An inexpensive modification of the laboratory computer display changes emergency physicians' work habits and perceptions.

PubMed

Marinakis, Harry A; Zwemer, Frank L

2003-02-01

Little is known about how the availability of laboratory data affects emergency physicians' practice habits and satisfaction. We modified our clinical information system to display laboratory test status with continuous updates, similar to an airport arrival display. The objective of this study was to determine whether the laboratory test status display altered emergency physicians' work habits and increased satisfaction compared with the time period before implementation of laboratory test status. A retrospective analysis was performed of emergency physicians' actual use of the clinical information system before and after implementation of the laboratory test status display. Emergency physicians were retrospectively surveyed regarding the effect of laboratory test status display on their practice habits and clinical information system use. Survey responses were matched with actual use of the clinical information system. Data were analyzed by using dependent t tests and Pearson correlation coefficients. The study was conducted at a university hospital. Clinical information system use by 46 emergency physicians was analyzed. Twenty-five surveys were returned (71.4% of available emergency physicians). All emergency physicians perceived fewer clinical information system log ons per day after laboratory test status display. The actual average decrease was 19%. Emergency physicians who reported the greatest decrease in log ons per day tended to have the greatest actual decrease (r =-0.36). There was no significant correlation between actual and perceived total time logged on (r =0.08). In regard to effect on emergency physicians' practice habits, 95% reported increased efficiency, 80% reported improved satisfaction with data access, and 65% reported improved communication with patients. An inexpensive computer modification, laboratory test status display, significantly increased subjective efficiency, changed work habits, and improved satisfaction regarding data access and patient communication among emergency physicians. Knowledge of the test queue changed emergency physician behavior and improved satisfaction.

Going Back Part-time: Family Leave Legislation and Women’s Return to Work

PubMed Central

2012-01-01

Using a multinomial logit model with data from the Survey of Income and Program Participation, this paper tests whether the implementation of the Family and Medical Leave Act (FMLA) is associated with an increase in return to work at part-time status among first-time mothers working full-time during their pregnancy. I find a statistically significant trend of increasingly higher odds of returning to work at part-time status relative to return at full-time status, beginning in 1993 (the year in which the FMLA is implemented). Furthermore, an additional week of either state or federal leave is significantly associated with a higher odds of return at part-time status. This article provides evidence that job protection and leave legislation may help facilitate higher levels of labor force participation among women with small children, through more flexible work arrangements. PMID:22685365

Going Back Part-time: Family Leave Legislation and Women's Return to Work.

PubMed

Schott, Whitney

2012-02-01

Using a multinomial logit model with data from the Survey of Income and Program Participation, this paper tests whether the implementation of the Family and Medical Leave Act (FMLA) is associated with an increase in return to work at part-time status among first-time mothers working full-time during their pregnancy. I find a statistically significant trend of increasingly higher odds of returning to work at part-time status relative to return at full-time status, beginning in 1993 (the year in which the FMLA is implemented). Furthermore, an additional week of either state or federal leave is significantly associated with a higher odds of return at part-time status. This article provides evidence that job protection and leave legislation may help facilitate higher levels of labor force participation among women with small children, through more flexible work arrangements.

Status of state forestry best management practices for the southeastern United States

Treesearch

R. Cristan; W.M. Aust; M.C. Bolding; S.M. Barrett; J.F. Munsell

2016-01-01

Forestry Best Management Practices (BMPs) are important measures for protecting the waters of the U.S., but few studies have compared monitoring strategies and implementation success of forestry BMPs across states. In order to assess the status of state forestry BMPs, a survey was sent to the state forestry agency in each U.S. state regarding their forestry BMP program...

75 FR 9407 - Agency Information Collection Activities; Proposed Collection; Comment Request; Implementation of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... Participation Survey; EPA ICR No. 2375.01 OMB Control No. 2060-New AGENCY: Environmental Protection Agency (EPA... No. 2060-New. ICR status: This ICR is for a new information collection activity. An Agency may not...

National nutrition surveys in Asian countries: surveillance and monitoring efforts to improve global health.

PubMed

Song, SuJin; Song, Won O

2014-01-01

Asian regions have been suffering from growing double burden of nutritional health problems, such as undernutrition and chronic diseases. National nutrition survey plays an essential role in helping to improve both national and global health and reduce health disparities. The aim of this review was to compile and present the information on current national nutrition surveys conducted in Asian countries and suggest relevant issues in implementation of national nutrition surveys. Fifteen countries in Asia have conducted national nutrition surveys to collect data on nutrition and health status of the population. The information on national nutrition survey of each country was obtained from government documents, international organizations, survey website of governmental agencies, and publications, including journal articles, books, reports, and brochures. The national nutrition survey of each country has different variables and procedures. Variables of the surveys include sociodemographic and lifestyle variables; foods and beverages intake, dietary habits, and food security of individual or household; and health indicators, such as anthropometric and biochemical variables. The surveys have focused on collecting data about nutritional health status in children aged under five years and women of reproductive ages, nutrition intake adequacy and prevalence of obesity and chronic diseases for all individuals. To measure nutrition and health status of Asian populations accurately, improvement of current dietary assessment methods with various diet evaluation tools is necessary. The information organized in this review is important for researchers, policy makers, public health program developers, educators, and consumers in improving national and global health.

Effect of a checklist on advanced trauma life support task performance during pediatric trauma resuscitation.

PubMed

Kelleher, Deirdre C; Carter, Elizabeth A; Waterhouse, Lauren J; Parsons, Samantha E; Fritzeen, Jennifer L; Burd, Randall S

2014-10-01

Advanced Trauma Life Support (ATLS) has been shown to improve outcomes related to trauma resuscitation; however, omissions from this protocol persist. The objective of this study was to evaluate the effect of a trauma resuscitation checklist on performance of ATLS tasks. Video recordings of resuscitations of children sustaining blunt or penetrating injuries at a Level I pediatric trauma center were reviewed for completion and timeliness of ATLS primary and secondary survey tasks, with and without checklist use. Patient and resuscitation characteristics were obtained from the trauma registry. Data were collected during two 4-month periods before (n = 222) and after (n = 213) checklist implementation. The checklist contained 50 items and included four sections: prearrival, primary survey, secondary survey, and departure plan. Five primary survey ATLS tasks (cervical spine immobilization, oxygen administration, palpating pulses, assessing neurologic status, and exposing the patient) and nine secondary survey ATLS tasks were performed more frequently (p ≤ 0.01 for all) and vital sign measurements were obtained faster (p ≤ 0.01 for all) after the checklist was implemented. When controlling for patient and event-specific characteristics, primary and secondary survey tasks overall were more likely to be completed (odds ratio [OR] = 2.66, primary survey; OR = 2.47, secondary survey; p < 0.001 for both) and primary survey tasks were performed faster (p < 0.001) after the checklist was implemented. Implementation of a trauma checklist was associated with greater ATLS task performance and with increased frequency and speed of primary and secondary survey task completion. © 2014 by the Society for Academic Emergency Medicine.

Current Implementation of and Opinions and Concerns Regarding Suicide Education for Social Work Undergraduate Students in Japan: A Cross-Sectional Study

ERIC Educational Resources Information Center

Kodaka, Manami; Hikitsuchi, Emi; Takai, Michiko; Okada, Sumie; Watanabe, Yasue; Fukushima, Kiyoko; Yamada, Mitsuhiko; Inagaki, Masatoshi; Takeshima, Tadashi; Matsumoto, Toshihiko

2018-01-01

This study explored the current implementation status of and opinions and concerns regarding suicide education at schools of social work in Japan. We conducted a survey of faculty members who taught at least one of the social work subjects. About half the respondents had given a lecture of some kind on suicide, and more than 80% agreed that…

Promoting Influenza Vaccination to Restaurant Employees.

PubMed

Graves, Meredith C; Harris, Jeffrey R; Hannon, Peggy A; Hammerback, Kristen; Parrish, Amanda T; Ahmed, Faruque; Zhou, Chuan; Allen, Claire L

2016-09-01

To evaluate an evidence-based workplace approach to increasing adult influenza vaccination levels applied in the restaurant setting We implemented an intervention and conducted a pre/post analysis to determine effect on vaccination. Eleven Seattle-area restaurants. Restaurants with 25+ employees speaking English or Spanish and over 18 years. Restaurants received influenza vaccination promotion materials, assistance arranging on-site vaccination events, and free influenza vaccinations for employees. Pre/post employee surveys of vaccination status with direct observation and employer interviews to evaluate implementation. We conducted descriptive analysis of employee survey data and performed qualitative analysis of implementation data. To assess intervention effect, we used a mixed-effects logistic regression model with a restaurant-specific random effect. Vaccination levels increased from 26% to 46% (adjusted odds ratio 2.33, 95% confidence interval 1.69, 3.22), with 428 employees surveyed preintervention, 305 surveyed postintervention, and response rates of 73% and 55%, respectively. The intervention was effective across subgroups, but there were restaurant-level differences. An access-based workplace intervention can increase influenza vaccination levels in restaurant employees, but restaurant-level factors may influence success. © 2016 by American Journal of Health Promotion, Inc.

Strategic Information Systems Planning in Malaysian Public Universities

ERIC Educational Resources Information Center

Ismail, Noor Azizi; Raja Mohd Ali, Raja Haslinda; Mat Saat, Rafeah; Hsbollah, Hafizah Mohamad

2007-01-01

Purpose: The paper's purpose is to investigate the current status, problems and benefits of strategic information systems planning implementation in Malaysian public universities. Design/methodology/approach: The study uses dual but mutually supportive strands of investigation, i.e. a questionnaire survey and interviews. Findings: Malaysian public…

Survey of standards applicable to a database management system

NASA Technical Reports Server (NTRS)

Urena, J. L.

1981-01-01

Industry, government, and NASA standards, and the status of standardization activities of standards setting organizations applicable to the design, implementation and operation of a data base management system for space related applications are identified. The applicability of the standards to a general purpose, multimission data base management system is addressed.

Change in visa status amongst Mandaean refugees: relationship to psychological symptoms and living difficulties.

PubMed

Nickerson, Angela; Steel, Zachary; Bryant, Richard; Brooks, Robert; Silove, Derrick

2011-05-15

Policies of deterrence, including the use of detention and temporary visas, have been widely implemented to dissuade asylum seekers from seeking protection in Western countries. The present study examined the impact of visa status change on the mental health of 97 Mandaean refugees resettled in Australia. At the time of the first survey (2004), 68 (70%) participants held temporary protection visas (TPVs) and 29 (30%) held permanent residency (PR) status, whereas by the second survey (2007), 97 (100%) participants held PR status. We tested a meditational model to determine whether the relationship between change in visa status and change in psychological symptoms was mediated by change in living difficulties associated with the visa categories. The conversion of visa status from TPV to PR status was associated with significant improvements in PTSD and depression symptoms, and increases in mental health-related quality of life (MHR-QOL). The relationship between change in visa status and reduced PTSD and depression symptoms was mediated by reductions in living difficulties. In contrast, the relationship between change in visa status and increased MHR-QOL was not mediated by changes in living difficulties. These results suggest that restriction of rights and access to services related to visa status negatively affect the mental health of refugees. Implications for government policies regarding refugees are discussed. Copyright © 2010. Published by Elsevier Ireland Ltd.

Associations between Food Security Status and Dietary Inflammatory Potential within Lower-Income Adults from the United States National Health and Nutrition Examination Survey, Cycles 2007 to 2014.

PubMed

Bergmans, Rachel S; Palta, Mari; Robert, Stephanie A; Berger, Lawrence M; Ehrenthal, Deborah B; Malecki, Kristen M

2018-06-01

Evidence suggests both that chronic inflammation mediates the association of food insecurity with adverse health outcomes and that diet may be a significant source of inflammation among food insecure individuals. To examine whether food security status is associated with dietary inflammatory potential. Cross-sectional data came from the National Health and Nutrition Examination Survey (NHANES), cycles 2007 to 2014 (n=10,630). The analysis sample is representative of noninstitutionalized US adults with an income-to-poverty ratio ≤3.00. Dietary Inflammatory Index (DII) score, calculated using the average of two 24-hour dietary recalls, was the main outcome measure. Type III F tests or χ 2 tests compared population characteristics by food security status, defined using the US Food Security Survey Module. Multivariable linear regression was used to estimate the association between food security status and the DII score and moderation by demographic factors. Survey weighting procedures accounted for the effects of stratification and clustering used in the NHANES study design. When accounting for socioeconomic status, demographic factors, and health status, DII score was higher at greater levels of food insecurity (P=0.0033). Those with very low food security had a 0.31 (95% CI=0.12 to 0.49) higher DII score than those with high food security. Age moderated the association between food security status and DII score (interaction P=0.0103), where the magnitude of the association between DII score and severity of food insecurity was higher for those >65 years than for younger age groups. Food security status may be associated with dietary inflammatory potential, which is hypothesized to play a role in multiple chronic health conditions. Further research is needed to determine the causal nature of this relationship and evaluate how best to implement programs designed to address health disparities within food insecure populations. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Use of ICT in College Libraries in Karnataka, India: A Survey

ERIC Educational Resources Information Center

Kumar, B. T. Sampath; Biradar, B. S.

2010-01-01

Purpose; The purpose of this paper is to examine the use of information communication technology (ICT) in 31 college libraries in Karnataka, India by investigating the ICT infrastructure, current status of library automation, barriers to implementation of library automation and also librarians' attitudes towards the use of ICT.…

Managing Information and Communication Technology in Sudanese Secondary School

ERIC Educational Resources Information Center

Ahmed, Abdelrahman

2015-01-01

This research article is based on a larger study whose purpose was to investigate the current status and implementation of ICT in Khartoum State secondary schools. The study, adopted a descriptive survey design. Two instruments questionnaires and a structured interview schedule were used to collect data. The target population comprised of 320…

The status of states' policies to support evidence-based practices in children's mental health.

PubMed

Cooper, Janice L; Aratani, Yumiko

2009-12-01

This study examined the efforts of states' mental health authorities to promote the use of evidence-based practices through policy. Data were drawn from three components of a national study, including a survey of state children's mental health directors (N=53), which was developed using a three-step process that involved stakeholders. Data from the directors' survey revealed that over 90% of states are implementing strategies to support the use of evidence-based practices. The scope of these efforts varies, with 36% reporting statewide reach. Further, states' strategies for implementing evidence-based practices are often not accompanied by comparable efforts to enhance information systems, even though enhancing such systems can bolster opportunities for successful implementation. Variability in the adoption of evidence-based practices, poor attention to information systems, and inconsistent fiscal policies threaten states' efforts to improve the quality of children's mental health services.

An Exploratory Study of OEE Implementation in Indian Manufacturing Companies

NASA Astrophysics Data System (ADS)

Kumar, J.; Soni, V. K.

2015-04-01

Globally, the implementation of Overall equipment effectiveness (OEE) has proven to be highly effective in improving availability, performance rate and quality rate while reducing unscheduled breakdown and wastage that stems from the equipment. This paper investigates the present status and future scope of OEE metrics in Indian manufacturing companies through an extensive survey. In this survey, opinions of Production and Maintenance Managers have been analyzed statistically to explore the relationship between factors, perspective of OEE and potential use of OEE metrics. Although the sample has been divers in terms of product, process type, size, and geographic location of the companies, they are enforced to implement improvement techniques such as OEE metrics to improve performance. The findings reveal that OEE metrics has huge potential and scope to improve performance. Responses indicate that Indian companies are aware of OEE but they are not utilizing full potential of OEE metrics.

Strategic planning, implementation, and evaluation processes in hospital systems: a survey from Iran.

PubMed

Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

2014-09-28

Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. All the investigated hospitals had a strategic plan. The obtained percentages for the items "the rate of the compliance to requirements" and "the quantity of planning facilitators" (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved.

Strategic Planning, Implementation, and Evaluation Processes in Hospital Systems: A Survey From Iran

PubMed Central

Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

2015-01-01

Aim & Background: Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. Methods: The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. Results: All the investigated hospitals had a strategic plan. The obtained percentages for the items “the rate of the compliance to requirements” and “the quantity of planning facilitators” (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). Conclusion: According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved. PMID:25716385

Individually Linked Household and Health Facility Vaccination Survey in 12 At-risk Districts in Kinshasa Province, Democratic Republic of Congo: Methods and Metadata.

PubMed

Burnett, Eleanor; Wannemuehler, Kathleen; Ngoie Mwamba, Guillaume; Yolande, Masembe; Guylain, Kaya; Muriel, Nzazi Nsambu; Cathy, Nzuzi; Patrice, Tshekoya; Wilkins, Karen; Yoloyolo, Norbert

2017-07-01

Health facility (HF) and household (HH) data can complement each other to provide a better understanding of the factors that contribute to vaccination status. In 12 zones with low vaccination coverage within Kinshasa Province, Democratic Republic of Congo, we conducted 2 surveys: (1) a linked HH and HF survey among 6-11-month-old infants, and (2) a HH survey among 12-23-month-old children. Linked survey objectives were to identify factors associated with vaccination status and to explore methodological considerations for linked survey implementation. To provide linked HH and HF data, we enrolled 6-11-month-old infants in HH clusters in each zone and then surveyed HFs located within the 12 zones and cited by caregivers of the enrolled infants as the most recent HF visited for vaccination or curative care. To provide vaccination coverage estimates for the 12-zone area, we enrolled 12-23-month-old children in every fourth HH. Of the HHs with a child aged 6-23 months, 16% were ineligible because they had resided in the neighborhood for <3 months or were unavailable to be interviewed, 4% refused, and 80% were eligible and participated. Of 1224 enrolled infants 6-11 months of age, records of 879 (72%) were linked to one of the 182 surveyed HFs. For the coverage survey, 710 children aged 12-23 months participated. Home-based vaccination cards were available for 1210 of 1934 children (63%) surveyed. The surveys were successful in assessing HH information for 2 age groups, documenting written vaccination history for a large proportion of 6-23-month-old children, linking the majority of infants with their most recently visited HF, and surveying identified HFs. The implementation of the individually linked survey also highlighted the need for a comprehensive list of HFs and an analysis plan that addresses cross-classified clusters with only 1 child. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Short-term evaluation of the impact of a fortified food aid program on the micronutrient nutritional status of Argentinian pregnant women.

PubMed

Malpeli, Agustina; Ferrari, María Guillermina; Varea, Ana; Falivene, Mariana; Etchegoyen, Graciela; Vojkovic, María; Carmuega, Estéban; Disalvo, Liliana; Apezteguía, María; Pereyras, Silvia; Tournier, Andrea; Vogliolo, Daniel; Gonzalez, Horacio F

2013-11-01

We studied the impact of a food supplementation program (Plan Más Vida (PMV)) on the micronutrient nutritional condition of pregnant women from low-income families 1 year after its implementation. The food program provided supplementary diet (wheat and maize--fortified flour, rice or sugar, and fortified soup). We performed a prospective, nonexperimental, cross-sectional study in the province of Buenos Aires, Argentina, evaluating pregnant women at baseline (n = 164) and 1 year after PMV implementation (n = 108). Biochemical tests (hemogram, ferritin, vitamin A, zinc, and folic acid), anthropometric assessments (weight and height), and dietary surveys (24 h recall) were performed at the two study points. One year after PMV implementation, no significant changes in anthropometric values were observed. Folic acid deficiency and the risk of vitamin A deficiency (retinol, 20-30 μg/dl) decreased significantly (35.8 to 6.1 % and 64 to 41 %, respectively; p < 0.000). Anemia and prevalence of iron and zinc deficiency values did not change. Diet survey results showed that although nutrient intake increased significantly, it was still below recommendations. Implementation of the PMV and of the government nutritional strategies had a high impact on the prevalence of folic acid deficiency. We also observed a decrease in the risk of vitamin A deficiency, and no impact on iron and zinc nutritional status. Adherence to the specific fortified food (soup) was not good and intra-family dilution and distribution of food was high.

The Implementation of Gender-Neutral Housing: A Mixed-Methods Study across ACUHO-I Member Institutions

ERIC Educational Resources Information Center

Taub, Deborah J.; Johnson, R. Bradley; Reynolds, Torry

2016-01-01

Gender-neutral housing has recently become an option at colleges and universities across the U.S. Chief housing officers at Association of College and University Housing Officers-International member institutions were surveyed online about the status of gender-neutral housing at their respective campuses, using an instrument adapted by the…

Enabling Access to Higher Education in Postsocialist Mongolia: Empirical Results for Implementation and Implications of Government Policies

ERIC Educational Resources Information Center

Okhidoi, Otgonjargal

2016-01-01

This quantitative study examines the effectiveness of government financial assistance policies in access to higher education in post-socialist Mongolia as of 2012, using probabilistic, cross-sectional Household Social and Economic Survey data. Using a six-subscale composite socioeconomic status (SES) variable, the study examines the effect of SES…

Teaching Spanish-Speaking Children to Read in New Jersey.

ERIC Educational Resources Information Center

Feeley, Joan T.

In order to learn the status of bilingual (Spanish/English) reading programs in New Jersey just before the implementation of a new bilingual education law in July 1975, a survey was conducted of school districts reporting a student body consisting of more than five percent Spanish-surnamed students. This document contains tables and discussions of…

Variation in Anticonvulsant Selection and Electroencephalographic Monitoring Following Severe Traumatic Brain Injury in Children-Understanding Resource Availability in Sites Participating in a Comparative Effectiveness Study.

PubMed

Kurz, Jonathan E; Poloyac, Samuel M; Abend, Nicholas S; Fabio, Anthony; Bell, Michael J; Wainwright, Mark S

2016-07-01

Early posttraumatic seizures may contribute to worsened outcomes after traumatic brain injury. Evidence to guide the evaluation and management of early posttraumatic seizures in children is limited. We undertook a survey of current practices of continuous electroencephalographic monitoring, seizure prophylaxis, and the management of early posttraumatic seizures to provide essential information for trial design and the development of posttraumatic seizure management pathways. Surveys were sent to site principal investigators at all 43 sites participating in the Approaches and Decisions in Acute Pediatric TBI trial at the time of the survey. Surveys consisted of 12 questions addressing strategies to 1) implement continuous electroencephalographic monitoring, 2) posttraumatic seizure prophylaxis, 3) treat acute posttraumatic seizures, 4) treat status epilepticus and refractory status epilepticus, and 5) monitor antiseizure drug levels. Institutions comprised a mixture of free-standing children's hospitals and university medical centers across the United States and Europe. Site principal investigators of the Approaches and Decisions in Acute Pediatric TBI trial. None. Continuous electroencephalographic monitoring was available in the PICU in the overwhelming majority of clinical sites (98%); however, the plans to operationalize such monitoring for children varied considerably. A similar majority of sites report that administration of prophylactic antiseizure medications is anticipated in children (93%); yet, a minority reports that a specified protocol for treatment of posttraumatic seizures is in place (43%). Reported medication choices varied substantially between sites, but the majority of sites reported pentobarbital for refractory status epilepticus (81%). The presence of treatment protocols for seizure prophylaxis, early posttraumatic seizures, posttraumatic status epilepticus, and refractory status epilepticus was associated with decreased reported medications (all p < 0.05). This study reports the current management practices for early posttraumatic seizures in select academic centers after pediatric severe traumatic brain injury. The substantial variation in continuous electroencephalographic monitoring implementation, choice of seizure prophylaxis medications, and management of early posttraumatic seizures across institutions was reported, signifying the areas of clinical uncertainty that will help provide focused design of clinical trials. Although sites with treatment protocols reported a decreased number of medications for the scenarios described, completion of the Approaches and Decisions in Acute Pediatric TBI trial will be able to determine if these protocols lead to decreased variability in medication administration in children at the clinical sites.

[Stunting in Mexico in the last quarter century: analysis of four national surveys].

PubMed

Rivera-Dommarco, Juan Ángel; Cuevas-Nasu, Lucía; González de Cosío, Teresita; Shamah-Levy, Teresa; García-Feregrino, Raquel

2013-01-01

To describe the magnitude, distribution, and trends of undernutrition and overweight from 1988 to 2006, and provide recommendations for their erradication. Antrhopometric indicators of nutritional status in children <5 y from four surveys were analyzed. Despite its significant reduction in the study period, stunting remains as a public health problem, with the highest prevalences in indigenous population, the rural south and the lowest living conditions quintile. Several policies and programs have demonstrated effectiveness, but implementation challenges persist among the poorest population, particularly in indigenous households. Measures for improving the effectiveness of the nutrition policies and programs, particularly among the indigenous and poorest population, are provided, which include adjusting current programs according to the results of evaluations, and the implementation of policies that address the social determinants of undernutrition.

Using Family-Focused Garden, Nutrition, and Physical Activity Programs To Reduce Childhood Obesity: The Texas! Go! Eat! Grow! Pilot Study.

PubMed

Spears-Lanoix, Erica C; McKyer, E Lisako J; Evans, Alexandra; McIntosh, William Alex; Ory, Marcia; Whittlesey, Lisa; Kirk, Alice; Hoelscher, Deanna M; Warren, Judith L

2015-12-01

The TEXAS! GROW! EAT! GO! (TGEG) randomized, control trial is a 5-year study to measure the impact of a nutrition and gardening intervention and/or physical activity (PA) intervention on the weight status of third-grade students. This article describes the results of the pilot study to test the feasibility of two interventions and test the measures to be used in the main trial. The pilot study was conducted in one school with third-grade students and their parents or guardians. The Junior Master Gardner (JMG) and Walk Across Texas (WAT) interventions were implemented over a 5-month period in three third-grade classrooms during spring 2012. The respective interventions focused on improving healthy eating and PA behaviors of children and their families. Baseline and immediate post-test data were collected from students and parents/guardians to measure four child, four parent, and four parent-child interaction behaviors. Process data regarding implementation were also collected from teachers and school administration. Forty-four students and 34 parents or guardians provided both pre- and post-test data. Paired-sample t-tests showed statistically significant changes in student knowledge, vegetable preferences, vegetable consumption, and home food availability (all p < 0.05). At baseline, participants' weight status categories included 57% obese, 10% overweight, and 31% normal weight. Postintervention, weight status categories included 39% obese, 16% overweight, and normal 45%. Data collected from teachers indicated high levels of implementation fidelity. Implementation of both interventions occurred at a very high fidelity level, which led to positive changes in BMI status, and several dietary and PA behaviors. Although the pilot study indicated feasibility of the two interventions for school implementation, results guided revisions to the TGEG program and its survey instruments.

School- and Individual-level Predictors of Weight Status Misperception among Korean Adolescents: A National Online Survey.

PubMed

Kim, Yongjoo; Kawachi, Ichiro

2016-01-01

Growing body of literature has reported that weight status estimation pattern, including accurate-, under-, and overestimation, was associated with weight related behaviors and weight change among adolescents and young adults. However, there have been a few studies investigating the potential role of school contexts in shaping adolescents' weight status estimation pattern among Korea adolescents. The aim of the present study was to investigate the association between weight status misperception patterns and factors at individual-, family-, and school-level, simultaneously, and whether there was significant between schools variation in the distribution of each weight status misperception pattern, underestimation and overestimation respectively, among Korean adolescents aged 12-18 years. Data from the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), 2012, a nationally representative online survey of 72,228 students (boys = 37,229, girls = 34,999) from a total of 797 middle and high schools were used. Sex stratified multilevel random intercept multinomial logistic models where adolescents (level 1) were nested within schools (level 2) were performed. At the school level, attending a school with higher average BMI (kg/m2) was positively associated with weight status underestimation, and inversely associated with weight status overestimation among boys and girls. Single-sex schooling was positively associated with weight status underestimation among girls. At the family level, higher household income (high/middle versus low) was inversely associated with both weight status under- and overestimation among boys and girls. Higher maternal education (equal to or more than college graduate versus equal to or less than high school graduate) was positively associated with weight status overestimation among boys, and living with both parents (compared to not living with both parents) was inversely associated with weight status underestimation among girls. At the individual level, high academic achievement (compared to low) was positively associated with weight status underestimation among boys and girls. While further research with prospective designs and objectively measured anthropometric information is needed, school environmental factors such as sex composition and school average BMI, as well as, family contexts such as socioeconomic status need to be considered when developing and implementing obesity prevention programs.

School- and Individual-level Predictors of Weight Status Misperception among Korean Adolescents: A National Online Survey

PubMed Central

2016-01-01

Background Growing body of literature has reported that weight status estimation pattern, including accurate-, under-, and overestimation, was associated with weight related behaviors and weight change among adolescents and young adults. However, there have been a few studies investigating the potential role of school contexts in shaping adolescents’ weight status estimation pattern among Korea adolescents. Objective The aim of the present study was to investigate the association between weight status misperception patterns and factors at individual-, family-, and school-level, simultaneously, and whether there was significant between schools variation in the distribution of each weight status misperception pattern, underestimation and overestimation respectively, among Korean adolescents aged 12–18 years. Method Data from the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), 2012, a nationally representative online survey of 72,228 students (boys = 37,229, girls = 34,999) from a total of 797 middle and high schools were used. Sex stratified multilevel random intercept multinomial logistic models where adolescents (level 1) were nested within schools (level 2) were performed. Results At the school level, attending a school with higher average BMI (kg/m2) was positively associated with weight status underestimation, and inversely associated with weight status overestimation among boys and girls. Single-sex schooling was positively associated with weight status underestimation among girls. At the family level, higher household income (high/middle versus low) was inversely associated with both weight status under- and overestimation among boys and girls. Higher maternal education (equal to or more than college graduate versus equal to or less than high school graduate) was positively associated with weight status overestimation among boys, and living with both parents (compared to not living with both parents) was inversely associated with weight status underestimation among girls. At the individual level, high academic achievement (compared to low) was positively associated with weight status underestimation among boys and girls. Conclusions While further research with prospective designs and objectively measured anthropometric information is needed, school environmental factors such as sex composition and school average BMI, as well as, family contexts such as socioeconomic status need to be considered when developing and implementing obesity prevention programs. PMID:27144319

Surgical Practical Skills Learning Curriculum: Implementation and Interns' Confidence Perceptions.

PubMed

Acosta, Danilo; Castillo-Angeles, Manuel; Garces-Descovich, Alejandro; Watkins, Ammara A; Gupta, Alok; Critchlow, Jonathan F; Kent, Tara S

To provide an overview of the practical skills learning curriculum and assess its effects over time on the surgical interns' perceptions of their technical skills, patient management, administrative tasks, and knowledge. An 84-hour practical skills curriculum composed of didactic, simulation, and practical sessions was implemented during the 2015 to 2016 academic year for general surgery interns. Totally, 40% of the sessions were held during orientation, whereas the remainder sessions were held throughout the academic year. Interns' perceptions of their technical skills, administrative tasks, patient management, and knowledge were assessed by the practical skills curriculum residents' perception survey at various time points during their intern year (baseline, midpoint, and final). Interns were also asked to fill out an evaluation survey at the completion of each session to obtain feedback on the curriculum. General Surgery Residency program at a tertiary care academic institution. 20 General Surgery categorical and preliminary interns. Significant differences were found over time in interns' perceptions on their technical skills, patient management, administrative tasks, and knowledge (p < 0.001 for all). The results were also statistically significant when accounting for a prior boot camp course in medical school, intern status (categorical or preliminary), and gender (p < 0.05 for all). Differences in interns' perceptions occurred both from baseline to midpoint, and from midpoint to final time point evaluations (p < 0.001 for all). Prior surgical boot camp in medical school status, intern status (categorical vs. preliminary), and gender did not differ in the interns' baseline perceptions of their technical skills, patient management, administrative tasks, and knowledge (p > 0.05 for all). Implementation of a Practical Skills Curriculum in surgical internships can improve interns' confidence perception on their technical skills, patient management skills, administrative tasks, and knowledge. Copyright © 2018. Published by Elsevier Inc.

The ILLIAC IV memory system: Current status and future possibilities

NASA Technical Reports Server (NTRS)

Stevenson, D. K.

1978-01-01

The future needs of researchers who will use the Illiac were examined and the requirements they will place on the memory system were evaluated. Various alternatives to replacing critical memory components were considered with regard to cost, risk, system impact, software requirements, and implementation schedules. The current system, its performance and status, and the limitations it places on possible enhancements are discussed as well as the planned enhancements to the Illiac processor. After a brief technology survey, different implementations are presented for each system memory component. Three different memory systems are proposed to meet the identified needs of the Illiac user community. These three alternatives differ considerably with respect to storage capacity and accessing capabilities, but they all offer significant improvements over the current system. The proposed systems and their relative merits are analyzed.

Uneven implementation of the National Perinatal Depression Initiative: findings from a survey of Australian women's hospitals.

PubMed

Fisher, Jane; Chatham, Elizabeth; Haseler, Sally; McGaw, Beth; Thompson, Jane

2012-12-01

Australia is a leader in recognising that perinatal mental health problems are prevalent and constitute a significant burden of disease among women. In 2009, the Australian government launched the National Perinatal Depression Initiative (NPDI) to address this. To investigate implementation of Australia's NPDI. Data were collected by a structured online survey assessing: screening for depression and depression risk in women receiving antenatal and postnatal care; staff training about perinatal depression; barriers and enablers to implementing the NPDI recommendations. All Australian members of Women's Healthcare Australasia (WHA) were invited to complete the survey in March 2011. Of 30 Australian WHA members, 14 (46.6%) completed the survey. The sample included a representative distribution of small, medium and large hospitals. All respondents had introduced some NPDI recommendations. Most (80%) reported using the Edinburgh Postnatal Depression Scale (EPDS) to screen for antenatal depression and for risk of developing depression but at varied gestational ages, and with differing cut-off scores for follow-up or referral. Only one assessed depression status postpartum. Responsibility for screening and feedback was predominantly assigned to midwives, most of whom were offered <4 h training. Implementation barriers included insufficient personnel; per-client time requirements; insufficient clarity about screening protocols; difficulties modifying the medical record; few referral options and a lack of training resources. Implementation of the NPDI is uneven among Australian maternity hospitals. Little is known about perinatal mental health screening practices in the private sector and hospitals with <1000 births annually. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

English-Medium Programmes at Austrian Business Faculties: A Status Quo Survey on National Trends and a Case Study on Programme Design and Delivery

ERIC Educational Resources Information Center

Unterberger, Barbara

2012-01-01

Internationalisation processes have accelerated the implementation of English-medium programmes (EMPs) across European higher education institutions. The field of business and management studies has been particularly affected by this trend (Wachter & Maiworm 2008: 46) with numerous new EMPs introduced each year. This paper presents key…

Southern Hospitality: How We Changed the NPO Practice in the Emergency Department.

PubMed

Denton, Traci D

2015-07-01

In the Vanderbilt Medical Center adult emergency department, the practice has been to keep patients on "nothing by mouth" (NPO) status throughout their assessment, diagnostic, and treatment phases. As a result, most patients have NPO status for a period of several hours to days. The consequences are patient discomfort, hunger, thirst, dehydration, interruptions in routine medication schedules, poor glucose control, and compromised acid/base balance. The purpose of this project was to modify the NPO practice in the adult emergency department. A survey of nursing staff perceptions demonstrated both staff and patient dissatisfaction with the NPO practice. Responses to postdischarge satisfaction surveys demonstrated that patients experienced some discomfort because of hunger or thirst. A search of the literature revealed that the American Society of Anesthesiologists (ASA) adopted guidelines in 1999 that patients should fast 6 hours from solids and 2 hours from liquids preoperatively. These guidelines were implemented in the adult emergency department using the Standard Rollout Process. Physician order sets for the emergency department and the ED chest pain unit were modified to reflect the ASA guidelines. After implementation of the ASA guidelines, a follow-up survey of nursing staff showed increased staff and patient satisfaction. After implementation, the patient satisfaction survey demonstrated an increase in patients who reported "no discomfort" because of hunger or thirst. No adverse outcomes or delays were reported in relation to the change in NPO standards. This change in practice resulted in improved satisfaction for patents and staff. The ASA guidelines have been in existence for more than a decade. They are evidence based. The role of the nurse is to advocate for the patient. Nurses need to be proactive in determining the timing of procedures and asking physicians to give diet orders that are in accordance with the ASA guidelines. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Objectives and metrics for wildlife monitoring

USGS Publications Warehouse

Sauer, J.R.; Knutson, M.G.

2008-01-01

Monitoring surveys allow managers to document system status and provide the quantitative basis for management decision-making, and large amounts of effort and funding are devoted to monitoring. Still, monitoring surveys often fall short of providing required information; inadequacies exist in survey designs, analyses procedures, or in the ability to integrate the information into an appropriate evaluation of management actions. We describe current uses of monitoring data, provide our perspective on the value and limitations of current approaches to monitoring, and set the stage for 3 papers that discuss current goals and implementation of monitoring programs. These papers were derived from presentations at a symposium at The Wildlife Society's 13th Annual Conference in Anchorage, Alaska, USA. [2006

Computers in Medical Education: A Cooperative Approach to Planning and Implementation

PubMed Central

Ellis, Lynda B.M.; Fuller, Sherrilynne

1988-01-01

After years of ‘ad hoc’ growth in the use of computers in the curriculum, the University of Minnesota Medical School in cooperation with the Bio-Medical Library and Health Sciences Computing Services developed and began implementation of a plan for integration of medical informatics into all phases of medical education. Objectives were developed which focus on teaching skills related to: 1) accessing, retrieving, evaluating and managing medical information; 2) appropriate utilization of computer-assisted instruction lessons; 3) electronic communication with fellow students and medical faculty; and 4) fostering a lifelong commitment to effective use of computers to solve clinical problems. Surveys assessed the status of computer expertise among faculty and entering students. The results of these surveys, lessons learned from this experience, and implications for the future of computers in medical education are discussed.

Aspects of the Patient-centered Medical Home currently in place: initial findings from preparing the personal physician for practice.

PubMed

Carney, Patricia A; Eiff, M Patrice; Saultz, John W; Douglass, Alan B; Tillotson, Carrie J; Crane, Steven D; Jones, Samuel M; Green, Larry A

2009-10-01

The Patient-centered Medical Home (PCMH) is a central concept in the evolving debate about American health care reform. We studied family medicine residency training programs' continuity clinics to assess baseline status of implementing PCMH components and to compare implementation status between community-based and university training programs. We conducted a survey 24 continuity clinics in 14 residency programs that are part of the Preparing the Personal Physicians for Practice (P(4)) program. We asked questions about aspects of P(4) that had been already implemented at the beginning of the P(4) program. We defined high implementation as aspects that were present in >50% of clinics and low implementation as those present in <50% of clinics. We compared features at university-based and community-based clinics. High areas of implementation were having an electronic health record (EHR), fully secured remote access, electronic patient notes/scheduling/billing, chronic disease management registries, and open-access scheduling. Low areas of implementation included hospital EHR with computerized physician order entry, asynchronous communication with patients, ongoing population-based QA using EHR, use of preventive registries, and practice-based research using EHR. Few differences were noted between university- and community-based residency programs. Many features of the PCMH were already established at baseline in programs participating in P(4).

A national survey of clubs medical personnel, facilities and protocols in Irish Rugby Union.

PubMed

Coughlan, G F; Fullen, B M; McCarthy, C

2014-03-01

Rugby Union is one of the most popular sports in Ireland. Participation in all sports carries risk, and there is an onus on governing bodies and those involved in sport to minimise this risk using injury prevention and management programmes. The aim of this study was to evaluate the current status of medical personnel, facilities and equipment in Rugby Union clubs in Ireland. A nationwide cross sectional survey of affiliated clubs in Ireland was undertaken at the beginning of the 2011-2012. Clubs were surveyed on a range of variables including their medical personnel, facilities, equipment, policies and concussion. 47.7 % of those surveyed responded. The majority reported involvement of appropriate medically qualified personnel, having a dedicated medical area/room, a first aid kit and defibrillator, and a demand for first aid courses. This survey provided key information on the current medical status of clubs in Ireland to the governing body. Many clubs have adequate medical resources in place, however a large number do not have medical professionals working with them or own basic medical equipment. The results of this study have lead to the development and implementation of a rugby specific injury prevention and management programme for medical and non-medical personnel at all levels of the game in Ireland.

[Hungarian Diet and Nutritional Status Survey - The OTAP2014 study. V. Vitamin intake of the Hungarian population].

PubMed

Schreiberné Molnár, Erzsébet; Nagy-Lőrincz, Zsuzsanna; Nagy, Barbara; Bakacs, Márta; Kis, Orsolya; Sarkadi Nagy, Eszter; Martos, Éva

2017-08-01

The Hungarian Diet and Nutritional Status Survey was implemented on a sub-sample of the European Health Interview Survey. In this paper, the authors present the data on the vitamin intake of the Hungarian population. The survey represents the vitamin intake of the Hungarian non-institutionalised adult population of 18 years and older. There are significant differences between men's and women's vitamin intake. The intake of all water-soluble vitamins except for vitamin C is higher in men than in women, and the difference between the genders regarding the intake of vitamin E and D is significant. The intake of vitamin B 1, B 2 , B 6 , B 12 , niacin and vitamin C is in line with the recommendations, however, there is an unfavourable decrease in the intake of vitamin A and β-carotene in the case of men compared to the previous survey. Vitamin D and folic acid intakes are critically low, particularly in the elderly, and mainly in case of vitamin D. The population's intake of panthotenic acid and biotin did not reach the recommendations. In order to reach the dietary reference intakes and to prevent deficiencies, it is necessary to inform the population and to make healthy food choices available. Orv Hetil. 2017; 158(33): 1302-1313.

[Current status on storage, processing and risk communication of medical radioactive waste in Japan].

PubMed

Watanabe, Hiroshi; Yamaguchi, Ichiro; Kida, Tetsuo; Hiraki, Hitoshi; Fujibuchi, Toshioh; Maehara, Yoshiaki; Tsukamoto, Atsuko; Koizumi, Mitsue; Kimura, Yumi; Horitsugi, Genki

2013-03-01

Decay-in-storage for radioactive waste including that of nuclear medicine has not been implemented in Japan. Therefore, all medical radioactive waste is collected and stored at the Japan Radioisotope Association Takizawa laboratory, even if the radioactivity has already decayed out. To clarify the current situation between Takizawa village and Takizawa laboratory, we investigated the radiation management status and risk communication activities at the laboratory via a questionnaire and site visiting survey in June 2010. Takizawa laboratory continues to maintain an interactive relationship with local residents. As a result, Takizawa village permitted the acceptance of new medical radioactive waste containing Sr-89 and Y-90. However, the village did not accept any non-medical radioactive waste such as waste from research laboratories. To implement decay-in-storage in Japan, it is important to obtain agreement with all stakeholders. We must continue to exert sincere efforts to acquire the trust of all stakeholders.

The oral health of people with learning disabilities - a user-friendly questionnaire survey.

PubMed

Owens, J; Jones, K; Marshman, Z

2017-03-01

To conduct a user-friendly questionnaire survey of the oral health and service needs of adults with learning disabilities. Researchers collaborated with local self-advocacy services to develop a questionnaire adapted from one used in a regional postal survey. The questionnaire, which covered dental status, oral health and dental services use, was sent to a random sample of people from the learning disability case register. Of 2,000 questionnaires mailed, 117 were returned undelivered and 625 were completed (response rate 31.3%). The self-reported dental status of people with learning disabilities appeared similar to that of the 2008 postal survey of the general population in Sheffield. The major difference in dental status was 11.5% of people with learning disabilities wore upper dentures and 7.2% wore lower dentures, compared to 21.2% and 12.1% of the general population in Sheffield. Using the case register as a recruitment instrument may have excluded people with learning disabilities not registered. Time and finances only permitted one mailing. Analysis on the basis of deprivation could not be conducted. Contrary to current practice, it is possible to include people with learning disabilities in oral health surveys. A multidisciplinary team was essential for enabling the progression and implementation of inclusive research and for people with learning disabilities and their supporters to engage meaningfully. This level of collaboration appears necessary if we are committed to ensuring that people with learning disabilities and their supporters are made visible to policy and decision-makers. Copyright© 2017 Dennis Barber Ltd

Knowledge and perceived implementation of food safety risk analysis framework in Latin America and the Caribbean region.

PubMed

Cherry, C; Mohr, A Hofelich; Lindsay, T; Diez-Gonzalez, F; Hueston, W; Sampedro, F

2014-12-01

Risk analysis is increasingly promoted as a tool to support science-based decisions regarding food safety. An online survey comprising 45 questions was used to gather information on the implementation of food safety risk analysis within the Latin American and Caribbean regions. Professionals working in food safety in academia, government, and private sectors in Latin American and Caribbean countries were contacted by email and surveyed to assess their individual knowledge of risk analysis and perceptions of its implementation in the region. From a total of 279 participants, 97% reported a familiarity with risk analysis concepts; however, fewer than 25% were able to correctly identify its key principles. The reported implementation of risk analysis among the different professional sectors was relatively low (46%). Participants from industries in countries with a long history of trade with the United States and the European Union, such as Mexico, Brazil, and Chile, reported perceptions of a higher degree of risk analysis implementation (56, 50, and 20%, respectively) than those from the rest of the countries, suggesting that commerce may be a driver for achieving higher food safety standards. Disagreement among respondents on the extent of the use of risk analysis in national food safety regulations was common, illustrating a systematic lack of understanding of the current regulatory status of the country. The results of this survey can be used to target further risk analysis training on selected sectors and countries.

Analysis of the healthcare waste management status in Tehran hospitals.

PubMed

Malekahmadi, Fariba; Yunesian, Masud; Yaghmaeian, Kamyar; Nadafi, Kazem

2014-01-01

Considering the importance of healthcare waste management, following the ratification of the Waste Management law in 2005 and the subsequent approval of its executive bylaw in 2006 and finally the healthcare waste management criteria passing by the parliament in 2008, a review on the status of healthcare waste management is needed to implement the mentioned law properly. In this retrospective study during six months period all public hospitals in Iran's capital city, Tehran, were selected to conduct the survey. Data collected through an expert-standardized questionnaire was analyzed by using SPSS software. The results of the current status of healthcare waste management in Tehran hospitals showed 5.6% of hospitals were ranked excellent, 50.7% good, 26.4% medium, and the 13.9% of hospitals were ranked weak and 3.5% ranked very poor. The findings showed that appropriate technologies should be used to have better disposal stage. As the ratified criteria were not fully observed by all the selected hospitals, training courses and comprehensive program conducting by each hospital could be enjoyed as practical tools to implement the all stages of healthcare waste management properly.

Final Status Survey Report for Corrective Action Unit 117 - Pluto Disassembly Facility, Building 2201, Nevada National Security Site, Nevada

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

Jeremy Gwin and Douglas Frenette

This document contains the process knowledge, radiological data and subsequent statistical methodology and analysis to support approval for the radiological release of Corrective Action Unit (CAU) 117 – Pluto Disassembly Facility, Building 2201 located in Area 26 of the Nevada National Security Site (NNSS). Preparations for release of the building began in 2009 and followed the methodology described in the Multi-Agency Radiation Survey and Site Investigation Manual (MARSSIM). MARSSIM is the DOE approved process for release of Real Property (buildings and landmasses) to a set of established criteria or authorized limits. The pre-approved authorized limits for surface contamination values andmore » corresponding assumptions were established by DOE O 5400.5. The release criteria coincide with the acceptance criteria of the U10C landfill permit. The U10C landfill is the proposed location to dispose of the radiologically non-impacted, or “clean,” building rubble following demolition. However, other disposition options that include the building and/or waste remaining at the NNSS may be considered providing that the same release limits apply. The Final Status Survey was designed following MARSSIM guidance by reviewing historical documentation and radiological survey data. Following this review a formal radiological characterization survey was performed in two phases. The characterization revealed multiple areas of residual radioactivity above the release criteria. These locations were remediated (decontaminated) and then the surface activity was verified to be less than the release criteria. Once remediation efforts had been successfully completed, a Final Status Survey Plan (10-015, “Final Status Survey Plan for Corrective Action Unit 117 – Pluto Disassembly Facility, Building 2201”) was developed and implemented to complete the final step in the MARSSIM process, the Final Status Survey. The Final Status Survey Plan consisted of categorizing each individual room into one of three categories: Class 1, Class 2 or Class 3 (a fourth category is a “Non-Impacted Class” which in the case of Building 2201 only pertained to exterior surfaces of the building.) The majority of the rooms were determined to fall in the less restrictive Class 3 category, however, Rooms 102, 104, 106, and 107 were identified as containing Class 1 and 2 areas. Building 2201 was divided into “survey units” and surveyed following the requirements of the Final Status Survey Plan for each particular class. As each survey unit was completed and documented, the survey results were evaluated. Each sample (static measurement) with units of counts per minute (cpm) was corrected for the appropriate background and converted to a value with units of dpm/100 cm2. With a surface contamination value in the appropriate units, it was compared to the surface contamination limits, or in this case the derived concentration guideline level (DCGLw). The appropriate statistical test (sign test) was then performed. If the survey unit was statistically determined to be below the DCGLw, then the survey unit passed and the null hypothesis (that the survey unit is above limits) was rejected. If the survey unit was equal to or below the critical value in the sign test, the null hypothesis was not rejected. This process was performed for all survey units within Building 2201. A total of thirty-three “Class 1,” four “Class 2,” and one “Class 3” survey units were developed, surveyed, and evaluated. All survey units successfully passed the statistical test. Building 2201 meets the release criteria commensurate with the Waste Acceptance Criteria (for radiological purposes) of the U10C landfill permit residing within NNSS boundaries. Based on the thorough statistical sampling and scanning of the building’s interior, Building 2201 may be considered radiologically “clean,” or free of contamination.« less

Measuring coverage in MNCH: design, implementation, and interpretation challenges associated with tracking vaccination coverage using household surveys.

PubMed

Cutts, Felicity T; Izurieta, Hector S; Rhoda, Dale A

2013-01-01

Vaccination coverage is an important public health indicator that is measured using administrative reports and/or surveys. The measurement of vaccination coverage in low- and middle-income countries using surveys is susceptible to numerous challenges. These challenges include selection bias and information bias, which cannot be solved by increasing the sample size, and the precision of the coverage estimate, which is determined by the survey sample size and sampling method. Selection bias can result from an inaccurate sampling frame or inappropriate field procedures and, since populations likely to be missed in a vaccination coverage survey are also likely to be missed by vaccination teams, most often inflates coverage estimates. Importantly, the large multi-purpose household surveys that are often used to measure vaccination coverage have invested substantial effort to reduce selection bias. Information bias occurs when a child's vaccination status is misclassified due to mistakes on his or her vaccination record, in data transcription, in the way survey questions are presented, or in the guardian's recall of vaccination for children without a written record. There has been substantial reliance on the guardian's recall in recent surveys, and, worryingly, information bias may become more likely in the future as immunization schedules become more complex and variable. Finally, some surveys assess immunity directly using serological assays. Sero-surveys are important for assessing public health risk, but currently are unable to validate coverage estimates directly. To improve vaccination coverage estimates based on surveys, we recommend that recording tools and practices should be improved and that surveys should incorporate best practices for design, implementation, and analysis.

[Hungarian Diet and Nutritional Status Survey - the OTAP2009 study. IV. Macroelement intake of the Hungarian population].

PubMed

Martos, Eva; Bakacs, Márta; Sarkadi-Nagy, Eszter; Ráczkevy, Tímea; Zentai, Andrea; Baldauf, Zsolt; Illés, Eva; Lugasi, Andrea

2012-07-22

The adequate intake of minerals is basically important for healthy nutrition. The Hungarian Diet and Nutritional Status Survey - joining to the European Health Interview Survey - studied the dietary habits of the Hungarian population. The present publication describes the macroelement intake. The salt intake is unusually high (17.2 g in men and 12.0 g in women), the potassium intake remains well below the recommendation. These factors substantially increase the risk of cardiovascular diseases including high blood-pressure. The calcium intake stays below the recommendation except in the youngest males, the oldest men and women are at risk from this point of view. While magnesium intake suited the recommendation, the intake of phosphorus exceeded it twice. Focusing on marcroelements, high sodium/salt intake represents the highest public health risk. The implementation of STOP SALT! National Salt Reducing Programme, i.e. decrease the salt content of processed food and provide proper information to the population about excessive salt consumption, should result in a beneficial change of salt intake and ameliorate the public health conditions.

Integrated Schistosomiasis and Soil-Transmitted Helminthiasis Control over Five Years on Kome Island, Tanzania

PubMed Central

Kaatano, Godfrey M.; Siza, Julius E.; Mwanga, Joseph R.; Min, Duk-Yong; Yong, Tai-Soon; Chai, Jong-Yil; Ko, Yunsuk; Chang, Su Young; Kullaya, Cyril M.; Rim, Han-Jong; Changalucha, John M.; Eom, Keeseon S.

