlations of HRQOL with other aspects of health and support are discussed. (SLD)

  4. LINKING PUBLIC HEALTH AND AIR QUALITY DATA FOR ACCOUNTABILITY

    EPA Science Inventory

    Program Area: Environmental Health

    Topic Area: Linking Public Health Data into Action

    Title of Presentation: Linking Public Health and Air Quality Data for Accountability

    Background and Significance

    Tracking environmental exposures to air pollutan...

  5. Applications and societal benefits of plastics

    PubMed Central

    Andrady, Anthony L.; Neal, Mike A.

    2009-01-01

    This article explains the history, from 1600 BC to 2008, of materials that are today termed ‘plastics’. It includes production volumes and current consumption patterns of five main commodity plastics: polypropylene, polyethylene, polyvinyl chloride, polystyrene and polyethylene terephthalate. The use of additives to modify the properties of these plastics and any associated safety, in use, issues for the resulting polymeric materials are described. A comparison is made with the thermal and barrier properties of other materials to demonstrate the versatility of plastics. Societal benefits for health, safety, energy saving and material conservation are described, and the particular advantages of plastics in society are outlined. Concerns relating to littering and trends in recycling of plastics are also described. Finally, we give predictions for some of the potential applications of plastic over the next 20 years. PMID:19528050

  6. Applications and societal benefits of plastics.

    PubMed

    Andrady, Anthony L; Neal, Mike A

    2009-07-27

    This article explains the history, from 1600 BC to 2008, of materials that are today termed 'plastics'. It includes production volumes and current consumption patterns of five main commodity plastics: polypropylene, polyethylene, polyvinyl chloride, polystyrene and polyethylene terephthalate. The use of additives to modify the properties of these plastics and any associated safety, in use, issues for the resulting polymeric materials are described. A comparison is made with the thermal and barrier properties of other materials to demonstrate the versatility of plastics. Societal benefits for health, safety, energy saving and material conservation are described, and the particular advantages of plastics in society are outlined. Concerns relating to littering and trends in recycling of plastics are also described. Finally, we give predictions for some of the potential applications of plastic over the next 20 years.

  7. Corporate management of quality in employee health plans.

    PubMed

    Maxwell, James; Temin, Peter

    2003-01-01

    As large companies move their employees into managed care, they must concern themselves with the quality and price of their employees' health care. Based on a survey of Fortune 500 companies, we show that most are integrating several aspects of quality into their purchasing and contracting decisions by focusing on three dimensions--customer service, network composition, and clinical quality. Companies focus on the customer service dimension while the medical community emphasizes clinical quality.

  8. Health information technology and quality of health care: strategies for reducing disparities in underresourced settings.

    PubMed

    Millery, Mari; Kukafka, Rita

    2010-10-01

    Health information technology (health IT) has potential for facilitating quality improvement and reducing quality disparities found in underresourced settings (URSs). With this systematic literature review, complemented by key informant interviews, the authors sought to identify evidence regarding health IT and quality outcomes in URSs. The review included 105 peer-reviewed studies (2004-2009) in all settings. Only 15 studies included URSs, and 8 focused on URSs. Based on literature across settings, most evidence was available for quality impact of order entry, clinical decision support systems, and computerized reminders. Study designs were predominantly quasi-experimental (37%) or descriptive (35%); 90% of the studies focused on the microsystem level of quality improvement, indicating a need for expanding research into patient experience and organizational and environmental levels. Key informants highlighted organizational partnerships and health IT champions and emphasized that for health IT to have an impact on quality, there must be an organizational culture of quality improvement.

  9. Issues in Measuring and Improving Health Care Quality

    PubMed Central

    Friedman, Maria A.

    1995-01-01

    This issue of the Health Care Financing Review focuses on issues and advances in measuring and improving the quality of care, particularly for Medicare and Medicaid beneficiaries. Discussions of quality-related topics are especially timely, given the growing and widespread interest in improving quality in the organization, financing, and delivery of health care services. This article has several purposes. The first is to provide a brief description of some of the causes underlying the growth of the health care quality movement; the second is to provide a contextual framework for discussion of some of the overarching themes that emerge in this issue. These themes include examining conceptual issues, developing quality measures for specific sites and populations, and creating or adapting data sets for quality-measurement purposes. PMID:10151882

  10. School-Based Health Education Programmes, Health-Learning Capacity and Child Oral Health--related Quality of Life

    ERIC Educational Resources Information Center

    Freeman, Ruth; Gibson, Barry; Humphris, Gerry; Leonard, Helen; Yuan, Siyang; Whelton, Helen

    2016-01-01

    Objective: To use a model of health learning to examine the role of health-learning capacity and the effect of a school-based oral health education intervention (Winning Smiles) on the health outcome, child oral health-related quality of life (COHRQoL). Setting: Primary schools, high social deprivation, Ireland/Northern Ireland. Design: Cluster…

  11. CHARACTERIZING AIR QUALITY FOR ENVIRONMENTAL PUBLIC HEALTH

    EPA Science Inventory

    NERL's Human Exposure and Atmospheric Sciences Division and other participants in the Public Health Air Surveillance Evaluation (PHASE) project will be presenting their results to the Environmnetal Public Health Tracking (EPHT) workshop in Tampa FL. The PHASE project is a collab...

  12. Health, Quality of Care and Quality of Life: A Case of Frail Older Adults

    ERIC Educational Resources Information Center

    Hsieh, Chang-Ming

    2009-01-01

    This study explores the relationship between health, quality of care of geriatric case management and quality of life for the purpose of furthering the understanding of the relationship between quality of life and geriatric case management. Using survey data from a group of frail older adults, this study assesses the relative merit of two…

  13. Societal Benefits of Ocean Altimetry Data

    NASA Technical Reports Server (NTRS)

    Srinivasen, Margaret; Leben, Robert

    2004-01-01

    The NASA/CNES Jason satellite, follow-on to the highly successful TOPEX/Poseidon mission, continues to provide oceanographers and marine operators across the globe with a continuous twelve-year, high quality stream of sea surface height data. The mission is expected to extend through 2007, when the NASA/NOAA/CNES follow-on mission, OSTM, will be launched with the wide-swath ocean altimeter on board. This unprecedented resource of valuable ocean data is being used to map sea surface height, geostrophic velocity, significant wave height, and wind speed over the global oceans. Altimeter data products are currently used by hundreds of researchers and operational users to monitor ocean circulation and improve our understanding of the role of the oceans in climate and weather. Ocean altimeter data has many societal benefits and has proven invaluable in many practical applications including; a) Ocean forecasting systems; b) Climate research and forecasting; c) Ship routing; d) Fisheries management; e) Marine mammal habitat monitoring; f) Hurricane forecasting and tracking; g) Debris tracking; and h) Precision marine operations such as cable-laying and oil production. The data has been cited in nearly 2,000 research and popular articles since the launch of TOPEX/Poseidon in 1992, and almost 200 scientific users receive the global coverage altimeter data on a monthly basis. In addition to the scientific and operational uses of the data, the educational community has seized the unique concepts highlighted by these altimeter missions as a resource for teaching ocean science to students from grade school through college. This presentation will highlight societal benefits of ocean altimetry data in the areas of climate studies, marine operations, marine research, and non-ocean investigations.

  14. Remote Sensing, Air Quality, and Public Health

    NASA Technical Reports Server (NTRS)

    Quattrochi, Dale A.; Rickman, Douglas; Mohammad, Al-Hamdan; Crosson, William; Estes, Maurice, Jr.; Limaye, Ashutosh; Qualters, Judith

    2008-01-01

    HELIX-Atlanta was developed to support current and future state and local EPHT programs to implement data linking demonstratio'n projects which could be part of the EPHT Network. HELIX-Atlanta is a pilot linking project in Atlanta for CDC to learn about the challenges the states will encounter. NASA/MSFC and the CDC are partners in linking environmental and health data to enhance public health surveillance. The use of NASA technology creates value - added geospatial products from existing environmental data sources to facilitate public health linkages. Proving the feasibility of the approach is the main objective

  15. Assessing Metadata Quality of a Federally Sponsored Health Data Repository.

    PubMed

    Marc, David T; Beattie, James; Herasevich, Vitaly; Gatewood, Laël; Zhang, Rui

    2016-01-01

    The U.S. Federal Government developed HealthData.gov to disseminate healthcare datasets to the public. Metadata is provided for each datasets and is the sole source of information to find and retrieve data. This study employed automated quality assessments of the HealthData.gov metadata published from 2012 to 2014 to measure completeness, accuracy, and consistency of applying standards. The results demonstrated that metadata published in earlier years had lower completeness, accuracy, and consistency. Also, metadata that underwent modifications following their original creation were of higher quality. HealthData.gov did not uniformly apply Dublin Core Metadata Initiative to the metadata, which is a widely accepted metadata standard. These findings suggested that the HealthData.gov metadata suffered from quality issues, particularly related to information that wasn't frequently updated. The results supported the need for policies to standardize metadata and contributed to the development of automated measures of metadata quality.

  16. [Health and quality of life vs. occupational activity].

    PubMed

    Kowalska, Małgorzata; Szemik, Szymon

    The level of quality of life and health status of the population largely depends on the determinants related to occupational activity. The results of reviewed bibliography indicate a significant and growing importance of employment conditions on the quality of life and population health status in most countries of the world, especially in those with market economy. Of the evaluated determinants the following factors should be listed in particular: sources and the amount of income, stability of the income and employment, the nature of work and the degree of job satisfaction, as well as autonomy and career prospects. Moreover, they proved that the situation of persisting and long-term unemployment and precarious employment leads to a significant deterioration in the quality of life and health, especially among young people. In conclusion, the study of quality of life and population health status should take into consideration factors related to occupational activity. Med Pr 2016;67(5):663-671.

  17. Assessing Metadata Quality of a Federally Sponsored Health Data Repository

    PubMed Central

    Marc, David T.; Beattie, James; Herasevich, Vitaly; Gatewood, Laël; Zhang, Rui

    2016-01-01

    The U.S. Federal Government developed HealthData.gov to disseminate healthcare datasets to the public. Metadata is provided for each datasets and is the sole source of information to find and retrieve data. This study employed automated quality assessments of the HealthData.gov metadata published from 2012 to 2014 to measure completeness, accuracy, and consistency of applying standards. The results demonstrated that metadata published in earlier years had lower completeness, accuracy, and consistency. Also, metadata that underwent modifications following their original creation were of higher quality. HealthData.gov did not uniformly apply Dublin Core Metadata Initiative to the metadata, which is a widely accepted metadata standard. These findings suggested that the HealthData.gov metadata suffered from quality issues, particularly related to information that wasn’t frequently updated. The results supported the need for policies to standardize metadata and contributed to the development of automated measures of metadata quality. PMID:28269883

  18. Childhood obesity: a societal problem to solve.

    PubMed

    Schwartz, M B; Puhl, R

    2003-02-01

    In contrast to other threats to American children's health, the treatment and prevention of childhood obesity are considered the responsibility of individual children and their parents. This pressure exists in the context of the societal stigmatization of overweight children and the powerful environmental inducements aimed directly at children to eat nutritionally poor foods. Parents of overweight children are left in the difficult position of fearing the social and health consequences of their child's obesity, and fighting a losing battle against the omnipotent presence of the media and constant exposure to unhealthy foods. This paper brings together several literatures to provide a comprehensive examination of the major challenges facing obese children and their families. In particular, this paper documents the extent of stigmatization towards overweight children and reviews evidence of the conflicting advice given to parents about how to help children develop healthful eating in the face of biological and learned food preferences. We conclude with a call for a shift in thinking about the role of our society in the aetiology, treatment and prevention of childhood obesity.

  19. Quality, CQI, and reengineering in health services organizations.

    PubMed

    Rakich, J S

    2001-01-01

    Quality in health care is defined with a focus on satisfying customer needs. The contemporary management philosophies of continuous quality improvement (CQI) and reengineering are defined; attributes and applications of each are described. Criticism of reengineering appearing in the literature is presented. It is likely that CQI will remain a predominate management philosophy in health services, while reengineering may not endure in its form of radical change.

  20. Impact of Influenza on Health-Related Quality of Life among Confirmed (H1N1)2009 Patients

    PubMed Central

    Hollmann, Malen; Garin, Olatz; Galante, Mariana; Ferrer, Montserrat; Dominguez, Angela; Alonso, Jordi

    2013-01-01

    Background We aimed to assess the changes in health-related quality of life (HRQL) in patients with confirmed diagnosis of influenza (H1N1)2009, and to estimate the individual and societal loss of quality-adjusted life years (QALYs) caused by the pandemic. Methods and Results Longitudinal study of patients recruited at major hospitals and primary care centers in Spain. Patients reported their HRQL (EQ-5D) during their influenza episode and seven days prior to it. A subsample was monitored to evaluate HRQL after recovery. HRQL loss was estimated as the difference between EQ-5D prior to the influenza episode and during it. Individual QALY loss (disutility multiplied by the duration of the influenza episode in days) for confirmed cases was calculated and used to estimate the societal loss in Spain (with the official estimations). A total of 432 inpatients and 563 outpatients were included, of whom 145 and 184, respectively, were followed up. Baseline mean HRQL loss was 0.58 (95% CI, 0.53–0.63) for inpatients and 0.43 (95% CI, 0.40–0.46) for outpatients. The majority of the 145 inpatients and 184 outpatients who were followed up regained initial HRQL levels, presenting a mean difference of 0.01 between the EQ-5D score prior to and after the influenza episode. Individual QALY losses for inpatients (0.031, 95% CI, 0.025–0.037) were higher than for outpatients (0.009, 95% CI, 0.007–0.011), while societal QALY losses were reversed: 94 years for inpatients and 6,778 years for outpatients. For fatal cases (an official number of 318), we estimated a QALY loss of 11,981. Conclusions The influenza (H1N1)2009 pandemic had a significant but temporary impact on the HRQL of the majority of confirmed in- and outpatients. The societal impact of the influenza pandemic in Spain was estimated to be higher than other acute conditions. These results provide useful data for future cost-utility analyses. PMID:23555979

  1. The structural quality of Tanzanian primary health facilities.

    PubMed Central

    Gilson, L.; Magomi, M.; Mkangaa, E.

    1995-01-01

    Structural quality is a key element in the quality of care provided at the primary level, which aims to offer health care interventions of proven efficacy. This assessment of the structural quality of Tanzanian primary health services indicated serious weaknesses in the available physical infrastructure, as well as supervision and other support, both for government and nongovernmental services and for dispensary and first referral-level services. Addressing these weaknesses is likely to require some additional funding and review of the functions of different groups of health care facilities within the primary care system. Although district health management teams have an important role to play in tackling the weaknesses, the existing division of management responsibilities indicates that they can only do so with the support of the regional and national levels of the health management structure. Study methods might be adapted to facilitate improved supervision and management. PMID:7704920

  2. Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

    PubMed

    Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

    2016-01-01

    Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.

  3. Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care

    PubMed Central

    Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

    2016-01-01

    Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

  4. [Quality in occupational health education and training].

    PubMed

    Manno, M

    2010-01-01

    According to the International Code of Ethics of the International Commission on Occupational Health (ICOH) "occupational health practice must be performed according to the highest professional standards and ethical principles". So, the first ethical requirement for an occupational physician is a scientifically and professionally sound conduct, and vice-versa, the ethical principles must be an integral part of his/her education and training. The different tools and contexts for the education and training in occupational health (OH) in Italy, at both the undergraduate and postgraduate level, are presented. Moreover, the past and present contribution of the academic institutions and professional associations active in occupational health, to improve the professional standards of the occupational physicians is discussed. It is suggested that the objectives and the contents in OH education and training should not be limited to simply fulfil the legal requirements aimed to the protection of health and safety in the workplace (as it seems to be largely the case today), but they should rather anticipate and overcome them, by also including a thorough discussion of the fundamental ethical principles and duties to be accomplished in OH.

  5. Construction of an environmental quality index for public health research

    EPA Science Inventory

    A more comprehensive estimate of environmental quality would improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) for all counties in the U.S. was developed. The EQI was developed in four parts: doma...

  6. The Quality Assurance Project: introducing quality improvement to primary health care in less developed countries.

    PubMed

    Nicholas, D D; Heiby, J R; Hatzell, T A

    1991-01-01

    Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems.

  7. [The objective assessment of the quality of oral health care and development of quality indicators].

    PubMed

    Pinke, Ildikó; Paulik, Edit; Kivovics, Péter; Segatto, Emil; Nagy, Katalin

    2011-12-01

    Public health care administration and decision-makers need appropriate tools and information to assess and monitor oral health needs and improve the performance of the oral health system. The aim of the article is to introduce the available methods of measurement of the quality of service, to give a brief summary considering the role of quality indicators in domestic and international sources and the European indicator project (EGOHID) and to introduce ICDAS (International Caries Detection and Assessment System), the method used for clinical examinations. The clinical indicators - that are produced from data gained from the questionnaires and screenings--provide an opportunity to improve and develop quality. Quality indicators are objective measure of the process or outcome of patient care. The 40 indicators were created by the experts of EGOHID program which are described in four categories. Part A is indicators for monitoring the oral health of children and adolescents, Part B is in general population, Part C is indicators for monitoring the oral health systems, Part D concerns indicators for monitoring the oral health quality of life. The purpose of developing public health care and--within it--dental care is the effective use of resources and besides it, reaching the popular level of health gain for which it is a necessary tool when forming and continuously developing the quality approach of providers.

  8. The Health-Related Quality of Life of Custodial Grandparents

    ERIC Educational Resources Information Center

    Neely-Barnes, Susan L.; Graff, J. Carolyn; Washington, Gregory

    2010-01-01

    Health-related quality of life (HRQOL) was explored in a sample of 119 custodial grandparents. A latent profile analysis identified three groups of grandparents along a continuum of good to poor HRQOL, with most custodial grandparents reporting Short Form-12 Health Survey (version 2) scores significantly below U.S. population means. Grandparent…

  9. Health Conditions and Perceived Quality of Life in Retirement.

    ERIC Educational Resources Information Center

    Dorfman, Lorraine T.

    1995-01-01

    Investigates the effects of specific health conditions on perceived quality of life for retirees (n=451). Pulmonary disease was a predictor of dissatisfaction for both sexes. Pulmonary disease and heart attack were the strongest predictors of dissatisfaction with health for men, followed closely by stroke. Arthritis was the strongest predictor of…

  10. Quality Improvement and School-Based Mental Health Programs.

    ERIC Educational Resources Information Center

    Nabors, Laura; Weist, Mark; Acosta, Olga; Tashman, Nancy

    This report discusses the outcomes of a study that reviewed activities to ensure quality of care for adolescents receiving mental health services in the School Mental Health Program (SMHP), based in the Department of Psychiatry at the University of Maryland School of Medicine. For this program a team of clinicians, as well as trainees in each…

  11. CHARACTERIZING AIR QUALITY FOR ENVIRONMENTAL PUBLIC HEALTH TRACKING

    EPA Science Inventory

    This presentation provides a brief summary of EPA's perspective on Environmental Public Health Tracking, the Public Health Air Surveillance Evaluation (PHASE), and EPA's efforts to provide air quality data to three states (Maine, New York, and Wisconsin) that are partners with CD...

  12. [Hypermedia in medical education: quality of health care].

    PubMed

    Kusec, Sanja; Jaksić, Zelimir; Vuletić, Gorka; Kovacić, Luka; Pavleković, Gordana

    2002-09-01

    The recent technological developments have found its place in medical education as well. Hypermedia has become very popular through the widespread use of the Internet. In its research project, the Department of Educational Technology of the Andrija Stampar School of Public Health studied and applied the educational methods in continuing training of health professionals using hypermedia and taking into account the specificities of medical and health practices. Potentials of hypermedia in medical education are presented within the topic on quality of health care. The result of this project is an interactive educational disk designed for physicians and other health professionals in primary health care faced with the issue of quality. This paper gives an overview of the experience gained during the work on the project and describes the created educational disk with all its specificities observed in the development of the educational hypermedia materials.

  13. Racial and Ethnic Disparities in the Quality of Health Care.

    PubMed

    Fiscella, Kevin; Sanders, Mechelle R

    2016-01-01

    The annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. These disparities result from complex interactions between patient factors related to social disadvantage, clinicians, and organizational and health care system factors. Separate and unequal systems of health care between states, between health care systems, and between clinicians constrain the resources that are available to meet the needs of disadvantaged groups, contribute to unequal outcomes, and reinforce implicit bias. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability based on progress toward defined, time-limited objectives using evidence-based, sufficiently resourced, multilevel quality improvement strategies that engage patients, clinicians, health care organizations, and communities.

  14. Cultural diversity, economic development and societal instability

    USGS Publications Warehouse

    Nettle, D.; Grace, J.B.; Choisy, M.; Cornell, H.V.; Guegan, J.-F.; Hochberg, M.E.

    2007-01-01

    Background. Social scientists have suggested that cultural diversity in a nation leads to societal instability. However, societal instability may be affected not only by within-nation on ?? diversity, but also diversity between a nation and its neighbours or ?? diversity. It is also necessary to distinguish different domains of diversity, namely linguistic, ethnic and religious, and to distinguish between the direct effects of diversity on societal instability, and effects that are mediated by economic conditions. Methodology/Principal Findings. We assembled a large cross-national dataset with information on ?? and ?? cultural diversity, economic conditions, and indices of societal instability. Structural equation modeling was used to evaluate the direct and indirect effects of cultural diversity on economics and societal stability. Results show that different type and domains of diversity have interacting effects. As previously documented, linguistic ?? diversity has a negative effect on economic performance, and we show that it is largely through this economic mechanism that it affects societal instability. For ?? diversity, the higher the linguistic diversity among nations in a region, the less stable the nation. But, religious ?? diversity has the opposite effect, reducing instability, particularly in the presence of high linguistic diversity. Conclusions. Within-nation linguistic diversity is associated with reduced economic performance, which, in turn, increases societal instability. Nations which differ linguistically from their neighbors are also less stable. However, religious diversity between, neighboring nations has the opposite effect, decreasing societal instability.

  15. Environmental Quality Index and Childhood Mental Health

    EPA Science Inventory

    Childhood mental disorders affect between 13%-20% of children in the United States (US) annually and impact the child, family, and community. Literature suggests associations exist between environmental and children’s mental health such as air pollution with autism and ADHD...

  16. Internal marketing: creating quality employee experiences in health care organizations.

    PubMed

    Masri, Maysoun Dimachkie; Oetjen, Dawn; Rotarius, Timothy

    2011-01-01

    To cope with the recent challenges within the health care industry, health care managers need to engage in the internal marketing of their various services. Internal marketing has been used as an effective management tool to increase employees' motivation, satisfaction, and productivity (J Mark Commun. 2010;16(5):325-344). Health care managers should understand that an intense focus on internal marketing factors will lead to a quality experience for employees that will ultimately have a positive effect on the patient experiences.

  17. [Valuation of health-related quality of life and utilities in health economics].

    PubMed

    Greiner, Wolfgang; Klose, Kristina

    2014-01-01

    Measuring health-related quality of life is an important aspect in economic evaluation of health programmes. The development of utility-based (preference-based) measures is advanced by the discipline of health economics. Different preference measures are applied for valuing health states to produce a weighted health state index. Those preference weights should be derived from a general population sample in case of resource allocation on a collective level (as in current valuation studies of the EuroQol group).

  18. Creating a culture for health care quality and safety.

    PubMed

    Roberts, Velma; Perryman, Martha M

    2007-01-01

    Approximately 67% of hospital quality indicators require some type of laboratory testing to monitor compliance. Unfortunately, in many hospitals, laboratory data information systems remain an untapped resource in eliminating medical errors and improving patient safety. Using case scenarios, this article demonstrates potential consequences for patient safety and quality of care when information sharing between medical technologists and nurses is not a part of a hospital's culture. The outcome for this patient could have been avoided if a more inclusive health care quality and safety culture existed. Creating a culture for health care quality and safety requires consensus building by clinical and administrative leaders. Consensus building occurs by managing relationships among and between a team of independent, autonomous physicians, nurses, allied health professionals, and health care administrators. These relationships are built on mutual respect and effective communication. Creating a quality culture is a challenging but necessary prerequisite for eliminating medical errors and ensuring patient safety. Physician leaders promoting and advancing cultural change in clinical care from one of exclusive decision making authority to a culture that is based on shared decision making are a necessary first step. Shared decision making requires mutual respect, trust, confidentiality, responsiveness, empathy, effective listening, and communication among all clinical team members. Physician and administrative leaders with a focus on patient safety and a willingness to change will ensure a culture of health care quality and safety.

  19. Client relations in South Asia: programmatic and societal determinants.

    PubMed

    Simmons, R; Koblinsky, M A; Phillips, J F

    1986-01-01

    Client relations constitute a neglected area of research in family planning. Findings from studies in northern India and Bangladesh reveal considerable variation in both the quantity and quality of contacts in programs that function under roughly comparable socioeconomic conditions. Client relations are determined by a complex set of forces in which both programmatic factors and conditions pertaining to the societal environment play a key role. Worker-client exchanges have a net, incremental effect on contraceptive use.

  20. Low health-related quality of life among abused women.

    PubMed

    Alsaker, Kjersti; Moen, Bente E; Nortvedt, Monica W; Baste, Valborg

    2006-08-01

    In a cross-sectional study, we sent a self-administered questionnaire to all the women's shelters in Norway to describe health-related quality of life among women who had experienced violence from an intimate partner. Every woman who could understand Norwegian and was staying at a women's shelter in Norway for more than 1 week from October 2002 to May 2003 was asked to participate. We described violence by intimate partners by using the Severity of Violence against Women Scale and the Psychological Maltreatment of Women Index. We used the SF-36 Health Survey to measure health-related quality of life. These women experienced a multitude of threats and actual physical and psychological violence during their partnership. Their health-related quality of life was low and significantly (p<0.001) below the norm for the female population of Norway in all dimensions. The SF-36 mental health dimension was 2.5 standard deviations below the norm. Women at women's shelters in Norway who had experienced domestic violence had very low and clinically significantly reduced health-related quality of life scores. Health care workers must give priority to developing intervention plans for victims of violence from intimate partners.

  1. Service quality perceptions in primary health care centres in Greece

    PubMed Central

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2012-01-01

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

  2. Price and quality transparency: how effective for health care reform?

    PubMed

    Nyman, John A; Li, Chia-Hsuan W

    2009-07-01

    Many in Minnesota and the United States are promoting price and quality transparency as a means for reforming health care. The assumption is that with such information, consumers and providers would be motivated to change their behavior and this would lead to lower costs and higher-quality care.This article attempts to determine the extent to which publicizing information about the cost and quality of medical care does, in fact, improve quality and lower costs, and thus should be included in any reform strategy. The authors reviewed a number of studies and concluded that there is a general lack of empirical evidence on the effect of price transparency on health care costs and that the evidence on the effectiveness of quality transparency is mixed.

  3. Quality of sleep and health-related quality of life in renal transplant recipients

    PubMed Central

    Liu, Hong-Xia; Lin, Jun; Lin, Xiao-Hong; Wallace, Linda; Teng, Sha; Zhang, Shu-Ping; Hao, Yu-Fang

    2015-01-01

    Aims and objectives: The purpose of this study was to examine the sleep quality and health-related quality of life (HRQOL) in patients after renal transplantation and to explore the relationship between the quality of sleep and the HRQOL. Background: Sleep disorders are still an important clinical problem after renal transplantation. Previous studies mainly focused on patients’ sleep quality before kidney transplant. More studies are needed to document sleep quality after renal transplantation. Design: A cross-sectional design was used in this study. Methods: A convenience sample of renal transplant recipients was recruited at an outpatient transplant clinic of a general hospital in Beijing, China. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep. The Medical Outcomes Study 36-item Short Form (MOS SF-36) was used to measure health-related quality of life. Results: The average PSQI score of the 204 renal transplant recipients was 5.81±3.52, significantly lower than the norm. Fifty (24.5%) recipients were classified as having poor sleep quality (global PSQI > 7). The mean scores of renal transplant recipients for SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) were 47.57±6.71 and 48.26±9.66 respectively. Compared with residents in Sichuan province, recipients’ scores for SF-36 dimensions were statistically lower except the dimension of mental health. SF-36 scores of poor sleepers (PSQI > 7) were significantly lower than the good sleepers (PSQI ≤ 7) in both the MCS and PCS. Significant differences exist between the groups in physical function, bodily pain, vitality, and mental health dimensions. Conclusions: Sleep quality and HRQOL of patients after renal transplantation were lower than the norm. Poor sleep is associated with lower HRQOL. Relevance to clinical practice: Health professionals need to pay attention to sleep quality and HRQOL in renal transplant recipients and take appropriate measures to

  4. Relation of Health Condition and Quality of Life: Examination of the Quality of Life of the Disadvantaged Population in Nyíregyháza by the FT Quality of Life Index

    ERIC Educational Resources Information Center

    Jávorné-Erdei, Renáta; Takács, Péter; Fábián, Gergely

    2015-01-01

    Improving the health of the population, stopping and changing the disadvantage trends have long been one of the health policy objectives in the regions. Unfortunately, in spite of the declared goals Hungary is far away from giving priority to health issues as they are not given proper attention either on individual or societal level. In modern…

  5. Health-Related Quality of Life and Health-Promoting Behaviors in Black Men

    ERIC Educational Resources Information Center

    Calvert, Wilma J.; Isaac,, E. Paulette; Johnson, Sharon

    2012-01-01

    This study examined the health-related quality of life and health-promoting behaviors in a convenience sample of low-income black men. Almost three-fourths reported their overall health as good or better. However, the mean number of recent (that is, past 30 days) mentally unhealthy days was 13.12, and more than half reported frequent (greater than…

  6. Air Quality Index (AQI) -- A Guide to Air Quality and Your Health

    MedlinePlus

    ... the AQI value, the greater the level of air pollution and the greater the health concern. For example, ... to 50. Air quality is considered satisfactory, and air pollution poses little or no risk. "Moderate" AQI is ...

  7. Innovative and responsible governance of nanotechnology for societal development

    NASA Astrophysics Data System (ADS)

    Roco, Mihail C.; Harthorn, Barbara; Guston, David; Shapira, Philip

    2011-09-01

    Governance of nanotechnology is essential for realizing economic growth and other societal benefits of the new technology, protecting public health and environment, and supporting global collaboration and progress. The article outlines governance principles and methods specific for this emerging field. Advances in the last 10 years, the current status and a vision for the next decade are presented based on an international study with input from over 35 countries.

  8. Competition and quality in home health care markets.

    PubMed

    Jung, Kyoungrae; Polsky, Daniel

    2014-03-01

    Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients' homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition.

  9. Improving Data Quality in Mass-Gatherings Health Research.

    PubMed

    Guy, Andrew; Prager, Ross; Turris, Sheila; Lund, Adam

    2017-03-09

    Mass gatherings attract large crowds and can strain the planning and health resources of the community, city, or nation hosting an event. Mass-Gatherings Health (MGH) is an evolving niche of prehospital care rooted in emergency medicine, emergency management, public health, and disaster medicine. To explore front-line issues related to data quality in the context of mass gatherings, the authors draw on five years of management experience with an online, mass-gathering event and patient registry, as well as clinical and operational experience amassed over several decades. Here the authors propose underlying human, environmental, and logistical factors that may contribute to poor data quality at mass gatherings, and make specific recommendations for improvement through pre-event planning, on-site actions, and post-event follow-up. The advancement of MGH research will rely on addressing factors that influence data quality and developing strategies to mitigate or enhance those factors. This is an exciting time for MGH research as higher order questions are beginning to be addressed; however, quality research must start from the ground up to ensure optimal primary data capture and quality. Guy A , Prager R , Turris S , Lund A . Improving data quality in mass-gatherings health research. Prehosp Disaster Med. 2017;32(3):1-4.

  10. [Nosocomial infections and quality of health care].

    PubMed

    Navarrete-Navarro, S; Rangel-Frausto, M S

    1999-01-01

    The main objective of a hospital-acquired infections control program is to decrease the risk of acquisition and the morbidity and costs associated. The organization of a team with technical and humanistic leadership is essential. Every infection control program must also develop strategies that allow: a) identification of the problems, b) to establish the importance of each one, c) to determine their causes, d) to develop solutions and e) the evaluation of the recommended solutions. The development of technical and humanistic abilities by the leader and the members of the team, and the use of the tools mentioned above have produced the only validate and highly effective program of quality improvement in the hospital.

  11. Diabetes in China: a societal solution for a personal challenge.

    PubMed

    Chan, Juliana C N; Zhang, Yuying; Ning, Guang

    2014-12-01

    China has a large burden of diabetes: in 2013, one in four people with diabetes worldwide were in China, where 11·6% of adults had diabetes and 50·1% had prediabetes. Many were undiagnosed, untreated, or uncontrolled. This epidemic is the result of rapid societal transition that has led to an obesogenic environment against a backdrop of traditional lifestyle and periods of famine, which together puts Chinese people at high risk of diabetes and multiple morbidities. Societal determinants including social disparity and psychosocial stress interact with factors such as low-grade infection, environmental pollution, care fragmentation, health illiteracy, suboptimal self-care, and insufficient community support to give rise to diverse subphenotypes and consequences, notably renal dysfunction and cancer. In the China National Plan for Non-Communicable Disease Prevention and Treatment (2012-15), the Chinese Government proposed use of public measures, multisectoral collaborations, and social mobilisation to create a health-enabling environment and to reform the health-care system. While awaiting results from these long-term strategies, we advocate the use of a targeted and proactive approach to identify people at high risk of diabetes for prevention, and of private-public-community partnerships that make integrated care more accessible and sustainable, focusing on registry, empowerment, and community support. The multifaceted nature of the societal and personal challenge of diabetes requires a multidimensional solution for prevention in order to reduce the growing disease burden.

  12. Service Quality Assessment Scale (SQAS): An Instrument for Evaluating Service Quality of Health-Fitness Clubs

    ERIC Educational Resources Information Center

    Lam, Eddie T. C.; Zhang, James J.; Jensen, Barbara E.

    2005-01-01

    This study was designed to develop the Service Quality Assessment Scale to evaluate the service quality of health-fitness clubs. Through a review of literature, field observations, interviews, modified application of the Delphi technique, and a pilot study, a preliminary scale with 46 items was formulated. The preliminary scale was administered to…

  13. Cocoa agronomy, quality, nutritional, and health aspects.

    PubMed

    Badrie, Neela; Bekele, Frances; Sikora, Elzbieta; Sikora, Marek

    2015-01-01

    The history of cocoa and chocolate including the birth and the expansion of the chocolate industry was described. Recent developments in the industry and cocoa economy were briefly depicted. An overview of the classification of cacao as well as studies on phenotypic and genetic diversity was presented. Cocoa agronomic practices including traditional and modern propagation techniques were reviewed. Nutrition-related health benefits derived from cocoa consumption were listed and widely reviewed. The specific action of cocoa antioxidants was compared to those of teas and wines. Effects of adding milk to chocolate and chocolate drinks versus bioavailability of cocoa polyphenols were discussed. Finally, flavor, sensory, microbiological, and toxicological aspects of cocoa consumption were presented.

  14. Patient perceptions of the quality of health services.

    PubMed

    Sofaer, Shoshanna; Firminger, Kirsten

    2005-01-01

    As calls are made for a more patient-centered health care system, it becomes critical to define and measure patient perceptions of health care quality and to understand more fully what drives those perceptions. This chapter identifies conceptual and methodological issues that make this task difficult, including the confusion between patient perceptions and patient satisfaction and the difficulty of determining whether systematic variations in patient perceptions should be attributed to differences in expectations or actual experiences. We propose a conceptual model to help unravel these knotty issues; review qualitative studies that report directly from patients on how they define quality; provide an overview of how health plans, hospitals, physicians, and health care in general are currently viewed by patients; assess whether and how patient health status and demographic characteristics relate to perceptions of health care quality; and identify where further, or more appropriately designed, research is needed. Our aim is to find out what patients want, need and experience in health care, not what professionals (however well-motivated) believe they need or get.

  15. Assessing Quality across Health Care Subsystems in Mexico

    PubMed Central

    Puig, Andrea; Pagán, José A.; Wong, Rebeca

    2012-01-01

    Recent healthcare reform efforts in Mexico have focused on the need to improve the efficiency and equity of a fragmented healthcare system. In light of these reform initiatives, there is a need to assess whether healthcare subsystems are effective at providing high-quality healthcare to all Mexicans. Nationally representative household survey data from the 2006 Encuesta Nacional de Salud y Nutrición (National Health and Nutrition Survey) were used to assess perceived healthcare quality across different subsystems. Using a sample of 7234 survey respondents, we found evidence of substantial heterogeneity in healthcare quality assessments across healthcare subsystems favoring private providers over social security institutions. These differences across subsystems remained even after adjusting for socioeconomic, demographic, and health factors. Our analysis suggests that improvements in efficiency and equity can be achieved by assessing the factors that contribute to heterogeneity in quality across subsystems. PMID:19305224

  16. [ISO 9000: guidelines for a total quality system in health].

    PubMed

    Pasini, E; Opasich, C; Scherillo, M

    1998-04-01

    The Italian National Health System has recently been revised and reorganized. In the new scenario, the quality of the service being provided is considered extremely important. The international ISO 9000 standard has made it possible to implement a total-quality management system that can be documented and certified independently by a third party. Several hospitals in Italy and abroad have implemented a total-quality system according to ISO 9000 standards in order to provide a service that can satisfy the expectations of the patients in a controlled and efficient way. This article describes ISO 9000, proposes its application to ensure quality in the structures and organizations involved in the national health system and reports several examples of how the standard has been implemented in hospitals.

  17. The management of health care service quality. A physician perspective.

    PubMed

    Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L

    2016-01-01

    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective.

  18. The management of health care service quality. A physician perspective

    PubMed Central

    Bobocea, L; Gheorghe, IR; Spiridon, St; Gheorghe, CM; Purcarea, VL

    2016-01-01

    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer’s perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician’s perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician’s perspective. PMID:27453745

  19. High-quality Health Information Provision for Stroke Patients

    PubMed Central

    Du, Hong-Sheng; Ma, Jing-Jian; Li, Mu

    2016-01-01

    Objective: High-quality information provision can allow stroke patients to effectively participate in healthcare decision-making, better manage the stroke, and make a good recovery. In this study, we reviewed information needs of stroke patients, methods for providing information to patients, and considerations needed by the information providers. Data Sources: The literature concerning or including information provision for patients with stroke in English was collected from PubMed published from 1990 to 2015. Study Selection: We included all the relevant articles on information provision for stroke patients in English, with no limitation of study design. Results: Stroke is a major public health concern worldwide. High-quality and effective health information provision plays an essential role in helping patients to actively take part in decision-making and healthcare, and empowering them to effectively self-manage their long-standing chronic conditions. Different methods for providing information to patients have their relative merits and suitability, and as a result, the effective strategies taken by health professionals may include providing high-quality information, meeting patients’ individual needs, using suitable methods in providing information, and maintaining active involvement of patients. Conclusions: It is suggested that to enable stroke patients to access high-quality health information, greater efforts need to be made to ensure patients to receive accurate and current evidence-based information which meets their individual needs. Health professionals should use suitable information delivery methods, and actively involve stroke patients in information provision. PMID:27569241

  20. Introducing quality management into primary health care services in Uganda.

    PubMed Central

    Omaswa, F.; Burnham, G.; Baingana, G.; Mwebesa, H.; Morrow, R.

    1997-01-01

    In 1994, a national quality assurance programme was established in Uganda to strengthen district-level management of primary health care services. Within 18 months both objective and subjective improvements in the quality of services had been observed. In the examples documented here, there was a major reduction in maternal mortality among pregnant women referred to Jinja District Hospital, a reduction in waiting times and increased patient satisfaction at Masaka District Hospital, and a marked reduction in reported cases of measles in Arua District. Beyond these quantitative improvements, increased morale of district health team members, improved satisfaction among patients, and greater involvement of local government in the decisions of district health committees have been observed. At the central level, the increased coordination of activities has led to new guidelines for financial management and the procurement of supplies. District quality management workshops followed up by regular support visits from the Ministry of Health headquarters have led to a greater understanding by central staff of the issues faced at the district level. The quality assurance programme has also fostered improved coordination among national disease-control programmes. Difficulties encountered at the central level have included delays in carrying out district support visits and the failure to provide appropriate support. At the district level, some health teams tackled problems over which they had little control or which were overly complex; others lacked the management capacity for problem solving. PMID:9185368

  1. Improving the quality of health care: what's taking so long?

    PubMed

    Chassin, Mark R

    2013-10-01

    Nearly fourteen years ago the Institute of Medicine's report, To Err Is Human: Building a Safer Health System, triggered a national movement to improve patient safety. Despite the substantial and concentrated efforts that followed, quality and safety problems in health care continue to routinely result in harm to patients. Desired progress will not be achieved unless substantial changes are made to the way in which quality improvement is conducted. Alongside important efforts to eliminate preventable complications of care, there must also be an effort to seriously address the widespread overuse of health services. That overuse, which places patients at risk of harm and wastes resources at the same time, has been almost entirely left out of recent quality improvement endeavors. Newer and much more effective strategies and tools are needed to address the complex quality challenges confronting health care. Tools such as Lean, Six Sigma, and change management are proving highly effective in tackling problems as difficult as hand-off communication failures and patient falls. Finally, the organizational culture of most American hospitals and other health care organizations must change. To create a culture of safety, leaders must eliminate intimidating behaviors that suppress the reporting of errors and unsafe conditions. Leaders must also hold everyone accountable for adherence to safe practices.

  2. Commentary: Societal Technology: A New Frontier.

    ERIC Educational Resources Information Center

    Decker, John P.

    1980-01-01

    The role of technology throughout history and its relationship to science is discussed. The new frontier of societal technology is considered in terms of human behavior and misbehavior in the face of conflict. (SA)

  3. Disparities in Health Care Quality among Asian Children with Special Health Care Needs.

    PubMed

    Son, Esther; Parish, Susan L; Igdalsky, Leah

    2017-03-02

    There is a dearth of information on the quality of health care for Asian American children and particularly Asian children with special health care needs (CSHCN). The goal of this article was to determine whether there were disparities in quality of health care for Asian CSHCN, whose experiences have not been studied. Data were derived from the 2009-2010 National Survey of Children with Special Health Care Needs (ns = 355 non-Hispanic Asian children and 4,343 non-Hispanic white CSHCN). Bivariate and multivariate logistic regression analyses were conducted to examine the relationship between racial identity (that is, non-Hispanic white and non-Hispanic Asian) and quality of health care. Racial disparities in quality of health care were substantial between Asian and white CSHCN in 2009-2010. Asian parents were significantly less likely than white parents to report that their health care provider provided the specific information they needed, helped them feel like a partner in their child's care, and was sensitive to the family's values and customs. The development and testing of specific, targeted policy and practice interventions to reduce disparities in health care quality for these children are urgently needed.

  4. An Evaluation of a Quality Assessment Tool for Health Care Administrators at Brooke Army Medical Center

    DTIC Science & Technology

    1986-07-23

    facing the administrator in the assessment of quality of I care is that, in most cases, the assessment must be based on clinical knowledge and judgement ...With that, it becomes clear that the care provided can be divided into two areas, the technical ("science") and the interpersonal ("art") (18). The...34great search." He proposes the interpersonal aspect of the healing encounter be defined and evaluated based on societal values and norms. He also

  5. Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

    PubMed

    Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

  6. Using Social Determinants of Health to Link Health Workforce Diversity, Care Quality and Access, and Health Disparities to Achieve Health Equity in Nursing

    PubMed Central

    Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators—health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work—both within and outside the nursing field—that is necessary to answer these important but largely unanswered questions. PMID:24385662

  7. Health impact assessment of quality wine production in Hungary.

    PubMed

    Adám, Balázs; Molnár, Agnes; Bárdos, Helga; Adány, Róza

    2009-12-01

    Alcohol-related health outcomes show strikingly high incidence in Hungary. The effects of alcohol consumption are influenced not only by the quantity, but also the quality of drinks; therefore, wine production can have an important effect on public health outcomes. Nevertheless, the Hungarian wine sector faces several vital problems and challenges influenced by the country's accession to the European Union and by the need for restructuring. A comprehensive health impact assessment (HIA) based on the evaluation of the Hungarian legislation related to the wine sector has been carried out, aiming to assess the impact of the production of quality wine versus that of table wine, using a range of public health and epidemiological research methods and data as well as HIA guidelines. The study finds that the toxic effects of alcohol can be reduced with an increased supply of quality wine and with decreased overall consumption due to higher cost, although this might drive some people to seek illegal sources. Quality wine production allows for improved use of land, creates employment opportunities and increases the incomes of producers and local communities; however, capital-scarce producers unable to manage restructuring may lose their source of subsistence. The supply of quality wine can promote social relations, contribute to a healthy lifestyle and reduce criminality related to alcohol's influence and adulteration. In general, the production and supply of quality wine can have an overall positive impact on health. Nevertheless, because of the several possible negative effects expected without purposeful restructuring, recommendations for the maximization of favourable outcomes and suggestions for monitoring the success of the analysis have been provided.

  8. Does Satisfaction Reflect the Technical Quality of Mental Health Care?

    PubMed Central

    Edlund, Mark J; Young, Alexander S; Kung, Fuan Yue; Sherbourne, Cathy D; Wells, Kenneth B

    2003-01-01

    Objective To analyze the relationship between satisfaction and technical quality of care for common mental disorders. Data Source A nationally representative telephone survey of 9,585 individuals conducted in 1997–1998. Study Design Using multinomial logistic regression techniques we investigated the association between a five-level measure of satisfaction with the mental health care available for personal or emotional problems and two quality indicators. The first measure, appropriate technical quality, was defined as use of either appropriate counseling or psychotropic medications during the prior year for a probable depressive or anxiety disorder. The second, active treatment, indicated whether the respondent had received treatment for a psychiatric disorder in the past year. Covariates included measures of physical and mental health and sociodemographic indicators. Principal Findings Appropriate technical quality of care was significantly associated with higher levels of satisfaction. The strength of the association was moderate. Conclusions Satisfaction is associated with technical quality of care. However, profiling quality of care with satisfaction will likely require large samples and case-mix adjustment, which may be more difficult for plans or provider groups to implement than measuring technical indicators. More importantly, satisfaction is not the same as technical quality, and our results suggest that at this time they cannot be made to approach each other closely enough to eliminate either. PMID:12785565

  9. Marital quality and health: A meta-analytic review

    PubMed Central

    Robles, Theodore F.; Slatcher, Richard B.; Trombello, Joseph M.; McGinn, Meghan M.

    2013-01-01

    This meta-analysis reviewed 126 published empirical articles over the past 50 years describing associations between marital relationship quality and physical health in over 72,000 individuals. Health outcomes included clinical endpoints (objective assessments of function, disease severity, and mortality; subjective health assessments) and surrogate endpoints (biological markers that substitute for clinical endpoints, such as blood pressure). Biological mediators included cardiovascular reactivity and hypothalamic-pituitary-adrenal axis activity. Greater marital quality was related to better health, with mean effect sizes from r = .07 to .21, including lower risk of mortality, r = .11, and lower cardiovascular reactivity during marital conflict, r = −.13, but not daily cortisol slopes or cortisol reactivity during conflict. The small effect sizes were similar in magnitude to previously found associations between health behaviors (e.g., diet) and health outcomes. Effect sizes for a small subset of clinical outcomes were susceptible to publication bias. In some studies, effect sizes remained significant after accounting for confounds such as age and socioeconomic status. Studies with a higher proportion of women in the sample demonstrated larger effect sizes, but we found little evidence for gender differences in studies that explicitly tested gender moderation, with the exception of surrogate endpoint studies. Our conclusions are limited by small numbers of studies for specific health outcomes, unexplained heterogeneity, and designs that limit causal inferences. These findings highlight the need to explicitly test affective, health behavior, and biological mechanisms in future research, and focus on moderating factors that may alter the relationship between marital quality and health. PMID:23527470

  10. Ventilation, indoor air quality, and health in homes undergoing weatherization.

    PubMed

    Francisco, P W; Jacobs, D E; Targos, L; Dixon, S L; Breysse, J; Rose, W; Cali, S

    2017-03-01

    Ventilation standards, health, and indoor air quality have not been adequately examined for residential weatherization. This randomized trial showed how ASHRAE 62-1989 (n=39 houses) and ASHRAE 62.2-2010 (n=42 houses) influenced ventilation rates, moisture balance, indoor air quality, and self-reported physical and mental health outcomes. Average total airflow was nearly twice as high for ASHRAE 62.2-2010 (79 vs. 39 cfm). Volatile organic compounds, formaldehyde and carbon dioxide were all significantly reduced for the newer standard and first-floor radon was marginally lower, but for the older standard, only formaldehyde significantly decreased. Humidity in the ASHRAE 62.2-2010 group was only about half that of the ASHRAE 62-1989 group using the moisture balance metric. Radon was higher in the basement but lower on the first floor for ASHRAE 62.2-2010. Children in each group had fewer headaches, eczema, and skin allergies after weatherization and adults had improvements in psychological distress. Indoor air quality and health improve when weatherization is accompanied by an ASHRAE residential ventilation standard, and the 2010 ASHRAE standard has greater improvements in certain outcomes compared to the 1989 standard. Weatherization, home repair, and energy conservation projects should use the newer ASHRAE standard to improve indoor air quality and health.

  11. Health effects of air quality regulations in Delhi, India

    NASA Astrophysics Data System (ADS)

    Foster, Andrew; Kumar, Naresh

    2011-03-01

    This, the first systematic study, quantifies the health effects of air quality regulations in Delhi, which adopted radical measures to improve air quality, including, for example, the conversion of all commercial vehicles to compressed natural gas (CNG), and the closure of polluting industries in residential areas from 2000 to 2002. Air pollution data, collected at 113 sites (spread across Delhi and its neighboring areas) from July-December 2003, were used to compute exposure at the place of residence of 3989 subjects. A socio-economic and respiratory health survey was administered in 1576 households. This survey collected time-use, residence histories, demographic information, and direct measurements of lung function with subjects. The optimal interpolation methods were used to link air pollution and respiratory health data at the place of their residence. Resident histories, in combination with secondary data, were used to impute cumulative exposure prior to the air-quality interventions, and the effects of recent air quality measures on lung function were then evaluated. Three important findings emerge from the analysis. First, the interventions were associated with a significant improvement in respiratory health. Second, the effect of these interventions varied significantly by gender and income. Third, consistent with a causal interpretation of these results, effects were the strongest among those individuals who spend a disproportionate share of their time out-of-doors.

  12. The Case for Quality Health Care for the Poor.

    ERIC Educational Resources Information Center

    Allen, Ethel D.

    1978-01-01

    This article shows that, while there has been a modification of health care facilities and new approaches to medical care, little change has been effected in the interrelationship between the poor and the delivery of quality medical care. (Author/GC)

  13. Water Quality Criteria for Human Health and Aquatic Life

    EPA Science Inventory

    Collaborative effort with the Office of Water to provide science in support of the development and implementation of new or revised ambient water quality criteria for microbial and chemical contaminants for human health and aquatic life. The research also addresses implementation...

  14. Leadership and management quality: key factors in effective health systems.

    PubMed

    Pfeffermann, Guy

    2012-01-01

    The effectiveness of health care systems in the developing world is related to the quality of their leadership and management, yet that factor has been neglected by academics and funders. Based on replicable existing models, the article proposes an approach to strengthening local management training institutions.

  15. College Student Mental Health and Quality of Workplace Relationships

    ERIC Educational Resources Information Center

    Vaughn, Allison A.; Drake, Richard R.; Haydock, Sarah

    2016-01-01

    Objective: The goal of this study was to examine the effect of quality of workplace relationships on the mental health of employed undergraduates, with work-related variables as a potential mechanism. Participants: Participants were 170 employed students (76% female, average age = 19.9) recruited in March 2011. Most worked part-time and had been…

  16. Hostility, Relationship Quality, and Health among African American Couples

    ERIC Educational Resources Information Center

    Guyll, Max; Cutrona, Carolyn; Burzette, Rebecca; Russell, Daniel

    2010-01-01

    Objective: This study investigated the association between hostility and health and whether it is moderated by the quality of an individual's primary romantic relationship. Method: Longitudinal data were provided by 184 African Americans, including 166 women. Participants averaged 38 years old and were married or in long-term marriagelike…

  17. Health-related quality of life in patients undergoing cholecystectomy.

    PubMed

    Hsueh, Li-Na; Shi, Hon-Yi; Wang, Tsai-Fan; Chang, Chiung-Ying; Lee, King-Teh

    2011-07-01

    This large-scale prospective cohort study of a Taiwan population applied generalized estimating equations to evaluate predictors of health-related quality of life (HRQOL) after open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) procedures performed between February 2007 and November 2008. The Gastrointestinal Quality of Life Index and Short Form-36 were used in a preoperative assessment and in 3(rd) month and 6(th) month postoperative assessments of 38 OC and 259 LC patients. The HRQOL of the cholecystectomy patients were significantly improved at 3 months and 6 months postsurgery (p<0.05). At 3 months postsurgery, HRQOL improvement was significantly larger in LC patients than in OC patients. Patient characteristics, clinical characteristics, and health care quality were also significantly related to HRQOL improvement (p<0.05). Additionally, after controlling for related variables, preoperative health status was significantly and positively associated with each subscale of the Gastrointestinal Quality of Life Index and Short Form-36 throughout the 6 months (p<0.05). Patients should be advised that their postoperative HRQOL may depend not only on their postoperative health care but also on their preoperative functional status.

  18. Challenges in Data Quality Assurance in Pervasive Health Monitoring Systems

    NASA Astrophysics Data System (ADS)

    Sriram, Janani; Shin, Minho; Kotz, David; Rajan, Anand; Sastry, Manoj; Yarvis, Mark

    Wearable, portable, and implantable medical sensors have ushered in a new paradigm for healthcare in which patients can take greater responsibility and caregivers can make well-informed, timely decisions. Health-monitoring systems built on such sensors have huge potential benefit to the quality of healthcare and quality of life for many people, such as patients with chronic medical conditions (such as blood-sugar sensors for diabetics), people seeking to change unhealthy behavior (such as losing weight or quitting smoking), or athletes wishing to monitor their condition and performance. To be effective, however, these systems must provide assurances about the quality of the sensor data. The sensors must be applied to the patient by a human, and the sensor data may be transported across multiple networks and devices before it is presented to the medical team. While no system can guarantee data quality, we anticipate that it will help for the system to annotate data with some measure of confidence. In this paper, we take a deeper look at potential health-monitoring usage scenarios and highlight research challenges required to ensure and assess quality of sensor data in health-monitoring systems.

  19. Identifying Key Hospital Service Quality Factors in Online Health Communities

    PubMed Central

    Jung, Yuchul; Hur, Cinyoung; Jung, Dain

    2015-01-01

    Background The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. Objective As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. Methods We defined social media–based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea’s two biggest online portals were used to test the effectiveness of detection of social media–based key quality factors for hospitals. Results To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is

  20. Impacts of Climate Policy on Regional Air Quality, Health, and Air Quality Regulatory Procedures

    NASA Astrophysics Data System (ADS)

    Thompson, T. M.; Selin, N. E.

    2011-12-01

    Both the changing climate, and the policy implemented to address climate change can impact regional air quality. We evaluate the impacts of potential selected climate policies on modeled regional air quality with respect to national pollution standards, human health and the sensitivity of health uncertainty ranges. To assess changes in air quality due to climate policy, we couple output from a regional computable general equilibrium economic model (the US Regional Energy Policy [USREP] model), with a regional air quality model (the Comprehensive Air Quality Model with Extensions [CAMx]). USREP uses economic variables to determine how potential future U.S. climate policy would change emissions of regional pollutants (CO, VOC, NOx, SO2, NH3, black carbon, and organic carbon) from ten emissions-heavy sectors of the economy (electricity, coal, gas, crude oil, refined oil, energy intensive industry, other industry, service, agriculture, and transportation [light duty and heavy duty]). Changes in emissions are then modeled using CAMx to determine the impact on air quality in several cities in the Northeast US. We first calculate the impact of climate policy by using regulatory procedures used to show attainment with National Ambient Air Quality Standards (NAAQS) for ozone and particulate matter. Building on previous work, we compare those results with the calculated results and uncertainties associated with human health impacts due to climate policy. This work addresses a potential disconnect between NAAQS regulatory procedures and the cost/benefit analysis required for and by the Clean Air Act.

  1. Quality at the centre of universal health coverage.

    PubMed

    Sobel, Howard L; Huntington, Dale; Temmerman, Marleen

    2016-05-01

    The last decade of the MDG era witnessed substantial focus on reaching the bottom economic quintiles in low and middle income countries. However, the inordinate focus on reducing financial risk burden and increasing coverage without sufficient focus on expanding quality of services may account for slow progress of the MDGs in many countries. Human Resources for Health underlie quality and service delivery improvements, yet remains under-addressed in many national strategies to achieve Universal Health Coverage. Without adequate investments in improving and expanding health professional education, making and sustaining gains will be unlikely. The transition from the Millennium Development Goals (MDG) to the Sustainable Development Goals (SDG), with exciting new financing initiatives such as the Global Financing Facility brings the potential to enact substantial gains in the quality of services delivered and upgrading human health resources. This focus should ensure effective methodologies to improve health worker competencies and change practice are employed and ineffective and harmful ones eliminated (including undue influence of commercial interests).

  2. Adult Day Health Center Participation and Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Schmitt, Eva M.; Sands, Laura P.; Weiss, Sara; Dowling, Glenna; Covinsky, Kenneth

    2010-01-01

    Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable…

  3. Quality and Health-Optimizing Physical Education: Using Assessment at the Health and Education Nexus

    ERIC Educational Resources Information Center

    Dudley, Dean; Goodyear, Victoria; Baxter, David

    2016-01-01

    Background: The United Nations Educational, Cultural and Scientific Organization (UNESCO) recognizes quality physical education (QPE) must, along with physical, social and affective educative goals, seek to improve the health status of youth (UNESCO, 2015). Health-Optimizing Physical Education (HOPE) is a model of physical education (PE) that…

  4. Water, water quality and health (Chapter 3 in Book entitled: Environmental Tracking for Public Health Surveillance).

    EPA Science Inventory

    This chapter identifies the role environmental tracking plays in identifying public health water hazard and water quality issues. It outlines public health issues to be examined and provides an integrated overview of water and diseases by combining knowledge of the hydrological ...

  5. Space Station Environmental Health System water quality monitoring

    NASA Technical Reports Server (NTRS)

    Vincze, Johanna E.; Sauer, Richard L.

    1990-01-01

    One of the unique aspects of the Space Station is that it will be a totally encapsulated environment and the air and water supplies will be reclaimed for reuse. The Environmental Health System, a subsystem of CHeCS (Crew Health Care System), must monitor the air and water on board the Space Station Freedom to verify that the quality is adequate for crew safety. Specifically, the Water Quality Subsystem will analyze the potable and hygiene water supplies regularly for organic, inorganic, particulate, and microbial contamination. The equipment selected to perform these analyses will be commercially available instruments which will be converted for use on board the Space Station Freedom. Therefore, the commercial hardware will be analyzed to identify the gravity dependent functions and modified to eliminate them. The selection, analysis, and conversion of the off-the-shelf equipment for monitoring the Space Station reclaimed water creates a challenging project for the Water Quality engineers and scientists.

  6. Monitoring Indoor Air Quality for Enhanced Occupational Health.

    PubMed

    Pitarma, Rui; Marques, Gonçalo; Ferreira, Bárbara Roque

    2017-02-01

    Indoor environments are characterized by several pollutant sources. Because people spend more than 90% of their time in indoor environments, several studies have pointed out the impact of indoor air quality on the etiopathogenesis of a wide number of non-specific symptoms which characterizes the "Sick Building Syndrome", involving the skin, the upper and lower respiratory tract, the eyes and the nervous system, as well as many building related diseases. Thus, indoor air quality (IAQ) is recognized as an important factor to be controlled for the occupants' health and comfort. The majority of the monitoring systems presently available is very expensive and only allow to collect random samples. This work describes the system (iAQ), a low-cost indoor air quality monitoring wireless sensor network system, developed using Arduino, XBee modules and micro sensors, for storage and availability of monitoring data on a web portal in real time. Five micro sensors of environmental parameters (air temperature, humidity, carbon monoxide, carbon dioxide and luminosity) were used. Other sensors can be added for monitoring specific pollutants. The results reveal that the system can provide an effective indoor air quality assessment to prevent exposure risk. In fact, the indoor air quality may be extremely different compared to what is expected for a quality living environment. Systems like this would have benefit as public health interventions to reduce the burden of symptoms and diseases related to "sick buildings".

  7. When Weather Matters: Science and Service to Meet Critical Societal Needs

    NASA Technical Reports Server (NTRS)

    2010-01-01

    The goal of weather prediction is to provide information people and organizations can use to reduce weather-related losses and enhance societal benefits, including protection of life and property, public health and safety, and support of economic prosperity and quality of life. In economic terms, the benefit of the investment in public weather forecasts and warnings is substantial: the estimated annualized benefit is about $31.5 billion, compared to the $5.1 billion cost of generating the information. Between 1980 and 2009, 96 weather disasters in the United States each caused at least $1 billion in damages, with total losses exceeding $700 billion. Between 1999 and 2008, there were an average of 629 direct weather fatalities per year. The annual impacts of adverse weather on the national highway system and roads are staggering: 1.5 million weather-related crashes with 7,400 deaths, more than 700,000 injuries, and $42 billion in economic losses.

  8. Health programmes for school employees: improving quality of life, health and productivity.

    PubMed

    Kolbe, Lloyd J; Tirozzi, Gerald N; Marx, Eva; Bobbitt-Cooke, Mary; Riedel, Sara; Jones, Jack; Schmoyer, Michael

    2005-01-01

    School health programmes in the 21st century could include eight components: 1) health services; 2) health education; 3) healthy physical and psychosocial environments; 4) psychological, counselling, and social services; 5) physical education and other physical activities; 6) healthy food services; and 7) integrated efforts of schools, families, and communities to improve the health of school students and employees. The eighth component of modern school health programmes, health programmes for school employees, is the focus of this article. Health programmes for school employees could be designed to increase the recruitment, retention, and productivity of school employees by partially focusing each of the preceding seven components of the school health programme on improving the health and quality of life of school employees as well as students. Thus, efforts to improve the quality of life, health, and productivity of school employees may be distinct from, but integrated with, efforts to improve the quality of life, health, and education of students. School employee health programmes can improve employee: 1) recruitment; 2) morale; 3) retention; and 4) productivity. They can reduce employee: 5) risk behaviours (e.g., physical inactivity); 6) risk factors (e.g., stress, obesity, high blood pressure); (7) illnesses; 8) work-related injuries; 9) absentee days; 10) worker compensation and disability claims; and 11) health care and health insurance costs. Further, if we hope to improve our schools' performance and raise student achievement levels, developing effective school employee health programmes can increase the likelihood that employees will: 12) serve as healthy role models for students; 13) implement effective school health programmes for students; and 14) present a positive image of the school to the community. If we are to improve the quality of life, health, and productivity of school employees in the 21st century: school administrators, employees, and

  9. Bypassing health providers: the quest for better price and quality of health care in Chad.

    PubMed

    Gauthier, Bernard; Wane, Waly

    2011-08-01

    This paper investigates individuals' bypassing behavior in the health sector in Chad and the determinants of individuals' facility choice. We introduce a new way for measuring bypassing which uses the patients' own knowledge of alternative health providers available to them, instead of assuming perfect information as previously done. We analyze how objective and perceived health care quality and prices impact patients' bypassing decisions. The analysis uses data from a health sector survey carried out in 2004 covering 281 primary health care centers and 1801 patients. We observe that income inequalities translate into health service inequalities. We find evidence of two distinct types of bypassing activities in Chad: (1) patients from low-income households bypass high quality facilities they cannot afford and go to low-quality facilities, and (2) rich individuals bypass low-quality facilities and aim for more expensive facilities which also offer a higher quality of care. These significant differences in patients' facility choices are observed across income groups as well as between rural and urban areas.

  10. Developing a risk-based air quality health index

    NASA Astrophysics Data System (ADS)

    Wong, Tze Wai; Tam, Wilson Wai San; Yu, Ignatius Tak Sun; Lau, Alexis Kai Hon; Pang, Sik Wing; Wong, Andromeda H. S.

    2013-09-01

    We developed a risk-based, multi-pollutant air quality health index (AQHI) reporting system in Hong Kong, based on the Canadian approach. We performed time series studies to obtain the relative risks of hospital admissions for respiratory and cardiovascular diseases associated with four air pollutants: sulphur dioxide, nitrogen dioxide, ozone, and particulate matter with an aerodynamic diameter less than 10 μm (PM10). We then calculated the sum of excess risks of the hospital admissions associated with these air pollutants. The cut-off points of the summed excess risk, for the issuance of different health warnings, were based on the concentrations of these pollutants recommended as short-term Air Quality Guidelines by the World Health Organization. The excess risks were adjusted downwards for young children and the elderly. Health risk was grouped into five categories and sub-divided into eleven bands, with equal increments in excess risk from band 1 up to band 10 (the 11th band is 'band 10+'). We developed health warning messages for the general public, including at-risk groups: young children, the elderly, and people with pre-existing cardiac or respiratory diseases. The new system addressed two major shortcomings of the current standard-based system; namely, the time lag between a sudden rise in air pollutant concentrations and the issue of a health warning, and the reliance on one dominant pollutant to calculate the index. Hence, the AQHI represents an improvement over Hong Kong's existing air pollution index.

  11. Quality of Life and Health-Related Quality of Life of Adolescents with Cerebral Palsy

    ERIC Educational Resources Information Center

    Rosenbaum, Peter L.; Livingston, Michael H.; Palisano, Robert J.; Galuppi, Barbara E.; Russell, Dianne J.

    2007-01-01

    This study assessed quality of life (QOL) and health-related quality of life (HRQOL) of 203 adolescents with cerebral palsy (111 males, 92 females; mean age 16y [SD 1y 9mo]). Participants were classified using the Gross Motor Function Classification System (GMFCS), as Level I (n=60), Level II (n=33), Level III (n=28), Level IV (n=50), or Level V…

  12. Changes in Quality of Health Care Delivery after Vertical Integration

    PubMed Central

    Carlin, Caroline S; Dowd, Bryan; Feldman, Roger

    2015-01-01

    Objectives To fill an empirical gap in the literature by examining changes in quality of care measures occurring when multispecialty clinic systems were acquired by hospital-owned, vertically integrated health care delivery systems in the Twin Cities area. Data Sources/Study Setting Administrative data for health plan enrollees attributed to treatment and control clinic systems, merged with U.S. Census data. Study Design We compared changes in quality measures for health plan enrollees in the acquired clinics to enrollees in nine control groups using a differences-in-differences model. Our dataset spans 2 years prior to and 4 years after the acquisitions. We estimated probit models with errors clustered within enrollees. Data Collection/Extraction Methods Data were assembled by the health plan’s informatics team. Principal Findings Vertical integration is associated with increased rates of colorectal and cervical cancer screening and more appropriate emergency department use. The probability of ambulatory care–sensitive admissions increased when the acquisition caused disruption in admitting patterns. Conclusions Moving a clinic system into a vertically integrated delivery system resulted in limited increases in quality of care indicators. Caution is warranted when the acquisition causes disruption in referral patterns. PMID:25529312

  13. Partnering health disparities research with quality improvement science in pediatrics.

    PubMed

    Lion, K Casey; Raphael, Jean L

    2015-02-01

    Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction.

  14. Oral Health Related Quality of Life in Diabetic Patients

    PubMed Central

    Sadeghi, Rokhsareh; Taleghani, Ferial; Farhadi, Sareh

    2014-01-01

    Background and aims. Diabetic patients display an increased risk of oral disorders, and oral health related quality of life (OHRQL) might affect their management and treatment modalities. The aim of the present study was to determine OHRQL and associated parameters in patients with diabetes. Materials and methods. In this study two hundred patients were recruited from the diabetes clinic in Mustafa Khomeini Hospital in Tehran, Iran. OHRQL was assessed using Oral Health Impact Profile Questionnaire (OHIP-20). Also, another questionnaire was designed which contained questions regarding participants’ knowledge about oral complications of diabetes and oral health behavior. OHRQL was categorized as low and good. Data were analyzed using logistic regression at P = 0.05. Results. Of the diabetic patients assessed, 77.5% were in good and 22.5% were in low categories of OHRQL. This quality was significantly associated with age (OR = 4.03, 95% CI = 1.63-11.29), knowledge about diabetes oral complications (OR = 18.17 95% CI = 4.42-158.6), educational level (OR = 26.31 95% CI = 4.2-1080.3), referred for dental visit by physician (OR = 3.16 95% CI = 1.48-6.69), frequency of brushing (OR = 10.29 95% CI = 3.96-31.2) and length of time diagnosed with diabetes (OR = 6.21 95% CI = 2.86-13.63). Conclusion. Oral health related quality of life was not negatively affected by diabetes mellitus in the assessed sample. PMID:25587385

  15. Partnering Health Disparities Research With Quality Improvement Science in Pediatrics

    PubMed Central

    Lion, K. Casey

    2015-01-01

    Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction. PMID:25560436

  16. 77 FR 42738 - Request for Information on Quality Measurement Enabled by Health IT

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... Enabled by Health IT AGENCY: Agency for Healthcare Research and Quality (AHRQ), Health and Human Services... information technology (IT) system developers, including vendors; payers, quality measure developers, end... regarding quality measurement enabled by health IT. Quality measurement--the assessment of the...

  17. Chronic Ischemic Heart Disease Affects Health Related Quality of Life

    PubMed Central

    Goreishi, Abolfazl; Shajari, Zahra; Mohammadi, Zeinab

    2012-01-01

    Background Chronic diseases endanger not only physical health but also psychological and social health of patient. Thus, evaluation of such patients for psychological treatment decisions is very important. Method This is a descriptive study that was performed with 50 chronic patients (ischemic heart disease) selected from Valiasr and Mousavi at cardiac wards in Zanjan Province. They were given three types of questionnaire: demographic, WHOQOL, and Zung depression and anxiety index. The information was statically analyzed by frequency chart, central indexes, dispersion, Chi-Square and t tests, Pearson’s correlation index (P < 0.05). Results The average of quality of life in all patients were calculated as was respectively 12.19, 11.98, 12.08, and 12.4 in physical, psychological, social and environmental domains respectively, 68 percent of total number of the patients had various degrees of anxiety and 78 percent of them had various degrees of depression. There was a significant relationship between the life quality average in all domains and anxiety intensity and depression intensity (P < 0.05) and there was a significant relationship between life quality average in all domains and income (P < 0.05). Conclusion As the level of depression and anxiety goes up, quality of life decreases pointing out that they have a reverse relationship. Depression and anxiety are one of the most significant factors of quality of life among other variables. Regarding specific conditions of the treatment, it is necessary to pay special attention to psychological aspects.

  18. Exploring Social Quality and Community Health Outcomes: An Ecological Model.

    PubMed

    Jung, Minsoo

    2015-01-01

    Quality of life is widely used as a measure of individual well-being in developed countries. Social quality (SQ), however, describes how favorable the socioenvironmental components are that impact the life chance of an individual. Despite the associations between SQ, including institutional capacity and citizen capacity, and other community indicators, the impact of SQ on community health status has not been fully examined. This study investigated the interrelationships among institutional capacity, citizen capacity, and their associations with community-level health indicators such as mortality and suicide among 230 local governments in South Korea. Under the principles of conceptual suitability, clarity, reliability, consistency, changeability, and comparability, a total of 81 SQ indicators were collected, and 19 indicators of the 81 indicators were selected. The 19 indicators were transformed by the imputation of missing values, standardization, and geographic information system transformation. It was found that the health outcome of local government was superior as social welfare, political participation, and education were higher. According to the result of the regression analysis based on the regional type, social welfare had the most influence on the health level of local government in both metropolises and small-/medium-sized cities. In addition, education and political participation had a positive effect on the health indicator of local metropolis government. However, SQ indicators did not have any meaningful influence at the county level. Therefore, small- and medium-sized cities need to promote the collective health of the local government through improving social welfare, and metropolises need to consider the complex relationship among other indicators while increasing the level of social welfare and education. Meanwhile, counties need to develop health indicators that reflect aged population characteristics and social environment of rural areas

  19. Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

    PubMed

    Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

    2017-02-01

    We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record

  20. The business case for health-care quality improvement.

    PubMed

    Swensen, Stephen J; Dilling, James A; Mc Carty, Patrick M; Bolton, Jeffrey W; Harper, Charles M

    2013-03-01

    The business case for health-care quality improvement is presented. We contend that investment in process improvement is aligned with patients' interests, the organization's reputation, and the engagement of their workforce. Four groups benefit directly from quality improvement: patients, providers, insurers, and employers. There is ample opportunity, even in today's predominantly pay-for-volume (that is, evolving toward value-based purchasing) insurance system, for providers to deliver care that is in the best interest of the patient while improving their financial performance.

  1. Total quality management and the Army health care system.

    PubMed

    Jeffer, E K

    1991-10-01

    Total quality management (TQM) is the newest in a long line of magic formulas which have been touted as saviors for American industry and medicine. The author discusses the basic concepts of TQM and notes that much of it resembles philosophical beliefs long held by the medical community. TQM does offer many opportunities to refine old concepts and further those goals of quality care to which health care providers have always aspired. If, however, it becomes simply another codified bureaucracy, then a great deal of time and money will be invested for very little gain.

  2. Tools for evaluating oral health and quality of life

    PubMed Central

    Bettie, Nirmal F.; Ramachandiran, Hari; Anand, Vijay; Sathiamurthy, Anusha; Sekaran, Preethi

    2015-01-01

    The seven dimensions of quality of life are required for a healthy living. Any impairment or disability affects any one or more of these dimensions resulting in functional impairment or handicap, which indicates the presence of disease. The success of any oral treatment depends on how far the individual is relieved of his disease process. Relief of symptoms provides patient comfort and enable functional activities. This well-being is considered as a measure of oral health and reflects patient satisfaction. This article presents various instruments or tools available in the form of a questionnaire that estimates patient satisfaction and thereby oral health. PMID:26538889

  3. Analysis of Critical Earth Observation Priorities for Societal Benefit

    NASA Astrophysics Data System (ADS)

    Zell, E. R.; Huff, A. K.; Carpenter, A. T.; Friedl, L.

    2011-12-01

    moisture content, burn scars, and meteorological parameters. Impacts to public health and livelihoods due to food insecurity, algal blooms, and air pollution can be addressed through NRT monitoring of specific events utilizing land cover, atmospheric composition, water quality, and meteorological observations. More broadly, the assessment of water availability for drinking and agriculture and the development of floods and storms rely on continuous feeds of NRT meteorological and atmospheric composition observations. Overall, this multi-disciplinary study of user needs for NRT data and products can inform the design and operation of NRT data systems. Follow-on work for this study will also be presented, focusing on the availability of current and future satellite measurements (including NRT) of the 30 most critical Earth observation priorities, as well as a detailed analysis of users' needs for precipitation data. The results of this study summarize the priorities for critical Earth observations utilized globally for societal benefit.

  4. Air Quality Strategies on Public Health and Health Equity in Europe-A Systematic Review.

    PubMed

    Wang, Li; Zhong, Buqing; Vardoulakis, Sotiris; Zhang, Fengying; Pilot, Eva; Li, Yonghua; Yang, Linsheng; Wang, Wuyi; Krafft, Thomas

    2016-12-02

    Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO₂) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO₂ were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no

  5. Air Quality Strategies on Public Health and Health Equity in Europe—A Systematic Review

    PubMed Central

    Wang, Li; Zhong, Buqing; Vardoulakis, Sotiris; Zhang, Fengying; Pilot, Eva; Li, Yonghua; Yang, Linsheng; Wang, Wuyi; Krafft, Thomas

    2016-01-01

    Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO2) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO2 were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent

  6. Quality of life and oral health in elderly

    PubMed Central

    Torrijos-Gómez, Gema; González-Serrano, José; López-Pintor-Muñoz, Rosa-María; López-Bermejo, Miguel-Ángel; Hernández-Vallejo, Gonzalo

    2016-01-01

    Background We want to assess quality of life in elderly patients in relation to the number of remaining teeth, the number of ingested drugs and xerostomía and to determine the correlation between an increased intake of drugs and a greater feeling of dry mouth and to know the most commonly used measures to control xerostomia. Material and Methods 30 subjects aged between 65 and 95 years (14 males, 16 females) completed the OHIP questionnaire to determine quality of life. For oral status, the number of remaining teeth according to WHO criteria and xerostomia using the xerostomia index (XI) were studied. In cases of dry mouth sensation, the measures to alleviate it were asked. Results The average quality of life according to the OHIP rate is 19.23 (Dt = 10.58), being 56 the worst quality of life. The Pearson correlation coefficient indicates that quality of life is not related to the number of remaining teeth (r = -0.046; p = 0.810) nor the number of ingested drugs (r = 0.226; p = 0.23) but a greater sensation of dry mouth is related to a poorer quality of life (r = 0.678; p = 0.230). There is no association between the number of ingested drugs and the xerostomia index (r = 0.144; p = 0.447). The most frequently measures used against dry mouth were drinking water (21 subjects) and sugarless candies (15 subjects). Conclusions Quality of life is not related to the number of remaining teeth nor the number of ingested drugs. However, a higher level of xerostomia was significantly associated with a poorer quality of life. There is no association between the number of drugs ingested and xerostomia index. Sugarless candies and drinking water are the more frequently used measures to alleviate dry mouth. Key words:Quality of life, oral health, elderly. PMID:27957276

  7. Health, Quality of Life and Population Density: A Preliminary Study on "Contextualized" Quality of Life

    ERIC Educational Resources Information Center

    Fassio, Omar; Rollero, Chiara; De Piccoli, Norma

    2013-01-01

    Quality of life concerns individual (physical and psychological health), interpersonal (social relationships) and contextual (environment) aspects, which are both subjective and objective. In considering contextual characteristics, empirical findings have demonstrated that people's relation to their living environment is a key issue for their…

  8. Assessing the Quality and Value of Psychological Health Care in Civilian Health Plans

    PubMed Central

    Martsolf, Grant R.; Osilla, Karen Chan; Mandel, Daniel; Hepner, Kimberly A.; Farmer, Carrie M.

    2016-01-01

    Abstract The Military Health System (MHS) strives to provide high-quality care and improve outcomes for individuals with psychological health conditions. Over the last decade, the MHS has provided care to a growing number of individuals with psychological health conditions, such as post-traumatic stress disorder (PTSD) and major depressive disorder (MDD). However, little is known about the extent to which the MHS delivers care that is consistent with evidence-based clinical practice guidelines or if it is achieving positive outcomes for its service members. To better understand these issues, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) asked the RAND Corporation to describe civilian health plansâ; approaches to systematically measuring the quality of psychological health care delivered by providers in their networks. This work was part of a larger effort by RAND to develop a framework and identify a set of measures for monitoring the quality of care provided by the MHS for psychological health conditions. PMID:28083426

  9. Air quality monitoring in NIS (SERBIA) and health impact assessment.

    PubMed

    Nikic, Dragana; Bogdanovic, Dragan; Nikolic, Maja; Stankovic, Aleksandra; Zivkovic, Nenad; Djordjevic, Amelija

    2009-11-01

    The aim of this study is to indicate the significance of air quality monitoring and to determine the air quality fields for the assessment of air pollution health effects, with special attention to risk population. Radial basis function network was used for air quality index mapping. Between 1991 and 2005, on the territory of Nis, several epidemiological studies were performed on risk groups (pre-school children, school children, pregnant women and persons older than 65). The total number of subjects was 5837. The exposed group comprised individuals living in the areas with unhealthy AQI, while the control group comprised individuals living in city areas with good or moderate AQI. It was determined that even relatively low levels of air pollution had impact on respiratory system and the occurrence of anaemia, allergy and skin symptoms.

  10. Improving Quality of Emergency Care Through Integration of Mental Health.

    PubMed

    Okafor, Martha; Wrenn, Glenda; Ede, Victor; Wilson, Nana; Custer, William; Risby, Emile; Claeys, Michael; Shelp, Frank E; Atallah, Hany; Mattox, Gail; Satcher, David

    2016-04-01

    The goal of this study was to better integrate emergency medical and psychiatric care at a large urban public hospital, identify impact on quality improvement metrics, and reduce healthcare cost. A psychiatric fast track service was implemented as a quality improvement initiative. Data on disposition from the emergency department from January 2011 to May 2012 for patients impacted by the pilot were analyzed. 4329 patients from January 2011 to August 2011 (pre-intervention) were compared with 4867 patients from September 2011 to May 2012 (intervention). There was a trend of decline on overall quality metrics of time to triage and time from disposition to discharge. The trend analysis of the psychiatric length of stay and use of restraints showed significant reductions. Integrated emergency care models are evidence-based approach to ensuring that patients with mental health needs receive proper and efficient treatment. Results suggest that this may also improve overall emergency department's throughput.

  11. Societal and ethical aspects of the Fukushima accident.

    PubMed

    Oughton, Deborah

    2016-10-01

    The Fukushima Nuclear Power Station accident in Japan in 2011 was a poignant reminder that radioactive contamination of the environment has consequences that encompass far more than health risks from exposure to radiation. Both the accident and remediation measures have resulted in serious societal impacts and raise questions about the ethical aspects of risk management. This article presents a brief review of some of these issues and compares similarities and differences with the lessons learned from the 1986 Chernobyl Nuclear Power Plant accident in Ukraine. Integr Environ Assess Manag 2016;12:651-653. © 2016 SETAC.

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

    PubMed

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

    2014-01-01

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

  13. Improving the quality of care for children in health systems.

    PubMed Central

    Homer, C J; Kleinman, L C; Goldman, D A

    1998-01-01

    OBJECTIVE: To summarize the state of the art in quality improvement, review its application to care for children, and define the information that will be needed so that care for children can be further improved. PRINCIPAL FINDINGS: Health services for children exhibit numerous deficiencies in quality of care. The deficiencies cross all major domains of pediatric care--preventive services, acute care, and chronic care--and provide the opportunity for creative application of improvement strategies with a potential to benefit the health and well-being of children. Approaches to quality improvement have changed over the past two decades from those emphasizing the inspection of structural aspects of care and the imposition of sanctions to more dynamic strategies that emphasize measurement and comparison to motivate change; the use of evidence to specify aims for improvement; and the adoption of a variety of management strategies adapted from business and the social sciences to achieve these aims. These modern approaches to quality improvement have rarely been subjected to rigorous testing of their effectiveness. Moreover, their application in pediatrics has been less widespread than in adult healthcare. For children, several aspects about health services, such as the relative rarity of chronic illness, the important effects of social factors on health, and the limited cost, make some of these approaches even more challenging and may require new approaches or meaningful modifications. RECOMMENDATIONS: Research to understand better the general process of improvement will benefit improvement efforts for children. Research that builds the base of knowledge about best practices for children--effectiveness research--will also result in an enhanced capacity for improvement of those systems that care for children's health. Quality of care for children would be enhanced by targeted research examining ways both to foster improvement across segments of society, and to make

  14. Health workers, quality of care, and child health: Simulating the relationships between increases in health staffing and child length

    PubMed Central

    Barber, Sarah L.; Gertler, Paul J.

    2010-01-01

    Objective One in three children globally is stunted in growth. Many of the conditions that promote child stunting are amenable to quality care provided by skilled health workers. Methods The study uses household and facility data from the Indonesian Family Life Surveys in 1993 and 1997. The first set of multivariate regression models evaluate whether the number of medical doctors (MDs), nurses, and midwives predict quality of care as measured by adherence to clinical guidelines. The second set explains the relationships between quality and length among children less than 36 months. Using the information generated from these two sets of regressions, we simulate the effect of increasing the number of MDs, nurses, and midwives on child length and stunting. Results Increases in the number of MDs and nurses predict increases in the quality of care. Higher quality care is associated with child length in centimeters and stunting. Simulations suggest that large health gains among children under 24 months of age result by placing MDs where none are available. Conclusions Improvements in child health could be made by increasing the number of qualified health staff. The returns to investing in improvements in human resources for health are high. PMID:19147250

  15. Minority Group Identification and Societal Integration.

    ERIC Educational Resources Information Center

    Noel, Donald L.

    Strong positive identification with a specific group is potentially both functional and dysfunctional for the solidarity of an encompassing larger social system. The impact of strong ethnic group identification upon societal integration is here explored by analyzing data obtained from 515 Negroes as part of the Cornell Studies in Intergroup…

  16. Atomoxetine's Effect on Societal Costs in Sweden

    ERIC Educational Resources Information Center

    Myren, Karl-Johan; Thernlund, Gunilla; Nylen, Asa; Schacht, Alexander; Svanborg, Par

    2010-01-01

    Objective: To compare societal costs between patients treated with atomoxetine and placebo in Sweden. Method: Ninety-nine pediatric ADHD patients were randomized to a 10-week double-blind treatment with atomoxetine (n = 49) or placebo (n = 50). All parents received four sessions of psycho-education. Parents filled out a resource utilization…

  17. Geospatial decision support systems for societal decision making

    USGS Publications Warehouse

    Bernknopf, R.L.

    2005-01-01

    While science provides reliable information to describe and understand the earth and its natural processes, it can contribute more. There are many important societal issues in which scientific information can play a critical role. Science can add greatly to policy and management decisions to minimize loss of life and property from natural and man-made disasters, to manage water, biological, energy, and mineral resources, and in general, to enhance and protect our quality of life. However, the link between science and decision-making is often complicated and imperfect. Technical language and methods surround scientific research and the dissemination of its results. Scientific investigations often are conducted under different conditions, with different spatial boundaries, and in different timeframes than those needed to support specific policy and societal decisions. Uncertainty is not uniformly reported in scientific investigations. If society does not know that data exist, what the data mean, where to use the data, or how to include uncertainty when a decision has to be made, then science gets left out -or misused- in a decision making process. This paper is about using Geospatial Decision Support Systems (GDSS) for quantitative policy analysis. Integrated natural -social science methods and tools in a Geographic Information System that respond to decision-making needs can be used to close the gap between science and society. The GDSS has been developed so that nonscientists can pose "what if" scenarios to evaluate hypothetical outcomes of policy and management choices. In this approach decision makers can evaluate the financial and geographic distribution of potential policy options and their societal implications. Actions, based on scientific information, can be taken to mitigate hazards, protect our air and water quality, preserve the planet's biodiversity, promote balanced land use planning, and judiciously exploit natural resources. Applications using the

  18. [Dentistry and supplementary health: regulatory framework, health promotion policies and quality of care].

    PubMed

    Garbin, Daniela; Mattevi, Gianina Salton; Carcereri, Daniela Lemos; Caetano, João Carlos

    2013-02-01

    Based on the regulatory framework and an overview of dentistry in supplementary health, this paper discusses the specifics of the dental sector with respect to health promotion policies and quality of health care services proposed by the National Supplementary Health Agency (ANS). The State's activities in supplementary health are based on law 9.656/98, which defines the relations between operators, products and their beneficiaries, and law 9.961/2000, which created the ANS. Concomitantly there was a great increase in dentistry in the private health plan market, because of changes in the practices of the profession. This required the need to know the logic of the organization of the services regarding the assistance provided and the model of care. The ANS develops measures to encourage operators to implement health promotion programs, striving for an integral care model. At the same time, it promotes the qualification policy of supplementary health care, with emphasis on the scope of care, though in dentistry the focus of evaluation is still individual and fragmented care. Indeed, the great challenge of dentistry is making it a public health policy, accessible to all, and the qualification of dental care in supplementary health.

  19. The economics of health care quality and medical errors.

    PubMed

    Andel, Charles; Davidow, Stephen L; Hollander, Mark; Moreno, David A

    2012-01-01

    Hospitals have been looking for ways to improve quality and operational efficiency and cut costs for nearly three decades, using a variety of quality improvement strategies. However, based on recent reports, approximately 200,000 Americans die from preventable medical errors including facility-acquired conditions and millions may experience errors. In 2008, medical errors cost the United States $19.5 billion. About 87 percent or $17 billion were directly associated with additional medical cost, including: ancillary services, prescription drug services, and inpatient and outpatient care, according to a study sponsored by the Society for Actuaries and conducted by Milliman in 2010. Additional costs of $1.4 billion were attributed to increased mortality rates with $1.1 billion or 10 million days of lost productivity from missed work based on short-term disability claims. The authors estimate that the economic impact is much higher, perhaps nearly $1 trillion annually when quality-adjusted life years (QALYs) are applied to those that die. Using the Institute of Medicine's (IOM) estimate of 98,000 deaths due to preventable medical errors annually in its 1998 report, To Err Is Human, and an average of ten lost years of life at $75,000 to $100,000 per year, there is a loss of $73.5 billion to $98 billion in QALYs for those deaths--conservatively. These numbers are much greater than those we cite from studies that explore the direct costs of medical errors. And if the estimate of a recent Health Affairs article is correct-preventable death being ten times the IOM estimate-the cost is $735 billion to $980 billion. Quality care is less expensive care. It is better, more efficient, and by definition, less wasteful. It is the right care, at the right time, every time. It should mean that far fewer patients are harmed or injured. Obviously, quality care is not being delivered consistently throughout U.S. hospitals. Whatever the measure, poor quality is costing payers and

  20. Leveraging Health-Related Quality of Life in Population Health Management: The Case for Healthy Days

    PubMed Central

    Slabaugh, S. Lane; Shah, Mona; Zack, Matthew; Cordier, Tristan; Havens, Eric; Davidson, Evan; Miao, Michael; Prewitt, Todd; Jia, Haomiao

    2017-01-01

    Abstract Measuring population health with morbidity and mortality data, often collected at the site of care, fails to capture the individual's perspective on health and well-being. Because health happens outside the walls of medical facilities, a holistic and singular measure of health that can easily be captured for an entire population could aid in understanding the well-being of communities. This paper postulates that Healthy Days, a health-related quality of life measure developed and validated by the Centers for Disease Control and Prevention, is an ideal survey instrument to advance population health. A systematic literature review was conducted and revealed a strong evidence base using Healthy Days with significant correlations to chronic disease conditions. Building on the literature base and experience, methods for analyzing Healthy Days data are discussed, including stratified sampling techniques, statistical measures to account for variance, and modeling techniques for skewed distributions. Using such analytic techniques, Healthy Days has been used extensively in national health surveillance. As the health care system faces increasing costs and constrained resources, the Healthy Days survey instrument can be used to inform public policies and allocate health service resources. Because Healthy Days captures broad dimensions of health from the individual's perspective, it is a simple way to holistically measure the health and well-being of a population and its trend over time. Expanded use of Healthy Days can aid population health managers and contribute to the understanding of the broader determinants of the nation's and individual community's health and aid in evaluating progress toward health goals. PMID:27031869

  1. Mitochondrial Protein Quality Control: The Mechanisms Guarding Mitochondrial Health

    PubMed Central

    Bohovych, Iryna; Chan, Sherine S.L.