2015-01-01

Integrated control strategies are important for sustainable control of schistosomiasis and soil-transmitted helminthiasis, despite their challenges for their effective implementation. With the support of Good Neighbors International in collaboration with National Institute of Medical Research, Mwanza, Tanzania, integrated control applying mass drug administration (MDA), health education using PHAST, and improved safe water supply has been implemented on Kome Island over 5 years for controlling schistosomiasis and soil-transmitted helminths (STHs). Baseline surveys for schistosomiasis and STHs was conducted before implementation of any integrated control strategies, followed by 4 cross-sectional follow-up surveys on randomly selected samples of schoolchildren and adults in 10 primary schools and 8 villages, respectively, on Kome islands. Those follow-up surveys were conducted for impact evaluation after introduction of control strategies interventions in the study area. Five rounds of MDA have been implemented from 2009 along with PHAST and improved water supply with pumped wells as other control strategies for complementing MDA. A remarkable steady decline of schistosomiasis and STHs was observed from 2009 to 2012 with significant trends in their prevalence decline, and thereafter infection rate has remained at a low sustainable control. By the third follow-up survey in 2012, Schistosoma mansoni infection prevalence was reduced by 90.5% and hookworm by 93.3% among schoolchildren while in adults the corresponding reduction was 83.2% and 56.9%, respectively. Integrated control strategies have successfully reduced S. mansoni and STH infection status to a lower level. This study further suggests that monitoring and evaluation is a crucial component of any large-scale STH and schistosomiasis intervention. PMID:26537032

Integrated Schistosomiasis and Soil-Transmitted Helminthiasis Control over Five Years on Kome Island, Tanzania.

PubMed

Kaatano, Godfrey M; Siza, Julius E; Mwanga, Joseph R; Min, Duk-Yong; Yong, Tai-Soon; Chai, Jong-Yil; Ko, Yunsuk; Chang, Su Young; Kullaya, Cyril M; Rim, Han-Jong; Changalucha, John M; Eom, Keeseon S

2015-10-01

Integrated control strategies are important for sustainable control of schistosomiasis and soil-transmitted helminthiasis, despite their challenges for their effective implementation. With the support of Good Neighbors International in collaboration with National Institute of Medical Research, Mwanza, Tanzania, integrated control applying mass drug administration (MDA), health education using PHAST, and improved safe water supply has been implemented on Kome Island over 5 years for controlling schistosomiasis and soil-transmitted helminths (STHs). Baseline surveys for schistosomiasis and STHs was conducted before implementation of any integrated control strategies, followed by 4 cross-sectional follow-up surveys on randomly selected samples of schoolchildren and adults in 10 primary schools and 8 villages, respectively, on Kome islands. Those follow-up surveys were conducted for impact evaluation after introduction of control strategies interventions in the study area. Five rounds of MDA have been implemented from 2009 along with PHAST and improved water supply with pumped wells as other control strategies for complementing MDA. A remarkable steady decline of schistosomiasis and STHs was observed from 2009 to 2012 with significant trends in their prevalence decline, and thereafter infection rate has remained at a low sustainable control. By the third follow-up survey in 2012, Schistosoma mansoni infection prevalence was reduced by 90.5% and hookworm by 93.3% among schoolchildren while in adults the corresponding reduction was 83.2% and 56.9%, respectively. Integrated control strategies have successfully reduced S. mansoni and STH infection status to a lower level. This study further suggests that monitoring and evaluation is a crucial component of any large-scale STH and schistosomiasis intervention.

Social Acceptance of Smoking Restrictions During 10 Years of Policy Implementation, Reversal, and Reenactment in the Netherlands: Findings From a National Population Survey.

PubMed

Hummel, Karin; Willemsen, Marc C; de Vries, Hein; Monshouwer, Karin; Nagelhout, Gera E

2017-02-01

Little is known about the extent to which smoking restrictions are socially accepted in a country such as the Netherlands where smoking restrictions have been implemented and reversed several times. The current study assessed trends as well as factors associated with two indicators of social acceptance of smoking restrictions in the Netherlands: acceptance of smoking in public places and implementation of home smoking bans. We used data from the Dutch Continuous Survey of Smoking Habits (DCSSH) between 2005 and 2014 (n = 182826). The DCSSH is a national population survey with a cross-sectional design in which respondents aged 15 years and older are surveyed weekly. Acceptance of smoking in public places decreased for six out of eight included venues, with the largest decrease for smoking in restaurants. The decrease in acceptance was larger among younger respondents and smokers. Smoking on terraces was an exception: decrease in acceptance there was larger among older respondents and ex-smokers. Implementation of home smoking bans increased over time. Having implemented a home smoking ban was associated with being male, being younger, having a high socioeconomic status, and being ex- or never smoker. Social acceptance of smoking restrictions has increased in the Netherlands, despite a suboptimal implementation process of smoking restrictions. However, there is still potential for improvement as acceptance of smoking is still quite high for some public venues like bars. It is important to strengthen smoking restrictions in order to further denormalize smoking in the Netherlands. We examined the extent to which smoking restrictions are socially accepted in the Netherlands where smoking restrictions have been implemented and reversed several times. Acceptance of smoking in public places decreased and implementation of home smoking bans increased between 2005 and 2014. Social acceptance of smoking restrictions increased in the Netherlands despite a suboptimal implementation process of smoking restrictions. However, acceptance of smoking in bars remains relatively high. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A solid waste management survey in Davao del Sur (school and household waste management survey)

NASA Astrophysics Data System (ADS)

Trondillo, Mark Jude F.; Amaba, Jeneley A.; Paniza, Lyndelle Ann D.; Cubol, John Rhico V.

2018-02-01

Environmental degradation has become a very alarming issue at present. Human activities have been the primary cause of this unfortunate event which has resulted to other complications such as health problems. The resources are limited and people solely depend on it for living. Thus, the necessity to address these concerns arises. Various solid waste management programs have been established however the people's commitment has continued to challenge the local authorities as well as the cooperating agencies. This study was conducted in order to assess the awareness, practice and attitude towards the existing solid waste management programs of the selected students in Davao del Sur. It also aims to measure the effectiveness and current status of these implemented programs. The study used survey method. One hundred sixty eight of 227 students were surveyed using a validated, self-administered instrument. The study revealed that majority of the students is well aware of the existing solid waste management programs, practice them and is willing to learn more about the issue. Others, on the other hand, do the opposite. It is of great importance that all citizens must commit in the implementation of environmental programs so as to be more effective.

Patient safety in external beam radiotherapy, results of the ACCIRAD project: Current status of proactive risk assessment, reactive analysis of events, and reporting and learning systems in Europe.

PubMed

Malicki, Julian; Bly, Ritva; Bulot, Mireille; Godet, Jean-Luc; Jahnen, Andreas; Krengli, Marco; Maingon, Philippe; Prieto Martin, Carlos; Przybylska, Kamila; Skrobała, Agnieszka; Valero, Marc; Jarvinen, Hannu

2017-04-01

To describe the current status of implementation of European directives for risk management in radiotherapy and to assess variability in risk management in the following areas: 1) in-country regulatory framework; 2) proactive risk assessment; (3) reactive analysis of events; and (4) reporting and learning systems. The original data were collected as part of the ACCIRAD project through two online surveys. Risk assessment criteria are closely associated with quality assurance programs. Only 9/32 responding countries (28%) with national regulations reported clear "requirements" for proactive risk assessment and/or reactive risk analysis, with wide variability in assessment methods. Reporting of adverse error events is mandatory in most (70%) but not all surveyed countries. Most European countries have taken steps to implement European directives designed to reduce the probability and magnitude of accidents in radiotherapy. Variability between countries is substantial in terms of legal frameworks, tools used to conduct proactive risk assessment and reactive analysis of events, and in the reporting and learning systems utilized. These findings underscore the need for greater harmonisation in common terminology, classification and reporting practices across Europe to improve patient safety and to enable more reliable inter-country comparisons. Copyright © 2017 Elsevier B.V. All rights reserved.

Lessons from a Community-Based Program to Monitor Forest Vertebrates in the Brazilian Amazon

NASA Astrophysics Data System (ADS)

Benchimol, Maíra; von Mühlen, Eduardo M.; Venticinque, Eduardo M.

2017-09-01

A large number of sustainable use reserves recently have been titled in the Brazilian Amazonia. These reserves require public participation in the design and implementation of management and monitoring programs. Species-monitoring programs that engage local stakeholders may be useful for assessing wildlife status over the long term. We collaborated on the development of a participatory program to monitor forest vertebrates in the Piagaçu-Purus Sustainable Development Reserve and to build capacity among the local people. We examined relations between the distance to the nearest human community and sighting rates of each species, and evaluated the program overall. Eighteen wildlife monitors received training in line transect and sign surveys and then conducted surveys along a total of ten transects. Sighting rates of most species in the Piagaçu-Purus Sustainable Development Reserve were higher than those reported in other Amazonian forests. Distance to the human community was not associated with the overall vertebrate sighting rate. Use of the trained monitors was successful in terms of data acquisition and engagement. The involvement of local people promoted discussions about regulation of hunting in the reserve. Implementation of community-based programs to monitor forest wildlife in Amazonian sustainable use reserves may empower local communities and assess the status of wildlife through time.

Measuring Coverage in MNCH: Design, Implementation, and Interpretation Challenges Associated with Tracking Vaccination Coverage Using Household Surveys

PubMed Central

Cutts, Felicity T.; Izurieta, Hector S.; Rhoda, Dale A.

2013-01-01

Vaccination coverage is an important public health indicator that is measured using administrative reports and/or surveys. The measurement of vaccination coverage in low- and middle-income countries using surveys is susceptible to numerous challenges. These challenges include selection bias and information bias, which cannot be solved by increasing the sample size, and the precision of the coverage estimate, which is determined by the survey sample size and sampling method. Selection bias can result from an inaccurate sampling frame or inappropriate field procedures and, since populations likely to be missed in a vaccination coverage survey are also likely to be missed by vaccination teams, most often inflates coverage estimates. Importantly, the large multi-purpose household surveys that are often used to measure vaccination coverage have invested substantial effort to reduce selection bias. Information bias occurs when a child's vaccination status is misclassified due to mistakes on his or her vaccination record, in data transcription, in the way survey questions are presented, or in the guardian's recall of vaccination for children without a written record. There has been substantial reliance on the guardian's recall in recent surveys, and, worryingly, information bias may become more likely in the future as immunization schedules become more complex and variable. Finally, some surveys assess immunity directly using serological assays. Sero-surveys are important for assessing public health risk, but currently are unable to validate coverage estimates directly. To improve vaccination coverage estimates based on surveys, we recommend that recording tools and practices should be improved and that surveys should incorporate best practices for design, implementation, and analysis. PMID:23667334

Current Status of Multidisciplinary Care in Psoriatic Arthritis in Spain: NEXUS 2.0 Project.

PubMed

Queiro, Rubén; Coto, Pablo; Joven, Beatriz; Rivera, Raquel; Navío Marco, Teresa; de la Cueva, Pablo; Alvarez Vega, Jose Luis; Narváez Moreno, Basilio; Rodriguez Martínez, Fernando José; Pardo Sánchez, José; Feced Olmos, Carlos; Pujol, Conrad; Rodríguez, Jesús; Notario, Jaume; Pujol Busquets, Manel; García Font, Mercè; Galindez, Eva; Pérez Barrio, Silvia; Urruticoechea-Arana, Ana; Hergueta, Merce; López Montilla, M Dolores; Vélez García-Nieto, Antonio; Maceiras, Francisco; Rodríguez Pazos, Laura; Rubio Romero, Esteban; Rodríguez Fernandez Freire, Lourdes; Luelmo, Jesús; Gratacós, Jordi

2018-02-26

1) To analyze the implementation of multidisciplinary care models in psoriatic arthritis (PsA) patients, 2) To define minimum and excellent standards of care. A survey was sent to clinicians who already performed multidisciplinary care or were in the process of undertaking it, asking: 1) Type of multidisciplinary care model implemented; 2) Degree, priority and feasibility of the implementation of quality standards in the structure, process and result for care. In 6 regional meetings the results of the survey were presented and discussed, and the ultimate priority of quality standards for care was defined. At a nominal meeting group, 11 experts (rheumatologists and dermatologists) analyzed the results of the survey and the regional meetings. With this information, they defined which standards of care are currently considered as minimum and which are excellent. The simultaneous and parallel models of multidisciplinary care are those most widely implemented, but the implementation of quality standards is highly variable. In terms of structure it ranges from 22% to 74%, in those related to process from 17% to 54% and in the results from 2% to 28%. Of the 25 original quality standards for care, 9 were considered only minimum, 4 were excellent and 12 defined criteria for minimum level and others for excellence. The definition of minimum and excellent quality standards for care will help achieve the goal of multidisciplinary care for patients with PAs, which is the best healthcare possible. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

National survey on school-based fluoride mouth-rinsing programme in Japan: regional spread conditions from preschool to junior high school in 2010.

PubMed

Komiyama, Karin; Kimoto, Kazunari; Taura, Katsuhiko; Sakai, Osamu

2014-06-01

We surveyed the state of implementation of the school-based fluoride mouth-rinsing programme (S-FMR) in schools in Japan from March 2010. Questionnaires on the implementation status of S-FMR in each type of school (including preschool and kindergarten) were sent by post to the oral health administration departments of all 47 prefectures and 89 cities (18 ordinance-designated cities, 23 special wards, 41 core cities and seven public health centres in ordinance-designated cities) with public health centres. The S-FMR implementation rate was low, at only 11% of all schools in Japan and only 6% of all participating school children aged 4-14 years. In many regions, the S-FMR was implemented more widely and received higher participation from children in either elementary schools and junior high schools or preschools and kindergartens. Inter-prefectural disparities were seen in S-FMR implementation, as some prefectures and cities did not include topical fluoride application in their health promotion plans, and some local public bodies did not include targets for fluoride mouth-rinsing. To reduce this disparity in Japan where systemic fluoride application is not performed, each local public body must consider implementing the S-FMR as a public health measure. We propose using the results of this survey as basic data for formulating S-FMR goals (numerical targets) and adopting S-FMR as a concrete measure in the second Healthy Japan 21, to be launched in the fiscal year for 2013, and within the basic matters of the Act Concerning the Promotion of Dental and Oral Health. © 2013 FDI World Dental Federation.

National survey on school-based fluoride mouth-rinsing programme in Japan: regional spread conditions from preschool to junior high school in 2010

PubMed Central

Komiyama, Karin; Kimoto, Kazunari; Taura, Katsuhiko; Sakai, Osamu

2014-01-01

Aims We surveyed the state of implementation of the school-based fluoride mouth-rinsing programme (S-FMR) in schools in Japan from March 2010. Methods Questionnaires on the implementation status of S-FMR in each type of school (including preschool and kindergarten) were sent by post to the oral health administration departments of all 47 prefectures and 89 cities (18 ordinance-designated cities, 23 special wards, 41 core cities and seven public health centres in ordinance-designated cities) with public health centres. Results The S-FMR implementation rate was low, at only 11% of all schools in Japan and only 6% of all participating school children aged 4–14 years. In many regions, the S-FMR was implemented more widely and received higher participation from children in either elementary schools and junior high schools or preschools and kindergartens. Conclusions Inter-prefectural disparities were seen in S-FMR implementation, as some prefectures and cities did not include topical fluoride application in their health promotion plans, and some local public bodies did not include targets for fluoride mouth-rinsing. To reduce this disparity in Japan where systemic fluoride application is not performed, each local public body must consider implementing the S-FMR as a public health measure. We propose using the results of this survey as basic data for formulating S-FMR goals (numerical targets) and adopting S-FMR as a concrete measure in the second Healthy Japan 21, to be launched in the fiscal year for 2013, and within the basic matters of the Act Concerning the Promotion of Dental and Oral Health. PMID:24256345

Web-Based and Telephone Surveys to Assess Public Perception Toward the National Health Insurance in Taiwan: A Comparison of Cost and Results

PubMed Central

Tan, Elise Chia-Hui

2015-01-01

Background Numerous studies have examined the impact of global budget payment systems of health insurance on patient access to medical care. In order to monitor the population’s accessibility to health services, a series of survey are often used to understand public perceptions of the health care provider. Taiwan implemented the single-payer National Health Insurance in 1995 and has been conducting a series of surveys to monitor public perception of the NHI after adopting a global budget payment system in 2002. Although telephone surveys are commonly used in obtaining public opinions on various public health issues, limitations such as higher cost and influence of interviewers do raise some concerns. Web-based surveys, one of the alternative methods, may be free from these problems. Objective Our aim was to examine the difference of sociodemographic characteristics, satisfaction of NHI and NHI-contracted health care providers, attitude toward NHI-related issues, behavior in seeking medical advice and self-reported health status between those who completed Web-based surveys and those reached by telephone. Methods This study compared the demographic factors of participants who took either a Web-based survey (1313 participants) or random digit dialing telephone survey (2411 participants) that contained identical questions. Results Compared to telephone survey respondents, Web-based respondents tended to be younger (P<.001), unmarried (P<.001), non-smokers (P<.001), with a higher education (P<.001), and a higher monthly household income (P<.001) and worse self-reported health status (P=.008); however, they were less likely to report suffering from a chronic disease (P<.001). Despite these differences in background characteristics, no significant differences were observed in their answers related to the seeking of medical care or NHI-related issues. Telephone survey respondents reported greater satisfaction with NHI services. Web-based surveys were also shown to provide a lower average cost per sample (US$0.71) compared to telephone surveys (US$3.98). Conclusions Web-based surveys provide a low-cost alternative method for the polling of public attitudes toward NHI-related issues. Despite general similarities between the two polling methods with regard to responses, respondents to telephone surveys reported a stronger agreement with regard to satisfaction with NHI services and a more positive self-reported health status. PMID:25886989

[Health literacy in Czech population results of the comparative representative research].

PubMed

Kučera, Zdeněk; Pelikan, Jurgen; Šteflová, Alena

Health literacy survey was carried out at the end of 2014 in the context of preparation of implementation strategy of the Program Health 2020 in the Czech Republic. The survey was conducted by the National Institute of Public Health with financial support from the Ministry of Health and the Czech WHO office. Sociological survey replicated comparative research conducted in eight EU countries in the first half of this decade. Representative survey in 1037 respondents in the age over 16 years, selected in all regions of the country. The identical methodology as used in the original study was utilized. Health literacy was measured in the areas of health care, disease prevention and health promotion.We found that 59,4 % of respondents showed limited general health literacy; health literacy in health care is proved to be 49.5 % of the population, in the area of disease prevention it was 54.1 % respondents and in health promotion it was even even 64.3 % of respondents. Compared to the other countries surveyed, Czech Republic occupies the eighth, penultimate place. Health literacy is correlated negatively with age and positively with education. We found a strong social gradient of health literacy which rises with social status. Health literacy quite significantly influences the health status and health behaviors.Key words: health literacy, health behaviour, health promotion, social determinants of health.

Development of a Medication Safety and Quality Survey for Small Rural Hospitals.

PubMed

Winterstein, Almut G; Johns, Thomas E; Campbell, Kyle N; Libby, Joel; Pannell, Bob

2017-12-01

We summarize the development and initial implementation of a survey tool to assess medication safety in small rural hospitals. As part of an ongoing rural hospital medication safety improvement program, we developed a survey tool in all 13 critical access hospitals (CAHs) in Florida. The survey was compiled from existing medication safety assessments and standards, clinical practice guidelines, and published literature. Survey items were selected based on considerations regarding practicality and relevance to the CAH setting.The final survey instrument included 134 items representing 17 medication safety domains. Overall hospital scores ranged from 41% to 95%, with a median of 59%. Most hospitals showed large variation in scores across domains, with 5 hospitals having at least 1 domain with scores less than 10%. Highest scores across all facilities were seen for safety procedures concerning high-alert or look-alike medications and the assembly of emergency carts. The lowest median scores included availability and consistent use of standardized order sets and the effective implementation of medication safety committees. Most hospitals used the survey results to identify and prioritize quality improvement activities. The survey can be used to conduct a short medication safety assessment specific to a limited number of areas and services in CAHs. It showed good ability to discriminate medication safety levels across participating sites and highlighted opportunities for improvement. It may need modification if case mix or services differ in other states or if the status quo of medication safety in CAHs or related standards advance. The described process of survey development might be helpful to support such modifications.

Using formative evaluation in an implementation project to increase vaccination rates in high-risk veterans: QUERI Series

PubMed Central

Wallace, Carolyn M; Legro, Marcia W

2008-01-01

Background Implementation of research into practice in health care systems is a challenging and often unsuccessful endeavor. The United States Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) research teams include formative evaluations (FE) in their action-oriented VA implementation projects to identify critical information about the processes of implementation that can guide adjustments to project activities, in order to better meet project goals. This article describes the development and use of FE in an action-oriented implementation research project. Methods This two-year action-oriented implementation research project was conducted at 23 VA Spinal Cord Injury (SCI) Centers, and targeted patients, staff and the system of care, such as administration and information technology. Data for FE were collected by electronic and paper surveys, semi-structured and open-ended interviews, notes during conference calls, and exchange of e-mail messages. Specific questions were developed for each intervention (designed to improve vaccination rates for influenza in veterans with spinal cord injury and disorder); informants were selected for their knowledge of interventions and their use in SCI Centers. Results Data from FE were compiled separately for each intervention to describe barriers to progress and guide adjustments to implementation activities. These data addressed the processes of implementing the interventions, problem-solving activities and the status of interventions at SCI Centers. Conclusion Formative evaluations provided the project team with a broad view of the processes of implementing multi-targeted interventions as well as the evolving status of the related best practice. Using FE was useful, although the challenges of conducting FE for non-field researchers should be addressed. Work is needed to develop methods for conducting FE across multiple sites, as well as acknowledging variations in local contexts that affect implementation of interventions. PMID:18430201

Implementation of Hospital Computerized Physician Order Entry Systems in a Rural State: Feasibility and Financial Impact

PubMed Central

Ohsfeldt, Robert L.; Ward, Marcia M.; Schneider, John E.; Jaana, Mirou; Miller, Thomas R.; Lei, Yang; Wakefield, Douglas S.

2005-01-01

Objective The aim of this study was to estimate the costs of implementing computerized physician order entry (CPOE) systems in hospitals in a rural state and to evaluate the financial implications of statewide CPOE implementation. Methods A simulation model was constructed using estimates of initial and ongoing CPOE costs mapped onto all general hospitals in Iowa by bed quantity and current clinical information system (CIS) status. CPOE cost estimates were obtained from a leading CPOE vendor. Current CIS status was determined through mail survey of Iowa hospitals. Patient care revenue and operating cost data published by the Iowa Hospital Association were used to simulate the financial impact of CPOE adoption on hospitals. Results CPOE implementation would dramatically increase operating costs for rural and critical access hospitals in the absence of substantial costs savings associated with improved efficiency or improved patient safety. For urban and rural referral hospitals, the cost impact is less dramatic but still substantial. However, relatively modest benefits in the form of patient care cost savings or revenue enhancement would be sufficient to offset CPOE costs for these larger hospitals. Conclusion Implementation of CPOE in rural or critical access hospitals may depend on net increase in operating costs. Adoption of CPOE may be financially infeasible for these small hospitals in the absence of increases in hospital payments or ongoing subsidies from third parties. PMID:15492033

The antimicrobial stewardship program in Gulf Cooperation Council (GCC) states: insights from a regional survey.

PubMed

Enani, Mushira A

2016-01-01

The purpose of the current study is to describe the prevalence and characteristics of antimicrobial stewardship programs (ASP) in Gulf Cooperation Council (GCC) states to explore opportunities and overcome barriers to effective ASP implementation. A cross-sectional questionnaire survey was used to evaluate the current status of ASP: major stewardship components, barriers of implementation and program impact in acute care hospitals of GCC states. Forty-seven healthcare professionals responded from four GCC states, the majority from Saudi Arabia (81%). Twenty-nine (62%) participating hospitals had ASP in place. Of these established programs, 35 (75%) reported lack of funding and personnel as major barriers to program implementation. The top three objectives cited for the hospital ASP were to reduce resistance (72.3%), improve clinical outcomes (70.2%) and reduce costs (44.7%). The reported impact of existing ASP was reduction of inappropriate prescribing (68%), reduction of broad spectrum antibiotic use (63.8%), reduction of healthcare-associated infections (61.7%), reduction of length of stay or mortality metrics (59.6%), reduction in direct antibiotic cost (57.4%) and reduction of reported antibiotic resistance (55.3%). Survey participants from GCC states who have implemented ASP report significant impacts in the reduction of broad spectrum antibiotic use, hospital-acquired infection, inappropriate prescribing and antimicrobial resistance. These findings suggest a promising opportunity to enhance existing ASP through sharing of best practices and support the development of regional guidelines across GCC states.

The antimicrobial stewardship program in Gulf Cooperation Council (GCC) states: insights from a regional survey

PubMed Central

2015-01-01

Objectives: The purpose of the current study is to describe the prevalence and characteristics of antimicrobial stewardship programs (ASP) in Gulf Cooperation Council (GCC) states to explore opportunities and overcome barriers to effective ASP implementation. Methods: A cross-sectional questionnaire survey was used to evaluate the current status of ASP: major stewardship components, barriers of implementation and program impact in acute care hospitals of GCC states. Results: Forty-seven healthcare professionals responded from four GCC states, the majority from Saudi Arabia (81%). Twenty-nine (62%) participating hospitals had ASP in place. Of these established programs, 35 (75%) reported lack of funding and personnel as major barriers to program implementation. The top three objectives cited for the hospital ASP were to reduce resistance (72.3%), improve clinical outcomes (70.2%) and reduce costs (44.7%). The reported impact of existing ASP was reduction of inappropriate prescribing (68%), reduction of broad spectrum antibiotic use (63.8%), reduction of healthcare-associated infections (61.7%), reduction of length of stay or mortality metrics (59.6%), reduction in direct antibiotic cost (57.4%) and reduction of reported antibiotic resistance (55.3%). Conclusion: Survey participants from GCC states who have implemented ASP report significant impacts in the reduction of broad spectrum antibiotic use, hospital-acquired infection, inappropriate prescribing and antimicrobial resistance. These findings suggest a promising opportunity to enhance existing ASP through sharing of best practices and support the development of regional guidelines across GCC states. PMID:28989448

Current status of portal vein thrombosis in Japan: Results of a questionnaire survey by the Japan Society for Portal Hypertension.

PubMed

Kojima, Seiichiro; Watanabe, Norihito; Koizumi, Jun; Kokubu, Shigehiro; Murashima, Naoya; Matsutani, Shoichi; Obara, Katsutoshi

2018-03-01

To investigate the current status of portal vein thrombosis (PVT) in Japan, the Clinical Research Committee of the Japan Society of Portal Hypertension undertook a questionnaire survey. A questionnaire survey of 539 cases of PVT over the previous 10 years was carried out at institutions affiliated with the Board of Trustees of the Japan Society of Portal Hypertension. The most frequent underlying etiology of PVT was liver cirrhosis in 75.3% of patients. Other causes included inflammatory diseases of the hepatobiliary system and the pancreas, malignant tumors, and hematologic diseases. The most frequent site was the main trunk of the portal vein (MPV) in 70.5%, and complete obstruction of the MPV was present in 11.5%. Among the medications for PVT, danaparoid was given to 45.8%, warfarin to 26.2%, heparin to 17.3%, and anti-thrombin III to 16.9%. Observation of the course was practiced in 22.4%. Factors contributing to therapeutic efficacy were implementation of various medications, thrombi localized to either the right or left portal vein only, non-complete obstruction of the MPV and Child-Pugh class A liver function. A survival analysis showed that the prognosis was favorable with PVT disappearance regardless of treatment. The questionnaire survey showed the current status of PVT in Japan. Any appropriate medication should be given to a patient with PVT when PVT is recognized. It is necessary to compile a large amount of information and reach a consensus on safe and highly effective management of PVT. © 2017 The Japan Society of Hepatology.

[Study on the overall implementation status of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

PubMed

Li, J J; Li, J L; Zhang, J; Jin, R R; Ma, S; Deng, G J; Su, X W; Bian, F; Qu, Y M; Hu, L L; Jiang, Y

2018-04-10

Objective: To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: According to the scheme design of the questionnaires, all the National Demonstration Areas were involved in this study. For each National Demonstration Areas, eight departments were selected to complete a total of 12 questionnaires. Results: Scores related to the implementation of the National Demonstration Areas accounted for 71.8% of the total 170 points. Based on the scores gathered from this study, the 23-items-index-system that represented the status of project implementation was classified into seven categories. Categories with higher percentile scores would include: monitoring (88.0%), safeguard measures (75.0%), health education and health promotion (75.0%). Categories with lower percentile scores would include: the national health lifestyle actions (67.7%), community diagnosis (66.7%), discovery and intervention of high-risk groups (64.7%), and patient management (60.9%). There were significant differences noticed among the eastern, central and western areas on items as safeguard measures, health education/promotion, discovery and intervention of high-risk groups. In all, the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions. As for the 23 items, five of the highest scores appeared on policy support, mortality surveillance, tumor registration, reporting system on cardiovascular/cerebrovascular events, and on tobacco control, respectively. However, the lowest five scores fell on healthy diet, patient self-management program, oral hygiene, setting up the demonstration units and promotion on basic public health services, respectively. The overall scores in the eastern region was higher than that in the central or the western regions. The scores in the central and western regions showed basically the same. Conclusions: The overall status of implementation on the National Demonstration Areas was satisfactory. Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups, which also presented the lowest scores, in this survey.

Human Papillomavirus Vaccination Uptake before and after the Affordable Care Act: Variation According to Insurance Status, Race, and Education (NHANES 2006-2014).

PubMed

Corriero, Rosemary; Gay, Jennifer L; Robb, Sara Wagner; Stowe, Ellen W

2018-02-01

The purpose of the study was to compare human papillomavirus (HPV) vaccination rates before and after Affordable Care Act (ACA) implementation among women, and examine differences according to insurance status and other sociodemographic variables. This was a cross-sectional analysis of the National Health and Nutrition Examination Survey questionnaire data. Participants (n = 4599) were from a random sample of the United States population. HPV vaccination status and number of doses received according to age, income, education, race, and insurance coverage. Over time, the proportion of women reporting HPV vaccination increased from 16.4% to 27.6%, and reporting vaccination completion (3 doses) increased from 56.8% to 67.2%. After ACA implementation, respondents were 3.3 times more likely to be vaccinated compared with before ACA implementation (95% confidence interval [CI], 2.0-5.5) adjusting for age, race, and insurance coverage. Similarly, respondents were more likely to have received 2 (odds ratio, 2.8; 95% CI, 1.5-5.3) or 3 doses (odds ratio, 5.8; 95% CI, 2.5-13.6). Vaccination uptake increased in a comparison of waves of data from before and after ACA implementation. This increase in vaccination coverage could be related to the increased preventative service coverage, which includes vaccines, required by the ACA. Future studies might focus on the role insurance has on vaccination uptake, and meeting Healthy People 2020 objectives for vaccination coverage. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Food provisioning and parental status in songbirds: can occupancy models be used to estimate nesting performance?

PubMed

Corbani, Aude Catherine; Hachey, Marie-Hélène; Desrochers, André

2014-01-01

Indirect methods to estimate parental status, such as the observation of parental provisioning, have been problematic due to potential biases associated with imperfect detection. We developed a method to evaluate parental status based on a novel combination of parental provisioning observations and hierarchical modeling. In the summers of 2009 to 2011, we surveyed 393 sites, each on three to four consecutive days at Forêt Montmorency, Québec, Canada. We assessed parental status of 2331 adult songbirds based on parental food provisioning. To account for imperfect detection of parental status, we applied MacKenzie et al.'s (2002) two-state hierarchical model to obtain unbiased estimates of the proportion of sites with successfully nesting birds, and the proportion of adults with offspring. To obtain an independent evaluation of detection probability, we monitored 16 active nests in 2010 and conducted parental provisioning observations away from them. The probability of detecting food provisioning was 0.31 when using nest monitoring, a value within the 0.11 to 0.38 range that was estimated by two-state models. The proportion of adults or sites with broods approached 0.90 and varied depending on date during the sampling season and year, exemplifying the role of eastern boreal forests as highly productive nesting grounds for songbirds. This study offers a simple and effective sampling design for studying avian reproductive performance that could be implemented in national surveys such as breeding bird atlases.

Food Provisioning and Parental Status in Songbirds: Can Occupancy Models Be Used to Estimate Nesting Performance?

PubMed Central

Corbani, Aude Catherine; Hachey, Marie-Hélène; Desrochers, André

2014-01-01

Indirect methods to estimate parental status, such as the observation of parental provisioning, have been problematic due to potential biases associated with imperfect detection. We developed a method to evaluate parental status based on a novel combination of parental provisioning observations and hierarchical modeling. In the summers of 2009 to 2011, we surveyed 393 sites, each on three to four consecutive days at Forêt Montmorency, Québec, Canada. We assessed parental status of 2331 adult songbirds based on parental food provisioning. To account for imperfect detection of parental status, we applied MacKenzie et al.'s (2002) two-state hierarchical model to obtain unbiased estimates of the proportion of sites with successfully nesting birds, and the proportion of adults with offspring. To obtain an independent evaluation of detection probability, we monitored 16 active nests in 2010 and conducted parental provisioning observations away from them. The probability of detecting food provisioning was 0.31 when using nest monitoring, a value within the 0.11 to 0.38 range that was estimated by two-state models. The proportion of adults or sites with broods approached 0.90 and varied depending on date during the sampling season and year, exemplifying the role of eastern boreal forests as highly productive nesting grounds for songbirds. This study offers a simple and effective sampling design for studying avian reproductive performance that could be implemented in national surveys such as breeding bird atlases. PMID:24999969

LSST communications middleware implementation

NASA Astrophysics Data System (ADS)

Mills, Dave; Schumacher, German; Lotz, Paul

2016-07-01

The LSST communications middleware is based on a set of software abstractions; which provide standard interfaces for common communications services. The observatory requires communication between diverse subsystems, implemented by different contractors, and comprehensive archiving of subsystem status data. The Service Abstraction Layer (SAL) is implemented using open source packages that implement open standards of DDS (Data Distribution Service1) for data communication, and SQL (Standard Query Language) for database access. For every subsystem, abstractions for each of the Telemetry datastreams, along with Command/Response and Events, have been agreed with the appropriate component vendor (such as Dome, TMA, Hexapod), and captured in ICD's (Interface Control Documents).The OpenSplice (Prismtech) Community Edition of DDS provides an LGPL licensed distribution which may be freely redistributed. The availability of the full source code provides assurances that the project will be able to maintain it over the full 10 year survey, independent of the fortunes of the original providers.

Computer integrated manufacturing/processing in the HPI. [Hydrocarbon Processing Industry

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

Yoshimura, J.S.

1993-05-01

Hydrocarbon Processing and Systemhouse Inc., developed a comprehensive survey on the status of computer integrated manufacturing/processing (CIM/CIP) targeted specifically to the unique requirements of the hydrocarbon processing industry. These types of surveys and other benchmarking techniques can be invaluable in assisting companies to maximize business benefits from technology investments. The survey was organized into 5 major areas: CIM/CIP planning, management perspective, functional applications, integration and technology infrastructure and trends. The CIM/CIP planning area dealt with the use and type of planning methods to plan, justify implement information technology projects. The management perspective section addressed management priorities, expenditure levels and implementationmore » barriers. The functional application area covered virtually all functional areas of organization and focused on the specific solutions and benefits in each of the functional areas. The integration section addressed the needs and integration status of the organization's functional areas. Finally, the technology infrastructure and trends section dealt with specific technologies in use as well as trends over the next three years. In February 1993, summary areas from preliminary results were presented at the 2nd International Conference on Productivity and Quality in the Hydrocarbon Processing Industry.« less

Who should be undertaking population-based surveys in humanitarian emergencies?

PubMed Central

Spiegel, Paul B

2007-01-01

Background Timely and accurate data are necessary to prioritise and effectively respond to humanitarian emergencies. 30-by-30 cluster surveys are commonly used in humanitarian emergencies because of their purported simplicity and reasonable validity and precision. Agencies have increasingly used 30-by-30 cluster surveys to undertake measurements beyond immunisation coverage and nutritional status. Methodological errors in cluster surveys have likely occurred for decades in humanitarian emergencies, often with unknown or unevaluated consequences. Discussion Most surveys in humanitarian emergencies are done by non-governmental organisations (NGOs). Some undertake good quality surveys while others have an already overburdened staff with limited epidemiological skills. Manuals explaining cluster survey methodology are available and in use. However, it is debatable as to whether using standardised, 'cookbook' survey methodologies are appropriate. Coordination of surveys is often lacking. If a coordinating body is established, as recommended, it is questionable whether it should have sole authority to release surveys due to insufficient independence. Donors should provide sufficient funding for personnel, training, and survey implementation, and not solely for direct programme implementation. Summary A dedicated corps of trained epidemiologists needs to be identified and made available to undertake surveys in humanitarian emergencies. NGOs in the field may need to form an alliance with certain specialised agencies or pool technically capable personnel. If NGOs continue to do surveys by themselves, a simple training manual with sample survey questionnaires, methodology, standardised files for data entry and analysis, and manual for interpretation should be developed and modified locally for each situation. At the beginning of an emergency, a central coordinating body should be established that has sufficient authority to set survey standards, coordinate when and where surveys should be undertaken and act as a survey repository. Technical expertise is expensive and donors must pay for it. As donors increasingly demand evidence-based programming, they have an obligation to ensure that sufficient funds are provided so organisations have adequate technical staff. PMID:17543107

Social relations and healthcare utilisation among middle-aged and older people: study protocol for an implementation and register-based study in Denmark.

PubMed

Mikkelsen, Anne Sophie Bech; Lund, Rikke; Kristiansen, Maria

2017-11-15

While previous research establishes an association between social relations, health and use of healthcare services among older people, how to implement this knowledge in real-life settings has received much less attention. This study will explore the relationship between social relations, health and use of healthcare services in a Danish mid-life population sample. In addition, the study will explore individual and contextual factors affecting the implementation of a group-based life story intervention aimed at establishing and strengthening social relations among older people at nursing homes in Denmark. A combined quantitative register-based approach and a qualitative implementation approach will be applied in this study. First, we will quantitatively analyse the relationship between social relations, health status and use of healthcare services among middle-aged people in Denmark by linking survey data on social relations, loneliness, self-perceived health and disease status from the Copenhagen Aging and Midlife Biobank (CAMB) (n = 7191) with national registries through the Public Health Database on use of healthcare services and demographic and socioeconomic factors. Second, we will qualitatively analyse individual and contextual factors affecting the implementation process of the group-based life story intervention based on semi-structured interviews (n = 16), observations and field notes with and among intervention stakeholders, i.e., participants and group leaders facilitating the intervention. The results of this study are expected to improve knowledge about mechanisms through which social relations are associated with health status and use of healthcare services and to inform the implementation of future interventions targeting social relations among older people at nursing homes. The study has been registered and approved by the Danish Data Protection Agency. Seperate approvals have been attained for the qualitative data (Approval No. SUND-2016-08), and for the quantitative data in the CAMB database which has also received approval from the local ethical committee (approval No.H-A-2008-126 and No. 2013-41-1814, respectively).

The North American Amphibian Monitoring Program. [abstract

USGS Publications Warehouse

Griffin, J.

1998-01-01

The North American Amphibian Monitoring Program has been under development for the past three years. The monitoring strategy for NAAMP has five main prongs: terrestrial salamander surveys, calling surveys, aquatic surveys, western surveys, and atlassing. Of these five, calling surveys were selected as one of the first implementation priorities due to their friendliness to volunteers of varying knowledge levels, relative low cost, and the fact that several groups had already pioneered the techniques involved. While some states and provinces had implemented calling surveys prior to NAAMP, like WI and IL, most states and provinces had little or no history of state/provincewide amphibian monitoring. Thus, the majority of calling survey programs were initiated in the past two years. To assess the progress of this pilot phase, a program review was conducted on the status of the NAAMP calling survey program, and the results of that review will be presented at the meeting. Topics to be discussed include: who is doing what where, extent of route coverage, the continuing random route discussions, quality assurance, strengths and weaknesses of calling surveys, reliability of data, and directions for the future. In addition, a brief overview of the DISPro project will be included. DISPro is a new amphibian monitoring program in National Parks, funded by the Demonstration of Intensive Sites Program (DISPro) through the EPA and NPS. It will begin this year at Big Bend and Shenandoah National Parks. The purpose of the DISPro Amphibian Project will be to investigate relationships between environmental factors and stressors and the distribution, abundance, and health of amphibians in these National Parks. At each Park, amphibian long-term monitoring protocols will be tested, distributions and abundance of amphibians will be mapped, and field research experiments will be conducted to examine stressor effects on amphibians (e.g., ultraviolet radiation, contaminants, acidification).

Identifying health insurance predictors and the main reported reasons for being uninsured among US immigrants by legal authorization status.

PubMed

Vargas Bustamante, Arturo; Chen, Jie; Fang, Hai; Rizzo, John A; Ortega, Alexander N

2014-01-01

This study identifies differences in health insurance predictors and investigates the main reported reasons for lacking health insurance coverage between short-stayed (≤ 10 years) and long-stayed (>10 years) US immigrant adults to parse the possible consequences of the Affordable Care Act among immigrants by length of stay and documentation status. Foreign-born adults (18-64 years of age) from the 2009 California Health Interview Survey are the study population. Health insurance coverage predictors and the main reasons for being uninsured are compared across cohorts and by documentation status. A logistic-regression two-part multivariate model is used to adjust for confounding factors. The analyses determine that legal status is a strong health insurance predictor, particularly among long-stayed undocumented immigrants. Immigration status is the main reported reason for lacking health insurance. Although long-stayed documented immigrants are likely to benefit from the Affordable Care Act implementation, undocumented immigrants and short-stayed documented immigrants may encounter difficulties getting health insurance coverage. Copyright © 2013 John Wiley & Sons, Ltd.

Identifying health insurance predictors and the main reported reasons for being uninsured among US immigrants by legal authorization status

PubMed Central

Bustamante, Arturo Vargas; Chen, Jie; Fang, Hai; Rizzo, John A.; Ortega, Alexander N.

2014-01-01

SUMMARY This study identifies differences in health insurance predictors and investigates the main reported reasons for lacking health insurance coverage between short-stayed (≤ 10 years) and long-stayed (> 10 years) US immigrant adults to parse the possible consequences of the Affordable Care Act among immigrants by length of stay and documentation status. Foreign-born adults (18–64 years of age) from the 2009 California Health Interview Survey are the study population. Health insurance coverage predictors and the main reasons for being uninsured are compared across cohorts and by documentation status. A logistic-regression two-part multivariate model is used to adjust for confounding factors. The analyses determine that legal status is a strong health insurance predictor, particularly among long-stayed undocumented immigrants. Immigration status is the main reported reason for lacking health insurance. Although long-stayed documented immigrants are likely to benefit from the Affordable Care Act implementation, undocumented immigrants and short-stayed documented immigrants may encounter difficulties getting health insurance coverage. PMID:24038524

Birds in Hawai'i Volcanoes National Park: Summary of the 2010 inventory and monitoring program survey

USGS Publications Warehouse

Camp, Richard J.; Judge, Seth W.; Hart, Patrick J.; Kudray, Greg; Gaudioso, Jacqueline M.; Hsu, Bobby H.

2012-01-01

The National Park Service (NPS) created the Inventory and Monitoring (I&M) Program in 1998 to establish baseline information and assess long-term trends in "vital signs" or key abiotic and biotic elements of National Parks (Fancy et al. 2009). The Pacific Island Network of the I&M Program developed a Landbirds Monitoring Protocol (LMP; Camp et al. 2011) to estimate species-specific status and monitor longterm trends in landbird distribution and abundance. Parks included in the LMP that harbor habitat critically important to native forest birds are Haleakala National Park (Maui Island), Hawai'i Volcanoes National Park (HAVO; Hawai'i Island), and the National Park of American Samoa (American Samoa). In 2010, the LMP was implemented in HAVO to survey landbird density and abundance. This implementation was the first anywhere in the Pacific Islands by the I&M Program, and continued monitoring is planned every five years in all three parks.

Hospital-Based Outpatient Direct Access to Physical Therapist Services: Current Status in Wisconsin.

PubMed

Boissonnault, William G; Lovely, Karen

2016-11-01

Direct access to physical therapist services is available in all 50 states, with reported benefits including reduced health care costs, enhanced patient satisfaction, and no apparent compromised patient safety. Despite the benefits and legality of direct access, few data exist regarding the degree of model adoption, implementation, and utilization. The purposes of the study were: (1) to investigate the extent of implementation and utilization of direct access to outpatient physical therapist services in Wisconsin hospitals and medical centers, (2) to identify barriers to and facilitators for the provisioning of such services, and (3) to identify potential differences between facilities that do and do not provide direct access services. A descriptive survey was conducted. Eighty-nine survey questionnaires were distributed via email to the directors of rehabilitation services at Wisconsin hospitals and medical centers. The survey investigated facility adoption of the direct access model, challenges to and resources utilized during model implementation, and current barriers affecting model utilization. Forty-seven (52.8%) of the 89 survey questionnaires were completed and returned. Forty-two percent of the survey respondents (20 of 47) reported that their facility offered direct access to physical therapist services, but fewer than 10% of patients were seen via direct access at 95% of the facilities offering such services. The most frequently reported obstacles to model implementation and utilization were lack of health care provider, administrator, and patient knowledge of direct access; its legality in Wisconsin; and physical therapists' differential diagnosis and medical screening abilities. Potential respondent bias and limited generalizability of the results are limitations of the study. These findings apply to hospitals and medical centers located in Wisconsin, not to facilities located in other geographic regions. Respondents representing direct access organizations reported more timely access to physical therapist services, enhanced patient satisfaction, decreased organizational health care costs, and improved efficiency of resource utilization as benefits of model implementation. For organizations without direct access, not being an organizational priority, concerns from referral sources, and concerns that the physician-patient relationship would be negatively affected were noted as obstacles to model adoption. © 2016 American Physical Therapy Association.

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

Yale, S H

A survey was conducted of x-ray facilities in 2000 dental offices under actual operating conditions. Each of 10 dental schools in the United States collected data on 200 local dental offices to implement geographic analysis of the status of radiation hygiene in the offices. The data provided records of roentgen (r) output of each machine, relative r dose to patient, and dose to operator. In addition, specific information relating to both operator and machine was coiiected and evaluated. Some dentists were found to be operating under unsafe conditions, but the average dentist covered in the survey was statistically safe. Onmore » the basis of the survey, it was concluded that the probiem of radiation hazards in dentistry will be resolved when all dental x-ray machines are properly filtered and collimated and high-speed dental x-ray film is used. (P.C.H.)« less

Survey of rabies vaccination status of Queensland veterinarians and veterinary students.

PubMed

Mendez, D; Foyle, L; Cobbold, R; Speare, R

2018-05-01

To determine the rabies vaccination status of Queensland veterinarians and veterinary students and their perception of zoonotic risk from Australian bat lyssavirus (ABLV). Cross-sectional questionnaire surveys. Questionnaires were sent by post in 2011 to veterinary surgeons registered in Queensland, to final-year veterinary students at James Cook University via SurveyMonkey® in 2013 and to final-year veterinary students at James Cook University and University of Queensland via SurveyMonkey® in 2014. The response rate for registered veterinarians was 33.5% and for veterinary students 33.3% and 30% in 2013 and 2014, respectively. Of the 466 registered veterinary surgeons, 147 (31.5%) had been vaccinated, with 72 (15.5%) currently vaccinated. For veterinary students the rabies vaccination rate was 20.0% (4/20) and 13.0% (6/46) in the 2013 and 2014 surveys, respectively. More than 95% of veterinary students had received the mandatory Q fever vaccine. Both veterinarians and students regarded bats and horses as high-risk species for zoonoses. Queensland veterinarians and veterinary students have low levels of protection against ABLV. Although incidents of ABLV spilling over from a bat to a domestic mammal are likely to remain rare, they pose a significant human health and occupational risk given the outcome of infection in humans is high consequence. Principals of veterinary practices and veterinary authorities in Australia should implement a policy of rabies vaccination for clinical staff and veterinary students. © 2018 Australian Veterinary Association.

School nutrition guidelines: overview of the implementation and evaluation.

PubMed

Gregorič, Matej; Pograjc, Larisa; Pavlovec, Alenka; Simčič, Marjan; Gabrijelčič Blenkuš, Mojca

2015-06-01

To holistically evaluate the extent of implementation of dietary guidelines in schools and present various monitoring systems. The study comprises three methods: (i) a cross-sectional survey (process evaluation); (ii) an indicator-based evaluation (menu quality); and (iii) a 5 d weighed food record of school lunches (output evaluation). Slovenian primary schools. A total 234 food-service managers from 488 schools completed a self-administrated questionnaire for process evaluation; 177 out of 194 randomly selected schools provided menus for menu quality evaluation; and 120 school lunches from twenty-four schools were measured and nutritionally analysed for output evaluation. The survey among food-service managers revealed high levels of implementation at almost all process evaluation areas of the guidelines. An even more successful implementation of these guidelines was found in relation to organization cultural issues as compared with technical issues. Differences found in some process evaluation areas were related to location, size and socio-economic characteristics of schools. Evaluation of school menu quality demonstrated that score values followed a normal distribution. Higher (better) nutrition scores were found in larger-sized schools and corresponding municipalities with higher socio-economic status. School lunches did not meet minimum recommendations for energy, carbohydrates or dietary fibre intake, nor for six vitamins and three (macro, micro and trace) elements. The implementation of the guidelines was achieved differently at distinct levels. The presented multilevel evaluation suggests that different success in implementation might be attributed to different characteristics of individual schools. System changes might also be needed to support and improve implementation of the guidelines.

Designing pharmacy services based on grocery store patron preferences.

PubMed

Lindstrom, Nicolette S Raya; Casper, Kristin A; Green, Tara R; Pedersen, Craig A

2007-01-01

To assess preferences of grocery store patrons concerning pharmacy services and identify study participant characteristics that may predict the success of pharmacy services in the community setting. Self-administered survey. Central Ohio from December 16, 2005, to January 12, 2006. 163 grocery store patrons. Eight grocery store survey events. Responses to survey items about (1) perceived importance of 28 pharmacy services, (2) identification of the 3 most important services, (3) frequency of grocery store and pharmacy use, (4) preferred methods of advertising pharmacy services, and (5) socioeconomic demographics. Preferred services delineated by various demographics also were analyzed. A total of 163 surveys were returned from study participants. Nine services appeared in both the top 12 overall preferred services and the 12 highest-ranked services. Statistically significant differences were observed among services ranked as important or very important by age, race, employment, income, caregiver status, and prescription drug coverage status. The three advertising tools selected most frequently included: weekly grocery store ads (68.6%), in-store signs (51.0%), and flyers attached to prescription bags (36.0%). Grocery store patrons would like a wide range of nontraditional pharmacy services that could be implemented into community pharmacies. Pharmacies in grocery stores need to provide both traditional and expanded pharmacy services to meet the desires and expectations of current and potential patients, and expanded marketing methods should be considered.

HIV testing in re-education through labour camps in Guangxi Autonomous Region, China (a cross-sectional survey)

PubMed Central

Yap, Lorraine; Reekie, Joanne; Liu, Wei; Chen, Yi; Wu, Zunyou; Li, Jianghong; Zhang, Lei; Wand, Handan; Donovan, Basil; Butler, Tony

2015-01-01

Objective HIV testing is mandatory in re-education-through-labour camps (laojiaosuo) in China yet no studies have reported on the process. Methods The survey response rate was 100% although 29 detainees were excluded because they were under 18 years of age. A cross-sectional face-to-face survey was conducted in three labour camps in Guangxi, located in the south-western region of China. Results Of the 755 detainees surveyed, 725 (96%) reported having a blood test in the labour camps of whom 493 (68%) thought this included an HIV test. 61 detainees self-reported they were HIV infected, their status confirmed by medical records, if available. Of these, 53 (87%) recalled receiving post-test HIV education, and 15 (25%) were currently receiving HIV antiretroviral therapy. Pretest education on HIV was provided to 233/725 (32%) detainees. The study further reports on detainees’ reactions and feelings towards non-disclosure and disclosure of their HIV test results in the labour camps. Conclusions Mandatory testing is almost universal in the labour camps although a proportion of detainees were unaware that this included an HIV test. HIV test results should be disclosed to all labour camp detainees to reduce their distress of not knowing and prevent misconceptions about their HIV status. Labour camps provide another opportunity to implement universal treatment (‘Test and Treat’) to prevent the spread of HIV. PMID:25739879

Graduate Periodontics Programs' Integration of Implant Provisionalization in Core Curricula: Implementation of CODA Standard 4-10.2.d.

PubMed

Barwacz, Christopher A; Pantzlaff, Ed; Allareddy, Veerasathpurush; Avila-Ortiz, Gustavo

2017-06-01

The aim of this descriptive study was to provide an overview of the status of implementation of Commission on Dental Accreditation (CODA) Standard 4-10.2.d (Provisionalization of Dental Implants) by U.S. graduate periodontics programs since its introduction in 2013. Surveys were sent in May 2015 to 56 accredited postdoctoral periodontics program directors to ascertain program director characteristics; status of planning, implementation, and curriculum resulting from adoption of Standard 4-10.2.d; preferred clinical protocols for implant provisionalization; interdisciplinary educational collaborators; and competency assessment mechanisms. The survey response rate was 52% (N=29); the majority were male, aged 55 or older, and had held their position for less than ten years. Among the responding programs, 93% had formal educational curricula established in implant provisionalization. Graduate periodontics (96%) and prosthodontics (63%) faculty members were predominantly involved with curriculum planning. Of these programs, 96% used immediate implant provisionalization, with direct (chairside) provisionalization protocols (86%) being preferred over indirect protocols (14%) and polyethylethylketone provisional abutments (75%) being preferred to titanium (25%) provisional abutments. Straight and concave transmucosal emergence profile designs (46% each) were preferred in teaching, with only 8% of programs favoring convex transmucosal profiles. A majority of responding programs (67%) lacked protocols for communicating to the restorative referral a mechanism to duplicate the mature peri-implant mucosal architecture. Regional location did not play a significant role in any educational component related to implant provisionalization for these graduate periodontal programs. Overall, this study found that a clear majority of graduate periodontics programs had established formal curricula related to implant provisionalization, with substantial clinical and philosophical consensus within the specialty.

An Overview of Cultural Competency Curricula in ACGME-accredited General Surgery Residency Programs.

PubMed

Shah, Sagar S; Sapigao, Francisco B; Chun, Maria B J

Cultural competency(CC) in surgical residency curricula is not the novel idea it was fourteen years ago when the ACGME challenged program directors to teach and assess six core competencies. CC is recognized as a component of "patient care", "professionalism", and "interpersonal and communication skills." The results of five programs (2004-2012) with CC curricula were identified in a 2013 paper by Ly and Chun. The primary objective of this paper is to provide the current status of CC curricula in general surgery residency programs. Three sources were used for this study. First, a four question survey on the current status of CC education was sent to program directors of ACGME-accredited surgery residency programs. Second, the lead authors from five programs previously reported in the 2013 paper were interviewed. Third, the survey mentioned above was resent to 52 residency programs who implemented New York University's (NYU) SPICE program, which has a CC component. Participants for the survey consisted of program directors of ACGME-accredited surgery residency programs. The interviews were conducted with the corresponding authors from the previous study by Ly and Chun. Of the 256 surveyed, nine responded; seven stated that CC is not taught formally at their institution while four stated that they do not feel any part of CC curricula is missing from their program. Due to the low response rate, we identified and conducted interviews with general surgery residency programs with CC curricula. Of the five programs contacted, only three remain active and utilize Objective Structured Clinical Examinations (OSCEs) to teach cultural competency. One of the three, the SPICE program at NYU, has expanded to 52 other residency programs in the US. Although the importance of CC has been identified in general surgery, formal curricula and documentation of implementation remains elusive. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Science for the changing Great Basin

USGS Publications Warehouse

Beever, Erik; Pyke, David A.

2004-01-01

The U.S. Geological Survey (USGS), with its multidisciplinary structure and role as a federal science organization, is well suited to provide integrated science in the Great Basin of the western United States. A research strategy developed by the USGS and collaborating partners addresses critical management issues in the basin, including invasive species, status and trends of wildlife populations and communities, wildfire, global climate change, and riparian and wetland habitats. Information obtained through implementation of this strategy will be important for decision-making by natural-resource managers.

A survey of breast feeding practices in infants seen in general practice.

PubMed

Chia, S F

1992-06-01

This is a study of infant feeding practices of 126 mothers. Seventy-seven mothers or 61.1% practised breast feeding. The typical breast feeding mother was more likely to be a Malay, with lower family income and residing in the rural area. The educational status of the mother was not an important factor in influencing her to breast feed. Health education on breast feeding should be intensified in schools to reinforce the implementation of the Malaysian Code of Ethics for Infant Formula Products.

The Medicare Health Outcomes Survey program: overview, context, and near-term prospects.

PubMed

Jones, Nathaniel; Jones, Stephanie L; Miller, Nancy A

2004-07-12

In 1996, the Centers for Medicare & Medicaid Services (CMS) initiated the Medicare Health Outcomes Survey (HOS). It is the first national survey to measure the quality of life and functional health status of Medicare beneficiaries enrolled in managed care. The program seeks to gather valid and reliable health status data in Medicare managed care for use in quality improvement activities, public reporting, plan accountability and improving health outcomes based on competition. The context that led to the development of the HOS was formed by the convergence of the following factors: 1) a recognized need to monitor the performance of managed care plans, 2) technical expertise and advancement in the areas of quality measurement and health outcomes assessment, 3) the existence of a tested functional health status assessment tool (SF-36)1, which was valid for an elderly population, 4) CMS leadership, and 5) political interest in quality improvement. Since 1998, there have been six baseline surveys and four follow up surveys. CMS, working with its partners, performs the following tasks as part of the HOS program: 1) Supports the technical/scientific development of the HOS measure, 2) Certifies survey vendors, 3) Collects Health Plan Employer Data and Information Set(HEDIS)2 HOS data, 4) Cleans, scores, and disseminates annual rounds of HOS data, public use files and reports to CMS, Quality Improvement Organizations (QIOs), Medicare+Choice Organizations (M+COs), and other stakeholders, 5) Trains M+COs and QIOs in the use of functional status measures and best practices for improving care, 6) Provides technical assistance to CMS, QIOs, M+COs and other data users, and 7) Conducts analyses using HOS data to support CMS and HHS priorities.CMS has recently sponsored an evaluation of the HOS program, which will provide the information necessary to enhance the future administration of the program. Information collected to date reveals that the HOS program is a valuable tool that provides a rich set of data that is useful for quality monitoring and improvement efforts. To enhance the future of the HOS program, many stakeholders recommend the implementation of incentives to encourage the use of the data, while others identify the need to monitor the health status of plan disenrollees.Overall, the HOS program represents an important vehicle for collecting outcomes data from Medicare beneficiaries. The new Medicare Prescription Drug, Improvement, and Modernization Act (2003) mandates the collection and use of data for outcomes measurement. Consequently, it is important to improve HOS to most effectively meet the mandate.

Overcoming Barriers to Experience Benefits: A Qualitative Analysis of Electronic Health Records and Health Information Exchange Implementation in Local Health Departments

PubMed Central

Williams, Karmen S.; Shah, Gulzar H.; Leider, JP; Gupta, Akarti

2017-01-01

Introduction: Electronic Health Records (EHRs) and Health Information Exchanges (HIEs) are changing surveillance and analytic operations within local health departments (LHDs) across the United States. The objective of this study was to analyze the status, benefits, barriers, and ways of overcoming challenges in the implementation of EHRs and HIEs in LHDs. Methods: This study employed a mixed methods approach, first using the 2013 National Profile of LHDs survey to ascertain the status of EHR and HIE implementation across the US, as well as to aid in selection of respondents for the second, interview-based part of project. Next, forty-nine key-informant interviews of local health department staff were conducted. Data were coded thematically and independently by two researchers. Coding was compared and re-coded using the consensus definitions. Results: Twenty-three percent of LHDs nationwide are using EHRs and 14 percent are using HIEs. The most frequently mentioned benefits for implementation were identified as care coordination, retrieval or managing information, and the ability to track outcomes of care. A few mentioned barriers included financial resources, resistance to change, and IT related issues during implementation. Discussion: Despite financial, technical capacity, and operational constraints, leaders interviewed as part of this project were optimistic about the future of EHRs in local health departments. Recent policy changes and accreditation have implications of improving processes to affect populations served. Conclusions: Overcoming the challenges in implementing EHRs can result in increased efficiencies in surveillance and higher quality patient care and tracking. However, significant opportunity cost does exist. PMID:29881738

[NUTRITIONAL STATUS AND BIOCHEMICAL MARKERS OF DEFICIENCY OR EXCESS OF MICRONUTRIENTS IN 4 TO 14 YEAR-OLD CHILEAN CHILDREN: A CRITICAL REVIEW].

PubMed

Rozowski Narkunska, Jaime; Castillo Valenzuela, Oscar; Figari Jullian, Nicole; García-Díaz, Diego F; Cruchet Muñoz, Sylvia; Weisstaub Nuta, Gerardo; Pérez-Bravo, Francisco; Gotteland Russel, Martín

2015-12-01

The prevalence of obesity in Chilean children has been increasing steadily for the last two decades. The first study to determine nutritional status and food intake in a representative sample of this population was carried out in 1960. Recently the National Food Consumption Survey (ENCA) carried out in 2012 was released by the Ministry of Health. However, this study did not include biochemical determinations of micronutrients which would allow a better diagnosis of nutritional status in children. to review the literature available from 2004 to 2014 in food intake and nutritional status in Chilean children aged 4 to 14 years. a total of 362 references published between 2004 and 2014 were obtained through searches in the databases PubMed, Lilacs, Embase and Scielo. From these, 40 articles were selected for a thorough review. food intake by children is characterized by a high-energy intake, a low consumption of fruits and vegetables and a high consumption of bread. The ENCA showed that 95% of the Chilean population has a deficient diet. A high prevalence of obesity is observed from very early in life. There is a dearth of data available on plasma indicators of vitamin and mineral status since 1960, which would provide more reliable information on nutritional assessment. It is imperative to implement a representative nutrition survey of children in Chile that includes biochemical indicators to get reliable information in order to develop strategies aimed to correct micronutrient malnutrition from excess or deficiency. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

The effect of increased primary schooling on adult women's HIV status in Malawi and Uganda: Universal Primary Education as a natural experiment.

PubMed

Behrman, Julia Andrea

2015-02-01

This paper explores the causal relationship between primary schooling and adult HIV status in Malawi and Uganda, two East African countries with some of the highest HIV infection rates in the world. Using data from the 2010 Malawi Demographic Health Survey and the 2011 Uganda AIDS Indicator Survey, the paper takes advantage of a natural experiment, the implementation of Universal Primary Education policies in the mid 1990s. An instrumented regression discontinuity approach is used to model the relationship between increased primary schooling and adult women's HIV status. Results indicate that a one-year increase in schooling decreases the probability of an adult woman testing positive for HIV by 0.06 (p < 0.01) in Malawi and by 0.03 (p < 0.05) in Uganda. These results are robust to a variety of model specifications. In a series of supplementary analyses a number of potential pathways through which such effects may occur are explored. Findings indicate increased primary schooling positively affects women's literacy and spousal schooling attainment in Malawi and age of marriage and current household wealth in Uganda. However primary schooling has no effect on recent (adult) sexual behavior. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

Wireless Technology to Track Surgical Patients after Discharge: A Pilot Study.

PubMed

Dawes, Aaron J; Reardon, Sarah; Chen, Victor L; Kaiser, William; Russell, Marcia M; Ko, Clifford Y; Lin, Anne Y

2015-10-01

Failure to detect changes in patients' postoperative health status increases the risk of adverse outcomes, including complications and readmission. We sought to design and implement a real-time surveillance system for postoperative colorectal surgery patients using wireless health technology. Participants were assigned a preprogrammed tablet computer during their inpatient hospitalization, and asked to complete a daily survey regarding their postoperative health status until their first clinic visit. Surveys were transmitted wirelessly to a secure database for review. As a pilot study, we report on our first 20 consecutively enrolled patients, monitored for 265 patient days. Overall compliance was 63 per cent (data available for 166 of the 265 days), but varied by patient from 26 to 100 per cent. We were able to reliably collect basic data on postoperative health status as well as patient-reported outcomes not previously captured by standard assessment techniques. Qualitative data suggest that the experience strengthened patients' relationship with their surgeon and aided in their recovery. Postoperative remote monitoring is feasible, and provides more detailed and complete information to the clinical team. Wireless health technology represents an opportunity to close the information gap between discharge and first clinic visit, and, eventually, to improve patient-provider communication, increase patient satisfaction, and prevent unnecessary readmissions.

Iodine Status and Iodised Salt Consumption in Portuguese School-Aged Children: The Iogeneration Study

PubMed Central

Costa Leite, João; Keating, Elisa; Pestana, Diogo; Cruz Fernandes, Virgínia; Maia, Maria Luz; Norberto, Sónia; Pinto, Edgar; Moreira-Rosário, André; Sintra, Diana; Moreira, Bárbara; Costa, Ana; Silva, Sofia; Costa, Vera; Martins, Inês; Castro Mendes, Francisca; Queirós, Pedro; Peixoto, Bruno; Carlos Caldas, José; Guerra, António; Fontoura, Manuel; Leal, Sandra; Moreira, Roxana; Palmares Carvalho, Irene; Matias Lima, Rui; Martins, Catia; Delerue-Matos, Cristina; Almeida, Agostinho; Azevedo, Luís; Calhau, Conceição

2017-01-01

The World Health Organization promotes salt iodisation to control iodine deficiency. In Portugal, the use of iodised salt in school canteens has been mandatory since 2013. The present study aimed to evaluate iodine status in school-aged children (6–12 years) and to monitor the use of iodised salt in school canteens. A total of 2018 participants were randomly selected to participate in a cross-sectional survey in northern Portugal. Children’s urine and salt samples from households and school canteens were collected. A lifestyle questionnaire was completed by parents to assess children’s eating frequency of iodine food sources. Urinary iodine concentration (UIC) was measured by inductively coupled plasma-mass spectrometry. The median UIC was 129 µg/L which indicates the adequacy of iodine status and 32% of the children had UIC < 100 µg/L. No school canteen implemented the iodised salt policy and only 2% of the households were using iodised salt. Lower consumption of milk, but not fish, was associated with a higher risk of iodine deficiency. Estimation of sodium intake from spot urine samples could be an opportunity for adequate monitoring of population means. Implementation of iodine deficiency control policies should include a monitoring program aligned with the commitment of reducing the population salt intake. PMID:28475154

Iodine Status and Iodised Salt Consumption in Portuguese School-Aged Children: The Iogeneration Study.

PubMed

Costa Leite, João; Keating, Elisa; Pestana, Diogo; Cruz Fernandes, Virgínia; Maia, Maria Luz; Norberto, Sónia; Pinto, Edgar; Moreira-Rosário, André; Sintra, Diana; Moreira, Bárbara; Costa, Ana; Silva, Sofia; Costa, Vera; Martins, Inês; Castro Mendes, Francisca; Queirós, Pedro; Peixoto, Bruno; Carlos Caldas, José; Guerra, António; Fontoura, Manuel; Leal, Sandra; Moreira, Roxana; Palmares Carvalho, Irene; Matias Lima, Rui; Martins, Catia; Delerue-Matos, Cristina; Almeida, Agostinho; Azevedo, Luís; Calhau, Conceição

2017-05-05

The World Health Organization promotes salt iodisation to control iodine deficiency. In Portugal, the use of iodised salt in school canteens has been mandatory since 2013. The present study aimed to evaluate iodine status in school-aged children (6-12 years) and to monitor the use of iodised salt in school canteens. A total of 2018 participants were randomly selected to participate in a cross-sectional survey in northern Portugal. Children's urine and salt samples from households and school canteens were collected. A lifestyle questionnaire was completed by parents to assess children's eating frequency of iodine food sources. Urinary iodine concentration (UIC) was measured by inductively coupled plasma-mass spectrometry. The median UIC was 129 µg/L which indicates the adequacy of iodine status and 32% of the children had UIC < 100 µg/L. No school canteen implemented the iodised salt policy and only 2% of the households were using iodised salt. Lower consumption of milk, but not fish, was associated with a higher risk of iodine deficiency. Estimation of sodium intake from spot urine samples could be an opportunity for adequate monitoring of population means. Implementation of iodine deficiency control policies should include a monitoring program aligned with the commitment of reducing the population salt intake.

Adjusting HIV prevalence estimates for non-participation: an application to demographic surveillance

PubMed Central

McGovern, Mark E.; Marra, Giampiero; Radice, Rosalba; Canning, David; Newell, Marie-Louise; Bärnighausen, Till

2015-01-01

Introduction HIV testing is a cornerstone of efforts to combat the HIV epidemic, and testing conducted as part of surveillance provides invaluable data on the spread of infection and the effectiveness of campaigns to reduce the transmission of HIV. However, participation in HIV testing can be low, and if respondents systematically select not to be tested because they know or suspect they are HIV positive (and fear disclosure), standard approaches to deal with missing data will fail to remove selection bias. We implemented Heckman-type selection models, which can be used to adjust for missing data that are not missing at random, and established the extent of selection bias in a population-based HIV survey in an HIV hyperendemic community in rural South Africa. Methods We used data from a population-based HIV survey carried out in 2009 in rural KwaZulu-Natal, South Africa. In this survey, 5565 women (35%) and 2567 men (27%) provided blood for an HIV test. We accounted for missing data using interviewer identity as a selection variable which predicted consent to HIV testing but was unlikely to be independently associated with HIV status. Our approach involved using this selection variable to examine the HIV status of residents who would ordinarily refuse to test, except that they were allocated a persuasive interviewer. Our copula model allows for flexibility when modelling the dependence structure between HIV survey participation and HIV status. Results For women, our selection model generated an HIV prevalence estimate of 33% (95% CI 27–40) for all people eligible to consent to HIV testing in the survey. This estimate is higher than the estimate of 24% generated when only information from respondents who participated in testing is used in the analysis, and the estimate of 27% when imputation analysis is used to predict missing data on HIV status. For men, we found an HIV prevalence of 25% (95% CI 15–35) using the selection model, compared to 16% among those who participated in testing, and 18% estimated with imputation. We provide new confidence intervals that correct for the fact that the relationship between testing and HIV status is unknown and requires estimation. Conclusions We confirm the feasibility and value of adopting selection models to account for missing data in population-based HIV surveys and surveillance systems. Elements of survey design, such as interviewer identity, present the opportunity to adopt this approach in routine applications. Where non-participation is high, true confidence intervals are much wider than those generated by standard approaches to dealing with missing data suggest. PMID:26613900

Awareness, practices, and barriers regarding smoking cessation treatment among physicians in Saudi Arabia.

PubMed

Jradi, Hoda

2017-01-01

Smoking cessation counseling and therapy provided by physicians play an important role in helping smokers quit. Awareness and practices of the clinical practice guidelines for tobacco dependence (in particular the 5A's: Ask, Assist, Assess, Advise, and Arrange) among physicians and perceived barriers for their implementation is needed to improve care for individuals who smoke/use tobacco products in Saudi Arabia. A cross-sectional self-administered survey was conducted among 124 general and family practitioners in primary health care clinics belonging to 2 major medical centers in Riyadh city, Saudi Arabia. Descriptive statistics were reported for all survey variables. Logistic regression was used to examine the predictors of physicians' use of the 5A's for smoking cessation counseling and therapy. Among the 216 contacted physicians, 124 responded (57.4%). The majority (63.7%) were males, between the ages of 40 and 49 years (52.4%), practicing full-time (95.2%), and had not received smoking cessation training during medical school education or residency training (68.6%). Approximately 85.5% reported some experience with the guidelines (heard, read, or used). Asking (71.8%) and advising (87.9%) were the most implemented for smoking cessation, while assisting (15.3%) and arranging for follow-up (17.7%) were the least implemented. Most (96.0%) did not prescribe pharmacotherapy and 53.2% reported documenting the patient's smoking status. Reported barriers were mostly lack of time (72.6%) and lack of training (66.9%). Awareness of the guidelines, physician's smoking status, perceived competence in ability to provide smoking cessation counseling and therapy, reporting the ineffectiveness of smoking cessation therapy as a barrier, and the perceived benefit of reducing patient's physical symptoms were independently statistically significant predictors of the implementation of the 5A's for smoking cessation therapy. This preliminary study showed that smoking cessation delivery, according to the clinical practice guidelines recommendation, in Saudi Arabia is inadequate. Barriers were identified regarding the delivery of smoking cessation therapy and counseling for the first time. Physician training is likely to improve compliance with implementing smoking cessation counseling and therapy.

Intelsat TDMA and its implementation in Australia

NASA Astrophysics Data System (ADS)

Howe, Stuart

The developmental history and characteristics of the Intelsat digital communications network are surveyed, with a focus on the current implementation status in Australia. Topics addressed include the fundamental principles and advantages of a TDMA system, the hardware required for a TDMA traffic station, and the Intelsat Indian Ocean Primary satellite network. Detailed consideration is given to TDMA test equipment (burst-mode link analyzers, PCM DSI test sets, burst-power meters, burst negators, and reference burst generators), terminal integration with terrestrial and RF links (TWT sharing and equalization), equipment compatibility, and traffic. Plans call for 950 TDMA circuits by the end of 1990, representing about 36.5 percent of the traffic between Australia and Europe, Africa, India and Pakistan, and the Middle East.

Survey of organizational research climates in three research intensive, doctoral granting universities.

PubMed

Wells, James A; Thrush, Carol R; Martinson, Brian C; May, Terry A; Stickler, Michelle; Callahan, Eileen C; Klomparens, Karen L

2014-12-01

The Survey of Organizational Research Climate (SOuRCe) is a new instrument that assesses dimensions of research integrity climate, including ethical leadership, socialization and communication processes, and policies, procedures, structures, and processes to address risks to research integrity. We present a descriptive analysis to characterize differences on the SOuRCe scales across departments, fields of study, and status categories (faculty, postdoctoral scholars, and graduate students) for 11,455 respondents from three research-intensive universities. Among the seven SOuRCe scales, variance explained by status and fields of study ranged from 7.6% (Advisor-Advisee Relations) to 16.2% (Integrity Norms). Department accounted for greater than 50% of the variance explained for each of the SOuRCe scales, ranging from 52.6% (Regulatory Quality) to 80.3% (Integrity Inhibitors). It is feasible to implement this instrument in large university settings across a broad range of fields, department types, and individual roles within academic units. Published baseline results provide initial data for institutions using the SOuRCe who wish to compare their own research integrity climates. © The Author(s) 2014.

Remote Monitoring Systems for Chronic Patients on Home Hemodialysis: Field Test of a Copresence-Enhanced Design

PubMed Central

Liu, Na; Jung, Younhyun; Arisy, Adani; Nicdao, Mary Ann; Mikaheal, Mary; Baldacchino, Tanya; Khadra, Mohamed; Sud, Kamal

2017-01-01

Background Patients undertaking long-term and chronic home hemodialysis (HHD) are subject to feelings of isolation and anxiety due to the absence of physical contact with their health care professionals and lack of feedback in regards to their dialysis treatments. Therefore, it is important for these patients to feel the “presence” of the health care professionals remotely while on hemodialysis at home for better compliance with the dialysis regime and to feel connected with health care professionals. Objective This study presents an HHD system design for hemodialysis patients with features to enhance patient’s perceived “copresence” with their health care professionals. Various mechanisms to enhance this perception were designed and implemented, including digital logbooks, emotion sharing, and feedback tools. The mechanism in our HHD system aims to address the limitations associated with existing self-monitoring tools for HHD patients. Methods A field trial involving 3 nurses and 74 patients was conducted to test the pilot implementation of the copresence design in our HHD system. Mixed method research was conducted to evaluate the system, including surveys, interviews, and analysis of system data. Results Patients created 2757 entries of dialysis cases during the period of study. Altogether there were 492 entries submitted with “Very Happy” as the emotional status, 2167 entries with a “Happy” status, 56 entries with a “Neutral” status, 18 entries with an “Unhappy” status, and 24 entries with a “Very unhappy” status. Patients felt assured to share their emotions with health care professionals. Health care professionals were able to prioritize the review of the entries based on the emotional status and also felt assured to see patients’ change in mood. There were 989 entries sent with short notes. Entries with negative emotions had a higher percentage of supplementary notes entered compared to the entries with positive and neutral emotions. The qualitative data further showed that the HHD system was able to improve patients’ feelings of being connected with their health care professionals and thus enhance their self-care on HHD. The health care professionals felt better assured with patients’ status with the use of the system and reported improved productivity and satisfaction with the copresence enhancement mechanism. The survey on the system usability indicated a high level of satisfaction among patients and nurses. Conclusions The copresence enhancement design complements the conventional use of a digitized HHD logbook and will further benefit the design of future telehealth systems. PMID:28851680

Evaluation of alternative school feeding models on nutrition, education, agriculture and other social outcomes in Ghana: rationale, randomised design and baseline data.

PubMed

Gelli, Aulo; Masset, Edoardo; Folson, Gloria; Kusi, Anthoni; Arhinful, Daniel K; Asante, Felix; Ayi, Irene; Bosompem, Kwabena M; Watkins, Kristie; Abdul-Rahman, Lutuf; Agble, Rosanna; Ananse-Baden, Getrude; Mumuni, Daniel; Aurino, Elisabetta; Fernandes, Meena; Drake, Lesley

2016-01-20

'Home-grown' school feeding programmes are complex interventions with the potential to link the increased demand for school feeding goods and services to community-based stakeholders, including smallholder farmers and women's groups. There is limited rigorous evidence, however, that this is the case in practice. This evaluation will examine explicitly, and from a holistic perspective, the simultaneous impact of a national school meals programme on micronutrient status, alongside outcomes in nutrition, education and agriculture domains. The 3-year study involves a cluster-randomised control trial designed around the scale-up of the national school feeding programme, including 116 primary schools in 58 districts in Ghana. The randomly assigned interventions are: 1) a school feeding programme group, including schools and communities where the standard government programme is implemented; 2) 'home-grown' school feeding, including schools and communities where the standard programme is implemented alongside an innovative pilot project aimed at enhancing nutrition and agriculture; and 3) a control group, including schools and households from communities where the intervention will be delayed by at least 3 years, preferably without informing schools and households. Primary outcomes include child health and nutritional status, school participation and learning, and smallholder farmer income. Intermediate outcomes along the agriculture and nutrition pathways will also be measured. The evaluation will follow a mixed-method approach, including child-, household-, school- and community-level surveys as well as focus group discussions with project stakeholders. The baseline survey was completed in August 2013 and the endline survey is planned for November 2015. The tests of balance show significant differences in the means of a number of outcome and control variables across the intervention groups. Important differences across groups include marketed surplus, livestock income, per capita food consumption and intake, school attendance, and anthropometric status in the 2-5 and 5-15 years age groups. In addition, approximately 19 % of children in the target age group received some form of free school meals at baseline. Designing and implementing the evaluation of complex interventions is in itself a complex undertaking, involving a multi-disciplinary research team working in close collaboration with programme- and policy-level stakeholders. Managing the complexity from an analytical and operational perspective is an important challenge. The analysis of the baseline data indicates that the random allocation process did not achieve statistically comparable treatment groups. Differences in outcomes and control variables across groups will be controlled for when estimating treatment effects. ISRCTN66918874 (registered on 5 March 2015).

Measuring Resident Physicians' Performance of Preventive Care

PubMed Central

Palonen, Katri P; Allison, Jeroan J; Heudebert, Gustavo R; Willett, Lisa L; Kiefe, Catarina I; Wall, Terry C; Houston, Thomas K

2006-01-01

BACKGROUND The Accreditation Council for Graduate Medical Education has suggested various methods for evaluation of practice-based learning and improvement competency, but data on implementation of these methods are limited. OBJECTIVE To compare medical record review and patient surveys on evaluating physician performance in preventive services in an outpatient resident clinic. DESIGN Within an ongoing quality improvement project, we collected baseline performance data on preventive services provided for patients at the University of Alabama at Birmingham (UAB) Internal Medicine Residents' ambulatory clinic. PARTICIPANTS Seventy internal medicine and medicine-pediatrics residents from the UAB Internal Medicine Residency program. MEASUREMENTS Resident- and clinic-level comparisons of aggregated patient survey and chart documentation rates of (1) screening for smoking status, (2) advising smokers to quit, (3) cholesterol screening, (4) mammography screening, and (5) pneumonia vaccination. RESULTS Six hundred and fifty-nine patient surveys and 761 charts were abstracted. At the clinic level, rates for screening of smoking status, recommending mammogram, and for cholesterol screening were similar (difference <5%) between the 2 methods. Higher rates for pneumonia vaccination (76% vs 67%) and advice to quit smoking (66% vs 52%) were seen on medical record review versus patient surveys. However, within-resident (N=70) comparison of 2 methods of estimating screening rates contained significant variability. The cost of medical record review was substantially higher ($107 vs $17/physician). CONCLUSIONS Medical record review and patient surveys provided similar rates for selected preventive health measures at the clinic level, with the exception of pneumonia vaccination and advising to quit smoking. A large variation among individual resident providers was noted. PMID:16499544

Temporal changes in the attitude towards smoking bans in public arenas among adults in the Capital Region of Denmark from 2007 to 2010.

PubMed

Lykke, Maja; Helbech, Bodil; Glümer, Charlotte

2014-07-01

The population's attitude towards smoking bans in public arenas is important for their passing, implementation and compliance. Smoking bans are believed to reduce the social acceptability of smoking, and once people experience them, public support increases--also among pre-ban sceptics. This study aimed to examine the temporal changes in public attitude towards smoking bans in public arenas from 2007 to 2010 and whether these changes differed across educational attainment, smoking status and intention to quit among smokers. Data from two surveys among adults (aged 25-79 years) in 2007 and 2010 in the Capital Region of Denmark (n=36,472/42,504, response rate = 52.3) was linked with data on sex, age and educational attainment from central registers. Age-standardised prevalence of supportive attitude towards smoking bans was estimated. Temporal changes in supportive attitude were explored in workplaces, restaurants and bars using logistic regression models. The prevalence of supportive attitude towards smoking bans increased significantly in all arenas from 2007 to 2010. Positive temporal changes in supportive attitude towards smoking bans were seen across educational attainment, smoking status and intention to quit smoking in restaurants and across smoking status for smoking bans in workplaces and bars. The results of this study show that the public's attitude towards smoking in public arenas has changed after the implementation of a comprehensive smoking ban. This change in attitude can support implementation of future legislation on smoking and may lead to positive changes in smoking norms. © 2014 the Nordic Societies of Public Health.

Internationalization of the animal science undergraduate curriculum: a survey of its current status, barriers to its implementation and its value.

PubMed

Forsberg, N E; Taur, J S; Xiao, Y; Chesbrough, H

2003-04-01

The goal of this project was to identify the current level at which internationalization has been adopted as a theme in the North American animal science curriculum and to identify its value and the barriers to its implementation. We surveyed animal, dairy, and poultry science departments across Canada and the United States. One hundred twenty-four surveys were mailed and 60% were returned. Associations between aspects of internationalization and student outcomes (admission to veterinary and graduate schools and starting salaries) were examined. Although administrators strongly believed internationalization had value, implementation was limited. The most common practices included international content in core animal science classes, advising, international internships, and participation of faculty in international scholarly activities. Few departments have incorporated internationalization into their mission statements or developed a specific international-themed class, scholarships devoted to international activities, or roles for international students. Few departments reported participation of students in international programs. Barriers included finances and limited commitment from higher administration. Student outcomes were positively associated with faculty size, percentage of international faculty, the ratio of international students to the total student population, international content in core animal science classes, a specific international-themed class, availability of international internships, and exchange of class material internationally via the Internet. Departments that did not offer international opportunities had a negative association (r = -0.79) with starting salary, but these relationships may not be causal. Alternatively, progressive departments may attract and retain exceptional students. The analysis indicated an awareness of the value of international programs, positive impacts in student outcomes, and financial barriers to implementation.

Effect of Occupational Health and Safety Management System on Work-Related Accident Rate and Differences of Occupational Health and Safety Management System Awareness between Managers in South Korea's Construction Industry

PubMed Central

Yoon, Seok J.; Lin, Hsing K.; Chen, Gang; Yi, Shinjea; Choi, Jeawook; Rui, Zhenhua

2013-01-01

Background The study was conducted to investigate the current status of the occupational health and safety management system (OHSMS) in the construction industry and the effect of OHSMS on accident rates. Differences of awareness levels on safety issues among site general managers and occupational health and safety (OHS) managers are identified through surveys. Methods The accident rates for the OHSMS-certified construction companies from 2006 to 2011, when the construction OHSMS became widely available, were analyzed to understand the effect of OHSMS on the work-related injury rates in the construction industry. The Korea Occupational Safety and Health Agency 18001 is the certification to these companies performing OHSMS in South Korea. The questionnaire was created to analyze the differences of OHSMS awareness between site general managers and OHS managers of construction companies. Results The implementation of OHSMS among the top 100 construction companies in South Korea shows that the accident rate decreased by 67% and the fatal accident rate decreased by 10.3% during the period from 2006 to 2011. The survey in this study shows different OHSMS awareness levels between site general managers and OHS managers. The differences were motivation for developing OHSMS, external support needed for implementing OHSMS, problems and effectiveness of implementing OHSMS. Conclusion Both work-related accident and fatal accident rates were found to be significantly reduced by implementing OHSMS in this study. The differences of OHSMS awareness between site general managers and OHS managers were identified through a survey. The effect of these differences on safety and other benefits warrants further research with proper data collection. PMID:24422176

Prevalence of anaesthesia information management systems in university-affiliated hospitals in Europe.

PubMed

Balust, Jaume; Egger Halbeis, Christoph B; Macario, Alex

2010-02-01

An increasing number of studies suggest that anaesthesia information management systems (AIMS) improve clinical care. The purpose of this web survey study was to assess the prevalence of AIMS in European university-affiliated anaesthesia departments and to identify the motivations for and barriers to AIMS adoption. A survey was e-mailed to 252 academic anaesthesia chairs of 294 university-affiliated hospitals in 22 European countries, with 41 e-mails returned as undeliverable, leaving the final sample equal to 211. Responders provided information on demographics, the other information technology systems available in their hospitals, and current implementation status of AIMS. Adopters were asked about motivations for installing AIMS, whereas nonadopters were asked about barriers to AIMS adoption. Eighty-six (29%) of 294 hospitals responded. Forty-four of the 86 departments (51%) were considered AIMS adopters because they were already using (n = 15), implementing (n = 13) or selecting an AIMS (n = 16). The 42 remaining departments (49%) were considered nonadopters as they were not expecting to install an AIMS owing to lack of funds (n = 27), other reasons (n = 13) such as lack of support from the information technology department, or simply did not have a plan (n = 2). The top ranked motivators for adopting AIMS were improved clinical documentation, improvement in patient care and safety, and convenience for anaesthesiologists. AIMS adopters were more likely than nonadopters to already have other information technology systems deployed throughout the hospital. At least 44 (or 15%) of the 294 university-affiliated departments surveyed in this study have already implemented, are implementing, or are currently selecting an AIMS. The main barrier identified by AIMS nonadopters is lack of funds.

Effect of Occupational Health and Safety Management System on Work-Related Accident Rate and Differences of Occupational Health and Safety Management System Awareness between Managers in South Korea's Construction Industry.

PubMed

Yoon, Seok J; Lin, Hsing K; Chen, Gang; Yi, Shinjea; Choi, Jeawook; Rui, Zhenhua

2013-12-01

The study was conducted to investigate the current status of the occupational health and safety management system (OHSMS) in the construction industry and the effect of OHSMS on accident rates. Differences of awareness levels on safety issues among site general managers and occupational health and safety (OHS) managers are identified through surveys. The accident rates for the OHSMS-certified construction companies from 2006 to 2011, when the construction OHSMS became widely available, were analyzed to understand the effect of OHSMS on the work-related injury rates in the construction industry. The Korea Occupational Safety and Health Agency 18001 is the certification to these companies performing OHSMS in South Korea. The questionnaire was created to analyze the differences of OHSMS awareness between site general managers and OHS managers of construction companies. The implementation of OHSMS among the top 100 construction companies in South Korea shows that the accident rate decreased by 67% and the fatal accident rate decreased by 10.3% during the period from 2006 to 2011. The survey in this study shows different OHSMS awareness levels between site general managers and OHS managers. The differences were motivation for developing OHSMS, external support needed for implementing OHSMS, problems and effectiveness of implementing OHSMS. Both work-related accident and fatal accident rates were found to be significantly reduced by implementing OHSMS in this study. The differences of OHSMS awareness between site general managers and OHS managers were identified through a survey. The effect of these differences on safety and other benefits warrants further research with proper data collection.

Away-from-home eating: nutritional status and dietary intake among Brazilian adults.

PubMed

Bezerra, Ilana Nogueira; Junior, Eliseu Verly; Pereira, Rosangela Alves; Sichieri, Rosely

2015-04-01

To evaluate the association between eating away from home and BMI and to examine whether dietary intake differs based on the consumption of away-from-home food (AFHF). Data were obtained from the first Brazilian National Dietary Survey, using food records. The association between the percentage of energy provided by foods consumed away from home and BMI status was tested using logistic regression models. The mean percentages of energy provided by protein, fat, saturated fat and free sugars were calculated based on the consumption of foods away from home among AFHF consumers. Urban areas of Brazil. Adults (n 13 736) between 25 and 65 years old. AFHF was not associated with BMI status. Individuals who consumed AFHF had higher intakes of free sugars away from home than at home and had higher intakes of energy-dense foods than AFHF non-consumers. Although AFHF consumption was not related to overweight or obesity status, individuals who consumed foods away from home had higher intakes of energy-dense foods. Public health policies should be implemented to help people make healthier food choices away from home.

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana.

PubMed

Debpuur, Cornelius; Welaga, Paul; Wak, George; Hodgson, Abraham

2010-09-27

Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people.

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana

PubMed Central

Debpuur, Cornelius; Welaga, Paul; Wak, George; Hodgson, Abraham

2010-01-01

Background Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. Objective To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. Methods The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. Results The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. Conclusion The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people. PMID:20963186

Wage differences according to health status in France.

PubMed

Ben Halima, Mohamed Ali; Rococo, Emeline

2014-11-01

Many OECD countries have implemented anti-discrimination laws in recent decades. However, according to the annual report published in 2010 by the French High Authority for the Fight against Discrimination and for Equality, the second most commonly cited factor in discrimination claims since 2005 is a handicap or health status. The aim of this research is to estimate the level of unexplained components in the wage gap that can be attributed to wage discrimination based on health status in France in 2010 utilizing data from the Health, Healthcare and Insurance survey among 1594 individuals. Three health indicators are used: self-perceived health status, activity limitations and long-term chronic illness. To measure the wage gap according to an individual's health status, the analysis considers the endogenous selection of health status and unobserved differences in productivity. The results demonstrate that wage discrimination is experienced by individuals in poor health regardless of the health indicator utilized. The hourly wage rate among individuals with poor self-assessed health status is on average 14.2% lower than among individuals with good self-assessed health status. However, for individuals suffering from a long-term chronic illness or an activity limitation, the gap is 6.3% and 4.5%, respectively. The decomposition performed on wage differences according to health status by correcting for health status selection bias and controlling for unobserved differences in productivity indicates that the 'unexplained component' that can be attributed to wage discrimination is equal to 50%. Copyright © 2014 Elsevier Ltd. All rights reserved.

Examining structural and clinical factors associated with implementation of standing orders for adult immunization.

PubMed

Yonas, Michael A; Nowalk, Mary Patricia; Zimmerman, Richard K; Ahmed, Faruque; Albert, Steven M

2012-01-01

A proven method to increase vaccination rates in primary care is a standing orders program (SOP) for nonphysician staff to assess and vaccinate eligible individuals without a specific written physician order. This study describes a mixed methods approach to examining physicians' beliefs and attitudes about and adoption of SOPs for adult immunizations, specifically, influenza and pneumococcal polysaccharide vaccine. Focus groups and in-depth interviews of physicians, nurses, practice managers, and the medical director of a managed care health plan were conducted. Results were used to enrich a concise survey based on the Awareness-to-Adherence model of physician behavior and previous research, which was mailed to 1,640 general internists and family physicians nationwide. Barriers to SOPs identified through qualitative methods were lack of interest in changing the status quo, a physician-dominated hierarchy, and fear of malpractice. Facilitators included having an electronic medical record and a practice culture that was open to change. The survey (response rate 67%) confirmed the facilitators and further identified patient, physician, and practice factors that served as barriers to establishing and maintaining SOPs. This mixed methods approach provided the opportunity to develop a tailored and practice-oriented survey for examining the contextual factors influencing clinical providers' decisions to implement SOPs for adult immunization. © 2011 National Association for Healthcare Quality.

Integration of Basic and Clinical Science Courses in US PharmD Programs

PubMed Central

Talukder, Rahmat M.; Taheri, Reza; Blanchard, Nicholas

2016-01-01

Objective. To determine the current status of and faculty perceptions regarding integration of basic and clinical science courses in US pharmacy programs. Methods. A 25-item survey instrument was developed and distributed to 132 doctor of pharmacy (PharmD) programs. Survey data were analyzed using Mann-Whitney U test or Kruskal-Wallis test. Thematic analysis of text-based comments was performed using the constant comparison method. Results. One hundred twelve programs responded for a response rate of 85%. Seventy-eight (70%) offered integrated basic and clinical science courses. The types of integration included: full integration with merging disciplinary contents (n=25), coordinated delivery of disciplinary contents (n=50), and standalone courses with integrated laboratory (n=3). Faculty perceptions of course integration were positive. Themes that emerged from text-based comments included positive learning experiences as well as the challenges, opportunities, and skepticism associated with course integration. Conclusion. The results suggest wide variations in the design and implementation of integrated courses among US pharmacy programs. Faculty training and buy-in play a significant role in successful implementation of curricular integration. PMID:28179715

Integration of Basic and Clinical Science Courses in US PharmD Programs.

PubMed

Islam, Mohammed A; Talukder, Rahmat M; Taheri, Reza; Blanchard, Nicholas

2016-12-25

Objective. To determine the current status of and faculty perceptions regarding integration of basic and clinical science courses in US pharmacy programs. Methods. A 25-item survey instrument was developed and distributed to 132 doctor of pharmacy (PharmD) programs. Survey data were analyzed using Mann-Whitney U test or Kruskal-Wallis test. Thematic analysis of text-based comments was performed using the constant comparison method. Results. One hundred twelve programs responded for a response rate of 85%. Seventy-eight (70%) offered integrated basic and clinical science courses. The types of integration included: full integration with merging disciplinary contents (n=25), coordinated delivery of disciplinary contents (n=50), and standalone courses with integrated laboratory (n=3). Faculty perceptions of course integration were positive. Themes that emerged from text-based comments included positive learning experiences as well as the challenges, opportunities, and skepticism associated with course integration. Conclusion. The results suggest wide variations in the design and implementation of integrated courses among US pharmacy programs. Faculty training and buy-in play a significant role in successful implementation of curricular integration.

CFD lends the government a hand

NASA Technical Reports Server (NTRS)

Lekoudis, Spiro; Singleton, Robert E.; Mehta, Unmeel B.

1992-01-01

The present survey of important and novel CFD applications being developed and implemented by U.S. Government contractors gives attention to naval vessel flow-modeling, Army ballistic and rotary wing aerodynamics, and NASA hypersonic vehicle related applications of CFD. CFD-generated knowledge of numerical algorithms, fluid motion, and supercomputer use is being incorporated into such additional areas as computational electromagnetics and acoustics. Attention is presently given to CFD methods' development status in such fields as submarine boundary layers, hypersonic kinetic energy projectile shock structures, helicopter main rotor tip flows, and National Aerospace Plane aerothermodynamics.

Can We Measure Immigrants’ Legal Status? Lessons from Two U.S. Surveys

PubMed Central

Bachmeier, James D.; Van Hook, Jennifer; Bean, Frank D.

2014-01-01

This research note examines response and allocation rates for legal status questions asked in publicly available U.S. surveys to address worries that the legal status of immigrants cannot be reliably measured. Contrary to such notions, we find that immigrants’ response rates to questions about legal status are typically not higher than response rates to other immigration-related questions, such as country of birth and year of immigration. Further exploration of two particular surveys – the Los Angeles Family and Neighborhood Survey (LAFANS) and the Survey of Income and Program Participation (SIPP) – reveals that these data sources produce profiles of the unauthorized immigrant population that compare favorably to independently estimated profiles. We also find in the case of the SIPP that the introduction of legal status questions does not appear to have an appreciable “chilling effect” on the subsequent survey participation of unauthorized immigrant respondents. Based on the results, we conclude that future data collection efforts should include questions about legal status in order to (a) improve models of immigrant incorporation and (b) better position assimilation research to inform policy discussions. PMID:25525285

NASA GRC MBSE Implementation Status

NASA Technical Reports Server (NTRS)

Parrott, Edith; Trase, Katie; Green, Randi; Varga, Denise; Powell, Joe

2016-01-01

This presentation gives a brief overview on GRCs Model Based System Engineering (MBSE) implementation status. This overview covers: history, project usage and implementation, challenges and future work.

Surveillance of healthcare-associated infections in Piemonte, Italy: results from a second regional prevalence study

PubMed Central

2014-01-01

Background A prevalence survey of healthcare-associated infections (HAIs) was previously performed in the Piemonte region in 2000. In the decade following the survey, many studies were performed at both the regional and hospital levels, and training courses were developed to address issues highlighted by the survey. In 2010, a second regional prevalence study was performed. The aim of this paper is to present the results of the second prevalence study and discuss them within the context of the HAI prevention and control programmes that have been implemented in the decade since the original survey was conducted. Methods The study involved all public hospitals in the Piemonte region. Uni- and multivariate analyses were performed to assess the main risk factors associated with HAIs, including both overall and site-specific infections. Results A total of 7841 patients were enrolled: 6.8% were affected by at least one HAI. The highest prevalence of HAIs was found in intensive care units (18.0%, 95% CI 14.0-22.6), while UTIs presented the highest relative frequency (26.7%), followed by respiratory tract infections (21.9%). The age of the patient, hospital size and urinary and central venous catheter status were significantly associated with HAIs. Conclusions The study results showed an increase in HAI prevalence, despite prevention and control efforts, as well as training implemented after the first regional survey. Nevertheless, these data are consistent with the current literature. Furthermore, despite its limits, the prevalence approach remains an important means for involving healthcare workers, emphasising HAIs and revealing critical problems that need be addressed. PMID:24899239

The impact of a nutrition education programme on the anthropometric nutritional status of low-income children in South Africa.

PubMed

Walsh, C M; Dannhauser, A; Joubert, G

2002-02-01

The study determined the impact of a community-based nutrition education programme, using trained community nutrition advisors, on the anthropometric nutritional status of mixed-race children aged between 2 and 5 years. The programme was implemented over two years in four study areas in the Free State and Northern Cape Provinces. Two control areas were included to differentiate between the effect of the education programme and a food aid programme that were implemented simultaneously. Weight-for-age, height-for-age and weight-for-height were summarised using standard deviations from the NCHS reference median. For each of the indicators, the difference in the percentage of children below minus two standard deviations from the reference NCHS median in the initial and follow-up surveys was determined. Initially 536 children were measured and, after two years of intervention, 815. Weight-for-age improved in all areas, but only significantly in boys and girls in the urban study area, and in boys in one rural study area. No significant improvement in height-for-age occurred in any area. Weight-for-height improved significantly in the urban study area. The education programme in combination with food aid succeeded in improving the weight status of children, but was unable to facilitate catch-up growth in stunted children after two years of intervention.

Does Person-Centered Care Improve Residents' Satisfaction With Nursing Home Quality?

PubMed

Poey, Judith L; Hermer, Linda; Cornelison, Laci; Kaup, Migette L; Drake, Patrick; Stone, Robyn I; Doll, Gayle

2017-11-01

Person-centered care (PCC) is meant to enhance nursing home residents' quality of life (QOL). Including residents' perspectives is critical to determining whether PCC is meeting residents' needs and desires. This study examines whether PCC practices promote satisfaction with QOL and quality of care and services (QOC and QOS) among nursing home residents. A longitudinal, retrospective cohort study using an in-person survey. Three hundred twenty nursing homes in Kansas enrolled or not enrolled in a pay-for-performance program, Promoting Excellent Alternatives in Kansas (PEAK 2.0), to promote PCC in nursing homes. A total of 6214 nursing home residents in 2013-2014 and 5538 residents in 2014-2015, with a Brief Interview for Mental Status score ≥8, participated in face-to-face interviews. Results were aggregated to the nursing home level. My InnerView developed a Resident Satisfaction Survey for Kansas composed of 32 questions divided into QOL, QOC, QOS, and global satisfaction subdomains. After controlling for facility characteristics, satisfaction with overall QOL and QOC was higher in homes that had fully implemented PCC. Although some individual measures in the QOS domain (eg, food) showed greater satisfaction at earlier levels of implementation, high satisfaction was observed primarily in homes that had fully implemented PCC. These findings provide evidence for the effectiveness of PCC implementation on nursing home resident satisfaction. The PEAK 2.0 program may provide replicable methods for nursing homes and states to implement PCC systematically. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

The role of systematic inpatient cardiac rehabilitation referral in increasing equitable access and utilization.

PubMed

Grace, Sherry L; Leung, Yvonne W; Reid, Robert; Oh, Paul; Wu, Gilbert; Alter, David A; CRCARE Investigators

2012-01-01

While systematic referral strategies have been shown to significantly increase cardiac rehabilitation (CR) enrollment to approximately 70%, whether utilization rates increase among patient groups who are traditionally underrepresented has yet to be established. This study compared CR utilization based on age, marital status, rurality, socioeconomic indicators, clinical risk, and comorbidities following systematic versus nonsystematic CR referral. Coronary artery disease inpatients (N = 2635) from 11 Ontario hospitals, utilizing either systematic (n = 8 wards) or nonsystematic referral strategies (n = 8 wards), completed a survey including sociodemographics and activity status. Clinical data were extracted from charts. At 1 year, 1680 participants completed a mailed survey that assessed CR utilization. The association of patient characteristics and referral strategy on CR utilization was tested using χ. When compared to nonsystematic referral, systematic strategies resulted in significantly greater CR referral and enrollment among obese (32 vs 27% referred, P = .044; 33 vs 26% enrolled, P = .047) patients of lower socioeconomic status (41 vs 34% referred, P = .026; 42 vs 32% enrolled, P = .005); and lower activity status (63 vs 54% referred, P = .005; 62 vs 51% enrolled, P = .002). There was significantly greater enrollment among those of lower education (P = .04) when systematically referred; however, no significant differences in degree of CR participation based on referral strategy. Up to 11% more socioeconomically disadvantaged patients and those with more risk factors utilized CR where systematic processes were in place. They participated in CR to the same high degree as their nonsystematically referred counterparts. These referral strategies should be implemented to promote equitable access.

Use of pharmacy delivery robots in intensive care units.

PubMed

Summerfield, Marc R; Seagull, F Jacob; Vaidya, Neelesh; Xiao, Yan

2011-01-01

The use of pharmacy delivery robots in an institution's intensive care units was evaluated. In 2003, the University of Maryland Medical Center (UMMC) began a pilot program to determine the logistic capability and functional utility of robotic technology in the delivery of medications from satellite pharmacies to patient care units. Three satellite pharmacies currently used the robotic system. Five data sources (electronic robot activation records, logs, interviews, surveys, and observations) were used to assess five key aspects of robotic delivery: robot use, reliability, timeliness, cost minimization, and acceptance. A 19-item survey using a 7-point Likert-type scale was developed to determine if pharmacy delivery robots changed nurses' perception of pharmacy service. The components measured included general satisfaction, reliability, timeliness, stat orders, services, interaction with pharmacy, and status tracking. A total of 23 pre-implementation, 96 post-implementation, and 30 two-year follow-up surveys were completed. After implementation of the robotic delivery system, time from fax to label, order preparation time, and idle time for medications to be delivered decreased, while nurses' general satisfaction with the pharmacy and opinion of the reliability of pharmacy delivery significantly increased. Robotic delivery did not influence the perceived quality of delivery service or the timeliness of orders or stat orders. Robot reliability was a major issue for the technician but not for pharmacists, who did not have as much interaction with the devices. By considering the needs of UMMC and its patients and matching them with available technology, the institution was able to improve the medication-use process and timeliness of medication departure from the pharmacy.

Multidisciplinary cancer care in Australia: a national audit highlights gaps in care and medico-legal risk for clinicians.

PubMed

Wilcoxon, Heidi; Luxford, Karen; Saunders, Christobel; Peterson, Janice; Zorbas, Helen

2011-03-01

Multidisciplinary care (MDC) is accepted as best practice in cancer treatment planning and care. Despite recognition of the importance of a team approach, limited data are available about the extent to which MDC has been implemented in Australia. The aim of the audit was to investigate the implementation of MDC for five main cancer types across Australia in line with best practice. A sample of 155 hospitals was surveyed to investigate the status of MDC for cancer treatment planning in Australia across five cancer types (breast, gynecological, lung, prostate and colorectal). The survey investigated team structure, meetings, patient consent, documentation of team recommendations and communication with the patient. Two-thirds of hospitals surveyed did not have a multidisciplinary team. Of those with such a team; in one-third patients were not informed their case would be discussed by the team, in half patient consent was not sought for all cases discussed by the team, in one-quarter the team's recommended treatment plan was not noted in the patient record. Less than 1% of teams reported routine attendance by the tumour-specific minimum core team. MDC is not being implemented in line with best practice or applied consistently across Australia. This audit has highlighted gaps in care delivery, despite national recommendations about MDC. Areas being neglected can affect the quality of care provided and may put clinicians at medico-legal risk. Recommendations to improve uptake and effectiveness of MDC are provided. © 2011 Blackwell Publishing Asia Pty Ltd.