    2015-01-01

    Abstract Significance: Mitochondria are complex dynamic organelles pivotal for cellular physiology and human health. Failure to maintain mitochondrial health leads to numerous maladies that include late-onset neurodegenerative diseases and cardiovascular disorders. Furthermore, a decline in mitochondrial health is prevalent with aging. A set of evolutionary conserved mechanisms known as mitochondrial quality control (MQC) is involved in recognition and correction of the mitochondrial proteome. Recent Advances: Here, we review current knowledge and latest developments in MQC. We particularly focus on the proteolytic aspect of MQC and its impact on health and aging. Critical Issues: While our knowledge about MQC is steadily growing, critical gaps remain in the mechanistic understanding of how MQC modules sense damage and preserve mitochondrial welfare, particularly in higher organisms. Future Directions: Delineating how coordinated action of the MQC modules orchestrates physiological responses on both organellar and cellular levels will further elucidate the current picture of MQC's role and function in health, cellular stress, and degenerative diseases. Antioxid. Redox Signal. 22, 977–994. PMID:25546710

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

    PubMed Central

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

    1992-01-01

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

  3. The Water Quality in Rio Highlights the Global Public Health ...

    EPA Pesticide Factsheets

    Water quality issues in Rio have been widely publicized because of the 2016 Olympics. Recent concerns about polluted waters that athletes may be exposed to highlights the conditions that more than a billion people globally are exposed to daily. Despite these unhealthy conditions, much is unknown about the risks and exposure pathways associated with bathing in or drinking untreated or partially treated sewage. Beyond acute illness, we are learning more about the chronic sequelae that arise from repeated exposure to pathogens found in sewage. Additionally, we do not know enough about how to measure water quality, especially in developing countries. A consequence of these knowledge gaps is that data from developed countries are used to guide public health approaches in low· and middle-income settings. More data that are locally specific are needed to inform guidelines for improving sanitation and water quality in Rio and other cities in developing countries. Recent media reports of high levels of sewage contamination have caused wide-ranging concerns about the safety of sailing, rowing, and other open water events at the upcoming Olympics. This commentary discusses the global public health problem of exposures to untreated sewage and describes the need for context specific solutions to monitoring and communication and risk assessment.

  4. Technical Limitations of Electronic Health Records in Community Health Centers: Implications on Ambulatory Care Quality

    ERIC Educational Resources Information Center

    West, Christopher E.

    2010-01-01

    Research objectives: This dissertation examines the state of development of each of the eight core electronic health record (EHR) functionalities as described by the IOM and describes how the current state of these functionalities limit quality improvement efforts in ambulatory care settings. There is a great deal of literature describing both the…

  5. Integrating health promotion with quality improvement in a Swedish hospital.

    PubMed

    Astnell, Sandra; von Thiele Schwarz, Ulrica; Hasson, Henna; Augustsson, Hanna; Stenfors-Hayes, Terese

    2016-09-01

    Integration of workplace employee health promotion (HP) and occupational health and safety (OHS) work into organizational quality improvement systems is suggested as a way to strengthen HP and OHS activities in an organization. The aim of this article was to study what consequences integration of HP, OHS and a quality improvement system called kaizen has on the frequency and type of HP and OHS activities. A quasi-experimental study design was used where an integration of the three systems for HP, OHS respectively kaizen, was performed at six intervention units at a Swedish hospital. The remaining six units served as controls. Document analysis of all employees' written improvement suggestions (kaizen notes) during 2013 was conducted. The findings show that the intervention group had more suggestions concerning HP and OHS (n = 114) when compared with the control group (n = 78) and a greater variety of HP and OHS suggestions. In addition, only the intervention group had included HP aspects. In both groups, most kaizen notes with health consideration had a preventive focus rather than rehabilitative. The intervention, i.e. the integration of HP, OHS and kaizen work, had a favourable effect on HP and OHS work when compared with the controls. The results of the study support that this system can work in practice at hospitals.

  6. Quality and Safety in Health Care, Part I: Five Pioneers in Quality.

    PubMed

    Harolds, Jay

    2015-08-01

    Five pioneers had a huge impact on the quality movement in health care in the United States. Ernest Codman contributed in many ways, including his focus on outcome analysis. Avidis Donabedian is known for his focus on the 3 domains of structure, process, and outcome in health care. Walter Shewhart is known especially for the control chart and early work on what W. Edwards Deming made into the PDSA cycle. Deming is also known for other contributions, including his 14 points of management, correcting system problems rather than blaming the workers, and his System of Profound Knowledge. Juran is known for the Pareto principle and his emphasis on customer satisfaction and addressing the human, not just statistical side, of quality improvement.

  7. The health mediators-qualified interpreters contributing to health care quality among Romanian Roma patients.

    PubMed

    Roman, Gabriel; Gramma, Rodica; Enache, Angela; Pârvu, Andrada; Moisa, Ştefana Maria; Dumitraş, Silvia; Ioan, Beatrice

    2013-11-01

    In order to assure optimal care of patients with chronic illnesses, it is necessary to take into account the cultural factors that may influence health-related behaviors, health practices, and health-seeking behavior. Despite the increasing number of Romanian Roma, research regarding their beliefs and practices related to healthcare is rather poor. The aim of this paper is to present empirical evidence of specificities in the practice of healthcare among Romanian Roma patients and their caregivers. Using a qualitative exploratory descriptive design, this study is based on data gathered through three focus groups with 30 health mediators in the counties of Iasi and Cluj (Romania). We identified various barriers to access to healthcare for Roma patients: lack of financial resources and health insurance coverage, lack of cognitive resources or lack of personal hygiene, but also important cultural issues, such as the shame of being ill, family function, disclosure of disease-related information, patient's autonomy, attitudes towards illness and health practices, that should be considered in order to create a culturally sensitive environment in Romanian medical facilities:… The role of the health mediators within the context of cultural diversity is also discussed, as cultural brokers contributing to health care quality among Romanian Roma patients Bridging cultural differences may improve patient-healthcare provider relationships, but may have limited impact in reducing ethnic disparities, unless coupled with efforts of Roma communities to get involved in creating and implementing health policies.

  8. Functional health outcomes as a measure of health care quality for Medicare beneficiaries.

    PubMed Central

    Bierman, A S; Lawrence, W F; Haffer, S C; Clancy, C M

    2001-01-01

    OBJECTIVE: the Medicare Health Outcomes Survey (HOS), a new quality measure in the Health Plan Employer Data and Information Set, is designed to assess physical and mental functional health outcomes of Medicare beneficiaries enrolled in Medicare+Choice organizations. We discuss the rationale for the HOS measure together with methodologic challenges in its use and interpretation, using descriptive data from the baseline Medicare HOS to illustrate some of these challenges. DATA SOURCES/STUDY DESIGN: The 1999 Cohort 2 Medicare HOS baseline data were used for a cross-sectional descriptive analysis. A random sample of 1,000 beneficiaries from each health plan with a Medicare+Choice contract was surveyed (N = 156,842; 282 organizations included in these analyses) . PRINCIPAL FINDINGS: The HOS measure is designed to assess a previously unmeasured dimension of quality. Plan-level variation was seen across all baseline measures of sociodemographic characteristics and illness burden. At the individual level socioeconomic position as measured by educational attainment was strongly associated with functional status. The least educated beneficiaries had the highest burden of illness on all measures examined, and there was a consistent and significant gradient in health and functional status across all levels of education. In analyses stratified by race and ethnicity, socioeconomic gradients in f un ct ion persist ed. CONCLUSIONS Despite limitations, by focusing at t en t ion on the need to improve functional health out comes among elderly Medicare beneficiaries enrolled in Medicare+Choice, the HOS can serve as an important new tool to support efforts to improve health care quality. The HOS provides valuable information at the federal, state, and health plan levels that can be used to identify, prioritize, and evaluate quality improvement interventions and monitor progress for the program overall as well as for vulnerable subgroups. To interpret the HOS as a quality measure

  9. [A quality evaluation tableau for health institutions: an educational tool].

    PubMed

    Moll, Marie Christine; Decavel, Frédérique; Merlet, Christine

    2009-09-01

    For a few years, health institutions have had to comply with the certification and the need to establish the new governance. Thanks to the accreditation version 2 (obtained in 2005), the elaboration of the hospital project (adopted in October, 2006) and the organization in poles since 2006, the quality oriented management became a priority axis at the University Hospital of Angers. The strategic adaptation to quality requirements leads to develop the hospital management, more especially at the level of the clinical, medico technical and administrative poles. The elements of the hospital project including the part about the quality, risk and evaluation aim at being adapted by every pole according to the level of its project. This adaptation which is imposed to each pole manager requires a practical and educational accompaniment allowing at the same time to realize a diagnosis of the progress of the quality approach, a measure of the impact of the global impregnation within the institution and a comparison between pole. A eight axis dashboard with criteria and a user guide were developed from certification ISO 9001, the EFQM manual and the certification manual version 2 of the Healthcare High Authorities. The criteria are transcribed in an EXCEL grid ready to use. Succeeding in estimating your own quality system means that you demonstrate the maturity of the quality approach. The results of this evaluation confirmed those of the certification. The dashboard is a management structuring tool at the service of the multidisciplinary team. Two considerations emerge from these results: First of all, for the hospital top management, the axes to be improved emerge as a priority to determine and target the next annual action plans. The results also allow to support the auto evaluation for the certification version 2010 planned in January of the same year. It is a pragmatic tool which allows auto evaluation and comparison to estimate the pole performances. It is a strategic

  10. How to evaluate the quality of health related websites.

    PubMed

    Gattoni, Filippo; Sicola, Chiara

    2005-03-01

    To establish reliable quality criteria for medical websites is of foremost importance in relation to the increasing number of Internet users, both health professionals and lay people, searching for medical information in the mass of these sites. Quality in general refers to a set of features that distinguish one person or thing from others of the same type. The quality of a website is usually related to its content and usability. The first criteria we considered are contents and readability, which must be targeted to the intended type of user. Other important criteria include: transparency, consistency, honesty, references to sources, accountability, respect of privacy, currency of content material, responsibility, and accessibility. Technical criteria are the use of consolidated and standard technologies, soft colours, short page download time. Good medical websites should also follow the suggestions of organizations such as the World Health Organization, the Food and Drug Administration, the European Communities. Another organization, Health On Net Foundation, has issued some guidelines for medical websites, summarized in eight points, fundamental to assign real scientific value to a site. We believe, in agreement with the literature, that it is unnecessary to apply strict rules to medical website developers. We want to stress the importance of guidelines and recommendations to be modified with the development of web technology and the cultural evolution of patient and physicians. In the near future the presence on the Internet of websites certified by national or international medical web authorities will lead users to trust and give their preference to such sites, leading to the self-regulation of website developers and users.

  11. Canadian soil quality guidelines for copper: Environmental and human health

    SciTech Connect

    1997-12-31

    This report begins with background information on the physical and chemical properties of copper, the production and use of copper in Canada, its levels in the Canadian environment, and existing guidelines and criteria regarding copper concentrations in various media. It then reviews the environmental fate and behaviour of copper, notably in the soil; the behavior and effects of copper in biota, including soil microbial processes, terrestrial plants and invertebrates, livestock and wildlife, and bioaccumulation; and the pharmacokinetics and toxicology of copper in mammals and humans, concluding with an overall toxicological evaluation and human exposure estimates. This information is used to derive environmental and human health soil quality guidelines for copper to protect environmental and human health receptors, for agricultural, residential/parkland, commercial, and industrial land uses.

  12. Perceptions of Local Health Care Quality in 7 Rural Communities with Telemedicine

    ERIC Educational Resources Information Center

    Nesbitt, Thomas S.; Marcin, James P.; Daschbach, Martha M.; Cole, Stacey L.

    2005-01-01

    Rural health services are difficult to maintain because of low patient volumes, limited numbers of providers, and unfavorable economies of scale. Rural patients may perceive poor quality in local health care, directly impacting the sustainability of local health care services. This study examines perceptions of local health care quality in 7…

  13. 77 FR 50692 - Request for Information on Quality Measurement Enabled by Health IT-Extension Date for Responses

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-22

    ... Enabled by Health IT--Extension Date for Responses AGENCY: Agency for Healthcare Research and Quality... diversified stakeholders (health information technology (IT) system developers, including vendors; payers... strategies and challenges regarding quality measurement enabled by health IT. Quality...

  14. Water quality associated public health risk in Bo, Sierra Leone.

    PubMed

    Jimmy, David H; Sundufu, Abu J; Malanoski, Anthony P; Jacobsen, Kathryn H; Ansumana, Rashid; Leski, Tomasz A; Bangura, Umaru; Bockarie, Alfred S; Tejan, Edries; Lin, Baochuan; Stenger, David A

    2013-01-01

    Human health depends on reliable access to safe drinking water, but in many developing countries only a limited number of wells and boreholes are available. Many of these water resources are contaminated with biological or chemical pollutants. The goal of this study was to examine water access and quality in urban Bo, Sierra Leone. A health census and community mapping project in one neighborhood in Bo identified the 36 water sources used by the community. A water sample was taken from each water source and tested for a variety of microbiological and physicochemical substances. Only 38.9% of the water sources met World Health Organization (WHO) microbial safety requirements based on fecal coliform levels. Physiochemical analysis indicated that the majority (91.7%) of the water sources met the requirements set by the WHO. In combination, 25% of these water resources met safe drinking water criteria. No variables associated with wells were statistically significant predictors of contamination. This study indicated that fecal contamination is the greatest health risk associated with drinking water. There is a need to raise hygiene awareness and implement inexpensive methods to reduce fecal contamination and improve drinking water safety in Bo, Sierra Leone.

  15. 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.

  16. The societal cost of Taenia solium cysticercosis in Tanzania.

    PubMed

    Trevisan, Chiara; Devleesschauwer, Brecht; Schmidt, Veronika; Winkler, Andrea Sylvia; Harrison, Wendy; Johansen, Maria Vang

    2017-01-01

    Taenia solium is a zoonotic parasite prevalent in many low income countries throughout Latin America, Asia and sub-Saharan Africa, including Tanzania. The parasite is recognized as a public health threat; however the burden it poses on populations of Tanzania is unknown. The aim of this study was to estimate the societal cost of T. solium cysticercosis in Tanzania, by assessing both the health and economic burden. The societal cost of T. solium cysticercosis was assessed in humans and pigs based on data obtained by a systematic review. Experts' opinion was sought in cases where data were not retrievable. The health burden was assessed in terms of annual number of neurocysticercosis (NCC) associated epilepsy incident cases, deaths and disability-adjusted life years (DALYs), while the economic burden was assessed in terms of direct and indirect costs imposed by NCC-associated epilepsy and potential losses due to porcine cysticercosis. Based on data retrieved from the systematic review and burden assessments, T. solium cysticercosis contributed to a significant societal cost for the population. The annual number of NCC-associated epilepsy incident cases and deaths were 17,853 (95% Uncertainty Interval (UI), 5666-36,227) and 212 (95% UI, 37-612), respectively. More than 11% (95% UI, 6.3-17) of the pig population was infected with the parasite when using tongue examination as diagnostic method. For the year 2012 the number of DALYs per thousand person-years for NCC-associated epilepsy was 0.7 (95% UI, 0.2-1.6). Around 5 million USD (95% UI, 797,535-16,933,477) were spent due to NCC-associated epilepsy and nearly 3 million USD (95% UI, 1,095,960-5,366,038) were potentially lost due to porcine cysticercosis. Our results show that T. solium imposes a serious public health, agricultural and economic threat for Tanzania. We urge that a One Health approach, which involves the joint collaboration and effort of veterinarians, medical doctors, agricultural extension officers

  17. Does maternal oral health predict child oral health-related quality of life in adulthood?

    PubMed Central

    2011-01-01

    Background A parental/family history of poor oral health may influence the oral-health-related quality of life (OHRQOL) of adults. Objectives To determine whether the oral health of mothers of young children can predict the OHRQOL of those same children when they reach adulthood. Methods Oral examination and interview data from the Dunedin Study's age-32 assessment, as well as maternal self-rated oral health data from the age-5 assessment were used. The main outcome measure was study members' short-form Oral Health Impact Profile (OHIP-14) at age 32. Analyses involved 827 individuals (81.5% of the surviving cohort) dentally examined at both ages, who also completed the OHIP-14 questionnaire at age 32, and whose mothers were interviewed at the age-5 assessment. Results There was a consistent gradient of relative risk across the categories of maternal self-rated oral health status at the age-5 assessment for having one or more impacts in the overall OHIP-14 scale, whereby risk was greatest among the study members whose mothers rated their oral health as "poor/edentulous", and lowest among those with an "excellent/fairly good" rating. In addition, there was a gradient in the age-32 mean OHIP-14 score, and in the mean number of OHIP-14 impacts at age 32 across the categories of maternal self-rated oral health status. The higher risk of having one or more impacts in the psychological discomfort subscale, when mother rated her oral health as "poor/edentulous", was statistically significant. Conclusions These data suggest that maternal self-rated oral health when a child is young has a bearing on that child's OHRQOL almost three decades later. The adult offspring of mothers with poor self-rated oral health had poorer OHRQOL outcomes, particularly in the psychological discomfort subscale. PMID:21736754

  18. Dietary phosphorus in bone health and quality of life.

    PubMed

    Takeda, Eiji; Yamamoto, Hironori; Yamanaka-Okumura, Hisami; Taketani, Yutaka

    2012-06-01

    Awareness of phosphorus intake is important because both phosphorus deficiency and overloading impair bone health and quality of life. Phosphorus consumption is increasing in many countries. Most dietary phosphorus is contained in protein-rich foods such as meat, milk, cheese, poultry, fish, and processed foods that contain phosphate-based additives to improve their consistency and appearance. Elevation of extracellular phosphorus levels causes endothelial dysfunction and medial calcification, which are closely associated with the development of cardiovascular disease (CVD). Long-term excessive phosphorus loading, even if it does not cause hyperphosphatemia, can be a risk factor for CVD. In epidemiological studies, higher levels of phosphorus intake have been associated with reduced blood pressure. Interestingly, when examined further, phosphorus from dairy products, but not from other sources, was usually associated with lower blood pressure. A dietary approach to phosphorus reduction is particularly important to prevent bone impairment and CVD in patients with chronic kidney disease. In order to improve bone health and quality of life in the general population, the impact of phosphorous, including in processed foods, should be considered, and measures to indicate the amount of phosphorous in food products should be implemented.

  19. Health-related quality of life in clinical practice.

    PubMed

    1999-12-01

    This month's question addressed something that many of us perhaps still have not formally incorporated into clinical practice, although we all are interested in our patients' health-related quality of life and want our inventions to result in improvements within this area. This view is exemplified by the response from Australia, which is one of several similar, unpublished, replies from the International Panel on this month's question (others came from Germany and Sweden). As mentioned in the introduction, health-related quality of life is becoming increasingly important as an outcome measure in clinical trials of new therapeutic interventions and several new measures have been and are developed. It is interesting and encouraging to hear about the new developments within this area that are being made by neuroscience nurses in different countries and within different subspecialties around the globe. As reported from the International Panel in here, new HRQL measures are currently developed in Canada and the UK focusing on patients with brains injuries and Huntington's disease (HD), respectively. In contrast to most established measures, the Canadian study has primarily been aimed at the positive aspects of life and not merely absence of the negative ones. Steve Smith in the UK has recently started developing a scale for use in clinical management of patients with HD. As far as I have been able to determine, this is the first measure of this kind to be developed for HD. Anyone who would like to know more about Steve's work or take part thereof is encouraged to contact him at this address above. Despite the fact that there already are several HRQL measures available, there is still a need for new instruments reflecting new aspects of health and disease. In addition, tools need to be designed for challenging conditions not readily addressed by existing measures. The replies from Canada and the UK represent these needs. It will be very interesting to eventually take

  20. Deciphering the imperative: translating public health quality improvement into organizational performance management gains.

    PubMed

    Beitsch, Leslie M; Yeager, Valerie A; Moran, John

    2015-03-18

    With the launching of the national public health accreditation program under the auspices of the Public Health Accreditation Board (PHAB), health department momentum around quality improvement adoption has accelerated. Domain 9 of the PHAB standards (one of 12 domains) focuses on evaluation and improvement of performance and is acting as a strong driver for quality improvement and performance management implementation within health departments. Widespread adoption of quality improvement activities in public health trails that in other US sectors. Several performance management models have received broad acceptance, including models among government and nonprofits. A model specifically for public health has been developed and is presented herein. All models in current use reinforce customer focus; streamlined, value-added processes; and strategic alignment. All are structured to steer quality improvement efforts toward organizational priorities, ensuring that quality improvement complements performance management. High-performing health departments harness the synergy of quality improvement and performance management, providing powerful tools to achieve public health strategic imperatives.

  1. Societal Literacy and the Status of the Aged.

    ERIC Educational Resources Information Center

    Lee, Gary R.; Kezis, Mindy

    1980-01-01

    The relationship of status of the aged to societal literacy in a sample of 122 cultures appears spurious because of effects of variables indexing societal complexity. Conclusions are: societal literacy has no independent effect on status of the aged; and the overall relationship between the two appears curvilinear. (Author)

  2. Health-Related Quality of Life and Appropriateness of Cholecystectomy

    PubMed Central

    Quintana, José Ma; Cabriada, Jose; Aróstegui, Inmaculada; Oribe, Victor; Perdigo, Luis; Varona, Mercedes; Bilbao, Amaia

    2005-01-01

    Ojbective: To evaluate the relationship among appropriateness of the use of cholecystectomy and outcomes. Summary Background Data: The use of cholecystectomy varies widely across regions and countries. Explicit appropriateness criteria may help identify suitable candidates for this commonly performed procedure. This study evaluates the relationship among appropriateness of the use of cholecystectomy and outcomes. Methods: Prospective observational study in 6 public hospitals in Spain of all consecutive patients on waiting lists to undergo cholecystectomy for nonmalignant disease. Explicit appropriateness criteria for the use of cholecystectomy were developed by a panel of experts using the RAND appropriateness methodology and applied to recruited patients. Patients were asked to complete 2 questionnaires that measure health-related quality of life—the Short Form 36 (SF-36) and the Gastrointestinal Quality of Life Index (GIQLI)—before the intervention and 3 months after it. Results: Patients judged as being appropriate candidates for cholecystectomy, using the panel's explicit appropriateness criteria, had greater improvements in the bodily pain, vitality, and social function domains of the SF-36 than those judged to be inappropriate candidates. They also demonstrated improvements in the GIQLI's physical impairment domain. Interventions judged as inappropriate were performed primarily among patients without symptoms of cholelithiasis. Those asymptomatic had a lower improvement in the bodily pain, social functioning, and physical summary scale of the SF-36 and in the symptomatology, physical impairment, and total score domains of the GIQLI. Conclusions: These results suggest a direct relationship between the application of explicit appropriateness criteria and better outcomes, as measured by health-related quality of life. They also indicate that patients without symptoms are not good candidates for cholecystectomy. PMID:15621998

  3. [Health-related quality of life in Parkinson's disease].

    PubMed

    Cano-de la Cuerda, Roberto; Vela-Desojo, Lydia; Miangolarra-Page, Juan C; Macías-Macías, Yolanda; Muñoz-Hellin, Elena

    2010-01-01

    Parkinson's disease is a disabling and progressive neurological condition characterized by multiple motor and non motor symptoms that contribute to deterioration in quality of life. The diversity of symptoms associated with the disease and its management affect the patients on their physical, social and mental quality of life. The aim of this study was to identify key dimensions of health related quality of life (HRQOL) in a population affected with Parkinson's disease with a degree of mild-moderate impairment. Thirty six patients with Parkinson were recruited. The Hoehn and Yarh scale, the Unified Parkinson's Disease Rate Scale, the scale of activities of daily life and Schwab & England Get Up & Go Test were applied. HRQOL was assessed with the EuroQol-5D and the specific questionnaire Parkinson's Disease Questionnaire-39 items. The dimensions of the PDQ-39, except the PDQ-39 Pain domain and the EuroQol-5D correlated significantly with the severity of the disease. HRQOL was correlated with the functional status of patients. Only the PDQ-39 pain domain correlated with the risk of falls. Our results suggest that the HRQOL of patients with PD, in a state of mild-moderate impairment, is strongly influenced by disease severity and functional status.

  4. Intensive Hemodialysis and Health-Related Quality of Life.

    PubMed

    Kraus, Michael A; Fluck, Richard J; Weinhandl, Eric D; Kansal, Sheru; Copland, Michael; Komenda, Paul; Finkelstein, Fredric O

    2016-11-01

    Diminished health-related quality of life (HRQoL) is common in dialysis patients and associated with increased risks for morbidity and mortality. Patients may present limitations in both physical and mental HRQoL. Poor physical HRQoL may be defined by limited physical function, role limitations due to physical health, dissatisfaction with physical ability, and impaired mobility. Sleep disorders such as obstructive sleep apnea, restless legs, and fatigue are typical manifestations of poor physical HRQoL in dialysis patients. Poor mental HRQoL may be defined by depressive thinking, lack of positive affect, anxiety, and feelings of social isolation. The prevalence of depression is high in dialysis patients. Intensive hemodialysis (HD) can positively address HRQoL. In 3 randomized clinical trials, relative to conventional HD, intensive HD increased physical and mental component summary scores from the 36-Item Short-Form Health Survey (SF-36), although individual treatment effects of daily nocturnal HD were not statistically significant. In another large prospective study, initiation of short daily HD therapy was followed after 12 months by improvements in all SF-36 domains, sleep quality, and restless legs symptoms. In a small study of nocturnal HD, apnea and hypopnea episodes per hour decreased by almost 70% after conversion from conventional HD. Intensive HD is also associated with a large reduction in postdialysis recovery time. In contrast, 2 randomized clinical trials failed to demonstrate statistically significant effects of intensive HD on the Beck Depression Inventory score despite a significant decrease in Beck Depression Inventory score in the prospective study of short daily HD. Furthermore, intensive HD may not improve objective physical performance and can increase burden on caregivers in the home setting. In conclusion, intensive HD potentially can address both physical and mental aspects of poor HRQoL relative to conventional HD. However, more studies

  5. Amiata Donkey Milk Chain: Animal Health Evaluation and Milk Quality

    PubMed Central

    Ragona, Giuseppe; Corrias, Franco; Benedetti, Martina; Paladini, Maria; Salari, Federica; Altomonte, lolanda; Martini, Mina

    2016-01-01

    This study presents an investigation of Amiata donkey health and quality of milk for human consumption. Thirty-one lactating dairy jennies were examined. The following samples were collected: faecal samples from the rectum of animals for parasitological examination; cervical swabs for the detection of bacteria causing reproductive disorders; and blood samples for serological diagnosis of main zoonotic (Brucella spp., Leptospira spp.) and donkey abortion agents (Brucella spp., Leptospira spp., Salmonella abortus equi, Equine viral arterithis virus, Equine herpesvirus type 1). In addition, individual milk samples were collected and analysed for mastitis-causing pathogens and milk quality. Regarding animal health, we detected a high prevalence of strongyle parasites in donkeys. It is very important to tackle parasitic diseases correctly. Selective control programmes are preferable in order to reduce anthelmintic drug use. For dairy donkeys, withdrawal periods from anthelmintic drugs need to be carefully managed, in accordance with EU and national regulations. The isolation of Staphylococcus aureus in milk highlights the importance of preventing contamination during milking, by adopting appropriate hygiene and safety practices at a farm level. Lysozyme activity was high compared to cow’s milk, contributing to the inhibitory activity against certain bacteria. Donkey milk was characterised by high lactose content, low caseins, low fat, higher levels of unsaturated fatty acids compared to ruminant milks. Unsaturated fatty acids and omega 3 fatty acids in particular have become known for their beneficial health effect, which is favourable for human diet. These characteristics make it suitable for infants and children affected by food intolerance/allergies to bovine milk proteins and multiple food allergies as well as for adults with dyslipidemias. It is also recommended to prevent cardiovascular diseases. PMID:27853717

  6. Client satisfaction and quality of health care in rural Bangladesh.

    PubMed Central

    Mendoza Aldana, J.; Piechulek, H.; al-Sabir, A.

    2001-01-01

    OBJECTIVE: To assess user expectations and degree of client satisfaction and quality of health care provided in rural Bangladesh. METHODS: A total of 1913 persons chosen by systematic random sampling were successfully interviewed immediately after having received care in government health facilities. FINDINGS: The most powerful predictor for client satisfaction with the government services was provider behaviour, especially respect and politeness. For patients this aspect was much more important than the technical competence of the provider. Furthermore, a reduction in waiting time (on average to 30 min) was more important to clients than a prolongation of the quite short (from a medical standpoint) consultation time (on average 2 min, 22 sec), with 75% of clients being satisfied. Waiting time, which was about double at outreach services than that at fixed services, was the only element with which users of outreach services were dissatisfied. CONCLUSIONS: This study underscores that client satisfaction is determined by the cultural background of the people. It shows the dilemma that, though optimally care should be capable of meeting both medical and psychosocial needs, in reality care that meets all medical needs may fail to meet the client's emotional or social needs. Conversely, care that meets psychosocial needs may leave the clients medically at risk. It seems important that developing countries promoting client-oriented health services should carry out more in-depth research on the determinants of client satisfaction in the respective culture. PMID:11436472

  7. Health-related quality of life in emphysema.

    PubMed

    Kaplan, Robert M; Ries, Andrew L

    2008-05-01

    Patients with emphysema may experience reduced health-related quality of life (HRQOL). HRQOL measures have evolved from two different measurement traditions: psychometric theory and decision theory. Psychometric methods typically create a profile of outcomes, whereas decision theory methods offer a summary score on a continuum ranging from 0.0 (for death or worst possible health) to 1.0 (for best possible health). Decision theory methods are better suited for cost-effectiveness studies. Generic HRQOL measures can be applied to any disease population, whereas disease-targeted measures are tailored to a specific clinical condition. Disease-targeted measures are typically more sensitive to clinical change, but cannot offer a comparison basis for different clinical conditions. This article reviews the measurement of HRQOL in patients with emphysema. The National Emphysema Treatment Trial (NETT) offers an example of the application of both generic and disease-targeted, as well as profile and decision theory, methods. The NETT illustrates how HRQOL measures can be used to assess outcomes and estimate cost-effectiveness in a major clinical trial.

  8. Cost-Effectiveness of Treatments for Relapsing Remitting Multiple Sclerosis: A French Societal Perspective

    PubMed Central

    Chevalier, Julie; Chamoux, Catherine; Hammès, Florence; Chicoye, Annie

    2016-01-01

    Objectives The paper aimed to estimate the incremental cost-effectiveness ratio (ICER) at the public published price for delayed-release dimethyl fumarate versus relevant Multiple Sclerosis disease-modifying therapies available in France in June 2015. Methods The economic model was adapted to the French setting in accordance with the Haute Autorité de Santé guidelines using a model previously developed for NICE. A cohort of Relapsing Remitting Multiple Sclerosis patients was simulated over a 30-year time horizon. Twenty one health states were taken into account: Kurtzke Expanded Disability Status Scale (EDSS) 0–9 for Relapsing Remitting Multiple Sclerosis patients, EDSS 0–9 for Secondary Progressive Multiple Sclerosis patients, and death. Estimates of relative treatment efficacy were determined using a mixed-treatment comparison. Probabilities of events were derived from the dimethyl fumarate pivotal clinical trials and the London Ontario Dataset. Costs and utilities were extracted from the published literature from both the payer and societal perspectives. Univariate and probabilistic sensitivity analyses were performed to assess the robustness of the model results. Results From both perspectives, dimethyl fumarate and interferon beta-1a (IFN beta-1a) 44mcg were the two optimal treatments, as the other treatments (IFN beta-1a 30mcg, IFN beta-1b 250mcg, teriflunomide, glatiramer acetate, fingolimod) were dominated on the efficiency frontier. From the societal perspective, dimethyl fumarate versus IFN beta-1a 44mcg incurred an incremental cost of €3,684 and an incremental quality-adjusted life year (QALY) of 0.281, corresponding to an ICER of €13,110/QALY. Conclusions Despite no reference threshold for France, dimethyl fumarate can be considered as a cost-effective option as it is on the efficiency frontier. PMID:26987055

  9. Optimism and diet quality in the Women's Health Initiative.

    PubMed

    Hingle, Melanie D; Wertheim, Betsy C; Tindle, Hilary A; Tinker, Lesley; Seguin, Rebecca A; Rosal, Milagros C; Thomson, Cynthia A

    2014-07-01

    Diet quality has not been well studied in relation to positive psychological traits. Our purpose was to investigate the relationship between optimism and diet quality in postmenopausal women enrolled in the Women's Health Initiative observational study (OS) and clinical trials (CTs), and to determine whether optimism was associated with diet change after a 1-year dietary intervention. Diet quality was scored with the Alternate Healthy Eating Index (AHEI) and optimism assessed with the Life Orientation Test-Revised. Baseline characteristics were compared across AHEI quintiles or optimism tertiles using regression models with each variable of interest as a function of quintiles or tertiles (OS, n=87,630; CT, n=65,360). Association between optimism and baseline AHEI and change in AHEI over 1 year were tested using multivariate linear regression (CT, n=13,645). Potential interaction between optimism and trial arm and demographic/lifestyle factors on AHEI change was tested using likelihood ratio test (CT intervention, n=13,645; CT control, n=20,242). Women reporting high AHEI were non-Hispanic white, educated, physically active, past or never smokers, hormone therapy users, had lower body mass index and waist circumference, and were less likely to have chronic conditions. In the CT intervention, higher optimism was associated with higher AHEI at baseline and with greater change over 1 year (P=0.001). Effect modification by intervention status was observed (P=0.014), whereas control participants with highest optimism achieved threefold greater AHEI increase compared with those with the lowest optimism. These data support a relationship between optimism and dietary quality score in postmenopausal women at baseline and over 1 year.

  10. Western Mineral and Environmental Resources Science Center--providing comprehensive earth science for complex societal issues

    USGS Publications Warehouse

    Frank, David G.; Wallace, Alan R.; Schneider, Jill L.

    2010-01-01

    Minerals in the environment and products manufactured from mineral materials are all around us and we use and come into contact with them every day. They impact our way of life and the health of all that lives. Minerals are critical to the Nation's economy and knowing where future mineral resources will come from is important for sustaining the Nation's economy and national security. The U.S. Geological Survey (USGS) Mineral Resources Program (MRP) provides scientific information for objective resource assessments and unbiased research results on mineral resource potential, production and consumption statistics, as well as environmental consequences of mining. The MRP conducts this research to provide information needed for land planners and decisionmakers about where mineral commodities are known and suspected in the earth's crust and about the environmental consequences of extracting those commodities. As part of the MRP scientists of the Western Mineral and Environmental Resources Science Center (WMERSC or 'Center' herein) coordinate the development of national, geologic, geochemical, geophysical, and mineral-resource databases and the migration of existing databases to standard models and formats that are available to both internal and external users. The unique expertise developed by Center scientists over many decades in response to mineral-resource-related issues is now in great demand to support applications such as public health research and remediation of environmental hazards that result from mining and mining-related activities. Western Mineral and Environmental Resources Science Center Results of WMERSC research provide timely and unbiased analyses of minerals and inorganic materials to (1) improve stewardship of public lands and resources; (2) support national and international economic and security policies; (3) sustain prosperity and improve our quality of life; and (4) protect and improve public health, safety, and environmental quality. The MRP

  11. mHealth Quality: A Process to Seal the Qualified Mobile Health Apps.

    PubMed

    Yasini, Mobin; Beranger, Jérôme; Desmarais, Pierre; Perez, Lucas; Marchand, Guillaume

    2016-01-01

    A large number of mobile health applications (apps) are currently available with a variety of functionalities. The user ratings in the app stores seem not to be reliable to determine the quality of the apps. The traditional methods of evaluation are not suitable for fast paced nature of mobile technology. In this study, we propose a collaborative multidimensional scale to assess the quality of mHealth apps. During our process, the app quality is assessed in various aspects including medical reliability, legal consistency, ethical consistency, usability aspects, personal data privacy and IT security. A hypothetico-deductive approach was used in various working groups to define the audit criteria based on the various use cases that an app could provide. These criteria were then implemented into a web based self-administered questionnaires and the generation of automatic reports were considered. This method is on the one hand specific to each app because it allows to assess each health app according to its offered functionalities. On the other hand, this method is automatic, transferable to all apps and adapted to the dynamic nature of mobile technology.

  12. Social and economic costs and health-related quality of life in stroke survivors in the Canary Islands, Spain

    PubMed Central

    2012-01-01

    Background Cost-of-illness analysis is the main method of providing an overall vision of the economic impact of a disease. Such studies have been used to set priorities for healthcare policies and inform resource allocation. The aim of this study was to determine the economic burden and health-related quality of life (HRQOL) in the first, second and third years after surviving a stroke in the Canary Islands, Spain. Methods Cross-sectional, retrospective study of 448 patients with stroke based on ICD 9 discharge codes, who received outpatient care at five hospitals. The study was approved by the Research Ethics Committee of Nuestra Señora de la Candelaria University Hospital. Data on demographic characteristics, health resource utilization, informal care, labor productivity losses and HRQOL were collected from the hospital admissions databases and questionnaires completed by stroke patients or their caregivers. Labor productivity losses were calculated from physical units and converted into monetary units with a human capital-based method. HRQOL was measured with the EuroQol EQ-5D questionnaire. Healthcare costs, productivity losses and informal care costs were analyzed with log-normal, probit and ordered probit multivariate models. Results The average cost for each stroke survivor was €17 618 in the first, €14 453 in the second and €12 924 in the third year after the stroke; the reference year for unit prices was 2004. The largest expenditures in the first year were informal care and hospitalizations; in the second and third years the main costs were for informal care, productivity losses and medication. Mean EQ-5D index scores for stroke survivors were 0.50 for the first, 0.47 for the second and 0.46 for the third year, and mean EQ-5D visual analog scale scores were 56, 52 and 55, respectively. Conclusions The main strengths of this study lie in our bottom-up-approach to costing, and in the evaluation of stroke survivors from a broad perspective (societal

  13. Towards Evidence-Based, Quality-Controlled Health Promotion: The Dutch Recognition System for Health Promotion Interventions

    ERIC Educational Resources Information Center

    Brug, Johannes; van Dale, Djoeke; Lanting, Loes; Kremers, Stef; Veenhof, Cindy; Leurs, Mariken; van Yperen, Tom; Kok, Gerjo

    2010-01-01

    Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals with more information on the quality and…

  14. Determinants of Health and the Quality of Life in the Bella Coola Valley

    ERIC Educational Resources Information Center

    Michalos, Alex C.; Thommasen, Harvey V.; Read, Rua; Anderson, Nancy; Zumbo, Bruno D.

    2005-01-01

    The aim of this investigation is to obtain some baseline self-reported data of the health status and overall quality of life of all residents of the Bella Coola Valley of British Columbia aged 17 years or older, and to measure the impact of a set of designated health determinants on their health and quality of life. In the period from August to…

  15. 77 FR 70786 - Request for Information Regarding Health Care Quality for Exchanges

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Request for Information Regarding Health Care... Improvement in Health Care (National Quality Strategy) to create national aims and priorities that would guide local, state, and national efforts to improve the quality of health care in the United States....

  16. Does health-related quality of life predict injury event?

    PubMed Central

    Soori, Hamid; Abachizadeh, Kambiz

    2009-01-01

    Abstract: Background: Unintentional injury is a leading threat to children's health. Some human factors have been determined as predictor of unintentional injury. Association between Health-Related Quality of Life (HRQOL) as a human factor and unintentional injuries is unclear. The objective of study is to examine the association between HRQOL and unintentional injuries among primary school children. Methods: This study was a cross-sectional conducted in Ahwaz, a city in Iran. Overall, 3375 children aged 6-10 years were randomly selected from primary school. HRQOL was measured by 56 items taken from seven domains of Netherlands Organization for Applied Scientific Research Academic Medical Center (TNO AZL) child quality of life (TACQOL) parent form. Parents were interviewed to collect information about incidence, cause and a brief description of injury within the past 12 months prior to the study. Results: The response rate was 3375 of 3792 (89%). There was a significant trend for increasing occurrence of injury with decreasing of HRQOL score (p was less than 0.001). Adjusted OR for injury was significantly higher in very low (2.38, 95% CI: 1.45-3.86), low (2.18, 95% CI: 1.34-3.56), and medium (1.73, 95%CI: 1.06-2.83) HRQOL groups compared to reference group (very high HRQOL). The median of total HRQOL (P less than 0.001) and all its domains (P=0.017) (except autonomous functioning) was lower in injured group compared to uninjured one. Conclusions: This study found an association between HRQOL and unintentional injury among primary school children. This is a preliminary finding and further investigations with a well-defined analytical design are needed. PMID:21483187

  17. Involving mental health service users in quality assurance

    PubMed Central

    Weinstein, Jenny

    2006-01-01

    Abstract Objective  This study compares the process and outcomes of two approaches to engaging mental health (MH) service users in the quality assurance (QA) process. Background  QA plays a significant role in health and care services, including those delivered in the voluntary sector. The importance of actively, rather than passively, involving service users in evaluation and service development has been increasingly recognized during the last decade. Design  This retrospective small‐scale study uses document analysis to compare two QA reviews of a MH Day Centre, one that took place in 1998 as a traditional inspection‐type event and one that took place in 2000 as a collaborative process with a user‐led QA agenda. Setting and participants  The project was undertaken with staff, volunteers and service users in a voluntary sector MH Day Centre. Intervention  The study compares the management, style, evaluation tools and service user responses for the two reviews; it considers staff perspectives and discusses the implications of a collaborative, user‐led QA process for service development. Results  The first traditional top–down inspection‐type QA event had less ownership from service users and staff and served the main purpose of demonstrating that services met organizational standards. The second review, undertaken collaboratively with a user‐led agenda focused on different priorities, evolving a new approach to seeking users’ views and achieving a higher response rate. Conclusions  Because both users and staff had participated in most aspects of the second review they were more willing to work together and action plan to improve the service. It is suggested that the process contributed to an evolving ethos of more effective quality improvement and user involvement within the organization. PMID:16677189

  18. Using law to fight a silent epidemic: the role of health literacy in health care access, quality, & cost.

    PubMed

    Clark, Brietta

    2011-01-01

    The dominant rhetoric in the health care policy debate about cost has assumed an inherent tension between access and quality on the one hand, and cost effectiveness on the other; but an emerging discourse has challenged this narrative by presenting a more nuanced relationship between access, quality, and cost. This is reflected in the discourse surrounding health literacy, which is viewed as an important tool for achieving all three goals. Health literacy refers to one's ability to obtain, understand and use health information to make appropriate health decisions. Research shows that improving patients' health literacy can help overcome access barriers and empower patients to be better health care partners, which should lead to better health outcomes. Promoting health literacy can also reduce expenditures for unnecessary or inappropriate treatment. This explains why, as a policy matter, improving health literacy is an objective that has been embraced by almost every sector of the health care system. As a legal matter, however, the role of health literacy in ensuring quality and access is not as prominent. Although the health literacy movement is relatively young, it has roots in longstanding bioethical principles of patient autonomy, beneficence, and justice as well as the corresponding legal principles of informed consent, the right to quality care, and antidiscrimination. Assumptions and concerns about health literacy seem to do important, yet subtle work in these legal doctrines--influencing conclusions about patient understanding in informed consent cases, animating decisions about patient responsibility in malpractice cases, and underlying regulatory guidance concerning the quality of language assistance services that are necessary for meaningful access to care. Nonetheless, health literacy is not explicitly treated as a legally relevant factor in these doctrines. Moreover, there is no coherent legal framework for incorporating health literacy research that

  19. Emergent Societal Effects of Crimino-Social Forces in an Animat Agent Model

    NASA Astrophysics Data System (ADS)

    Scogings, Chris J.; Hawick, Ken A.