African Doppler Surveys (ADOS).

DTIC Science & Technology

1983-06-01

UP TO 31 MARCH 1983 MAILING DATE: 11 APRIL 1983 SURVEY STATUS DATA STATUSDOPPLER STATION L1 OR1ATION - ______(hte 1,(Whether data dis- GEOD . TIES...SURVEY STATUS DTA STATUS DOPPLER STATION INFORMATION (Whet~her data dia- GEOD . TIES patched to...data dis- GEOD . TIES patched to COUNThY STATION NAME APPROXIMAT OPPLER designated CODE AND ADOS NO. SZION ()outh Comp. Center) COORDINATES fin- Yes

Wide extragalactic (sub-)millimeter surveys with SCUBA and AzTEC

NASA Astrophysics Data System (ADS)

Aretxaga, I.; Hughes, D. H.; SHADES Collaboration; AzTEC Collaboration

2009-05-01

We summarize the present status of our knowledge of the millimeter galaxy population derived from extensive (sub-) millimeter extragalactic surveys like the SCUBA HAlf Degree Survey (SHADES), and the current status of the next generation of surveys traced with the AzTEC camera, that has, so far, surveyed more than 2 degrees at 1.1wavelengths.

Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients.

PubMed

Glurich, Ingrid; Nycz, Gregory; Acharya, Amit

2017-06-01

Escalating prevalence of both diabetes and periodontal disease, two diseases associated with bi-directional exacerbation, has been reported. Periodontal disease represents a modifiable risk factor that may reduce diabetes onset or progression, and integrated models of cross-disciplinary care are needed to establish and manage glycemic control in affected patients. An ad-hoc environmental scan of current literature and media sought to characterize factors impacting status of integrated care models based on review of the existing evidence base in literature and media surrounding: (1) current cross-disciplinary practice patterns, (2) epidemiological updates, (3) status on risk assessment and screening for dysglycemia in the dental setting, (4) status on implementation of quality metrics for oral health, (5) care model pilots, and (6) public health perspectives. The survey revealed: escalating prevalence of diabetes and periodontitis globally; greater emphasis on oral health assessment for diabetic patients in recent medical clinical practice guidelines; high knowledgeability surrounding oral-systemic impacts on diabetes and growing receptivity to medical-dental integration among medical and dental providers; increasing numbers of programs/studies reporting on positive impact of emerging integrated dental-medical care models on diabetic patient healthcare access and health outcomes; a growing evidence base for clinically significant rates of undiagnosed dysglycemia among dental patients reported by point-of-care pilot studies; no current recommendation for population-based screening for dysglycemia in dental settings pending a stronger evidence base; improved definition of true periodontitis prevalence in (pre)/diabetics; emerging recognition of the need for oral health quality indicators and tracking; evidence of persistence in dental access disparity; updated status on barriers to integration. The potential benefit of creating clinically-applicable integrated care models to support holistic management of an escalating diabetic population by targeting modifiable risk factors including periodontitis is being recognized by the health industry. Cross-disciplinary efforts supported by high quality research are needed to mitigate previously- and newly-defined barriers of care integration and expedite development and implementation of integrated care models in various practice settings. Implementation of quality monitoring in the dental setting will support definition of the impact and efficacy of interventional clinical care models on patient outcomes. © 2017 Marshfield Clinic.

[The Present Implementation Status and Problems of Vital-signs Measurement by Community Pharmacists in Home Medical Care in Osaka].

PubMed

Niki, Kazuyuki; Takemura, Miho; Kitagawa, Kyosuke; Shimizu, Ruka; Takahashi, Yuri; Hatabu, Asuka; Uejima, Etsuko

2018-01-01

　While the community-based integrated care systems are in the process of being structured currently, more and more community pharmacists want to learn physical assessment skills. However, no large-scale survey focusing on present implementation status and problems of physical assessment by community pharmacists has been conducted yet. Osaka has the 2nd highest number of community pharmacies in Japan now, and the population aged ≥65 years will be expected to become the 3rd highest in 2025. Thus, Osaka can become a national leading model case for community pharmacists' activity in future home medical care. Therefore, this study aimed to reveal the present implementation status and problems of physical assessment by community pharmacists in Osaka, especially focusing on vital-signs. The questionnaires were sent to all the 3571 insurance pharmacies belonging to the Osaka Pharmaceutical Association and 871 pharmacies responded. Many pharmacists recognized the necessity for vital-signs measurement by pharmacists in home medical care (81.5% of pharmacies that offered home medical care and 75.4% of pharmacies that did not offer one). However, the proportion of pharmacies that conduct vital-signs measurement in home medical care was 18.7%, therefore, it was suggested that the present problem is "many pharmacists cannot conduct vital-signs measurement, although they think it should be conducted". Moreover, the most common reason for not measuring vital-signs was the lack of instruments, such as stethoscopes and sphygmomanometer (43.2%). This is the latest report with a large-scale sample, thus, it can serve as valuable knowledge in considering what pharmacists do for the future.

Effect of home-based HIV counselling and testing on stigma and risky sexual behaviours: serial cross-sectional studies in Uganda.

PubMed

Nuwaha, Fred; Kasasa, Simon; Wana, Godwill; Muganzi, Elly; Tumwesigye, Elioda

2012-06-04

A large, district-wide, home-based HIV counselling and testing (HBHCT) programme was implemented in Bushenyi district of Uganda from 2004 to 2007. This programme provided free HBHCT services to all consenting adults of Bushenyi district and had a very high uptake and acceptability. We measured population-level changes in knowledge of HIV status, stigma and HIV-risk behaviours before and after HBHCT to assess whether widespread HBHCT had an effect on trends of risky sexual behaviours and on stigma and discrimination towards HIV. Serial cross-sectional surveys were carried out before and after the implementation of HBHCT programme in Bushenyi district of Uganda. A total of 1402 randomly selected adults (18 to 49 years) were interviewed in the baseline survey. After the implementation, a different set of randomly selected 1562 adults was interviewed using the same questionnaire. Data was collected on socio-demographic characteristics, sexual behaviour, whether respondents had ever tested for HIV and stigma and discrimination towards HIV/AIDS. The proportion of people who had ever tested for HIV increased from 18.6% to 62% (p<0.001). Among people who had ever tested, the proportion of people who shared HIV test result with a sexual partner increased from 41% to 57% (p<0.001). The proportion of persons who wanted infection status of a family member not to be revealed decreased from 68% to 57% (p<0.001). Indicators of risk behaviour also improved; the proportion of people who exchanged money for sex reduced from 12% to 4% (p<0.001), who used a condom when money was exchanged during a sexual act increased from 39% to 80% (p<0.001) and who reported genital ulcer/discharge decreased from 22% to 10% (p<0.001). These data suggest that HBHCT rapidly increased the uptake of HCT and may have led to reduction in high-risk behaviours at population level as well as reduction in stigma and discrimination. Because HBCT programmes are cost-effective, they should be considered for implementation in delivery of HIV services especially in areas where access to HCT is low.

50 CFR 648.90 - NE multispecies assessment, framework procedures and specifications, and flexible area action...

Code of Federal Regulations, 2011 CFR

2011-10-01

...; survey results; stock status; current estimates of fishing mortality and overfishing levels; social and... survey data or, if sea sampling data are unavailable, length frequency information from trawl surveys... effort, survey results, stock status, current estimates of fishing mortality, and any other relevant...

Moving Beyond Accidental Leadership: A Graduate Medical Education Leadership Curriculum Needs Assessment.

PubMed

Hartzell, Joshua D; Yu, Clifton E; Cohee, Brian M; Nelson, Michael R; Wilson, Ramey L

2017-07-01

Despite calls for greater physician leadership, few medical schools, and graduate medical education programs provide explicit training on the knowledge, skills, and attitudes necessary to be an effective physician leader. Rather, most leaders develop through what has been labeled "accidental leadership." A survey was conducted at Walter Reed to define the current status of leadership development and determine what learners and faculty perceived as key components of a leadership curriculum. A branching survey was developed for residents and faculty to assess the perceived need for a graduate medical education leadership curriculum. The questionnaire was designed using survey best practices and established validity through subject matter expert reviews and cognitive interviewing. The survey instrument assessed the presence of a current leadership curriculum being conducted by each department, the perceived need for a leadership curriculum for physician leaders, the topics that needed to be included, and the format and timing of the curriculum. Administered using an online/web-based survey format, all 2,041 house staff and educators at Walter Reed were invited to participate in the survey. Descriptive statistics were conducted using SPSS (version 22). The survey response rate was 20.6% (421/2,041). Only 17% (63/266) of respondents stated that their program had a formal leadership curriculum. Trainees ranked their current leadership abilities as slightly better than moderately effective (3.22 on a 5-point effectiveness scale). Trainee and faculty availability were ranked as the most likely barrier to implementation. Topics considered significantly important (on a 5-point effectiveness scale) were conflict resolution (4.1), how to motivate a subordinate (4.0), and how to implement change (4.0). Respondents ranked the following strategies highest in perceived effectiveness on a 5-point scale (with 3 representing moderate effectiveness): leadership case studies (3.3) and small group exercises (3.2). Online power points were reported as only slightly effective (1.9). Free text comments suggest that incorporating current duties, a mentoring and coaching component, and project based would be valuable to the curriculum. Few training programs at Walter Reed have a dedicated leadership curriculum. The survey data provide important information for programs considering implementing a leadership development curriculum in terms of content and delivery. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Ways of Research: The Status of the Traditional Research Paper Assignment in First-Year Writing/Composition Courses

ERIC Educational Resources Information Center

Hood, Carra Leah

2010-01-01

I created my Exploratory Survey on the Status of the Research Paper Assignment in First-year Writing/Composition Courses to learn whether the traditional research paper remained as common an assignment in 2009 as it had been in the past. My survey updates results from two previous surveys on the status of this assignment. Ambrose N. Manning's…

Status Survey of Secondary School Home Economics Programs in the State of Wisconsin, 1972; Abstract of Status Survey.

ERIC Educational Resources Information Center

Monts, Elizabeth A.; And Others

A survey of the middle and senior high school home economics teachers and principals in Wisconsin was conducted to identify the present status of the home economics program which would serve as a basis for future program development and staff education. To obtain an accurate description of the home economics program, questionnaires were developed…

Implementation of Workplace-Based Smoking Cessation Support Activities and Smoking Cessation Among Employees: The Finnish Public Sector Study

PubMed Central

Kivimäki, Mika; Oksanen, Tuula; Pentti, Jaana; Heponiemi, Tarja; Väänänen, Ari; Virtanen, Marianna; Vahtera, Jussi

2012-01-01

Objectives. We investigated the relationship between implementation of workplace smoking cessation support activities and employee smoking cessation. Methods. In 2 cohort studies, participants were 6179 Finnish public-sector employees who self-reported as smokers at baseline in 2004 (study 1) or 2008 (study 2) and responded to follow-up surveys in 2008 (study 1; n = 3298; response rate = 71%) or 2010 (study 2; n = 2881; response rate = 83%). Supervisors’ reports were used to assess workplace smoking cessation support activities. We conducted multilevel logistic regression analyses to examine changes in smoking status. Results. After adjustment for sociodemographic characteristics, number of cigarettes smoked per day, work unit size, shift work, type of job contract, health status, and health behaviors, baseline smokers whose supervisors reported that the employing agency had offered pharmacological treatments or financial incentives were more likely than those in workplaces that did not offer such support to have quit smoking. In general, associations were stronger among moderate or heavy smokers (≥ 10 cigarettes/day) than among light smokers (< 10 cigarettes/day). Conclusions. Cessation activities offered by employers may encourage smokers, particularly moderate or heavy smokers, to quit smoking. PMID:22594722

Remote Monitoring Systems for Chronic Patients on Home Hemodialysis: Field Test of a Copresence-Enhanced Design.

PubMed

Liu, Na; Kim, Jinman; Jung, Younhyun; Arisy, Adani; Nicdao, Mary Ann; Mikaheal, Mary; Baldacchino, Tanya; Khadra, Mohamed; Sud, Kamal

2017-08-29

Patients undertaking long-term and chronic home hemodialysis (HHD) are subject to feelings of isolation and anxiety due to the absence of physical contact with their health care professionals and lack of feedback in regards to their dialysis treatments. Therefore, it is important for these patients to feel the "presence" of the health care professionals remotely while on hemodialysis at home for better compliance with the dialysis regime and to feel connected with health care professionals. This study presents an HHD system design for hemodialysis patients with features to enhance patient's perceived "copresence" with their health care professionals. Various mechanisms to enhance this perception were designed and implemented, including digital logbooks, emotion sharing, and feedback tools. The mechanism in our HHD system aims to address the limitations associated with existing self-monitoring tools for HHD patients. A field trial involving 3 nurses and 74 patients was conducted to test the pilot implementation of the copresence design in our HHD system. Mixed method research was conducted to evaluate the system, including surveys, interviews, and analysis of system data. Patients created 2757 entries of dialysis cases during the period of study. Altogether there were 492 entries submitted with "Very Happy" as the emotional status, 2167 entries with a "Happy" status, 56 entries with a "Neutral" status, 18 entries with an "Unhappy" status, and 24 entries with a "Very unhappy" status. Patients felt assured to share their emotions with health care professionals. Health care professionals were able to prioritize the review of the entries based on the emotional status and also felt assured to see patients' change in mood. There were 989 entries sent with short notes. Entries with negative emotions had a higher percentage of supplementary notes entered compared to the entries with positive and neutral emotions. The qualitative data further showed that the HHD system was able to improve patients' feelings of being connected with their health care professionals and thus enhance their self-care on HHD. The health care professionals felt better assured with patients' status with the use of the system and reported improved productivity and satisfaction with the copresence enhancement mechanism. The survey on the system usability indicated a high level of satisfaction among patients and nurses. The copresence enhancement design complements the conventional use of a digitized HHD logbook and will further benefit the design of future telehealth systems. ©Na Liu, Jinman Kim, Younhyun Jung, Adani Arisy, Mary Ann Nicdao, Mary Mikaheal, Tanya Baldacchino, Mohamed Khadra, Kamal Sud. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 29.08.2017.

Empirical Analysis of Green Supply Chain Management Practices in Indian Automobile Industry

NASA Astrophysics Data System (ADS)

Luthra, S.; Garg, D.; Haleem, A.

2014-04-01

Environmental sustainability and green environmental issues have an increasing popularity among researchers and supply chain practitioners. An attempt has been made to identify and empirically analyze green supply chain management (GSCM) practices in Indian automobile industry. Six main GSCM practices (having 37 sub practices) and four expected performance outcomes (having 16 performances) have been identified by implementing GSCM practices from literature review. Questionnaire based survey has been made to validate these practices and performance outcomes. 123 complete questionnaires were collected from Indian automobile organizations and used for empirical analysis of GSCM practices in Indian automobile industry. Descriptive statistics have been used to know current implementation status of GSCM practices in Indian automobile industry and multiple regression analysis has been carried out to know the impact on expected organizational performance outcomes by current GSCM practices adopted by Indian automobile industry. The results of study suggested that environmental, economic, social and operational performances improve with the implementation of GSCM practices. This paper may play an important role to understand various GSCM implementation issues and help practicing managers to improve their performances in the supply chain.

Physicists' views on hadrontherapy: a survey of members of the Italian Association of Medical Physics (AIFM).

PubMed

Giandini, Tommaso; Tenconi, Chiara; Carrara, Mauro; Ciocca, Mario; Russo, Stefania; Panaino, Costanza M V; Cattani, Federica; Ciardo, Delia; Morlino, Sara; Avuzzi, Barbara; Bedini, Nice; Villa, Sergio; Marvaso, Giulia; Romanelli, Paola; Hasegawa, Azusa; Vischioni, Barbara; Valvo, Francesca; Jereczek-Fossa, Barbara A; Orecchia, Roberto; Valdagni, Riccardo; Pignoli, Emanuele

2017-09-18

This study was based on a survey to investigate perceptions of hadrontherapy of the members of the Italian Association of Medical Physics (AIFM). The survey was digitally submitted to the 991 members between the end of January and the beginning of April 2016. A 19-item questionnaire was designed focusing on advantages and disadvantages of hadrontherapy, current status and possible future improvements, and need and opportunities for future investments in Italy and abroad. Information about professional qualifications, main fields of clinical involvement and specific competencies of the respondents was also collected. The survey was completed by 121 AIFM members (response rate 12.2%). In the answers collected, it was shown that medical physicists expressed interest in hadrontherapy mainly for reasons of personal interest rather than for professional needs (90% ± 2.5% vs. 52% ± 4.3% of the respondents, respectively), with a good knowledge of the related basic aspects as well as of the pros and cons of its application. However, poor knowledge of the current status of hadrontherapy was observed among the medical physicists not directly involved at a professional level, who were less than 3% of the physicists working in radiotherapy. In light of these results, the implementation of new training and education initiatives should be devised to promote a deeper and global knowledge of hadrontherapy-related issues, not only from a theoretical point of view but also in practical terms. Moreover, a close collaboration between highly specialized medical physicists employed in hadrontherapy centers and others in oncology hospitals should be -encouraged.

Changes in characteristics of veterans using the VHA health care system between 1996 and 1999

PubMed Central

Liu, Chuan-Fen; Maciejewski, Matthew L; Sales, Anne EB

2005-01-01

Background The Department of Veterans Affairs' Veterans Health Administration (VHA) provides a health care safety net to veterans. This study examined changes in characteristics of veterans using the VHA health care system between 1996 and 1999 when VHA implemented major organizational changes to improve access of ambulatory care and to provide care to more veterans. Methods The study used two cross-sectional samples of the Medical Expenditures Panel Survey (MEPS), a national representative survey, in 1996 and 1999. The 1996 MEPS survey included 1,944 veterans and the 1999 MEPS survey included 1,974 veterans. There were 534 veterans and 740 veterans who used VHA services in 1996 and 1999, respectively. Results The proportion of veterans using the VHA system increased from 12.4% in 1996 to 14.6% in 1999. In both years, veterans were more likely to use VHA care if they were older, male, less educated, uninsured, unemployed, and in fair or poor health status. Only two variables, marital status and income, were different between the two years. Married veterans were more likely to use VHA care in 1999, but not in 1996. Veterans with higher incomes had greater odds of using VHA care in 1996, but there was no significant association between income and VHA use in 1999. Conclusion Characteristics of VHA users did not fundamentally change despite the reorganization of VHA health care delivery system and changes in eligibility and enrollment policy. The VHA system maintains its safety net mission while attracting more veterans. PMID:15836789

Progress on water data integration and distribution: a summary of select U.S. Geological Survey data systems

USGS Publications Warehouse

Blodgett, David L.; Lucido, Jessica M.; Kreft, James M.

2016-01-01

Critical water-resources issues ranging from flood response to water scarcity make access to integrated water information, services, tools, and models essential. Since 1995 when the first water data web pages went online, the U.S. Geological Survey has been at the forefront of water data distribution and integration. Today, real-time and historical streamflow observations are available via web pages and a variety of web service interfaces. The Survey has built partnerships with Federal and State agencies to integrate hydrologic data providing continuous observations of surface and groundwater, temporally discrete water quality data, groundwater well logs, aquatic biology data, water availability and use information, and tools to help characterize the landscape for modeling. In this paper, we summarize the status and design patterns implemented for selected data systems. We describe how these systems contribute to a U.S. Federal Open Water Data Initiative and present some gaps and lessons learned that apply to global hydroinformatics data infrastructure.

[Knowledge and attitudes toward smoke-free law among smoking and non-smoking medical students].

PubMed

Zielińska-Danch, Wioleta; Goniewicz, Maciej Ł; Koszowski, Bartosz; Leszczyńska, Joanna; Czogała, Jan; Szołtysek-Bołdys, Izabela; Antosiewicz, Beata; Sobczak, Andrzej

2010-01-01

Tobacco smoking is common among various social groups. There is still high prevalence of smoking among health care professionals. The aim of the study was to assess knowledge about smoke-free law in public places in Poland among smoking and nonsmoking students of selected medical university. We surveyed 50 students of one medical university aged 23 +/- 2 years. Control group consisted with 61 students of other universities located in the same region aged 23 +/- 3 years. We developed a new survey to assess students knowledge about smoke-free regulations and their implementations in various public places. Smoking status was verified with exhaled carbon monoxide levels (COex). 57% off all surveyed students declared being familiar with smoke-free law. However, we detected a significant difference between the knowledge of medical vs. nonmedical students (76% vs. 41%, p < 0.05). The knowledge about smoke-free law in Poland among students is not sufficient, especially among nonmedical students.

Health disparities among wage workers driven by employment instability in the Republic of Korea.

PubMed

Jung, Minsoo

2013-01-01

Even though labor market flexibility continues to be a source of grave concern in terms of employment instability, as evidenced by temporary employment, only a few longitudinal studies have examined the effects of employment instability on the health status of wage workers. Against this backdrop, this study assesses the manner in which changes in employment type affect the health status of wage workers. The data originate from the Korean Labor and Income Panel Study's health-related surveys for the first through fourth years (n = 1,789; 1998 to 2001). This study estimates potential damage to self-rated health through the application of a generalized estimating equation, according to specific levels of employment instability. While controlling for age, socioeconomic position, marital status, health behavior, and access to health care, the study analysis confirms that changes in employment type exert significant and adverse effects on health status for a given year (OR = 1.47; 95% CII 1.10-1.96), to an extent comparable to the marked effects of smoking on human health (OR = 1.47; 95% CI 1.05-2.04). Given the global prevalence of labor flexibility, policy interventions must be implemented if employment instability triggers broad discrepancies not only in social standing, wage, and welfare benefits, but also in health status.

Identifying misclassification in youth self-reported smoking status: testing different consent processes of biological sample collection to capture misclassification.

PubMed

Dietz, Noella A; Arheart, Kristopher L; Lee, David J; Sly, David F; McClure, Laura A

2015-04-01

In Florida, since 1998, identical survey items have been used to measure youth smoking status for the CDC sponsored state school-based survey and the tobacco control program evaluation telephone survey. The two surveys should parallel one another to track tobacco use. Tobacco items collected in the two surveys closely paralleled one another until recently. Since 2008, data show dramatically divergent youth smoking estimates (e.g., relative differences as high as 50%), which cannot be explained by differences in survey and sampling design. As a first step in detecting misclassification of smoking status, we examined the feasibility of asking youth to self-report their smoking behavior and collect a biological sample, with the expectation that some youth will misreport their smoking status. Using a cross-sectional population level telephone survey, youth were randomly assigned to one of three groups to test mode effects of collecting biological data with self-reported survey data (n = 303). It showed two groups of youth (those who are not asked for a biological and those asked for a biological with an indirect explanation of its use) had similar response rates and self-reported smoking status, while the third group (biological request with a direct explanation of its use) had a substantially lower response rate and self-reported smoking status. The data show youth who are given an indirect explanation of how biological data are to be used were as likely to self-report their smoking status as youth who were not asked to provide a biological sample. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Occupational stress perception and its potential impact on work ability.

PubMed

Yong, Mei; Nasterlack, Michael; Pluto, Rolf-Peter; Lang, Stefan; Oberlinner, Christoph

2013-01-01

To examine perceived stress across employees with different occupational status, to investigate the impact of stress on work ability and to derive conclusions regarding health promotion activities. A comprehensive survey combining questionnaire and medical examination was offered in one division in BASF Ludwigshafen. Among 867 voluntary participants, 653 returned complete questionnaires. The questions were directed at perception of safety at the workplace, self-rated health status, frequency of stress symptoms, unrealistic job demands, time pressure and maladjustment of work life balance. The outcome of interest was self-estimated health measured by the Work Ability Index (WAI). Occupational stressors were perceived differently across occupational status groups. Frontline operators had more health concerns due to workplace conditions, while professional and managerial staff reported higher frequencies of perceived tension, time pressure, and maladjustment of work life balance. After adjustment for occupational status, demographic and lifestyle factors, perceived stress was associated with a modest to strong decline in WAI scores. While perceived occupational stress had an apparent impact on WAI, and WAI has been demonstrated to be predictive of early retirement, more intensive and employee group-specific stress management interventions are being implemented beyond traditional strategies of routine occupational medical surveillance.

A descriptive study of California hospice providers' perceptions of public reporting of quality data using the Family Evaluation of Hospice Care Survey.

PubMed

Nelson, Marsha; Gale, Randall C; Naierman, Naomi; DeViney, Meredith

2014-06-01

The Affordable Care Act requires US hospices to report quality data to the Centers for Medicare and Medicaid Services (CMS) in 2013 with data eventually being made public. There may be some benefit to participating in a voluntary public-reporting program prior to public disclosure by CMS; therefore, we developed and conducted an electronic survey exploring California hospices' perceptions of public reporting. The majority (78.1%) of respondents reported current use of the Family Evaluation of Hospice Care tool and a willingness to consider voluntary participation in a public-reporting program outside of what is being implemented by CMS (58.6%). Tax status of responding hospices was not predictive of a willingness to participate in a statewide public-reporting program of hospice quality in our study.

National Water-Quality Assessment Program - Red River of the North

USGS Publications Warehouse

Stoner, J.D.

1991-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources, and to provide a sound scientific understanding of the primary natural and human factors affecting the quality of these resources. The program will produce a wealth of water-quality information that will be useful to policy makers and managers at the national, State, and local levels.

Canadian oncology nurse work environments: part II.

PubMed

Bakker, Debra; Conlon, Michael; Fitch, Margaret; Green, Esther; Butler, Lorna; Olson, Karin; Cummings, Greta

2012-03-01

In the aftermath of healthcare restructuring, it is important to pay attention to nurses' perceptions of workplace and professional practice factors that attract nurses and influence their retention. Continuing constraints on cancer care systems make the issue of health human resources an ongoing priority. This paper presents the findings of a follow-up study of a cohort of Canadian oncology nurses that aimed to compare nurses' perceptions of their work environment, job satisfaction and retention over a two-year period. Participants of the follow-up survey represented 65% (397/615) of the initial cohort. Many similar perceptions about the work environment were found over two years; however, at follow-up a larger proportion of nurses reported an absence of enough RNs to provide quality care and a lack of support for innovative ideas. With respect to career status, only 6% (25/397) of the follow-up sample had left oncology nursing. However, the proportion of nurses declaring an intention to leave their current job increased from 6.4% (39/615) on the initial survey to 26% (102/397) on the follow-up survey. Findings suggest that decision-makers need to use both the growing body of workplace knowledge and the input from staff nurses to implement changes that positively influence nurse recruitment and retention. Future research should focus on the implementation and evaluation of strategies that address workplace issues such as nurse staffing adequacy, leadership and organizational commitment.

A survey of palliative medicine education in Japan's undergraduate medical curriculum.

PubMed

Nakamura, Yoichi; Takamiya, Yusuke; Saito, Mari; Kuroko, Koichi; Shiratsuchi, Tatsuko; Oshima, Kenzaburo; Ito, Yuko; Miyake, Satoshi

2017-06-07

This study aimed to examine the status of undergraduate palliative care education among Japanese medical students using data from a survey conducted in 2015. A questionnaire was originally developed, and the survey forms were sent to universities. The study's objectives, methods, disclosure of results, and anonymity were explained to participating universities in writing. Responses returned by the universities were considered to indicate consent to participate. Descriptive statistical methodology was employed. The response rate was 82.5% (66 of 80 medical faculties and colleges). Palliative care lectures were implemented in 98.5% of the institutions. Regarding lecture titles, "palliative medicine," "palliative care," and "terminal care" accounted for 42.4, 30.3, and 9.1% of the lectures, respectively. Teachers from the Department of Anesthesia, Palliative Care, and Psychiatry administered 51.5, 47.0, and 28.8% of lectures, respectively. Subjects of lectures included general palliative care (81.8%), pain management (87.9%), and symptom management (63.6%). Clinical clerkship on palliative care was a compulsory and non-compulsory course in 43.9 and 25.8% of the schools, respectively; 30.3% had no clinical clerkship curriculum. Undergraduate palliative care education is implemented in many Japanese universities. Clinical clerkship combined with participation in actual medical practice should be further improved by establishing a medical education certification system in compliance with the international standards.

NPDES CAFO Regulations Implementation Status Reports

EPA Pesticide Factsheets

EPA compiles annual summaries on the implementation status of the NPDES CAFO regulations. Reports include, for each state: total number of CAFOs, number and percentage of CAFOs with NPDES permits, and other information associated with implementation of the

EFFECT OF HIV PREVENTION AND TREATMENT PROGRAM ON HIV AND HCV TRANSMISSION AND HIV MORTALITY AT AN INDONESIAN NARCOTIC PRISON.

PubMed

Nelwan, Erni J; Indrati, Agnes K; Isa, Ahmad; Triani, Nurlita; Alam, Nisaa Nur; Herlan, Maria S; Husen, Wahid; Pohan, Herdiman T; Alisjahbana, Bachti; Meheus, Andre; Van Crevel, Reinout; van der Ven, Andre Jam

2015-09-01

Validated data regarding HIV-transmission in prisons in developing countries is scarce. We examined sexual and injecting drug use behavior and HIV and HCV transmission in an Indonesian narcotic prison during the implementation of an HIV prevention and treatment program during 2004-2007 when the Banceuy Narcotic Prison in Indonesia conducted an HIV transmission prevention program to provide 1) HIV education, 2) voluntary HIV testing and counseling, 3) condom supply, 4) prevention of rape and sexual violence, 5) antiretroviral treatment for HIV-positive prisoners and 6) methadone maintenance treatment. During a first survey that was conducted between 2007 and 2009, new prisoners entered Banceuy Narcotics Prison were voluntary tested for HIV and HCV-infection after written informed consent was obtained. Information regarding sexual and injecting risk behavior and physical status were also recorded at admission to the prison. Participants who tested negative for both HIV and HCV during the first survey were included in a second survey conducted during 2008-2011. During both surveys, data on mortality among HIV-seropositive patients were also recorded. All HIV-seropositive participants receive treatment for HIV. HIV/ AIDS-related deaths decreased: 43% in 2006, 18% in 2007, 9% in 2008 and 0% in 2009. No HIV and HCV seroconversion inside Banceuy Narcotic Prison were found after a median of 23 months imprisonment (maximum follow-up: 38 months). Total of 484.8 person-years observation was done. Participants reported HIV transmission risk-behavior in Banceuy Prison during the second survey was low. After implementation of HIV prevention and treatment program, no new HIV or HCV cases were detected and HIV-related mortality decreased.

Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, DMS Industry Survey

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

Singh, Ravindra; Uluski, Robert; Reilly, James T.

The objective of this survey is to benchmark current practices for DMS implementation to serve as a guide for future system implementations. The survey sought information on current plans to implement DMS, DMS functions of interest, implementation challenges, functional benefits achieved, and other relevant information. These survey results were combined (where possible) with results of similar surveys conducted in the previous four years to observe trends over time.

In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon.

PubMed

Heintzman, John; Bailey, Steffani R; DeVoe, Jennifer; Cowburn, Stuart; Kapka, Tanya; Duong, Truc-Vi; Marino, Miguel

2017-06-01

Early survey evidence suggests a reduction of disparities in insurance coverage between Latinos and non-Hispanic Whites post-Affordable Care Act (ACA). These findings may not describe the insurance status of vulnerable, low-income Latino populations served in community health centers (CHCs) over the course of this policy change. Cross-sectional surveys also may be of limited use in describing longitudinal phenomena such as changes in health insurance status. Using electronic health record (EHR) data, we compared the insurance status of N = 42,392 low-income patients served in 23 CHCs in Oregon, by race/ethnicity and language, over a period of 6 years straddling the implementation of ACA-related Medicaid expansion on January 1, 2014. Prior to 2014, Spanish-preferring Latinos were more likely to be uninsured than English-preferring Latinos and non-Hispanic Whites. Among uninsured patients who returned for at least one visit in 2014, Spanish-preferring Latinos had the largest increase in insurance coverage rates, and all three racial/ethnic/language groups had similar rates of insurance coverage. There were no racial/ethnic/language differences between those who did and did not have visit in 2014. Among previously uninsured low-income patients returning to Oregon CHCs, insurance disparities were eliminated after Medicaid expansion, especially in Spanish-speaking Latinos. Further study is needed to understand the elimination of insurance disparities in this cohort.

In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon

PubMed Central

Bailey, Steffani R.; DeVoe, Jennifer; Cowburn, Stuart; Kapka, Tanya; Duong, Truc-Vi; Marino, Miguel

2016-01-01

Background Early survey evidence suggests a reduction of disparities in insurance coverage between Latinos and non-Hispanic Whites post-Affordable Care Act (ACA). These findings may not describe the insurance status of vulnerable, low-income Latino populations served in community health centers (CHCs) over the course of this policy change. Cross-sectional surveys also may be of limited use in describing longitudinal phenomena such as changes in health insurance status. Methods Using electronic health record (EHR) data, we compared the insurance status of N = 42,392 low-income patients served in 23 CHCs in Oregon, by race/ethnicity and language, over a period of 6 years straddling the implementation of ACA-related Medicaid expansion on January 1, 2014. Findings Prior to 2014, Spanish-preferring Latinos were more likely to be uninsured than English-preferring Latinos and non-Hispanic Whites. Among uninsured patients who returned for at least one visit in 2014, Spanish-preferring Latinos had the largest increase in insurance coverage rates, and all three racial/ethnic/language groups had similar rates of insurance coverage. There were no racial/ethnic/language differences between those who did and did not have visit in 2014. Conclusion Among previously uninsured low-income patients returning to Oregon CHCs, insurance disparities were eliminated after Medicaid expansion, especially in Spanish-speaking Latinos. Further study is needed to understand the elimination of insurance disparities in this cohort. PMID:27105630

Northern goshawk monitoring in the western Great Lakes bioregion

USGS Publications Warehouse

Bruggeman, Jason E.; Andersen, David E.; Woodford, James E.

2011-01-01

Uncertainties about factors affecting Northern Goshawk (Accipiter gentilis) ecology and the status of populations have added to the challenge of managing this species. To address data needs for determining the status of goshawk populations, Hargis and Woodbridge (2006) developed a bioregional monitoring protocol based on estimating occupancy. The goal of our study was to implement this protocol and collect data to determine goshawk population status in the western Great Lakes (WGL) bioregion, which encompasses portions of Minnesota, Wisconsin, and Michigan, and is a mixture of private and public property. We used 366 goshawk nest locations obtained between 1979 and 2006 throughout the WGL bioregion to develop a model of landscape use consisting of forest canopy cover and land-cover covariates. We then used the model to develop a stratified sampling design for selecting 600-ha Primary Sampling Units (PSUs) to survey for goshawks. Project collaborators surveyed 86 PSUs for goshawk presence using broadcasted calls twice between mid-May and mid-August 2008, and recorded 30 goshawk detections in 21 different PSUs. Seventy-four percent of detections occurred at call stations with canopy closure >75%. Goshawk detection probabilities were 0.549 ± 0.118 (standard error) for the first visit to PSUs and 0.750 ± 0.126 for the second visit. We estimated the proportion of PSUs occupied by goshawks as 0.266 ± 0.047, which corresponded to 5184 ± 914 PSUs occupied by goshawks in our study area and suggested that goshawks are widely, but sparsely, distributed throughout the WGL bioregion.

Maternal employment and the health of low-income young children.

PubMed

Gennetian, Lisa A; Hill, Heather D; London, Andrew S; Lopoo, Leonard M

2010-05-01

This study examines whether maternal employment affects the health status of low-income, elementary-school-aged children using instrumental variables estimation and experimental data from a welfare-to-work program implemented in the early 1990s. Maternal report of child health status is predicted as a function of exogenous variation in maternal employment associated with random assignment to the experimental group. IV estimates show a modest adverse effect of maternal employment on children's health. Making use of data from another welfare-to-work program we propose that any adverse effect on child health may be tempered by increased family income and access to public health insurance coverage, findings with direct relevance to a number of current policy discussions. In a secondary analysis using fixed effects techniques on longitudinal survey data collected in 1998 and 2001, we find a comparable adverse effect of maternal employment on child health that supports the external validity of our primary result.

Simulations of Observations with the Far-Infrared Surveyor: Design Overview and Current Status

NASA Astrophysics Data System (ADS)

Jeong, W.; Pak, S.; Lee, H. M.; Kim, S.; Matsuura, M.; Nakagawa, T.; Yamamura, I.; Murakami, H.; Matsuura, S.; Kawada, M.; Kaneda, H.; Shibai, H.

2000-12-01

The Far-Infrared Surveyor (FIS) is one of the on-board instruments on the ASTRO-F satellite, which will be launched in early 2004. The first a half year of its mission period of 500 days is dedicated to an all sky survey in four bands between 50 and 200 micron. On the basis of the present hardware specifications and configurations of the FIS, we have written a computer program to simulate the FIS. The program can be used to evaluate the performance of the instrument as well as to produce input for the data reduction system. In this paper, we describe the current status of the program. As an example of the usage of the simulation program, we present the expected observing data for three different detector sampling rates. The functions which should be implemented into the program, in the future, are enumerated.

Mandatory universal drug plan, access to health care and health: Evidence from Canada.

PubMed

Wang, Chao; Li, Qing; Sweetman, Arthur; Hurley, Jeremiah

2015-12-01

This paper examines the impacts of a mandatory, universal prescription drug insurance program on health care utilization and health outcomes in a public health care system with free physician and hospital services. Using the Canadian National Population Health Survey from 1994 to 2003 and implementing a difference-in-differences estimation strategy, we find that the mandatory program substantially increased drug coverage among the general population. The program also increased medication use and general practitioner visits but had little effect on specialist visits and hospitalization. Findings from quantile regressions suggest that there was a large improvement in the health status of less healthy individuals. Further analysis by pre-policy drug insurance status and the presence of chronic conditions reveals a marked increase in the probability of taking medication and visiting a general practitioner among the previously uninsured and those with a chronic condition. Copyright © 2015 Elsevier B.V. All rights reserved.

Health promotion interventions in social economy companies in Flanders (Belgium).

PubMed

Hublet, Anne; Maes, Lea; Mommen, Jasmine; Deforche, Benedicte; De Bourdeaudhuij, Ilse

2016-01-05

Disadvantaged groups are often not reached by mainstream health promotion interventions. Implementing health promotion (HP) interventions in social economy companies, can be an opportunity to reach those people. The implementation of these interventions in social economy companies was studied. Factors that could be related to the implementation of HP and being supportive towards implementation in the future, were investigated. An online, quantitative survey was sent to all 148 sheltered and social workshops in Flanders. In the questionnaire, the status of HP interventions and characteristics of the workshop were explored. Personal factors (such as attitudes towards HP, behavioural control, social norms and moral responsibility) were asked to the person responsible for implementation of HP interventions. Univariate and multivariate logistic regressions were performed. Respondents of 88 workshops completed the questionnaire. Almost 60% of the workshops implemented environmental or policy interventions. Having a positive attitude towards HP, being more morally responsible, and having the subjective norm that employees are positive towards health promotion at work, were related to being more supportive towards the implementation of HP in the univariate analyses. Only attitude stayed significantly related to being more supportive towards the implementation of HP in the multivariate analyses. Sheltered and social workshops are open to HP interventions, but more can be done to optimize the implementation. To persuade persons responsible for the implementation of HP to invest more in HP, changing attitudes concerning the benefits of health promotion for the employee and the company, is an important strategy.

Relationships among Subjective Social Status, Weight Perception, Weight Control Behaviors, and Weight Status in Adolescents: Findings from the 2009 Korea Youth Risk Behaviors Web-Based Survey

ERIC Educational Resources Information Center

Ha, Yeongmi; Choi, Eunsook; Seo, Yeongmi; Kim, Tae-gu

2013-01-01

Background: This study identified relationships among subjective social status (SSS), weight perception, weight control behaviors, and weight status in Korean adolescents using nationally representative data collected from the 2009 Korea Youth Risk Behaviors Web-Based Survey. Methods: Data from 67,185 students aged 12-18 years were analyzed.…

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania.

PubMed

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki G M; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-12-30

A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey.

Variations in Oncologist Recommendations for Chemotherapy for Stage IV Lung Cancer: What Is the Role of Performance Status?

PubMed

Tisnado, Diana; Malin, Jennifer; Kahn, Katherine; Landrum, Mary Beth; Fletcher, Robert; Klabunde, Carrie; Clauser, Steven; Rogers, Selwyn O; Keating, Nancy L

2016-07-01

Chemotherapy prolongs survival in patients with advanced non-small-cell lung cancer. However, few studies have included patients with poor performance status. This study examined rates of oncologists' recommendations for chemotherapy by patient performance status and symptoms and how physician characteristics influence chemotherapy recommendations. We surveyed medical oncologists involved in the care of a population-based cohort of patients with lung cancer from the CanCORS (Cancer Care Outcomes Research and Surveillance) study. Physicians were queried about their likelihood to recommend chemotherapy to patients with stage IV lung cancer with varying performance status (Eastern Cooperative Oncology Group performance status 0 [good] v 3 [poor]) and presence or absence of tumor-related pain. Repeated measures logistic regression was used to estimate the independent associations of patients' performance status and symptoms and physicians' demographic and practice characteristics with chemotherapy recommendations. Nearly all physicians (adjusted rate, 97% to 99%) recommended chemotherapy for patients with good performance status, and approximately half (adjusted rate, 38% to 53%) recommended chemotherapy for patients with poor performance status (P < .001). Compared with patient factors, physician and practice characteristics were less strongly associated with chemotherapy recommendations in adjusted analyses. Strong consensus among oncologists exists for chemotherapy in patients with advanced non-small-cell lung cancer and good performance status. However, the relatively high rate of chemotherapy recommendations for patients with poor performance status despite the unfavorable risk-benefit profile highlights the need for ongoing work to define high-value care in oncology and to implement and evaluate strategies to align incentives for such care. Copyright © 2016 by American Society of Clinical Oncology.

The effect of prenatal education curriculum on mother's prenatal examination utilization, delivery mode and recovery status: a cross-sectional survey in China.

PubMed

Shi, Yuhui; Wang, Dongxu; Yuan, Yanfei; Jiang, Ying; Zeng, Qingqi; Chang, Chun

2015-11-01

To examine the participation, implementation, and effect of the prenatal education curriculum provided by hospitals in China, and to provide evidence for the improvement of prenatal education. A cross-sectional survey was conducted in the hospitals in Hunan Province, China. Mothers aged 20-45 years who had given birth between 1 May 2011 and 1 May 2012 and not diagnosed with pregnancy-related complications were invited to participate in the study. A self-administered, structured questionnaire was used to examine the effect of prenatal education curriculum on prenatal examination utilization, delivery mode, and recovery status from delivery. Among the total 604 respondents, only 175 (29.1 %) surveyed mothers participated in prenatal education curriculum provided by hospitals during their latest delivery. These mothers had a higher rate of attending all the required prenatal examinations (57.9 vs. 48.3 %), and a higher rate of recovering very well and well (80 vs. 73.7 %) from the latest delivery, than those who did not participate in prenatal education curriculum (P < 0.05). However, there was no statistical difference in the delivery mode between mothers who participated and those who did not participate in the prenatal education curriculum provided by hospitals. Prenatal education is indispensable for the improvement of maternal and child health, and thus should be advocated. In China, a standard and convenient specification prenatal education curriculum provided by hospitals and their doctors is appropriated for providing prenatal education to pregnant women.

Population trajectory of burrowing owls (Athene cunicularia) in eastern Washington

USGS Publications Warehouse

Conway, C.J.; Pardieck, K.L.

2006-01-01

Anecdotal evidence suggests that burrowing owls have declined in Washington. The Washington Department of Fish and Wildlife is currently conducting a status review for burrowing owls which will help determine whether they should be listed as threatened or endangered in the state. To provide insights into the current status of burrowing owls (Athene cunicularia), we analyzed data from the North American Breeding Bird Survey using two analytical approaches to determine their current population trajectory in eastern Washington. We used a one-sample t-test to examine whether trend estimates across all BBS routes in Washington differed from zero. We also used a mixed model analysis to estimate the rate of decline in number of burrowing owls detected between 1968 and 2005. The slope in number of burrowing owls detected was negative for 12 of the 16 BBS routes in Washington that have detected burrowing owls. Numbers of breeding burrowing owls detected in eastern Washington declined at a rate of 1.5% annually. We suggest that all BBS routes that have detected burrowing owls in past years in eastern Washington be surveyed annually and additional surveys conducted to track population trends of burrowing owls at finer spatial scales in eastern Washington. In the meantime, land management and regulatory agencies should ensure that publicly managed areas with breeding burrowing owls are not degraded and should implement education and outreach programs to promote protection of privately owned areas with breeding owls.

An Epidemiological Survey of the Suicide Incidence Trends in the Southwest Iran: 2004-2009

PubMed Central

Najafi, Farid; Hasanzadeh, Jafar; Moradinazar, Mehdi; Faramarzi, Hossain; Nematollahi, Alireza

2013-01-01

Background: Elimination of suicide attempts is impossible, but they can be reduced dramatically by an organized planning. The present study aimed to survey the suicide trends in Fars province (Iran), during 2004-2009 to better understand the prevalence and status of suicide. Methods: This survey was a cross-sectional study. The demographic data were collected from the civil status registry between 2004 and 2009. Suicide and suicide attempt data were collected of three sources including the affiliated hospitals of Shiraz University of Medical Sciences, mortality data of Vice Chancellery of Health in Fars province and data from forensic medicine. Then, they were analyzed by Excel and SPSS. Chi-square and regression analyses were used for data analysis. Results: During the study, 10671 people attempted suicide, of which 5697 (53%) were women and 4974 (47%) were men. Among them, 1047 people (9.8%) died, of which 363 (34%) were women and 679 (64%) were men. There was a significant relationship between gender and fatal suicide. The mean suicide attempt for both genders was 53 per 100,000 and 49, 57 for men and women, respectively. The trends in the incidence of Suicidal attempts were decreasing. Conclusion: Without implementing effective preventive measures, the health care system in Iran will face a further burden of fatal suicides among young people. Therefore; enhancing the primary health care and specialized mental health services for those with unsuccessful suicide attempts can effectively reduce the burden of suicide. PMID:24596868

Bovine tuberculosis surveillance in cattle and free-ranging wildlife in EU Member States in 2013: a survey-based review.

PubMed

Rivière, J; Carabin, K; Le Strat, Y; Hendrikx, P; Dufour, B

2014-10-10

Bovine tuberculosis (TB) is a common disease in cattle and wildlife, with animal health, zoonotic and economic impacts. Most of the TB data for the European Union (EU) concern the epidemiological situation, but comprehensive descriptions of the way in which surveillance is conducted in each country are rare, despite being essential for cross-Europe comparisons. A European survey was conducted in the 28 Member States and in three other neighboring countries (Norway, Macedonia and Switzerland), to review TB surveillance in cattle and wildlife. EU legislation currently requires TB surveillance solely in cattle. Considerable differences between the surveillance systems of the 26 responding countries were observed, according to the official TB-freedom status of the country and the local prevalence of TB. These differences related principally to the combination of surveillance components (routine screening test in herd and/or movement testing and/or slaughterhouse surveillance), the tests used and their interpretation, and the definition of an infected herd or animal. For wildlife TB surveillance, only 8 on 21 respondent countries have declared to have implemented passive and/or active surveillance, with marked differences concerning the species and the geographical scale of the surveillance. The choice of the combination of surveillance components depends on the national or regional epidemiological situation, the species involved in TB epidemiology and epidemiological risk factors, although various surveillance systems have been recorded for countries with similar epidemiological status. Assessments of the cost-effectiveness of each surveillance system would be useful, to confirm the advantages of implementing one or more components. Copyright © 2014 Elsevier B.V. All rights reserved.

Principles on Radiological Characterization of the Unit 1 at Ignalina NPP for Decommissioning Purposes

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

Poskas, P.; Zujus, R.; Drumstas, G.

There is only one nuclear power plant in Lithuania - Ignalina NPP (INPP). The INPP operated two similar units with installed capacity of 1500 MW(each). They were commissioned in 12/1983 and 08/1987, and the original design lifetime was projected out to 2010 and 2015 respectively. But the first Unit of Ignalina NPP was shutdown December 31, 2004, and second Unit will be closed down before 2010 taking into consideration substantial long-term financial assistance from the EU, G7 and other states as well as international institutions. Implementation of dismantling activities requires detailed knowledge of the radiological situation at the Unit 1.more » General Programme of Radiological Survey for Ignalina NPP Unit 1 based on NUREG-1575 was prepared in 2005- 2006 by Consortium led by Lithuanian Energy Institute and approved by Regulatory Bodies. It includes such main steps as historical site assessment, scoping, characterization, remedial actions/decontamination support surveys and final status surveys. General Programme of Radiological Survey defines content and principles of the surveys, and preliminary survey considerations, including identification of the contaminants, establishment of the free release levels, principles on areas classification depending on contamination potential, identification of the final survey units, criteria for selection survey instrumentation, techniques and methods etc. So, in the paper information on these principles and the content of the different stages in General Programme of Radiological Survey is presented. (authors)« less

The importance of assessing self-reported HIV status in bio-behavioural surveys.

PubMed

Johnston, Lisa G; Sabin, Miriam Lewis; Prybylski, Dimitri; Sabin, Keith; McFarland, Willi; Baral, Stefan; Kim, Andrea A; Raymond, H Fisher

2016-08-01

In bio-behavioural surveys measuring prevalence of infection with human immunodeficiency virus (HIV), respondents should be asked the results of their last HIV test. However, many government authorities, nongovernmental organizations, researchers and other civil society stakeholders have stated that respondents involved in such surveys should not be asked to self-report their HIV status. The reasons offered for not asking respondents to report their status are that responses may be inaccurate and that asking about HIV status may violate the respondents' human rights and exacerbate stigma and discrimination. Nevertheless, we contend that, in the antiretroviral therapy era, asking respondents in bio-behavioural surveys to self-report their HIV status is essential for measuring and improving access to - and coverage of - services for the care, treatment and prevention of HIV infection. It is also important for estimating the true size of the unmet needs in addressing the HIV epidemic and for interpreting the behaviours associated with the acquisition and transmission of HIV infection correctly. The data available indicate that most participants in health-related surveys are willing to respond to a question about HIV status - as one of possibly several sensitive questions about sexual and drug use behaviours. Ultimately, normalizing the self-reporting of HIV status could help the global community move from an era of so-called exceptionalism to one of destigmatization - and so improve the epidemic response worldwide.

TRIAD II: do living wills have an impact on pre-hospital lifesaving care?

PubMed

Mirarchi, Ferdinando L; Kalantzis, Stella; Hunter, Daniel; McCracken, Emily; Kisiel, Theresa

2009-02-01

Living wills accompany patients who present for emergent care. To the best of our knowledge, no studies assess pre-hospital provider interpretations of these instructions. Determine how a living will is interpreted and assess how interpretation impacts lifesaving care. Three-part survey administered at a regional emergency medical system educational symposium to 150 emergency medical technicians (EMTs) and paramedics. Part I assessed understanding of the living will and do-not-resuscitate (DNR) orders. Part II assessed the living will's impact in clinical situations of patients requiring lifesaving interventions. Part III was similar to part II except a code status designation (full code) was incorporated into the living will. There were 127 surveys completed, yielding an 87% response rate. The majority were male (55%) and EMTs (74%). The average age was 44 years and the average duration of employment was 15 years. Ninety percent (95% confidence interval [CI] 84.6-95.4%) of respondents determined that, after review of the living will, the patient's code status was DNR, and 92% (95% CI 86.5-96.6%) defined their understanding of DNR as comfort care/end-of-life care. When the living will was applied to clinical situations, it resulted in a higher proportion of patients being classified as DNR as opposed to full code (Case A 78% [95% CI 71.2-85.6%] vs. 22% [95% CI 14.4-28.8%], respectively; Case B 67% [95% CI 58.4-74.9%] vs. 33% [95% CI 25.1-1.6%], respectively; Case C 63% [95% CI 55.1-71.9%] vs. 37% [95% CI 28.1-44.9%]), respectively. With the scenarios presented, this DNR classification resulted in a lack of or a delay in lifesaving interventions. Incorporating a code status into the living will produced statistically significant increases in the provision of lifesaving care. In Case A, intubation increased from 15% to 56% (p < 0.0001); Case B, defibrillation increased from 40% to 59% (p < 0.0001); and Case C, defibrillation increased from 36% to 65% (p < 0.0001). Significant confusion and concern for patient safety exists in the pre-hospital setting due to the understanding and implementation of living wills and DNR orders. This confusion can be corrected by implementing clearly defined code status into the living will.