    Societal behaviour can be studied at a causal level by perturbing a stable multi-agent model with new microscopic behaviours and observing the statistical response over an ensemble of simulated model systems. We report on the effects of introducing criminal and law-enforcing behaviours into a large scale animat agent model and describe the complex spatial agent patterns and population changes that result. Our well-established predator-prey substrate model provides a background framework against which these new microscopic behaviours can be trialled and investigated. We describe some quantitative results and some surprising conclusions concerning the overall societal health when individually anti-social behaviour is introduced.

  20. Health significance of fat quality in the diet.

    PubMed

    Nettleton, Joyce A; Villalpando, Salvador; Cassani, Roberta Soares Lara; Elmadfa, Ibrahim

    2013-01-01

    This paper summarizes three presentations on the global and Latin American perspectives on the health significance of fat quality in the diet given at the 16th Congress of the Society of Latin American Nutrition in Havana, Cuba, November 11-16, 2012. Dietary fat quality contributes to the risk of the leading chronic diseases and is more important than fat quantity in reducing the risk of chronic disease mortality, especially from cardiovascular disease (CVD). In many countries, the consumption of saturated fats exceeds the recommended limit of 10% energy (%E) and intakes of polyunsaturated fats (PUFAs) are often below the recommended range of 6-11%E. Consumption of long-chain ω-3 PUFAs is especially low. In many Latin American countries, high consumption of carbohydrates, especially sugars, contributes to obesity, diabetes, hypertension and CVD, while intakes of total fat and PUFAs may be low. Thus, dietary fat recommendations must consider the dietary fat patterns of each country. Nutrition counseling can be effective in teaching individuals and families to modify their food intake patterns and control the major risk factors for chronic disease.

  1. Association between overuse of mobile phones on quality of sleep and general health among occupational health and safety students.

    PubMed

    Eyvazlou, Meysam; Zarei, Esmaeil; Rahimi, Azin; Abazari, Malek

    2016-01-01

    Concerns about health problems due to the increasing use of mobile phones are growing. Excessive use of mobile phones can affect the quality of sleep as one of the important issues in the health literature and general health of people. Therefore, this study investigated the relationship between the excessive use of mobile phones and general health and quality of sleep on 450 Occupational Health and Safety (OH&S) students in five universities of medical sciences in the North East of Iran in 2014. To achieve this objective, special questionnaires that included Cell Phone Overuse Scale, Pittsburgh's Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ) were used, respectively. In addition to descriptive statistical methods, independent t-test, Pearson correlation, analysis of variance (ANOVA) and multiple regression tests were performed. The results revealed that half of the students had a poor level of sleep quality and most of them were considered unhealthy. The Pearson correlation co-efficient indicated a significant association between the excessive use of mobile phones and the total score of general health and the quality of sleep. In addition, the results of the multiple regression showed that the excessive use of mobile phones has a significant relationship between each of the four subscales of general health and the quality of sleep. Furthermore, the results of the multivariate regression indicated that the quality of sleep has a simultaneous effect on each of the four scales of the general health. Overall, a simultaneous study of the effects of the mobile phones on the quality of sleep and the general health could be considered as a trigger to employ some intervention programs to improve their general health status, quality of sleep and consequently educational performance.

  2. Systematic review of health-related quality of life models

    PubMed Central

    2012-01-01

    Background A systematic literature review was conducted to (a) identify the most frequently used health-related quality of life (HRQOL) models and (b) critique those models. Methods Online search engines were queried using pre-determined inclusion and exclusion criteria. We reviewed titles, abstracts, and then full-text articles for their relevance to this review. Then the most commonly used models were identified, reviewed in tables, and critiqued using published criteria. Results Of 1,602 titles identified, 100 articles from 21 countries met the inclusion criteria. The most frequently used HRQOL models were: Wilson and Cleary (16%), Ferrans and colleagues (4%), or World Health Organization (WHO) (5%). Ferrans and colleagues’ model was a revision of Wilson and Cleary’s model and appeared to have the greatest potential to guide future HRQOL research and practice. Conclusions Recommendations are for researchers to use one of the three common HRQOL models unless there are compelling and clearly delineated reasons for creating new models. Disease-specific models can be derived from one of the three commonly used HRQOL models. We recommend Ferrans and colleagues’ model because they added individual and environmental characteristics to the popular Wilson and Cleary model to better explain HRQOL. Using a common HRQOL model across studies will promote a coherent body of evidence that will more quickly advance the science in the area of HRQOL. PMID:23158687

  3. [Burnout of general practitioners in Belgium: societal consequences and paths to solutions].

    PubMed

    Kacenelenbogen, N; Offermans, A M; Roland, M

    2011-09-01

    The definition of burn-out the most often cited and proposed by Maslach and Jackson, clarifies the three cardinal symptoms affecting doctors, namely, emotional exhaustion, with depersonalization of their patients and reduction of the feeling of personal accomplishment. The causes of this phenomenon are relatively well-known: individual psychological factors, stressful factors intrinsic to the medical practice and finally extrinsic factors related to the professional environment and its organization. The purpose of this review is to estimate the prevalence of burnout within the population of Belgian family physicians and to understand both individual and societal consequences. About the method. This is a literature review using databases Medline, Cochrane Library, and the American Psychological Association from 2000 to 2011 with the keywords: primary health care, family practice, burnout, emotional exhaustion, psychological stressors, distress, fatigue, depersonalization, substance and alcohol abuse, depression, well-being, quality of life, job satisfaction, professional efficiency, patient care, physician-patient relations, medical errors, quality of health care, pharmaceutical/health expenditure/statistics-numerical data, obstacles to prevention, health system assessment, medical demography. Selecting of the most relevant articles through the reading of abstracts and then full text reading of 49 selected articles. In conclusion, the exact prevalence of burn-out amongst Belgian general practitioners is not known. From some works, it is estimated that about half of them would be achieved at least in terms of emotional exhaustion. The symptoms related to burn-out are potentially serious: ea depression, alcohol and tobacco abuse and cardiovascular complications. There are also arguments demonstrating the fact that this disorder amongst general practitioners influences negatively the quality of care, their cost, but also medical demography of primary care with as a

  4. The how and why of societal publications for citizen science projects and scientists

    NASA Astrophysics Data System (ADS)

    van Vliet, Arnold J. H.; Bron, Wichertje A.; Mulder, Sara

    2014-05-01

    In the scientific community, the importance of communication to society is often underestimated. Scientists and scientific organisations often lack the skills to organise such communication effectively. The Dutch citizen science phenology network Nature's Calendar has been successful in communicating to the general public via numerous newspaper articles, television appearances, presentations, websites and social media. We refer to these publications as societal publications. Due to active communication to mass media, we frequently reach millions of people. This communication helped us to involve thousands of volunteers in recording the timing of phenological events like the start of flowering, leaf unfolding and bird migration, but also several health-related events like hay fever symptoms and tick bites. In this paper, we analyse and present our experiences with the Nature's Calendar project regarding societal publications. Based on this analysis, we explain the importance of societal publications for citizen science projects and scientists in general, and we show how scientists can increase the newsworthiness of scientific information and what factors and activities can increase the chances of media paying attention to this news. We show that societal publications help phenological networks by facilitating the recruitment, retention and instruction of observers. Furthermore, they stimulate the generation of new ideas and partners that lead to an increase in knowledge, awareness and behavioural change of the general public or specific stakeholders. They make projects, and scientists involved, better known to the public and increase their credibility and authority. Societal publications can catalyse the production of new publications, thereby enforcing the previous mentioned points.

  5. Construction of an environmental quality index for public health research

    PubMed Central

    2014-01-01

    Background A more comprehensive estimate of environmental quality would improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) for all counties in the U.S. was developed. Methods The EQI was developed in four parts: domain identification; data source acquisition; variable construction; and data reduction. Five environmental domains (air, water, land, built and sociodemographic) were recognized. Within each domain, data sources were identified; each was temporally (years 2000–2005) and geographically (county) restricted. Variables were constructed for each domain and assessed for missingness, collinearity, and normality. Domain-specific data reduction was accomplished using principal components analysis (PCA), resulting in domain-specific indices. Domain-specific indices were then combined into an overall EQI using PCA. In each PCA procedure, the first principal component was retained. Both domain-specific indices and overall EQI were stratified by four rural–urban continuum codes (RUCC). Higher values for each index were set to correspond to areas with poorer environmental quality. Results Concentrations of included variables differed across rural–urban strata, as did within-domain variable loadings, and domain index loadings for the EQI. In general, higher values of the air and sociodemographic indices were found in the more metropolitan areas and the most thinly populated areas have the lowest values of each of the domain indices. The less-urbanized counties (RUCC 3) demonstrated the greatest heterogeneity and range of EQI scores (−4.76, 3.57) while the thinly populated strata (RUCC 4) contained counties with the most positive scores (EQI score ranges from −5.86, 2.52). Conclusion The EQI holds promise for improving our characterization of the overall environment for public health. The EQI describes the non-residential ambient county-level conditions to which residents are

  6. Improving mental health outcomes: achieving equity through quality improvement

    PubMed Central

    Poots, Alan J.; Green, Stuart A.; Honeybourne, Emmi; Green, John; Woodcock, Thomas; Barnes, Ruth; Bell, Derek

    2014-01-01

    Objective To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting A psychological therapy service in Westminster, London, UK. Participants People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-referral) between February 2009 and May 2012. Intervention(s) Social marketing interventions were used to increase referrals, including the promotion of the service through local media and through existing social networks. Main Outcome Measure(s) (i) Severity of depression on entry using Patient Health Questionnaire-9 (PHQ9). (ii) Changes to severity of depression following treatment (ΔPHQ9). (iii) Changes in attainment of a meaningful improvement in condition assessed by a key performance indicator. Results Patients from areas of high deprivation entered the service with more severe depression (M = 15.47, SD = 6.75), compared with patients from areas of low (M = 13.20, SD = 6.75) and medium (M = 14.44, SD = 6.64) deprivation. Patients in low, medium and high deprivation areas attained similar changes in depression score (ΔPHQ9: M = −6.60, SD = 6.41). Similar proportions of patients achieved the key performance indicator across initiative phase and deprivation categories. Conclusions QI methods improved access to mental health services; this paper finds no evidence for differences in clinical outcomes in patients, regardless of level of deprivation, interpreted as no evidence of inequity in the service with respect to this outcome. PMID:24521701

  7. Making the Case for Universal School-Based Mental Health Screening

    ERIC Educational Resources Information Center

    Humphrey, Neil; Wigelsworth, Michael

    2016-01-01

    Mental health difficulties affect 1 in 10 children and adolescents, and up to half of adult cases begin during the school years. The individual and societal impacts of such difficulties are huge, and include poorer quality of life, lost economic productivity, destabilisation of communities, and high rates of health, education and social care…

  8. Ecological network analysis of China's societal metabolism.

    PubMed

    Zhang, Yan; Liu, Hong; Li, Yating; Yang, Zhifeng; Li, Shengsheng; Yang, Naijin

    2012-01-01

    Uncontrolled socioeconomic development has strong negative effects on the ecological environment, including pollution and the depletion and waste of natural resources. These serious consequences result from the high flows of materials and energy through a socioeconomic system produced by exchanges between the system and its surroundings, causing the disturbance of metabolic processes. In this paper, we developed an ecological network model for a societal system, and used China in 2006 as a case study to illustrate application of the model. We analyzed China's basic metabolic processes and used ecological network analysis to study the network relationships within the system. Basic components comprised the internal environment, five sectors (agriculture, exploitation, manufacturing, domestic, and recycling), and the external environment. We defined 21 pairs of ecological relationships in China's societal metabolic system (excluding self-mutualism within a component). Using utility and throughflow analysis, we found that exploitation, mutualism, and competition relationships accounted for 76.2, 14.3, and 9.5% of the total relationships, respectively. In our trophic level analysis, the components were divided into producers, consumers, and decomposers according to their positions in the system. Our analyses revealed ways to optimize the system's structure and adjust its functions, thereby promoting healthier socioeconomic development, and suggested ways to apply ecological network analysis in future socioeconomic research.

  9. Multinational investigation of cross-societal cooperation.

    PubMed

    Dorrough, Angela Rachael; Glöckner, Andreas

    2016-09-27

    In a globalized world, establishing successful cooperation between people from different nations is becoming increasingly important. We present results from a comprehensive investigation of cross-societal cooperation in one-shot prisoner's dilemmas involving population-representative samples from six countries and identify crucial facilitators of and obstacles to cooperation. In interactions involving mutual knowledge about only the other players' nationalities, we demonstrate that people hold strong and transnationally shared expectations (i.e., stereotypes) concerning the cooperation level of interaction partners from other countries. These expectations are the strongest determinants of participant cooperation. Paradoxically, however, they turn out to be incorrect stereotypes that even correlate negatively with reality. In addition to erroneous expectations, participants' cooperation behavior is driven by (shared) social preferences that vary according to the interaction partner's nationality. In the cross-societal context, these social preferences are influenced by differences in wealth and ingroup favoritism, as well as effects of specific country combinations but not by spatial distance between nations.

  10. Multinational investigation of cross-societal cooperation

    PubMed Central

    Dorrough, Angela Rachael

    2016-01-01

    In a globalized world, establishing successful cooperation between people from different nations is becoming increasingly important. We present results from a comprehensive investigation of cross-societal cooperation in one-shot prisoner’s dilemmas involving population-representative samples from six countries and identify crucial facilitators of and obstacles to cooperation. In interactions involving mutual knowledge about only the other players’ nationalities, we demonstrate that people hold strong and transnationally shared expectations (i.e., stereotypes) concerning the cooperation level of interaction partners from other countries. These expectations are the strongest determinants of participant cooperation. Paradoxically, however, they turn out to be incorrect stereotypes that even correlate negatively with reality. In addition to erroneous expectations, participants’ cooperation behavior is driven by (shared) social preferences that vary according to the interaction partner’s nationality. In the cross-societal context, these social preferences are influenced by differences in wealth and ingroup favoritism, as well as effects of specific country combinations but not by spatial distance between nations. PMID:27621437

  11. Genetic Diversity and Societally Important Disparities

    PubMed Central

    Rosenberg, Noah A.; Kang, Jonathan T. L.

    2015-01-01

    The magnitude of genetic diversity within human populations varies in a way that reflects the sequence of migrations by which people spread throughout the world. Beyond its use in human evolutionary genetics, worldwide variation in genetic diversity sometimes can interact with social processes to produce differences among populations in their relationship to modern societal problems. We review the consequences of genetic diversity differences in the settings of familial identification in forensic genetic testing, match probabilities in bone marrow transplantation, and representation in genome-wide association studies of disease. In each of these three cases, the contribution of genetic diversity to social differences follows from population-genetic principles. For a fourth setting that is not similarly grounded, we reanalyze with expanded genetic data a report that genetic diversity differences influence global patterns of human economic development, finding no support for the claim. The four examples describe a limit to the importance of genetic diversity for explaining societal differences while illustrating a distinction that certain biologically based scenarios do require consideration of genetic diversity for solving problems to which populations have been differentially predisposed by the unique history of human migrations. PMID:26354973

  12. Societal reintegration following cadaveric orthotopic liver transplantation

    PubMed Central

    Kelly, Ryan; Hurton, Scott; Ayloo, Subhashini; Cwinn, Mathew; De Coutere-Bosse, Sarah

    2016-01-01

    Background Studies on patients’ societal reintegration following orthotopic liver transplantation (OLT) are scarce. Methods Between September 2006 and January 2008, all adults who were alive after 3 years post OLT were included in this prospective cohort study. Validated questionnaires were administered to all candidates with the primary aim of investigating the rate of their social re-integration following OLT and potential barriers they might have encountered. Results Among 157 eligible patients 110 (70%) participated. Mean participants’ age was 57 years (SD 11.4) and 43% were females. Prior to OLT, 75% of patients were married and 6% were divorced. Following OLT there was no significant difference in marital status. Employment rate fell from 72% to 30% post-OLT. Patients who had been employed in either low-skill or advanced-skill jobs were less likely to return to work. After OLT, personal income fell an average of 4,363 Canadian dollars (CAN$) (SD 20,733) (P=0.03) but the majority of recipients (80%) reported high levels of satisfaction for their role in society. Conclusions Although patients’ satisfaction post-OLT is high, employment status is likely to be negatively affected for individuals who are not self-employed. Strategies to assist recipients in returning to their pre-OLT jobs should be developed to improve patients’ economical status and societal ability to recoup resources committed for OLT. PMID:27275465

  13. Quality Improvement: Lessons Learned from an Infant Mental Health-based Early Head Start Program.

    ERIC Educational Resources Information Center

    Brophy-Herb, Holly; Schiffman, Rachel; McKelvey, Lorraine; Cunningham-DeLuca, Mary; Hawver, Marshelle

    2001-01-01

    Continuous quality improvement efforts are vital to high-quality early intervention services. This article describes an ongoing quality improvement project within an infant mental health-based Early Head Start program. Both strategies and challenges in implementing issues and lessons learned in the initial 2-year phase of the quality improvement…

  14. Heat stress and societal impacts in the 21st century

    NASA Astrophysics Data System (ADS)

    Coffel, E.; Horton, R. M.; de Sherbinin, A. M.

    2015-12-01

    Heat is the number-one weather related killer in the US and around the world. As a result of rising temperatures and steady or slightly rising levels of specific humidity, heat stress is projected to become increasingly severe. Here we show that heat stress as measured by two common indices -- the heat index and the wet-bulb temperature -- is projected to rapidly and dramatically increase, and that by mid-century crippling summertime conditions are possible across some of the most densely populated regions of the planet. Many of these regions are places where cooling infrastructure is scarce, adaptive capacity is low, and populations are rapidly rising. We find that by the end of the 21st century, the habitability of some regions of the planet may be questionable due to heat stress alone, and in many other regions severe impacts to human health, infrastructure, agriculture, and economic performance will create significant societal stress and necessitate rapid adaptation.

  15. End-user perspectives on e-commerce and health care web site quality.

    PubMed

    Le Rouge, Cynthia; De Leo, Gianluca

    2008-11-06

    We explore and compare the importance of various quality dimensions for health care and e-commerce web sites. The results show that the importance of various quality attributes for all except four of ten quality dimensions studied differ between health care and e-commerce web sites. These results can help health care managers to improve and/or to guide the design of their web sites.

  16. Health-Related Quality of Life in Children with High-Functioning Autism

    ERIC Educational Resources Information Center

    Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A.; Wood-Dauphinee, Sharon; Kehayia, Eva

    2015-01-01

    The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of…

  17. Health-related quality of life in patients with pulmonary arterial hypertension

    PubMed Central

    Taichman, Darren B; Shin, Jennifer; Hud, Laryssa; Archer-Chicko, Christine; Kaplan, Sandra; Sager, Jeffery S; Gallop, Robert; Christie, Jason; Hansen-Flaschen, John; Palevsky, Harold

    2005-01-01

    Background Improved outcomes with expanding treatment options for patients with pulmonary arterial hypertension present the opportunity to consider additional end-points in approaching therapy, including factors that influence health-related quality of life. However, comparatively little is known about health-related quality of life and its determinants in patients with pulmonary arterial hypertension. Methods Health-related quality of life was evaluated in a cross sectional study of 155 outpatients with pulmonary arterial hypertension using generic and respiratory-disease specific measurement tools. Most patients had either World Health Organization functional Class II or III symptoms. Demographic, hemodynamic and treatment variables were assessed for association with health-related quality of life scores. Results Patients with pulmonary arterial hypertension suffered severe impairments in both physical and emotional domains of health-related quality of life. Patients with idiopathic ("primary") pulmonary arterial hypertension had the best, and those with systemic sclerosis the worst health-related quality of life. Greater six-minute walk distance correlated with better health-related quality of life scores, as did functional Class II versus Class III symptoms. Hemodynamic measurements, however, did not correlate with health-related quality of life scores. No differences in health-related quality of life were found between patients who were being treated with calcium channel antagonists, bosentan or continuously infused epoprostenol at the time of quality of life assessment. Conclusion Health-related quality of life is severely impaired in patients with pulmonary arterial hypertension and is associated with measures of functional status. Specific associations with impaired health-related quality of life suggest potential areas for targeted intervention. PMID:16092961

  18. Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking

    PubMed Central

    El-Jardali, Fadi; Bou Karroum, Lama; Bawab, Lamya; Kdouh, Ola; El-Sayed, Farah; Rachidi, Hala; Makki, Malak

    2015-01-01

    Background Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting. Methods Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted. Results Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts’ opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities. Conclusion Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can

  19. Health Care Spending and Quality in Year 1 of the Alternative Quality Contract

    PubMed Central

    Song, Zirui; Safran, Dana Gelb; Landon, Bruce E.; He, Yulei; Ellis, Randall P.; Mechanic, Robert E.; Day, Matthew P.; Chernew, Michael E.

    2012-01-01

    Background In 2009, Blue Cross Blue Shield of Massachusetts (BCBS) implemented a global payment system called the Alternative Quality Contract (AQC). Provider groups in the AQC system assume accountability for spending, similar to accountable care organizations that bear financial risk. Moreover, groups are eligible to receive bonuses for quality. Methods Seven provider organizations began 5-year contracts as part of the AQC system in 2009. We analyzed 2006–2009 claims for 380,142 enrollees whose primary care physicians (PCPs) were in the AQC system (intervention group) and for 1,351,446 enrollees whose PCPs were not in the system (control group). We used a propensity-weighted difference-in-differences approach, adjusting for age, sex, health status, and secular trends to isolate the treatment effect of the AQC in comparisons of spending and quality between the intervention group and the control group. Results Average spending increased for enrollees in both the intervention and control groups in 2009, but the increase was smaller for enrollees in the intervention group — $15.51 (1.9%) less per quarter (P = 0.007). Savings derived largely from shifts in outpatient care toward facilities with lower fees; from lower expenditures for procedures, imaging, and testing; and from a reduction in spending for enrollees with the highest expected spending. The AQC system was associated with an improvement in performance on measures of the quality of the management of chronic conditions in adults (P<0.001) and of pediatric care (P = 0.001), but not of adult preventive care. All AQC groups met 2009 budget targets and earned surpluses. Total BCBS payments to AQC groups, including bonuses for quality, are likely to have exceeded the estimated savings in year 1. Conclusions The AQC system was associated with a modest slowing of spending growth and improved quality of care in 2009. Savings were achieved through changes in referral patterns rather than through changes in

  20. HON label and DISCERN as content quality indicators of health-related websites.

    PubMed

    Khazaal, Yasser; Chatton, Anne; Zullino, Daniele; Khan, Riaz

    2012-03-01

    Content quality indicators are warranted in order to help patients and consumers to judge the content quality of health-related on-line information. The aim of the present study is to evaluate web-based information on health topics and to assess particular content quality indicators like HON (Health on the Net) and DISCERN. The present study is based on the analysis of data issued from six previous studies which assessed with a standardized tool the general and content quality (evidence-based health information) of health-related websites. Keywords related to Social phobia, bipolar disorders, pathological gambling as well as cannabis, alcohol and cocaine addiction were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality (evidence-based information). "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of 874 websites identified, 388 were included. Despite an observed association with higher content quality scores, the HON label fails to predict good content quality websites when used in a multiple regression. Sensibility and specificity of a DISCERN score >40 in the detection of good content quality websites were, respectively, 0.45 and 0.96. The DISCERN is a potential quality indicator with a relatively high specificity. Further developments in this domain are warranted in order to facilitate the identification of high-quality information on the web by patients.

  1. Assessment of the quality of measures of child oral health-related quality of life

    PubMed Central

    2014-01-01

    Background Several measures of oral health-related quality of life have been developed for children. The most frequently used are the Child Perceptions Questionnaire (CPQ), the Child Oral Impacts on Daily Performances (C-OIDP) and the Child Oral Health Impact Profile (COHIP). The aim of this study was to assess the methodological quality of the development and testing of these three measures. Methods A systematic search strategy was used to identify eligible studies published up to December 2012, using both MEDLINE and Web of Science. Titles and abstracts were read independently by two investigators and full papers retrieved where the inclusion criteria were met. Data were extracted by two teams of two investigators using a piloted protocol. The data were used to describe the development of the measures and their use against existing criteria. The methodological quality and measurement properties of the measures were assessed using standards proposed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) group. Results The search strategy yielded 653 papers, of which 417 were duplicates. Following analysis of the abstracts, 119 papers met the inclusion criteria. The majority of papers reported cross-sectional studies (n = 117) with three of longitudinal design. Fifteen studies which had used the original version of the measures in their original language were included in the COSMIN analysis. The most frequently used measure was the CPQ. Reliability and construct validity appear to be adequate for all three measures. Children were not fully involved in item generation which may compromise their content validity. Internal consistency was measured using classic test theory with no evidence of modern psychometric techniques being used to test unidimensionality of the measures included in the COSMIN analysis. Conclusion The three measures evaluated appear to be able to discriminate between groups. CPQ has been most widely

  2. Motivational Processes in Children's Physical Activity and Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Gu, Xiangli; Solmon, Melinda A.

    2016-01-01

    Background: School physical education (PE) not only offers and promotes health-related physical activity (PA), but also encompasses the promotion and development of health-related well-being such as health-related quality of life (HRQOL). Furthermore, assessing PA and HRQOL have become major issues in pediatric public health and also serve as a…

  3. 76 FR 70831 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... Care)) Activity; Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs... Efficiency of VA Health Care), VA Form 10-21088. OMB Control Number: 2900-0725. Type of Review: Extension of... necessary to promote quality and efficient delivery of health care through the use of health...

  4. 77 FR 3841 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... Care)) Activities Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans... VA Health Care), VA Form 10-21088. OMB Control Number: 2900-0725. Type of Review: Extension of a... promote quality and efficient delivery of health care through the use of health information...

  5. Data quality assessment in the routine health information system: an application of the Lot Quality Assurance Sampling in Benin.

    PubMed

    Glèlè Ahanhanzo, Yolaine; Ouendo, Edgard-Marius; Kpozèhouen, Alphonse; Levêque, Alain; Makoutodé, Michel; Dramaix-Wilmet, Michèle

    2015-09-01

    Health information systems in developing countries are often faulted for the poor quality of the data generated and for the insufficient means implemented to improve system performance. This study examined data quality in the Routine Health Information System in Benin in 2012 and carried out a cross-sectional evaluation of the quality of the data using the Lot Quality Assurance Sampling method. The results confirm the insufficient quality of the data based on three criteria: completeness, reliability and accuracy. However, differences can be seen as the shortcomings are less significant for financial data and for immunization data. The method is simple, fast and can be proposed for current use at operational level as a data quality control tool during the production stage.

  6. Sensory Impairment and Health-Related Quality of Life

    PubMed Central

    KWON, Hye-Jin; KIM, Ji-su; KIM, Yoon-jung; KWON, Su-jin; YU, Jin-Na

    2015-01-01

    Background: Sensory impairment is a common condition that exerts negative effects on health-related quality of life (HRQoL) in the elderly. This study aimed to determine the relationship between sensory impairment and HRQoL and identify sensory-specific differences in the HRQoL of elderly. Methods: This study used data from the Korean National Health and Nutrition Examination Survey V (2010–2012), analyzing 5,260 subjects over 60 years of age who completed ophthalmic and otologic examinations. Vision and hearing impairment were measured and classified. HRQoL was determined according to the European QoL five dimension test (EQ-5D). Multivariate logistic regression analysis and analysis of covariance were performed to identify relationships between sensory impairment and HRQoL dimensions as well as differences in HRQoL scores. Results: In the final adjusted multivariate model, there was a statistically higher proportion of those with dual sensory impairment who reported problems with mobility (adjusted odds ratio [aOR] 2.30, 95% confidence interval [CI] 1.45–5.03), usual activities (aOR 2.32, 95% CI 1.16–4.64), and pain/discomfort among EQ-5D subcategories (aOR 1.79, 95% CI 1.07–2.97). In the EQ-5D dimensions, the means and standard deviations of vision impairment (0.86 [0.01]) and dual sensory impairment (0.84 [0.02]) appeared meaningfully lower than those for no sensory impairment (0.88 [0.00]) or hearing impairment (0.88 [0.01]); P = .02). Conclusion: Sensory impairment reduces HRQoL in the elderly. Improvement of HRQoL in the elderly thus requires regular screening and appropriate management of sensory impairment. PMID:26258089

  7. Health-related quality of life in multiple sclerosis

    PubMed Central

    Fisk, John D.; Patten, Scott B.; Tremlett, Helen; Wolfson, Christina; Warren, Sharon; Fiest, Kirsten M.; McKay, Kyla A.; Marrie, Ruth Ann

    2016-01-01

    Objective: To evaluate the direct and indirect influences of physical comorbidity, symptoms of depression and anxiety, fatigue, and disability on health-related quality of life (HRQoL) in persons with multiple sclerosis (MS). Methods: A large (n = 949) sample of adults with MS was recruited from 4 Canadian MS clinics. HRQoL was assessed using the patient-reported Health Utilities Index Mark 3. Expanded Disability Status Scale scores, physical comorbidity, depression, anxiety, and fatigue were evaluated as predictors of HRQoL in a cross-sectional path analysis. Results: All predictors were significantly associated with HRQoL and together accounted for a large proportion of variance (63%). Overall, disability status most strongly affected HRQoL (β = −0.52) but it was closely followed by depressive symptoms (β = −0.50). The direct associations of physical comorbidity and anxiety with HRQoL were small (β = −0.08 and −0.10, respectively), but these associations were stronger when indirect effects through other variables (depression, fatigue) were also considered (physical comorbidity: β = −0.20; anxiety: β = −0.34). Conclusions: Increased disability, depression and anxiety symptoms, fatigue, and physical comorbidity are associated with decreased HRQoL in MS. Disability most strongly diminishes HRQoL and, thus, interventions that reduce disability are expected to yield the most substantial improvement in HRQoL. Yet, interventions targeting other factors amenable to change, particularly depression but also anxiety, fatigue, and physical comorbidities, may all result in meaningful improvements in HRQoL, as well. Our findings point to the importance of further research confirming the efficacy of such interventions. PMID:26962068

  8. Quality of Mental Health Care for Nursing Home Residents: A Literature Review

    PubMed Central

    Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.

    2010-01-01

    Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors. PMID:20223943

  9. The effects of congestions tax on air quality and health

    NASA Astrophysics Data System (ADS)

    Johansson, Christer; Burman, Lars; Forsberg, Bertil

    -berg since reductions are expected in both respiratory and cardiovascular morbidity. This study demonstrates the importance of not only assessing the effects on air quality limit values, but also to make quantitative estimates of health impacts, in order to justify actions to reduce air pollution.

  10. Integrating health profile with survival for quality of life assessment.

    PubMed

    Hwang, Jing-Shiang; Wang, Jung-Der

    2004-02-01

    In cohort studies or clinical trials, measurements of quality of life (QoL) were averaged across available individuals for each group at given points in time to produce single measures for comparisons. However, estimates of these single measures may be severely biased if substantial mortality occurs over time. The objective of this study is to develop a method that integrates QoL measurement and survival for long-term evaluation of health services. We defined a mean QoL score function over time for an index population as the average QoL score of all individuals both alive and dead at each time point in the population. While a living subject's QoL can be assessed by asking one's subjective preference, the score of a decedent can be assigned a fixed value depending on the specific facet on health profile. The mean QoL score function over time is reduced to a single measure of expected cumulative QoL score, which is the area under the curve of mean QoL score function over a given time interval and can be estimated by taking a random sample from a cross-sectional survey. For the QoL score function to be extrapolated to life-long, it requires the assumption that the disease causes premature death or a long-term moderate impairment of QoL. We provided methods and computer programs for estimating mean QoL score functions and the reduced single measures for use in comparisons. A cohort of 779 breast cancer patients from Chiangmai, Thailand were followed for 12 years to demonstrate the proposed methods. The data included the 12-year complete survival records and QoL scores on 233 patients collected from a cross-sectional survey using WHOQOL questionnaire and standard gamble method. The expected cumulative QoL scores using utility and psychometric scales were compared among patients in four groups of clinical stages in this cohort for time from onset up to 12 years and life-long. We conclude that such an integration of QoL measurement with survival can be useful for the

  11. Health-related quality of life after liver transplantation for adult recipients.

    PubMed

    Bownik, Hillary; Saab, Sammy

    2009-11-01

    1. Pretransplantation health-related quality of life scores are affected by the etiology of liver cirrhosis, with hepatocellular and cholestatic etiologies having higher health-related quality of life scores than alcohol or viral hepatitis etiologies. 2. Posttransplantation health-related quality of life scores are not affected by the etiology of the original liver cirrhosis, but transplant recipient scores continue to remain significantly lower than those of healthy patient controls. 3. During the first 6 months after liver transplantation, the majority of physical and mental components of health-related quality of life scores improve, but these increases are not sustained in the long term. 4. At 1 year after liver transplantation, emotional and mental health-related quality of life scores begin to decrease. 5. During postoperative years 1 to 5, episodes of acute cellular rejection and patient age over 60 years decrease physical function and overall general health-related quality of life scores. 6. Beyond 5 years after orthotopic liver transplantation, age over 60, osteoporosis, and episodes of chronic rejection decrease health-related quality of life scores through decreases in the physical function and bodily pain domains. 7. Hepatitis C as an indication for liver transplantation is an independent factor in decreasing posttransplantation health-related quality of life scores. 8. Further studies are necessary that include a complete evaluation of the effects of gender, socioeconomic status, education, and ethnicity in order to better understand factors influencing post-liver transplantation health-related quality of life scores. 9. The development of a health-related quality of life assessment tool specific to transplantation could help us to more accurately assess factors (such as immunosuppression) that alter posttransplantation health-related quality of life.

  12. Critical Zone Science and Global Societal Challenges

    NASA Astrophysics Data System (ADS)

    Goldhaber, M. B.; Banwart, S. A.

    2014-12-01

    Earth's Critical Zone (CZ) is the thin outer veneer of our planet from the top of the tree canopy to the bottom of our drinking water aquifers that supports almost all human activity. Despite its fundamental importance to terrestrial life, understanding of the operation of the coupled geologic, hydrologic, topographic, and biotic CZ processes across time and space is far from complete. These interactions are complex and they establish a mechanistic 'chain of impact' that transmits the effects of environmental change throughout the CZ. Characterization of these processes is made more urgent by the fact that globally, the CZ is experiencing ever-increasing pressure from growth in human population and wealth. Within the next four decades, demand for food and fuel is expected to double along with a more than 50% increase in demand for clean water. Understanding, predicting and managing intensification of land use and associated economic services, while mitigating and adapting to rapid climate change, is now one of the most pressing societal challenges of the 21st century. In this talk we summarize the profound global societal impacts to the Earth's near surface arising from exponential human population growth, increasing affluence, and technological advance, to provide context for discussions on constructing an array of CZ observatories to both characterize fundamental critical zone processes and forecast the effects of planetary change. We will suggest goals and options relevant to planning for a future international array of CZ observatories and a research agenda that matches the urgency of the projected resource demands and environmental pressures of the coming four decades.

  13. Space-based societal applications—Relevance in developing countries

    NASA Astrophysics Data System (ADS)

    Bhaskaranarayana, A.; Varadarajan, C.; Hegde, V. S.

    2009-11-01

    Space technology has the vast potential for addressing a variety of societal problems of the developing countries, particularly in the areas of communication, education and health sectors, land and water resources management, disaster management and weather forecasting. Both remote sensing and communication technologies can be used to achieve this goal. With its primary emphasis on application of space technology, on an end-to-end basis, towards national development, the Indian Space Programme has distinguished itself as one of the most cost-effective and development-oriented space programmes in the world. Developing nations are faced with the enormous task of carrying development-oriented education to the masses at the lower strata of their societies. One important feature of these populations is their large number and the spread over vast and remote areas of these nations, making the reaching out to them a difficult task. Satellite communication (Satcom) technology offers the unique capability of simultaneously reaching out to very large numbers, spread over vast areas, including the remote corners of the country. It is a strong tool to support development education. India has been amongst the first few nations to explore and put to use the Satcom technology for education and development-oriented services to the rural masses. Most of the developing countries have inadequate infrastructure to provide proper medical care to the rural population. Availability of specialist doctors in rural areas is a major bottleneck. Use of Satcom and information technology to connect rural clinics to urban hospitals through telemedicine systems is one of the solutions; and India has embarked upon an effective satellite-based telemedicine programme. Space technology is also useful in disaster warning and management related applications. Use of satellite systems and beacons for locating the distressed units on land, sea or air is well known to us. Indian Space Research Organisation

  14. Quality of Health Management Information System for Maternal & Child Health Care in Haryana State, India

    PubMed Central

    Sharma, Atul; Rana, Saroj Kumar; Prinja, Shankar; Kumar, Rajesh

    2016-01-01

    Background Despite increasing importance being laid on use of routine data for decision making in India, it has frequently been reported to be riddled with problems. Evidence suggests lack of quality in the health management information system (HMIS), however there is no robust analysis to assess the extent of its inaccuracy. We aim to bridge this gap in evidence by assessing the extent of completeness and quality of HMIS in Haryana state of India. Methods Data on utilization of key maternal and child health (MCH) services were collected using a cross-sectional household survey from 4807 women in 209 Sub-Centre (SC) areas across all 21 districts of Haryana state. Information for same services was also recorded from HMIS records maintained by auxiliary nurse midwives (ANMs) at SCs to check under- or over-recording (Level 1 discordance). Data on utilisation of MCH services from SC ANM records, for a subset of the total women covered in the household survey, were also collected and compared with monthly reports submitted by ANMs to assess over-reporting while report preparation (Level 2 discordance) to paint the complete picture for quality and completeness of routine HMIS. Results Completeness of ANM records for various MCH services ranged from 73% for DPT1 vaccination dates to 94.6% for dates of delivery. Average completeness level for information recorded in HMIS was 88.5%. Extent of Level 1 discordance for iron-folic acid (IFA) supplementation, 3 or more ante-natal care (ANC) visits and 2 Tetanus toxoid (TT) injections was 41%, 16% and 2% respectively. In 48.2% cases, respondents from community as well as HMIS records reported at least one post-natal care (PNC) home visit by ANM. Extent of Level 2 discordance ranged from 1.6% to 6%. These figures were highest for number of women who completed IFA supplementation, contraceptive intra-uterine device insertion and provision of 2nd TT injection during ANC. Conclusions HMIS records for MCH services at sub-centre level

  15. A vision for the systematic monitoring and improvement of the quality of electronic health data.

    PubMed

    Dixon, Brian E; Rosenman, Marc; Xia, Yuni; Grannis, Shaun J

    2013-01-01

    In parallel with the implementation of information and communications systems, health care organizations are beginning to amass large-scale repositories of clinical and administrative data. Many nations seek to leverage so-called Big Data repositories to support improvements in health outcomes, drug safety, health surveillance, and care delivery processes. An unsupported assumption is that electronic health care data are of sufficient quality to enable the varied use cases envisioned by health ministries. The reality is that many electronic health data sources are of suboptimal quality and unfit for particular uses. To more systematically define, characterize and improve electronic health data quality, we propose a novel framework for health data stewardship. The framework is adapted from prior data quality research outside of health, but it has been reshaped to apply a systems approach to data quality with an emphasis on health outcomes. The proposed framework is a beginning, not an end. We invite the biomedical informatics community to use and adapt the framework to improve health data quality and outcomes for populations in nations around the world.

  16. A curriculum for training quality scholars to improve the health and health care of veterans and the community at large.

    PubMed

    Splaine, Mark E; Aron, David C; Dittus, Robert S; Kiefe, Catarina I; Landefeld, C Seth; Rosenthal, Gary E; Weeks, William B; Batalden, Paul B

    2002-01-01

    In 1998, the Veterans Health Administration invested in the creation of the Veterans Administration National Quality Scholars Fellowship Program (VAQS) to train physicians in new ways to improve the quality of health care. We describe the curriculum for this program and the lessons learned from our experience to date. The VAQS Fellowship program has developed a core improvement curriculum to train postresidency physicians in the scholarship, research, and teaching of the improvement of health care. The curriculum covers seven domains of knowledge related to improvement: health care as a process; variation and measurement; customer/beneficiary knowledge; leading, following, and making changes in health care; collaboration; social context and accountability; and developing new, locally useful knowledge. We combine specific knowledge about the improvement of health care with the use of adult learning strategies, interactive video, and development of learner competencies. Our program provides insights for medical education to better prepare physicians to participate in and lead the improvement of health care.

  17. Rural-Urban Analyses of Health-Related Quality of Life among People with Multiple Sclerosis

    ERIC Educational Resources Information Center

    Buchanan, Robert J.; Zhu, Li; Schiffer, Randolph; Radin, Dagmar; James, Wesley

    2008-01-01

    Context: Health-related quality of life (HRQOL) is a multi-dimensional construct including aspects of life quality or function that are affected by physical health and symptoms, psychosocial factors, and psychiatric conditions. HRQOL gives a broader measure of the burden of disease than physical impairment or disability levels. Purpose: To…

  18. Health and Quality of Life of Aboriginal Residential School Survivors, Bella Coola Valley, 2001

    ERIC Educational Resources Information Center

    Barton, Sylvia S.; Thommasen, Harvey V.; Tallio, Bill; Zhang, William; Michalos, Alex C.

    2005-01-01

    The purpose of this study was to make comparisons between Aboriginal residential school survivors' perceptions of health status and overall quality of life, and Aboriginal non-residential school attendees, as well as between non-Aboriginals. Data were obtained from thirty-three questions derived from the 2001 Determinants of Health and Quality of…

  19. Child Health-Related Quality of Life and Parental Social Capital in Greece: An Exploratory Study

    ERIC Educational Resources Information Center

    El-Dardiry, Giulia; Dimitrakaki, Christine; Tzavara, Chara; Ravens-Sieberer, Ulrike; Tountas, Yannis

    2012-01-01

    In this paper, we examined dimensions of child health-related quality of life in Greece in relation to parental assessments of neighbourhood social capital and social support networks. For the analysis, two main measures were used: (1) child self-reported health-related quality of life in ten dimensions, as measured by the KIDSCREEN questionnaire;…

  20. Perceptions of Neighborhood Problems and Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Hill, Erin M.; Shepherd, Daniel; Welch, David; Dirks, Kim N.; McBride, David

    2012-01-01

    This article examines the association between perceptions of neighborhood problems and health-related quality of life (HRQOL) in a sample of New Zealand residents (n = 692). A modified version of the Neighborhood Problems Scale (originally developed by Steptoe and Feldman, 2001) and the World Health Organization Quality of Life (WHOQOL-BREF) were…

  1. Health-Related Quality of Life among Abused Women One Year after Leaving a Violent Partner

    ERIC Educational Resources Information Center

    Alsaker, Kjersti; Moen, Bente E.; Kristoffersen, Kjell

    2008-01-01

    This is the first follow up study measuring quality of life among abused women who have left their abusive partner. The women (n = 22) answered a questionnaire while staying at women's shelter and one year later. The aim was to examine long-term effects of intimate partner violence against women on health-related quality of life. Health-related…

  2. A Nursing Interaction Approach to Consumer Internet Training on Quality Health Care

    ERIC Educational Resources Information Center

    Lesley, Marsha L.; Oermann, Marilyn H.; Vander Wal, Jillon S.

    2004-01-01

    This study examined the effectiveness of using the Internet to teach consumers about quality health care, compared consumer definitions of quality health care prior to and following completion of the Internet experience, and compared ratings of learning, satisfaction and value of the Internet instruction between consumers who completed the…

  3. Quality Health Care for People with Developmental Disabilities: A Guide for Parents and Other Caregivers.

    ERIC Educational Resources Information Center

    Pfaffinger, Kathleen M.; Nelson, Richard P.

    Starting with the premise that all people have a right to quality health care, this guide emphasizes that assisting people with developmental disabilities to obtain health care and maintain healthy life styles will enhance the quality of their lives at home and in the community. The guide consists of four sections. A section on obtaining care…

  4. Quality Improvement Initiative in School-Based Health Centers across New Mexico

    ERIC Educational Resources Information Center

    Booker, John M.; Schluter, Janette A.; Carrillo, Kris; McGrath, Jane

    2011-01-01

    Background: Quality improvement principles have been applied extensively to health care organizations, but implementation of quality improvement methods in school-based health centers (SBHCs) remains in a developmental stage with demonstration projects under way in individual states and nationally. Rural areas, such as New Mexico, benefit from the…

  5. Health promoting schools and children’s oral health related quality of life

    PubMed Central

    2013-01-01

    Background The study objective was to compare children’s oral health related quality of life (OHRQoL) in schools with 6 years of implementation of a health promoting school model in Malaysia, i.e. the Doktor Muda Programme (DMP) and in schools without the DMP. Methods This report was part of a larger study to evaluate the DMP impact on schoolchildren’s oral health knowledge, attitudes, behaviour, caries progression and OHRQoL. It was conducted in Negri Sembilan state. The sample comprised 3455, Year 6 (11–12 year old) children; 1282 from DMP (intervention) and 2173 from non-DMP (control) schools. The Malay Child-OIDP index was used to evaluate children’s levels of oral impacts on 8 daily performances after 6 years of DMP implementation (2006–2011). Prevalence, score, impact intensity, causes and extent of impacts were compared. Chi-square and Mann–Whitney tests were used in the data analysis. Results Overall response rate was 95.1%. Prevalence of overall impacts was 57.8% and 60.8% (mean total impact score was 7.10 and 7.77) in the intervention and control group, respectively. The three most frequently affected performances in both groups were eating, cleaning teeth and emotional stability. Significantly less DMP children had oral impact on cleaning teeth (p = 0.034). The majority of children with impacts in both groups reported ‘very little’ to ‘moderate’ levels of impact intensity. Significantly more DMP children reported having ‘very little’ and ‘little’ levels of impact intensity on cleaning teeth (p = 0.037) and emotional stability (p = 0.020), respectively. Significantly less DMP children reported having ‘very severe’ level of impact intensity on speaking (p = 0.038). The most prevalent cause of impacts in both groups was toothache. Significantly less DMP children reported bleeding gums (p = 0.016) and presence of plaque/calculus as causes of impacts (p = 0.032). About 75% of children with impacts in both groups reported having

  6. Religious Practice and Health-Related Quality of Life in Iranian Adolescent Girls.

    PubMed

    Mirghafourvand, Mojgan; Charandabi, Sakineh Mohammad-Alizadeh; Sharajabad, Fariba Alizadeh; Sanaati, Favziye

    2017-03-24

    This study aimed to determine the relationship between religious practice and health-related quality of life in adolescent girls in Tabriz, Iran, 2014-2015. This cross-sectional study was conducted on 520 female students who were selected using the random sampling method. Religious practice and health-related quality of life questionnaires were used for data collection. Multivariate linear regression analysis showed a significant relationship between health-related quality of life and received religious support, religiosity, father's and mother's education, father's occupation, family economic status, and the number of children. It is necessary to find ways to further promote religious practices in adolescents and ultimately their quality of life.

  7. Quality of reproductive health services at commune health stations in Viet Nam: implications for national reproductive health care strategy.

    PubMed

    Ngo, Anh D; Hill, Peter S

    2011-05-01

    This paper presents a qualitative study conducted in 2009 of provider and patient perceptions of primary level reproductive health services provided by commune health stations (CHSs), and the implications for Viet Nam's 2011-2020 National Strategy for Reproductive Health Care. In the three provinces of Thai Nguyen, Thua Thien Hue, and Vinh Long, we interviewed the heads of CHSs, held focus group discussions with midwives and women patients, and observed facilities. Half the 30 CHSs visited were in poor physical condition; the rest were newly renovated. However, the model of service delivery was largely unchanged from ten years before. Many appeared to fall short in meeting patient expectations in terms of modern medical equipment and technology, range of drug supplies, and levels of staff expertise. As a result, many women were turning to private doctors and public hospitals, at least in urban areas, or seeking medication from pharmacies. To make CHS clinics sustainable, promotion of access to reproductive health services should be undertaken concurrently with quality improvement. A responsive payment scheme must also be developed to generate revenues. Efforts should be made to reduce the unnecessary use of more costly services from private clinics and higher level public facilities.

  8. Health-related quality of life in migrant preschool children

    PubMed Central

    2013-01-01

    Background Minority groups have a lower health-related quality of life (HRQOL), but there is little information if this finding also applies to children. In this study, we compared HRQOL between young children with and without migrant parents. Methods Two cross-sectional studies of culturally diverse preschool populations in Switzerland: Ballabeina (40 preschools, 258 girls and 232 boys aged 4 to 6 years) and Youp’là Bouge (58 child care centers, 453 girls and 522 boys aged 2 to 4 years). Most children were born in Switzerland (Ballabeina: 92.3%; Youp’là Bouge: 93.7%). Number of migrant parents was considered as the main exposure. HRQOL was measured using the 23-item Pediatric Quality of Life Inventory. Results Children of migrant parents had a significantly lower HRQOL total score (mean ± SD, Ballabeina: 84.2 ± 9.1; 82.7 ± 9.6 and 81.7 ± 11.7 for children with none, one or two migrant parents, respectively; Youp’là Bouge: 83.8 ± 8.6; 82.9 ± 9.5; 80.7 ± 11.7, all p < 0.05). Similar results were found in Ballabeina and Youp’là Bouge for social, school and physical functioning (all p < 0.05), but not for emotional functioning. The differences in HRQOL measures were partly mediated by children’s place of birth, parental education, paternal occupational level, children’s BMI, screen time and physical activity in one study (Ballabeina), but not in the other (Youp’là Bouge). Conclusion In preschoolers, children of migrant parents have lower HRQOL than children of non-migrant parents. These differences are only partly mediated by other sociocultural characteristics or lifestyle behavior. These families may need assistance to prevent further inequalities. PMID:23617686

  9. Health-Related Quality of Life of Former Lead Workers in Brazil

    PubMed Central

    Teixeira, Martha Carvalho Pereira; Carvalho, Fernando Martins; Lins, Liliane

    2015-01-01

    Little is known about the health-related quality of life of former lead workers. Using the Short-Form 36 Questionnaire (SF-36), a cross-section design study evaluated the health-related quality of life of 186 former workers of a lead smelter that operated in Santo Amaro da Purificação, Brazil, from 1960 to 1993, when it closed down. The smelter had very poor occupational and environmental hygiene standards. The health-related quality of life of former lead workers was low, compared to population-based and other nosological groups from Brazil. Former lead workers who indicated metal poisoning, difficulty getting another job and who could not get another job after dismissal by the smelter presented poorer health-related quality of life. Former lead workers with poor health-related quality of life form part of the huge occupational liability left by the Santo Amaro lead smelter. PMID:26540067

  10. Health-Related Quality of Life of Former Lead Workers in Brazil.

    PubMed

    Teixeira, Martha Carvalho Pereira; Carvalho, Fernando Martins; Lins, Liliane

    2015-11-03

    Little is known about the health-related quality of life of former lead workers. Using the Short-Form 36 Questionnaire (SF-36), a cross-section design study evaluated the health-related quality of life of 186 former workers of a lead smelter that operated in Santo Amaro da Purificação, Brazil, from 1960 to 1993, when it closed down. The smelter had very poor occupational and environmental hygiene standards. The health-related quality of life of former lead workers was low, compared to population-based and other nosological groups from Brazil. Former lead workers who indicated metal poisoning, difficulty getting another job and who could not get another job after dismissal by the smelter presented poorer health-related quality of life. Former lead workers with poor health-related quality of life form part of the huge occupational liability left by the Santo Amaro lead smelter.

  11. A survey of pedagogical approaches and quality mechanisms used in education programs for mental health professionals.

    PubMed

    McCann, Edward; Higgins, Agnes; Maguire, Gerry; Alexander, Jane; Watts, Mike; Creaner, Mary; Rani, Shobha

    2012-09-01

    The provision of high-quality education and training that is responsive, relevant, accessible and evidence based is critical if the vision for quality mental health services presented in recent policy initiatives in Ireland is to be fulfilled. This paper reports the findings related to pedagogical approaches and quality assurance mechanisms utilized within mental health education. The study involved canvassing all Higher Education Institutions in Ireland. A total of 227 courses in 31 educational institutes were identified and 149 questionnaires were returned from 129 Course Coordinators. Various quality processes were identified in existing programs; however, formal feedback from service providers, service users and carers was seldom reported. Ongoing evaluation and quality assurance strategies are a key element of governance and there is a need to develop strategies that explore the impact of education programs on mental health education and health outcomes. Recommendations are made in terms of future interprofessional mental health education and practice.

  12. Aspirations for quality health care in Uganda: How do we get there?

    PubMed Central

    2013-01-01

    Background Despite significant investments and reforms, health care remains poor for many in Africa. To design an intervention to improve access and quality of health care at health facilities in eastern Uganda, we aimed to understand local priorities for qualities in health care, and factors that enable or prevent these qualities from being enacted. Methods In 2009 to 2010, we carried out 69 in-depth interviews and 6 focus group discussions with 65 health workers at 17 health facilities, and 10 focus group discussions with 113 community members in Tororo District, Uganda. Results Health-care workers and seekers valued technical, interpersonal and resource qualities in their aspirations for health care. However, such qualities were frequently not enacted, and our analysis suggests that meeting aspirations required social and financial resources to negotiate various power structures. Conclusions We argue that achieving aspirations for qualities valued in health care will require a genuine reorientation of focus by health workers and their managers toward patients, through renewed respect and support for these providers as professionals. PMID:23521859

  13. Evaluating outcomes of care and targeting quality improvement using Medicare health outcomes survey data.

    PubMed

    Bowen, Sonya E

    2012-01-01

    The Medicare Health Outcomes Survey (HOS) provides a rich source of outcomes data on the Medicare Advantage (MA) program for the US Department of Health and Human Services, managed care organizations participating in Medicare, quality improvement organizations, and health services researchers working to improve quality of care for Medicare enrollees. Since 1998, the Centers for Medicare and Medicaid Services has collected longitudinal functional status information to assess the performance of Medicare managed care organizations. This introduction reviews the goals of the HOS program, how the HOS supports health care reform, and outlines recent HOS studies exploring data applications for monitoring outcomes and implementing quality improvement activities.

  14. Methodological quality of systematic reviews and clinical trials on women's health published in a Brazilian evidence-based health journal

    PubMed Central

    Macedo, Cristiane Rufino; Riera, Rachel; Torloni, Maria Regina

    2013-01-01

    OBJECTIVES: To assess the quality of systematic reviews and clinical trials on women's health recently published in a Brazilian evidence-based health journal. METHOD: All systematic reviews and clinical trials on women's health published in the last five years in the Brazilian Journal of Evidence-based Health were retrieved. Two independent reviewers critically assessed the methodological quality of reviews and trials using AMSTAR and the Cochrane Risk of Bias Table, respectively. RESULTS: Systematic reviews and clinical trials accounted for less than 10% of the 61 original studies on women's health published in the São Paulo Medical Journal over the last five years. All five reviews were considered to be of moderate quality; the worst domains were publication bias and the appropriate use of study quality in formulating conclusions. All three clinical trials were judged to have a high risk of bias. The participant blinding, personnel and outcome assessors and allocation concealment domains had the worst scores. CONCLUSIONS: Most of the systematic reviews and clinical trials on women's health recently published in a Brazilian evidence-based journal are of low to moderate quality. The quality of these types of studies needs improvement. PMID:23778332

  15. NASA Earth Observation Systems and Applications for Health and Air Quality

    NASA Technical Reports Server (NTRS)

    Omar, Ali H.

    2015-01-01

    There is a growing body of evidence that the environment can affect human health in ways that are both complex and global in scope. To address some of these complexities, NASA maintains a diverse constellation of Earth observing research satellites, and sponsors research in developing satellite data applications across a wide spectrum of areas. These include environmental health; infectious disease; air quality standards, policies, and regulations; and the impact of climate change on health and air quality in a number of interrelated efforts. The Health and Air Quality Applications fosters the use of observations, modeling systems, forecast development, application integration, and the research to operations transition process to address environmental health effects. NASA has been a primary partner with Federal operational agencies over the past nine years in these areas. This talk presents the background of the Health and Air Quality Applications program, recent accomplishments, and a plan for the future.

  16. Health-related quality of life in multiple system atrophy.

    PubMed

    Schrag, Anette; Geser, Felix; Stampfer-Kountchev, Michaela; Seppi, Klaus; Sawires, Martin; Köllensperger, Martin; Scherfler, Christoph; Quinn, Niall; Pellecchia, Maria T; Barone, Paolo; Del Sorbo, Francesca; Albanese, Alberto; Ostergaard, Karen; Dupont, Erik; Cardozo, Adriana; Tolosa, Eduardo; Nilsson, Christer F; Widner, Håkan; Lindvall, Olle; Giladi, Nir; Gurevich, Tanya; Daniels, Christine; Deuschl, Günther; Coelho, Miguel; Sampaio, Cristina; Abele, Michael; Klockgether, Thomas; Schimke, Nicole; Eggert, Karla M; Oertel, Wolfgang; Djaldetti, Ruth; Colosimo, Carlo; Meco, Giuseppe; Poewe, Werner; Wenning, Gregor K

    2006-06-01

    Although multiple system atrophy (MSA) is a neurodegenerative disorder leading to progressive disability and decreased life expectancy, little is known about patients' own evaluation of their illness and factors associated with poor health-related quality of life (Hr-QoL). We, therefore, assessed Hr-QoL and its determinants in MSA. The following scales were applied to 115 patients in the European MSA-Study Group (EMSA-SG) Natural History Study: Medical Outcome Study Short Form (SF-36), EQ-5D, Beck Depression Inventory (BDI), Mini-Mental state examination (MMSE), Unified MSA Rating Scale (UMSARS), Hoehn & Yahr (H&Y) Parkinson's disease staging scale, Composite Autonomic Symptom Scale (COMPASS), and Parkinson's Disease Sleep Scale (PDSS). Forty-six percent of patients had moderate to severe depression (BDI > or = 17); Hr-QoL scores on the SF-36 and EQ-5D were significantly impaired. Pain, the only domain with similar scores in MSA and published PD patients, was reported more frequently in patients with MSA-P (predominantly parkinsonian motor subtype) than MSA-C (predominantly cerebellar motor subtype; 76% vs. 50%; P = 0.005). Hr-QoL scores correlated most strongly with UMSARS motor, COMPASS, and BDI scores but not with MMSE scores, age at onset, or disease duration. The COMPASS and UMSARS activities of daily living scores were moderate-to-strong predictors for the SF-36 physical summary score and the BDI and UMSARS motor scores for the SF-36 mental summary score. This report is the first study to show that Hr-QoL is significantly impaired in MSA. Although not all possible factors related to impaired Hr-QoL in MSA could be assessed, autonomic dysfunction, motor impairment, and depression were most closely associated with poor Hr-QoL, and therapeutic management, therefore, should concentrate upon these aspects of the disease.

  17. Mental Health, Quality of Life, and Health Functioning in Women Veterans: Differential Outcomes Associated with Military and Civilian Sexual Assault

    ERIC Educational Resources Information Center

    Suris, Alina; Lind, Lisa; Kashner, T. Michael; Borman, Patricia D.

    2007-01-01

    The present study examined psychiatric, physical, and quality-of-life functioning in a sample of 270 women veterans receiving outpatient treatment at a Veterans Affairs medical center. Participants were interviewed regarding their civilian (CSA) and military sexual assault (MSA) histories, and data regarding quality of life and health outcomes…

  18. Assessing Health-Related Quality of Life in Northern Plains American Indians: Prominence of Physical Activity as a Health Behavior

    ERIC Educational Resources Information Center

    Poltavski, Dmitri; Holm, Jeffrey; Vogeltanz-Holm, Nancy; McDonald, Leander

    2010-01-01

    Associations of behavioral health risks and healthy behaviors with self-reported health-related quality of life measures were investigated in a Northern Plains American Indian sample. Participants were surveyed in person using the Behavioral Risk Factor Surveillance Survey. The results showed that regular physical activity was significantly…

  19. The Relative Contribution of Health Status and Quality of Life Domains in Subjective Health in Old Age

    ERIC Educational Resources Information Center

    Prieto-Flores, Maria-Eugenia; Moreno-Jimenez, Antonio; Fernandez-Mayoralas, Gloria; Rojo-Perez, Fermina; Forjaz, Maria Joao

    2012-01-01

    To analyze the influence of different health status dimensions and quality of life (QoL) domains on older adults' subjective health, and to assess the role that residential satisfaction plays in these relationships. A QoL survey was conducted on a representative sample of the community-dwelling older adult population in Madrid province (Spain).…

  20. Quality Measures For Mental Health And Substance Use: Gaps, Opportunities, And Challenges.

    PubMed

    Pincus, Harold Alan; Scholle, Sarah Hudson; Spaeth-Rublee, Brigitta; Hepner, Kimberly A; Brown, Jonathan

    2016-06-01

    Following up on its Crossing the Quality Chasm report, in 2006 the Institute of Medicine issued a report that included sweeping recommendations to improve the quality of behavioral health care in the United States. To date, few of those recommendations have been implemented, and there is little evidence that behavioral health care quality has improved significantly over the past ten years. However, the advent of health care reform, parity of insurance coverage, and growing recognition of the impact of behavioral health disorders on population health and health care costs have created new demands and opportunities for expanded and innovative strategies to assess the quality of care for this patient population. We provide an overview of the current state of quality measurement in behavioral health, identify key priorities for measure development, and describe the most important challenges. We recommend a coordinated plan that would boost investment in developing, evaluating, and implementing behavioral health quality measures; conduct research to develop the evidence necessary to support a more robust set of measures; overcome barriers to the improvement and linking of data sources; and expand efforts to build the capacity of the clinical workforce, in partnership with consumers, to improve quality.

  1. Convenient meat and meat products. Societal and technological issues.

    PubMed

    Leroy, Frédéric; Degreef, Filip

    2015-11-01

    In past and contemporary foodscapes, meat and meat products have not only been following convenience trends, they have been at the heart of them. Historically, the first substantial demands for meat convenience must have been for the outsourcing of hunting or domestication, as well as slaughtering activities. In its turn, this prompted concerns for shelf-life stabilisation and the development of preservation strategies, such as meat fermentation. Demands for ease of preparation and consumption can be traced back to Antiquity but have gained in importance over the centuries, especially with the emergence of novel socio-cultural expectations and (perceived) time scarcity. Amongst other trends, this has led to the creation of ready meals and meat snacks and the expansion of urban fast food cultures. Additionally, contemporary requirements focus on the reduction of mental investments, via the "convenient" concealment of slaughtering, the optimisation of nutritional qualities, and the instant incorporation of more intangible matters, such as variety, hedonistic qualities, reassurance, and identity. An overview is given of the technological issues related to the creation of meat convenience, in its broadest sense, along with their societal implications.

  2. Health on the Net Foundation: assessing the quality of health web pages all over the world.

    PubMed

    Boyer, Célia; Gaudinat, Arnaud; Baujard, Vincent; Geissbühler, Antoine

    2007-01-01

    The Internet provides a great amount of information and has become one of the communication media which is most widely used [1]. However, the problem is no longer finding information but assessing the credibility of the publishers as well as the relevance and accuracy of the documents retrieved from the web. This problem is particularly relevant in the medical area which has a direct impact on the well-being of citizens. In this paper, we assume that the quality of web pages can be controlled, even when a huge amount of documents has to be reviewed. But this must be supported by both specific automatic tools and human expertise. In this context, we present various initiatives of the Health on the Net Foundation informing the citizens about the reliability of the medical content on the web.

  3. The effect of health information technology on quality in U.S. hospitals.

    PubMed

    McCullough, Jeffrey S; Casey, Michelle; Moscovice, Ira; Prasad, Shailendra

    2010-04-01

    Health information technology (IT), such as computerized physician order entry and electronic health records, has potential to improve the quality of health care. But the returns from widespread adoption of such technologies remain uncertain. We measured changes in the quality of care following adoption of electronic health records among a national sample of U.S. hospitals from 2004 to 2007. The use of computerized physician order entry and electronic health records resulted in significant improvements in two quality measures, with larger effects in academic than nonacademic hospitals. We conclude that achieving substantive benefits from national implementation of health IT may be a lengthy process. Policies to improve health IT's efficacy in nonacademic hospitals might be more beneficial than adoption subsidies.

  4. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    PubMed

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  5. English Language Proficiency and Health-Related Quality of Life among Chinese and Korean Immigrant Elders

    ERIC Educational Resources Information Center

    Mui, Ada C.; Kang, Suk-Young; Kang, Dooyeon; Domanski, Margaret Dietz

    2007-01-01

    This study examined the association between English language proficiency and health outcomes in a regional probability sample (n = 205) of elderly Chinese and Korean immigrants. Data support that these two Asian ethnic subgroups differ in English proficiency and health-related quality of life. Chinese and Korean elders had poorer health than the…

  6. Techniques for Developing Health Quality of Life Scales for Point of Service Use

    ERIC Educational Resources Information Center

    Lee, Young-Sun; Douglas, Jeffrey; Chewning, Betty

    2007-01-01

    Clinical and health policy research frequently involves health status measurement using generic or disease specific instruments. These instruments are generally developed to arrive at several scales, each measuring a distinct domain of health quality of life (HQOL). Clinical settings are starting to explore how to integrate patient perspectives of…

  7. Comparative analysis of quality assurance in health care delivery and higher medical education.

    PubMed

    Busari, Jamiu O

    2012-01-01

    Quality assurance (QA) in higher medical education involves the development, sustenance, improvement, and evaluation of the standard of training of medical professionals. In health care delivery, QA focuses on guaranteeing and maintaining a high standard of the service provided in different health care systems. When the service delivered by the care provider is in accordance with what the recipients of health care expect, then quality in health care is considered to be present. There are several factors in higher medical education and health care that are responsible for the emergence of QA. These include externally imposed obligations requiring demonstration of public accountability and responsibility from educational institutions, as well as the need for activity-specific information by policy makers as an aid for important decision-making within educational institutions. In health care delivery on the other hand, the emergence of QA is linked to the need for containing rising health care costs in the face of limited resources and to guaranteeing high quality patient care in a changing health care environment where the power relationship between doctors and patients is shifting towards patients. Although medical education can be regarded as a distinct entity in the health care industry, it still remains an inherent part of the health care delivery system. As a result, different strategies aimed at guaranteeing and assuring high standards of health care and education in many countries tend to overlap. This paper reflects on whether quality assurance in health care delivery and medical education should be seen as separate entities.

  8. Family Impacts among Children with Autism Spectrum Disorder: The Role of Health Care Quality

    PubMed Central

    Zuckerman, Katharine E.; Lindly, Olivia J.; Bethell, Christina D.; Kuhlthau, Karen

    2014-01-01

    Objectives To compare health care quality and family employment and financial impacts among children with special health care needs (CSHCN) with autism spectrum disorder (CSHCN+ASD), CSHCN with functional limitations (CSHCN+FL), and CSHCN lacking these conditions (other CSHCN). To test whether high health care quality was associated with reduced family impacts among CSHCN+ASD. Methods Data from the 2009-2010 National Survey of CSHCN were used to compare 3025 CSHCN+ASD, 6505 CSHCN+FL, and 28 296 other CSHCN. Weighted multivariate logistic regression analyses examined six age-relevant, federally-defined health care quality indicators and five family financial and employment impact indicators. Two composite measures were additionally used: (1) receipt of care that met all age-relevant quality indicators; and (2) had ≥ two of the five adverse family impacts. Results Across all health care quality indicators CSHCN+ASD fared poorly, with only 7.4% meeting all age-relevant indicators. CSHCN+ASD had worse health care quality than other CSHCN, including CSHCN+FL. CSHCN+ASD also had high rates of adverse family impact, with over half experiencing two or more adverse impacts. Rates of adverse family impact were higher in CSHCN+ASD than other CSHCN, including CSHCN+FL. Among CSHCN+ASD, those whose health care that met federal quality standards were less likely to have multiple adverse family impacts than CSHCN+ASD whose health care did not meet federal quality standards. Conclusions CSHCN+ASD are more prone to experience poor health care quality and family impacts than other CSHCN, even CSHCN+FL. Receipt of care meeting federal quality standards may potentially lessen adverse family impacts for CSHCN+ASD. PMID:24976352

  9. Patients' perceptions of service quality dimensions: an empirical examination of health care in New Zealand.

    PubMed

    Clemes, M D; Ozanne, L K; Laurensen, W L

    2001-01-01

    The 1984 liberalization of the New Zealand economy has resulted in a health care sector that has become very competitive (Zwier and Clarke, 1999). The private sector is now able to supply health care services and, as a result, a greater value is being placed on patient satisfaction (Zwier and Clarke, 1999). However, despite the increasing focus on customer satisfaction, research into health care patients' perceptions of the dimensions of service quality is scarce. This can be problematic, as quality of care is an essential issue in the strategic marketing of health care services (Turner and Pol, 1995). This study takes a step towards addressing this deficiency by identifying patients' perceptions of the dimensions of service quality in health care. The findings of this study are based on the empirical analysis of a sample of 389 respondents interviewed by telephone. The findings indicate that the service quality dimensions identified in this health care specific study differ in number and dimensional structure from the widely adopted service quality dimensions first identified by Parasuraman, Berry and Zeithaml (1988): reliability, responsiveness, assurance, empathy and tangibles. The service quality dimensions identified in this study were: reliability, tangibles, assurance, empathy, food, access, outcome, admission, discharge and responsiveness. In addition, health care patients perceive the service quality dimensions relating to the core product in health care delivery (for example, outcome and reliability) as more important than the service quality dimensions relating to the peripheral product in health care delivery (for example, food, access and tangibles). Finally, the results of this study suggest that patients with different geographic, demographic, and behavioristic characteristics have different needs and wants during health care delivery and therefore perceive different service quality dimensions as important.

  10. Satellite Power System (SPS) societal assessment

    SciTech Connect

    Not Available

    1980-12-01

    Construction and operation of a 60-unit (300 GW) domestic SPS over the period 2000 to 2030 would stress many segments of US society. A significant commitment of resources (land, energy, materials) would be required, and a substantial proportion of them would have to be committed prior to the production of any SPS electricity. Estimated resource demands, however, seem to be within US capabilities. Modifications will be required of institutions called upon to deal with SPS. These include financial, managerial and regulatory entities and, most particularly, the utility industry. Again, the required changes, while certainly profound, seem to be well within the realm of possibility. Enhanced cooperation in international affairs will be necessary to accommodate development and operation of the SPS. To remove its potential as a military threat and to reduce its vulnerability, either the SPS itself must become an international enterprise, or it must be subject to unrestricted international inspection. How either of these objectives could, in fact, be achieved, or which is preferable, remains unclear. Forty-four concerns about the SPS were identified via a public outreach experiment involving 9000 individuals from three special interest organizations. The concerns focused on environmental impacts (particularly the effects of microwave radiation) and the centralizing tendency of the SPS on society. The interim results of the public outreach experiment influenced the scope and direction of the CDEP; the final results will be instrumental in defining further societal assessment efforts.

  11. Future societal issues in industrial biotechnology.

    PubMed

    Schuurbiers, Daan; Osseweijer, Patricia; Kinderlerer, Julian

    2007-09-01

    Three international stakeholder meetings were organized by The Netherlands-based "Kluyver Center for Genomics of Industrial Fermentation" with the objective to identify the future societal issues in the field of industrial biotechnology and to develop a coordinated strategy for public dialogue. The meetings resulted in five unanimous recommendations: (i) that science, industry and the European Commission in conjunction with other stakeholders create a comprehensive roadmap towards a bio-based economy; (ii) that the European Commission initiate a series of round-table meetings to further articulate the views, interests and responsibilities of the relevant stakeholders and to define policy; (iii) that the development of new innovative communication activities is stimulated to increase public engagement and to discuss the ways that we do or do not want technologies to shape our common future; (iv) that further social studies are undertaken on public attitudes and behaviors to the bio-based economy and that novel methods are developed to assess public views of future technological developments; and (v) that the concept of sustainability is further operationalized and taken as a core value driving research and development and policy making.

  12. Reducing societal vulnerability to drought: A methodology

    SciTech Connect

    Wilhite, D.A.

    1995-12-31

    Given worldwide experience with drought during the past several decades and the magnitude of associated impacts, it is apparent that vulnerability to extended periods of water shortage is escalating. Developing a national or provincial drought policy and preparedness plan is a complicated but essential first step toward reducing societal vulnerability. Until recently, nations had devoted little effort to drought preparedness, preferring instead the reactive or crisis management approach. Presently, an increasing number of nations are pursuing a more proactive approach that emphasizes the principles of risk management and sustainable development. Because of the multitude of impacts associated with drought and the numerous governmental agencies that have responsibility for some aspect of monitoring, assessment, mitigation, and planning, developing a policy and plan must be an integrated process within and between levels of government. This paper outlines a generic process that can be adopted by governments that desire to develop a more comprehensive and long-term approach to drought management and planning. Countries and states or provincial authorities that have adopted this approach is presented as case studies. This process is timely, given the declaration of the 1990s as the International Decade for Natural Disaster Reduction and the recent International Convention to Combat Desertification and Drought (June, 1994), an offshoot of deliberations at the United Nations Conference on Environment and Development.

  13. Computer ethics education: Impact from societal norms

    SciTech Connect

    White, G.B.

    1994-12-31

    Discussions have occurred on the best way to implement the horizontal and vertical integration of education on the social, ethical and professional issues relating to computer science. These discussions have not only included debates on the subject matter and what manner to approach it (i.e. integrated among all computer science courses taught, as a separate required course, or a combination of both), but have also involved debates over who is best qualified to address the subject. What has seldom been addressed, however, is how societal impressions of what is ethical have impacted both those who develop software and those who use it. In light of the experience of such institutions as the U.S. Air Force Academy which recently instituted a program called the Center for Character Development (due to a perceived erosion of the core values of its recruits), should academia and industry expect more from computer scientists than from the population as a whole? It is the integration of ethics courses in the computer science curriculum in light of a general erosion of ethical values in society as a whole that is addressed in this paper.

  14. Economics and societal impacts of tornadoes

    NASA Astrophysics Data System (ADS)

    Bluestein, Howard B.

    2011-08-01

    During the spring of 2011, there were a record number of unusually strong and devastating tornadoes in the United States, which killed more than 500 people, the most in the country since 1953. Tornadoes are responsible for more than $1 billion annually (adjusted to 2007 U.S. dollars) in property damage and for disrupting thousands of lives and businesses. The most notable tornado this past spring devastated Joplin, Mo.; tornadoes also struck such diverse locations as Springfield, Mass.; Tuscaloosa, Ala.; Raleigh, N. C.; communities near Oklahoma City, Okla.; Minneapolis, Minn.; central and east Texas; Philadelphia, Pa.; and St. Louis, Mo. It is therefore timely to assess the economic and societal impacts of tornadoes. In this book the authors use various statistical techniques to evaluate the cost of tornadoes to society. They begin by reviewing the methodologies of formulating a tornado climatology across diverse regions according to tornado intensity, deaths, injuries, and property damage, and they then provide a history of the U.S. National Weather Service's (NWS) public warning efforts, describe tornado shelters and how the public responds to warnings, and suggest ways to reduce tornado risk.

  15. [Study monitoring: a useful tool for quality health research].

    PubMed

    Arias Valencia, Samuel Andrés; Hernández Pinzón, Giovanna

    2009-05-01

    As well as protecting the rights of participants, a study's ethics must encompass the quality of its execution. As such, international standards have been established for studies involving human subjects. The objective of this review is to evaluate the usefulness of the Guide to Good Clinical Practice and "study monitoring" as tools useful to producing quality research. The Guide provides scientific ethics and quality standards for designing, conducting, registering, and notifying studies involving human subjects. By implementing specific processes and procedures, study monitoring seeks to ensure that research is followed and evaluated from inception, through execution and closure, thus producing studies with high quality standards.

  16. The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview

    PubMed Central

    Black, Ashly D.; Car, Josip; Pagliari, Claudia; Anandan, Chantelle; Cresswell, Kathrin; Bokun, Tomislav; McKinstry, Brian; Procter, Rob; Majeed, Azeem; Sheikh, Aziz

    2011-01-01

    Background There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. Methods and Findings We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective

  17. Development and implementation of surface water quality standards for protection of human health in Korea.

    PubMed

    An, Youn-Joo; Kwak, Jin; Nam, Sun-Hwa; Jung, Myung Sook

    2014-01-01

    Current water quality standards for the protection of human health in Korea include 17 substances found in rivers and streams. Due to increasing concern over the release of hazardous chemicals into the aquatic environment, there has been a demand for additional water quality standards. Therefore, the Korean Ministry of the Environment plans to gradually increase the number of water quality standards to 30 substances, including 22 substances for protection of human health and 8 substances for protection of aquatic ecosystems by 2015. In this study, new water quality standards for protection of human health were established for 1,4-dioxane, formaldehyde, and hexachlorobenzene. We selected candidate hazardous chemicals, conducted a human health risk assessment to determine priority chemicals, established water quality standards based on technical analyses and comparison with domestic and developed countries' water quality standards, and conducted an expert review. Water quality standards for protection of aquatic ecosystems will be derived in the near future. This study describes how the water quality standards for protection of human health were developed and implemented. Current status, recent expansion, and future plans for water quality standards in Korea are also covered.

  18. Sensitivity of health risk estimates to air quality adjustment procedure

    SciTech Connect

    Whitfield, R.G.

    1997-06-30

    This letter is a summary of risk results associated with exposure estimates using two-parameter Weibull and quadratic air quality adjustment procedures (AQAPs). New exposure estimates were developed for children and child-occurrences, six urban areas, and five alternative air quality scenarios. In all cases, the Weibull and quadratic results are compared to previous results, which are based on a proportional AQAP.

  19. Blackberry fruit quality components, composition, and potential health benefits.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Blackberries have long been a popular small fruit. Their chemical composition data was assembled for this invited book chapter. Briefly, primary and secondary metabolites important to blackberry fruit quality were summarized. Metabolites are involved in many critical aspects of fruit quality includi...

  20. Progress on quality management in the German health system – a long and winding road

    PubMed Central

    Breckenkamp, Juergen; Wiskow, Christiane; Laaser, Ulrich

    2007-01-01

    The interest in quality management in health care has increased in the last decades as the financial crises in most health systems generated the need for solutions to contain costs while maintaining quality of care. In Germany the development of quality management procedures has been closely linked with health care reforms. Starting in the early nineties quality management issues gained momentum in reform legislation only 10 years later. This review summarizes recent developments in medical quality management as related to the federal reform legislation in Germany. It provides an overview on the infrastructure, actors and on the current discussion concerning quality management in medical care. Germany had to catch up on implementing quality management in the health system compared to other countries. Considerable progress has been made, however, it is recognized that the full integration of quality management will require long-term commitment in developing methods, instruments and communication procedures. The most ambitious project at present is the development of a comprehensive comparative quality management system for hospitals at national level, including public reporting. For the time being medical quality management in Germany is dealt with as a technical and professional issue while the aspects of patient orientation and transparency need further advancement. PMID:17550593

  1. Innovations to Enhance the Quality of Health Professions Education at the University of Zimbabwe College of Health Sciences -NECTAR Program

    PubMed Central

    Ndhlovu, Chiratidzo E; Nathoo, Kusum; Borok, Margaret; Chidzonga, Midion; Aagaard, Eva M.; Connors, Susan C.; Barry, Michele; Campbell, Thomas; Hakim, James

    2014-01-01

    The University of Zimbabwe College of Health Sciences (UZCHS) is Zimbabwe's premier health professions training institution. However, several concerns were raised during the past decade over the quality of health education at UZCHS. The number of faculty and students declined markedly until 2010, when there was a medical student intake of 147 while the faculty comprised only 122 (39%) of a possible 314 positions. The economic and political crises that the country experienced from 1999 to 2009 compounded the difficulties faced by the institution by limiting the availability of resources. The Medical Education Partnership Initiative (MEPI) funding opportunity has given UZCHS the stimulus to embark on reforms to improve the quality of health education it offers. UZCHS, in partnership with the University of Colorado School of Medicine (UCSOM), the University of Colorado Denver Evaluation Center (UCDEC), and Stanford University designed the Novel Education Clinical Trainees and Researchers (NECTAR) program to implement a series of health education innovations to meet this challenge. Between 2010 and 2013, innovations that have positively affected the quality of health professions education at UZCHS include the launch of comprehensive faculty development programs and mentored clinical and research programs for postgraduate students. A competency-based curriculum reform process has been initiated; a health professions department has been established; and the Research Support Center has been strengthened, providing critical resources to institutionalize health education and research implementation at the college. A core group of faculty trained in medical education has been assembled, helping to ensure the sustainability of these NECTAR activities. PMID:25072588

  2. An integrated model for continuous quality improvement and productivity improvement in health services organizations.

    PubMed

    Rakich, J S; Darr, K; Longest, B B

    1993-01-01

    The health services paradigm with respect to quality has shifted to that of conformance to requirements (the absence of defects) and fitness for use (meeting customer expectations and needs). This article presents an integrated model of continuous quality improvement (CQI) (often referred to as total quality management) and productivity improvement for health services organizations. It incorporates input-output theory and focuses on the CQI challenge--"How can we be certain that we do the right things right the first time, every time?" The twin pillars of CQI are presented. Achievement of both will result in productivity improvement and enhancement of the health services organization's competitive position.

  3. Quality of life measures in health care. I: Applications and issues in assessment.

    PubMed Central

    Fitzpatrick, R.; Fletcher, A.; Gore, S.; Jones, D.; Spiegelhalter, D.; Cox, D.

    1992-01-01

    Many clinicians remain unsure of the relevance of measuring quality of life to their clinical practice. In health economics quality of life measures have become the standard means of assessing the results of health care interventions and, more controversially, the means of prioritising funding; but they have many other applications. This article--the first of three on measuring quality of life--reviews the instruments available and their application in screening programmes, audit, health care research, and clinical trials. Using the appropriate instrument is essential if outcome measures are to be valid and clinically meaningful. Images p1076-a PMID:1467690

  4. The New Zealand World Health Organization Quality of Life (WHOQOL) Group.

    PubMed

    Billington, D Rex; Landon, Jason; Krägeloh, Christian U; Shepherd, Daniel

    2010-05-28

    With the approval of the World Health Organization (WHO), AUT University has established a new centre to develop and promote the use of the World Health Organization Quality of Life (WHOQOL) assessment instruments for health and health-related studies in New Zealand. The purpose of this paper is to introduce the NZ WHOQOL Group and to describe the structure and properties of the questionnaires in order to help the reader decide whether the instruments are suitable for their research and their use.

  5. Impact of Health and Fitness-Related Behavior on Quality of Life

    DTIC Science & Technology

    1992-01-01

    Weight status did not emerge as a predictor of overall QOL. Con- sidering that overweight is viewed negatively in American society, it was excepted that...Psychosomatic Research 9, p. 249. Slater, C. and B. Carlton: 1985, ’Behavior, lifestyle, and socioeconomic variables as determinants of health status ...RELATED BEHAVIOR ON QUALITY OF LIFE (Received 23 May, 199 1) ABSTRACT. While the relationships between (a) health behavior and health status and (b) health

  6. [Promoting competition and improving quality. Accepting the intergenerational contract by stabilizing health care reform].

    PubMed

    Wasem, J

    2002-08-01

    The challenge of demographic transition requires a health care reform which strengthens competition and quality in health care. With this, important contributions in stabilizing intergenerational relations, especially intergenerational solidarity in the public health care system, can be achieved. The reform proposal by an expert group, invited by the Friedrich-Ebert-Foundation to develop a concept of health care reform, takes these considerations into account.

  7. Health-related quality of life in early breast cancer.

    PubMed

    Groenvold, Mogens

    2010-09-01

    The treatment of primary breast cancer usually consists of surgery often followed by adjuvant therapy (radiotherapy, chemotherapy, hormonal treatment, etc.) to reduce the risk of recurrence. The cancer diagnosis and the treatments may have significant impact on the patients' quality of life. This thesis deals with scientific aspects and clinical results of a study aimed at assessing the impact of breast cancer (and its treatment) on the patients' quality of life. Studies such as this assessing the problems and symptoms experienced by the patients are often referred to as health-related quality of life (HRQL) research. HRQL research deals with subjective experiences and raises challenging, scientific questions. Therefore, much attention was directed towards methodological issues in this clinically motivated project. The study was a prospective, longitudinal, questionnaire-based investigation of women with newly diagnosed breast cancer registered in the Danish Breast Cancer Co-operative Group's DBCG 89 Program. The patients were sub-divided into low-risk and high-risk patients. High-risk patients were offered randomisation in one of three randomised adjuvant therapy trials involving chemotherapy, ovarian ablation, and endocrine therapy. After a literature study and interviews with breast cancer patients, a questionnaire was composed that included two widely used standard questionnaires (EORTC QLQ-C30 and Hospital Anxiety and Depression (HAD) Scale) and a DBCG 89 Questionnaire developed for this study. A total of 1,898 eligible patients were invited by post to participate in the study involving six assessments over a 2-year period, and 1,713 patients (90%) completed the first questionnaire. Furthermore, a questionnaire was sent to 872 women selected at random from the general population; 608 (70%) responded. The multi-item scales of the two standard questionnaires were analysed for so-called differential item functioning (DIF) in order to investigate whether the

  8. Health risk assessment of heavy metals in wheat using different water qualities: implication for human health.

    PubMed

    Khan, Zafar Iqbal; Ahmad, Kafeel; Rehman, Sidrah; Siddique, Samra; Bashir, Humayun; Zafar, Asma; Sohail, Muhammad; Ali, Salem Alhajj; Cazzato, Eugenio; De Mastro, Giuseppe

    2017-01-01

    In the recent years, the use of sewage water for irrigation has attracted the attention of arid and semi-arid countries where the availability of fresh water is poor. Despite the potential use of sewage water in crop irrigation as effective and sustainable strategy, the environmental and human risks behind this use need to be deeply investigated. In this regard, an experiment was carried out under field conditions in Nursery, University College of Agriculture Sargodha, to evaluate the possible health risks of undesirable metals in wheat grains. Wheat variety Sarang was cultivated and irrigated with different combinations of ground (GW) and sewage water (SW). The concentrations of heavy metals (Cr, Cd, Ni, and Pb) and trace elements (Cu, Zn, and Fe) in wheat grains as well as in soil were determined. Moreover, the pollution load index (PLI), accumulation factor (AF), daily intake of metals (DIM), and health risk index (HRI) were calculated. Results showed that the concentration trend of heavy metals was Pbquality, whereas Pb concentration in grain was within the acceptable levels as suggested by World Health Organization, when 100 % of SW was used for irrigation. Similar observation was reported for Cd concentration in the soil when wheat was irrigated with 100 % SW. In comparison to soil, the edible part of wheat presented lower concentration of all studied metals, except for Zn which was much higher compared to the tested soil samples. The higher concentration of Zn was responsible for increasing the DIM of Zn where, in average, the highest value was reported, particularly in 75 % SW treatment. This was reflected also in HRI where the maximum value was reported for Zinc under the same treatment. Higher value of HRI for wheat cultivated on polluted soils suggested that appropriate management of

  9. The effect of school quality on black-white health differences: evidence from segregated southern schools.

    PubMed

    Frisvold, David; Golberstein, Ezra

    2013-12-01

    This study assesses the effect of black-white differences in school quality on black-white differences in health in later life resulting from the racial convergence in school quality for cohorts born between 1910 and 1950 in southern states with segregated schools. Using data from the 1984-2007 National Health Interview Surveys linked to race-specific data on school quality, we find that reductions in the black-white gap in school quality led to modest reductions in the black-white gap in disability.

  10. Promoting health-related quality of life in patients with an implantable cardioverter defibrillator.

    PubMed

    Wong, Florence

    2017-03-01

    Implantable cardioverter defibrillators (ICDs) are an effective treatment to reduce mortality rates in patients who are at risk of sudden cardiac death. However, ICDs have been shown to reduce the patient's mental and physical health-related quality of life. It is essential for nurses to have an understanding of the factors associated with health-related quality of life in patients with ICDs, to develop appropriate strategies to improve patient care and optimise quality of life. A case study is included in this article to enhance understanding of the effects these devices can have on a patient's quality of life.

  11. The Effect of School Quality on Black-White Health Differences: Evidence From Segregated Southern Schools

    PubMed Central

    Frisvold, David; Golberstein, Ezra

    2013-01-01

    This study assesses the effect of black-white differences in school quality on black-white differences in health in later life resulting from the racial convergence in school quality for cohorts born between 1910 and 1950 in southern states with segregated schools. Using data from the 1984 through 2007 National Health Interview Surveys linked to race-specific data on school quality, we find that reductions in the black-white gap in school quality led to modest reductions in the black-white gap in disability. PMID:23839102

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  13. RELATING AIR QUALITY AND ENVIRONMENTAL PUBLIC HEALTH TRACKING DATA

    EPA Science Inventory

    Initiated in February 2004, the Public Health Air Surveillance Evaluation (PHASE) Project is a multi-disciplinary collaboration between the Centers for Disease Control and Prevention (CDC), the U.S Environmental Protection Agency (EPA), and three Environmental Public Health Track...

  14. Healthcare delivery systems: designing quality into health information systems.

    PubMed

    Joyce, Phil; Green, Rosamund; Winch, Graham

    2007-01-01

    To ensure that quality is 'engineered in' a holistic, integrated and quality approach is required, and Total Quality Management (TQM) principles are the obvious foundations for this. This paper describes a novel approach to viewing the operations of a healthcare provider where electronic means could be used to distribute information (including electronic fund settlements), building around the Full Service Provider core. Specifically, an approach called the "triple pair flow" model is used to provide a view of healthcare delivery that is integrated, yet detailed, and that combines the strategic enterprise view with a business process view.