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

75 FR 78676 - Proposed Information Collection; Comment Request; Current Population Survey (CPS) Basic...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... age, marital status, gender, Armed Forces status, education, race, origin, and family income. We use... sponsor the basic monthly survey. The Census Bureau also prepares and conducts all the field work. At the.... Some of the information within that portion includes employment status, number of hours worked, job...

78 FR 77646 - Proposed Information Collection; Comment Request; Current Population Survey (CPS) Basic...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-24

... age, marital status, gender, Armed Forces status, education, race, origin, and family income. We use... sponsor the basic monthly survey. The Census Bureau also prepares and conducts all the field work. At the.... Some of the information within that portion includes employment status, number of hours worked, job...

A fish survey of the White River, Nevada

USGS Publications Warehouse

Scoppettone, G. Gary; Rissler, Peter H.; Shea, Sean

2004-01-01

In spring and summer 1991 and 1992, we surveyed fishes of the White River system, Nye and White Pine Counties, Nevada, to determine the status of natives. There are 5 known native fishes to the White River: Lepidomeda albivallis (White River spinedace), Crenichthys baileyi albivallis (Preston White River springfish), Crenichthys baileyi thermophilus (Moorman White River springfish), Catostomus clarki intermedius (White River desert sucker), and Rhinichthys osculus ssp. (White River speckled dace). All 5 had declined in range. Lepidomeda albivallis had experienced the greatest decline, with less than 50 remaining, and these were restricted to a 70-m stream reach. Rhinichthys osculus spp. was most widespread, found in 18 spring systems. Cottus bairdi (mottled sculpin) was collected for the 1st time from the White River system, where it was probably native. Protective measures should be implemented to conserve all native White River fishes to include C. bairdi.

Antimicrobial Resistance Control Strategies: A Coordinated Research Initiative Experience in the Asia Pacific Region.

PubMed

Lapierre, Lisette; Asenjo, Gabriela; Vergara, Constanza; Cornejo, Javiera

2017-05-01

The objective was to gather information on the status of antimicrobial surveillance in the Asia Pacific region and suggest control strategies. Twenty-one economies of the Asia Pacific region participated in this initiative. A survey was conducted on antimicrobial use and surveillance throughout the region. A workshop was carried out to create awareness about the issue and discuss the implementation of control strategies. Based on the survey results and workshop conclusions, it can be established that there is better understanding of the implications of antimicrobial resistance in the human medicine area. Only few economies take actions to control antimicrobial resistance on a veterinary/agricultural level. To confront antimicrobial resistance, it is critical to raise awareness; cooperation between all countries is needed to apply international standards, to be able to have harmonized public policies. Countries must align and improve their systems for surveillance and monitoring of antimicrobial resistance in human, animals, and the environment.

Clinician Perspectives on Challenges to Patient Centered Care at the End of Life.

PubMed

Bardach, Shoshana H; Dunn, Edward J; Stein, J Christopher

2017-04-01

Discussions regarding patient preferences for resuscitation are often delayed and preferences may be neglected, leading to the receipt of unwanted medical care. To better understand barriers to the expression and realization of patients' end of life wishes, a preventive ethics team in one Veterans Affairs Medical Center conducted a survey of physicians, nurses, social workers, and respiratory therapists. Surveys were analyzed through qualitative analysis, using sorting methodologies to identify themes. Analysis revealed barriers to patient wishes being identified and followed, including discomfort conducting end-of-life discussions, difficulty locating patients' preferences in medical records, challenges with expiring do not resuscitate (DNR) orders, and confusion over terminology. Based on these findings, the preventive ethics team proposed new terminology for code status preferences, elimination of the local policy for expiration of DNR orders, and enhanced systems for storing and retrieving patients' end-of-life preferences. Educational efforts were initiated to facilitate implementation of the proposed changes.

Willingness to Pay for Home-Based Rehabilitation Service Among Older Adults.

PubMed

Li, Xuemei; Wan, Xia; Pang, Yajuan; Zhou, Lanshu

2018-06-18

This study aims to investigate the willingness to pay (WTP) for a home-based rehabilitation service and explore the influencing factors of WTP among older adults in Shanghai, China. A cross-sectional design was used. A questionnaire survey based on the contingent valuation method was conducted by face-to-face survey over 3 months. Only 242 (44%) participants were willing to pay for a home-based rehabilitation service. The median amount they were willing to pay was RMB 8 (US$1.15) per visit. Older adults who had higher monthly income, had at least one partner who worked, and had medical insurance were willing to pay more for the service. Older adults showed low WTP for a home-based rehabilitation service. Economic status and health condition are the significant influencing factors of WTP. Studies on recipients' precise needs and ability to pay are required before home-based services are implemented.

A Status Report on Hunger and Homelessness in America's Cities: 1990. A 30-City Survey.

ERIC Educational Resources Information Center

Waxman, Laura DeKoven; Reyes, Lilia M.

To assess the status of hunger and homelessness in urban America during 1990, the U.S. Conference of Mayors surveyed the 30 major cities whose mayors are members of its Task Force on Hunger and Homelessness. This report summarizes survey findings. The survey sought information from each city on the following questions: (1) the demand for emergency…

Use of dental clinics and oral hygiene practices in the Kingdom of Saudi Arabia, 2013.

PubMed

El Bcheraoui, Charbel; Tuffaha, Marwa; Daoud, Farah; Kravitz, Hannah; AlMazroa, Mohammad A; Al Saeedi, Mohammad; Memish, Ziad A; Basulaiman, Mohammed; Al Rabeeah, Abdullah A; Mokdad, Ali H

2016-04-01

We conducted a large household survey in 2013 to determine the current status of oral health practices and use of oral health services in the Kingdom of Saudi Arabia (KSA). The Saudi Health Information Survey is a national multistage survey of individuals ≥ 15 years of age. We used a backward elimination multivariate logistic regression model to measure the association between having been to a dental clinic during the last year, and sex, age, marital status, education, time since last routine medical examination, history of diagnosis with a cardiovascular chronic condition, brushing or flossing teeth and use of Miswak (a chewing stick). Between April and June 2013, 10,735 participants completed the survey (89.4% of the households contacted). An estimated 1.5 million (11.5%) and 6.3 million (48.6%) Saudi Arabian people, ≥ 15 years of age, had visited a dental clinic for a routine check-up and for a complaint during the last year, respectively. In total, 16.3%, 85.0% and 52% of Saudi Arabian people never brush their teeth, never floss their teeth or never use Miswak, respectively. The probability of visiting a dental clinic increased with education, among individuals who brushed or flossed their teeth and who used Miswak. Oral hygiene practices are not common among Saudi Arabian people, and use of health care for prevention of oral disease is limited. Hence, the need for oral health promotion is pressing. The KSA Ministry of Health should develop and implement programmes, through its primary health clinics, to increase the awareness of the importance of good oral health. © 2016 The Authors. International Dental Journal published by John Wiley & Sons Ltd on behalf of World Dental Federation.

Population status of chimpanzees in the Masito-Ugalla Ecosystem, Tanzania.

PubMed

Piel, Alex K; Cohen, Naomi; Kamenya, Shadrack; Ndimuligo, Sood A; Pintea, Lilian; Stewart, Fiona A

2015-10-01

More than 75 percent of Tanzania's chimpanzees live at low densities on land outside national parks. Chimpanzees are one of the key conservation targets in the region and long-term monitoring of these populations is essential for assessing the overall status of ecosystem health and the success of implemented conservation strategies. We aimed to assess change in chimpanzee density within the Masito-Ugalla Ecosystem (MUE) by comparing results of re-walking the same line transects in 2007 and 2014. We further used published remote sensing data derived from Landsat satellites to assess forest cover change within a 5 km buffer of these transects over that same period. We detected no statistically significant decline in chimpanzee density across the surveyed areas of MUE between 2007 and 2014, although the overall mean density of chimpanzees declined from 0.09 individuals/km(2) in 2007 to 0.05 individuals/km(2) in 2014. Whether this change is biologically meaningful cannot be determined due to small sample sizes and large, entirely overlapping error margins. It is therefore possible that the MUE chimpanzee population has been stable over this period and indeed in some areas (Issa Valley, Mkanga, Kamkulu) even showed an increase in chimpanzee density. Variation in chimpanzee habitat preference for ranging or nesting could explain variation in density at some of the survey sites between 2007 and 2014. We also found a relationship between increasing habitat loss and lower mean chimpanzee density. Future surveys will need to ensure a larger sample size, broader geographic effort, and random survey design, to more precisely determine trends in MUE chimpanzee density and population size over time. © 2015 Wiley Periodicals, Inc.

Development of Mental Health Indicators in Korea

PubMed Central

Han, Hyeree; Ahn, Dong Hyun; Song, Jinhee; Hwang, Tae Yeon

2012-01-01

Objective Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation. PMID:23251193

Universal combination antiretroviral regimens to prevent mother-to-child transmission of HIV in rural Zambia: a two-round cross-sectional study

PubMed Central

Musonda, Patrick; Lembalemba, Mwila K; Chintu, Namwinga T; Gartland, Matthew G; Mulenga, Saziso N; Bweupe, Maximillian; Turnbull, Eleanor; Stringer, Elizabeth M; Stringer, Jeffrey SA

2014-01-01

Abstract Objective To evaluate if a pilot programme to prevent mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV) was associated with changes in early childhood survival at the population level in rural Zambia. Methods Combination antiretroviral regimens were offered to pregnant and breastfeeding, HIV-infected women, irrespective of immunological status, at four rural health facilities. Twenty-four-month HIV-free survival among children born to HIV-infected mothers was determined before and after PMTCT programme implementation using community surveys. Households were randomly selected and women who had given birth in the previous 24 months were asked to participate. Mothers were tested for HIV antibodies and children born to HIV-infected mothers were tested for viral deoxyribonucleic acid. Multivariable models were used to determine factors associated with child HIV infection or death. Findings In the first survey (2008–2009), 335 of 1778 women (18.8%) tested positive for HIV. In the second (2011), 390 of 2386 (16.3%) tested positive. The 24-month HIV-free survival in HIV-exposed children was 0.66 (95% confidence interval, CI: 0.63–0.76) in the first survey and 0.89 (95% CI: 0.83–0.94) in the second. Combination antiretroviral regimen use was associated with a lower risk of HIV infection or death in children (adjusted hazard ratio: 0.33, 95% CI: 0.15–0.73). Maternal knowledge of HIV status, use of HIV tests and use of combination regimens during pregnancy increased between the surveys. Conclusion The PMTCT programme was associated with an increased HIV-free survival in children born to HIV-infected mothers. Maternal utilization of HIV testing and treatment in the community also increased. PMID:25177073

Variations in Missed Care Across Oncology Nursing Specialty Units.

PubMed

Villamin, Colleen; Anderson, Jacqueline; Fellman, Bryan; Urbauer, Diana; Brassil, Kelly

2018-04-19

An opportunity was identified to compare perceptions of the occurrence and types of missed care at a comprehensive cancer center. The purpose was to evaluate the difference in perceived occurrence and types of missed care between medical, surgical, and hematologic oncology units in the context of a newly implemented patient care delivery system, Primary Team Nursing (PTN). A descriptive, repeated-measures design was used. The MISSCARE survey was distributed electronically to 580 staff members across 6 inpatient units. Frequently perceived elements of missed nursing care were ambulation, turning every 2 hours, and care conference attendance. At the time of study implementation, surgical units reported 0.24 higher scores than medical units (P = .017); hematology units reported 0.26 lower scores than surgical units (P = .005). PTN status did not affect MISSCARE scores (P = .525). Study findings suggest that perceived missed care in a comprehensive cancer center is similar to that in other hospital settings.

Fidelity of Implementation of a State Antibullying Policy With a Focus on Protected Social Classes.

PubMed

Hall, William J; Chapman, Mimi V

2018-01-01

Bullying threatens the mental and educational well-being of students. All states have enacted antibullying laws. This study surveyed 634 educators about the implementation of the North Carolina School Violence Prevention Act, which enumerated social classes protected from bullying: race, national origin, gender, socioeconomic status, sexual orientation, gender identity, appearance, and disability. Results showed that local antibullying policies most often included race as a protected class and least often included sexual orientation and gender identity. More educators had been trained on bullying based on race than any other social class. Students were more often informed that bullying based on race was prohibited and were least often informed about prohibitions regarding sexual orientation and gender identity. Reporting, investigating, and remediating bullying was highest for racial bullying, followed by disability bullying, and was lowest for bullying based on sexual orientation and gender identity.

Enhancing national data to align with policy objectives: Aboriginal and Torres Strait Islander smoking prevalence at finer geographic levels.

PubMed

Wright, Alyson; Lovett, Ray; Roe, Yvette; Richardson, Alice

2017-06-05

Objectives The aim of the study was to assess the utility of national Aboriginal survey data in a regional geospatial analysis of daily smoking prevalence for Aboriginal and Torres Strait Islander Australians and discuss the appropriateness of this analysis for policy and program impact assessment. Methods Data from the last two Australian Bureau of Statistics (ABS) national surveys of Aboriginal and Torres Strait Islander people, the National Aboriginal and Torres Strait Islander Social Survey 2014-15 (n=7022 adults) and the National Aboriginal and Torres Strait Islander Health Survey 2012-13 (n=10896 adults), were used to map the prevalence of smoking by Indigenous regions. Results Daily smoking prevalence in 2014-15 at Indigenous regions ranges from 27.1% (95%CI 18.9-35.3) in the Toowoomba region in Queensland to 68.0% (95%CI 58.1-77.9) in the Katherine region in the Northern Territory. The confidence intervals are wide and there is no significant difference in daily smoking prevalence between the two time periods for any region. Conclusion There are significant limitations with analysing national survey data at finer geographical scales. Given the national program for Indigenous tobacco control is a regional model, evaluation requires finer geographical analysis of smoking prevalence to inform public health progress, policy and program effects. Options to improve the data currently collected include increasing national survey sample sizes, implementing a smoking status question in census surveys, investing in current cohort studies focused on this population or implementing localised surveys. What is known about the topic? The last geospatial analysis of Aboriginal and Torres Strait Islander smoking prevalence was undertaken in 1997. Current national survey data have not been analysed geospatially. What does this paper add? This paper provides new insights into the use of national survey data for understanding regional patterns and prevalence levels of smoking in Aboriginal and Torres Strait Islander populations. What are the implications for practitioners? The findings of the study suggest caution when interpreting prevalence maps and highlight the need for greater sample sizes in national survey data. The analysis is also an opportunity to assess the use of national survey data in evaluating the policy impact of programs targeted at a regional level.

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania

PubMed Central

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki GM; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-01-01

Background A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Methods Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Results Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Conclusion Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey. PMID:19116022

Prevalence of Malnutrition and Associated Factors among Children in Rural Ethiopia

PubMed Central

Endris, Neima; Asefa, Henok

2017-01-01

Background Child malnutrition continues to be the leading public health problem in developing countries. In Ethiopia, malnutrition is a leading cause of child illness and death. Recently the composite index of anthropometric failure (CIAF) has been implemented to measure the prevalence of malnutrition. This index presents a more complete picture compared with the previous conventional indices. In this study, CIAF was used to determine the prevalence of malnutrition among children aged 0–59 months in rural Ethiopia. Methods Data was extracted from the 2014 Ethiopian Mini Demographic and Health Survey (EMDHS) for this study. A total of 3095 children were included in the analysis. The composite index of anthropometric failure (CIAF) was used to measure the nutritional status of the children. Logistic regression was fitted, to identify factors associated with malnutrition among children in rural Ethiopia, using STATA 13. Result The prevalence of malnutrition among rural children in Ethiopia was 48.5%. Age of the children, preceding birth interval, educated status of mother, wealth status, and region were factors independently associated with nutritional status of children in rural Ethiopia. Conclusion The prevalence of malnutrition among children in rural Ethiopia was high. A child older than 12 months, having uneducated mother, living in a household with poor wealth status, born with short birth interval, and living in some region of the country are associated with increased odds of being malnourished. PMID:28596966

Prevalence of Malnutrition and Associated Factors among Children in Rural Ethiopia.

PubMed

Endris, Neima; Asefa, Henok; Dube, Lamessa

2017-01-01

Child malnutrition continues to be the leading public health problem in developing countries. In Ethiopia, malnutrition is a leading cause of child illness and death. Recently the composite index of anthropometric failure (CIAF) has been implemented to measure the prevalence of malnutrition. This index presents a more complete picture compared with the previous conventional indices. In this study, CIAF was used to determine the prevalence of malnutrition among children aged 0-59 months in rural Ethiopia. Data was extracted from the 2014 Ethiopian Mini Demographic and Health Survey (EMDHS) for this study. A total of 3095 children were included in the analysis. The composite index of anthropometric failure (CIAF) was used to measure the nutritional status of the children. Logistic regression was fitted, to identify factors associated with malnutrition among children in rural Ethiopia, using STATA 13. The prevalence of malnutrition among rural children in Ethiopia was 48.5%. Age of the children, preceding birth interval, educated status of mother, wealth status, and region were factors independently associated with nutritional status of children in rural Ethiopia. The prevalence of malnutrition among children in rural Ethiopia was high. A child older than 12 months, having uneducated mother, living in a household with poor wealth status, born with short birth interval, and living in some region of the country are associated with increased odds of being malnourished.

Vitamin D status and its predictors in New Zealand aged-care residents eligible for a government-funded universal vitamin D supplementation programme.

PubMed

MacDonell, Sue O; Miller, Jody C; Harper, Michelle J; Waters, Debra L; Houghton, Lisa A

2016-12-01

The provision of prescribed vitamin D to all aged-care residents has been implemented in New Zealand as part of a government-led falls prevention programme. To our knowledge, there has been no evaluation of this universal programme on vitamin D status and functional and health outcomes. Thus, we aimed to determine 25-hydroxyvitamin D (25(OH)D) concentrations and their predictors in aged-care residents across the country and to investigate whether the government-funded programme was associated with adequate vitamin D status. Cross-sectional survey of sociodemographic, biochemical, anthropometric, dietary and health characteristics. Blood samples were analysed for serum 25(OH)D and other biochemical measures. Multiple regression was used to examine predictors of vitamin D status. Sixteen residential aged-care facilities throughout New Zealand. Residents aged ≥60 years with residency duration >12 weeks (n 309). Mean serum 25(OH)D was 89·9 (95 % CI 85·2, 94·5) nmol/l and monthly supplements (1250 µg (50 000 IU)) were taken by 75 % of all residents. Of those not taking a funded supplement, 65·3 % had serum 25(OH)D 125 nmol/l. Residents taking supplemental vitamin D had adequate vitamin D status; however monitoring of long-term supplementation should be considered, due to the high proportion of participants with high serum 25(OH)D levels.

Impact of implementing performance-based financing on childhood malnutrition in Rwanda.

PubMed

Binagwaho, Agnes; Condo, Jeanine; Wagner, Claire; Ngabo, Fidele; Karema, Corine; Kanters, Steve; Forrest, Jamie I; Bizimana, Jean de Dieu

2014-11-04

Malnutrition remains a serious concern in Rwanda, particularly among children under-5 years. Performance-based financing (PBF), an innovative health systems financing strategy, has been implemented at the national level since 2008. This study aimed to assess the impact of PBF and other factors associated with the prevalence of three classifications of malnutrition (stunting, wasting and underweight) in children under-5 years in Rwanda. The study is a cross-sectional study comprising of 713 children under five years old from 557 households, whose anthropometric measurements (height, weight and age) had been obtained as part of the 2008 Rwanda General Health and HIV household survey. Z-scores for height-for-age, weight-for-age, weight-for-height, and body mass index-for-age were analyzed according to the World Health Organization 2006 Child Growth Standards. Random intercept logistic regression models were used to regress each anthropometric measure (WAZ, HAZ and WHZ) against child, maternal and household characteristics. Child participants ranged in age from 0 to 60 months, 20.2% of children were under 12 months and 5.1% were HIV positive. The prevalence of wasting was 8.8%; of stunting was 58.4%; and of underweight status was 20.7%. Maternal emotional and social wellbeing was protective of wasting in children under-5 years of age. Living in districts implementing PBF was protective of wasting (Adjusted Odds Ratio: 0.43; 95% confidence interval: 0.19-0.97). Living in a district with PBF was not found to be associated with either stunting or underweight status among children under-5. PBF may have a protective association with particular forms of malnutrition among children under-5 years in Rwanda. These findings warrant further investigation in relation to the impact of implementing innovative financing schemes on health outcomes.

Why Don't We Ask? A Complementary Method for Assessing the Status of Great Apes

PubMed Central

Meijaard, Erik; Mengersen, Kerrie; Buchori, Damayanti; Nurcahyo, Anton; Ancrenaz, Marc; Wich, Serge; Atmoko, Sri Suci Utami; Tjiu, Albertus; Prasetyo, Didik; Nardiyono; Hadiprakarsa, Yokyok; Christy, Lenny; Wells, Jessie; Albar, Guillaume; Marshall, Andrew J.

2011-01-01

Species conservation is difficult. Threats to species are typically high and immediate. Effective solutions for counteracting these threats, however, require synthesis of high quality evidence, appropriately targeted activities, typically costly implementation, and rapid re-evaluation and adaptation. Conservation management can be ineffective if there is insufficient understanding of the complex ecological, political, socio-cultural, and economic factors that underlie conservation threats. When information about these factors is incomplete, conservation managers may be unaware of the most urgent threats or unable to envision all consequences of potential management strategies. Conservation research aims to address the gap between what is known and what knowledge is needed for effective conservation. Such research, however, generally addresses a subset of the factors that underlie conservation threats, producing a limited, simplistic, and often biased view of complex, real world situations. A combination of approaches is required to provide the complete picture necessary to engage in effective conservation. Orangutan conservation (Pongo spp.) offers an example: standard conservation assessments employ survey methods that focus on ecological variables, but do not usually address the socio-cultural factors that underlie threats. Here, we evaluate a complementary survey method based on interviews of nearly 7,000 people in 687 villages in Kalimantan, Indonesia. We address areas of potential methodological weakness in such surveys, including sampling and questionnaire design, respondent biases, statistical analyses, and sensitivity of resultant inferences. We show that interview-based surveys can provide cost-effective and statistically robust methods to better understand poorly known populations of species that are relatively easily identified by local people. Such surveys provide reasonably reliable estimates of relative presence and relative encounter rates of such species, as well as quantifying the main factors that threaten them. We recommend more extensive use of carefully designed and implemented interview surveys, in conjunction with more traditional field methods. PMID:21483859

Missouri Industrial and Educational Graphic Arts Survey. Final Report.

ERIC Educational Resources Information Center

Keseman, Charles E.

The Missouri Industrial and Educational Graphic Arts (MIEGA) survey was done to determine the current status and trends of the graphic arts industry and graphic arts education in Missouri for use as the basis for the later development of secondary school graphic arts state curriculum guides. Data were collected through two status surveys in…

Biomonitoring of intermittent rivers and ephemeral streams in Europe: Current practice and priorities to enhance ecological status assessments.

PubMed

Stubbington, Rachel; Chadd, Richard; Cid, Núria; Csabai, Zoltán; Miliša, Marko; Morais, Manuela; Munné, Antoni; Pařil, Petr; Pešić, Vladimir; Tziortzis, Iakovos; Verdonschot, Ralf C M; Datry, Thibault

2018-03-15

Intermittent rivers and ephemeral streams (IRES) are common across Europe and dominate some Mediterranean river networks. In all climate zones, IRES support high biodiversity and provide ecosystem services. As dynamic ecosystems that transition between flowing, pool, and dry states, IRES are typically poorly represented in biomonitoring programmes implemented to characterize EU Water Framework Directive ecological status. We report the results of a survey completed by representatives from 20 European countries to identify current challenges to IRES status assessment, examples of best practice, and priorities for future research. We identify five major barriers to effective ecological status classification in IRES: 1. the exclusion of IRES from Water Framework Directive biomonitoring based on their small catchment size; 2. the lack of river typologies that distinguish between contrasting IRES; 3. difficulties in defining the 'reference conditions' that represent unimpacted dynamic ecosystems; 4. classification of IRES ecological status based on lotic communities sampled using methods developed for perennial rivers; and 5. a reliance on taxonomic characterization of local communities. Despite these challenges, we recognize examples of innovative practice that can inform modification of current biomonitoring activity to promote effective IRES status classification. Priorities for future research include reconceptualization of the reference condition approach to accommodate spatiotemporal fluctuations in community composition, and modification of indices of ecosystem health to recognize both taxon-specific sensitivities to intermittence and dispersal abilities, within a landscape context. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Development and psychometric testing of the childhood obesity perceptions (COP) survey among African American caregivers: A tool for obesity prevention program planning.

PubMed

Alexander, Dayna S; Alfonso, Moya L; Cao, Chunhua

2016-12-01

Currently, public health practitioners are analyzing the role that caregivers play in childhood obesity efforts. Assessing African American caregiver's perceptions of childhood obesity in rural communities is an important prevention effort. This article's objective is to describe the development and psychometric testing of a survey tool to assess childhood obesity perceptions among African American caregivers in a rural setting, which can be used for obesity prevention program development or evaluation. The Childhood Obesity Perceptions (COP) survey was developed to reflect the multidimensional nature of childhood obesity including risk factors, health complications, weight status, built environment, and obesity prevention strategies. A 97-item survey was pretested and piloted with the priority population. After pretesting and piloting, the survey was reduced to 59-items and administered to 135 African American caregivers. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was conducted to test how well the survey items represented the number of Social Cognitive Theory constructs. Twenty items were removed from the original 59-item survey and acceptable internal consistency of the six factors (α=0.70-0.85) was documented for all scales in the final COP instrument. CFA resulted in a less than adequate fit; however, a multivariate Lagrange multiplier test identified modifications to improve the model fit. The COP survey represents a promising approach as a potentially comprehensive assessment for implementation or evaluation of childhood obesity programs. Copyright © 2016 Elsevier Ltd. All rights reserved.

40 CFR 49.9862 - Approval status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony of Oregon § 49.9862 Approval status. There are currently no EPA-approved Tribal rules or measures in the implementation plan for the Reservation of the Burns...

Sanitation practices and perceptions in Kakuma refugee camp, Kenya: Comparing the status quo with a novel service-based approach

PubMed Central

Nyoka, Raymond; Foote, Andrew D.; Woods, Emily; Lokey, Hana; O’Reilly, Ciara E.; Magumba, Fred; Okello, Patrick; Mintz, Eric D.; Marano, Nina

2017-01-01

Globally, an estimated 2.5 billion people lack access to improved sanitation. Unimproved sanitation increases the risk of morbidity and mortality, especially in protracted refugee situations where sanitation is based on pit latrine use. Once the pit is full, waste remains in the pit, necessitating the construction of a new latrine, straining available land and funding resources. A viable, sustainable solution is needed. This study used qualitative and quantitative methods to design, implement, and pilot a novel sanitation system in Kakuma refugee camp, Kenya. An initial round of 12 pre-implementation focus group discussions (FGDs) were conducted with Dinka and Somali residents to understand sanitation practices, perceptions, and needs. FGDs and a supplementary pre-implementation survey informed the development of an innovative sanitation management system that incorporated the provision of urine and liquid-diverting toilets, which separate urine and fecal waste, and a service-based sanitation system that included weekly waste collection. The new system was implemented on a pilot scale for 6 weeks. During the implementation, bi-weekly surveys were administered in each study household to monitor user perceptions and challenges. At the end of the pilot, the sanitation system was assessed using a second round of four post-implementation FGDs. Those who piloted the new sanitation system reported high levels of user satisfaction. Reported benefits included odor reduction, insect/pest reduction, the sitting design, the appropriateness for special populations, and waste collection. However, urine and liquid diversion presented a challenge for users who perform anal washing and for women who had experienced female genital mutilation. Refugee populations are often culturally and ethnically diverse. Using residents’ input to inform the development of sanitation solutions can increase user acceptability and provide opportunities to improve sanitation system designs based on specific needs. PMID:28704504

Income Inequality and Health Status in the United States: Evidence from the Current Population Survey.

ERIC Educational Resources Information Center

Mellor, Jennifer M.; Milyo, Jeffrey

2002-01-01

Current Population Survey data on self-reported health status and income for the general population and those in poverty were analyzed. No consistent association was found between income inequality and individual health status. Previous findings of such an association were attributed to ecological fallacy or failure to control for individual…

Relationships of health literacy, health behavior, and health status regarding infectious respiratory diseases: application of a skill-based measure.

PubMed

Sun, Xinying; Yang, Shuaishuai; Fisher, Edwin B; Shi, Yuhui; Wang, Yanling; Zeng, Qingqi; Ji, Ying; Chang, Chun; Du, Weijing

2014-01-01

This study aimed to explain the relationships among health literacy, health behavior, and health status, using a newly developed skills-based measure of health literacy regarding respiratory infectious diseases. This instrument was designed to measure individuals' reading, understanding, and calculating ability, as well as their oral communication and Internet-based information-seeking abilities. A pilot survey was conducted with 489 residents in Beijing, China, to test the reliability and validity of the new measure. Next, a larger study with 3,222 residents in three cities with multistage stratified cluster sampling was implemented to validate a latent variable model (goodness of fit index=0.918, root mean square residual=0.076). In this model higher educational attainment (β=0.356) and more health knowledge (β=0.306) were positively and directly associated with greater health literacy skill, while age was negatively associated with it (β=-0.341). Age (β=0.201) and health knowledge (β=0.246) had positive and direct relationship with health behavior, which was, in turn, positively associated with health status (β=0.209). The results illustrate the complex relationships among these constructs and should be considered when developing respiratory intervention strategies to promote health behavior and health status.

How does parents' visual perception of their child's weight status affect their feeding style?

PubMed

Yilmaz, Resul; Erkorkmaz, Ünal; Ozcetin, Mustafa; Karaaslan, Erhan

2013-01-01

Eating style is one of the prominente factors that determine energy intake. One of the influencing factors that determine parental feeding style is parental perception of the weight status of the child. The aim of this study is to evaluate the relationship between maternal visual perception of their children's weight status and their feeding style. A cross-sectional survey was completed with only mother's of 380 preschool children with age of 5 to 7 (6.14 years). Visual perception scores were measured with a sketch and maternal feeding style was measured with validated "Parental Feeding Style Questionnaire". The parental feeding dimensions "emotional feeding" and "encouragement to eat" subscale scores were low in overweight children according to visual perception classification. "Emotional feeding" and "permissive control" subscale scores were statistically different in children classified as correctly perceived and incorrectly low perceived group due to maternal misperception. Various feeding styles were related to maternal visual perception. The best approach to preventing obesity and underweight may be to focus on achieving correct parental perception of the weight status of their children, thus improving parental skills and leading them to implement proper feeding styles. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

40 CFR 52.1673 - Approval status.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New York § 52.1673 Approval status. (a) With the exceptions set forth in this section, the Administrator approves the New York State Implementation...

Educational Intervention for Nutrition Education in Patients Attending an Outpatient Wound Care Clinic: A Feasibility Study.

PubMed

Green, Lisa M; Ratcliffe, Desi; Masters, Kathleen; Story, Lachel

2016-01-01

The purpose of this study was to determine whether nurses could use a structured intervention to educate patients with wounds about foods that promote healing and whether this educational intervention could be provided in a cost-effective manner. Cross-sectional survey. The study was conducted at an outpatient wound care center located on a hospital campus in the Southern United States; 3 full-time nurses and 2 nurses employed on part-time status delivered the intervention. A nutrition education intervention was developed through collaborative efforts of a registered dietitian and a nurse. A cross-sectional survey design was used to (1) evaluate nurses' perceptions of the intervention and (2) identify barriers to implementation of the intervention. Direct costs related to materials and nursing time required to deliver the intervention were calculated. Participants indicated they were competent to deliver the structured intervention, and all were willing to continue its use. Survey results indicated that nurses believed the intervention was beneficial to their patients and they indicated that patients were responsive to the intervention. The intervention was found to be low cost ($8.00 per teaching session); no barriers to implementation of the intervention were identified. The results of this exploratory study suggest that a structured nutrition education intervention can be provided by nurses in outpatient wound clinics at low cost. Further study is needed to determine the impact of this intervention on nutritional intake and wound healing.

Variation in anticonvulsant selection and EEG monitoring following severe traumatic brain injury in children – Understanding resource availability in sites participating in a comparative effectiveness study

PubMed Central

Kurz, Jonathan E.; Poloyac, Samuel M.; Abend, Nicholas S.; Fabio, Anthony; Bell, Michael J.; Wainwright, Mark S.

2016-01-01

Objective Early post-traumatic seizures (PTS) may contribute to worsened outcomes after traumatic brain injury (TBI). Evidence to guide the evaluation and management of early PTS in children is limited. We undertook a survey of current practices of continuous electroencephalographic monitoring (cEEG), seizure prophylaxis and the management of early PTS to provide essential information for trial design and the development of PTS management pathways. Design Surveys were sent to site principal investigators at all 43 sites participating in the ADAPT (Approaches and Decisions in Acute Pediatric TBI) trial at the time of the survey. Surveys consisted of 12 questions addressing strategies to (i) implement cEEG monitoring, (ii) PTS prophylaxis, (iii) treat acute PTS, (iv) treat status epilepticus (SE) and refractory status epilepticus (RSE) and (v) monitor anti-seizure drug levels. Setting Institutions comprised a mixture of free-standing children’s hospitals and university medical centers across the United States and Europe. Measurements and Main Results cEEG monitoring was available in the pediatric intensive care unit in the overwhelming majority of clinical sites (98%); however, the plans to operationalize such monitoring for children varied considerably. A similar majority of sites report that administration of prophylactic anti-seizure medications is anticipated in children (93%), yet a minority reports that a specified protocol for treatment of PTS is in place (43%). Reported medication choices varied substantially between sites, but the majority of sites reported pentobarbital for RSE (81%). Presence of an treatment protocols for seizure prophylaxis, early PTS, post-traumatic SE and RSE was associated with decreased reported medications (all p < 0.05). Conclusions This study reports the current management practices for early PTS in select academic centers after pediatric severe TBI. The substantial variation in cEEG implementation, choice of seizure prophylaxis medications, and management of early PTS across institutions was reported, signifying areas of clinical uncertainty that will help provide for focused design of clinical trials. While sites with treatment protocols reported decreased number of medications for the scenarios described, completion of the ADAPT Trial will be able to determine if these protocols lead to decreased variability in medication administration in children at the clinical sites. PMID:27243415

Radiological Final Status Survey of the Hammond Depot, Hammond, Indiana

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

T.J. Vitkus

2008-04-07

ORISE conducted extensive scoping, characterization, and final status surveys of land areas and structures at the DNSC’s Hammond Depot located in Hammond, Indiana in multiple phases during 2005, 2006 and 2007.

Validation study of a web-based assessment of functional recovery after radical prostatectomy.

PubMed

Vickers, Andrew J; Savage, Caroline J; Shouery, Marwan; Eastham, James A; Scardino, Peter T; Basch, Ethan M

2010-08-05

Good clinical care of prostate cancer patients after radical prostatectomy depends on careful assessment of post-operative morbidities, yet physicians do not always judge patient symptoms accurately. Logistical problems associated with using paper questionnaire limit their use in the clinic. We have implemented a web-interface ("STAR") for patient-reported outcomes after radical prostatectomy. We analyzed data on the first 9 months of clinical implementation to evaluate the validity of the STAR questionnaire to assess functional outcomes following radical prostatectomy. We assessed response rate, internal consistency within domains, and the association between survey responses and known predictors of sexual and urinary function, including age, time from surgery, nerve sparing status and co-morbidities. Of 1581 men sent an invitation to complete the instrument online, 1235 responded for a response rate of 78%. Cronbach's alpha was 0.84, 0.86 and 0.97 for bowel, urinary and sexual function respectively. All known predictors of sexual and urinary function were significantly associated with survey responses in the hypothesized direction. We have found that web-based assessment of functional recovery after radical prostatectomy is practical and feasible. The instrument demonstrated excellent psychometric properties, suggested that validity is maintained when questions are transferred from paper to electronic format and when patients give responses that they know will be seen by their doctor and added to their clinic record. As such, our system allows ready implementation of patient-reported outcomes into routine clinical practice.

Development and validation of measures to assess prevention and control of AMR in hospitals.

PubMed

Flanagan, Mindy; Ramanujam, Rangaraj; Sutherland, Jason; Vaughn, Thomas; Diekema, Daniel; Doebbeling, Bradley N

2007-06-01

The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. To develop and validate a measurement scale for assessing hospitals' efforts to implement recommended AMR prevention and control measures. Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. : Four hundred forty-eight infection control professionals participated (67% response rate). Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. "Derivation" and "validation" samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

Validation study of a web-based assessment of functional recovery after radical prostatectomy

PubMed Central

2010-01-01

Background Good clinical care of prostate cancer patients after radical prostatectomy depends on careful assessment of post-operative morbidities, yet physicians do not always judge patient symptoms accurately. Logistical problems associated with using paper questionnaire limit their use in the clinic. We have implemented a web-interface ("STAR") for patient-reported outcomes after radical prostatectomy. Methods We analyzed data on the first 9 months of clinical implementation to evaluate the validity of the STAR questionnaire to assess functional outcomes following radical prostatectomy. We assessed response rate, internal consistency within domains, and the association between survey responses and known predictors of sexual and urinary function, including age, time from surgery, nerve sparing status and co-morbidities. Results Of 1581 men sent an invitation to complete the instrument online, 1235 responded for a response rate of 78%. Cronbach's alpha was 0.84, 0.86 and 0.97 for bowel, urinary and sexual function respectively. All known predictors of sexual and urinary function were significantly associated with survey responses in the hypothesized direction. Conclusions We have found that web-based assessment of functional recovery after radical prostatectomy is practical and feasible. The instrument demonstrated excellent psychometric properties, suggested that validity is maintained when questions are transferred from paper to electronic format and when patients give responses that they know will be seen by their doctor and added to their clinic record. As such, our system allows ready implementation of patient-reported outcomes into routine clinical practice. PMID:20687938

Integrating smoking control policies into employee benefits: a survey of large California corporations.

PubMed Central

Schauffler, H H

1993-01-01

OBJECTIVES. Public health policy promotes the use of risk-rating health insurance and payment for smoking cessation as economic incentives to encourage smoking cessation. This study was undertaken to learn more about the adoption of these policies in large corporations. METHODS. A random sample survey of 280 private California corporations with more than 500 employees was undertaken to document the prevalence of policies integrating smoking control into employee benefit designs. RESULTS. Only 8.6% of large corporations had ever considered risk-rating health insurance premiums using smoking status and only 2.15% had implemented a risk-rating policy. Nearly 20% of the companies offered health insurance plans that covered smoking cessation services. Subsidization or payment for smoking cessation outside health insurance was provided by over 37% of the companies surveyed, and 87% had adopted formal work-site smoking policies. CONCLUSION. Benefit policies that provide financial support to smokers to participate in smoking cessation services are much more prevalent and are viewed more positively by the benefits managers in large corporations than are policies to risk-rate health insurance premiums on the basis of smoking. PMID:8362996

Community burden of undiagnosed HIV infection among adolescents in Zimbabwe following primary healthcare-based provider-initiated HIV testing and counselling: A cross-sectional survey.

PubMed

Simms, Victoria; Dauya, Ethel; Dakshina, Subathira; Bandason, Tsitsi; McHugh, Grace; Munyati, Shungu; Chonzi, Prosper; Kranzer, Katharina; Ncube, Getrude; Masimirembwa, Collen; Thelingwani, Roslyn; Apollo, Tsitsi; Hayes, Richard; Weiss, Helen A; Ferrand, Rashida A

2017-07-01

Children living with HIV who are not diagnosed in infancy often remain undiagnosed until they present with advanced disease. Provider-initiated testing and counselling (PITC) in health facilities is recommended for high-HIV-prevalence settings, but it is unclear whether this approach is sufficient to achieve universal coverage of HIV testing. We aimed to investigate the change in community burden of undiagnosed HIV infection among older children and adolescents following implementation of PITC in Harare, Zimbabwe. Over the course of 2 years (January 2013-January 2015), 7 primary health clinics (PHCs) in southwestern Harare implemented optimised, opt-out PITC for all attendees aged 6-15 years. In February 2015-December 2015, we conducted a representative cross-sectional survey of 8-17-year-olds living in the 7 communities served by the study PHCs, who would have had 2 years of exposure to PITC. Knowledge of HIV status was ascertained through a caregiver questionnaire, and anonymised HIV testing was carried out using oral mucosal transudate (OMT) tests. After 1 participant taking antiretroviral therapy was observed to have a false negative OMT result, from July 2015 urine samples were obtained from all participants providing OMTs and tested for antiretroviral drugs to confirm HIV status. Children who tested positive through PITC were identified from among survey participants using gender, birthdate, and location. Of 7,146 children in 4,251 eligible households, 5,486 (76.8%) children in 3,397 households agreed to participate in the survey, and 141 were HIV positive. HIV prevalence was 2.6% (95% CI 2.2%-3.1%), and over a third of participants with HIV were undiagnosed (37.7%; 95% CI 29.8%-46.2%). Similarly, among the subsample of 2,643 (48.2%) participants with a urine test result, 34.7% of those living with HIV were undiagnosed (95% CI 23.5%-47.9%). Based on extrapolation from the survey sample to the community, we estimated that PITC over 2 years identified between 18% and 42% of previously undiagnosed children in the community. The main limitation is that prevalence of undiagnosed HIV was defined using a combination of 3 measures (OMT, self-report, and urine test), none of which were perfect. Facility-based approaches are inadequate in achieving universal coverage of HIV testing among older children and adolescents. Alternative, community-based approaches are required to meet the Joint United Nations Programme on HIV/AIDS (UNAIDS) target of diagnosing 90% of those living with HIV by 2020 in this age group.

A Survey of Preparation for Metric Changeover among Supervisors of Science and Mathematics at the State Department of Education Level.

ERIC Educational Resources Information Center

Trueblood, Cecil R.; And Others

1981-01-01

Described is the Northeast Metric Education Consortium survey to study the status of metric conversion throughout the United States. The six categories in the survey included teacher certification practices, status of full metric conversion, state's commitment to metrics, state supervisors' budgetary needs, state metric-resources availability, and…

Poor Socioeconomic and Nutritional Status Are Associated with Osteoporosis in Korean Postmenopausal Women: Data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES) 2009.

PubMed

Kim, Mi-Hyun; Lee, Jung Sun; Johnson, Mary Ann

2015-01-01

As the population ages, osteoporosis is a growing global public health problem. This study examined potential risk factors associated with osteoporosis in a nationally representative sample of Korean postmenopausal women. This study used data from a nationally representative sample of Korean menopausal women participating in the Korea National Health and Nutrition Examination Survey KNHANES 2009 (n = 1467; mean age ± SE = 65.2 ± 0.3 years). Bone mineral density of total femur, femoral neck, and spine was measured by dual-energy X-ray absorptiometry. Osteoporosis was determined as t-score of -2.5 or below in at least 1 of the 3 sites. Menopausal status was confirmed by self-reports. About 41% of the study sample met the criteria for osteoporosis. Poor socioeconomic status, lower BMI, and shorter estrogen exposure duration were significantly associated with osteoporosis in the study sample. Poor dietary intake was also related to osteoporosis. In the age- and energy-adjusted logistic regression models, participants consuming less protein, vitamin B2, or vitamin C than the estimated average requirement (EAR) showed higher odds of having osteoporosis than their counterparts. Participants consuming no milk or milk products had 45% increased odds of having osteoporosis than those consuming milk or milk products. The findings of this study suggest several risk factors associated with osteoporosis, which can be addressed in the development and implementation of tailored nutritional interventions to promote the bone health of Korean postmenopausal women.

Can Health Promoting Schools contribute to the better health and wellbeing of young people? The Hong Kong experience

PubMed Central

Lee, Albert; Cheng, Frances F K; Fung, Yanas

2006-01-01

Background The Health Promoting School (HPS) is a WHO sponsored framework, compiled to enable education and health sectors to be more effective in school based initiatives. Aims This study attempted to test the hypothesis that students from schools that had comprehensively embraced the HPS concept as indicated by the Healthy School Award, were better, in terms of health risk behaviour, self reported health status, and academic results, than students from schools that did not reach the standard of the award. Methods and Results The results presented came from nine schools (four primary and five secondary) applying for accreditation of the Healthy Schools Award after adopting the HPS framework for two years. Regular consultancy support and training were available to all schools. Students had completed before and after surveys to assess their health behaviours, self reported health status, and academic standing before the two year intervention, and at its end. Data from the before and after surveys of the students attending schools that reached certain level of HPS standard as indicated by the award, were compared with students whose schools did not receive the award, and the results showed differences. Some differences were found to be more significant among the primary school students than secondary schools students. This illustrated early intervention for lifestyle changes to be more effective. Students' satisfaction with life also improved if their schools adopted the concept of HPS comprehensively. Conclusions The results suggest that comprehensive implementation of HPS would contribute to differences in certain behaviours and self reported health and academic status. PMID:16698986

Can Health Promoting Schools contribute to the better health and wellbeing of young people? The Hong Kong experience.

PubMed

Lee, Albert; Cheng, Frances F K; Fung, Yanas; St Leger, Lawrence

2006-06-01

The Health Promoting School (HPS) is a WHO sponsored framework, compiled to enable education and health sectors to be more effective in school based initiatives. This study attempted to test the hypothesis that students from schools that had comprehensively embraced the HPS concept as indicated by the Healthy School Award, were better, in terms of health risk behaviour, self reported health status, and academic results, than students from schools that did not reach the standard of the award. The results presented came from nine schools (four primary and five secondary) applying for accreditation of the Healthy Schools Award after adopting the HPS framework for two years. Regular consultancy support and training were available to all schools. Students had completed before and after surveys to assess their health behaviours, self reported health status, and academic standing before the two year intervention, and at its end. Data from the before and after surveys of the students attending schools that reached certain level of HPS standard as indicated by the award, were compared with students whose schools did not receive the award, and the results showed differences. Some differences were found to be more significant among the primary school students than secondary schools students. This illustrated early intervention for lifestyle changes to be more effective. Students' satisfaction with life also improved if their schools adopted the concept of HPS comprehensively. The results suggest that comprehensive implementation of HPS would contribute to differences in certain behaviours and self reported health and academic status.

Preliminary evidence for mediation of the association between acculturation and sun-safe behaviors

PubMed Central

Andreeva, Valentina A.; Cockburn, Myles G.; Yaroch, Amy L.; Unger, Jennifer B.; Rueda, Robert; Reynolds, Kim D.

2013-01-01

Objectives To identify and test mediators of the relationship between acculturation and sun-safe behaviors among Latinos in the United States. We hypothesized that the effect of acculturation on use of sunscreen, shade, and sun-protective clothing would be mediated by perceived health status, educational level, access to healthcare, and contact with social networks regarding health matters. Design The 2005 Health Information National Trends Survey, implemented by the National Cancer Institute. Setting Nationwide survey. Participants A probability-based sample of the US civilian, noninstitutionalized adult population, comprising 496 Latino respondents. Main outcome measures Use of sunscreen, shade, and sun-protective clothing when outdoors on sunny days, assessed by self-reports on frequency scales. Results The positive association between acculturation and sunscreen use and the negative association between acculturation and use of sun-protective clothing were mediated by educational level (P<0.05 for both). Perceived health status and contact with social networks regarding health matters were supported as mediators only for sunscreen use (P<0.05). Health care access was not supported as a mediator for any of the outcomes. Conclusions Structural equation models revealed distinct direct and indirect paths between acculturation and each sun-safe practice. Our findings place an emphasis on behavior-specific mediated associations and could inform sun safety programming for Latinos with low and high levels of acculturation. The models support education level, contact with social networks regarding health matters, and perceived health status as mediators primarily for sunscreen use. Future research should test different mediators for use of shade or sun-protective clothing. PMID:21768480

Interprofessional Education in the Internal Medicine Clerkship Post-LCME Standard Issuance: Results of a National Survey.

PubMed

Alexandraki, Irene; Hernandez, Caridad A; Torre, Dario M; Chretien, Katherine C

2017-08-01

Several decades of work have detailed the value and goals of interprofessional education (IPE) within the health professions, defining IPE competencies and best practices. In 2013, the Liaison Committee for Medical Education (LCME) elevated IPE to a U.S. medical school accreditation standard. To examine the status of IPE within internal medicine (IM) clerkships including perspectives, curricular content, barriers, and assessment a year after the LCME standard issuance. Anonymous online survey. IM clerkship directors from each of the Clerkship Directors in Internal Medicine's 121 U.S. and Canadian member medical schools in 2014. In 2014, a section on IPE (18 items) was included in the Clerkship Directors in Internal Medicine annual survey of its 121 U.S. and Canadian member medical schools. Items (18) assessed clerkship director (CD) perspectives, status of IPE curricula in IM clerkships, and barriers to IPE implementation. Data were analyzed using descriptive statistics and qualitative analysis of free-text responses to one of the survey questions. The overall survey response rate was 78% (94/121). The majority (88%) agreed that IPE is important to the practice of IM, and 71% believed IPE should be part of the IM clerkship. Most (76%) CDs agreed there is need for faculty development programs in IPE; 27% had such a program at their institution. Lack of curricular time, scheduling conflicts, and lack of faculty trained in IPE were the most frequently cited barriers. Twenty-nine percent had formal IPE activities within their IM clerkships, and 38% were planning to make changes. Of those with formal IPE activities, over a third (37%) did not involve student assessment. Since LCME standard issuance, only a minority of IM clerkships have included formal IPE activities, with lectures as the predominant method. Opportunities exist for enhancing educational methods as well as IPE faculty development.

The Faculty Status of Academic Librarians in Ohio.

ERIC Educational Resources Information Center

Byerly, Greg

1980-01-01

Summarizes a survey to determine the extent of faculty status for academic librarians as defined by ACRL standards. The study also explores adherence to these standards and discusses relevant demographic characteristics of the survey respondents. (Author/RAA)

It's Not Over Yet: The Annual Report on the Economic Status of the Profession, 2010-11

ERIC Educational Resources Information Center

Curtis, John W.

2011-01-01

This paper presents the annual report of the American Association of University Professors on the economic status of the profession for 2010-2011. This analysis of the economic status of the faculty begins with results from this year's annual survey of full-time faculty compensation. Survey report table 1 presents the most basic results, while…

Anaemia management in patients with inflammatory bowel disease: routine practice across nine European countries.

PubMed

Stein, Jürgen; Bager, Palle; Befrits, Ragnar; Gasche, Christoph; Gudehus, Maja; Lerebours, Eric; Magro, Fernando; Mearin, Fermin; Mitchell, Daniell; Oldenburg, Bas; Danese, Silvio

2013-12-01

Anaemia and iron deficiency (ID) are common complications in inflammatory bowel disease (IBD). In patients undergoing iron therapy, intravenous iron supplementation is recommended in preference to oral therapy. This study evaluated routine practice in the management of IBD-associated anaemia and ID to verify implementation of international treatment guidelines. Gastroenterologists from nine European countries (n=344) were surveyed about their last five IBD patients treated for anaemia (n=1404). Collected information included tests performed at anaemia diagnosis, haemoglobin (Hb) levels and iron status parameters, the anaemia treatment given and, if applicable, the iron administration route. Selection of diagnostic tests and treatment for IBD-associated anaemia varied considerably across Europe. Anaemia and iron status were mainly assessed by Hb (88%) and serum ferritin (75%). Transferrin saturation was only tested in 25% of patients. At diagnosis of anaemia, 56% presented with at least moderate anaemia (Hb<10 g/dl) and 15% with severe anaemia (Hb<8 g/dl). ID (ferritin<30 ng/ml) was detected in 76%. Almost all patients (92%) received iron supplementation; however, only 28% received intravenous iron and 67% oral iron. Management practice was similar in 2009 and 2011. In clinical practice, most IBD patients received oral iron even though this administration route may aggravate the disease, and despite international guidelines recommending intravenous administration as the preferred route. The high frequency of ID suggests insufficient monitoring of iron status in IBD patients. There is a need to increase awareness and implementation of international guidelines on iron supplementation in patients with IBD.

Academic Status of Plastic Surgery in the United States and the Relevance of Independence.