  15. Can disease management reduce health care costs by improving quality?

    PubMed

    Fireman, Bruce; Bartlett, Joan; Selby, Joe

    2004-01-01

    Disease management (DM) promises to achieve cost savings by improving the quality of care for chronic diseases. During the past decade the Permanente Medical Group in Northern California has implemented extensive DM programs. Examining quality indicators, utilization, and costs for 1996-2002 for adults with four conditions, we find evidence of substantial quality improvement but not cost savings. The causal pathway--from improved care to reduced morbidity to cost savings--has not produced sufficient savings to offset the rising costs of improved care. We conclude that the rationale for DM programs, like the rationale for any medical treatments, should rest on their effectiveness and value.

  16. Home health care quality conferences: promoting change through dialogue.

    PubMed

    Rudin, Danylle

    2006-01-01

    The following brief is based on the results of two conferences on home care quality hosted by the Center for Home Care Policy and Research of the Visiting Nurse Service of New York. For more information about the conference outcomes and proceedings please see: Feldman, P.H.,Peterson, L.E., Reische, L., Bruno, L., & Clark, A. (2004). Charting the course for home healthcare quality: Action steps for achieving sustainable improvement. Conference proceedings. Home Healthcare Nurse, 22(12): 841-850; and Feldman, P.H., Clark, A., & Bruno, L. (2006). Advancing the agenda for home healthcare quality: Conference proceedings and findings. Home Healthcare Nurse, 24(5): 282-290.

  17. Human initiated cascading failures in societal infrastructures.

    PubMed

    Barrett, Chris; Channakeshava, Karthik; Huang, Fei; Kim, Junwhan; Marathe, Achla; Marathe, Madhav V; Pei, Guanhong; Saha, Sudip; Subbiah, Balaaji S P; Vullikanti, Anil Kumar S

    2012-01-01

    In this paper, we conduct a systematic study of human-initiated cascading failures in three critical inter-dependent societal infrastructures due to behavioral adaptations in response to a crisis. We focus on three closely coupled socio-technical networks here: (i) cellular and mesh networks, (ii) transportation networks and (iii) mobile call networks. In crises, changes in individual behaviors lead to altered travel, activity and calling patterns, which influence the transport network and the loads on wireless networks. The interaction between these systems and their co-evolution poses significant technical challenges for representing and reasoning about these systems. In contrast to system dynamics models for studying these interacting infrastructures, we develop interaction-based models in which individuals and infrastructure elements are represented in detail and are placed in a common geographic coordinate system. Using the detailed representation, we study the impact of a chemical plume that has been released in a densely populated urban region. Authorities order evacuation of the affected area, and this leads to individual behavioral adaptation wherein individuals drop their scheduled activities and drive to home or pre-specified evacuation shelters as appropriate. They also revise their calling behavior to communicate and coordinate among family members. These two behavioral adaptations cause flash-congestion in the urban transport network and the wireless network. The problem is exacerbated with a few, already occurring, road closures. We analyze how extended periods of unanticipated road congestion can result in failure of infrastructures, starting with the servicing base stations in the congested area. A sensitivity analysis on the compliance rate of evacuees shows non-intuitive effect on the spatial distribution of people and on the loading of the base stations. For example, an evacuation compliance rate of 70% results in higher number of overloaded

  18. Human Initiated Cascading Failures in Societal Infrastructures

    PubMed Central

    Barrett, Chris; Channakeshava, Karthik; Huang, Fei; Kim, Junwhan; Marathe, Achla; Marathe, Madhav V.; Pei, Guanhong; Saha, Sudip; Subbiah, Balaaji S. P.; Vullikanti, Anil Kumar S.

    2012-01-01

    In this paper, we conduct a systematic study of human-initiated cascading failures in three critical inter-dependent societal infrastructures due to behavioral adaptations in response to a crisis. We focus on three closely coupled socio-technical networks here: (i) cellular and mesh networks, (ii) transportation networks and (iii) mobile call networks. In crises, changes in individual behaviors lead to altered travel, activity and calling patterns, which influence the transport network and the loads on wireless networks. The interaction between these systems and their co-evolution poses significant technical challenges for representing and reasoning about these systems. In contrast to system dynamics models for studying these interacting infrastructures, we develop interaction-based models in which individuals and infrastructure elements are represented in detail and are placed in a common geographic coordinate system. Using the detailed representation, we study the impact of a chemical plume that has been released in a densely populated urban region. Authorities order evacuation of the affected area, and this leads to individual behavioral adaptation wherein individuals drop their scheduled activities and drive to home or pre-specified evacuation shelters as appropriate. They also revise their calling behavior to communicate and coordinate among family members. These two behavioral adaptations cause flash-congestion in the urban transport network and the wireless network. The problem is exacerbated with a few, already occurring, road closures. We analyze how extended periods of unanticipated road congestion can result in failure of infrastructures, starting with the servicing base stations in the congested area. A sensitivity analysis on the compliance rate of evacuees shows non-intuitive effect on the spatial distribution of people and on the loading of the base stations. For example, an evacuation compliance rate of 70% results in higher number of overloaded

  19. A novel framework for assessing metadata quality in epidemiological and public health research settings.

    PubMed

    McMahon, Christiana; Denaxas, Spiros

    2016-01-01

    Metadata are critical in epidemiological and public health research. However, a lack of biomedical metadata quality frameworks and limited awareness of the implications of poor quality metadata renders data analyses problematic. In this study, we created and evaluated a novel framework to assess metadata quality of epidemiological and public health research datasets. We performed a literature review and surveyed stakeholders to enhance our understanding of biomedical metadata quality assessment. The review identified 11 studies and nine quality dimensions; none of which were specifically aimed at biomedical metadata. 96 individuals completed the survey; of those who submitted data, most only assessed metadata quality sometimes, and eight did not at all. Our framework has four sections: a) general information; b) tools and technologies; c) usability; and d) management and curation. We evaluated the framework using three test cases and sought expert feedback. The framework can assess biomedical metadata quality systematically and robustly.

  20. A novel framework for assessing metadata quality in epidemiological and public health research settings

    PubMed Central

    McMahon, Christiana; Denaxas, Spiros

    2016-01-01

    Metadata are critical in epidemiological and public health research. However, a lack of biomedical metadata quality frameworks and limited awareness of the implications of poor quality metadata renders data analyses problematic. In this study, we created and evaluated a novel framework to assess metadata quality of epidemiological and public health research datasets. We performed a literature review and surveyed stakeholders to enhance our understanding of biomedical metadata quality assessment. The review identified 11 studies and nine quality dimensions; none of which were specifically aimed at biomedical metadata. 96 individuals completed the survey; of those who submitted data, most only assessed metadata quality sometimes, and eight did not at all. Our framework has four sections: a) general information; b) tools and technologies; c) usability; and d) management and curation. We evaluated the framework using three test cases and sought expert feedback. The framework can assess biomedical metadata quality systematically and robustly. PMID:27570670

  1. Software Quality Evaluation Models Applicable in Health Information and Communications Technologies. A Review of the Literature.

    PubMed

    Villamor Ordozgoiti, Alberto; Delgado Hito, Pilar; Guix Comellas, Eva María; Fernandez Sanchez, Carlos Manuel; Garcia Hernandez, Milagros; Lluch Canut, Teresa

    2016-01-01

    Information and Communications Technologies in healthcare has increased the need to consider quality criteria through standardised processes. The aim of this study was to analyse the software quality evaluation models applicable to healthcare from the perspective of ICT-purchasers. Through a systematic literature review with the keywords software, product, quality, evaluation and health, we selected and analysed 20 original research papers published from 2005-2016 in health science and technology databases. The results showed four main topics: non-ISO models, software quality evaluation models based on ISO/IEC standards, studies analysing software quality evaluation models, and studies analysing ISO standards for software quality evaluation. The models provide cost-efficiency criteria for specific software, and improve use outcomes. The ISO/IEC25000 standard is shown as the most suitable for evaluating the quality of ICTs for healthcare use from the perspective of institutional acquisition.

  2. Developing and Transitioning Numerical Air Quality Models to Improve Air Quality and Public Health Decision-Making in El Salvador and Costa Rica As Part of the Servir Applied Sciences Team

    NASA Astrophysics Data System (ADS)

    Thomas, A.; Huff, A. K.; Gomori, S. G.; Sadoff, N.

    2014-12-01

    In order to enhance the capacity for air quality modeling and improve air quality monitoring and management in the SERVIR Mesoamerica region, members of SERVIR's Applied Sciences Team (AST) are developing national numerical air quality models for El Salvador and Costa Rica. We are working with stakeholders from the El Salvador Ministry of the Environment and Natural Resources (MARN); National University of Costa Rica (UNA); the Costa Rica Ministry of the Environment, Energy, and Telecommunications (MINAET); and Costa Rica National Meteorological Institute (IMN), who are leaders in air quality monitoring and management in the Mesoamerica region. Focusing initially on these institutions will build sustainability in regional modeling activities by developing air quality modeling capability that can be shared with other countries in Mesoamerica. The air quality models are based on the Community Multi-scale Air Quality (CMAQ) model and incorporate meteorological inputs from the Weather Research and Forecasting (WRF) model, as well as national emissions inventories from El Salvador and Costa Rica. The models are being optimized for urban air quality, which is a priority of decision-makers in Mesoamerica. Once experimental versions of the modeling systems are complete, they will be transitioned to servers run by stakeholders in El Salvador and Costa Rica. The numerical air quality models will provide decision support for stakeholders to identify 1) high-priority areas for expanding national ambient air monitoring networks, 2) needed revisions to national air quality regulations, and 3) gaps in national emissions inventories. This project illustrates SERVIR's goal of the transition of science to support decision-making through capacity building in Mesoamerica, and it aligns with the Group on Earth Observations' health societal benefit theme. This presentation will describe technical aspects of the development of the models and outline key steps in our successful

  3. Quality Of Health Care In India: Challenges, Priorities, And The Road Ahead.

    PubMed

    Mohanan, Manoj; Hay, Katherine; Mor, Nachiket

    2016-10-01

    India's health care sector provides a wide range of quality of care, from globally acclaimed hospitals to facilities that deliver care of unacceptably low quality. Efforts to improve the quality of care are particularly challenged by the lack of reliable data on quality and by technical difficulties in measuring quality. Ongoing efforts in the public and private sectors aim to improve the quality of data, develop better measures and understanding of the quality of care, and develop innovative solutions to long-standing challenges. We summarize priorities and the challenges faced by efforts to improve the quality of care. We also highlight lessons learned from recent efforts to measure and improve that quality, based on the articles on quality of care in India that are published in this issue of Health Affairs The rapidly changing profile of diseases in India and rising chronic disease burden make it urgent for state and central governments to collaborate with researchers and agencies that implement programs to improve health care to further the quality agenda.

  4. A review of data quality assessment methods for public health information systems.

    PubMed

    Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

    2014-05-14

    High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users' concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process.

  5. A Review of Data Quality Assessment Methods for Public Health Information Systems

    PubMed Central

    Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

    2014-01-01

    High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users’ concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process. PMID:24830450

  6. Health-related quality of life in children with high-functioning autism.

    PubMed

    Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A; Wood-Dauphinee, Sharon; Kehayia, Eva

    2015-01-01

    The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of life of children. A cross-sectional study of children with high-functioning autism (n = 30) and peers (n = 31) was conducted using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Children with high-functioning autism had significantly poorer health-related quality of life than peers whether reported by themselves (p < .001) or their parents (p < .001), although disagreement (intra-class coefficient = -.075) between children and parental scores suggested variance in points of view. This study specifically investigated health-related quality of life in children with high-functioning autism as compared to a sample of peers, from the child's perspective. It strengthens earlier findings that children with high-functioning autism experience poorer health-related quality of life than those without this disorder and points to the importance of clinicians working with families to identify areas in a child's life that promote or hinder their sense of well-being.

  7. Evaluation of the quality of the general health information webpages in Spain: influence of page source.

    PubMed

    Conesa-Fuentes, Maria C; Aguinaga-Ontoso, Enrique; Hernandez-Morante, Juan J

    2013-12-01

    The Internet, regardless of whether or not it is reliable, is considered the main source of health information. However, the lay-user does not know which sources offer good quality information. The main objective of the present study, therefore, was to evaluate the quality of Spanish health-related webpages, and to determine whether the webpage source influences this quality. To this end, 36 webpages were selected through the PageRank® system. The webpages from all the Regional Health Services of Spain (19 sites) were also included. The quality evaluation, which was carried out by applying the Andalusian Health Quality Agency Test, indicated that the quality information offered by Spanish webpages is very low, since no site reached the maximum score. In addition, several important aspects, including those related with personal data management and the updating of information, were not considered by most of the evaluated pages. In summary, this work shows that quality of the health information webpages in Spain is generally low, and draws particular attention to certain responsibilities, that are not met by most evaluated webpages, including sites from the Regional Health Services.

  8. Health-Related Quality of Life and Functional Status Quality Indicators for Older Persons with Multiple Chronic Conditions

    PubMed Central

    Dy, Sydney M.; Pfoh, Elizabeth R.; Salive, Marcel E.; Boyd, Cynthia M.

    2015-01-01

    OBJECTIVES To explore central challenges with translating self-reported measurement tools for functional status and health-related quality of life (HRQOL) into ambulatory quality indicators for older people with multiple chronic conditions (MCCs). DESIGN Review. SETTING Sources including the National Quality Measures Clearinghouse and National Quality Forum were reviewed for existing ambulatory quality indicators relevant to functional status, HRQOL, and people with MCCs. PARTICIPANTS Seven informants with expertise in indicators using functional status and HRQOL. MEASUREMENTS Informant interviews were conducted to explore knowledge about these types of indicators, particularly usability and feasibility. RESULTS Nine important existing indicators were identified in the review. For process, identified indicators addressed whether providers assessed functional status; outcome indicators addressed quality of life. In interviews, informants agreed that indicators using self-reported data were important in this population. Challenges identified included concerns about usability due to inability to discriminate quality of care adequately between organizations and feasibility concerns regarding high data collection burden, with a correspondingly low response rate. Validity was also a concern because evidence is mixed that healthcare interventions can improve HRQOL or functional status for this population. As a possible first step, a structural standard could be systematic collection of these measures in a specific setting. CONCLUSION Although functional status and HRQOL are important outcomes for older people with MCCs, few relevant ambulatory quality indicators exist, and there are concerns with usability, feasibility, and validity. Further research is needed on how best to incorporate these outcomes into quality indicators for people with MCCs. PMID:24320819

  9. Analysis of Water Conflicts across Natural and Societal Boundaries: Integration of Quantitative Modeling and Qualitative Reasoning

    NASA Astrophysics Data System (ADS)

    Gao, Y.; Balaram, P.; Islam, S.

    2009-12-01

    Water issues and problems have bewildered humankind for a long time yet a systematic approach for understanding such issues remain elusive. This is partly because many water-related problems are framed from a contested terrain in which many actors (individuals, communities, businesses, NGOs, states, and countries) compete to protect their own and often conflicting interests. We argue that origin of many water problems may be understood as a dynamic consequence of competition, interconnections, and feedback among variables in the Natural and Societal Systems (NSSs). Within the natural system, we recognize that triple constraints on water- water quantity (Q), water quality (P), and ecosystem (E)- and their interdependencies and feedback may lead to conflicts. Such inherent and multifaceted constraints of the natural water system are exacerbated often at the societal boundaries. Within the societal system, interdependencies and feedback among values and norms (V), economy (C), and governance (G) interact in various ways to create intractable contextual differences. The observation that natural and societal systems are linked is not novel. Our argument here, however, is that rigid disciplinary boundaries between these two domains will not produce solutions to the water problems we are facing today. The knowledge needed to address water problems need to go beyond scientific assessment in which societal variables (C, G, and V) are treated as exogenous or largely ignored, and policy research that does not consider the impact of natural variables (E, P, and Q) and that coupling among them. Consequently, traditional quantitative methods alone are not appropriate to address the dynamics of water conflicts, because we cannot quantify the societal variables and the exact mathematical relationships among the variables are not fully known. On the other hand, conventional qualitative study in societal domain has mainly been in the form of individual case studies and therefore

  10. Assessment of primary health care received by the elderly and health related quality of life: a cross-sectional study

    PubMed Central

    2013-01-01

    Background Population aging leads to increased burden of chronic diseases and demand in public health. This study aimed to assess whether the score of Primary Health Care (PHC) is associated with a) the model of care - Family Health Strategy (FHS) vs. traditional care model (the Basic Health Units; BHU); b) morbid conditions such as - hypertension, diabetes mellitus, mental disorders, chronic pain, obesity and central obesity; c) quality of life in elderly individuals who received care in those units. Methods A survey was conducted among the elderly between August 2010 and August 2011, in Ilheus, Bahia. We interviewed elderly patients - 60 years or older - who consulted at BHU or FHS units in that day or participated in a group activity, and those who were visited at home by the staff of PHC, selected through a random sample. Demographic and socioeconomic characteristics, services’ attainment of primary care attributes, health problems and quality of life were investigated. The Short Form Health Survey (SF-12) was used to assess quality of life and PCATool to generate PHC scores. In addition, weight, height and waist circumference were measured. Trained research assistants, under supervision performed the data collection. Results A total of 511 elderly individuals were identified, two declined to participate, resulting in 509 individuals interviewed. The health care provided by the FHS has higher attainment of PHC attributes, in comparison to the BHU, resulting in lower prevalence of score below six. Except for hypertension and cardiovascular disease, other chronic problems were not independently associated with low scores in PHC. It was observed an independent and positive association between PHC score and the mental component of quality of life and an inverse association with the physical component. Conclusions This study showed higher PHC attributes attainment in units with FHS, regardless of the health problem. The degree of orientation to PHC increased the

  11. Quality of life in patients with hand eczema as health promotion: a case control study.

    PubMed

    Ghaderi, Reza; Saadatjoo, Alireza

    2014-01-01

    Health promotion has been defined by the World Health Organization's (WHO) 2005 Bangkok Charter for Health Promotion as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health". One of the most important determinants of health is quality of life. Hand eczema is a common skin disease that can adversely affect the quality of life of patients. The aim of this study was to determine the quality of life in patients with hand eczema. This case-control study was performed on 70 patients with hand eczema and 70 healthy controls. All the patients filled out two questionnaires: Short Form 36 (SF-36) and Dermatology Life Quality index (DLQI). The data were analyzed using the statistical software package for social sciences (SPSS). The mean score score of quality of life in dimensions of physical functioning, vitality, and general health in the SF-36 was lower compared to the control group. The mean score in DLQI in patients with hand eczema was 8.68. There was a significant negative correlation between the scores of different dimensions of QOL obtained in the two questionnaires (SF36 and DLQI). The study demonstrated that the quality of life in patients with hand eczema was lower than that of controls. It seems advisable that psychiatric consultations or psychotherapy be included in the treatment of chronic hand eczema.

  12. Improving Health Care Workers for Seasonal Influenza Vaccination at University Health System: A Paradigm for Closing the Quality Chasm

    PubMed Central

    Patterson, Jan E.; Cadena, Jose; Prigmore, Teresa; Bowling, Jason; Ayala, Beth Ann; Kirkman, Leni; Parekh, Amruta; Scepanski, Theresa

    2011-01-01

    Significant gaps in quality and patient safety in the US health-care system have been identified and were reported in the past decade by the Institute of Medicine. Despite recognition of these gaps in “knowing versus doing,” change in health care is slow and difficult. The quality improvement and clinical safety movement is increasing among US medical centers. Our health science center implemented the UT System Clinical Safety and Effectiveness course, providing project-based teaching of quality-improvement tools and principles of patient safety. A quality-improvement project that increased healthcare workers' influenza vaccination rate by 17.8% from that in 2008 to a rate of 76.6% in 2009 serves as a paradigm of how physicians can lead quality-improvement project teams to narrow the quality chasm (1). Local efforts to narrow the chasm are discussed in the present paper, including inter-professional education in quality improvement and clinical safety. PMID:21686222

  13. Blending Key Ingredients to Assure Quality in Home Health Care.

    ERIC Educational Resources Information Center

    Griffith, Deloris G.

    1986-01-01

    Careful staff selection, training, and review are among the methods the author recommends to home care agencies striving to provide top-notch services. Discusses measuring the quality of care employees are providing, accreditation, and the benefits of accreditation. (CT)

  14. [Quality assurance at a health center: 2 years' experience].

    PubMed

    Marquet, R; Davins, J; Casas, J; Fernández, R M

    1991-11-01

    In the Primary Care field there is very little experience of organizing a quality control programme that covers all aspects of care. In our centre, at the beginning of 1989, a Quality Control Commission (QCC) was formed with the aim of establishing and coordinating these activities. We describe our two year experience in this report, with special emphasis on the programme's organizational side and the methodological difficulties we encountered while introducing the programme.

  15. The how and why of societal publications for citizen science projects and scientists.

    PubMed

    van Vliet, Arnold J H; Bron, Wichertje A; Mulder, Sara

    2014-05-01

    In the scientific community, the importance of communication to society is often underestimated. Scientists and scientific organisations often lack the skills to organise such communication effectively. The Dutch citizen science phenology network Nature's Calendar has been successful in communicating to the general public via numerous newspaper articles, television appearances, presentations, websites and social media. We refer to these publications as societal publications. Due to active communication to mass media, we frequently reach millions of people. This communication helped us to involve thousands of volunteers in recording the timing of phenological events like the start of flowering, leaf unfolding and bird migration, but also several health-related events like hay fever symptoms and tick bites. In this paper, we analyse and present our experiences with the Nature's Calendar project regarding societal publications. Based on this analysis, we explain the importance of societal publications for citizen science projects and scientists in general, and we show how scientists can increase the news worthiness of scientific information and what factors and activities can increase the chances of media paying attention to this news. We show that societal publications help phenological networks by facilitating the recruitment, retention and instruction of observers. Furthermore, they stimulate the generation of new ideas and partners that lead to an increase in knowledge, awareness and behavioural change of the general public or specific stakeholders. They make projects, and scientists involved, better known to the public and increase their credibility and authority. Societal publications can catalyse the production of new publications, thereby enforcing the previous mentioned points.

  16. Future Directions in the Use of Telemental Health to Improve the Accessibility and Quality of Children's Mental Health Services

    PubMed Central

    Myers, Kathleen

    2016-01-01

    Abstract Objectives: This concluding commentary offers a brief overview of progress to date in providing telemental health services to children, and then offers a critical vision for future research needed to provide the rigorous empirical foundation for telemental health to be considered a well-established format for the delivery of children's mental health services. Methods: We review how recent years have witnessed advances in the science and practice of children's telemental health, and the articles in this special series collectively offered a critical step forward in the establishment of a guiding literature to provide informed direction for child providers incorporating remote technologies to extend their practices. Results: Researchers must be cautious not to develop a “horse race” mentality and a misguided search for a decisive “winner” regarding the ultimate effectiveness of child telemental health versus traditional clinic-based treatments. Instead, research efforts are needed to examine key mediators and moderators of telemental health treatment response. The question should not be simply whether telemental health strategies are supported, but rather when, under what circumstances, and for whom telemental health formats may be most indicated. Barriers to the continued evolution of children's telemental health are discussed, and we consider issues of telemental health reimbursement and matters of cross-state professional jurisdiction. Conclusions: Continued efforts are needed in order to fully actualize the potential of children's telemental health to optimize the quality and transform the accessibility of mental health services for all children, regardless of income or geography. PMID:26859722

  17. Switching health insurers: the role of price, quality and consumer information search.

    PubMed

    Boonen, Lieke H H M; Laske-Aldershof, Trea; Schut, Frederik T

    2016-04-01

    We examine the impact of price, service quality and information search on people's propensity to switch health insurers in the competitive Dutch health insurance market. Using panel data from annual household surveys and data on health insurers' premiums and quality ratings over the period 2006-2012, we estimate a random effects logit model of people's switching decisions. We find that switching propensities depend on health plan price and quality, and on people's age, health, education and having supplementary or group insurance. Young people (18-35 years) are more sensitive to price, whereas older people are more sensitive to quality. Searching for health plan information has a much stronger impact on peoples' sensitivity to price than to service quality. In addition, searching for health plan information has a stronger impact on the switching propensity of higher than lower educated people, suggesting that higher educated people make better use of available health plan information. Finally, having supplementary insurance significantly reduces older people's switching propensity.

  18. End-stage renal disease: a proving ground for quality improvement in health care.

    PubMed

    Rutherford, W E; Gibney, R

    1997-05-01

    This article chronicles the health care quality improvement efforts that relate to patients with end stage renal disease (ESRD). The emphasis is on quality improvement as a management system as opposed to the quality improvements that resulted from strictly technical dialysis-related issues. The government has exercised considerable oversight on the ESRD program because of its growth and cost. History has shown that quality assurance (QA) has had little effect on improving quality or decreasing cost. The philosophy, methods, and tools of continuous quality improvement (CQI) have been shown to work in health care. CQI is a management system that offers hope for higher quality affordable health care. Computer technology is at last sophisticated enough to permit the collection of large amounts of clinical data at the point of care. This will permit CQI methods and tools to be applied generally at reasonable costs. Physicians in general and nephrologists in particular are beginning to understand the managed care environment. They are beginning to understand the paradigm shift that is required to effect the changes necessary for physicians to assume their leadership role in health care. This article reviews the quality efforts of the past and present. It discusses the strengths and weaknesses of efforts to improve quality and lastly presents a vision for the future.

  19. Risk management: Role of societal factors in major industrial accidents

    SciTech Connect

    Hovden, J.; Rausand, M.; Sergeev, G.

    1995-12-31

    The paper discusses factors influencing the occurrence of major accidents in complex technological systems. Societal factors are identified as most significant in this context. Important types of societal factors are pin-pointed and discussed. The safety situation in the former Soviet Union and in today`s Russian is described. The calamities at Chernobyl, Three Mile Island, and partly also Bhopal are discussed, and the role of societal factors identified. A main point of view is that it is not surprising that these catastrophes happened in the then existing conditions. What is surprising is that they did not happen earlier!

  20. Global challenges for e-waste management: the societal implications.

    PubMed

    Magalini, Federico

    2016-03-01

    Over the last decades the electronics industry and ICT Industry in particular has revolutionized the world: electrical and electronic products have become ubiquitous in today's life around the planet. After use, those products are discarded, sometimes after re-use cycles in countries different from those where they were initially sold; becoming what is commonly called e-waste. Compared to other traditional waste streams, e-waste handling poses unique and complex challenges. e-Waste is usually regarded as a waste problem, which can cause environmental damage and severe human health consequences if not safely managed. e-Waste contains significant amounts of toxic and environmentally sensitive materials and is, thus, extremely hazardous to humans and the environment if not properly disposed of or recycled. On the other hand, e-waste is often seen as a potential source of income for individuals and entrepreneurs who aim to recover the valuable materials (metals in particular) contained in discarded equipment. Recently, for a growing number of people, in developing countries in particular, recycling and separation of e-waste has become their main source of income. In most cases, this is done informally, with no or hardly any health and safety standards, exposing workers and the surrounding neighborhoods to extensive health dangers as well as leading to substantial environmental pollution. Treatment processes of e-waste aim to remove the hazardous components and recover as much reusable material (e.g. metals, glass and plastics) as possible; achieving both objectives is most desired. The paper discuss societal implications of proper e-waste management and key elements to be considered in the policy design at country level.

  1. Quality of life and people living with AIDS: relationship with sociodemographic and health aspects1

    PubMed Central

    da Costa, Tadeu Lessa; de Oliveira, Denize Cristina; Gomes, Antonio Marcos Tosoli; Formozo, Gláucia Alexandre

    2014-01-01

    OBJECTIVE: to analyze the relationship of sociodemographic and health dimensions with the quality of life of people living with the human immunodeficiency virus. METHOD: descriptive and quantitative study. The subjects were 131 seropositive people treated in a specialized center of the Norte-Fluminense municipality, Brazil. A form with sociodemographic and health data was applied, as well as the World Health Organization instrument for the assessment of the quality of life of people with the human immunodeficiency virus. RESULTS: the statistical analysis revealed a significant difference in the assessment of the various dimensions of quality of life by the subjects for gender, education, employment, personal income, medical condition, self-perception of sickness, history of hospitalizations, and bodily alterations due to the antiretroviral drugs. CONCLUSION: professional nursing and health care, as well as public policies in the area, should valorize the quality of life approach, considering the conditions related to its configuration. PMID:25296141

  2. Quality of diabetes related health information on internet: an Indian context.

    PubMed

    Talati, Kandarp; Upadhyay, Vandana; Gupta, Puneet; Joshi, Ashish

    2013-01-01

    Diabetes is a growing public health concern in Indian subcontinent. More and more people are searching internet for health information, however, the quality of internet-based medical information is extremely variable. This study aims to evaluate quality of health information about type-II diabetes mellitus in an Indian context. We used key words 'diabetes', 'diabetes management', 'diabetes prevention' and 'diabetes monitoring' and searched over Google, Yahoo and Bing during August 2011. Two independent reviewers used DISCERN tool to assess quality of health information of the final 84 websites. Majority of the websites were '.com' and DISCERN scores were highest in 'other' category. Inter-rater reliability analysis suggests 81% (N = 17) DISCERN criteria are in substantial agreement between two reviewers. There is no significant difference between two reviewers as well as among four website categories (.com, .edu, .org and others) for reliability of publication, specific details about treatment choices and overall quality rating.

  3. Parental knowledge and adolescent adjustment: substance use and health-related quality of life.

    PubMed

    Jiménez-Iglesias, Antonia; Moreno, Carmen; Granado-Alcón, M Carmen; López, Ana

    2012-03-01

    This study analyses two models (maternal and paternal) in which parental care and sources of parental knowledge moderated the relationship between parents' knowledge about their adolescents' lives and adolescents' substance use and health-related quality of life. The sample was made up of 15942 Spanish adolescents who participated in the 2006 edition of Health Behavior in School-aged Children Study. Results showed that increased parents' knowledge about their adolescents' lives reduced adolescents' substance use and increased their quality of life. With respect to the moderation relationship, a limited effect was found. However, parental care and sources of parental knowledge used by both parents generally had main effects on adolescents' substance use and health-related quality of life, with care being the most relevant variable in the health-related quality of life, while knowledge was the most relevant one for substance use.

  4. WATER QUALITY AND OYSTER HEALTH (CRASSOSTREA VIRGINICA): AN INTEGRATED APPROACH TO DETERMINING HABITAT RESTORATION POTENTIAL

    EPA Science Inventory

    Volety, Aswani K., S. Gregory Tolley and James T. Winstead. 2001. Water Quality and Oyster Health (Crassostrea virginica): An Integrated Approach to Determining Habitat Restoration Potential (Abstract). Presented at the 5th International Conference on Shellfish Restoration, 18-21...

  5. Creating an Overall Environmental Quality Index to Examine Health Outcomes

    EPA Science Inventory

    The interaction between environmental conditions and human health transpire from complex processes. Environmental exposures tend to cluster and disamenities such as landfills or industrial plants are often located in areas with high a percentage of minority and poor residents. Wh...

  6. Interoperability as a quality label for portable & wearable health monitoring systems.

    PubMed

    Chronaki, Catherine E; Chiarugi, Franco

    2005-01-01

    Advances in ICT promising universal access to high quality care, reduction of medical errors, and containment of health care costs, have renewed interest in electronic health records (EHR) standards and resulted in comprehensive EHR adoption programs in many European states. Health cards, and in particular the European health insurance card, present an opportunity for instant cross-border access to emergency health data including allergies, medication, even a reference ECG. At the same time, research and development in miniaturized medical devices and wearable medical sensors promise continuous health monitoring in a comfortable, flexible, and fashionable way. These trends call for the seamless integration of medical devices and intelligent wearables into an active EHR exploiting the vast information available to increase medical knowledge and establish personal wellness profiles. In a mobile connected world with empowered health consumers and fading barriers between health and healthcare, interoperability has a strong impact on consumer trust. As a result, current interoperability initiatives are extending the traditional standardization process to embrace implementation, validation, and conformance testing. In this paper, starting from the OpenECG initiative, which promotes the consistent implementation of interoperability standards in electrocardiography and supports a worldwide community with data sets, open source tools, specifications, and online conformance testing, we discuss EHR interoperability as a quality label for personalized health monitoring systems. Such a quality label would support big players and small enterprises in creating interoperable eHealth products, while opening the way for pervasive healthcare and the take-up of the eHealth market.

  7. Impact of the quality of life related to foot health in a sample of pregnant women

    PubMed Central

    López-López, Daniel; Rodríguez-Vila, Inés; Losa-Iglesias, Marta Elena; Rodríguez-Sanz, David; Calvo-Lobo, César; Romero-Morales, Carlos; Becerro-de-Bengoa-Vallejo, Ricardo

    2017-01-01

    Abstract Pregnancy women coincide with numerous anatomical and physiological changes, which are believed to have a harmful effect on the quality of life related to foot health. The goal of this research was to identify and compare the impact foot health and overall health in a sample of pregnancy women and women without pregnancies with normalised reference values. A sample of 159 participants of a mean age of 30.13 ± 6.28 came to the area of midwifery center where self-reported data were registered, informants’ with a 1 or various pregnancy was determined and the scores obtained were compared in the foot health status questionnaire (FHSQ). This has 13 questions that assess 4 health domains of the feet, namely pain, function, general health, and footwear. The pregnant women group showed a worse quality of life related to health in general and to foot health specifically at the following domains, foot function, footwear, general foot, health, physical activity, social capacity, and vigor (P < 0.05) and there were no differences at foot pain and general health (P > 0.05). Pregnant women present a negative impact on the quality of life related to foot health, which appears to be associated with the pregnancy period. PMID:28328852

  8. [Review of data quality dimensions and applied methods in the evaluation of health information systems].

    PubMed

    Lima, Claudia Risso de Araujo; Schramm, Joyce Mendes de Andrade; Coeli, Claudia Medina; da Silva, Márcia Elizabeth Marinho

    2009-10-01

    In Brazil, quality monitoring of data from the various health information systems does not follow a regular evaluation plan. This paper reviews quality evaluation initiatives related to the Brazilian information systems, identifying the selected quality dimensions and the method employed. The SciELO and LILACS databases were searched, as were the bibliographical references from articles identified in the search. 375 articles were initially identified, leaving a final total of 78 after exclusions. The four most frequent dimensions in articles totaled approximately 90% of the analyses. The studies prioritized certain quality dimensions: reliability, validity, coverage, and completeness. Half of the studies were limited to data from Rio de Janeiro and São Paulo. The limited number of studies on some systems and their unequal distribution between regions of the country hinder a comprehensive quality assessment of Brazil's health information systems. The importance of accurate information highlights the need to implement a data management policy for health information systems in Brazil.

  9. NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

    NASA Technical Reports Server (NTRS)

    Estes, Sue; Haynes, John; Omar, Ali

    2012-01-01

    Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

  10. NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

    NASA Technical Reports Server (NTRS)

    Estes, Sue; Haynes, John; Omar, Ali

    2013-01-01

    Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

  11. NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

    NASA Astrophysics Data System (ADS)

    Estes, S. M.; Haynes, J. A.; Omar, A. H.

    2012-12-01

    Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

  12. Societal and ethical issues in human biomonitoring – a view from science studies

    PubMed Central

    Bauer, Susanne

    2008-01-01

    Background Human biomonitoring (HBM) has rapidly gained importance. In some epidemiological studies, the measurement and use of biomarkers of exposure, susceptibility and disease have replaced traditional environmental indicators. While in HBM, ethical issues have mostly been addressed in terms of informed consent and confidentiality, this paper maps out a larger array of societal issues from an epistemological perspective, i.e. bringing into focus the conditions of how and what is known in environmental health science. Methods In order to analyse the effects of HBM and the shift towards biomarker research in the assessment of environmental pollution in a broader societal context, selected analytical frameworks of science studies are introduced. To develop the epistemological perspective, concepts from "biomedical platform sociology" and the notion of "epistemic cultures" and "thought styles" are applied to the research infrastructures of HBM. Further, concepts of "biocitizenship" and "civic epistemologies" are drawn upon as analytical tools to discuss the visions and promises of HBM as well as related ethical problematisations. Results In human biomonitoring, two different epistemological cultures meet; these are environmental science with for instance pollution surveys and toxicological assessments on the one hand, and analytical epidemiology investigating the association between exposure and disease in probabilistic risk estimation on the other hand. The surveillance of exposure and dose via biomarkers as envisioned in HBM is shifting the site of exposure monitoring to the human body. Establishing an HBM platform faces not only the need to consider individual decision autonomy as an ethics issue, but also larger epistemological and societal questions, such as the mode of evidence demanded in science, policy and regulation. Conclusion The shift of exposure monitoring towards the biosurveillance of human populations involves fundamental changes in the ways

  13. Oral health-related quality of life in children with orofacial clefts.

    PubMed

    Ward, Jared A; Vig, Katherine W L; Firestone, Allen R; Mercado, Ana; da Fonseca, Marcio; Johnston, William

    2013-03-01

    Objectives : To determine the impact of orofacial clefts on the oral health-related quality of life of affected children and whether the oral health-related quality of life of children with orofacial clefts differs among different age groups. To assess whether the responses of children with orofacial clefts differ from the caregivers' perceptions of their child's oral health-related quality of life and compare with data from a control group. Design : Cross-sectional study. Patients/Setting : A total of 75 subjects with cleft lip and/or cleft palate (mean age, 13.0 years) from the Nationwide Children's Hospital Craniofacial Anomalies Clinic, as well as their caregivers, and 75 control subjects (mean age, 13.9 years). Main Outcome Measure : Self-reported oral health-related quality of life measured with the Child Oral Health Impact Profile, a reliable and valid questionnaire designed for use with children and teenagers. Results : Children with orofacial clefts had statistically significant lower quality of life scores than control subjects had for overall oral health-related quality of life, Functional Well-being, and Social Emotional Well-being. There was a statistically significant difference in the interaction of age group and Social-Emotional Well-being between children with orofacial clefts and control children. No statistically significant differences were found between the responses of children with orofacial clefts and their caregivers' reports. Conclusions : Presence of an orofacial cleft significantly decreases overall oral health-related quality of life, Functional Well-being, and Social-Emotional Well-being in children and adolescents. The negative impact of orofacial clefts on Social-Emotional Well-being is greater in 15- to 18-year-olds than in younger age groups. Children with orofacial clefts and their caregivers had very similar evaluations of the child's oral health-related quality of life.

  14. Multi-pollutant surface objective analyses and mapping of air quality health index over North America.

    PubMed

    Robichaud, Alain; Ménard, Richard; Zaïtseva, Yulia; Anselmo, David

    2016-01-01

    Air quality, like weather, can affect everyone, but responses differ depending on the sensitivity and health condition of a given individual. To help protect exposed populations, many countries have put in place real-time air quality nowcasting and forecasting capabilities. We present in this paper an optimal combination of air quality measurements and model outputs and show that it leads to significant improvements in the spatial representativeness of air quality. The product is referred to as multi-pollutant surface objective analyses (MPSOAs). Moreover, based on MPSOA, a geographical mapping of the Canadian Air Quality Health Index (AQHI) is also presented which provides users (policy makers, public, air quality forecasters, and epidemiologists) with a more accurate picture of the health risk anytime and anywhere in Canada and the USA. Since pollutants can also behave as passive atmospheric tracers, they provide information about transport and dispersion and, hence, reveal synoptic and regional meteorological phenomena. MPSOA could also be used to build air pollution climatology, compute local and national trends in air quality, and detect systematic biases in numerical air quality (AQ) models. Finally, initializing AQ models at regular time intervals with MPSOA can produce more accurate air quality forecasts. It is for these reasons that the Canadian Meteorological Centre (CMC) in collaboration with the Air Quality Research Division (AQRD) of Environment Canada has recently implemented MPSOA in their daily operations.

  15. Globalization of water, water solidarity, and societal resilience

    NASA Astrophysics Data System (ADS)

    D'Odorico, P.; Laio, F.; Ridolfi, L.

    2010-12-01

    In arid and semiarid regions the availability of freshwater resources has historically limited food production and population growth. Although international trade developed early in the history of civilization, until recently the growth of human populations has been constrained for most part by the availability of local resources as well as by other cultural and health-related factors. More recently, the global trade of massive amounts of food has allowed population growth to exceed in some dryland regions the limits posed by the local water budget. Here we show how the uncontrolled trade of food products and of water virtually embedded in these commodities reduces the resilience of human societies with respect to drought and famine. Globalization of virtual water may prevent in the short term malnourishment, famine, and conflicts, but in the long run leaves fewer options available to cope with exceptional droughts and crop failures. We propose a system of water solidarity as an alternative model of global allocation and redistribution of water resources, which limits the effects of drought-induced famine while maintaining societal resilience.

  16. Does globalization of water reduce societal resilience to drought?

    NASA Astrophysics Data System (ADS)

    D'Odorico, Paolo; Laio, Francesco; Ridolfi, Luca

    2010-07-01

    Most food production depends, directly or indirectly, on freshwater resources. In the absence of importation of food commodities, population growth is constrained by the availability of local resources—including water—as well as by cultural and health-related factors. The global trade of massive amounts of food makes societies less reliant on locally available water resources, thereby allowing some populations to exceed the limits posed by their local water budget. Thus, international trade implies a virtual transfer of water resources from areas of food production to importing regions. While it is recognized that in the short term this globalization of (virtual) water resources may prevent malnourishment, famine, and conflicts, its long-term effects on the coupled human-natural system remain poorly investigated. Here we develop a minimalist modeling framework to investigate the effect of the uncontrolled trade of food products on the resilience of human societies with respect to drought and famine. Our results suggest that in the long run the globalization of water resources reduces the societal resilience with respect to water limitations in that it leaves fewer options available to cope with exceptional droughts and crop failure.

  17. "They Treat you a Different Way:" Public Insurance, Stigma, and the Challenge to Quality Health Care.

    PubMed

    Martinez-Hume, Anna C; Baker, Allison M; Bell, Hannah S; Montemayor, Isabel; Elwell, Kristan; Hunt, Linda M

    2017-03-01

    Under the Affordable Care Act, Medicaid Expansion programs are extending Medicaid eligibility and increasing access to care. However, stigma associated with public insurance coverage may importantly affect the nature and content of the health care beneficiaries receive. In this paper, we examine the health care stigma experiences described by a group of low-income public insurance beneficiaries. They perceive stigma as manifest in poor quality care and negative interpersonal interactions in the health care setting. Using an intersectional approach, we found that the stigma of public insurance was compounded with other sources of stigma including socioeconomic status, race, gender, and illness status. Experiences of stigma had important implications for how subjects evaluated the quality of care, their decisions impacting continuity of care, and their reported ability to access health care. We argue that stigma challenges the quality of care provided under public insurance and is thus a public health issue that should be addressed in Medicaid policy.

  18. Health insurance coverage, income distribution and healthcare quality in local healthcare markets.

    PubMed

    Damianov, Damian S; Pagán, José A

    2013-08-01

    We develop a theoretical model of a local healthcare system in which consumers, health insurance companies, and healthcare providers interact with each other in markets for health insurance and healthcare services. When income and health status are heterogeneous, and healthcare quality is associated with fixed costs, the market equilibrium level of healthcare quality will be underprovided. Thus, healthcare reform provisions and proposals to cover the uninsured can be interpreted as an attempt to correct this market failure. We illustrate with a numerical example that if consumers at the local level clearly understand the linkages between health insurance coverage and the quality of local healthcare services, health insurance coverage proposals are more likely to enjoy public support.

  19. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    PubMed Central

    2010-01-01

    Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international

  20. Health behavior: issues, contradictions and dilemmas.

    PubMed

    Alonzo, A A

    1993-10-01

    American medicine faces many contradictions and dilemmas. This is especially the case with regard to preventive health behavior. This paper explores the effects of several issues, contradictions and dilemmas on the American experience with primary preventive health behavior. These issues include: individualism, victim blaming, therapeutic nihilism, the over abundance of health information, America as a culture of risk takers, and the dilemma of the jungle vs the zoo. Four types of health behavior are defined. The first type of health behavior is the primary prevention of disease, defect, injury or disability. The second type is detection of asymptomatic disease, injury and defect. Third, is the promotion of enhanced levels of health, wellness and quality of life. And the fourth, at a more societal level, protective behaviors to make environmental transactions safe from disease, injury, defect and disability. These four types of health behavior are each explored in relation to societal values, technology and economics to determine which of these facilitate or impede health behavior at both the individual and societal levels.