PubMed

Liu, P; Singh, M; Eriksson, E

2016-04-01

The basic administrative structures at most academic institutions were implemented more than 50 years ago and have remained largely unchanged. Since the surgical specialties were in nascent stages during that time, they were clubbed together within the department of surgery. There has been extensive growth in the breadth and depth of plastic surgery over the past few decades and current administrative structures might not truly reflect the current standing of plastic surgery. The goal of this article was to review the academic status of Plastic Surgery in the United States and assess the relevance of independence from the department of surgery. A national survey of 94 hospitals with plastic surgery residency training programs in the United States was conducted to investigate the academic status of plastic surgery. 25 out of those 94 programs had department status with their respective hospitals while another 9 programs were actively planning on transitioning to department status. Out of the 25 plastic surgery hospital departments, 17 programs were also University departments. The number of plastic surgery departments has more than doubled over the past 10 years and continues to rise as more plastic surgery divisions seek department status. There are multiple advantages to seeking department status such as financial and administrative autonomy, ability to participate in medical school curricula, easier access to interdepartmental institutes and faculties, parity with other specialties, and increased control of resident education. There has been concerted advocacy for separating from surgery departments and seeking independent departmental status for plastic surgery. However, the transition from a division to department is a slow and demanding process and requires a well-planned strategy. © Georg Thieme Verlag KG Stuttgart · New York.

Assessment of the monitoring and evaluation system for integrated community case management (ICCM) in Ethiopia: a comparison against global benchmark indicators.

PubMed

Mamo, Dereje; Hazel, Elizabeth; Lemma, Israel; Guenther, Tanya; Bekele, Abeba; Demeke, Berhanu

2014-10-01

Program managers require feasible, timely, reliable, and valid measures of iCCM implementation to identify problems and assess progress. The global iCCM Task Force developed benchmark indicators to guide implementers to develop or improve monitoring and evaluation (M&E) systems. To assesses Ethiopia's iCCM M&E system by determining the availability and feasibility of the iCCM benchmark indicators. We conducted a desk review of iCCM policy documents, monitoring tools, survey reports, and other rele- vant documents; and key informant interviews with government and implementing partners involved in iCCM scale-up and M&E. Currently, Ethiopia collects data to inform most (70% [33/47]) iCCM benchmark indicators, and modest extra effort could boost this to 83% (39/47). Eight (17%) are not available given the current system. Most benchmark indicators that track coordination and policy, human resources, service delivery and referral, supervision, and quality assurance are available through the routine monitoring systems or periodic surveys. Indicators for supply chain management are less available due to limited consumption data and a weak link with treatment data. Little information is available on iCCM costs. Benchmark indicators can detail the status of iCCM implementation; however, some indicators may not fit country priorities, and others may be difficult to collect. The government of Ethiopia and partners should review and prioritize the benchmark indicators to determine which should be included in the routine M&E system, especially since iCCMdata are being reviewed for addition to the HMIS. Moreover, the Health Extension Worker's reporting burden can be minimized by an integrated reporting approach.

Evaluating the pictorial warnings on tobacco products in Arabian Gulf countries against other international pictorial warnings.

PubMed

BinDhim, Nasser F; McGeechan, Kevin; Alanazi, Anwar K T; Alanazi, Hossam M S; Alanazi, Sasoun A J; Al-Hadlaq, Solaiman M; Aljadhey, Hisham; Alhawassi, Tariq M; Alghamdi, Nadia A; Shaman, Ahmed M; Alquwayzani, Meshari S; Basyouni, Mada H

2017-05-12

Few assessments of pictorial warnings (PWs) on cigarette packs implemented in Gulf Cooperation Council (GCC) countries have been done. This article includes two cross-sectional studies. In Study 1, convenience samples of adults from the Kingdom of Saudi Arabia (n=111) and USA (n=115) participated in a consumer survey to rate a total of nine PWs from the GCC, Australia and the UK. Outcome measures were affective responses to PWs and concerns about smoking. In Study 2, tobacco control experts (n=14) from multiple countries rated the same PWs on a potential efficacy scale and completed one open-ended question about each. The PWs were altered to mask their country of origin. Analyses compared ranking on multiple outcomes and examined ratings by country of origin and by smoking status. In the consumer survey, participants from both countries rated the PWs from GCC lower than PWs from other countries on the two measures. The mixed-model analysis showed significant differences between the PWs from Australia and those from the GCC and between the PWs from the UK and those from the GCC (p<0.001) in the consumer and expert samples. The experts' comments about the PWs implemented in the GCC were negative overall and confirmed previously identified themes about effective PWs. This study shows PWs originating from the GCC had significantly lower ratings than those implemented in Australia and the UK. The GCC countries may need to re-evaluate the currently implemented PWs and update them periodically. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran.

PubMed

Piroozi, Bakhtiar; Moradi, Ghobad; Nouri, Bijan; Mohamadi Bolbanabad, Amjad; Safari, Hossein

2016-03-14

One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE) after the implementation of HSEP and the factors that determine CHE. A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO) definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of recent reform, thus financially protecting public against CHE. © 2016 by Kerman University of Medical Sciences

Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

PubMed Central

Piroozi, Bakhtiar; Moradi, Ghobad; Nouri, Bijan; Mohamadi Bolbanabad, Amjad; Safari, Hossein

2016-01-01

Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE) after the implementation of HSEP and the factors that determine CHE. Methods: A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO) definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. Results: The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. Conclusion: The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of recent reform, thus financially protecting public against CHE. PMID:27694669

Equity of the essential public health service in rural china: evidence from a nationwide survey of hypertensive patients.

PubMed

Zhou, Donghua; Feng, Zhanchun; He, Shasha; Sun, Xi; Ma, Caihui; Lv, Benyan; Zou, Xiong

2013-07-01

To explore healthcare disparities in rural China two years after the implementation of the Essential Public Health Service (EPHS) reform in 2009. A cross-sectional study was conducted by surveying 930 hypertension patients (HPs) from different regions in rural China in 2011. The percentages of patients using recommended four or more follow-up visits in a year were calculated by patient socio-demographic characteristics and statistically examined using chi-square and logistic regression to uncover disparities and correlated factors in EPHS use. The rates were not significantly different by age, gender, education, insurance status or income, but significantly different by region and hypertension history (p<0.01). Higher rates were also observed on patients who sought actively follow-up service at clinics, making appointment for the next follow-up with doctors, awareness of the need of follow-up, more satisfied with the follow-up services, and better medication adherence (p<0.01). There were no disparities observed among HPs in the use of follow-up services, suggesting that the reform has to some extent achieved its goal in ensuring equal access to EPHS. In this regard, regional implementation of the national policies and improvement of EPHS management at local level should be further improved.

[A socio-demographic sample survey of the population in 1985].

PubMed

Labutova, T

1984-01-01

This paper contains a brief description of the socio-demographic survey scheduled to be carried out in the Soviet Union in January 1985. Topics that the survey was designed to cover include sex, age, marital status, education, source of income, social status, length of residence at current address, age at marriage, cause of divorce, births of children, and housing conditions.

Status of Microsurgical Simulation Training in Plastic Surgery: A Survey of United States Program Directors.

PubMed

Al-Bustani, Saif; Halvorson, Eric G

2016-06-01

Various simulation models for microsurgery have been developed to overcome the limitations of Halstedian training on real patients. We wanted to assess the status of microsurgery simulation in plastic surgery residency programs in the United States. Data were analyzed from responses to a survey sent to all plastic surgery program directors in the United States, asking for type of simulation, quality of facilities, utilization by trainees, evaluation of trainee sessions, and perception of the relevance of simulation. The survey response rate was 50%. Of all programs, 69% provide microsurgical simulation and 75% of these have a laboratory with microscope and 52% provide live animal models. Half share facilities with other departments. The quality of facilities is rated as good or great in 89%. Trainee utilization is once every 3 to 6 months in 82% of programs. Only in 11% is utilization monthly. Formal evaluation of simulation sessions is provided by 41% of programs. All program directors agree simulation is relevant to competence in microsurgery, 60% agree simulation should be mandatory, and 43% require trainees to complete a formal microsurgery course prior to live surgery. There seems to be consensus that microsurgical simulation improves competence, and the majority of program directors agree it should be mandatory. Developing and implementing standardized simulation modules and assessment tools for trainees across the nation as part of a comprehensive competency-based training program for microsurgery is an important patient safety initiative that should be considered. Organizing with other departments to share facilities may improve their quality and hence utilization.

Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU)

PubMed Central

Pelikan, Jürgen M.; Röthlin, Florian; Ganahl, Kristin; Slonska, Zofia; Doyle, Gerardine; Fullam, James; Kondilis, Barbara; Agrafiotis, Demosthenes; Uiters, Ellen; Falcon, Maria; Mensing, Monika; Tchamov, Kancho; van den Broucke, Stephan; Brand, Helmut

2015-01-01

Background: Health literacy concerns the capacities of people to meet the complex demands of health in modern society. In spite of the growing attention for the concept among European health policymakers, researchers and practitioners, information about the status of health literacy in Europe remains scarce. This article presents selected findings from the first European comparative survey on health literacy in populations. Methods: The European health literacy survey (HLS-EU) was conducted in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain (n = 1000 per country, n = 8000 total sample). Data collection was based on Eurobarometer standards and the implementation of the HLS-EU-Q (questionnaire) in computer-assisted or paper-assisted personal interviews. Results: The HLS-EU-Q constructed four levels of health literacy: insufficient, problematic, sufficient and excellent. At least 1 in 10 (12%) respondents showed insufficient health literacy and almost 1 in 2 (47%) had limited (insufficient or problematic) health literacy. However, the distribution of levels differed substantially across countries (29–62%). Subgroups within the population, defined by financial deprivation, low social status, low education or old age, had higher proportions of people with limited health literacy, suggesting the presence of a social gradient which was also confirmed by raw bivariate correlations and a multivariate linear regression model. Discussion: Limited health literacy represents an important challenge for health policies and practices across Europe, but to a different degree for different countries. The social gradient in health literacy must be taken into account when developing public health strategies to improve health equity in Europe. PMID:25843827

Satellite-aided survey sampling and implementation in low- and middle-income contexts: a low-cost/low-tech alternative.

PubMed

Haenssgen, Marco J

2015-01-01

The increasing availability of online maps, satellite imagery, and digital technology can ease common constraints of survey sampling in low- and middle-income countries. However, existing approaches require specialised software and user skills, professional GPS equipment, and/or commercial data sources; they tend to neglect spatial sampling considerations when using satellite maps; and they continue to face implementation challenges analogous to conventional survey implementation methods. This paper presents an alternative way of utilising satellite maps and digital aides that aims to address these challenges. The case studies of two rural household surveys in Rajasthan (India) and Gansu (China) compare conventional survey sampling and implementation techniques with the use of online map services such as Google, Bing, and HERE maps. Modern yet basic digital technology can be integrated into the processes of preparing, implementing, and monitoring a rural household survey. Satellite-aided systematic random sampling enhanced the spatial representativeness of the village samples and entailed savings of approximately £4000 compared to conventional household listing, while reducing the duration of the main survey by at least 25 %. This low-cost/low-tech satellite-aided survey sampling approach can be useful for student researchers and resource-constrained research projects operating in low- and middle-income contexts with high survey implementation costs. While achieving transparent and efficient survey implementation at low costs, researchers aiming to adopt a similar process should be aware of the locational, technical, and logistical requirements as well as the methodological challenges of this strategy.

[Health status identification and their relationship with socieconomics and geographic characteristics: a population survey analysis in México].

PubMed

Vargas-Palacios, Armando; Gutiérrez, Juan Pablo; Carreón-Rodríguez, Víctor

2006-01-01

To estimate the effectiveness of using standardized health vignettes to adjust self-reported health taking into account household and community variables to correct for systematic bias. The national health survey "Evaluación del Desempeño 2002" (Mexican component of the World Health Survey) was used. This survey analyzed subject's health perception based on their responses to hypothetical questions referring to third parties in the vignettes within eight domains. Variations in responses were attributed to socio-demographic, socioeconomic, community, differences of the subjects. To assess those variations, an index for each domain was constructed and used as a variable in a series of linear regression models to estimate the relation between health perceptions, self-reported health, socioeconomic and socio-demographic characteristics. The health perception index derived from the vignettes showed a positive, logarithmic correlation with household expenditure for each health domain, after controlling for socio-demographic, health and community characteristics. No relationship was found between the health status described in the vignettes and self-reported health status. In no case was the explanatory power above 10%. The low explanatory power of the models, and the lack of correlation between self reported health status and the health perception index, suggest that the variability in the vignettes responses cannot be explained by differences in self-reported health status or socioeconomic and socio-demographic characteristics. These results from Mexico suggest that vignette-based methods to correct for systematic variability in perception of own health status are of limited efficacy and reinforce the importance of collecting objective measures of health status in health surveys.

Status of States' Progress in Implementing Part H of IDEA: Report #3.

ERIC Educational Resources Information Center

Harbin, Gloria L.; And Others

This report focuses on progress in the implementation of Part H of the Individuals with Disabilities Education Act (IDEA) through a comparison of states' status on three yearly administrations of the State Progress Scale. The scale was designed to monitor implementation of the required 14 components in the stages of policy development, policy…

Dental services utilization by women of childbearing age by socioeconomic status.

PubMed

Kaylor, Mary B; Polivka, Barbara J; Chaudry, Rosemary; Salsberry, Pamela; Wee, Alvin G

2010-04-01

For women of childbearing age, oral health not only affects their physical and psychological well-being but also that of their children. This study used the 2003-2004 Ohio Family Health Survey (N = 9,819) to examine dental need and utilization by women in Ohio. Predisposing, enabling, and need variables were examined as they effect dental health service utilization by women of childbearing age at different socioeconomic status (SES) levels. The proportion of women in the low SES group self reporting a dental need (18%) was 3 times that of the proportion of women in the higher SES group with a self reported need (6%). Results of bivariate analysis showed that having a dental visit in the past year varied significantly by SES, race, insurance status, provider density, and need. A racial disparity in dental service utilization was noted in the bivariate analysis of the middle SES group. While dental need and type of dental coverage varied by SES, both were significantly associated with utilization of dental services within all 3 SES categories in the logistic regressions. These results suggest that measures need to be implemented to meet the goal of increasing access and utilization of dental health services by low-income populations.

Low Urinary Iodine Concentration among Mothers and Children in Cambodia

PubMed Central

Laillou, Arnaud; Sophonneary, Prak; Kuong, Khov; Hong, Rathavuth; Un, Samoeurn; Chamnan, Chhoun; Poirot, Etienne; Berger, Jacques; Wieringa, Frank

2016-01-01

A 2014 national assessment of salt iodization coverage in Cambodia found that 62% of samples were non-iodized, suggesting a significant decline in daily iodine intakes. The Cambodian Micronutrient Survey conducted in 2014 (CMNS-2014) permitted obtaining national data on urinary iodine concentrations (UIC) to assess iodine status and whether iodized salt use had an impact. Urine samples were collected from mothers (n = 736) and children (n = 950). The median UIC was 63 µg/L and 72 µg/L in mothers and children respectively. More than 60% of mothers and their children had a UIC < 100 µg/L, thereby indicating a serious public health problem. Iodine status was significantly lower among mothers and children living in rural areas, belonging to the poorest socioeconomic category, or living in a household not using iodized salt. The limited enforcement of the legislation for iodized salt has resulted in a major decrease in the prevalence of iodized salt, which in turn has compromised iodine status in Cambodia. It is essential for the government to enhance enforcement of the iodized salt legislation, and implement short term strategies, such as iodine supplementation, to prevent an increase of severe complications due to iodine deficiency in the Cambodian population. PMID:27058551

Prevaccination antibody screening and immunization program for healthcare personnel against measles, mumps, rubella, and varicella in a Japanese tertiary care hospital.

PubMed

Kanamori, Hajime; Tokuda, Koichi; Ikeda, Shinobu; Endo, Shiro; Ishizawa, Chiyuki; Hirai, Yukari; Takahashi, Masami; Aoyagi, Tetsuji; Hatta, Masumitsu; Gu, Yoshiaki; Yano, Hisakazu; Weber, David J; Kaku, Mitsuo

2014-10-01

Susceptible healthcare personnel (HCP) are at high risk for acquiring and transmitting measles, mumps, rubella, and varicella (MMRV). Presumptive evidence of immunity to MMRV is recommended for HCP. The aim of this investigation was to examine the seroprevalence of MMRV in Japanese HCP and the association with history or vaccination in terms of occupational safety. To improve infection control at our hospital, we also assessed their immune status by implementing prevaccination antibody screening and an immunization program with postvaccination serological testing. We implemented seroprevalence surveys on MMRV antibodies among 243 newly and 2,664 previously hired HCP in a Japanese tertiary care hospital. Self-administered questionnaires about history of MMRV and vaccination with or without written documentation were completed for newly hired HCP. Prevaccination and postvaccination serological tests were performed using virus-specific IgG enzyme-linked immunosorbent assays. Indeed, only a few HCP accurately remembered or had written records of their disease or vaccination history. After our immunization program was implemented, the seropositivity rate reached levels as high as ~98% for measles, rubella, and varicella, and increased to ~80% for mumps. Our program was cost-effective, and no severe adverse reactions were reported. The prevaccination antibody screening for HCP would be helpful, given the lack of written vaccination records or documented disease history, and is also useful for the prevention of adverse reactions associated with unnecessary vaccination. It is important for infection control practitioners to comprehend the immune status of HCP against MMRV, and then provide an appropriate immunization program for susceptible HCP.

Health equity in the New Zealand health care system: a national survey.

PubMed

Sheridan, Nicolette F; Kenealy, Timothy W; Connolly, Martin J; Mahony, Faith; Barber, P Alan; Boyd, Mary Anne; Carswell, Peter; Clinton, Janet; Devlin, Gerard; Doughty, Robert; Dyall, Lorna; Kerse, Ngaire; Kolbe, John; Lawrenson, Ross; Moffitt, Allan

2011-10-20

In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. A national survey of district health boards (DHBs) was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Survey responses were received from the majority of DHBs (15/21), some PHOs (21/84) and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so for other ethnic groups or by geography. Populations that conventional practitioners find hard to reach, despite recognized needs, are often underserved. Nurses and community health workers carried a disproportionate burden of care. Cultural and diversity training is not a condition of employment. There is a struggle to put equity principles into practice, indicating will without enactment. Equity is not addressed systematically below strategic levels and equity does not shape funding decisions, program development, implementation and monitoring. Equity is not incentivized although examples of exceptional practice, driven by individuals, are evident across New Zealand.

Health equity in the New Zealand health care system: a national survey

PubMed Central

2011-01-01

Introduction In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. Methods A national survey of district health boards (DHBs) was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Results Survey responses were received from the majority of DHBs (15/21), some PHOs (21/84) and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so for other ethnic groups or by geography. Populations that conventional practitioners find hard to reach, despite recognized needs, are often underserved. Nurses and community health workers carried a disproportionate burden of care. Cultural and diversity training is not a condition of employment. Conclusions There is a struggle to put equity principles into practice, indicating will without enactment. Equity is not addressed systematically below strategic levels and equity does not shape funding decisions, program development, implementation and monitoring. Equity is not incentivized although examples of exceptional practice, driven by individuals, are evident across New Zealand. PMID:22014211

Smart Home Technologies: Insights into Generation-Specific Acceptance Motives

NASA Astrophysics Data System (ADS)

Gaul, Sylvia; Ziefle, Martina

In this research we examine the generation specific acceptance motives of eHealth technologies in order to assess the likelihood of success for these new technologies. 280 participants (14 - 92 years of age) volunteered to participate in a survey, in which using motives and barriers toward smart home technologies were explored. The scenario envisaged was the use of a medical stent implemented into the body, which monitors automatically the health status and which is able to remotely communicate with the doctor. Participants were asked to evaluate the pros and cons of the usage of this technology, their acceptance motives and potential utilization barriers. In order to understand the complex nature of acceptance, personal variables (age, technical expertise, health status), individual's cognitive concepts toward ageing as well as perceived usefulness were related. Outcomes show that trust, believe in the reliability of technology, privacy and security as well as intimacy facets are essential for acceptance and should be considered in order to proactively design a successful rollout of smart home technologies.

The influence of marital status and spousal employment on retirement behavior in Germany and Spain.

PubMed

Radl, Jonas; Himmelreicher, Ralf K

2015-05-01

This article analyzes the impact of marital status and spousal employment on the timing of retirement in Germany and Spain. Retirement behavior is examined by means of event-history models, with a competing risks framework being used to distinguish between voluntary and involuntary work-exit transitions. To take account of the role of social policies, we adopt a comparative approach. Data are drawn from a 2006 special retirement module implemented analogously in national labor force surveys. The results show that spousal labor market participation plays a large role in work-exit transitions, even when retirement is involuntary. This finding questions the widespread belief that coretirement is exclusively due to preference for joint retirement shared among spouses. Moreover, widows and widowers tend to retire prematurely in Germany, whereas no such effect could be found in Spain. This finding is explained by reference to specific economic incentives arising from national pension legislation. © The Author(s) 2014.

Mothers’ Employment and Health of Low-Income Children

PubMed Central

Gennetian, Lisa; Hill, Heather; Lopoo, Leonard; London, Andrew

2010-01-01

This study examines whether maternal employment affects the health status of low-income, elementary-school-aged children using instrumental variables estimation and experimental data from a welfare-to-work program implemented in the early 1990s. Mother’s report of child health status is predicted as a function of exogenous variation in maternal employment associated with random assignment to the program group. IV estimates show a modest adverse effect of maternal employment on children’s health. Making use of data from another welfare-to-work program we propose that any adverse effect on child health may be tempered by increased family income and access to public health insurance coverage, findings with direct relevance to a number of current policy discussions. In a secondary analysis using fixed effects techniques on longitudinal survey data collected in 1998 and 2001, we find a comparable adverse effect of maternal employment on child health that supports the external validity of our primary result. PMID:20356641

Principal Attrition and Mobility: Results from the 2012-13 Principal Follow-Up Survey. First Look. NCES 2014-064

ERIC Educational Resources Information Center

Goldring, Rebecca; Taie, Soheyla

2014-01-01

This report presents selected findings from the Public School Principal Status and Private School Principal Status Data Files of the 2012-13 Principal Follow-up Survey (PFS). The PFS is a nationally representative sample survey of public and private K-12 schools in the 50 states and District of Columbia and was initiated to inform discussions and…

A Status Report on Hunger and Homelessness in America's Cities: 1991. A 28-City Survey.

ERIC Educational Resources Information Center

Waxman, Laura DeKoven

To assess the status of hunger and homelessness in urban America during 1991, The U.S. Conference of Mayors surveyed 28 major cities whose mayors are members of its Task Force on Hunger and Homelessness. The survey sought information and estimates from each city on: (1) the demand for emergency food assistance and emergency shelter and the…

A Status Report on Hunger and Homelessness in America's Cities, 2000: A 25-City Survey.

ERIC Educational Resources Information Center

Lowe, Eugene T.

To assess the status of hunger and homelessness in U.S. cities during the year 2000, the U.S. Conference of Mayors surveyed 25 major cities whose mayors were members of its Task Force on Hunger and Homelessness. The survey sought information and estimates from each city on emergency food supplies and services, the causes of hunger and…

Seasonality, household food security, and nutritional status in Dinajpur, Bangladesh.

PubMed

Hillbruner, Chris; Egan, Rebecca

2008-09-01

The influence of seasonality on food security and nutritional status is widely accepted. However, research has typically focused on rural households and has not explored the specific mechanisms underlying seasonal effects. To investigate the role of seasonality in determining the food security and nutritional status of low-income urban households and to isolate specific pathways through which seasonality has its impact. Secondary panel data from CARE/IFPRI were utilized. Three rounds of data were collected from approximately 600 households in low-income areas of Dinajpur, Bangladesh, from 2002 through 2003, twice during the monsoon season and once in the dry season. Household-level surveys collected data on income and expenditure, employment, urban agriculture, health, and assets. Height and weight measurements were taken from children between the ages of 6 and 72 months. Paired t-tests and logistic fixed-effects modeling were then used to explore the role of seasonality. The prevalence rates of food insecurity, wasting, and inadequate growth were all significantly higher during the monsoon season as compared with the dry season. Dietary diversity and lost work due to the weather were identified as specific pathways through which season affected household food security. However, mechanisms hypothesized to contribute to seasonal declines in nutritional status, such as child illness, were not found to be significant. Season had a significant effect on both food security and nutritional status in Dinajpur, with households consistently worse off during the monsoon season. Initiatives to promote food market development, support employment during the hunger season, and prevent seasonal declines in nutritional status should be implemented.

An overview of human biomonitoring of environmental chemicals in the Canadian Health Measures Survey: 2007-2019.

PubMed

Haines, Douglas A; Saravanabhavan, Gurusankar; Werry, Kate; Khoury, Cheryl

2017-03-01

Human biomonitoring (HBM) is used to indicate and quantify exposure by measuring environmental chemicals, their metabolites or reaction products in biological specimens. The biomonitoring component of the Canadian Health Measures Survey (CHMS) is the most comprehensive initiative providing general population HBM data in Canada. The CHMS is an ongoing cross-sectional direct measures survey implemented in 2-year cycles. It provides nationally-representative data on health, nutritional status, environmental exposures, and related risks and protective characteristics. The survey follows a robust planning, design and sampling protocol as well as a comprehensive quality assurance and quality control regime implemented for all aspect of the survey to ensure the validity of the HBM results. HBM blood and urine data are available for CHMS cycles 1 (2007-2009), 2 (2009-2011) and 3 (2012-2013). Field collection has been completed for cycle 4 (2014-2015), with cycle 5 (2016-2017) in progress and cycle 6 planning (2018-2019) being finalized. Biomonitoring results for 279 chemicals are expected over the six cycles of the CHMS (220 in individual blood, urine or hair samples, and 59 in pooled serum samples). The chemicals include metals and trace elements, polychlorinated biphenyls (PCBs), organochlorines, flame retardants, perfluoroalkyl substances, volatile organic compounds (VOCs) and metabolites, environmental phenols, triclocarban, acrylamide, pesticides (e.g., triazines, carbamates, organophosphates, phenoxy, pyrethroids) and/or their metabolites, chlorophenols, polycyclic aromatic hydrocarbon (PAH) metabolites, phthalates and alternate plasticizer metabolites, and tobacco biomarkers. Approximately one half of the chemicals measured in individual blood and urine samples over the first three cycles were detected in more than 60% of samples. CHMS biomonitoring data have been used to establish baseline HBM concentrations in Canadians; inform public health, regulatory risk assessment and management decisions; and fulfil national and international reporting requirements. Concurrent efforts are underway in Canada to develop statistically- and risk-based concepts and tools to interpret biomonitoring data. Crown Copyright © 2016. Published by Elsevier GmbH. All rights reserved.

Prevalence of Smoking and Obesity Among U.S. Cancer Survivors: Estimates From the National Health Interview Survey, 2008-2012.

PubMed

Shoemaker, Meredith L; White, Mary C; Hawkins, Nikki A; Hayes, Nikki S

2016-07-01

To describe smoking and obesity prevalence among male and female cancer survivors in the United States.
. Cross-sectional survey.
. Household interviews.
. 9,753 survey respondents who reported ever having a malignancy, excluding nonmelanoma skin cancers. 
. Data from the National Health Interview Survey (2008-2012) were used to calculate weighted smoking status prevalence estimates. Cross-tabulations of smoking and weight status were produced, along with Wald chi-square tests and linear contrasts.
. Cancer history, smoking status, obesity status, gender, age, and age at diagnosis.
. Seventeen percent of cancer survivors reported current smoking. Female survivors had higher rates of current smoking than males, particularly in the youngest age category. Male survivors who currently smoked had lower obesity prevalence rates than males who previously smoked or never smoked. Among female survivors, 31% were obese and no significant differences were seen in obesity prevalence by smoking status for all ages combined. 
. The findings highlight the variation in smoking status and weight by age and gender. Smoking interventions may need to be targeted to address barriers specific to subgroups of cancer survivors.
. Nurses can be instrumental in ensuring that survivors receive comprehensive approaches to address both weight and tobacco use to avoid trading one risk for another.

[Analysis on current status of drinking water quality in rural areas of China].

PubMed

Zhang, L; Chen, Y; Chen, C; Wang, H; Yan, H Z; Zhao, Y C

1997-01-01

An investigation on drinking water quality in rural areas of 180 counties in 26 provinces, municipalities and autonomous regions of China was carried out. The population surveyed was 89.39 million. 69.6% of which was supplied with ground water. Central water supply systems served 47.1% of population. Quality of drinking water was graded according to the "Guidelines for Implementation of the 'Sanitary Standard for Drinking Water' in Rural Areas". The rate of population supplied with unqualified drinking water was 42.7%. The bacteriological indices of drinking water exceeded the standard seriously. Organic pollution occurred extensively. Some regions supplied with water of high concentration of fluoride.

Sexual Violence Among College Students Attending a Nonresidential Campus.

PubMed

Solinas-Saunders, Monica

2018-03-01

Using the empirical powers of theories of intersectionality, the study investigates the association between students' demographics (such as gender identity, race, ethnicity, age, and socioeconomic status) and sexual violence victimization. An anonymous survey was employed to collect data from a cluster random sample of 966 students attending face-to-face courses at a midsize urban nonresidential campus. The empirical findings suggest that being older and female are the only statistically significant factors in the analysis. As the first attempt to focus on students attending nonresidential programs in the United States, the study presents implications for policy and program implementation to include issues pertinent to students' diversity to better respond to students' risk of victimization.

Development and Implementation of Culturally Tailored Offline Mobile Health Surveys.

PubMed

McIntosh, Scott; Pérez-Ramos, José; Demment, Margaret M; Vélez Vega, Carmen; Avendaño, Esteban; Ossip, Deborah J; Dye, Timothy D

2016-06-02

In low and middle income countries (LMICs), and other areas with low resources and unreliable access to the Internet, understanding the emerging best practices for the implementation of new mobile health (mHealth) technologies is needed for efficient and secure data management and for informing public health researchers. Innovations in mHealth technology can improve on previous methods, and dissemination of project development details and lessons learned during implementation are needed to provide lessons learned to stakeholders in both the United States and LMIC settings. The aims of this paper are to share implementation strategies and lessons learned from the development and implementation stages of two survey research projects using offline mobile technology, and to inform and prepare public health researchers and practitioners to implement new mobile technologies in survey research projects in LMICs. In 2015, two survey research projects were developed and piloted in Puerto Rico and pre-tested in Costa Rica to collect face-to-face data, get formative evaluation feedback, and to test the feasibility of an offline mobile data collection process. Fieldwork in each setting involved survey development, back translation with cultural tailoring, ethical review and approvals, data collector training, and piloting survey implementation on mobile tablets. Critical processes and workflows for survey research projects in low resource settings were identified and implemented. This included developing a secure mobile data platform tailored to each survey, establishing user accessibility, and training and eliciting feedback from data collectors and on-site LMIC project partners. Formative and process evaluation strategies are necessary and useful for the development and implementation of survey research projects using emerging mHealth technologies in LMICs and other low resource settings. Lessons learned include: (1) plan institutional review board (IRB) approvals in multiple countries carefully to allow for development, implementation, and feedback, (2) in addition to testing the content of survey instruments, allow time and consideration for testing the use of novel mHealth technology (hardware and software), (3) incorporate training for and feedback from project staff, LMIC partner staff, and research participants, and (4) change methods accordingly, including content, as mHealth technology usage influences and is influenced by the content and structure of the survey instrument. Lessons learned from early phases of LMIC research projects using emerging mHealth technologies are critical for informing subsequent research methods and study designs.

[Healthcare in One's Own Home or Outside: A Comparison of the Health Status of Family Caregivers].

PubMed

Mußgnug, T; Korotkaia, A

2017-12-01

The GEDA-Survey 2012 is a representative, nationwide survey conducted by means of computer-assisted telephone interviews (CATI) between March 2012 and March 2013 by the Robert Koch Institute with 19 294 completed interviews. A total of 1 219 persons tending to the needs of a care-dependent person responded to questions about sex, age and health status. Using the statistics software "SPSS", the GEDA-data were evaluated descriptively and finally visualized with "Microsoft Office". The survey results reveal that 47,2% of family caregivers from this cohort are between 45 and 64 years old. This cohort had more female caregivers (62,8%) than males (37,2%). Comparing the frequency of information on health status in 3 age groups, our survey indicated that persons tending to an individual outside their own homes assessed their health status to be better than those caring for individuals in their own homes. © Georg Thieme Verlag KG Stuttgart · New York.

Emergency nurses' knowledge and experience with the triage process in Hunan Province, China.

PubMed

Hammad, Karen; Peng, Lingli; Anikeeva, Olga; Arbon, Paul; Du, Huiyun; Li, Yinglan

2017-11-01

Triage is implemented to facilitate timely and appropriate treatment of patients, and is typically conducted by senior nurses. Triage accuracy and consistency across emergency departments remain a problem in mainland China. This study aimed to investigate the current status of triage practice and knowledge among emergency nurses in Changsha, Hunan Province, China. A sample of 300 emergency nurses was selected from 13 tertiary hospitals in Changsha and a total of 193 completed surveys were returned (response rate=64.3%). Surveys were circulated to head nurses, who then distributed them to nurses who met the selection criteria. Nurses were asked to complete the surveys and return them via dedicated survey return boxes that were placed in discreet locations to ensure anonymity. Just over half (50.8%) of participants reported receiving dedicated triage training, which was provided by their employer (38.6%), an education organisation (30.7%) or at a conference (26.1%). Approximately half (53.2%) reported using formal triage scales, which were predominantly 4-tier (43%) or 5-tier (34%). The findings highlight variability in triage practices and training of emergency nurses in Changsha. This has implications for the comparability of triage data and transferability of triage skills across hospitals. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Reduced preoperative fasting periods. Current status after a survey of patients and colleagues].

PubMed

Breuer, J-P; Bosse, G; Prochnow, L; Seifert, S; Langelotz, C; Wassilew, G; Francois-Kettner, H; Polze, N; Spies, C

2010-07-01

Since October 2004 German Anaesthesiology Societies have officially recommended a decreased fasting period of 2 h for clear fluids and 6 h for solid food before elective surgery. A survey of patients and health care workers was carried out in our university clinic to assess the implementation of the new fasting recommendations. Surgical patients (n=865) as well as physicians and nurses specialized in anaesthesia and surgery (n=2,355) were invited to complete a written questionnaire. The survey inquired about prescribed and practiced duration of fasting, attitudes towards reduced preoperative fasting and knowledge of the new guidelines. Data from 784 patients (91%) and 557 health care workers (24%) were analysed. Patients reported mean fasting times of 10+/-5 h for fluids and 15+/-4 h for solid food. Of the patients 52% and 16% would have preferred to drink and eat before surgery, respectively and 10% were informed about the new recommendations of shorter preoperative fluid and solid fasting. Such patients reported significantly reduced fasting times for fluids compared with those who were recommended to fast for the traditional longer periods (8+/-6 versus 12+/-4 h, p<0.001). Preoperative fasting advice remembered by the patients significantly differed from the prescribed recommendations (2 h fluid fasting, 22 versus 53%, p<0.001). Anaesthesiologists were significantly more knowledgeable of the new guidelines (90 versus 32-42%, p<0.001) and significantly more willing to recommend the new short preoperative fasting times (75 versus 15-19%, p<0.001) than other health care workers. Of all health care workers 82% and 32% reported patients' frequent desire to drink and eat before surgery, respectively, 92% considered reduced preoperative fasting to be positive, 76% feared increased risks for patients and 42% expected a decreased flexibility in their daily work. The current guidelines for preoperative fasting have not been widely implemented. Besides a knowledge discrepancy, remarkable concerns remain regarding higher risk for patients which may be important barriers to implementation. Nevertheless, health care workers are aware of patients' desire for shorter preoperative fasting. If the new guidelines are recommended patients will make use of them. Further training of staff and adequate implementation tools are needed.

Evolution in intergenerational exchanges between elderly people and their grandchildren in Taiwan; data from a multiple round cross-sectional study from 1993 to 2007

PubMed Central

2011-01-01

Background This study aimed to evaluate social evolution in Taiwan in recent decades using the changing pattern of care provided by grandparents for their grandchildren as an indicator. Methods Data from the second, fourth and sixth wave surveys of the Study of Health and Living Status of the Middle-Aged and Elderly in Taiwan were used for the analysis. This survey collected individual characteristics, including age, gender, education, ethnicity, dwelling place, living with partners, co-resident with children, employment status, self-reported health status and their provision of care for their grandchildren. Information about the attitudes toward National Health Insurance (NHI) was further collected in a questionnaire of 1999 following the implementation of NHI in 1995. By elders, we mean persons 60 or more years old. By grandchildren, we mean persons under 16 years of age. First, changes in individual characteristics were compared during these study periods (chi-square test). Then the logistic regression was performed to determine how significantly elders' grandchild-care behavior was associated with their individual characteristics. Results The percentage of elders providing grandchild care increased from 7.7% in 1993 to 13.6% in 1999, and then to 19.4% in 2007. By analysis, significant association was found between behavior in taking care of grandchildren and individuals of lower age, grandmothers, those living with partners or co-residing with children, those unemployed and those with better self-reported health status. And the effect of year was confirmed in the multivariable analysis. Conclusions This study pointed out the changing pattern of elders' behavior in taking care of their grandchildren as the main indicator and their related individual characteristics. We argue the need for improving social security policies in an ageing society. We suggest that the interaction between population policies and those of social welfare, including policies for health care and childcare, should be carefully evaluated. PMID:21835009

Maternal Education and Diarrhea among Children aged 0-24 Months in Nigeria.

PubMed

Desmennu, Adeyimika T; Oluwasanu, Mojisola M; John-Akinola, Yetunde O; Oladunni, Opeyemi; Adebowale, Ayo S

2017-09-01

Childhood diarrhea remains a problem in countries like Nigeria where access to potable water, good hygiene and sanitation are lacking. Maternal education is an important determinant of health status of under-five children. Very few studies have investigated the relationship between maternal education and diarrhea in children in Nigeria. Therefore, this study was implemented to fill the gap. The study design was cross-sectional and 2013 National Survey was used. Children aged 0-24 months were investigated and the dependent variable was diarrhea status of the index child in the last two weeks prior the survey. The main independent variable was maternal education. Data were analyzed using Chi-square and Logistic regression models (α=0.05). Diarrhea prevalence was 13.7% and higher (15.5%) among children of women who have no formal education, and mothers living in the North East region of Nigeria experienced the highest prevalence (26.4%). Children whose mothers had no formal education were 2.69(CI= 1.800-4.015, p <0.001) more likely to have diarrhea as compared to those who had higher education. Maternal education is an important predictor of diarrhea among children aged 0-24 months in Nigeria. Policies to reduce diarrhea among children in Nigeria should target children of the illiterate, less educated mothers and those living in the North-West.

Long-term effect of dietary fibre intake on glycosylated haemoglobin A1c level and glycaemic control status among Chinese patients with type 2 diabetes mellitus.

PubMed

Yang, Luxi; Shu, Le; Jiang, Junyi; Qiu, Hua; Zhao, Genming; Zhou, Yi; Jiang, Qingwu; Sun, Qiao; Qin, Guoyou; Wu, Hongyan; Yang, Liming; Ruan, Xiaonan; Xu, Wang Hong

2014-08-01

Dietary fibre has been linked to lower levels of glycosylated haemoglobin A1c (HbA1c) among diabetes patients. The present study aimed to evaluate the long-term effect of dietary fibre on HbA1c levels among Chinese patients with type 2 diabetes mellitus. Two cross-sectional surveys were conducted in 2006 and 2011, with the second one being a repeat survey on a sub-sample from the initial one. In both surveys, an in-person interview was conducted to collect information on demographic characteristics and lifestyles following a similar protocol. Dietary intake was assessed with a validated FFQ. Anthropometric measures and biochemical assays were performed at the interview. Communities in Pudong New Area of Shanghai, China. Chinese patients (n 934) with type 2 diabetes mellitus. An inverse association was observed between dietary fibre and glycaemic status indicated by HbA1c level in both surveys, although it was significant only in the first survey. Among 497 patients participating in both surveys, dietary fibre intake at the first survey was inversely associated with uncontrolled glycaemic status at the second survey, with adjusted odds ratios across the tertiles of intake being 1·00, 0·72 (95 % CI 0·43, 1·21) and 0·58 (95 % CI 0·34, 0·99; P trend = 0·048). The change in fibre intake was slightly associated with glycaemic status, with each increase in tertile scores of intake linked to a 0·138 % (β = -0·138; 95 % CI -0·002, 0·278) decrease in HbA1c value and a 19 % (OR = 0·81; 95 % CI 0·65, 1·02) reduced risk of uncontrolled glycaemic status at the second survey. Dietary fibre may have a long-term beneficial effect on HbA1c level among Chinese diabetes patients.

ACE Objectives, Current Status and the 2017 Decadal Survey

NASA Technical Reports Server (NTRS)

Da Silva, Arlindo

2018-01-01

In this talk we present an overview of the Aerosol-Cloud-Ecosystems (ACE) preformulation studies, a tier-2 satellite mission recommended by the 2007 Decadal Survey. We discuss the current status of ACE measurement concepts and associated retrieval algorithms. We conclude with a brief discussion of the recommendations by the 2017 Decadal Survey and how ACE accomplishments can inform the future Aerosol and Cloud, Convection & Precipitation Designated Observables.

Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009. Data from the National Health Interview Survey. Vital and Health Statistics. Series 10, Number 249. DHHS Publication No. (PHS) 2011-1577

ERIC Educational Resources Information Center

Pleis, J. R.; Ward, B. W.; Lucas, J. W.

2010-01-01

Objectives: This report presents health statistics from the 2009 National Health Interview Survey (NHIS) for the civilian noninstitutionalized adult population, classified by sex, age, race and ethnicity, education, family income, poverty status, health insurance coverage, marital status, and place and region of residence. Estimates are presented…

Patient Radiation Exposure Tracking: Worldwide Programs and Needs—Results from the First IAEA Survey

PubMed Central

Rehani, Madan M.; Frush, Donald P.; Berris, Theocharis; Einstein, Andrew J.

2012-01-01

The purpose of this study was to assess the current status of patient radiation exposure tracking internationally, gauge interest and develop recommendations for implementation. A survey questionnaire was distributed to representatives of countries to obtain information, including the existence of a patient exposure tracking program currently available in the country, plans for future programs, perceived needs and goals of future programs, which examinations will be tracked, whether procedure tracking alone or dose tracking is planned, and which dose quantities will be tracked. Responses from 76 countries, including all of the six most populous countries and 16 of the 20 most populous, showed that although no country has yet implemented a patient exposure tracking program at a national level, there is increased interest in this issue. Eight countries (11%) indicated that such a program is actively being planned and 3 (4%) stated that they have a program for tracking procedures only, but not for dose. Twenty-two (29%) feel that such a program will be “extremely useful”, 46 (60%) “very useful” and 8 (11%) “moderately useful”, with no respondents stating “Mildly useful” or “Not useful”. Ninety-nine percent of countries indicated an interest in developing and promoting such a program. In a first global survey covering 76 countries, it is clear that no country has yet achieved exposure tracking at a national level, although there are successful examples at sub-national level. Almost all have indicated interest and some have plans to achieve dose tracking in the near future. PMID:22840382

Estimating the impact of vitamin A-fortified vegetable oil in Bangladesh in the absence of dietary assessment data.

PubMed

Fiedler, John L; Lividini, Keith; Bermudez, Odilia I

2015-02-01

Vitamin A deficiency is a serious health problem in Bangladesh. The 2011-12 Bangladesh Micronutrient Survey found 76·8% of children of pre-school age were vitamin A deficient. In the absence of nationally representative, individual dietary assessment data, we use an alternative--household income and expenditure survey data--to estimate the potential impact of the introduction of vitamin A-fortified vegetable oil in Bangladesh. Items in the household income and expenditure survey were matched to food composition tables to estimate households' usual vitamin A intakes. Then, assuming (i) the intra-household distribution of food is in direct proportion to household members' share of the household's total adult male consumption equivalents, (ii) all vegetable oil that is made from other-than mustard seed and that is purchased is fortifiable and (iii) oil fortification standards are implemented, we modelled the additional vitamin A intake due to the new fortification initiative. Nationwide in Bangladesh. A weighted sample of 12,240 households comprised of 55,580 individuals. Ninety-nine per cent of the Bangladesh population consumes vegetable oil. The quantities consumed are sufficiently large and, varying little by socio-economic status, are able to provide an important, large-scale impact. At full implementation, vegetable oil fortification will reduce the number of persons with inadequate vitamin A intake from 115 million to 86 million and decrease the prevalence of inadequate vitamin A intake from 80% to 60%. Vegetable oil is an ideal fortification vehicle in Bangladesh. Its fortification with vitamin A is an important public health intervention.

AED in Europe. Report on a survey.

PubMed

Bahr, Jan; Bossaert, Leo; Handley, Anthony; Koster, Ruud; Vissers, Bart; Monsieurs, Koen

2010-02-01

Based on the strategies for community defibrillation defined by a joint policy conference of ESC and ERC, we have conducted a survey to identify the current status of AED programmes in Europe. All registered visitors to the website of the ERC were contacted by e-mail and invited to participate in a web-based survey. Of the 983 usable responses, 899 came from 36 European countries, representing a total of 748 million inhabitants. In 11 countries AED use by non-physicians has been implemented partially. All but 3 countries reported that first-tier ambulances are equipped with defibrillators. In 13 countries everybody is allowed to use an AED and in 11 countries anybody who has been trained. In 14 countries there are a few community responder programmes, in 14 countries there are hardly any, and in 7 countries there are none. Thirteen countries have implemented a few on-site responder programmes; in 16 countries there are hardly any such programmes, and in 7 countries none. Programmes for home responders can hardly be found in 19 countries; in-hospital programmes exist in 7 countries nearly everywhere. Only 1 country reported that epidemiologic and/or economic evaluations are carried out nearly everywhere when planning AED programmes. Nationwide registries to collect data from resuscitation attempts have been set up in 4 countries. In 27 countries inventories for AEDs can be found here and there. Much has been achieved concerning the provision and use of AEDs in Europe, but there is still a long way to go. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Assessing the impact of innovative training of family physicians for the patient-centered medical home.

PubMed

Carney, Patricia A; Eiff, M Patrice; Saultz, John W; Lindbloom, Erik; Waller, Elaine; Jones, Samuel; Osborn, Jamie; Green, Larry

2012-03-01

New approaches to enhance access in primary care necessitate change in the model for residency education. To describe instrument design, development and testing, and data collection strategies for residency programs, continuity clinics, residents, and program graduates participating in the Preparing the Personal Physician for Practice (P(4)) project. We developed and pilot-tested surveys to assess demographic characteristics of residents, clinical and operational features of the continuity clinics and educational programs, and attitudes about and implementation status of Patient Centered Medical Home (PCMH) characteristics. Surveys were administered annually to P(4) residency programs since the project started in 2007. Descriptive statistics were used to profile data from the P(4) baseline year. Most P(4) residents were non-Hispanic white women (60.7%), married or partnered, attended medical school in the United States and were the first physicians in their families to attend medical school. Nearly 85% of residency continuity clinics were family health centers, and about 8% were federally qualified health centers. The most likely PCMH features in continuity clinics were having an electronic health record and having fully secure remote access available; both of which were found in more than 50% of continuity clinics. Approximately one-half of continuity clinics used the electronic health record for safety projects, and nearly 60% used it for quality-improvement projects. We created a collaborative evaluation model in all 14 P(4) residencies. Successful implementation of new surveys revealed important baseline features of residencies and residents that are pertinent to studying the effects of new training models for the PCMH.

Policies and availability of orphan medicines in outpatient care in 24 European countries.

PubMed

Sarnola, Kati; Ahonen, Riitta; Martikainen, Jaana E; Timonen, Johanna

2018-04-09

To assess pricing and reimbursement policies specific to orphan medicines and the availability and distribution settings of ten recently authorised medicinal products suitable for outpatient care with orphan status and centralised marketing authorisation in Europe, and whether patients receive these products free of charge or have to pay some or all of the costs themselves. Web survey to authorities and representatives of third party payers in the Pharmaceutical Pricing and Reimbursement Information (PPRI) network in April 2016. In most of the 24 countries, special policies were not implemented in the assessment of reimbursement status (22 countries) or in the pricing (20 countries) of orphan medicines. An average of five of the ten recently authorised products per country were available for outpatient care. Products were dispensed from community pharmacies in eight countries and from health care units in five countries. In four countries, both distribution settings were used. When products were dispensed from community pharmacies, patients typically paid some of the price themselves. Products dispensed from health care units were often free of charge for patients. Most European countries had not implemented pricing and reimbursement policies specific to orphan medicines. The availability of orphan products varied between countries. It is important to discuss whether orphan medicines should be considered as a separate group in the reimbursement regulations in order to secure patient access to these medicines.

Prevalence and severity of dental caries among American Indians and Alaska Natives.

PubMed

Niendorff, W J; Jones, C M

2000-01-01

This paper reports findings from the 1991 IHS Patient Oral Health Status and Treatment Needs Survey (1991 IHS patient survey) and presents trends in caries among American Indian and Alaska Native (Native American) populations since 1957. The 1991 IHS patient survey obtained data from approximately 10 percent (25,000) of the dental patients seen annually at IHS, tribal, and urban Indian clinics. The results of this survey are compared descriptively with previous surveys conducted by the IHS beginning in 1957. Findings from the 1991 IHS patient survey indicate that Native Americans experience a much higher prevalence of dental caries in their primary and permanent dentitions than the general US population. However, caries rates in Native American children peaked in 1983-84 and have been going down since that time. While progress has been made in preventing dental caries among Native Americans, the high prevalence and severity at all ages in this rapidly growing population have resulted in a large backlog of untreated disease with an overwhelming demand on the resources available to provide care. Continued emphasis on dental caries prevention and health promotion is an important part of the solution. New strategies such as targeting preventive services toward individuals and groups with the highest risk of disease and the use of modern conservative treatment methods to control disease must be employed. Full implementation of these strategies and identification of the resources required will depend upon new and ongoing partnerships among tribes, federal and state governments, and the private sector.

Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries.

PubMed

Charles, M Katherine; Lindegren, Mary Lou; Wester, C William; Blevins, Meridith; Sterling, Timothy R; Dung, Nguyen Thi; Dusingize, Jean Claude; Avit-Edi, Divine; Durier, Nicolas; Castelnuovo, Barbara; Nakigozi, Gertrude; Cortes, Claudia P; Ballif, Marie; Fenner, Lukas

2016-01-01

World Health Organization advocates for integration of HIV-tuberculosis (TB) services and recommends intensive case finding (ICF), isoniazid preventive therapy (IPT), and infection control ("Three I's") for TB prevention and control among persons living with HIV. To assess the implementation of the "Three I's" of TB-control at HIV treatment sites in lower income countries. Survey conducted between March-July, 2012 at 47 sites in 26 countries: 6 (13%) Asia Pacific, 7 (15%), Caribbean, Central and South America, 5 (10%) Central Africa, 8 (17%) East Africa, 14 (30%) Southern Africa, and 7 (15%) West Africa. ICF using symptom-based screening was performed at 38% of sites; 45% of sites used symptom-screening plus additional diagnostics. IPT at enrollment or ART initiation was implemented in only 17% of sites, with 9% of sites providing IPT to tuberculin-skin-test positive patients. Infection control measures varied: 62% of sites separated smear-positive patients, and healthcare workers used masks at 57% of sites. Only 12 (26%) sites integrated HIV-TB services. Integration was not associated with implementation of TB prevention measures except for IPT provision at enrollment (42% integrated vs. 9% non-integrated; p = 0.03). Implementation of TB screening, IPT provision, and infection control measures was low and variable across regional HIV treatment sites, regardless of integration status.

Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities.

PubMed

Allegranzi, Benedetta; Conway, Laurie; Larson, Elaine; Pittet, Didier

2014-03-01

The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign. Copyright © 2014 World Health Organization. Published by Mosby, Inc. All rights reserved.

Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities

PubMed Central

Allegranzi, Benedetta; Conway, Laurie; Larson, Elaine; Pittet, Didier

2014-01-01

Background The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. Methods From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. Results Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). Conclusion Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign. PMID:24581011

Public support for smoke-free policies in Jordan, a high tobacco burden country with weak implementation of policies: Status, opportunities, and challenges.

PubMed

Obeidat, Nour A; Ayub, Hiba S; Bader, Rasha K; Shtaiwi, Aisha S; Shihab, Rawan A; Habashneh, Malek A; Hawari, Feras I

2016-12-01

Several Eastern Mediterranean (EM) countries, including Jordan, suffer from high smoking prevalence but weak implementation of smoking bans (SB). Public support (PS) influences successful implementation of SB, but little is known about PS for SB in EM countries with weak SB implementation. We conducted a cross-sectional survey measuring knowledge and perceptions of a large purposive sample of the Jordanian public regarding tobacco harms and anti-tobacco laws. Among 1169 respondents, 46% of whom used tobacco, PS for SB varied from 98% to 39% based on venue, being highest for health facilities and lowest for coffee shops. In venues with relatively lower PS (restaurants, coffee shops), lower educational groups, older age groups, nonsmokers, and those who had more knowledge regarding tobacco and secondhand smoke harms were significantly more likely to support SB than the highest educational group, the youngest age group, smokers, and those who had less knowledge (respectively). Our results suggest that aggressive promotion of SB is needed in countries like Jordan (where smoking is increasing), tailored to venue and specific sociodemographic characteristics of the public accessing these venues, particularly restaurants and coffee shops. Multifaceted health messages that enhance public knowledge can be of benefit in improving PS for SB.

Special-Status Plant Species Surveys and Vegetation Mapping at Lawrence Livermore National Laboratory

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

Preston, R E

This report presents the results of Jones & Stokes special-status plant surveys and vegetation mapping for the University of California, Lawrence Livermore National Laboratory (LLNL). Special-status plant surveys were conducted at Site 300 in April to May 1997 and in March to April 2002. Eight special-status plants were identified at Site 300: large-flowered fiddleneck, big tarplant, diamond-petaled poppy, round-leaved filaree, gypsum-loving larkspur, California androsace, stinkbells, and hogwallow starfish. Maps identifying the locations of these species, a discussion of the occurrence of these species at Site 300, and a checklist of the flora of Site 300 are presented. A reconnaissance surveymore » of the LLNL Livermore Site was conducted in June 2002. This survey concluded that no special-status plants occur at the Livermore Site. Vegetation mapping was conducted in 2001 at Site 300 to update a previous vegetation study done in 1986. The purpose of the vegetation mapping was to update and to delineate more precisely the boundaries between vegetation types and to map vegetation types that previously were not mapped. The vegetation map is presented with a discussion of the vegetation classification used.« less

Status of the Scorpion Planet Survey: Establishing the Frequency of HR8799b-Like Planets

NASA Astrophysics Data System (ADS)

Wagner, K. R.; Daniel, A.; Kasper, M.

2017-11-01

Wide-orbit giant planets will likely affect plant formation and habitability of inner planets. In this presentation we will review the existing evidence on the occurrence rates of super-Jupiters and present the status of our VLT/SPHERE survey.

Refusal bias in HIV prevalence estimates from nationally representative seroprevalence surveys.

PubMed

Reniers, Georges; Eaton, Jeffrey

2009-03-13

To assess the relationship between prior knowledge of one's HIV status and the likelihood to refuse HIV testing in populations-based surveys and explore its potential for producing bias in HIV prevalence estimates. Using longitudinal survey data from Malawi, we estimate the relationship between prior knowledge of HIV-positive status and subsequent refusal of an HIV test. We use that parameter to develop a heuristic model of refusal bias that is applied to six Demographic and Health Surveys, in which refusal by HIV status is not observed. The model only adjusts for refusal bias conditional on a completed interview. Ecologically, HIV prevalence, prior testing rates and refusal for HIV testing are highly correlated. Malawian data further suggest that amongst individuals who know their status, HIV-positive individuals are 4.62 (95% confidence interval, 2.60-8.21) times more likely to refuse testing than HIV-negative ones. On the basis of that parameter and other inputs from the Demographic and Health Surveys, our model predicts downward bias in national HIV prevalence estimates ranging from 1.5% (95% confidence interval, 0.7-2.9) for Senegal to 13.3% (95% confidence interval, 7.2-19.6) for Malawi. In absolute terms, bias in HIV prevalence estimates is negligible for Senegal but 1.6 (95% confidence interval, 0.8-2.3) percentage points for Malawi. Downward bias is more severe in urban populations. Because refusal rates are higher in men, seroprevalence surveys also tend to overestimate the female-to-male ratio of infections. Prior knowledge of HIV status informs decisions to participate in seroprevalence surveys. Informed refusals may produce bias in estimates of HIV prevalence and the sex ratio of infections.

75 FR 57960 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-23

... respondents respondent (in hours) Student Student Effectiveness 10,158 1 35/60 Baseline Survey. 1st Student mid- 3,612 1 25/60 implementation survey. 2nd Student mid- 3,612 1 25/60 implementation survey. Student Effectiveness 8,126 1 35/60 Follow-up Survey. Principal Baseline principal survey.. 49 1 15/60 Mid...

Changes in Sugary Beverage Consumption and Public Perceptions in Upstate New York After Implementation of a Community Awareness Campaign and Healthier Vending Strategies.

PubMed

Durant, Danielle J; Lowenfels, Ann; Ren, Jia; Brissette, Ian; Martin, Erika G

2018-02-23

We evaluated the impact of a community-based healthy beverage procurement and serving practices program, and educational media campaign, on residents' behaviors and beliefs regarding sugary beverages. Repeated cross-sectional population surveys in 2013 and 2014 were conducted, as well as semistructured interviews with key informants. We employed multivariate differences-in-differences regression analysis, adjusting for demographics and weight status, using the survey data. Key informant interviews were reviewed for common themes. Three rural counties in upstate New York with high prevalence of children living in poverty and childhood obesity. Residents of Broome, Cattaraugus, and Chautauqua, with Chemung as a control, reached through cross-sectional random-digit-dial landline and cellular telephones, and practitioners involved in intervention implementation. Community organizations were encouraged through presentations to leadership to adopt healthier vending policies, providing more low- and no-sugar options, and were provided assistance with implementation. In addition, a media campaign supported by presentations to the public aimed to educate residents regarding the health consequences of sugary beverage consumption. The survey measured population demographics and sugary beverage consumption frequency, availability, beliefs about harmfulness, and support for regulation, pre- and postintervention. Key informant interviews elicited perceived program challenges and successes. Compared with temporal trends in the control county, availability of regular soda in the intervention counties decreased (differences-in-differences estimator: β = -.341, P = .04) and support for regulation increased (differences-in-differences estimator: β = .162, P = .02). However, there were no differences regarding beliefs about harmfulness or consumption. Practitioners confirmed that the intervention increased awareness but was insufficient to spur action. Although public education on the harmfulness of sugary beverages and provision of healthier options in some vending machines successfully impacted soda availability and support for regulation, it did not reduce consumption. This intervention seems promising but should be paired with other community-based interventions for a more comprehensive approach.

Correlational analysis of neck/shoulder pain and low back pain with the use of digital products, physical activity and psychological status among adolescents in Shanghai.

PubMed

Shan, Zhi; Deng, Guoying; Li, Jipeng; Li, Yangyang; Zhang, Yongxing; Zhao, Qinghua

2013-01-01

This study investigates the neck/shoulder pain (NSP) and low back pain (LBP) among current high school students in Shanghai and explores the relationship between these pains and their possible influences, including digital products, physical activity, and psychological status. An anonymous self-assessment was administered to 3,600 students across 30 high schools in Shanghai. This questionnaire examined the prevalence of NSP and LBP and the level of physical activity as well as the use of mobile phones, personal computers (PC) and tablet computers (Tablet). The CES-D (Center for Epidemiological Studies Depression) scale was also included in the survey. The survey data were analyzed using the chi-square test, univariate logistic analyses and a multivariate logistic regression model. Three thousand sixteen valid questionnaires were received including 1,460 (48.41%) from male respondents and 1,556 (51.59%) from female respondents. The high school students in this study showed NSP and LBP rates of 40.8% and 33.1%, respectively, and the prevalence of both influenced by the student's grade, use of digital products, and mental status; these factors affected the rates of NSP and LBP to varying degrees. The multivariate logistic regression analysis revealed that Gender, grade, soreness after exercise, PC using habits, tablet use, sitting time after school and academic stress entered the final model of NSP, while the final model of LBP consisted of gender, grade, soreness after exercise, PC using habits, mobile phone use, sitting time after school, academic stress and CES-D score. High school students in Shanghai showed high prevalence of NSP and LBP that were closely related to multiple factors. Appropriate interventions should be implemented to reduce the occurrences of NSP and LBP.

Endosonography-related mortality and morbidity for pulmonary indications: a nationwide survey in the Netherlands.

PubMed

von Bartheld, Martin B; Annema, Jouke T

2015-12-01

Endosonography is being implemented rapidly in pulmonary medicine for the diagnosis and staging of lung cancer, the assessment of sarcoidosis, and the assessment of mediastinal lesions. Although serious adverse events (SAEs) have been described, safety data outside cohort studies are scarce. To assess the SAE and mortality rate of EUS-guided FNA (EUS-FNA) and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal and/or hilar analysis. Nationwide, retrospective survey by using questionnaires. All hospitals in the Netherlands. All patients undergoing EUS-FNA and EBUS-TBNA for intrathoracic analysis in the period 1999 to 2011. EUS-FNA and EBUS-TBNA. Occurrence of fatal outcomes and SAEs. Detailed information was obtained for each reported case, and all cases were reviewed independently by 2 investigators, including identification of risk factors. All 89 hospitals (100%) responded. An estimated 14,075 EUS-FNA and 2675 EBUS procedures were performed. Seven patients died after endosonography (5 EUS-FNA, 2 EBUS [mortality rate 0.04%]). All fatalities occurred in patients of poor performance status (American Society of Anesthesiologists Physical Status Classification System score of III/IV). Twenty-five SAEs were reported (22 EUS-FNA, 3 EBUS [SAE rate of 0.15%; EUS-FNA 0.16%, EBUS 0.11%]). SAEs were mostly (64%) of infectious origin. No specific risk factors for infectious adverse events could be identified. Retrospective study, possible recall bias, overrepresentation of EUS-FNA cases. Endosonography appears to be a safe technique for the analysis of mediastinal and/or hilar lesions. Poor performance status is a risk factor for fatal outcomes. Mediastinitis and/or mediastinal abscess formation is rare but is a potential and dangerous adverse event of endosonography. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Attitudes towards suicide in urban and rural China: a population based, cross-sectional study.

PubMed

Zou, Yaming; Leung, Ricky; Lin, Shao; Yang, Mingan; Lu, Tao; Li, Xianyun; Gu, Jing; Hao, Chun; Dong, Guanghui; Hao, Yuantao

2016-05-26

Suicide intervention programs have been guided by findings that attitude towards suicide and suicidal behavior may be causally linked. These findings also make it imperative to identify the factors that influence attitudes towards suicide. However, there has been little research on attitudes towards suicide among the general population, especially in low-income and middle-income countries. This population-based, cross-sectional study investigated the associated factors of attitudes towards suicide among a representative sample of urban and rural adult residents in China. A multi-stage, stratified random sampling approach was implemented to select participants. Data were collected by a survey using the Scale of Public Attitudes about Suicide (SPAS). The survey also collected some socio-demographic factors and suicidal history of participants. Statistical tests were conducted to identify associated factors that account for variations in attitudes towards suicide. The residents in China generally hold a neutral attitude towards suicide. Attitudes towards suicide among Chinese residents were associated with age, duration of formal education, marital status, job and suicidal ideation. Different attitudinal subscales seemed not to share the same risk factors. However, gender, ethnicity, religious belief, housing style and economic status might not influence residents' attitudes towards suicide. Attitudes towards suicide among Chinese urban and rural residents generally had no statistical difference with one notable exception: opinions on whether or not suicides and suicide attempts are different phenomena. Age, duration of formal education, marital status, job and suicidal ideation seem to have an impact on attitudes towards suicide among residents. Urban and rural residents have similar attitudes towards suicide with the only statistically significance difference being their opinions on whether or not suicides and suicide attempts are different phenomena.

Open dumps in the Hellenic prefecture of Laconia: statistical analysis of characteristics and restoration prioritization on the basis of a field survey.

PubMed

Tsatsarelis, Thomas; Antonopoulos, Ioannis; Karagiannidis, Avraam; Perkoulidis, George

2007-10-01

This study presents an assessment of the current status of open dumps in Laconia prefecture of Peloponnese in southern Greece, where all open dumps are targeted for closure by 2008. An extensive field survey was conducted in 2005 to register existing sites in the prefecture. The data collected included the site area and age, waste depth, type of disposed waste, distance from nearest populated area, local geographical features and observed practices of open burning and soil coverage. On the basis of the collected data, a GIS database was developed, and the above parameters were statistically analysed. Subsequently, a decision tool for the restoration of open dumps was implemented, which led to the prioritization of site restorations and specific decisions about appropriate restoration steps for each site. The sites requiring restoration were then further classified using Principal Component Analysis, in order to categorize them into groups suitable for similar restoration work, thus facilitating fund allocation and subsequent restoration project management.

Dynamic MRI-based computer aided diagnostic systems for early detection of kidney transplant rejection: A survey

NASA Astrophysics Data System (ADS)

Mostapha, Mahmoud; Khalifa, Fahmi; Alansary, Amir; Soliman, Ahmed; Gimel'farb, Georgy; El-Baz, Ayman

2013-10-01

Early detection of renal transplant rejection is important to implement appropriate medical and immune therapy in patients with transplanted kidneys. In literature, a large number of computer-aided diagnostic (CAD) systems using different image modalities, such as ultrasound (US), magnetic resonance imaging (MRI), computed tomography (CT), and radionuclide imaging, have been proposed for early detection of kidney diseases. A typical CAD system for kidney diagnosis consists of a set of processing steps including: motion correction, segmentation of the kidney and/or its internal structures (e.g., cortex, medulla), construction of agent kinetic curves, functional parameter estimation, diagnosis, and assessment of the kidney status. In this paper, we survey the current state-of-the-art CAD systems that have been developed for kidney disease diagnosis using dynamic MRI. In addition, the paper addresses several challenges that researchers face in developing efficient, fast and reliable CAD systems for the early detection of kidney diseases.

International travel among HIV-positive and HIV-negative men who have sex with men, San Francisco, USA.

PubMed

Taylor, K D; Raymond, H Fisher; Truong, H-H M; Ick, T; Le, B; Rive, J; McFarland, W

2011-10-01

We measured the prevalence of international travel, the demographic and risk profile of international travellers and risk and preventive behaviours of travellers among HIV-negative and HIV-positive men who have sex with men (MSM), based in San Francisco, CA, USA, through the addition of questions to the local implementation of the National HIV Behavioral Surveillance survey in 2008. Of 270 MSM participating in the survey, slightly more than one-quarter (26.3%) had travelled internationally in the last year. Those with a history of international travel were more likely to be foreign born, of a higher socioeconomic status and HIV uninfected. Of eight HIV-positive MSM who travelled internationally (11.3% of HIV-positive MSM), all were on antiretroviral therapy and only three recalled being vaccinated for hepatitis A and B. Human papillomavirus infection was also higher among international travellers. Travel health services must be improved to address special needs of this population of international travellers.

The World Health Organization STEPwise Approach to Noncommunicable Disease Risk-Factor Surveillance: Methods, Challenges, and Opportunities

PubMed Central

Guthold, Regina; Cowan, Melanie; Savin, Stefan; Bhatti, Lubna; Armstrong, Timothy; Bonita, Ruth

2016-01-01

Objectives. We sought to outline the framework and methods used by the World Health Organization (WHO) STEPwise approach to noncommunicable disease (NCD) surveillance (STEPS), describe the development and current status, and discuss strengths, limitations, and future directions of STEPS surveillance. Methods. STEPS is a WHO-developed, standardized but flexible framework for countries to monitor the main NCD risk factors through questionnaire assessment and physical and biochemical measurements. It is coordinated by national authorities of the implementing country. The STEPS surveys are generally household-based and interviewer-administered, with scientifically selected samples of around 5000 participants. Results. To date, 122 countries across all 6 WHO regions have completed data collection for STEPS or STEPS-aligned surveys. Conclusions. STEPS data are being used to inform NCD policies and track risk-factor trends. Future priorities include strengthening these linkages from data to action on NCDs at the country level, and continuing to develop STEPS’ capacities to enable a regular and continuous cycle of risk-factor surveillance worldwide. PMID:26696288

The World Health Organization STEPwise Approach to Noncommunicable Disease Risk-Factor Surveillance: Methods, Challenges, and Opportunities.

PubMed

Riley, Leanne; Guthold, Regina; Cowan, Melanie; Savin, Stefan; Bhatti, Lubna; Armstrong, Timothy; Bonita, Ruth

2016-01-01

We sought to outline the framework and methods used by the World Health Organization (WHO) STEPwise approach to noncommunicable disease (NCD) surveillance (STEPS), describe the development and current status, and discuss strengths, limitations, and future directions of STEPS surveillance. STEPS is a WHO-developed, standardized but flexible framework for countries to monitor the main NCD risk factors through questionnaire assessment and physical and biochemical measurements. It is coordinated by national authorities of the implementing country. The STEPS surveys are generally household-based and interviewer-administered, with scientifically selected samples of around 5000 participants. To date, 122 countries across all 6 WHO regions have completed data collection for STEPS or STEPS-aligned surveys. STEPS data are being used to inform NCD policies and track risk-factor trends. Future priorities include strengthening these linkages from data to action on NCDs at the country level, and continuing to develop STEPS' capacities to enable a regular and continuous cycle of risk-factor surveillance worldwide.

Current status of psychiatric rehabilitation in Portugal: A national survey.

PubMed

Teixeira, Carina; Santos, Eduardo; Abreu, Manuel Viegas; Rogers, E Sally

2015-09-01

This article reports on the current state of psychiatric rehabilitation in Portugal. A paper-and-pencil survey was sent to 70 institutions to inquire about the provision of psychiatric rehabilitation services and programs. With a response rate of 40%, 14% of institutions indicated that supported education was provided, 36% offered nonmainstream vocational training, and 29% provided supported employment; none provided evidence-based Individual Placement and Support. Permanent group homes in the community (29%) followed by transitional group homes on institutional grounds (18%) were the most common residential services, with supported housing services (14%) offered less frequently. Finally, 93% of institutions offered occupational activities, 61% provided multifamily psychoeducation, and 36% provided single-family psychoeducation. Despite recent national initiatives promoting effective psychiatric rehabilitation services, supported employment, supported education, and supported housing are not widely implemented in Portugal. To achieve better outcomes for clients, it is critical that evidence-based and promising practices be extensively disseminated. (c) 2015 APA, all rights reserved).

Health service accreditation: report of a pilot programme for community hospitals.

PubMed Central

Shaw, C. D.; Collins, C. D.

1995-01-01

Voluntary accreditation in the United Kingdom is being used by health care providers to improve and market their services and by commissioners to define and monitor service contracts. In a three year pilot scheme in the south west of England, 43 out of 57 eligible community hospitals volunteered to be surveyed; 37 of them were ultimately accredited for up to two years by the hospital accreditation programme. The main causes for non-accreditation related to safety, clinical records, and medical organisation. Follow up visits in 10 hospitals showed that, overall, 69% of recommendations were implemented. An independent survey of participating hospitals showed the perceived benefits to include team building, review of operational policies, improvement of data systems, and the generation of local prestige. Purchasers are increasingly influenced by accreditation status but are mostly unwilling to finance the process directly. None the less, the concept may become an important factor moderating the quality of service in the new NHS. PMID:7711585

Pediatric Provider Insight Into Newborn Screening for Glucose-6-Phosphate Dehydrogenase Deficiency.

PubMed

Bernardo, Janine; Nock, Mary

2015-06-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a major contributor to neonatal hyperbilirubinemia, yet newborn screening for this disorder in the United States is not standard practice. We surveyed pediatric providers regarding a novel newborn G6PD screening program successfully implemented in 2007 at a US urban women's hospital newborn nursery. An electronic survey was distributed to 472 pediatric providers addressing extent to which they were influenced by the screening program. Ninety-two (20%) providers responded, of whom 74 (80%) had taken care of G6PD-deficient patients diagnosed by the screening program. A majority found the diagnosis helpful for patient management and influential in their management. Most common changes in management included more counseling on jaundice and follow-up and avoidance of hemolytic crisis triggers. General pediatric providers support newborn G6PD screening and appreciate the current program. Knowing the G6PD deficiency status of newborns informed and influenced pediatric providers' care. © The Author(s) 2014.

Attitudes of Chilean students from different socioeconomic levels at the beginning of the implementation of the law governing the sale and advertising of foods high in critical nutrients

PubMed

Olivares Cortes, Sonia; Araneda Flores, Jacqueline; Morales Illanes, Gladys; Leyton Dinamarca, Bárbara; Bustos Zapata, Nelly; Hernández Moreno, María Angélica; Oyarzún Macchiavello, María Teresa

2017-03-30

Background: On June 27th 2016 the law that regulates sale and advertising of foods high in critical nutrients was implemented in Chile. This law regulates the processed food packaging labelling of foods high in calories, saturated fats, sugars and sodium. Objective: To determine 8-12 year old school children attitudes, from different socioeconomic levels (SEL) and nutritional status, toward the new food labelling law. Methods: A previously validated survey was applied, adding questions regarding the new logos to be added on the packaging of foods and beverages. A descriptive analysis of the variables being studied was conducted and differences in relation to the SEL and nutritional status were determined using the Chi2 test. Results: Statistically significant differences were not observed for gender or city. Regarding the new logos, 87.3% of the children from a medium to high SEL and 78.5% from low SEL indicated that they liked to be informed about the contents of food (p < 0.01). Fifty-three per cent from medium to high SEL and 48% from low SEL would stop buying the foods with logos. Fourteen per cent to 22% will continue to consume sweet biscuits, sugary drinks, chocolates and chips, without a difference in SEL. Children with a normal nutritional status and medium to high SEL placed more importance on logos high in calories, saturated fats and sodium, and children of low SEL on logos high in sugar. Overweight or obese children from medium to high SEL considered all four logos more important than children of low SEL. Discussion: These results will facilitate educational and social marketing support to improve the understanding, compliance and fulfillment of the law.

The impact of Michigan's Dr Ron Davis smoke-free air law on levels of cotinine, tobacco-specific lung carcinogen and severity of self-reported respiratory symptoms among non-smoking bar employees.

PubMed

Wilson, Teri; Shamo, Farid; Boynton, Katherine; Kiley, Janet

2012-11-01

To determine the impact on bar employee's health and exposure to secondhand smoke (SHS) before and after the implementation of Michigan's Dr Ron Davis smoke-free air law that went into effect on 1 May 2010, prohibiting smoking in places of work, including bars. This study used a pre/postintervention experimental design. The setting was bars in 12 Michigan counties. Subjects were bar employees, recruited through flyers and individual discussions with local health department staff. Participants completed a screening questionnaire to determine eligibility. A total of 40 eligible employees completed a demographic survey, provided urine samples for analysis of cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and completed questionnaires on respiratory and general health status 6 weeks before and 6-10 weeks after the law went into effect. The main outcome measures were urine samples for total cotinine and total NNAL and data from a self-administered respiratory and general health status questionnaire collected during the pre-law and post-law study periods. There was a significant decrease in the mean cotinine levels from 35.9 ng/ml to a non-quantifiable value (p<0.001), and there was a significant reduction in the mean NNAL level from 0.086 pmol/ml to 0.034 pmol/ml (p<0.001) 2 months after implementation of the law. There was also a significant improvement in all six self-reported respiratory symptoms (p<0.001) and general health status (p<0.001). The reduction in the SHS biomarkers cotinine and NNAL and reported improvement in respiratory health demonstrates that the Michigan smoke-free workplace law is protecting bar employee health.

Monitoring the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel.

PubMed

Siyam, Amani; Zurn, Pascal; Rø, Otto Christian; Gedik, Gulin; Ronquillo, Kenneth; Joan Co, Christine; Vaillancourt-Laflamme, Catherine; dela Rosa, Jennifer; Perfilieva, Galina; Dal Poz, Mario Roberto

2013-11-01

To present the findings of the first round of monitoring of the global implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel ("the Code"), a voluntary code adopted in 2010 by all 193 Member States of the World Health Organization (WHO). WHO requested that its Member States designate a national authority for facilitating information exchange on health personnel migration and the implementation of the Code. Each designated authority was then sent a cross-sectional survey with 15 questions on a range of topics pertaining to the 10 articles included in the Code. A national authority was designated by 85 countries. Only 56 countries reported on the status of Code implementation. Of these, 37 had taken steps towards implementing the Code, primarily by engaging relevant stakeholders. In 90% of countries, migrant health professionals reportedly enjoy the same legal rights and responsibilities as domestically trained health personnel. In the context of the Code, cooperation in the area of health workforce development goes beyond migration-related issues. An international comparative information base on health workforce mobility is needed but can only be developed through a collaborative, multi-partnered approach. Reporting on the implementation of the Code has been suboptimal in all but one WHO region. Greater collaboration among state and non-state actors is needed to raise awareness of the Code and reinforce its relevance as a potent framework for policy dialogue on ways to address the health workforce crisis.

1393 Ring Bus at JPL: Description and Status

NASA Technical Reports Server (NTRS)

Wysocky, Terry R.

2007-01-01

Completed Ring Bus IC V&V Phase - Ring Bus Test Plan Completed for SIM Project - Applicable to Other Projects Implemented a Avionics Bus Based upon the IEEE 1393 Standard - Excellent Starting Point for a General Purpose High-Speed Spacecraft Bus - Designed to Meet SIM Requirements for - Real-time deterministic, distributed systems. - Control system requirements - Fault detection and recovery Other JPL Projects Considering Implementation F'light Software Ring Bus Driver Module Began in 2006, Continues Participating in Standard Revision. Search for Earth-like planets orbiting nearby stars and measure the masses and orbits of the planets it finds. Survey 2000 nearby stars for planetary systems to learn whether our Solar System is unusual, or typical. Make a new catalog of star position 100 times more accurate than current measurements. Learn how our galaxy formed and will evolve by studying the dynamics of its stars. Critically test models of exactly how stars shine, including exotic objects like black holes, neutron stars and white dwarfs.

[Working with a family systems therapy approach as part of the routine treatment on acute psychiatric wards: sustained effects on team members' workload].

PubMed

Haun, Markus W; Kordy, Henrike; Ochs, Matthias; Schweitzer, Jochen; Zwack, Julika

2012-11-01

Assessing long-term effects of a family systems therapy approach (systems therapy methods in acute psychiatry, SYMPA) on occupational stress and interdisciplinary cooperation of team members in three German psychiatric hospitals. Pre-post-follow-up survey using the Maslach Burnout Inventory (MBI) and Team Climate Inventory (TCI) questionnaires complemented by semi-structured in-depth interviews (N = 56). Three years after implementing a family systems therapy approach, experienced work load and staff burnout remain significantly lower than before. Interdisciplinary cooperation was intensified and nursing staff status increased. Following systemic case conceptualisations and interventions the therapeutic alliance moved towards a need-adapted treatment approach. Seven years after implementation, the family systems therapy approach still included significantly lower workload burden, an intensified interdisciplinary cooperation, and a need-adapted treatment orientation that strengthens the alliance between staff and client system. © Georg Thieme Verlag KG Stuttgart · New York.

Influence of gender on office staff management in orthodontics.

PubMed

Holmes, Patrick B; Shroff, Bhavna; Best, Al M; Lindauer, Steven J

2010-11-01

To examine the gender differences in managing practice and staff members in orthodontic practices. All orthodontists in Virginia and Maryland (n = 427) were surveyed and demographic information was collected. For the crude analyses of the data, a Fisher's exact test or chi(2) test was performed. For the adjusted analyses, genders were compared using a logistic regression or analysis of covariance. The covariates were adjusted for age, program length, years in practice, number of years since graduation, and practice state. The length of the residency program attended did not differ with gender. No gender differences in practice ownership or creating the practice were observed. There was a significant gender difference in implementation of performance reviews: female orthodontists were more likely to provide performance reviews and tended to accept more poor reviews before staff termination than male orthodontists. However, when provided, no gender difference was observed in the number of performance reviews. Gender has a significant impact on the implementation of performance reviews in practices. Practice ownership status was not influenced by providers' gender.

Academic Librarians' Changing Perceptions of Faculty Status and Tenure

ERIC Educational Resources Information Center

Silva, Elise; Galbraith, Quinn; Groesbeck, Michael

2017-01-01

This study explores how time and experience affect an academic librarian's perception of tenure. Researchers surveyed 846 librarians at ARL institutions, reporting on institutions that offer both tenure and faculty status for their academic librarians or neither. The survey reported how librarians rated tenure's benefit to patrons, its effect in…

Racial and Socioeconomic Differences Manifest in Process Measure Adherence for Enhanced Recovery After Surgery Pathway.

PubMed

Leeds, Ira L; Alimi, Yewande; Hobson, Deborah R; Efron, Jonathan E; Wick, Elizabeth C; Haut, Elliott R; Johnston, Fabian M

2017-10-01

Adherence to care processes and surgical outcomes varies by population subgroups for the same procedure. Enhanced recovery after surgery pathways are intended to standardize care, but their effect on process adherence and outcomes for population subgroups is unknown. This study aims to demonstrate the association between recovery pathway implementation, process measures, and short-term surgical outcomes by population subgroup. This study is a pre- and post-quality improvement implementation cohort study. This study was conducted at a tertiary academic medical center. A modified colorectal enhanced recovery after surgery pathway was implemented. Patients were included who had elective colon and rectal resections before (2013) and following (2014-2016) recovery pathway implementation. Thirty-day outcomes by race and socioeconomic status were analyzed using a difference-in-difference approach with correlation to process adherence. We identified 639 cases (199 preimplementation, 440 postimplementation). In these cases, 75.2% of the patients were white, and 91.7% had a high socioeconomic status. Groups were similar in terms of other preoperative characteristics. Following pathway implementation, median lengths of stay improved in all subgroups (-1.0 days overall, p ≤ 0.001), but with no statistical difference by race or socioeconomic status (p = 0.89 and p = 0.29). Complication rates in both racial and socioeconomic groups were no different (26.4% vs 28.8%, p = 0.73; 27.3% vs 25.0%, p = 0.86) and remained unchanged with implementation (p = 0.93, p = 0.84). By race, overall adherence was 31.7% in white patients and 26.5% in nonwhite patients (p = 0.32). Although stratification by socioeconomic status demonstrated decreased overall adherence in the low-status group (31.8% vs 17.1%, p = 0.05), white patients were more likely to have regional pain therapy (57.1% vs 44.1%, p = 0.02) with a similar trend seen with socioeconomic status. Data were collected primarily for quality improvement purposes. Differences in outcomes by race and socioeconomic status did not arise following implementation of an enhanced recovery pathway. Differences in process measures by population subgroups highlight differences in care that require further investigation. See Video Abstract at http://links.lww.com/DCR/A386.

The U.S. Geological Survey Federal-State Cooperative Water-Resources Program, fiscal year 1986

USGS Publications Warehouse

Gilbert, B.K.; Mann, W.B.

1987-01-01

The U.S. Geological Survey 's Federal-State Cooperative Water Resources Program has been in operation for 91 years as of fiscal year (FY) 1986. Hydrologic data collection and interpretive investigations are underway in every State, Puerto Rico, and several territories in cooperation with more than 900 State, regional and local agencies. Federal funds amounted to $49.8 million in this 50-50 matching activity. Total funding was about $106 million, which included $6.9 million furnished by cooperating agencies on an unmatched basis. The Cooperative Program comprised more than 40% of the overall FY 1986 budget of the Survey 's Water Resources Division. The areas of principal emphasis during the year included groundwater contamination, stream quality, water supply and demand, and hydrologic hazards. Information is presented on program priorities and investigations implemented under the merit proposal process. The status of water use information activities, which are being carried out in 48 states and Puerto Rico is reviewed briefly. Standard methods for collecting the data are being developed. Each state has a computerized State Water-Use Data System for storage and retrieval of water-use data for individual users or facilities. (Lantz-PTT)

Prevalence of Smoking and Obesity Among U.S. Cancer Survivors: Estimates From the National Health Interview Survey, 2008–2012

PubMed Central

Shoemaker, Meredith L.; White, Mary C.; Hawkins, Nikki A.; Hayes, Nikki S.

2017-01-01

Purpose/Objectives To describe smoking and obesity prevalence among male and female cancer survivors in the United States. Design Cross-sectional survey. Setting Household interviews. Sample 9,753 survey respondents who reported ever having a malignancy, excluding nonmelanoma skin cancers. Methods Data from the National Health Interview Survey (2008–2012) were used to calculate weighted smoking status prevalence estimates. Cross-tabulations of smoking and weight status were produced, along with Wald chi-square tests and linear contrasts. Main Research Variables Cancer history, smoking status, obesity status, gender, age, and age at diagnosis. Findings Seventeen percent of cancer survivors reported current smoking. Female survivors had higher rates of current smoking than males, particularly in the youngest age category. Male survivors who currently smoked had lower obesity prevalence rates than males who previously smoked or never smoked. Among female survivors, 31% were obese and no significant differences were seen in obesity prevalence by smoking status for all ages combined. Conclusions The findings highlight the variation in smoking status and weight by age and gender. Smoking interventions may need to be targeted to address barriers specific to subgroups of cancer survivors. Implications for Nursing Nurses can be instrumental in ensuring that survivors receive comprehensive approaches to address both weight and tobacco use to avoid trading one risk for another. PMID:27314186

Implementing Project Based Survey Research Skills to Grade Six ELP Students with "The Survey Toolkit" and "TinkerPlots"[R

ERIC Educational Resources Information Center

Walsh, Thomas, Jr.

2011-01-01

"Survey Toolkit Collecting Information, Analyzing Data and Writing Reports" (Walsh, 2009a) is discussed as a survey research curriculum used by the author's sixth grade students. The report describes the implementation of "The Survey Toolkit" curriculum and "TinkerPlots"[R] software to provide instruction to students learning a project based…

Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU).

PubMed

Sørensen, Kristine; Pelikan, Jürgen M; Röthlin, Florian; Ganahl, Kristin; Slonska, Zofia; Doyle, Gerardine; Fullam, James; Kondilis, Barbara; Agrafiotis, Demosthenes; Uiters, Ellen; Falcon, Maria; Mensing, Monika; Tchamov, Kancho; van den Broucke, Stephan; Brand, Helmut

2015-12-01

Health literacy concerns the capacities of people to meet the complex demands of health in modern society. In spite of the growing attention for the concept among European health policymakers, researchers and practitioners, information about the status of health literacy in Europe remains scarce. This article presents selected findings from the first European comparative survey on health literacy in populations. The European health literacy survey (HLS-EU) was conducted in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain (n = 1000 per country, n = 8000 total sample). Data collection was based on Eurobarometer standards and the implementation of the HLS-EU-Q (questionnaire) in computer-assisted or paper-assisted personal interviews. The HLS-EU-Q constructed four levels of health literacy: insufficient, problematic, sufficient and excellent. At least 1 in 10 (12%) respondents showed insufficient health literacy and almost 1 in 2 (47%) had limited (insufficient or problematic) health literacy. However, the distribution of levels differed substantially across countries (29-62%). Subgroups within the population, defined by financial deprivation, low social status, low education or old age, had higher proportions of people with limited health literacy, suggesting the presence of a social gradient which was also confirmed by raw bivariate correlations and a multivariate linear regression model. Limited health literacy represents an important challenge for health policies and practices across Europe, but to a different degree for different countries. The social gradient in health literacy must be taken into account when developing public health strategies to improve health equity in Europe. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

Life as an evacuee after the Fukushima Daiichi nuclear power plant accident is a cause of polycythemia: the Fukushima Health Management Survey.

PubMed

Sakai, Akira; Ohira, Tetsuya; Hosoya, Mitsuaki; Ohtsuru, Akira; Satoh, Hiroaki; Kawasaki, Yukihiko; Suzuki, Hitoshi; Takahashi, Atsushi; Kobashi, Gen; Ozasa, Kotaro; Yasumura, Seiji; Yamashita, Shunichi; Kamiya, Kenji; Abe, Masafumi

2014-12-23

The Great East Japan Earthquake and the Fukushima Daiichi nuclear disaster forced people to evacuate their hometowns. Many evacuees from the government-designated evacuation zone were forced to change their lifestyle, diet, exercise, and other personal habits. The Comprehensive Health Check (CHC), 1 of 4 detailed surveys of The Fukushima Health Management Survey (FHMS), was implemented to support the prevention of lifestyle-related disease. The aim of this study was to analyze changes in red blood cell count (RBC), hemoglobin (Hb) levels, and hematocrit (Ht) levels by comparing data from the medical health checkup before and after the disaster in individuals who were 40 years old or older. Subjects in this study were Japanese men and women living in the vicinity of the Fukushima Daiichi Nuclear Power Plant in Fukushima prefecture. Annual health checkups with a focus on metabolic syndrome for insured persons/dependents aged 40 or older by Health Care Insurers have been conducted since 2008. All analyses in this study were limited to men and women aged 40-90 years. Changes in RBC, Hb levels, Ht levels, and prevalence of polycythemia before and after the disaster were compared. First, RBC, Hb, and Ht significantly increased in both men and women evacuees. The evacuation was significantly associated with increased Hb levels after adjustment for age, gender, smoking status, excess ethanol intake, BMI, and baseline Hb level (β = 0.16, p < 0.001). Furthermore, the prevalence of polycythemia stratified by smoking status or obesity also increased in the evacuee group. To our knowledge, this is the first report revealing that the evacuation was associated with the risk of polycythemia. This information could be very important for periodic health checkup and lifestyle recommendations for evacuees in the future.

Inclusion of persons with disabilities in systems of social protection: a population-based survey and case–control study in Peru

PubMed Central

Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vasquez, Alberto; Kuper, Hannah; Walsham, Matthew; Blanchet, Karl

2016-01-01

Objective This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. Design Population based-survey with a nested case–control study. Setting Morropon, a semiurban district located in Piura, northern Peru. Participants For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case–control study, only one participant, case or control, per household was included in the study. Primary and secondary outcome measures Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconomic status, education, health and rehabilitation and social protection participation. Results The survey included 3684 participants, 1848 (50.1%) females, mean age: 36.4 (SD: 21.7). A total of 290 participants (7.9%; 95% CI 7.0% to 8.7%) were classified as having disability. Adults with disabilities were more likely to be single (OR=3.40; 95% CI 1.54 to 7.51) and not to be working (OR=4.36; 95% CI 2.26 to 8.40), while those who did work were less likely to receive the national minimum wage (ie, 750 PEN or about US$265; p=0.007). People with disabilities were more likely to experience health problems. There was no difference between those enrolled in any social protection programme among participants with and without disabilities. Conclusions People with disabilities were found to have higher needs for social protection, but were not more likely to be enrolled in social protection programmes. The Peruvian social protection system should consider adding disability status to selection criteria in their cash transfer programmes as well as implementing disability-specific interventions. PMID:27566630

A mixed-methods study of mid-career science teachers: The growth of professional empowerment

NASA Astrophysics Data System (ADS)

Moreland, Amy Laphelia

The purpose of this concurrent, mixed-methods study was to examine the professional empowerment qualities of mid-career (years 4-8), science teachers. I used the construct of professional empowerment as the theoretical frame to explore K-12 mid-career science teachers' career trajectories and consider how they can be supported professionally and ideally retained over time. In investigating the qualities of these teachers, I also constructed a new teaching trajectory model and tested the differences between mid-career and veteran science teachers. I analyzed seventy-eight surveys of mid-career science teachers across Texas, including six in-depth, interview-based case studies. The qualitative piece used behavior-over-time graphing combined with the interviews and the quantitative component used survey data from the Teacher Empowerment Survey (TES). Results indicated that science content knowledge gain through professional development opportunities was an especially important factor in supporting mid-career teachers' sense of empowerment. This increased content knowledge connected positively with the dimensions of decision-making, status, and impact. In a between-group analysis using a larger subset of TES data, I analyzed 254 surveys by conducting a nonparametric statistical test. A statistically significant difference was found between the two groups, in that mid-career science teachers had a lower sense of "status" than their more experienced counterparts (p < .05). I could infer that, for this sample, as teaching experience increases, so does at least one dimension of empowerment. The study was situated within a broader scope of exploring how educational leaders and professional development providers can understand and support science teachers of varying experience levels. A well-designed and possibly differentiated professional development program could successfully connect with these kind of empowered and receptive mid-career science teachers, and thus increase the probability of implementing quality science education programs, content, and pedagogy into schools. The results of this study also have the potential to provide self-reflective career empowerment information to science teachers in their mid-career years.

Parental recognition of overweight in school-age children.

PubMed

West, Delia S; Raczynski, James M; Phillips, Martha M; Bursac, Zoran; Heath Gauss, C; Montgomery, Brooke E E

2008-03-01

Examine the accuracy of parental weight perceptions of overweight children before and after the implementation of childhood obesity legislation that included BMI screening and feedback. Statewide telephone surveys of parents of overweight (BMI > or = 85th percentile) Arkansas public school children before (n = 1,551; 15% African American) and after (n = 2,508; 15% African American) policy implementation were examined for correspondence between parental perception of child's weight and objective classification. Most (60%) parents of overweight children underestimated weight at baseline. Parents of younger children were significantly more likely to underestimate (65%) than parents of adolescents (51%). Overweight parents were not more likely to underestimate, nor was inaccuracy associated with parental education or socioeconomic status. African-American parents were twice as likely to underestimate as whites. One year after BMI screening and feedback was implemented, the accuracy of classification of overweight children improved (53% underestimation). African-American parents had significantly greater improvements than white parents (P < 0.0001). Parental recognition of childhood overweight may be improved with BMI screening and feedback, and African-American parents may specifically benefit. Nonetheless, underestimation of overweight is common and may have implications for public health interventions.

Community burden of undiagnosed HIV infection among adolescents in Zimbabwe following primary healthcare-based provider-initiated HIV testing and counselling: A cross-sectional survey

PubMed Central

Dakshina, Subathira; McHugh, Grace; Munyati, Shungu; Chonzi, Prosper; Ncube, Getrude; Masimirembwa, Collen; Thelingwani, Roslyn; Apollo, Tsitsi; Ferrand, Rashida A.

2017-01-01

Background Children living with HIV who are not diagnosed in infancy often remain undiagnosed until they present with advanced disease. Provider-initiated testing and counselling (PITC) in health facilities is recommended for high-HIV-prevalence settings, but it is unclear whether this approach is sufficient to achieve universal coverage of HIV testing. We aimed to investigate the change in community burden of undiagnosed HIV infection among older children and adolescents following implementation of PITC in Harare, Zimbabwe. Methods and findings Over the course of 2 years (January 2013–January 2015), 7 primary health clinics (PHCs) in southwestern Harare implemented optimised, opt-out PITC for all attendees aged 6–15 years. In February 2015–December 2015, we conducted a representative cross-sectional survey of 8–17-year-olds living in the 7 communities served by the study PHCs, who would have had 2 years of exposure to PITC. Knowledge of HIV status was ascertained through a caregiver questionnaire, and anonymised HIV testing was carried out using oral mucosal transudate (OMT) tests. After 1 participant taking antiretroviral therapy was observed to have a false negative OMT result, from July 2015 urine samples were obtained from all participants providing OMTs and tested for antiretroviral drugs to confirm HIV status. Children who tested positive through PITC were identified from among survey participants using gender, birthdate, and location. Of 7,146 children in 4,251 eligible households, 5,486 (76.8%) children in 3,397 households agreed to participate in the survey, and 141 were HIV positive. HIV prevalence was 2.6% (95% CI 2.2%–3.1%), and over a third of participants with HIV were undiagnosed (37.7%; 95% CI 29.8%–46.2%). Similarly, among the subsample of 2,643 (48.2%) participants with a urine test result, 34.7% of those living with HIV were undiagnosed (95% CI 23.5%–47.9%). Based on extrapolation from the survey sample to the community, we estimated that PITC over 2 years identified between 18% and 42% of previously undiagnosed children in the community. The main limitation is that prevalence of undiagnosed HIV was defined using a combination of 3 measures (OMT, self-report, and urine test), none of which were perfect. Conclusions Facility-based approaches are inadequate in achieving universal coverage of HIV testing among older children and adolescents. Alternative, community-based approaches are required to meet the Joint United Nations Programme on HIV/AIDS (UNAIDS) target of diagnosing 90% of those living with HIV by 2020 in this age group. PMID:28742829

Comprehensive electronic medical record implementation levels not associated with 30-day all-cause readmissions within Medicare beneficiaries with heart failure.

PubMed

Patterson, M E; Marken, P; Zhong, Y; Simon, S D; Ketcherside, W

2014-01-01

Regulatory standards for 30-day readmissions incentivize hospitals to improve quality of care. Implementing comprehensive electronic health record systems potentially decreases readmission rates by improving medication reconciliation at discharge, demonstrating the additional benefits of inpatient EHRs beyond improved safety and decreased errors. To compare 30-day all-cause readmission incidence rates within Medicare fee-for-service with heart failure discharged from hospitals with full implementation levels of comprehensive EHR systems versus those without. This retrospective cohort study uses data from the American Hospital Association Health IT survey and Medicare Part A claims to measure associations between hospital EHR implementation levels and beneficiary readmissions. Multivariable Cox regressions estimate the hazard ratio of 30-day all-cause readmissions within beneficiaries discharged from hospitals implementing comprehensive EHRs versus those without, controlling for beneficiary health status and hospital organizational factors. Propensity scores are used to account for selection bias. The proportion of heart failure patients with 30-day all-cause readmissions was 30%, 29%, and 32% for those discharged from hospitals with full, some, and no comprehensive EHR systems. Heart failure patients discharged from hospitals with fully implemented comprehensive EHRs compared to those with no comprehensive EHR systems had equivalent 30-day readmission incidence rates (HR = 0.97, 95% CI 0.73 - 1.3). Implementation of comprehensive electronic health record systems does not necessarily improve a hospital's ability to decrease 30-day readmission rates. Improving the efficiency of post-acute care will require more coordination of information systems between inpatient and ambulatory providers.

The North American Breeding Bird Survey 1966–2011: Summary analysis and species accounts

USGS Publications Warehouse

Sauer, John R.; Link, William A.; Fallon, Jane E.; Pardieck, Keith L.; Ziolkowski, David J.

2013-01-01

The North American Breeding Bird Survey is a roadside, count-based survey conducted by volunteer observers. Begun in 1966, it now is a primary source of information on spatial and temporal patterns of population change for North American birds. We analyze population change for states, provinces, Bird Conservation Regions, and the entire survey within the contiguous United States and southern Canada for 426 species using a hierarchical log-linear model that controls for observer effects in counting. We also map relative abundance and population change for each species using a spatial smoothing of data at the scale of survey routes. We present results in accounts that describe major breeding habitats, migratory status, conservation status, and population trends for each species at several geographic scales. We also present composite results for groups of species categorized by habitats and migratory status. The survey varies greatly among species in percentage of species' range covered and precision of results, but consistent patterns of decline occur among eastern forest, grassland, and aridland obligate birds while generalist bird species are increasing.

Instrument and Survey Analysis Technical Report: Program Implementation Survey. Technical Report #1112

ERIC Educational Resources Information Center

Alonzo, Julie; Tindal, Gerald

2011-01-01

This technical document provides guidance to educators on the creation and interpretation of survey instruments, particularly as they relate to an analysis of program implementation. Illustrative examples are drawn from a survey of educators related to the use of the easyCBM learning system. This document includes specific sections on…

75 FR 51328 - Agency Information Collection Activities: Request for Comments for a New Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... National Transportation Systems Center (Volpe Center) have designed the survey and will submit the survey... Phase 2 Implementation Study Survey. The Federal Register notice with a 60-day public comment period...-LU Section 6009 Phase 2 Implementation Study Survey. Background: Section 6009 of the Safe...

Are quality improvement methods a fashion for hospitals in Taiwan?

PubMed

Chung, Kuo-Piao; Yu, Tsung-Hsien

2012-08-01

This study reviews the rise and fall of the quality improvement (QI) methods implemented by hospitals in Taiwan, and examines the factors related to these methods. Cross-sectional, questionnaire-based survey. One hundred and thirty-nine district teaching hospitals, regional hospitals and medical centers. Directors or the persons in charge of implementing QI methods. s) None. s) Breadth and depth of the 18 QI methods. Seventy-two hospitals responded to the survey, giving a response rate of 52%. In terms of breadth based on the hospitals' self-reporting, the average number of QI methods adopted per hospital was 11.78 (range: 7-17). More than 80% of the surveyed hospitals had implemented eight QI methods, and >50% had implemented five QI methods. The QI methods adopted by over 80% of the surveyed hospitals had been implemented for a period of ∼7 years. On the basis of the authors' classification, seven of the eight QI methods (except for QI team in total quality management) had an implementation depth of almost 70% or higher in the surveyed hospitals. This study provides a snapshot of the QI methods implemented by hospitals in Taiwan. The results show that the average breadth of the QI methods adopted was 11.78; however, only 8.83 were implemented deeply. The hospitals' accreditation level was associated with the breadth and depth of QI method implementation.

Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan

PubMed Central

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient’s economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households. PMID:29445672

Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan.

PubMed

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient's economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households.

Status of the Landsat Data Continuity Mission

NASA Technical Reports Server (NTRS)

Irons, James R.; Ochs, William R.

2004-01-01

Efforts to begin implementing a successor mission to Landsat 7, called the Landsat Data Continuity Mission (LDCM), suffered a set back in 2003. NASA and the Department of Interior (DOI)/U.S. Geological Survey (USGS) currently manage the Landsat Program as an interagency partnership. The two agencies had planned to purchase data meeting LDCM specifications from a privately owned and commercially operated satellite system beginning in March, 2007. This approach represented a departure from the traditional procurement of a government owned and operated satellite system. NASA, however, cancelled a Request-for-Proposals (RFP) for providing the required data after an evaluation of proposals received from private industry. NASA concluded that the proposals failed to meet a key objective and expectation of the RFP, namely, to form a fair and equitable partnership between the Government and private industry. Alternative strategies for implementing an LDCM are now under consideration. The Executive Office of the President formed an interagency working group on the LDCM following the RFP cancellation. The working group is considering other options for implementing a successor system to Landsat 7 consistent with the Land Remote Sensing Policy Act of 1992 (Public Law 102-555). This Act lists four management options for consideration: 1) private sector funding and management; 2) an international consortium; 3) funding and management by the U.S. Government; and 4) a cooperative effort between the US. Government and the private sector. The working group is currently attempting to minimize the risk of a Landsat data gap through development of a strategy that leads to a Landsat 7 successor mission. The selected strategy and the status of the mission will be presented at the Symposium.

Implementation and first results of a tablet-based assessment referring to patient-reported outcomes in an inpatient cancer care unit.

PubMed

Schuler, Markus; Trautmann, Freya; Radloff, Mirko; Hentschel, Leopold; Petzold, Thomas; Eberlein-Gonska, Maria; Ehninger, Gerhard; Schmitt, Jochen

2017-04-01

Inclusion of patient-reported outcomes (PROs) in routine cancer care is of key importance for individualized treatment, shared decision making and patient satisfaction. To describe the implementation under routine conditions of an electronic self-administered PRO assessment and comparison of PROs before and after inpatient treatment in oncologic care. In a tablet-based survey PROs on symptom burden, global health status/ quality of life (QoL) and health utility were collected twice (at hospital admission and discharge) in an inpatient oncological setting over a 17-month period using the EORTC QLQ-C30 and EQ-5D questionnaires. Data were linked to the hospital information system (HIS). Patient acceptability, recruitment rates, symptom burden, and clinically meaningful changes in PROs over time were analyzed. From a total of 384 hospitalized patients invited to participate at admission 371 (96.6 %) participated. At discharge, 195 patients were approached for a follow-up assessment, and 192 patients (98.5 %) participated. Despite strong acceptance among patients, recruitment rates were decreasing over time. During the hospital stay clinically meaningful improvements were observed for health utility (33.3 %, n = 64) and global health status/QoL (43.2 %, n = 83). Patients reported a variety of symptoms at admission and discharge. Implementation of PRO assessment in routine care and data integration into the HIS provides valuable information for the entire medical staff as symptom burden is present during the entire hospital stay. Long-term maintenance of PRO assessment in a clinical setting as a prerequisite of value-based healthcare requires continuous involvement of the nursing team, which can only be achieved by allocating resources to this task. Copyright © 2017. Published by Elsevier GmbH.

Safety benefits of implementing adaptive signal control technology : survey results.

DOT National Transportation Integrated Search

2013-01-01

The safety benefits and costs associated with implementing adaptive signal control technology (ASCT) were evaluated in : this study. A user-friendly online survey was distributed to 62 agencies that had implemented ASCT in the United States. : Twenty...

Global Evidence on the Association between POS Advertising Bans and Youth Smoking Participation.

PubMed

Shang, Ce; Huang, Jidong; Cheng, Kai-Wen; Li, Qing; Chaloupka, Frank J

2016-03-09

Point-of-sale (POS) tobacco advertising has been linked to youth smoking susceptibility and experimental smoking. However, there is limited evidence of the association between POS advertising bans and youth smoking participation. This study aims to examine how such bans are associated with current smoking, daily smoking, and regular smoking (≥ 1 cigarettes per day) participation among youth. one to two waves (primarily one wave) of the Global Youth Tobacco Survey were conducted in 130 countries between 2007 and 2011. These surveys were linked to the WHO "MPOWER" data using country and year identifiers to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and smoking participation in the past month. Weighted logistic regressions were employed to analyze this association while controlling for age, gender, parents' smoking status, 6 MPOWER policy scores, and GDP per capita. We find that in countries with POS advertising bans, current smoking (OR = 0.73, p ≤ 0.1), daily smoking (OR = 0.70, p ≤ 0.1), and regular smoking (OR = 0.75, p ≤ 0.05) participation in the past month is significantly lower, suggesting that POS promotion bans can potentially reduce youth smoking. This study provides evidence to support the implementation of POS promotion regulations by the US FDA and implementation of the WHO FCTC guidelines regarding restrictions on tobacco POS promotion.