  1. Total Quality Management in Health Care - A Study on TQM Implementation and its Application to the Army Health Care System

    DTIC Science & Technology

    1993-04-15

    Quality Management in a 300- Bed Community Hospital : The Quality Improvement Process Translated to Health Care." QMB, September 1992, pp. 293-300. Hume...get a irnzmogram. She called the Army Community Hospital for assistance. After several telephone calls, she was directed to the Radiology Department...assisted her in having her marmogram done under an external partnership agreement in the local civilian hospital . Within two weeks, Mrs. Smith was

  2. The Huntington's Disease health-related Quality of Life questionnaire (HDQoL): a disease-specific measure of health-related quality of life

    PubMed Central

    Hocaoglu, MB; Gaffan, EA; Ho, AK

    2012-01-01

    Hocaoglu MB, Gaffan EA, Ho AK. The Huntington's disease health-related quality of life questionnaire: a disease-specific measure of health-related quality of life. Huntington's disease (HD) is a genetic neurodegenerative disorder characterized by motor, cognitive and psychiatric disturbances, and yet there is no disease-specific patient-reported health-related quality of life outcome measure for patients. Our aim was to develop and validate such an instrument, i.e. the Huntington's Disease health-related Quality of Life questionnaire (HDQoL), to capture the true impact of living with this disease. Semi-structured interviews were conducted with the full spectrum of people living with HD, to form a pool of items, which were then examined in a larger sample prior to data-driven item reduction. We provide the statistical basis for the extraction of three different sets of scales from the HDQoL, and present validation and psychometric data on these scales using a sample of 152 participants living with HD. These new patient-derived scales provide promising patient-reported outcome measures for HD. Section Editor: Aad Tibben, email: a.tibben@lumc.nl PMID:22151007

  3. Empowering Graduate Students to Lead on Interdisciplinary Societal Issues

    NASA Astrophysics Data System (ADS)

    Grubert, E.

    2015-12-01

    Challenging societal problems that cannot be solved by one method or one discipline alone, like epidemic preparedness, mental health, and climate change, demand leadership and the ability to work across disciplines from those with specialized expertise. Teaching leadership at the graduate school level is a challenge that many schools are striving to meet, through mechanisms like project-based courses, leadership skill development workshops, and others. We argue that some of the most valuable but most difficult leadership skills to learn are those that require cultural norms that are fundamentally different from those traditionally encountered in graduate school. These include the ability to make informed decisions based on limited knowledge and resources, the need to make choices in the face of uncertainty, and the recognition that one ultimately bears responsibility for the outcomes. These skills are also among the most important for students planning on nonacademic careers. Acquiring such skills requires a focus on learning-by-doing and a culture of graduate student empowerment. This submission focuses on the experience of students in a student-centered, interdisciplinary, cross-campus leadership program called Emerging Leaders in Science and Society (ELISS), hosted by the American Association for the Advancement of Science (AAAS). ELISS establishes the expectation that students act as leaders, which in itself reframes leadership as an achievable goal. A major finding from two years of experience with ELISS is the critical importance of establishing cultures of trust and empowerment at the graduate level in order to foster development of transferable skills. ELISS graduate students specifically focus on interdisciplinary collaboration (the 13 2015 fellows come from 13 academic disciplines); stakeholder engagement, primarily focused on outreach to both traditional and nontraditional experts in our communities outside of academia; and solution-generating rather

  4. 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.…

  5. Evaluating the impact of wind turbine noise on health-related quality of life.

    PubMed

    Shepherd, Daniel; McBride, David; Welch, David; Dirks, Kim N; Hill, Erin M

    2011-01-01

    We report a cross-sectional study comparing the health-related quality of life (HRQOL) of individuals residing in the proximity of a wind farm to those residing in a demographically matched area sufficiently displaced from wind turbines. The study employed a nonequivalent comparison group posttest-only design. Self-administered questionnaires, which included the brief version of the World Health Organization quality of life scale, were delivered to residents in two adjacent areas in semirural New Zealand. Participants were also asked to identify annoying noises, indicate their degree of noise sensitivity, and rate amenity. Statistically significant differences were noted in some HRQOL domain scores, with residents living within 2 km of a turbine installation reporting lower overall quality of life, physical quality of life, and environmental quality of life. Those exposed to turbine noise also reported significantly lower sleep quality, and rated their environment as less restful. Our data suggest that wind farm noise can negatively impact facets of HRQOL.

  6. Ecosystem and Societal Consequences of Ocean versus Atmosphere Carbon Storage

    NASA Astrophysics Data System (ADS)

    Barry, J. P.; Adams, E. E.; Bleck, R.; Caldeira, K.; Carman, K.; Erickson, D.; Kennett, J. P.; Sarmiento, J. L.; Tsouris, C.

    2005-12-01

    high emission scenarios appears weaker, due partially to uncertainty in the trajectories of ecosystem change and societal issues. For high emission scenarios (e.g. SRES A1F1, A2; 900 ppm CO2, 4.2 oC global temperature increase by 2100), the mitigation effect of ocean sequestration is still ~ -0.4 oC, with a reduction of atmospheric CO2 near 50 ppm. However, under such high emissions, the effects of large global temperature on societal issues such as disease, hunger, and water are expected to be severe, with an unknown incremental benefit from ocean sequestration. These results indicate the importance of a careful consideration of the benefits and liabilities of ocean sequestration, in terms of ecosystem health for global ecosystems and terrestrial concerns. A cautionary approach to ocean carbon sequestration in consideration of the global consequences of anthropogenic climate change may differ from an approach considering deep-ocean ecosystems alone.

  7. Determinants of Quality of Family Planning Counseling among Private Health Facilities in Lagos.

    PubMed

    Johnson, Doug; Ugaz, Jorge

    2016-09-01

    We use a unique dataset that includes an objective measure of the quality of family planning counseling from 927 private health facilities in Lagos State, Nigeria, to determine which variables at the facility and provider levels are most closely correlated with the quality of family planning counseling. Our data on quality come from mystery client surveys in which the clients posed as women seeking family planning counseling. We find that quality is strongly associated with the cadre of provider, with doctors delivering substantially higher-quality counselling than nurses. Doctors not only outperform nurses overall, but also perform better on each category of quality and spend nearly three minutes longer on average counseling the mystery client. Location, fees charged for the service, and facility type are also strongly correlated with quality. The degree to which a facility specializes in family planning and facility size are only weakly predictive of quality.

  8. Body weight and health-related quality of life in Catalonia, Spain.

    PubMed

    Oliva-Moreno, Juan; Gil-Lacruz, Ana

    2013-02-01

    Obesity poses important burdens not only on the individuals whose quality of life is reduced but on national welfare systems that have to face growing premature mortality rates, increase healthcare expenditures to treat obesity-related diseases, and earmark vast amounts of healthcare resources for prevention. The main goal of this paper is to analyze the relationship between excess body weight and different dimensions of health-related quality of life for people 16 years and older and to identify the health dimensions most affected by excess weight. We have drawn data from the Catalonia Health Survey (2006). Our results reveal a relationship between excess weight and health-related quality of life. Even after controlling for socio-economic status and objective health variables, excess weight is shown to have a significant negative effect on health-related quality of life. Subjects responses revealed that the negative effect of excess weight was felt the strongest in the health-related quality of life dimensions of mobility and pain/discomfort. Our results indicate there are important differences among gender and age groups. Women and older people are more likely to suffer from the negative consequences of excess weight.

  9. Availability and quality of mobile health app privacy policies.

    PubMed

    Sunyaev, Ali; Dehling, Tobias; Taylor, Patrick L; Mandl, Kenneth D

    2015-04-01

    Mobile health (mHealth) customers shopping for applications (apps) should be aware of app privacy practices so they can make informed decisions about purchase and use. We sought to assess the availability, scope, and transparency of mHealth app privacy policies on iOS and Android. Over 35,000 mHealth apps are available for iOS and Android. Of the 600 most commonly used apps, only 183 (30.5%) had privacy policies. Average policy length was 1755 (SD 1301) words with a reading grade level of 16 (SD 2.9). Two thirds (66.1%) of privacy policies did not specifically address the app itself. Our findings show that currently mHealth developers often fail to provide app privacy policies. The privacy policies that are available do not make information privacy practices transparent to users, require college-level literacy, and are often not focused on the app itself. Further research is warranted to address why privacy policies are often absent, opaque, or irrelevant, and to find a remedy.

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

    PubMed

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

    2011-11-01

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

  11. Health-Related Quality of Life in Children Attending Special and Typical Education Greek Schools

    ERIC Educational Resources Information Center

    Papadopoulou, D.; Malliou, P.; Kofotolis, N.; Vlachopoulos, S. P.; Kellis, E.

    2017-01-01

    The purpose of this study was to examine parental perceptions about Health Related Quality of Life (HRQoL) of typical education and special education students in Greece. The Pediatric Quality of Life Inventory (PedsQL) was administered to the parents of 251 children from typical schools, 46 students attending integration classes (IC) within a…

  12. The Importance of Good Quality Services for People with Complex Health Needs

    ERIC Educational Resources Information Center

    Campbell, Martin

    2008-01-01

    This article describes the use of a set of evidence-based quality indicators to assess performance by 15 NHS Boards across Scotland in a national review, with a particular focus on the quality of services for people with complex health needs. Evidence based best practice and evaluative data from previous inspections were used to develop Quality…

  13. A model of service quality perceptions and health care consumer behavior.

    PubMed

    O'Connor, S J; Shewchuk, R M; Bowers, M R

    1991-01-01

    Analysis of covariance structures (LISREL) was used to examine the influence of consumer held perceptions of service quality on consumer satisfaction and intentions to return. Results indicate that service quality is a significant predictor of consumer satisfaction which, in turn, predicts intention to return. Health care marketing implications are discussed.

  14. Relationship between Sleep Quality and Health Risk Behaviors in Undergraduate College Students

    ERIC Educational Resources Information Center

    Vail-Smith, Karen; Felts, W. Michael; Becker, Craig

    2009-01-01

    The Sleep Quality Index (SQI) and the Centers for Disease Control's National College Health Risk Survey (NCHRS) were administered to 859 undergraduates at a large southeastern university. Results indicated that 76.6% reported occasional sleep problems and 11.8 % experienced poor sleep quality. Among the problems reported, "general morning…

  15. A Qualitative Study of the Health-Related Quality of Life of Disabled Children

    ERIC Educational Resources Information Center

    Young, Bridget; Rice, Helen; Dixon-Woods, Mary; Colver, Allan F.; Parkinson, Kathryn N.

    2007-01-01

    This qualitative study investigated what disabled children thought most important in their lives and examined how well their priorities are represented in KIDSCREEN, a generic health-related quality of life (HRQoL) instrument. Participants were a subgroup of families who had previously taken part in a study of quality of life and participation in…

  16. Integration of Satellite, Modeled, and Ground Based Aerosol Data for use in Air Quality and Public Health Applications

    NASA Astrophysics Data System (ADS)

    Garcia, V.; Kondragunta, S.; Holland, D.; Dimmick, F.; Boothe, V.; Szykman, J.; Chu, A.; Kittaka, C.; Al-Saadi, J.; Engel-Cox, J.; Hoff, R.; Wayland, R.; Rao, S.; Remer, L.

    2006-05-01

    Advancements in remote sensing over the past decade have been recognized by governments around the world and led to the development of the international Global Earth Observation System of Systems 10-Year Implementation Plan. The plan for the U.S. contribution to GEOSS has been put forth in The Strategic Plan for the U.S. Integrated Earth Observation System (IEOS) developed under IWGEO-CENR. The approach for the development of the U.S. IEOS is to focus on specific societal benefits that can be achieved by integrating the nation's Earth observation capabilities. One such challenge is our ability to understand the impact of poor air quality on human health and well being. Historically, the air monitoring networks put in place for the Nations air quality programs provided the only aerosol air quality data on an ongoing and systematic basis at national levels. However, scientific advances in the remote sensing of aerosols from space have improved dramatically. The MODIS sensor and GOES Imager aboard NASA and NOAA satellites, respectively, provide synoptic-scale measurements of aerosol optical depth (AOD) which have been demonstrated to correlate with high levels of PM10 and PM2.5 at the surface. The MODIS sensor has been shown to be capable of a 1 km x 1 km (at nadir) AOD product, while the GOES Imager can provide AOD at 4 km x 4 km every 30 minutes. Within the next several years NOAA and EPA will begin to issue PM2.5 air quality forecasts over the entire domain of the eastern United States, eventually extending to national coverage. These forecasts will provide continuous estimated values of PM2.5 on a daily basis. A multi-agency collaborative project among government and academia is underway to improve the spatial prediction of fine particulate matter through the integration of multi-sensor and multi-platform aerosol observations (MODIS and GOES), numerical model output, and air monitoring data. By giving more weight to monitoring data in monitored areas and relying

  17. [Health policies and politicized health? An analysis of sexual and reproductive health policies in Peru from the perspective of medical ethics, quality of care, and human rights].

    PubMed

    Miranda, J Jaime; Yamin, Alicia Ely

    2008-01-01

    Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the individual and health policy levels. The current study seeks to analyze such paradigms, based on a case study of sexual and reproductive health policies in Peru in the last 10 years.

  18. Associations Between Cardiovascular Health and Health-Related Quality of Life, Behavioral Risk Factor Surveillance System, 2013

    PubMed Central

    Fang, Jing; Zack, Matthew; Moore, Latetia; Loustalot, Fleetwood

    2016-01-01

    Introduction The American Heart Association established 7 cardiovascular health metrics as targets for promoting healthier lives. Cardiovascular health has been hypothesized to play a role in individuals’ perception of quality of life; however, previous studies have mostly assessed the effect of cardiovascular risk factors on quality of life. Methods Data were from the 2013 Behavioral Risk Factor Surveillance System, a state-based telephone survey of adults 18 years or older (N = 347,073). All measures of cardiovascular health and health-related quality of life were self-reported. The 7 ideal cardiovascular health metrics were normal blood pressure, cholesterol, body mass index, not having diabetes, not smoking, being physically active, and having adequate fruit or vegetable intake. Cardiovascular health was categorized into meeting 0–2, 3–5, or 6–7 ideal cardiovascular health metrics. Logistic regression models examined the association between cardiovascular health, general health status, and 3 measures of unhealthy days per month, adjusting for age, sex, race/ethnicity, education, and annual income. Results Meeting 3 to 5 or 6 to 7 ideal cardiovascular health metrics was associated with a 51% and 79% lower adjusted prevalence ratio (aPR) of fair/poor health, respectively (aPR = 0.49, 95% confidence interval [CI] [0.47–0.50], aPR = 0.21, 95% CI [0.19–0.23]); a 47% and 72% lower prevalence of ≥14 physically unhealthy days (aPR = 0.53, 95% CI [0.51–0.55], aPR = 0.28, 95% CI [0.26–0.20]); a 43% and 66% lower prevalence of ≥14 mentally unhealthy days (aPR = 0.57, 95% CI [0.55–0.60], aPR = 0.34, 95% CI [0.31–0.37]); and a 50% and 74% lower prevalence of ≥14 activity limitation days (aPR = 0.50, 95% CI [0.48–0.53], aPR = 0.26, 95% CI [0.23–0.29]) in the past 30 days. Conclusion Achieving a greater number of ideal cardiovascular health metrics may be associated with less impairment in health-related quality of life. PMID:27468158

  19. WATER QUALITY AND SWIMMING-ASSOCIATED HEALTH EFFECTS

    EPA Science Inventory

    Evidence from various sources around the world indicate that there is a relationship between gastroenteritis in swimmers and the quality of the bathing water as measured with bacterial indicators of fecal contamination. Current EPA guidelines recommend the use of cultural method...

  20. Health and Quality of Life in Northern Plains Indians

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Quality of life and standard of living are consistently depicted as indigent among American Indian and Alaska Native (AI/AN) populations. American Indians (AI) are among the most heterogeneous and impoverished ethnic groups in the U.S.,have the highest per capita suicide rate at 247% of the national...

  1. Quality of Life and Functional Health Status of Long-Term Meditators

    PubMed Central

    Manocha, Ramesh; Black, Deborah; Wilson, Leigh

    2012-01-01

    Background. There is very little data describing the long-term health impacts of meditation. Aim. To compare the quality of life and functional health of long-term meditators to that of the normative population in Australia. Method. Using the SF-36 questionnaire and a Meditation Lifestyle Survey, we sampled 343 long-term Australian Sahaja Yoga meditation practitioners and compared their scores to those of the normative Australian population. Results. Six SF-36 subscales (bodily pain, general health, mental health, role limitation—emotional, social functioning, and vitality) were significantly better in meditators compared to the national norms whereas two of the subscales (role limitation—physical, physical functioning) were not significantly different. A substantial correlation between frequency of mental silence experience and the vitality, general health, and especially mental health subscales (P < 0.005) was found. Conclusion. Long-term practitioners of Sahaja yoga meditation experience better functional health, especially mental health, compared to the general population. A relationship between functional health, especially mental health, and the frequency of meditative experience (mental silence) exists that may be causal. Evidence for the potential role of this definition of meditation in enhancing quality of life, functional health and wellbeing is growing. Implications for primary mental health prevention are discussed. PMID:22611427

  2. Quality of life and functional health status of long-term meditators.

    PubMed

    Manocha, Ramesh; Black, Deborah; Wilson, Leigh

    2012-01-01

    Background. There is very little data describing the long-term health impacts of meditation. Aim. To compare the quality of life and functional health of long-term meditators to that of the normative population in Australia. Method. Using the SF-36 questionnaire and a Meditation Lifestyle Survey, we sampled 343 long-term Australian Sahaja Yoga meditation practitioners and compared their scores to those of the normative Australian population. Results. Six SF-36 subscales (bodily pain, general health, mental health, role limitation-emotional, social functioning, and vitality) were significantly better in meditators compared to the national norms whereas two of the subscales (role limitation-physical, physical functioning) were not significantly different. A substantial correlation between frequency of mental silence experience and the vitality, general health, and especially mental health subscales (P < 0.005) was found. Conclusion. Long-term practitioners of Sahaja yoga meditation experience better functional health, especially mental health, compared to the general population. A relationship between functional health, especially mental health, and the frequency of meditative experience (mental silence) exists that may be causal. Evidence for the potential role of this definition of meditation in enhancing quality of life, functional health and wellbeing is growing. Implications for primary mental health prevention are discussed.

  3. School Nurse Case Management for Children with Chronic Illness: Health, Academic, and Quality of Life Outcomes

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.; Swanson, Melvin

    2008-01-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with…

  4. Improving Access to Needed Health Care Improves Low-Income Children's Quality of Life: Research Highlights

    ERIC Educational Resources Information Center

    Seid, Michael. Varni, James W.; Cummings, Leslie; Schonlau, Matthias

    2006-01-01

    This research brief describes an examination of the effect of the State Children's Health Insurance Program (SCHIP) on children's access to needed health services and on their quality of life. The analysis focused on a sample of California families who had recently enrolled in that state's SCHIP. The study found that, after enrollment, children…

  5. A Longitudinal Analysis of Rural and Urban Veterans' Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Wallace, Amy E.; Lee, Richard; MacKenzie, Todd A.; West, Alan N.; Wright, Steven; Booth, Brenda M.; Hawthorne, Kara; Weeks, William B.

    2010-01-01

    Context: Cross-sectional studies have identified rural-urban disparities in veterans' health-related quality-of-life (HRQOL) scores. Purpose: To determine whether longitudinal analyses confirmed that these disparities in veterans' HRQOL scores persisted. Methods: We obtained data from the SF-12 portion of the veterans health administration's…

  6. Health Related Quality of Life among Insulin-Dependent Diabetics: Disease-Related and Psychosocial Correlates.

    ERIC Educational Resources Information Center

    Aalto, Anna-Mari; Uutela, Antti; Aro, Arja R.

    1997-01-01

    The associations of health and psychosocial factors with the Health Related Quality of Life Questionnaire were examined in adult type 1 diabetic patients (N=385). The most important factors from multivariate analysis were self-efficacy and diabetes-related social support, especially among those in good physical condition. Diabetes-specific factors…

  7. Examining the Relationship between Electronic Health Record Interoperability and Quality Management

    ERIC Educational Resources Information Center

    Purcell, Bernice M.

    2013-01-01

    A lack of interoperability impairs data quality among health care providers' electronic health record (EHR) systems. The problem is whether the International Organization for Standardization (ISO) 9000 principles relate to the problem of interoperability in implementation of EHR systems. The purpose of the nonexperimental quantitative research…

  8. Marketing and Quality of Life: A Model for Improving Perinatal Health Status

    ERIC Educational Resources Information Center

    Dever, G. E. Alan; Smith, Leah T.; Stamps, Bunnie V.

    2005-01-01

    Introduction: A marketing/business model using non-traditional Quality of Life measures was developed to assess perinatal health status on a micro-geographic level. This perinatal health status needs assessment study for Georgia South Central Region was conducted for the years 1994-1999. The model may be applied to any geographic unit in the…

  9. How could the quality and outcomes framework (QOF) do more to tackle health inequalities?

    PubMed Central

    Thorne, Tim

    2016-01-01

    Abstract This paper outlines how the quality and outcomes framework (QOF) has done little to close the health inequality gap, and proposes possible ways in which future iterations of QOF could do more to address this crucial public health problem. PMID:28250839

  10. Quality of psoriasis care in Germany: results of the national health care study "PsoHealth3".

    PubMed

    Langenbruch, Anna; Radtke, Marc Alexander; Jacobi, Arnd; Purwins, Sandra; Haack, Kristina; Reich, Kristian; Stroemer, Klaus; Mrowietz, Ulrich; Augustin, Matthias

    2016-08-01

    Two national surveys conducted in 2005 and 2007 indicated deficits in psoriasis care and induced the composition of the ''National Goals for Health Care in Psoriasis 2010-2015''. The aim of this work was to (1) evaluate the quality of care for patients with psoriasis in Germany, (2) compare this with prior psoriasis studies PsoHealth1 (2005) and PsoHealth2 (2007), and (3) review the implementation of national treatment goals. By means of a cross sectional study the following indicators of health care quality were collected: psoriasis severity (Psoriasis Area Severity Index (PASI) and proportion of PASI >20), quality of life (Dermatology Life Quality Index (DLQI) were corporated: proportion of DLQI >10), previous systemic treatment, inpatient treatment, and days absent from work due to psoriasis. Between January 2013 and March 2014, 1265 patients from 82 dermatological centres were included (mean age of 52 years). 9.2 % had a PASI >20 (2007: 11.6 %; 2005: 17.8 %). 21.3 % reported strong quality of life restrictions (DLQI >10) (2007: 28.2 %; 2005: 34.0 %). 59.5 % had received a systemic treatment at least once within the last 5 years (2007: 47.3 %; 2005: 32.9 %). 20.1 % were treated inpatient within the last 5 years (2007: 20.1 %; 2005: 26.9 %). The current data indicate a better health care situation for psoriasis in Germany. The implementation of the S3-Guideline and the ''National Goals for Health Care in Psoriasis 2010-2015'' could have been contributing factors.

  11. Societal issues as Mars mission impediments: planetary protection and contamination concerns.

    PubMed

    Race, M S

    1995-03-01

    Societal and non-scientific factors represent potentially significant impediments for future Mars missions, especially in areas involving planetary protection. This paper analyzes public concerns about forward contamination to Mars and back contamination to Earth, evaluates major areas where lack of information may lead to uncontrollable impacts on future missions, and concludes that NASA should adopt a strategy that actively plans both the generation and subsequent management of planetary protection information to ensure that key audiences obtain needed information in a timely manner. Delay or avoidance in dealing with societal issues early in mission planning will increase the likelihood of public opposition, cost increases and missed launch windows. While this analysis of social and non-scientific considerations focuses on future Mars missions, the findings are also relevant for RTG launches, nuclear propulsion and other NASA activities perceived to have health, safety or environmental implications.

  12. United States societal experiments via the Communications Technology Satellite. [antenna coverage

    NASA Technical Reports Server (NTRS)

    Donoughe, P. L.

    1976-01-01

    The Communications Technology Satellite (CTS) is a cooperative experimental program of the United States and Canadian governments. The CTS uses a high-power transponder at the frequencies of 14/12 GHz for two-way television and voice communication. The United States and Canada have agreed to share equally in the use of CTS. The U.S. program includes a variety of societal experiments. The ground stations for these experiments are located from the Atlantic to the Pacific. The satellite communications capabilities and the antenna coverage for the U.S. are summarized. Emphasis is placed on the U.S. societal experiments in the areas of education, health care, and community and special services; nine separate experiments are discussed.

  13. Enhancing the health-beneficial qualities of whole grain rice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Various pre- and post-harvest approaches (i.e. pre-germination of whole grains and reduced milling degree) to enhancing the health beneficial compounds of whole grain and milled rice have been reported. A discussion of the results from our pre-harvest efforts is as follows. The majority of rice cons...

  14. Mental Health Profiles and Quality of Life among Korean Adolescents

    ERIC Educational Resources Information Center

    Kim, Eui Kyung; Dowdy, Erin; Furlong, Michael J.; You, Sukkyung

    2017-01-01

    In an attempt to identify and intervene with students in need of services, the South Korean government has implemented national mental health screening. However, concerns raised about the unintended stigmatization of the screening assessment that focuses on student deficits prompts the need for additional research. This study evaluated the…

  15. A health plan work in progress: hospital-physician price and quality transparency.

    PubMed

    Tynan, Ann; Liebhaber, Allison; Ginsburg, Paul B

    2008-08-01

    Responding to large employers' interest in greater health care price and quality transparency, health plans are developing consumer tools to compare price and quality information across hospitals and physicians, but the tools' pervasiveness and usefulness are limited, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Many large employers view price and quality transparency as key to a broader consumerism strategy, where employees take more responsibility for medical costs, lifestyle choices and treatment decisions. Some health plans believe providing price and quality information to enrollees is a competitive advantage, while others are skeptical about the benefits and are proceeding cautiously to avoid potential unintended consequences. Health plans are in various stages of making price information available to enrollees. Plans generally provide some type of price information on inpatient and outpatient procedures and services from data based on their own negotiated prices or through aggregated health plan claims data obtained through a vendor; few plans provide price information on services in physician offices. However, the information provided often lacks specificity about individual providers, and its availability is often limited to enrollees in specific geographic areas. Health plans generally rely on third-party sources to package publicly available quality information instead of using information gleaned from their own claims or other data. Health plans' ability to advance price and quality comparison tools to the point where a critical mass of consumers trust and use the information to choose physicians and hospitals will likely have considerable influence on the ultimate success of broader health consumerism efforts.

  16. Quality of Care for PTSD and Depression in the Military Health System: Phase 1 Report

    DTIC Science & Technology

    2016-01-01

    measure. We examined variations in quality measure rates by service branch (Army, Air Force, Marine Corps, Navy) and TRICARE region (North, South...T15a and T15b), Army and 76 Quality of Care for PTSD and Depression in the Military Health System Air Force members showed much higher rates of...C O R P O R A T I O N Quality of Care for PTSD and Depression in the Military Health System Phase I Report Kimberly A. Hepner, Elizabeth M. Sloss

  17. Impact of Climate Change on Air Quality and Public Health in Urban Areas.

    PubMed

    Hassan, Noor Artika; Hashim, Zailina; Hashim, Jamal Hisham

    2016-03-01

    This review discusses how climate undergo changes and the effect of climate change on air quality as well as public health. It also covers the inter relationship between climate and air quality. The air quality discussed here are in relation to the 5 criteria pollutants; ozone (O3), carbon dioxide (CO2), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter (PM). Urban air pollution is the main concern due to higher anthropogenic activities in urban areas. The implications on health are also discussed. Mitigating measures are presented with the final conclusion.

  18. Comparative analysis of quality assurance in health care delivery and higher medical education

    PubMed Central

    Busari, Jamiu O

    2012-01-01

    Quality assurance (QA) in higher medical education involves the development, sustenance, improvement, and evaluation of the standard of training of medical professionals. In health care delivery, QA focuses on guaranteeing and maintaining a high standard of the service provided in different health care systems. When the service delivered by the care provider is in accordance with what the recipients of health care expect, then quality in health care is considered to be present. There are several factors in higher medical education and health care that are responsible for the emergence of QA. These include externally imposed obligations requiring demonstration of public accountability and responsibility from educational institutions, as well as the need for activity-specific information by policy makers as an aid for important decision-making within educational institutions. In health care delivery on the other hand, the emergence of QA is linked to the need for containing rising health care costs in the face of limited resources and to guaranteeing high quality patient care in a changing health care environment where the power relationship between doctors and patients is shifting towards patients. Although medical education can be regarded as a distinct entity in the health care industry, it still remains an inherent part of the health care delivery system. As a result, different strategies aimed at guaranteeing and assuring high standards of health care and education in many countries tend to overlap. This paper reflects on whether quality assurance in health care delivery and medical education should be seen as separate entities. PMID:23762010

  19. Quality Health Care for Children and the Affordable Care Act: A Voltage Drop Checklist

    PubMed Central

    Wise, Paul H.; Halfon, Neal

    2014-01-01

    The Affordable Care Act (ACA) introduces enormous policy changes to the health care system with several anticipated benefits and a growing number of unanticipated challenges for child and adolescent health. Because the ACA gives each state and their payers substantial autonomy and discretion on implementation, understanding potential effects will require state-by-state monitoring of policies and their impact on children. The “voltage drop” framework is a useful interpretive guide for assessing the impact of insurance market change on the quality of care received. Using this framework we suggest a state-level checklist to examine ACA statewide implementation, assess its impact on health care delivery, and frame policy correctives to improve child health system performance. Although children’s health care is a small part of US health care spending, child health provides the foundation for adult health and must be protected in ACA implementation. PMID:25225140

  20. The role of quality tools in assessing reliability of the internet for health information.

    PubMed

    Hanif, Faisal; Read, Janet C; Goodacre, John A; Chaudhry, Afzal; Gibbs, Paul

    2009-12-01

    The Internet has made it possible for patients and their families to access vast quantities of information that previously would have been difficult for anyone but a physician or librarian to obtain. Health information websites, however, are recognised to differ widely in quality and reliability of their content. This has led to the development of various codes of conduct or quality rating tools to assess the quality of health websites. However, the validity and reliability of these quality tools and their applicability to different health websites also varies. In principle, rating tools should be available to consumers, require a limited number of elements to be assessed, be assessable in all elements, be readable and be able to gauge the readability and consistency of information provided from a patient's view point. This article reviews the literature on the trends of the Internet use for health and analyses various codes of conduct/ethics or 'quality tools' available to monitor the quality of health websites from a patient perspective.

  1. Relationship Between Ways of Coping and Quality of Life in Married Women: Toward Mental Health Promotion

    PubMed Central

    Mirabzadeh, Arash; Baradaran Eftekhari, Monir; Setareh Forouzan, Ameneh; Sajadi, Homeira; Rafiee, Hassan

    2013-01-01

    Background Adaptive ways of coping with stress are as a major component of mental health and also this is considered as a key element in quality of life. Objectives The aim of this study was to investigate the relationship between quality of life and coping mechanisms in married women ages between 18-65 years in order to develop appropriate intervention programs to promote mental health. Patients and Methods This study was a part of interventional project to mental health promotion in married women that completed through a cross sectional studies using two standard questionnaires: Ways of Coping (WOC) and Quality of Life questionnaire (WHO, QOL-BREF). Results The most and the least used ways in coping with stress were Planful Problem Solving and Confronting Coping. Considering the quality of life, the most and the least scores were related to social dimension and mental health. Also women who have higher quality of life used more Positive Reappraisal way and less Escape-Avoidance way to deal with stress (P < 0.05). Conclusions It seems that implementation of an appropriate interventional program related to adaptive ways of coping in order to deal with stress is effective in mental health and quality of life promotion. PMID:24578846

  2. The reporting characteristics and methodological quality of Cochrane reviews about health policy research.

    PubMed

    Xiu-xia, Li; Ya, Zheng; Yao-long, Chen; Ke-hu, Yang; Zong-jiu, Zhang

    2015-04-01

    The systematic review has increasingly become a popular tool for researching health policy. However, due to the complexity and diversity in the health policy research, it has also encountered more challenges. We set out the Cochrane reviews on health policy research as a representative to provide the first examination of epidemiological and descriptive characteristics as well as the compliance of methodological quality with the AMSTAR. 99 reviews were included by inclusion criteria, 73% of which were Implementation Strategies, 15% were Financial Arrangements and 12% were Governance Arrangements; involved Public Health (34%), Theoretical Exploration (18%), Hospital Management (17%), Medical Insurance (12%), Pharmaceutical Policy (9%), Community Health (7%) and Rural Health (2%). Only 39% conducted meta-analysis, and 49% reported being updates, and none was rated low methodological quality. Our research reveals that the quantity and quality of the evidence should be improved, especially Financial Arrangements and Governance Arrangements involved Rural Health, Health Care Reform and Health Equity, etc. And the reliability of AMSTAR needs to be tested in larger range in this field.

  3. Lower Health-Related Quality of Life in Polytrauma Patients

    PubMed Central

    Zwingmann, Jörn; Hagelschuer, Paul; Langenmair, Elia; Bode, Gerrit; Herget, Georg; Südkamp, Norbert P.; Hammer, Thorsten

    2016-01-01

    Abstract Although trauma-associated mortality has fallen in recent decades, and medical care has continued to improve in many fields, the quality of life after experiencing polytrauma has attracted little attention in the literature. This group of patients suffer from persisting physical disabilities. Moreover, they experience long-term social, emotional, and psychological effects that limit/lower considerably their quality of life. We analyzed retrospective data on 147 polytraumatized patients by administering written questionnaires and conducting face-to-face interviews 6 ± 0.8 years after the trauma in consideration of the following validated scores: Glasgow Outcome Scale, European Quality of Life Score, Short Form-36, Trauma Outcome Profile, and Beck Depressions Inventory II. Our analysis of these results reveals that polytraumatized patients suffer from persistent pain and functional disabilities after >5 years. We also observed changes in their socioeconomic situation, as well as psychological after-effects. The rehabilitation of this particular group of patients should not only address their physical disabilities. The psychological after-effects of trauma must be acknowledged and addressed for an even longer period of time. PMID:27175646

  4. Practical approaches for health care: Indoor air quality management

    SciTech Connect

    Turk, A.R.; Poulakos, E.M.

    1996-05-01

    The management of indoor air quality (IAQ) is of interest to building occupants, managers, owners, and regulators alike. Whether by poor design, improper attention, inadequate maintenance or the intent to save energy, many buildings today have significantly degraded IAQ levels. Acceptable IAQ is defined by the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) in Standard 62-1989 {open_quotes}Ventilation for Acceptable Indoor Air Quality{close_quotes} as {open_quotes}air in which there are no known contaminants at harmful concentrations as determined by cognizant authorities and with which a substantial majority (80 percent or more) of the people exposed do not express dissatisfaction.{close_quotes} ASHRAE`s definition not only addresses the chemical compounds that may be present in the air, but it also recognizes a need to address both physiological and psychosocial comfort. The second step is to conduct a performance review of the HVAC systems based on equipment design specifications and guidelines for acceptable IAQ. And the third step is to identify potential chemical, physical and biological sources that are known to contribute to adverse air quality. Upon completion of these three steps, you will able to identify the more significant contributors to IAQ problems and establish applications for prevention and mitigation.

  5. Individual and Societal Wisdom: Explaining the Paradox of Human Aging and High Well-Being.

    PubMed

    Jeste, Dilip V; Oswald, Andrew J

    2014-03-26

    Objective: Although human aging is characterized by loss of fertility and progressive decline in physical abilities, later life is associated with better psychological health and well-being. Furthermore, there has been an unprecedented increase in average lifespan over the past century without corresponding extensions of fertile and healthy age spans. We propose a possible explanation for these paradoxical phenomena. Method: We reviewed the relevant literature on aging, well-being, and wisdom. Results: An increase in specific components of individual wisdom in later life may make up for the loss of fertility as well as declining physical health. However, current data on the relationship between aging and individual wisdom are not consistent and do not explain increased longevity in the general population during the past century. We propose that greater societal wisdom (including compassion) may account for the notable increase in average lifespan over the last century. Data in older adults with serious mental illnesses are limited, but suggest that many of them too experience improved psychosocial functioning, although their longevity has not yet increased, suggesting persistent stigma against mental illness and inadequate societal compassion. Conclusions: The proposed construct of societal wisdom needs more investigation. Research should also focus on the reasons for discrepant findings related to age-associated changes in different components of individual wisdom. Studies of wisdom and well-being are warranted in older people with serious mental illnesses, along with campaigns to enhance societal compassion for these disenfranchised individuals. Finally, effective interventions to enhance wisdom need to be developed and tested.

  6. Validating Health Information Exchange (HIE) Data For Quality Measurement Across Four Hospitals

    PubMed Central

    Garg, Nupur; Kuperman, Gil; Onyile, Arit; Lowry, Tina; Genes, Nicholas; DiMaggio, Charles; Richardson, Lynne; Husk, Gregg; Shapiro, Jason S

    2014-01-01

    Health information exchange (HIE) provides an essential enhancement to electronic health records (EHR), allowing information to follow patients across provider organizations. There is also an opportunity to improve public health surveillance, quality measurement, and research through secondary use of HIE data, but data quality presents potential barriers. Our objective was to validate the secondary use of HIE data for two emergency department (ED) quality measures: identification of frequent ED users and early (72-hour) ED returns. We compared concordance of various demographic and encounter data from an HIE for four hospitals to data provided by the hospitals from their EHRs over a two year period, and then compared measurement of our two quality measures using both HIE and EHR data. We found that, following data cleaning, there was no significant difference in the total counts for frequent ED users or early ED returns for any of the four hospitals (p<0.001). PMID:25954362

  7. Measuring health care quality: comparing and contrasting the medical and the marketing approaches.

    PubMed

    Bowers, Michael R; Kiefe, Catarina I

    2002-01-01

    Health care quality, a key concept for medical practice and research, is also a widely used construct in health care administration and marketing research. We explored discipline-specific differences in the definition of quality, with the intent of finding a more unified approach. We summarized definitions and basic conceptual approaches to quality in both disciplines and then compared them on several attributes: basic goals, sources of measurement, role of patient perceptions, role of health care personnel, and need for risk adjustment. We developed a conceptual model combining the 2 approaches. Both disciplines could benefit from broadening their outcome measures. Patient satisfaction deserves more attention from medical researchers, whereas marketing approaches should go beyond using patient satisfaction as the only outcome of interest. It is conceptually feasible to integrate medical and marketing approaches to quality, with important insights resulting from this integration.

  8. Socioeconomic inequalities in the access to and quality of health care services

    PubMed Central

    Nunes, Bruno Pereira; Thumé, Elaine; Tomasi, Elaine; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

    2014-01-01

    OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services. PMID:26039400

  9. Quality assurance in health sciences literature searching: applying the ISO 9000 quality standard.

    PubMed

    Cullen, R; Mason, D

    1995-09-01

    Medicine is a literature-based discipline. Ensuring that the literature review which precedes a significant piece of medical research has met predetermined standards is essential. A list of items reviewed carries no guarantees that all appropriate items have been included in the survey of the literature, or that appropriate sources have been efficiently searched. This would be a matter for concern in any discipline. In medicine it is a matter of life and death. Quality assurance procedures that offer guarantees of the standards built into the process, rather than quality control which measures only outputs, can provide the necessary reassurance. The ISO 9000 quality standard offers a much needed quality assurance process. A methodology for applying the ISO 9000 standard to the task of searching the medical literature is outlined in this paper. A new role for medical librarians in promoting a rigorous methodology in the literature review equal to that of the research it supports is defined.

  10. Societal and economic consequences of influenza.

    PubMed

    Piedra, Pedro A

    2008-10-01

    High rates of vaccination coverage for preschool and school-aged children can reduce morbidity and mortality related to influenza outbreak. More focused and effective influenza prevention strategies are necessary to improve quality of life and to limit the burden of flu complications.

  11. Health providers' perception of quality of care for neonates in health facilities in a municipality in Southern Ghana.

    PubMed

    Elikplim Pomevor, Kokui; Adomah-Afari, Augustine

    2016-10-10

    Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers' perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana. Data were analysed using thematic framework through the process of coding in six phases to create and establish meaningful patterns. Findings The study revealed that health providers were concerned about the number of staff available, their competence and also equipment available for them to work more efficiently. Some essential equipment for neonatal care was either not available or was non-functional where it was available, while aseptic procedures were not adhered to. Moreover, personal protective equipment such as facemask, caps, aprons were not used except in the labour wards where staff had to change their footwear before entering. Research limitations/implications Limited number of health providers and facilities used, lack of exploration of parents of neonates' perspective of quality of neonatal care in this study and other settings, including the teaching hospitals. The authors did not examine issues related to the ineffective use of IV cannulation for neonates by nurses as well as referral of neonates. Additionally, the authors did not explore the perspectives of management of the municipal and regional health directorates or policy makers of the Ministry of Health and Ghana Health Service regarding the shortage of staff, inadequate provision of medical equipment and infrastructure. Practical implications This paper suggests the need for policy makers to redirect their attention to the issues that would improve the quality of

  12. The effect of quality information on consumer health plan switching: evidence from the Buyers Health Care Action Group.

    PubMed

    Abraham, Jean M; Feldman, Roger; Carlin, Caroline; Christianson, Jon

    2006-07-01

    We examine the factors that lead employees to search for health plan quality information and the effect of such information on the decision to switch plans. Extending Hirshleifer and Riley's model [Hirshleifer, J., Riley, J.G., 1979. The analytics of uncertainty and information--an expositional survey. Journal of Economic Literature 17 (December (4)), 1375-1421] of the economics of information, we develop a two-equation model of quality information awareness and switching behavior. We estimate the model using data from a random sample of 651 single employees from 16 firms that are members of the Buyers Health Care Action Group, a health care purchasing coalition in the Minneapolis-St. Paul region. Our empirical results do not support either a link between quality information and switching behavior, or between perceived health plan satisfaction and switching. We do, however, find that switching is influenced by changes in premiums and whether an individual has an existing relationship with a health care provider.

  13. Health behaviors and quality of life predictors for risk of hospitalization in an electronic health record-linked biobank

    PubMed Central

    Takahashi, Paul Y; Ryu, Euijung; Olson, Janet E; Winkler, Erin M; Hathcock, Matthew A; Gupta, Ruchi; Sloan, Jeff A; Pathak, Jyotishman; Bielinski, Suzette J; Cerhan, James R

    2015-01-01

    Background Hospital risk stratification models using electronic health records (EHRs) often use age and comorbid health burden. Our primary aim was to determine if quality of life or health behaviors captured in an EHR-linked biobank can predict future risk of hospitalization. Methods Participants in the Mayo Clinic Biobank completed self-administered questionnaires at enrollment that included quality of life and health behaviors. Participants enrolled as of December 31, 2010 were followed for one year to ascertain hospitalization. Data on comorbidities and hospitalization were derived from the Mayo Clinic EHR. Hazard ratios (HR) and 95% confidence interval (CI) were used, adjusted for age and sex. We used gradient boosting machines models to integrate multiple factors. Different models were compared using C-statistic. Results Of the 8,927 eligible Mayo Clinic Biobank participants, 834 (9.3%) were hospitalized. Self-perceived health status and alcohol use had the strongest associations with risk of hospitalization. Compared to participants with excellent self-perceived health, those reporting poor/fair health had higher risk of hospitalization (HR =3.66, 95% CI 2.74–4.88). Alcohol use was inversely associated with hospitalization (HR =0.57 95% CI 0.45–0.72). The gradient boosting machines model estimated self-perceived health as the most influential factor (relative influence =16%). The predictive ability of the model based on comorbidities was slightly higher than the one based on the self-perceived health (C-statistic =0.67 vs 0.65). Conclusion This study demonstrates that self-perceived health may be an important piece of information to add to the EHR. It may be another method to determine hospitalization risk. PMID:26316799

  14. Association between social capital, health-related quality of life, and mental health: a structural-equation modeling approach

    PubMed Central

    Hassanzadeh, Jafar; Asadi-Lari, Mohsen; Baghbanian, Abdolvahab; Ghaem, Haleh; Kassani, Aziz; Rezaianzadeh, Abbas

    2016-01-01

    Aim To explore the association(s) between demographic factors, socioeconomic status (SES), social capital, health-related quality of life (HRQoL), and mental health among residents of Tehran, Iran. Methods The pooled data (n = 31 519) were extracted from a population-based survey Urban Health Equity Assessment and Response Tool-2 (Urban HEART-2) conducted in Tehran in 2011. Mental health, social capital, and HRQoL were assessed using the 28-item General Health Questionnaire (GHQ-28), social capital questionnaire, and Short-Form Health Survey (SF-12), respectively. The study used a multistage sampling method. Social capital, HRQoL, and SES were considered as latent variables. The association between these latent variables, demographic factors, and mental health was determined by structural-equation modeling (SEM). Results The mean age and mental health score were 44.48 ± 15.87 years and 23.33 ± 11.10 (range, 0-84), respectively. The prevalence of mental disorders was 41.76% (95% confidence interval 41.21-42.30). The SEM model showed that age was directly associated with social capital (P = 0.016) and mental health (P = 0.001). Sex was indirectly related to mental health through social capital (P = 0.018). SES, HRQoL, and social capital were associated both directly and indirectly with mental health status. Conclusion This study suggests that changes in social capital and SES can lead to positive changes in mental health status and that individual and contextual determinants influence HRQoL and mental health. PMID:26935615

  15. Feeding trials in organic food quality and health research.

    PubMed

    Velimirov, Alberta; Huber, Machteld; Lauridsen, Charlotte; Rembiałkowska, Ewa; Seidel, Kathrin; Bügel, Susanne

    2010-01-30

    Feeding experiments comparing organically and conventionally produced food are performed to assess the overall impact on the animals' health as a model for the effects experienced by the human consumers. These experiments are based on systems research and characterized by their focus on production methods, whole food testing and procedures in accordance with the terms of organic farming. A short review of such experiments shows that the majority of these tests revealed effects of the organically produced feed on health parameters such as reproductive performance and immune responses. Systems research is not just about simple cause-effect chains, but rather about the pluralism of interactions in biological networks; therefore, the interpretation of the outcome of whole food experiments is difficult. Furthermore, the test diets of organic and conventional origin can be constituted in different ways, compensating for or maintaining existing differences in nutrient and energy contents. The science-based results suggest positive influences from organic feeds, but there is still a need for confirmation in animals and, finally, in humans. For this purpose animal feeding trials with feed from different production systems should be conducted, with the aims to define health indicators and to establish biomarkers as a basis for future dietary intervention studies in humans.

  16. Edible Mushrooms: Improving Human Health and Promoting Quality Life

    PubMed Central

    Valverde, María Elena; Hernández-Pérez, Talía; Paredes-López, Octavio

    2015-01-01

    Mushrooms have been consumed since earliest history; ancient Greeks believed that mushrooms provided strength for warriors in battle, and the Romans perceived them as the “Food of the Gods.” For centuries, the Chinese culture has treasured mushrooms as a health food, an “elixir of life.” They have been part of the human culture for thousands of years and have considerable interest in the most important civilizations in history because of their sensory characteristics; they have been recognized for their attractive culinary attributes. Nowadays, mushrooms are popular valuable foods because they are low in calories, carbohydrates, fat, and sodium: also, they are cholesterol-free. Besides, mushrooms provide important nutrients, including selenium, potassium, riboflavin, niacin, vitamin D, proteins, and fiber. All together with a long history as food source, mushrooms are important for their healing capacities and properties in traditional medicine. It has reported beneficial effects for health and treatment of some diseases. Many nutraceutical properties are described in mushrooms, such as prevention or treatment of Parkinson, Alzheimer, hypertension, and high risk of stroke. They are also utilized to reduce the likelihood of cancer invasion and metastasis due to antitumoral attributes. Mushrooms act as antibacterial, immune system enhancer and cholesterol lowering agents; additionally, they are important sources of bioactive compounds. As a result of these properties, some mushroom extracts are used to promote human health and are found as dietary supplements. PMID:25685150

  17. Edible mushrooms: improving human health and promoting quality life.

    PubMed

    Valverde, María Elena; Hernández-Pérez, Talía; Paredes-López, Octavio

    2015-01-01

    Mushrooms have been consumed since earliest history; ancient Greeks believed that mushrooms provided strength for warriors in battle, and the Romans perceived them as the "Food of the Gods." For centuries, the Chinese culture has treasured mushrooms as a health food, an "elixir of life." They have been part of the human culture for thousands of years and have considerable interest in the most important civilizations in history because of their sensory characteristics; they have been recognized for their attractive culinary attributes. Nowadays, mushrooms are popular valuable foods because they are low in calories, carbohydrates, fat, and sodium: also, they are cholesterol-free. Besides, mushrooms provide important nutrients, including selenium, potassium, riboflavin, niacin, vitamin D, proteins, and fiber. All together with a long history as food source, mushrooms are important for their healing capacities and properties in traditional medicine. It has reported beneficial effects for health and treatment of some diseases. Many nutraceutical properties are described in mushrooms, such as prevention or treatment of Parkinson, Alzheimer, hypertension, and high risk of stroke. They are also utilized to reduce the likelihood of cancer invasion and metastasis due to antitumoral attributes. Mushrooms act as antibacterial, immune system enhancer and cholesterol lowering agents; additionally, they are important sources of bioactive compounds. As a result of these properties, some mushroom extracts are used to promote human health and are found as dietary supplements.

  18. Accreditation of public health education in India: Enhancing quality, competence and trust.

    PubMed

    Sharma, Kavya; Zodpey, Sanjay; Zahiruddin, Quazi Syed

    2013-01-01

    With an increase in the number of institutes offering public health education, there is a need for discussion on future directions and challenges. The World Health Report 2006 identified the need to improve the quality of public health education. There are various mechanisms and bodies that look after accreditation issues in several countries. The Council on Education for Public Health in the USA assists in the accreditation of schools of public health, as well as public health programmes. The Australian Network of Academic Public Health Institutions is actively engaged in discussions to improve the quality of its programme and institutions. In Europe, the European Agency for Accreditation in Public Health Education is responsible for accreditation. The South-East Asia Public Health Education Institutes Network facilitates accreditation of public health education in the region. In India, public health education varies across institutes. India needs an accreditation system to ensure that public health education is of the desired quality. Certain initiatives, such as conferences, consultation and the Calcutta Declaration, have been taken in the past two decades. However, the ideas mooted have yet to be translated into reality. The broad framework for accreditation may entail an institutional self-assessment against set standards, preparation of a database, cataloguing, and site visits by a peer team. There is a need for an apical body with all stakeholders participating in the process. Accreditation has specific benefits, but there are critical challenges as well. For example, the autonomy of the institutions needs to be protected, the accreditation bodies should exhibit professionalism and substantial financial resources are required. Before tackling specific criteria for accreditation, it is necessary to define a collective vision for schools of public health in India.

  19. A cost-efficiency and health benefit approach to improve urban air quality.

    PubMed

    Miranda, A I; Ferreira, J; Silveira, C; Relvas, H; Duque, L; Roebeling, P; Lopes, M; Costa, S; Monteiro, A; Gama, C; Sá, E; Borrego, C; Teixeira, J P

    2016-11-01

    When ambient air quality standards established in the EU Directive 2008/50/EC are exceeded, Member States are obliged to develop and implement Air Quality Plans (AQP) to improve air quality and health. Notwithstanding the achievements in emission reductions and air quality improvement, additional efforts need to be undertaken to improve air quality in a sustainable way - i.e. through a cost-efficiency approach. This work was developed in the scope of the recently concluded MAPLIA project "Moving from Air Pollution to Local Integrated Assessment", and focuses on the definition and assessment of emission abatement measures and their associated costs, air quality and health impacts and benefits by means of air quality modelling tools, health impact functions and cost-efficiency analysis. The MAPLIA system was applied to the Grande Porto urban area (Portugal), addressing PM10 and NOx as the most important pollutants in the region. Four different measures to reduce PM10 and NOx emissions were defined and characterized in terms of emissions and implementation costs, and combined into 15 emission scenarios, simulated by the TAPM air quality modelling tool. Air pollutant concentration fields were then used to estimate health benefits in terms of avoided costs (external costs), using dose-response health impact functions. Results revealed that, among the 15 scenarios analysed, the scenario including all 4 measures lead to a total net benefit of 0.3M€·y(-1). The largest net benefit is obtained for the scenario considering the conversion of 50% of open fire places into heat recovery wood stoves. Although the implementation costs of this measure are high, the benefits outweigh the costs. Research outcomes confirm that the MAPLIA system is useful for policy decision support on air quality improvement strategies, and could be applied to other urban areas where AQP need to be implemented and monitored.

  20. Violence towards health care staff and possible effects on the quality of patient care.

    PubMed

    Arnetz, J E; Arnetz, B B

    2001-02-01

    Much of the research on violence in the health care sector has focused on the immediate and long-term effects of patient violence on staff victims. There is a lack of studies, however, examining whether individual reactions to violent episodes, such as anger and increased fear in one's work, have any measurable effect on staff behaviour toward their patients, and ultimately on the quality of patient care. The aim of the present study was to investigate whether an association exists between staff experiences with violence and patient-rated quality of patient care. A theoretical model was presented, suggesting that violence or threats experienced by health care staff have a negative effect on the quality of health care services offered, as measured by patients. In addition, it was theorised that there would be an association between staff work environment and staff reports of violence. Six questionnaire studies, three concerning hospital staff's views of their work environment and three dealing with patients' perceptions of the quality of care, provided the data for evaluating the model. Work environment and quality of care studies were carried out simultaneously at a single hospital in 1994, 1995, and again in 1997. Regression analysis was used to see which combination of work environment and quality of care variables would best predict a positive overall grade for quality of care from the patient perspective. Violence entered consistently as an important predictor into each of the three best regression equations for 1994, 1995, and 1997, respectively. The results of this analysis suggest that the violence experienced by health care staff is associated with lower patient ratings of the quality of care. The study indicates that violence is not merely an occupational health issue, but may have significant implications for the quality of care provided.

  1. [Research on quality of health care from the Mexican Social Security Institute: a bibliometric study].

    PubMed

    Navarrete-Navarro, Susana; Gómez-Delgado, Alejandro; Riebeling-Navarro, Carlos; López-García, Gloria Araceli; Nava-Zavala, Arnulfo

    2013-12-01

    OBJECTIVE. To identify studies on quality of health care in the IMSS. MATERIALS AND METHODS. A bibliometric, descriptive cross-sectional and retrospective study was conducted, from 1992 to 2011. RESULTS. We identified 881 research studies related to the issue of quality (CI95% 10.6-12.0) of 7 762 studies presented at the annual research meetings. 10 521 articles were published in this period of time and only 946 (CI95% 8.4-9.5) were linked to the issue of quality. CONCLUSIONS. The results of this study allowed us to identify the interest about research on quality. Further research is needed to establish what has been the impact on the improvement of quality in health care.

  2. PHYSIOLOGICAL INFORMATION FOR PAVEMENT HEALTH MONITORING BASED ON SURFACE RIDE QUALITY

    NASA Astrophysics Data System (ADS)

    Tomiyama, Kazuya; Kawamura, Akira; Takahashi, Kiyoshi; Ishida, Tateki

    Pavement ride quality testing has traditionally been based on subjective questionnaire ratings. The questionnaire survey has ability to directly measure the sense of road users' ride quality. However, it is difficult to quantify the evaluation results based on the questionnaire due to its lack of objectivity. This study examines pavement health monitoring method using physiological information such as heart rate variability (HRV) for detecting mental stress of road users toward pavement ride quality. First, a results of a driving simulator experiment shows that potential mental stress caused by road roughness can be observed in high-frequency oscillations in 0.15-0.4Hz of HRV processed by continuous wavelet transform. Then, the high-frequency oscillations of HRV is summarized as an index related to the mental stress that makes objective ride quality evaluation possible. Finally, this study indicates that the index contributes to improve the accuracy of pavement health monitoring based on surface ride quality.

  3. The impact of medical interpreter services on the quality of health care: a systematic review.

    PubMed

    Flores, Glenn

    2005-06-01

    Twenty-one million Americans are limited in English proficiency (LEP), but little is known about the effect of medical interpreter services on health care quality. Asystematic literature review was conducted on the impact of interpreter services on quality of care. Five database searches yielded 2,640 citations and a final database of 36 articles, after applying exclusion criteria. Multiple studies document that quality of care is compromised when LEP patients need but do not get interpreters. LEP patients' quality of care is inferior, and more interpreter errors occur with untrained ad hoc interpreters. Inadequate interpreter services can have serious consequences for patients with mental disorders. Trained professional interpreters and bilingual health care providers positively affect LEP patients' satisfaction, quality of care, and outcomes. Evidence suggests that optimal communication, patient satisfaction, and outcomes and the fewest interpreter errors occur when LEP patients have access to trained professional interpreters or bilingual providers.

  4. The role of Environmental Health System air quality monitors in Space Station Contingency Operations

    NASA Technical Reports Server (NTRS)

    Limero, Thomas F.; Wilson, Steve; Perlot, Susan; James, John

    1992-01-01

    This paper describes the Space Station Freedom (SSF) Environmental Health System's air-quality monitoring strategy and instrumentation. A two-tier system has been developed, consisting of first-alert instruments that warn the crew of airborne contamination and a volatile organic analyzer that can identify volatile organic contaminants in near-real time. The strategy for air quality monitoring on SSF is designed to provide early detection so that the contamination can be confined to one module and so that crew health and safety can be protected throughout the contingency event. The use of air-quality monitors in fixed and portable modes will be presented as a means of following the progress of decontamination efforts and ensuring acceptable air quality in a module after an incident. The technology of each instrument will be reviewed briefly; the main focus of this paper, however, will be the use of air-quality monitors before, during, and after contingency incidents.

  5. A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review

    PubMed Central

    Domínguez-Mayo, F. J.; Escalona, M. J.; Mejías, M.; Aragón, G.; García-García, J. A.; Torres, J.; Enríquez, J. G.

    2015-01-01

    e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems. PMID:26146656

  6. Lessons learned from building a culture and infrastructure for continuous quality improvement at Cabarrus Health Alliance.

    PubMed

    Randolph, Greg D; Stanley, Cappie; Rowe, Bobbie; Massie, Sara E; Cornett, Amanda; Harrison, Lisa Macon; Lea, C Suzanne

    2012-01-01

    This case study describes a local public health agency's multiyear effort to establish an infrastructure and organizational culture for continuous quality improvement, using data from interviews with the agency's senior leaders, managers, and frontline staff. Lessons learned include the importance of setting stretch goals, engaging leaders at all levels of the organization, empowering frontline staff to make changes, providing quality improvement training for staff and leaders, starting with small projects first, spreading quality improvement efforts to involve all parts of the agency, and sustaining momentum by creating a supporting infrastructure for continuous quality improvement and continually initiating new projects.

  7. Service quality and performance in the public health-care sector.

    PubMed

    Chahal, Hardeep; Kumari, Neetu

    2012-01-01

    The purpose of this article is to evaluate service quality and service performance relationship in the health-care sector using respective developed multidimensional scales. Data were collected from 400 inpatient respondents, using stratified sampling method from five departments, namely general medicine, surgery, pediatrics, orthopedics, gynecology, and ENT of a tertiary hospital (North India). The results confirm significant relationship among subdimensions of physical environment quality and interaction quality (service quality) and four service performance measures, namely waiting time, patient satisfaction, patient loyalty, and image in public hospitals.

  8. Mobile App Rating Scale: A New Tool for Assessing the Quality of Health Mobile Apps

    PubMed Central

    Kavanagh, David J; Zelenko, Oksana; Tjondronegoro, Dian; Mani, Madhavan

    2015-01-01

    Background The use of mobile apps for health and well being promotion has grown exponentially in recent years. Yet, there is currently no app-quality assessment tool beyond “star”-ratings. Objective The objective of this study was to develop a reliable, multidimensional measure for trialling, classifying, and rating the quality of mobile health apps. Methods A literature search was conducted to identify articles containing explicit Web or app quality rating criteria published between January 2000 and January 2013. Existing criteria for the assessment of app quality were categorized by an expert panel to develop the new Mobile App Rating Scale (MARS) subscales, items, descriptors, and anchors. There were sixty well being apps that were randomly selected using an iTunes search for MARS rating. There were ten that were used to pilot the rating procedure, and the remaining 50 provided data on interrater reliability. Results There were 372 explicit criteria for assessing Web or app quality that were extracted from 25 published papers, conference proceedings, and Internet resources. There were five broad categories of criteria that were identified including four objective quality scales: engagement, functionality, aesthetics, and information quality; and one subjective quality scale; which were refined into the 23-item MARS. The MARS demonstrated excellent internal consistency (alpha = .90) and interrater reliability intraclass correlation coefficient (ICC = .79). Conclusions The MARS is a simple, objective, and reliable tool for classifying and assessing the quality of mobile health apps. It can also be used to provide a checklist for the design and development of new high quality health apps. PMID:25760773

  9. The image of health status and quality of life in a Caribbean society

    PubMed Central

    Bourne, Paul A.; McGrowder, Donovan A.; Charles, Christopher A.D.; Francis, Cynthia G.

    2010-01-01

    Background: Health is defined as the presence or absence of illness. This conceptualization of health status is dominant in health treatment and in fashioning the health care system. However, very little research has been done on how Jamaicans view health status and quality of life (QoL). Aims: This article seeks to understand how Jamaicans conceptualize health status and QoL because definitional content has implications for their health. Material and Methods: The current study utilized two national cross-sectional probability surveys from the Centre for Leadership and Governance (CLG) which looked at QoL among other variables and the Jamaican Survey of Living Conditions (JSLC) which measured living standards including health status. The sample in both surveys was 8,120 participants. Results: The majority of the respondents in the CLG (54%) and the JSLC (82.2%) surveys reported good health status. There was a strong statistical relationship between area of residence and health status (P < 0.0001) unlike the relationship between area of residence and quality of life (P < 0.137). The respondents dichotomized health status and QoL and a significant relationship was found between both variables (P < 0.0001). The respondents’ dichotomization of health status and QoL is explained by the significant relationship between health status and self reported illness (P < 0.0001) where respondents view health status as the absence or presence of illness, excluding QoL. Conclusion: Health status means the presence or absence of illness and excludes QoL which is not in keeping with previous findings. This distinction is culturally determined. PMID:22624140

  10. Healthy lifestyles and health-related quality of life among men living with HIV infection.

    PubMed

    Uphold, Constance R; Holmes, Wanda; Reid, Kimberly; Findley, Kimberly; Parada, Jorge P

    2007-01-01

    Although healthy lifestyles are related to improved quality of life in the general population, little is known about the role of healthy lifestyles during HIV infection. The authors examined the relationships between health-promoting behaviors, risk behaviors, stress, and health-related quality of life (HRQOL) among 226 men with HIV infection who were attending three infectious disease clinics. As hypothesized, health-promoting behaviors were positively related and stress was negatively related with most of the HRQOL dimensions. Contrary to the hypothesis, tobacco use, recreational drug use, and unsafe sexual behaviors were not related to the HRQOL dimensions. Hazardous alcohol use was negatively associated with one HRQOL dimension--social functioning. The association of modifiable factors, such as health-promoting behaviors and stress, with HQROL offers opportunities for improving HIV-related health care. Relatively simple, straightforward changes in lifestyles such as eating well, remaining active, and avoiding stressful life events may result in improvements in HRQOL.

  11. Baccalaureate Nursing Students' Abilities in Critically Identifying and Evaluating the Quality of Online Health Information.

    PubMed

    Theron, Maggie; Redmond, Anne; Borycki, Elizabeth M

    2017-01-01

    Both the Internet and social media have become important tools that patients and health professionals, including health professional students, use to obtain information and support their decision-making surrounding health care. Students in the health sciences require increased competence to select, appraise, and use online sources to adequately educate and support patients and advocate for patient needs and best practices. The purpose of this study was to ascertain if second year nursing students have the ability to critically identify and evaluate the quality of online health information through comparisons between student and expert assessments of selected online health information postings using an adapted Trust in Online Health Information scale. Interviews with experts provided understanding of how experts applied the selected criteria and what experts recommend for implementing nursing informatics literacy in curriculums. The difference between student and expert assessments of the quality of the online information is on average close to 40%. Themes from the interviews highlighted several possible factors that may influence informatics competency levels in students, specifically regarding the critical appraisal of the quality of online health information.

  12. Impact of oral health conditions on the quality of life of workers.

    PubMed

    Guerra, Maria Júlia Campos; Greco, Rosangela Maria; Leite, Isabel Cristina Gonçalves; Ferreira e Ferreira, Efigênia; de Paula, Marcos Vinícius Queiroz

    2014-12-01

    Occupational health has been the scope of numerous studies, primarily due to the concern that the worker should enjoy good working conditions and a satisfactory quality of life. This study seeks to analyze the impact of oral health on the quality of life of workers at a public university using the simplified version of the Oral Health Impact Profile (OHIP-14) and associated factors. A cross-sectional study was conducted with 326 workers who responded the questions of OHIP-14 about self-rated health, oral morbidity, and socioeconomic and demographic questions. Multiple linear regression analysis was performed to verify the association between the independent variables and OHIP-14. About 40% of the impact of oral health on quality of life can be explained by the variables: education level (p = 0,03), age (p = 0,03), reason for visiting a dentist (p = 0,01), oral health perception (p < 0,01) and satisfaction with teeth and mouth (p < 0,01). The use of OHIP-14 can be useful for planning programs and actions focused on health education for occupational health, prioritizing workers with greater psychosocial impacts caused by oral problems.

  13. Quality of Primary Health Care for children and adolescents living with HIV 1

    PubMed Central

    do Nascimento, Leticia; de Paula, Cristiane Cardoso; Magnago, Tania Solange Bosi de Souza; Padoin, Stela Maris de Mello; Harzheim, Erno; da Silva, Clarissa Bohrer

    2016-01-01

    Abstract Objective: to evaluate the quality of health care for children and adolescents living with HIV, among the different types of Primary Health Care services of Santa Maria, Rio Grande do Sul. Method: cross-sectional study, developed with 118 Primary Health Care professionals. The Primary Care Evaluation Instrument, Professional version, was used. For verification of the variables associated with the high score, Poisson Regression was used. Results: the professionals of the Family Health Strategy, when compared to those of the Primary Health Units, obtained a greater degree of orientation to primary care, both for the overall score and for the derived attributes score, as well as for the integrality and community orientation attributes. A specialization in Primary Health Care, other employment and a statutory work contract were associated with quality of care. Conclusion: the Family Health Strategy was shown to provide higher quality health care for children and adolescents living with HIV, however, the coverage is still low. The need was highlighted to expand this coverage and invest in vocational training directed toward Primary Care and making the professionals effective, through public selection procedure, as well as an improvement program that recognizes the care requirements, in these settings, of children and adolescents infected with HIV. PMID:27579927

  14. Mental Health, Sleep Quality, Drinking Motives, and Alcohol-Related Consequences: A Path-Analytic Model

    PubMed Central

    Kenney, Shannon R.; Lac, Andrew; LaBrie, Joseph W.; Hummer,, Justin F.; Pham, Andy

    2013-01-01

    Objective: Poor mental health, sleep problems, drinking motivations, and high-risk drinking are prevalent among college students. However, research designed to explicate the interrelationships among these health risk behaviors is lacking. This study was designed to assess the direct and indirect influences of poor mental health (a latent factor consisting of depression, anxiety, and stress) to alcohol use and alcohol-related consequences through the mediators of global sleep quality and drinking motives in a comprehensive model. Method: Participants were 1,044 heavy-drinking college students (66.3% female) who completed online surveys. Results: A hybrid structural equation model tested hypotheses involving relations leading from poor mental health to drinking motives and poorer global sleep quality to drinking outcomes. Results showed that poor mental health significantly predicted all four subscales of drinking motivations (social, coping, conformity, and enhancement) as well as poor sleep. Most of the drinking motives and poor sleep were found to explain alcohol use and negative alcohol consequences. Poor sleep predicted alcohol consequences, even after controlling for all other variables in the model. The hypothesized mediational pathways were examined with tests of indirect effects. Conclusions: This is the first study to assess concomitantly the relationships among three vital health-related domains (mental health, sleep behavior, and alcohol risk) in college students. Findings offer important implications for college personnel and interventionists interested in reducing alcohol risk by focusing on alleviating mental health problems and poor sleep quality. PMID:24172110

  15. Sustainable improvement of animal health care by systematic quality risk management according to the HACCP concept.

    PubMed

    Noordhuizen, J P; Welpelo, H J

    1996-12-01

    This paper addresses the principles of the Hazard Analysis Critical Control Point (HACCP) concept as applied to animal health management strategy. Characteristics of the concept were analysed and compared with those of current animal health care strategies for disease risk identification and herd health management, insurance, and certification. HACCP is a hybrid strategy of quality control at both production process and product level. Animal health is considered a particular quality feature. We show that process control (expressed in terms of controlling both general and specific disease risk factors) and product control (expressed in terms of testing animals or animal products for specific disease agents) could form the basis for improving animal health. We conclude that HACCP provides ample opportunity for preventive health action and risk management at a relatively low cost in terms of labour, finance and documentation expenditure, at both the farm and sector level. Epidemiological field studies are currently needed to identify critical control points and to design HACCP procedures for livestock producers. In the long run, HACCP based animal health care can be further developed into a quality control systems approach to cover all aspects that are related, either directly or indirectly, to animal health.

  16. Health Literacy and Education Predict Nutrient Quality of Diet of Socioeconomically Diverse, Urban Adults

    PubMed Central

    Kuczmarski, Marie F.; Adams, Erica L.; Cotugna, Nancy; Pohlig, Ryan T.; Beydoun, May A.; Zonderman, Alan B.; Evans, Michele K.

    2016-01-01

    Background Research has shown that health literacy may be a stronger predictor of health than age, employment status, education level, race, and income. Evidence supports a strong link between low health literacy and poor dietary management of chronic diseases. Objective The aim was to evaluate the relationship of micronutrient quality of diet, health numeracy and health literacy in White and African American adults randomly selected from 13 Baltimore neighborhoods. Design Cross-sectional analysis of Wave 3 (2009–2013) of the longitudinal Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study initiated in 2004. Main Outcome Measures Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM). Health numeracy was measured using the numeracy subscale of the Test of Functional Health Literacy in Adults (TOFHLA). Nutrient-based diet quality was measured using Mean Adequacy Ratio (MAR-S) scores calculated from 17 micronutrients from diet plus dietary supplement intake. Statistical Analyses The relationship of MAR-S scores to the health literacy measures were explored with multiple ordinary least square regression models, adjusting for a number of potential confounders. Results REALM but not numeracy was associated with MAR-S; significant covariates included age, current cigarette smoking status, and energy intake. The interactions of race and educational attainment, and REALM and educational attainment were significant, with the relationship between REALM and MAR-S becoming stronger as education level increased. Conclusion There is a synergistic relationship between health literacy and educational attainment in predicting nutrient-based diet quality. Education was a stronger predictor for Whites compared to African Americans emphasizing the need for health professionals to focus on both education and literacy when creating and providing diet and health-related interventions and resources. PMID:28154842

  17. What is important in evaluating health care quality? An international comparison of user views

    PubMed Central

    Groenewegen, Peter P; Kerssens, Jan J; Sixma, Herman J; van der Eijk, Ingrid; Boerma, Wienke GW

    2005-01-01

    Background Quality of care from the perspective of users is increasingly used in evaluating health care performance. Going beyond satisfaction studies, quality of care from the users' perspective is conceptualised in two dimensions: the importance users attach to aspects of care and their actual experience with these aspects. It is well established that health care systems differ in performance. The question in this article is whether there are also differences in what people in different health care systems view as important aspects of health care quality. The aim is to describe and explain international differences in the importance that health care users attach to different aspects of health care. Methods Data were used from different studies that all used a version of the QUOTE-questionnaire that measures user views of health care quality in two dimensions: the importance that users attach to aspects of care and their actual experience. Data from 12 European countries and 5133 individuals were used. They were analysed using multi-level analysis. Results Although most of the variations in importance people attach to aspects of health care is located at the individual level, there are also differences between countries. The ranking of aspects shows similarities. 'My GP should always take me seriously' was in nearly all countries ranked first, while an item about waiting time in the GP's office was always ranked lowest. Conclusion Differences between countries in how health care users value different aspects of care are difficult to explain. Further theorising should take into account that importance and performance ratings are positively related, that people compare their experiences with those of others, and that general and instrumental values might be related through the institutions of the health care system. PMID:15723701

  18. Quality Assurance in Breast Health Care and Requirement for Accreditation in Specialized Units

    PubMed Central

    Güler, Sertaç Ata; Güllüoğlu, Bahadır M.

    2014-01-01

    Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a “reviewing/auditing” procedure that checks if all of these functions existing in the health system are carried out at the desired level and an “accreditation” system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5–10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer. PMID:28331658

  19. Quality Assurance in Breast Health Care and Requirement for Accreditation in Specialized Units.

    PubMed

    Güler, Sertaç Ata; Güllüoğlu, Bahadır M

    2014-07-01

    Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a "reviewing/auditing" procedure that checks if all of these functions existing in the health system are carried out at the desired level and an "accreditation" system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5-10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer.

  20. Assessing the quality of mental health promotion and prevention in Croatia: the case of Istria.

    PubMed

    Mihić, Josipa; Novak, Miranda; Hosman, Clemens; Domitrovich, Celene

    2015-12-20

    While the availability of mental health promotion and prevention programs worldwide is growing, there is divergence in their level of effectiveness that has led to increasing interest in the development of 'effect management' strategies. Mental health promotion and prevention science and practice has a relatively young history in Croatia, but major investments towards its development have been made over the last decade. This paper reports on a research project that took place within the Istrian Region. The long-term goal of the initiative is to establish quality assurance indicators for mental health promotion and prevention interventions. The current study involved adapting the Dutch Preffi 2.0 instrument for use in Croatia. The content of the Preffi reflects the literature regarding research-based effect predictors. An instrument allows users to assess whether programs have been designed and implemented in ways that maximize their ability to be effective. The Preffi scores can be used for improving a program and the quality with which it is implemented. The first aim of the study is to determine if independent researchers can use the Preffi reliably as a quality assessment instrument. The second aim is to use the Preffi to describe the quality of one cohort of mental health promotion and prevention programs. The study represents the first steps toward developing a strategy for quality assurance that strengthens community capacity for effective service delivery and that could inform other countries whose mental health promotion and prevention efforts are in early stages of development.

  1. Impact of air quality on lung health: myth or reality?

    PubMed Central

    Marino, Elisa; Caruso, Massimo; Campagna, Davide

    2015-01-01

    The respiratory system is a primary target of the harmful effects of key air pollutants of health concern. Several air pollutants have been implicated including particulate matter (PM), ozone (O3), nitrogen dioxide (NO2) polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs). It is well known that episodes of exposure to high concentrations of outdoor air pollutants can cause acute respiratory exacerbations. However, there is now increasing evidence suggesting that significant exposure to outdoor air pollutants may be also associated with development of lung cancer and with incident cases of chronic obstructive pulmonary disease (COPD) and respiratory allergies. Here we provide a critical appraisal of the impact of air pollution on respiratory diseases and discuss strategies for preventing excessive exposure to harmful air pollutants. However, the evidence that significant exposure to air pollutants is causing COPD, lung cancer or respiratory allergies is not conclusive and therefore regulators must be aware that execution of clean air policies may not be that cost-effective and may lead to unintended consequences. Addressing the lung health effects of air pollution must be considered work in progress. PMID:26336597

  2. The role of Health Impact Assessment in the setting of air quality standards: An Australian perspective

    SciTech Connect

    Spickett, Jeffery; Katscherian, Dianne; Harris, Patrick

    2013-11-15

    The approaches used for setting or reviewing air quality standards vary from country to country. The purpose of this research was to consider the potential to improve decision-making through integration of HIA into the processes to review and set air quality standards used in Australia. To assess the value of HIA in this policy process, its strengths and weaknesses were evaluated aligned with review of international processes for setting air quality standards. Air quality standard setting programmes elsewhere have either used HIA or have amalgamated and incorporated factors normally found within HIA frameworks. They clearly demonstrate the value of a formalised HIA process for setting air quality standards in Australia. The following elements should be taken into consideration when using HIA in standard setting. (a) The adequacy of a mainly technical approach in current standard setting procedures to consider social determinants of health. (b) The importance of risk assessment criteria and information within the HIA process. The assessment of risk should consider equity, the distribution of variations in air quality in different locations and the potential impacts on health. (c) The uncertainties in extrapolating evidence from one population to another or to subpopulations, especially the more vulnerable, due to differing environmental factors and population variables. (d) The significance of communication with all potential stakeholders on issues associated with the management of air quality. In Australia there is also an opportunity for HIA to be used in conjunction with the NEPM to develop local air quality standard measures. The outcomes of this research indicated that the use of HIA for air quality standard setting at the national and local levels would prove advantageous. -- Highlights: • Health Impact Assessment framework has been applied to a policy development process. • HIA process was evaluated for application in air quality standard setting.

  3. Measuring health-related quality of life in tuberculosis: a systematic review

    PubMed Central

    Guo, Na; Marra, Fawziah; Marra, Carlo A

    2009-01-01

    Introduction Tuberculosis remains a major public health problem worldwide. In recent years, increasing efforts have been dedicated to assessing the health-related quality of life experienced by people infected with tuberculosis. The objectives of this study were to better understand the impact of tuberculosis and its treatment on people's quality of life, and to review quality of life instruments used in current tuberculosis research. Methods A systematic literature search from 1981 to 2008 was performed through a number of electronic databases as well as a manual search. Eligible studies assessed multi-dimensional quality of life in people with tuberculosis disease or infection using standardized instruments. Results of the included studies were summarized qualitatively. Results Twelve original studies met our criteria for inclusion. A wide range of quality of life instruments were involved, and the Short-Form 36 was most commonly used. A validated tuberculosis-specific quality of life instrument was not located. The findings showed that tuberculosis had a substantial and encompassing impact on patients' quality of life. Overall, the anti-tuberculosis treatment had a positive effect of improving patients' quality of life; their physical health tended to recover more quickly than the mental well-being. However, after the patients successfully completed treatment and were microbiologically 'cured', their quality of life remained significantly worse than the general population. Conclusion Tuberculosis has substantially adverse impacts on patients' quality of life, which persist after microbiological 'cure'. A variety of instruments were used to assess quality of life in tuberculosis and there has been no well-established tuberculosis-specific instrument, making it difficult to fully understand the impact of the illness. PMID:19224645

  4. Relationship between nurses' and physicians' perceptions of organizational health and quality of patient care.

    PubMed

    Hussein, A H M

    2014-10-20

    This study investigated the relationship between nurses' and physicians' perceptions of the organizational health of a hospital and the quality of patient care. Data were collected using 2 self-report questionnaires from 75 nurses and 49 physicians working in 4 intensive care units in a university-affiliated hospital in Saudi Arabia. Among the determinants of hospital health in the modified Quality Work Competence questionnaire (12 domains), teamwork was the highest scoring determinant [mean percentage score 70.5 (SD 11.8)]; however it was not significantly correlated with any of the predictors of quality of patient care. In the Quality of Patient Care questionnaire (7 domains) quality results was the highest scoring predictor [69.7 (SD 14.3)]. There was a significant positive correlation between participants' perception of overall mean percentage scores on the determinants of organizational hospital health and the predictors of the quality of patient care (r = 0.26). In contrast, patient-centred care had no significant positive correlation with any of the studied hospital health determinants.

  5. Usability Evaluation and Implementation of a Health Information Technology Dashboard of Evidence-Based Quality Indicators.

    PubMed

    Schall, Mark Christopher; Cullen, Laura; Pennathur, Priyadarshini; Chen, Howard; Burrell, Keith; Matthews, Grace

    2016-12-21

    Health information technology dashboards that integrate evidence-based quality indicators can efficiently and accurately display patient risk information to promote early intervention and improve overall quality of patient care. We describe the process of developing, evaluating, and implementing a dashboard designed to promote quality care through display of evidence-based quality indicators within an electronic health record. Clinician feedback was sought throughout the process. Usability evaluations were provided by three nurse pairs and one physician from medical-surgical areas. Task completion times, error rates, and ratings of system usability were collected to compare the use of quality indicators displayed on the dashboard to the indicators displayed in a conventional electronic health record across eight experimental scenarios. Participants rated the dashboard as "highly usable" following System Usability Scale (mean, 87.5 [SD, 9.6]) and Poststudy System Usability Questionnaire (mean, 1.7 [SD, 0.5]) criteria. Use of the dashboard led to reduced task completion times and error rates in comparison to the conventional electronic health record for quality indicator-related tasks. Clinician responses to the dashboard display capabilities were positive, and a multifaceted implementation plan has been used. Results suggest application of the dashboard in the care environment may lead to improved patient care.

  6. A Model for the Departmental Quality Management Infrastructure Within an Academic Health System.

    PubMed

    Mathews, Simon C; Demski, Renee; Hooper, Jody E; Biddison, Lee Daugherty; Berry, Stephen A; Petty, Brent G; Chen, Allen R; Hill, Peter M; Miller, Marlene R; Witter, Frank R; Allen, Lisa; Wick, Elizabeth C; Stierer, Tracey S; Paine, Lori; Puttgen, Hans A; Tamargo, Rafael J; Pronovost, Peter J

    2016-09-06

    As quality improvement and patient safety come to play a larger role in health care, academic medical centers and health systems are poised to take a leadership role in addressing these issues. Academic medical centers can leverage their large integrated footprint and have the ability to innovate in this field. However, a robust quality management infrastructure is needed to support these efforts. In this context, quality and safety are often described at the executive level and at the unit level. Yet, the role of individual departments, which are often the dominant functional unit within a hospital, in realizing health system quality and safety goals has not been addressed. Developing a departmental quality management infrastructure is challenging because departments are diverse in composition, size, resources, and needs.In this article, the authors describe the model of departmental quality management infrastructure that has been implemented at the Johns Hopkins Hospital. This model leverages the fractal approach, linking departments horizontally to support peer and organizational learning and connecting departments vertically to support accountability to the hospital, health system, and board of trustees. This model also provides both structure and flexibility to meet individual departmental needs, recognizing that independence and interdependence are needed for large academic medical centers. The authors describe the structure, function, and support system for this model as well as the practical and essential steps for its implementation. They also provide examples of its early success.

  7. FACTORS ASSOCIATED WITH HEALTH-RELATED QUALITY OF LIFE AMONG UNIVERSITY STUDENTS IN TURKEY

    PubMed Central

    Oztasan, Nuray; Ozyrek, Pakize; Kilic, Ibrahim

    2016-01-01

    Introduction: Purpose of this descriptive study is to determine the mental health problems and quality of life levels of college students and examine the relationship between them. Methods: The sample of the study consisted of 429 students continuing their education in Health School at Afyon Kocatepe University. Data were collected by using information form, Brief Symptom Inventory (BSI), SF 36 Quality of Life Scale questionnaires. In the analysis of obtained data, descriptive statistics, t-test, ANOVA and correlation analyses were used. Findings: Mental symptoms which the students got the highest scores from the subscales of BSI were respectively, depression (1.31±0.75), hostility (1.22±0.67) and anxiety (1.00±0.65). Discomfort severity index which is the overall score of the scale was found 1.07±0.61. Relation between state of mind and quality of life was found statistically significant (F: 70.894; p<0.000). When quality of life summary scores examined, it was found out that physical health summary score (48.92±7.93) and mental health summary score (43.44±9.52) points were low. Conclusions: Consequently, according to averages of scores, it can be said that frequency of the mental symptoms of students are high but their quality of life is low. It was found that when students’ quality of life decreased, their mental symptoms increased. PMID:27482164

  8. Patient mobility and health care quality when regions and patients differ in income.

    PubMed

    Brekke, Kurt R; Levaggi, Rosella; Siciliani, Luigi; Straume, Odd Rune

    2016-12-01

    We study the effects of cross-border patient mobility on health care quality and welfare when income varies across and within regions. We use a Salop model with a high-, middle-, and low-income region. In each region, a policy maker chooses health care quality to maximise the utility of its residents when health care costs are financed by general income taxation. In equilibrium, regions with higher income offer better quality, which creates an incentive for patient mobility from lower- to higher-income regions. Assuming a prospective payment scheme based on DRG-pricing, we find that lower non-monetary (administrative) mobility costs have (i) no effect on quality or welfare in the high-income region; (ii) a negative effect on quality but a positive effect on welfare for the middle-income region; and (iii) ambiguous effects on quality and welfare for the low-income region. Lower monetary mobility costs (copayments) might reduce welfare in both the middle- and low-income region. Thus, health policies that stimulate cross-border patient mobility can be counterproductive when regions differ in income.

  9. Degraded water quality influences microbial community composition and perception of health risks in the Chattooga River.

    PubMed

    Kent, Angela D; Bayne, Zachary L

    2010-09-01

    Bacterial skin infections are a chronic problem among whitewater rafters on the Chattooga River in the southeastern United States; however, little is known about the source of such infections. The Chattooga River is a federally designated "Wild and Scenic" river, with a forested riparian buffer zone designed to protect water quality in the river. Riverine water quality can be negatively impacted by tributaries that are not protected by federal guidelines. Water quality in Stekoa Creek, a major tributary of the Chattooga River, is degraded by sediment that runs off from construction sites near the creek, as well as fecal coliform contamination from wastewater treatment facilities. Degraded water quality may impact the health of visitors recreating on the river, as well as recreation industry workers. We demonstrate that inputs from the impaired creek influence microbial community composition in Chattooga River waters. A survey of whitewater raft guides was conducted to collect data on incidence of skin infection, and to assess perceived health risk from recreation activities. Whitewater rafting guides working on the Chattooga River reported concerns about their personal health related to degraded water quality and microbial contamination from Stekoa Creek. Incidence of bacterial skin infection and perceived health risk was strongly correlated among the whitewater rafting guides (r = 0.67). Concerns about environmental quality appear to be shaped by the incidence of skin infection. Such concerns are also correlated with changes in recreation practices among whitewater rafting guides (r = 0.67).

  10. Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014

    PubMed Central

    Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran

    2016-01-01

    Introduction Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. Methods This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach’s Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. Results The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors’ offices had the highest quality gap of −1.420 ± 0.82 and −1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were −0.883 ± 0.67, −0.882 ± 0.83, and −0.804 ± 0.62, respectively. There was a significant relationship between peoples’ perceptions and expectations concerning the quality of health services and their educational levels. Conclusion The higher gaps in quality in hospitals and in doctors’ offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors. PMID:27123214

  11. Identification of Health-Related Quality of Life (HRQOL) Issues Relevant to Individuals with HD

    PubMed Central

    Tulsky, David S.

    2013-01-01

    This qualitative study explored health-related quality of life (HRQOL) in individuals with Huntington disease (HD). Sixteen focus groups were conducted (n=6 groups with symptomatic HD individuals; n=5 with individuals who are at-risk or prodromal for HD; n=3 non-clinical HD caregivers; n=2 groups with HD clinicians). Qualitative analysis indicated that 28% of focus group comments were related to emotional health, 27% to social participation, 26% to physical health, 10% to cognitive health, and 9% to end of life issues. Findings highlight the importance of developing HD-targeted items to ensure sensitive assessment of HRQOL in HD research and clinical practice. PMID:22427174

  12. Relationships between technical efficiency and the quality and costs of health care in Italy†

    PubMed Central

    Nuti, S.; Daraio, C.; Speroni, C.; Vainieri, M.

    2011-01-01

    Objectives This paper reports the measurement of technical efficiency of Tuscan Local Health Authorities and its relationship with quality and appropriateness of care. Design First, a bias-corrected measure of technical efficiency was developed using the bootstrap technique applied to data envelopment analysis. Then, correlation analysis was used to investigate the relationships among technical efficiency, quality and appropriateness of care. Setting and Participants These analyses have been applied to the Local Health Authorities of Tuscany Region (Italy), which provide not only hospital inpatient services, but also prevention and primary care. All top managers of Tuscan Local Health Authorities were involved in selection of the inputs and outputs for calculating technical efficiency. Main Outcome Measures The main measures used in this study are volume, quality and appropriateness indicators monitored by the multidimensional performance evaluation system developed in the Tuscany Region. Results On average, Tuscan Local Health Authorities experienced 14(%) of bias-corrected inefficiency in 2007. Correlation analyses showed a significant negative correlation between per capita costs and overall performance. No correlation was found in 2007 between technical efficiency and overall performance or between technical efficiency and per capita costs. Conclusions Technical efficiency cannot be considered as an extensive measure of healthcare performance, but evidence shows that Tuscan Local Health Authorities have room for improvement in productivity levels. Indeed, correlation findings suggest that, to pursue financial sustainability, Local Health Authorities mainly have to improve their performance in terms of quality and appropriateness. PMID:21454349

  13. Hamilton study: distribution of factors confounding the relationship between air quality and respiratory health

    SciTech Connect

    Pengelly, L.D.; Kerigan, A.T.; Goldsmith, C.H.; Inman, E.M.

    1984-10-01

    Hamilton, Ontario is an industrial city with a population of 300,000 which is situated at the western end of Lake Ontario. Canada's two largest iron and steel mills are located here; the city historically has had relatively poor air quality, which has improved markedly in the last 25 years. Concern about the health effects of current air quality recently led us to carry out an epidemiological study of the effects of air pollution on the respiratory health of over 3500 school children. Respiratory health was measured by pulmonary function testing of each child, and by an assessment of each child's respiratory symptoms via a questionnaire administered to the parents. Previous studies had shown that other environmental factors (e.g. parental smoking, parental cough, socioeconomic level, housing, and gas cooking) might also affect respiratory health, and thus confound any potential relationships between health and air pollution. The questionnaire also collected information on many of these confounding factors. For the purposes of initial analysis, the city was divided into five areas in which differences in air quality were expected. In general, factors which have been associated with poor respiratory health were observed to be more prevalent in areas of poorer air quality.

  14. Nurse mentorship to improve the quality of health care