Wide variation in adoption of screening and infection control interventions for multidrug-resistant organisms: a national study.

PubMed

Pogorzelska, Monika; Stone, Patricia W; Larson, Elaine L

2012-10-01

We performed a survey of National Healthcare Safety Network hospitals in 2008 to describe adoption of screening and infection control policies aimed at multidrug-resistant organisms (MDRO) in intensive care units (ICUs) and identify predictors of their presence, monitoring, and implementation. Four hundred forty-one infection control directors were surveyed using a modified Dillman technique. To explore differences in screening and infection control policies by setting characteristics, bivariate and multivariable logistic regression models were constructed. In total, 250 hospitals participated (57% response rate). Study ICUs (n = 413) routinely screened for methicillin-resistant Staphylococcus aureus (59%); vancomycin-resistant Enterococcus (22%); multidrug-resistant, gram-negative rods (12%); and Clostridium difficile (11%). Directors reported ICU policies to screen all admissions for any MDRO (40%), screen periodically (27%), utilize presumptive isolation/contact precautions pending a screen (31%), and cohort colonized patients (42%). Several independent predictors of the presence and implementation of different interventions including mandatory reporting and teaching status were identified. This study found wide variation in adoption of MDRO screening and infection control interventions, which may reflect differences in published recommendations or their interpretation. Further research is needed to provide additional insight on effective strategies and how best to promote compliance. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Trends in the nutritional status of Salvadorian children: the post-war experience.

PubMed

Grummer-Strawn, L M; Cáceres, J M; Herrera de Jaimes, B P

1996-01-01

This article examines trends in the nutritional status of children in EI Salvador between 1988 and 1993 (before and after the signing of a peace accord that ended the civil war.) The data derive from two national surveys, each of which included measurements of the height and weight of children aged 3-59 months. The prevalence of low weight-for-age (< -2 SD) dropped from 15% in 1988 to 10.5% in 1993. The prevalence of low weight-for-height (< -2 SD) was minimal in both surveys: falling from 3.9% to 2.9%. The prevalence of low height-for-age (< -2 SD) fell from 28.1% to 22%. These declines in malnutrition indicators resulted from an upward shift in the distributions of weight and height of children, not from thinner lower tails of the distributions. The quality of anthropometric data appears to be high for both surveys: < 1% of surveyed children had heights or weights outside the expected range. This analysis demonstrates the value of repeated surveys of nutritional status.

Marital Status and Living Arrangements: March 1985.

ERIC Educational Resources Information Center

Saluter, Arlene F.

1986-01-01

This report presents detailed information on the marital status and living arrangements of the noninstitutional population of the United States by age, sex, race, and Spanish origin. The text of this report compares the mid-decade census estimates based on the March, 1985 "Current Population Survey" with the survey data from 1980, 1970, and 1960.…

A Survey on Clinical Research Training Status and Needs in Public Hospitals from Shenzhen

ERIC Educational Resources Information Center

Ji, Ping; Wang, Haibo; Zhang, Chao; Liu, Min; Zhou, Liping; Xiao, Ping; Wang, Yanfang; Wu, Yangfeng

2017-01-01

Objective: To obtain information on the current clinical research training status and evaluate the training needs comprehensively for medical staff in hospitals. Methods: This survey was initiated and conducted by the Health and Family Planning Commission of Shenzhen in conjunction with the Peking University Clinical Research Institute (Shenzhen)…

Population Status of the Seaside Sparrow in Rhode Island: A 25-Year Assessment.

EPA Science Inventory

To assess long-term changes in the population status of breeding Ammodramus maritimus Wilson (Seaside Sparrow) in Rhode Island, we repeated surveys conducted in 1982 by Stoll and Golet (1983). In June and July of 2007 and 2008, we surveyed 20 of Rhode Island’s largest salt ...

Summary Health Statistics for U.S. Children: National Health Interview Survey, 1999.

ERIC Educational Resources Information Center

Blackwell, Debra L.; Tonthat, Luong

This report presents statistics from the 1999 National Health Interview Survey (NHIS) on selected health measures for children under 18 years of age, classified by sex, age, race/ethnicity, family structure, parent education, family income, poverty status, health insurance coverage, place of residence, region, and current health status. The NHIS…

Status of Clean Air Act (CAA) 110(a)(2)(D)(i)(I) SIPs Final Rule TSD

EPA Pesticide Factsheets

This document describes, for each state subject to a Federal implementation plan (FIP) with respect to ozone and/or PM2.5 NAAQS under the Transport Rule, the status of each Clean Air Act state implementation plan (SIP) for the relevant NAAQS.

An American knowledge base in England - Alternate implementations of an expert system flight status monitor

NASA Technical Reports Server (NTRS)

Butler, G. F.; Graves, A. T.; Disbrow, J. D.; Duke, E. L.

1989-01-01

A joint activity between the Dryden Flight Research Facility of the NASA Ames Research Center (Ames-Dryden) and the Royal Aerospace Establishment (RAE) on knowledge-based systems has been agreed. Under the agreement, a flight status monitor knowledge base developed at Ames-Dryden has been implemented using the real-time AI (artificial intelligence) toolkit MUSE, which was developed in the UK. Here, the background to the cooperation is described and the details of the flight status monitor and a prototype MUSE implementation are presented. It is noted that the capabilities of the expert-system flight status monitor to monitor data downlinked from the flight test aircraft and to generate information on the state and health of the system for the test engineers provides increased safety during flight testing of new systems. Furthermore, the expert-system flight status monitor provides the systems engineers with ready access to the large amount of information required to describe a complex aircraft system.

Perceived financial status, health, and maladjustment in adolescence.

PubMed

Hamilton, Hayley A; Noh, Samuel; Adlaf, Edward M

2009-04-01

This study examines the relationship between adolescent perception of family financial status and diverse aspects of health and maladjustment. Data were derived from the 2005 Ontario Student Drug Use Survey of 7th-12th grade students in ontario, Canada. This biennial survey monitors mental and physical health, substance use, and delinquent behavior in adolescent students. Results indicate that the significance of perceived financial status varies across adolescent outcomes. Greater emotional distress and lower self-rated health are associated with a perception of below average financial status. The associations of illicit drug use and hazardous and harmful drinking with perceived financial status vary for younger and older adolescents. Adjustments for parental education highlight differences in the influences of perceived financial status and parental education on health and behavior. Results highlight the utility of perceived family financial status in examinations of adolescent health and behavior, and the importance of examining diverse aspects of health and maladjustment.

[Clinical risk management in german hospitals - does size really matter?].

PubMed

Bohnet-Joschko, S; Jandeck, L M; Zippel, C; Andersen, M; Krummenauer, F

2011-06-01

In the last years, German hospitals have implemented different measures to increase patient safety. Special importance has been attached to near miss reporting systems (critical incident reporting system, CIRS) as instruments for risk identification in health care, instruments that promise high potential for organisational learning. To gain insight into the current status of critical incident reporting systems and other instruments for clinical risk management, a survey among 341 hospitals was carried out in 2009. Questions covered a process of six steps: from risk strategy to methods for risk identification, to risk analysis and risk assessment, to risk controlling and risk monitoring. Structured telephone interviews were conducted with 341 German hospitals, featuring in their statutory quality reports certain predefined key terms that indicated the concluded or planned implementation of clinical risk management. The main objective of those interviews was to check the relation between status/organisation of self-reported risk management and both operator (private, public, NPO) and size of hospital. The implementation of near miss reporting systems (CIRS) in German hospitals has been constantly rising since 2004: in 2009, 54 % of the interviewed hospitals reported an implemented CIRS; of these, 72 % reported the system to be hospital-wide. An association between CIRS and private, public or NPO-operator could not be detected (Fisher p = 1.000); however, the degree of CIRS implementation was significantly increasing with the size of the hospital, i.e., the number of beds (Fisher p = 0.008): only 38 % of the hospitals with less than 100 beds reported CIRS implementation against 52 % of those between 100 to 500 beds, and 67 % of those with more than 500 beds. While 62 % of the hospitals interviewed reported the maintenance of a risk management committee, only 14 % reported the implementation of risk analysing techniques. As to clinical risk management, 92 % of the hospitals see potential for internal improvement; 44 % have already communicated with external consultants. While identification of clinical risks with near miss and other incident reporting systems meets increasing acceptance, the learning potential based on incident reporting is not yet appropriately being used. There is a deficit regarding systematic and comprehensive risk assessment and controlling; this will have to be met by improving the organisational framework for clinical risk management. © Georg Thieme Verlag KG Stuttgart · New York.

Glass-Cockpit Pilot Subjective Ratings of Predictive Information, Collocation, and Mission Status Graphics: An Analysis and Summary of the Future Focus of Flight Deck Research Survey

NASA Technical Reports Server (NTRS)

Bartolone, Anthony; Trujillo, Anna

2002-01-01

NASA Langley Research Center has been researching ways to improve flight crew decision aiding for systems management. Our current investigation is how to display a wide variety of aircraft parameters in ways that will improve the flight crew's situation awareness. To accomplish this, new means are being explored that will monitor the overall health of a flight and report the current status of the aircraft and forecast impending problems to the pilots. The initial step in this research was to conduct a survey addressing how current glass-cockpit commercial pilots would value a prediction of the status of critical aircraft systems. We also addressed how this new type of data ought to be conveyed and utilized. Therefore, two other items associated with predictive information were also included in the survey. The first addressed the need for system status, alerts and procedures, and system controls to be more logically grouped together, or collocated, on the flight deck. The second idea called for the survey respondents opinions on the functionality of mission status graphics; a display methodology that groups a variety of parameters onto a single display that can instantaneously convey a complete overview of both an aircraft's system and mission health.

Women's health in a rural community in Kerala, India: do caste and socioeconomic position matter?

PubMed Central

Mohindra, K S; Haddad, Slim; Narayana, D

2006-01-01

Objectives To examine the social patterning of women's self‐reported health status in India and the validity of the two hypotheses: (1) low caste and lower socioeconomic position is associated with worse reported health status, and (2) associations between socioeconomic position and reported health status vary across castes. Design Cross‐sectional household survey, age‐adjusted percentages and odds ratios, and multilevel multinomial logistic regression models were used for analysis. Setting A panchayat (territorial decentralised unit) in Kerala, India, in 2003. Participants 4196 non‐elderly women. Outcome measures Self‐perceived health status and reported limitations in activities in daily living. Results Women from lower castes (scheduled castes/scheduled tribes (SC/ST) and other backward castes (OBC) reported a higher prevalence of poor health than women from forward castes. Socioeconomic inequalities were observed in health regardless of the indicators, education, women's employment status or household landholdings. The multilevel multinomial models indicate that the associations between socioeconomic indicators and health vary across caste. Among SC/ST and OBC women, the influence of socioeconomic variables led to a “magnifying” effect, whereas among forward caste women, a “buffering” effect was found. Among lower caste women, the associations between socioeconomic factors and self‐assessed health are graded; the associations are strongest when comparing the lowest and highest ratings of health. Conclusions Even in a relatively egalitarian state in India, there are caste and socioeconomic inequalities in women's health. Implementing interventions that concomitantly deal with caste and socioeconomic disparities will likely produce more equitable results than targeting either type of inequality in isolation. PMID:17108296

Majorana zero modes in superconductor-semiconductor heterostructures

NASA Astrophysics Data System (ADS)

Lutchyn, R. M.; Bakkers, E. P. A. M.; Kouwenhoven, L. P.; Krogstrup, P.; Marcus, C. M.; Oreg, Y.

2018-05-01

Realizing topological superconductivity and Majorana zero modes in the laboratory is a major goal in condensed-matter physics. In this Review, we survey the current status of this rapidly developing field, focusing on proposals for the realization of topological superconductivity in semiconductor-superconductor heterostructures. We examine materials science progress in growing InAs and InSb semiconductor nanowires and characterizing these systems. We then discuss the observation of robust signatures of Majorana zero modes in recent experiments, paying particular attention to zero-bias tunnelling conduction measurements and Coulomb blockade experiments. We also outline several next-generation experiments probing exotic properties of Majorana zero modes, including fusion rules and non-Abelian exchange statistics. Finally, we discuss prospects for implementing Majorana-based topological quantum computation.

ESA's satellite communications programme

NASA Astrophysics Data System (ADS)

Bartholome, P.

1985-02-01

The developmental history, current status, and future plans of the ESA satellite-communications programs are discussed in a general survey and illustrated with network diagrams and maps. Consideration is given to the parallel development of national and European direct-broadcast systems and telecommunications networks, the position of the European space and electronics industries in the growing world market, the impact of technological improvements (both in satellite systems and in ground-based networks), and the technological and commercial advantages of integrated space-terrestrial networks. The needs for a European definition of the precise national and international roles of satellite communications, for maximum speed in implementing such decisions (before the technology becomes obsolete), and for increased cooperation and standardization to assure European equipment manufacturers a reasonable share of the market are stressed.

Engineering Management Capstone Project EM 697: Compare and Contrast Risk Management Implementation at NASA and the US Army

NASA Technical Reports Server (NTRS)

Brothers, Mary Ann; Safie, Fayssal M. (Technical Monitor)

2002-01-01

NASA at Marshall Space Flight Center (MSFC) and the U.S. Army at Redstone Arsenal were analyzed to determine whether they were successful in implementing their risk management program. Risk management implementation surveys were distributed to aid in this analysis. The scope is limited to NASA S&MA (Safety and Mission Assurance) at MSFC, including applicable support contractors, and the US Army Engineering Directorate, including applicable contractors, located at Redstone Arsenal. NASA has moderately higher risk management implementation survey scores than the Army. Accordingly, the implementation of the risk management program at NASA is considered good while only two of five of the survey categories indicated that the risk management implementation is good at the Army.

The international implications of national and local coordination on building energy codes: Case studies in six cities

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

Evans, Meredydd; Yu, Sha; Staniszewski, Aaron

Building energy efficiency is an important strategy for reducing greenhouse gas emissions globally. In fact, 55 countries have included building energy efficiency in their Nationally Determined Contributions (NDCs) under the Paris Agreement. This research uses building energy code implementation in six cities across different continents as case studies to assess what it may take for countries to implement the ambitions of their energy efficiency goals. Specifically, we look at the cases of Bogota, Colombia; Da Nang, Vietnam; Eskisehir, Turkey; Mexico City, Mexico; Rajkot, India; and Tshwane, South Africa, all of which are “deep dive” cities under the Sustainable Energy formore » All's Building Efficiency Accelerator. The research focuses on understanding the baseline with existing gaps in implementation and coordination. The methodology used a combination of surveys on code status and interviews with stakeholders at the local and national level, as well as review of published documents. We looked at code development, implementation, and evaluation. The cities are all working to improve implementation, however, the challenges they currently face include gaps in resources, capacity, tools, and institutions to check for compliance. Better coordination between national and local governments could help improve implementation, but that coordination is not yet well established. For example, all six of the cities reported that there was little to no involvement of local stakeholders in development of the national code; only one city reported that it had access to national funding to support code implementation. More robust coordination could better link cities with capacity building and funding for compliance, and ensure that the code reflects local priorities. By understanding gaps in implementation, it can also help in designing more targeted interventions to scale up energy savings.« less

The international implications of national and local coordination on building energy codes: Case studies in six cities

DOE PAGES

Evans, Meredydd; Yu, Sha; Staniszewski, Aaron; ...

2018-04-17

Building energy efficiency is an important strategy for reducing greenhouse gas emissions globally. In fact, 55 countries have included building energy efficiency in their Nationally Determined Contributions (NDCs) under the Paris Agreement. This research uses building energy code implementation in six cities across different continents as case studies to assess what it may take for countries to implement the ambitions of their energy efficiency goals. Specifically, we look at the cases of Bogota, Colombia; Da Nang, Vietnam; Eskisehir, Turkey; Mexico City, Mexico; Rajkot, India; and Tshwane, South Africa, all of which are “deep dive” cities under the Sustainable Energy formore » All's Building Efficiency Accelerator. The research focuses on understanding the baseline with existing gaps in implementation and coordination. The methodology used a combination of surveys on code status and interviews with stakeholders at the local and national level, as well as review of published documents. We looked at code development, implementation, and evaluation. The cities are all working to improve implementation, however, the challenges they currently face include gaps in resources, capacity, tools, and institutions to check for compliance. Better coordination between national and local governments could help improve implementation, but that coordination is not yet well established. For example, all six of the cities reported that there was little to no involvement of local stakeholders in development of the national code; only one city reported that it had access to national funding to support code implementation. More robust coordination could better link cities with capacity building and funding for compliance, and ensure that the code reflects local priorities. By understanding gaps in implementation, it can also help in designing more targeted interventions to scale up energy savings.« less

Factors associated with health-related quality of life in Koreans aged over 50 Years: the fourth and fifth Korea National Health and Nutrition Examination Survey.

PubMed

Kwon, Kyoung Min; Lee, Jung Soo; Jeon, Na Eun; Kim, Yeo Hyung

2017-12-16

To evaluate and analyse the factors associated with health-related quality of life (HR-QoL) in the Korean population aged 50 years and older. We used data obtained from the fourth and fifth Korea National Health and Nutrition Examination Survey (KNHANES IV-V) 2007-2012, a national, cross-sectional health examination and survey, for which representative data on the health, nutritional status, and physical activities of the Korean general population are collected by the Korea Centres for Disease Control and Prevention (KCDC). The sampling protocol for the KNHANES was designed to involve a complex, stratified, multistage probability cluster survey of a representative sample of the noninstitutionalized civilian population in South Korea using a cross-sectional design. The association between HR-QoL and socio-economic factors and medical comorbidities in adults aged 50 years and older was investigated using data from the KNHANES IV-V from 2007 to 2012 (n = 17,937). The EuroQol 5-Dimension Questionnaire (EQ-5D) was used to evaluate HR-QoL, and the factors associated with HR-QoL were analysed after adjusting for socio-economic and demographic factors, anthropometric measurements and clinical comorbidities. Health status declined with ageing, and low socio-economic status had negative associations with health status. Gender had no association with health status. Among chronic medical conditions, arthritis and depression had significant associations with health status in older people when stratified by age and gender (P < 0.05). These findings suggest that older people may value the ability to perform daily activities, which may mean that it is necessary to pay more attention to the factors associated with musculoskeletal pain and emotional distress, as well as socio-economic status or chronic diseases. The Korea National Health and Nutrition Examination Survey (KNHNES) is not a clinical trial registry, but the national health survey conducted by the Government of the Republic of Korea, to gather information on health and nutritional status of Korean population, to plan public health services and health education programs, and to do statistical studies of the efficiency of public health services required for setting up welfare and healthcare policies.

Breastfeeding and maternal employment: results from three national nutritional surveys in Mexico.

PubMed

Rivera-Pasquel, Marta; Escobar-Zaragoza, Leticia; González de Cosío, Teresita

2015-05-01

To evaluate the association between maternal employment and breastfeeding (both duration and status) in Mexican mothers using data from three National Health and Nutrition Surveys conducted in 1999, 2006 and 2012. We analyzed data from the 1999 National Nutrition Survey, the 2006 National Nutrition and Health Survey, and the 2012 National Nutrition and Health Survey (NNS-1999, NHNS-2006 and NHNS-2012) on 5,385 mothers aged 12-49 years, with infants under 1 year. Multivariate logistic regression models were used to analyze the association between breastfeeding and maternal employment adjusted for maternal and infant's socio-demographic covariates. Maternal formal employment was negatively associated with breastfeeding in Mexican mothers with infants under 1 year. Formally employed mothers were 20 % less likely to breastfeed compared to non-formally employed mothers and 27 % less likely to breastfeed compared to unemployed mothers. Difference in median duration of breastfeeding between formally employed and unemployed mothers was 5.7 months for NNS-1999, 4.7 months for NNHS-2006 and 6.7 months for NNHS-2012 respectively (p < 0.05). In NHNS-2006 and NHNS-2012, health care access was associated with longer breastfeeding duration. Maternal employment has been negatively associated with breastfeeding in Mexican mothers of <1 year infants at least for the last 15 years. For Mexicans involved in policy design, implementation or modification, these data might offer robust evidence on this negative association, and can be used confidently as basis for conceiving a more just legislation for working lactating women.

An integrated approach to assess broad-scale condition of coastal wetlands - The Gulf of Mexico Coastal Wetlands pilot survey

USGS Publications Warehouse

Nestlerode, J.A.; Engle, V.D.; Bourgeois, P.; Heitmuller, P.T.; Macauley, J.M.; Allen, Y.C.

2009-01-01

The Environmental Protection Agency (EPA) and U.S. Geological Survey (USGS) initiated a two-year regional pilot survey in 2007 to develop, test, and validate tools and approaches to assess the condition of northern Gulf of Mexico (GOM) coastal wetlands. Sampling sites were selected from estuarine and palustrine wetland areas with herbaceous, forested, and shrub/scrub habitats delineated by the US Fish and Wildlife Service National Wetlands Inventory Status and Trends (NWI S&T) program and contained within northern GOM coastal watersheds. A multi-level, stepwise, iterative survey approach is being applied to multiple wetland classes at 100 probabilistically-selected coastal wetlands sites. Tier 1 provides information at the landscape scale about habitat inventory, land use, and environmental stressors associated with the watershed in which each wetland site is located. Tier 2, a rapid assessment conducted through a combination of office and field work, is based on best professional judgment and on-site evidence. Tier 3, an intensive site assessment, involves on-site collection of vegetation, water, and sediment samples to establish an integrated understanding of current wetland condition and validate methods and findings from Tiers 1 and 2. The results from this survey, along with other similar regional pilots from the Mid-Atlantic, West Coast, and Great Lakes Regions will contribute to a design and implementation approach for the National Wetlands Condition Assessment to be conducted by EPA's Office of Water in 2011. ?? Springer Science+Business Media B.V. 2008.

A concurrent resolution expressing the sense of Congress that the census surveys and the information derived from those surveys are crucial to the national welfare.

THOMAS, 112th Congress

Sen. Rockefeller, John D., IV [D-WV

2012-08-02

Senate - 08/29/2012 Committee on Homeland Security and Governmental Affairs referred to Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Survey Findings on the Status of General Business Courses

ERIC Educational Resources Information Center

Furjanic, Sheila Whitney

1976-01-01

The McGraw Hill Book Company conducted a nationwide survey of 2,000 teachers regarding the status of general business courses. The discussion of responses reveals general business is a strong subject, ninth and tenth grade enrollments are increasing, and consumer and career related topics are of major interest to teacher and student. (Author/BP)

A Status Report on Hunger and Homelessness in America's Cities, 2002: A 25-City Survey.

ERIC Educational Resources Information Center

Lowe, Eugene T.

To assess the status of hunger and homelessness in U.S. cities during 2002, 25 major cities completed surveys regarding demand for emergency food assistance and emergency shelter and capacity of local agencies to meet the demand; causes of hunger and homelessness and demographics of populations experiencing these problems; exemplary programs or…

The Appalachian Region: A Data Overview from the 2011-2015 American Community Survey. Chartbook

ERIC Educational Resources Information Center

Pollard, Kelvin; Jacobsen, Linda A.

2017-01-01

This study examines state- and county-level data on population, age, race and ethnicity, housing occupancy and housing tenure, education, labor force, employment and unemployment, income and poverty, health insurance coverage, disability status, migration patterns, and veteran status from the 2011-2015 American Community Survey (ACS) for the 13…

The Appalachian Region: A Data Overview from the 2010-2014 American Community Survey. Chartbook

ERIC Educational Resources Information Center

Pollard, Kelvin; Jacobsen, Linda A.

2016-01-01

This study examines state- and county-level data on population, age, race and ethnicity, housing occupancy and housing tenure, education, labor force, employment and unemployment, income and poverty, health insurance coverage, disability status, migration patterns, and veteran status from the 2010-2014 American Community Survey (ACS) for the 13…

Lost in the Margins? Intersections between Disability and Other Nondominant Statuses with Regard to Peer Victimization

ERIC Educational Resources Information Center

McGee, Marjorie G.

2014-01-01

This study examined the extent to which disability status, alone and in combination with other social identities, was associated with differential levels of exposure to peer victimization. Logistic analyses of survey responses from eleventh graders completing the 2008 Oregon Healthy Teen survey (N = 7,091) utilized an intersectional,…

Based on the development status of British BIM, exploring China’s BIM road

NASA Astrophysics Data System (ADS)

Tiangang, Chu; hui, Li; shanjun, Zhang; Ningshan, Jiang; Dan, Zhang; Yu, Zhang; Guibo, Bao

2018-05-01

This article mainly analyses the development and application status and development trend of BIM technology after the implementation of the British government, to explore the policies and methods that our government should carry out in the development of BIM. The article also summarizes and analyses the relevant policies and standards implemented by various provincial and municipal governments in promoting BIM technology in China and summarizes the strengths and weaknesses of each other by comparing the development status of the implementation of BIM policies in various provinces and cities. The article also analysed the obstacles encountered in the implementation of some specific projects at the current stage of BIM technology, and summarized the feasible solutions. The article mainly analyses the application prospects of BIM from the technical aspects of design, the application of technology in the construction process, and the strategic implementation and operation of the company, and provides a reference for promoting the application of BIM in the construction industry in China, especially in the western region.

The GGOS Bureau of Networks and Observations: an update on the Space Geodesy Network and the New Implementation Plan for 2017 -18

NASA Astrophysics Data System (ADS)

Pearlman, Michael R.; Ma, Chopo; Neilan, Ruth; Noll, Carey; Pavlis, Erricos; Saunier, Jérôme; Schoene, Tilo; Barzaghi, Riccardo; Thaller, Daniela; Bergstrand, Sten; Mueller, Juergen

2017-04-01

Working with the IAG geometric services (VLBI, SLR, GNSS, and DORIS) the Bureau continues to advocate for the expansion and upgrade of the space geodesy networks for the maintenance and improvement of the reference frame and other application, and for the extension and integration with other techniques. New sites are being established following the GGOS concept of "core" and co-location sites; new technologies are being implemented to enhance performance in data yield as well as accuracy. In particular, several groups are undertaking initiatives and seeking partnerships to update existing sites and expand the networks in geographic areas void of coverage. The Bureau continues to meet with organizations to discuss possibilities of new and expanded participation and to promote the concept of partnerships. The Bureau provides the opportunity for representatives from the services to meet and share progress and plans, and to discuss issues of common interest. The Bureau monitors the status and projects the evolution of the network based on information from the current and expected future participants. Of particular interest at the moment is the integration of gravity and tide gauge networks. The Committees and Joint Working Groups play an essential role in the Bureau activity. The Standing Committee on Performance Simulations and Architectural Trade-off (PLATO) uses simulation and analysis techniques to project future network capability and to examine trade-off options. The Committee on Data and Information is working on a strategy for a GGOS metadata system on a near term plan for data products and a more comprehensive longer-term plan for an all-inclusive system. The Committee on Satellite Missions is working to enhance communication with the space missions, to advocate for missions that support GGOS goals and to enhance ground systems support. The IERS Working Group on Site Survey and Co-location (also participating in the Bureau) is working to enhance standardization in procedures, outreach and to encourage new survey groups to participate, and improve procedures to determine systems reference points. The 2017-2018 Implementation Plan for the GGOS Bureau of Networks and Observations has been posted on the GGOS website. We will outline progress over the past two years and discuss the status of the network and updated plan.

Age or health status: which influences medical insurance enrollment greater?

PubMed Central

Xu, Wei; Cai, Gong–Jie; Li, Guan–Nan; Cao, Jing–Jing; Shi, Qiong–Hua; Bai, Jie

2016-01-01

Background The New Cooperative Medical Scheme (NCMS) for peasantries implemented in 2003 and the Urban Resident Basic Medical Insurance (URBMI) for the urban unemployed implemented in 2007 have many similarities. They both apply the financing mode of individual premiums plus government’s subsidies, and the voluntary enrollment. The Chinese government plans to integrate these two systems and build a unified basic medical insurance system for the unemployed in order to achieve the medical equity and increase the general health level. Thus, to analyze the main influencing factors of the enrollment of the urban unemployed and rural residents is very important for improving the system and securing the stability of the system during the transition. Methods The study uses data from the China Health and Nutrition Survey (CHNS) and adopts logistic regression models to test which factors influence the enrollment of the URBMI and the NCMS under the background of rather high enrollment rate of Chinese basic medical insurances and strong fiscal support of the Chinese government, especially whether health status or age influences enrollment of these two insurances greater. Results There is indeed some adverse selection in the URBMI and the NCMS. Whether the individual has chronic diseases have significant influence on enrollments of both the urban unemployed and rural residents, while whether the individual got ill in last four weeks just influences enrollments of the urban unemployed. Age influences enrollment greater than health status. The older the insured are, the larger the enrollment rates are. Conclusion Because of the active support for basic medical insurances of the Chinese government, the enrollment performance of the urban unemployed and rural residents has already changed. When implementing the new policy, the government should pay attention to the willingness to enroll in and the change of enrollment performance of the insured. Therefore, under the policy of voluntary enrollment, every coordinated province and city should enlarge the proportion of young people to insuring group, optimizing the age structure, and the financing proportion of governments and individuals should be measured properly. With the increasing of governments’ subsidies, the proportion of individual’s premiums should also be increased. PMID:28028435

Breast interest group faculty of radiation oncology: Australian and New Zealand patterns of practice survey on breast radiotherapy.

PubMed

Nguyen, Kimberley; Mackenzie, Penny; Allen, Angela; Dreosti, Marcus; Morgia, Marita; Zissiadis, Yvonne; Lamoury, Gilian; Windsor, Apsara

2017-08-01

This patterns of practice study was conducted on behalf of the RANZCR Breast Interest Group in order to document current radiotherapy practices for breast cancer in Australia and New Zealand. The survey identifies variations and highlights potential contentious aspects of radiotherapy management of breast cancer. A fifty-eight question survey was disseminated via the Survey Monkey digital platform to 388 Radiation Oncologists in Australia and New Zealand. In total, 156 responses were received and collated. Areas of notable consensus among respondents included hypofractionation (77.3% of respondents would 'always' or 'sometimes' consider hypofractionation in the management of ductal carcinoma in-situ and 99.3% in early invasive breast cancer); margin status in early breast cancer (73.8% believe a clear inked margin is sufficient and does not require further surgery) and use of bolus in post-mastectomy radiotherapy (PMRT) (91.1% of participants use bolus in PMRT). Areas with a wider degree of variability amongst respondents included regional nodal irradiation and components of radiotherapy planning and delivery (examples include the technique used for delivery of boost and frequency of bolus application for PMRT). The results of these patterns of practice survey informs radiation oncologists in Australia and New Zealand of the current clinical practices being implemented by their peers. The survey identifies areas of consensus and contention, the latter of which may lead to a development of research trials and/or educational activities to address these areas of uncertainty. © 2016 The Royal Australian and New Zealand College of Radiologists.

Change in quality of malnutrition surveys between 1986 and 2015.

PubMed

Grellety, Emmanuel; Golden, Michael H

2018-01-01

Representative surveys collecting weight, height and MUAC are used to estimate the prevalence of acute malnutrition. The results are then used to assess the scale of malnutrition in a population and type of nutritional intervention required. There have been changes in methodology over recent decades; the objective of this study was to determine if these have resulted in higher quality surveys. In order to examine the change in reliability of such surveys we have analysed the statistical distributions of the derived anthropometric parameters from 1843 surveys conducted by 19 agencies between 1986 and 2015. With the introduction of standardised guidelines and software by 2003 and their more general application from 2007 the mean standard deviation, kurtosis and skewness of the parameters used to assess nutritional status have each moved to now approximate the distribution of the WHO standards when the exclusion of outliers from analysis is based upon SMART flagging procedure. Where WHO flags, that only exclude data incompatible with life, are used the quality of anthropometric surveys has improved and the results now approach those seen with SMART flags and the WHO standards distribution. Agencies vary in their uptake and adherence to standard guidelines. Those agencies that fully implement the guidelines achieve the most consistently reliable results. Standard methods should be universally used to produce reliable data and tests of data quality and SMART type flagging procedures should be applied and reported to ensure that the data are credible and therefore inform appropriate intervention. Use of SMART guidelines has coincided with reliable anthropometric data since 2007.

Food security in South Africa: a review of national surveys.

PubMed

Labadarios, Demetre; McHiza, Zandile June-Rose; Steyn, Nelia Patricia; Gericke, Gerda; Maunder, Eleni Maria Winifred; Davids, Yul Derek; Parker, Whadi-ah

2011-12-01

To assess the status of food security--i.e., access to food, food availability and food utilization--in South Africa. A systematic search of national surveys that used the Community Childhood Hunger Identification Project (CCHIP) index to measure food security in South Africa over a period of 10 years (1999-2008) was conducted. Anthropometric data for children aged 1-9 years were used to assess food utilization, and household food inventory data were used to assess food availability. Only three national surveys had used the CCHIP index, namely, the 1999 and 2005 National Food Consumption Surveys (NFCS) and the 2008 South African Social Attitudes Survey. These surveys showed a relatively large decrease in food insecurity between 1999 and 2008. However, the consistent emerging trend indicated that in poorer households women were either feeding their children a poor diet or skipping meals so their children could eat. In terms of food access and availability, the 1999 NFCS showed that households that enjoyed food security consumed an average of 16 different food items over 24 hours, whereas poorer households spent less money on food and consumed fewer than 8 different food items. Moreover, children had low mean scores for dietary diversity (3.58; standard deviation, SD: ± 1.37) and dietary variety (5.52; SD: ± 2.54) scores. In terms of food utilization, the NFCS showed that stunting in children decreased from 21.6% in 1999 to 18% in 2005. The South African government must implement measures to improve the undesirably high level of food insecurity in poorer households.

Psychosocial factors as mediators of food insecurity and weight status among middle school students.

PubMed

Willis, Don E; Fitzpatrick, Kevin M

2016-08-01

Research regarding the association between food insecurity and weight status among youth has produced mixed results. However, few studies on this topic have utilized data that includes survey responses from children themselves regarding their experience with food insecurity. This study was undertaken to examine the association between food insecurity and weight status among youth, as well as the potential mediation by psychosocial factors. A survey of 5th-7th grade students was administered to gather information on food insecurity, social and psychological resources, and health. The primary analysis includes OLS (Ordinary Least Squares) regression conducted using SPSS software and Sobel's test for mediation. Results suggest a positive association between food insecurity and weight status even when controlling for key demographic variables. In addition, we find that this association is mediated by psychosocial factors-namely, perceived social status and depression. Insights from this work highlight the need to consider non-nutritional pathways through which food insecurity impacts health as well the need to continue surveying youth directly when examining their experiences with food insecurity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Weak lensing in the Dark Energy Survey

NASA Astrophysics Data System (ADS)

Troxel, Michael

2016-03-01

I will present the current status of weak lensing results from the Dark Energy Survey (DES). DES will survey 5000 square degrees in five photometric bands (grizY), and has already provided a competitive weak lensing catalog from Science Verification data covering just 3% of the final survey footprint. I will summarize the status of shear catalog production using observations from the first year of the survey and discuss recent weak lensing science results from DES. Finally, I will report on the outlook for future cosmological analyses in DES including the two-point cosmic shear correlation function and discuss challenges that DES and future surveys will face in achieving a control of systematics that allows us to take full advantage of the available statistical power of our shear catalogs.

The most common problem facing by the maintenance department: A case Study between Universiti Tun Hussein Onn Malaysia (UTHM) and Universiti Teknologi Malaysia (UTM)

NASA Astrophysics Data System (ADS)

Norazam Yasin, Mohd; Mohamad Zin, Rosli; Halid Abdullah, Abd; Shafiq Mahmad, Muhammad; Fikri Hasmori, Muhammad

2017-11-01

From time to time, the maintenance works become more challenging due to construction of new building and also aging of the existing buildings. University buildings without any exception require proper maintenance services to support their function requirements and this can be considered as major responsibilities to be fulfilled by the maintenance department in the universities. Maintenance department specifically will face various kinds of problems in their operation works and thus this might influence the maintenance work operations itself. This study purposely to identify the common problem facing by the maintenance department and also to examine the current status of the maintenance department. In addition, this study would also propose any suitable approach that could be implemented to overcome the problem facing by the maintenance department. To achieve the objectives of this study, a combination of deep literature study and carrying out a survey is necessary. Literature study aimed to obtain deeper information about this study, meanwhile a survey aimed at identifying the common problem facing by the maintenance department and also to provide the information of the maintenance department’s organization. Several methods will be used in analyzing the data obtained through the survey, including Microsoft Office Excel and also using mean index formula. This study has identified three categories of problem in the maintenance department, which are management problems, human resource problem, and technical problems. Following the findings, several solutions being proposed which can be implemented as the solution to the problem facing. These suggestions have the potential to improve the maintenance department work efficiency, thus could help to increase the department productivity.

Current practices in long-term video-EEG monitoring services: A survey among partners of the E-PILEPSY pilot network of reference for refractory epilepsy and epilepsy surgery.

PubMed

Kobulashvili, Teia; Höfler, Julia; Dobesberger, Judith; Ernst, Florian; Ryvlin, Philippe; Cross, J Helen; Braun, Kees; Dimova, Petia; Francione, Stefano; Hecimovic, Hrvoje; Helmstaedter, Christoph; Kimiskidis, Vasilios K; Lossius, Morten Ingvar; Malmgren, Kristina; Marusic, Petr; Steinhoff, Bernhard J; Boon, Paul; Craiu, Dana; Delanty, Norman; Fabo, Daniel; Gil-Nagel, Antonio; Guekht, Alla; Hirsch, Edouard; Kalviainen, Reetta; Mameniskiené, Ruta; Özkara, Çiğdem; Seeck, Margitta; Rubboli, Guido; Krsek, Pavel; Rheims, Sylvain; Trinka, Eugen

2016-05-01

The European Union-funded E-PILEPSY network aims to improve awareness of, and accessibility to, epilepsy surgery across Europe. In this study we assessed current clinical practices in epilepsy monitoring units (EMUs) in the participating centers. A 60-item web-based survey was distributed to 25 centers (27 EMUs) of the E-PILEPSY network across 22 European countries. The questionnaire was designed to evaluate the characteristics of EMUs, including organizational aspects, admission, and observation of patients, procedures performed, safety issues, cost, and reimbursement. Complete responses were received from all (100%) EMUs surveyed. Continuous observation of patients was performed in 22 (81%) EMUs during regular working hours, and in 17 EMUs (63%) outside of regular working hours. Fifteen (56%) EMUs requested a signed informed consent before admission. All EMUs performed tapering/withdrawal of antiepileptic drugs, 14 (52%) prior to admission to an EMU. Specific protocols on antiepileptic drugs (AED) tapering were available in four (15%) EMUs. Standardized Operating Procedures (SOP) for the treatment of seizure clusters and status epilepticus were available in 16 (59%). Safety measures implemented by EMUs were: alarm seizure buttons in 21 (78%), restricted patient's ambulation in 19 (70%), guard rails in 16 (59%), and specially designated bathrooms in 7 (26%). Average costs for one inpatient day in EMU ranged between 100 and 2200 Euros. This study shows a considerable diversity in the organization and practice patterns across European epilepsy monitoring units. The collected data may contribute to the development and implementation of evidence-based recommended practices in LTM services across Europe. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Assessing Opportunities to Enhance Comprehensive Health Promotion and Wellness Programming in a State Community College System.

PubMed

Linnan, Laura A; Arandia, Gabriela; Naseer, Carolyn; Li, Jiang; Pomerantz, Meg; Diehl, Sandra J

2017-01-01

BACKGROUND North Carolina has the third largest community college system in the nation and reaches residents in all 100 counties. Few studies have focused on the health of employees who work at these institutions. We assessed the current status of and interest in supporting health promotion efforts among North Carolina Community College System members. METHODS North Carolina Community College System presidents completed a brief 15-item survey assessing support for and interest in offering health promotion programs. Wellness coordinators completed a 60-item questionnaire assessing current health promotion programming and organizational, environmental, and policy supports for health promotion efforts. Onsite interviews with a sub-sample of Wellness coordinators offered insights into important implementation considerations. We examined differences by campus size with Fisher's exact test. RESULTS All 58 presidents (100%) and 51 wellness coordinators (88%) completed surveys. Ten percent of colleges offered comprehensive employee health promotion programming. Most offered physical activity (70.6%), tobacco cessation (51.0%), weight loss/management (49.0%), and/or nutrition counseling (47.1%). Larger colleges were more likely to offer programming and environmental support. Nearly all presidents (89.7%) believed it is "very" or "extremely" important to offer health promotion programs to employees, and most (84%) were interested in promoting health through a university partnership. LIMITATIONS Despite very high survey response rates from presidents and wellness coordinators at each community college, onsite interviews were only done at select campuses, limiting the generalizability and scope of conclusions derived from interview data. CONCLUSION Community colleges in North Carolina are promising settings for promoting employee health. Findings identify resources, barriers, and technical assistance that could facilitate greater adoption and implementation of programs. ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Assessing the Changing Landscape of Sexual Health Clinical Service After the Implementation of the Affordable Care Act.

PubMed

Mettenbrink, Christie; Al-Tayyib, Alia; Eggert, Jeffrey; Thrun, Mark

2015-12-01

Federal health reform has the potential to impact many public health services, especially sexual health clinics. To assess the impact of such reform within the Denver Sexual Health Clinic (DSHC), we conducted a survey of patients to better understand our client population and their care-seeking behavior. Survey data were collected from patients attending the DSHC at 3 different points in time to ascertain insurance status, reasons for not having insurance, reasons for choosing care at the DSHC, and health care use over the past 12 months. A total of 1603 surveys were completed. Forty-two percent of participants were enrolled in health insurance at the time of visit. The percentage of patients with Medicaid increased more than 200% across the survey cycles. Cost was the main reason cited for not having insurance. Participants identified confidentiality and convenience among the top reasons for seeking care at the DSHC regardless of sex or insurance. Although there was no difference in health care use for sexual health services, individuals with health insurance were more likely to have used nonsexual health services in the past 12 months than those without insurance. Patients continue to visit the DSHC despite having health insurance. Sexual health clinics must work to understand what drives people to seek care so that they can better prepare for the future.

Regional survey supports national initiative for 'water-only' schools in New Zealand.

PubMed

Mansoor, Osman David; Ali, Rukhsana; Richards, Ruth

2017-10-01

To support a national initiative to remove sugary drinks from schools and limit drinks to water or unflavoured milk ('water-only'). We emailed all 201 schools with primary school aged children in the Greater Wellington region with a survey on (1) current status of, (2) support needs for, and (3) barriers to or lessons learned from, a 'water-only' school policy. Only 78 (39%) of schools responded. Most supported 'water-only': 22 (28%) had implemented a policy; 10 (13%) in process of doing so; 22 (28%) were considering it; and 12 (15%) were 'water-only', but did not have a policy. Only 12 (15%) were not considering a 'water-only' policy. The main barrier reported was lack of community and/or family support. Many schools did not see any barriers beyond the time needed for consultation. Monitoring and communication were identified as key to success. A quarter of schools requested public health nurse support for a 'water-only' policy. The survey elicited a range of views on 'water-only' policies for schools, but suggests that 'water-only' may be an emerging norm for schools. Implications for public health: Our survey shows how local assessment can support a national initiative by providing a baseline, identifying schools that want support, and sharing lessons. Making schools 'water-only' could be a first step in changing our children's environment to prevent obesity. © 2017 Regional Public Health.

[Effect of control program of human intestinal parasitic diseases in Nanping City].

PubMed

Ming-Ying, Zhuo; Zhi-Ping, Zhang; Hong-Mei, Zhu; Hui, Zhang; Jia-Mei, Huang; Hui, Wen; Han-Guo, Xie

2016-01-22

To understand the epidemic status of human intestinal parasitic diseases and evaluate the effect of the control program in Nanping City, so as to provide an evidence for improving the disease control. The villages were selected by the stratified cluster sampling method and the residents in these villages were surveyed for human intestinal parasitic diseases, and kindergartens were also selected and the children in these kindergartens were surveyed for Enterobius vermicularis infection. In 2007, before the control program, 9 851 residents of Nanping City were surveyed, with the parasitic infection rate of 9.10% (896 infection cases), and the infection rate of E. vermicularis of children was 18.56% (328/1 767). From 2011 to 2014, when the control program was performed, 4 679 residents were surveyed, with the infection rate of 4.06% (190 infection cases), and the infection rate of E. vermicularis of children was 3.87% (33/853). After the control program was launched, the infection rates of human intestinal parasites were decreased. The overall parasitic infection rate and hookworm infection rate showed increasing trends by age ( χ 2 = 49.03 and 53.58 respectively, both P < 0.01). The infection situation of human intestinal parasites is decreased after the implementation of the control program but the infection rate is still at a high level, and the control work should be strengthened.

Policy-driven development of cost-effective, risk-based surveillance strategies.

PubMed

Reist, M; Jemmi, T; Stärk, K D C

2012-07-01

Animal health and residue surveillance verifies the good health status of the animal population, thereby supporting international free trade of animals and animal products. However, active surveillance is costly and time-consuming. The development of cost-effective tools for animal health and food hazard surveillance is therefore a priority for decision-makers in the field of veterinary public health. The assumption of this paper is that outcome-based formulation of standards, legislation leaving room for risk-based approaches and close collaboration and a mutual understanding and exchange between scientists and policy makers are essential for cost-effective surveillance. We illustrate this using the following examples: (i) a risk-based sample size calculation for surveys to substantiate freedom from diseases/infection, (ii) a cost-effective national surveillance system for Bluetongue using scenario tree modelling and (iii) a framework for risk-based residue monitoring. Surveys to substantiate freedom from infectious bovine rhinotracheitis and enzootic bovine leucosis between 2002 and 2009 saved over 6 million € by applying a risk-based sample size calculation approach, and by taking into account prior information from repeated surveys. An open, progressive policy making process stimulates research and science to develop risk-based and cost-efficient survey methodologies. Early involvement of policy makers in scientific developments facilitates implementation of new findings and full exploitation of benefits for producers and consumers. Copyright © 2012 Elsevier B.V. All rights reserved.

Free-Roaming Dog Population Estimation and Status of the Dog Population Management and Rabies Control Program in Dhaka City, Bangladesh

PubMed Central

Tenzin, Tenzin; Ahmed, Rubaiya; Debnath, Nitish C.; Ahmed, Garba; Yamage, Mat

2015-01-01

Beginning January 2012, a humane method of dog population management using a Catch-Neuter-Vaccinate-Release (CNVR) program was implemented in Dhaka City, Bangladesh as part of the national rabies control program. To enable this program, the size and distribution of the free-roaming dog population needed to be estimated. We present the results of a dog population survey and a pilot assessment of the CNVR program coverage in Dhaka City. Free-roaming dog population surveys were undertaken in 18 wards of Dhaka City on consecutive days using mark-resight methods. Data was analyzed using Lincoln-Petersen index-Chapman correction methods. The CNVR program was assessed over the two years (2012–2013) whilst the coverage of the CNVR program was assessed by estimating the proportion of dogs that were ear-notched (processed dogs) via dog population surveys. The free-roaming dog population was estimated to be 1,242 (95 % CI: 1205–1278) in the 18 sampled wards and 18,585 dogs in Dhaka City (52 dogs/km2) with an estimated human-to-free-roaming dog ratio of 828:1. During the two year CNVR program, a total of 6,665 dogs (3,357 male and 3,308 female) were neutered and vaccinated against rabies in 29 of the 92 city wards. A pilot population survey indicated a mean CNVR coverage of 60.6% (range 19.2–79.3%) with only eight wards achieving > 70% coverage. Given that the coverage in many neighborhoods was below the WHO-recommended threshold level of 70% for rabies eradications and since the CNVR program takes considerable time to implement throughout the entire Dhaka City area, a mass dog vaccination program in the non-CNVR coverage area is recommended to create herd immunity. The findings from this study are expected to guide dog population management and the rabies control program in Dhaka City and elsewhere in Bangladesh. PMID:25978406

Free-roaming dog population estimation and status of the dog population management and rabies control program in Dhaka City, Bangladesh.

PubMed

Tenzin, Tenzin; Ahmed, Rubaiya; Debnath, Nitish C; Ahmed, Garba; Yamage, Mat

2015-05-01

Beginning January 2012, a humane method of dog population management using a Catch-Neuter-Vaccinate-Release (CNVR) program was implemented in Dhaka City, Bangladesh as part of the national rabies control program. To enable this program, the size and distribution of the free-roaming dog population needed to be estimated. We present the results of a dog population survey and a pilot assessment of the CNVR program coverage in Dhaka City. Free-roaming dog population surveys were undertaken in 18 wards of Dhaka City on consecutive days using mark-resight methods. Data was analyzed using Lincoln-Petersen index-Chapman correction methods. The CNVR program was assessed over the two years (2012-2013) whilst the coverage of the CNVR program was assessed by estimating the proportion of dogs that were ear-notched (processed dogs) via dog population surveys. The free-roaming dog population was estimated to be 1,242 (95 % CI: 1205-1278) in the 18 sampled wards and 18,585 dogs in Dhaka City (52 dogs/km2) with an estimated human-to-free-roaming dog ratio of 828:1. During the two year CNVR program, a total of 6,665 dogs (3,357 male and 3,308 female) were neutered and vaccinated against rabies in 29 of the 92 city wards. A pilot population survey indicated a mean CNVR coverage of 60.6% (range 19.2-79.3%) with only eight wards achieving > 70% coverage. Given that the coverage in many neighborhoods was below the WHO-recommended threshold level of 70% for rabies eradications and since the CNVR program takes considerable time to implement throughout the entire Dhaka City area, a mass dog vaccination program in the non-CNVR coverage area is recommended to create herd immunity. The findings from this study are expected to guide dog population management and the rabies control program in Dhaka City and elsewhere in Bangladesh.

Current Status of The Low Frequency All Sky Monitor

NASA Astrophysics Data System (ADS)

Dartez, Louis; Creighton, Teviet; Jenet, Fredrick; Dolch, Timothy; Boehler, Keith; Bres, Luis; Cole, Brent; Luo, Jing; Miller, Rossina; Murray, James; Reyes, Alex; Rivera, Jesse

2018-01-01

The Low Frequency All Sky Monitor (LoFASM) is a distributed array of cross-dipole antennas that are sensitive to radio frequencies from 10 to 88 MHz. LoFASM consists of antennas and front end electronics that were originally developed for the Long Wavelength Array by the U.S. Naval Research Lab, the University of New Mexico, Virginia Tech, and the Jet Propulsion Laboratory. LoFASM, funded by the U.S. Department of Defense, will initially consist of 4 stations, each consisting of 12 dual- polarization dipole antenna stands. The primary science goals of LoFASM will be the detection and study of low-frequency radio transients, a high priority science goal as deemed by the National Research Council’s ASTRO2010 decadal survey. The data acquisition system for the LoFASM antenna array uses Field Programmable Gate Array (FPGA) technology to implement a real time full Stokes spectrometer and data recorder. This poster presents an overview of the LoFASM Radio Telescope as well as the status of data analysis of initial commissioning observations.

Prevalence and Socio-Demographic Determinants of Tobacco, Alcohol, Substance Use and Drug Misuse in General Population in Turkey

PubMed Central

İLHAN, Mustafa Necmi; ARIKAN, Zehra; KOTAN, Zeynep; TUNÇOĞLU, Tolga; PINARCI, Mustafa; TAŞDEMİR, Ahmet; AY, Bülent; KOÇAK, Nadir

2016-01-01

Introduction The aim of the current study is to determine prevalence ratios of tobacco, alcohol, substance use and drug misuse in a large scale sample of general population and recognize related socio-demographic factors. Methods The study was based on a cross-sectional survey conducted with a nationally representative sample of 8045 individuals with face-to-face, in-house interviews implemented by a trained team of interviewers. Results Life-time prevalences of tobacco, alcohol, substance use and drug misuse are 51.8%, 28.3%, 2.8% and 10.5% respectively. Age, gender, education level and marital status are important socio-demographic determinants for tobacco, alcohol use and drug misuse. Income level is an important determinant for alcohol and substance use. Conclusion Tobacco, alcohol, substance use and drug misuse are significant health concerns in Turkey. Socio-demographic status is an important determinant of several aspects of tobacco, alcohol, substance use and drug misuse and should therefore be evaluated carefully to develop effective protective and preventive strategies. PMID:28373796

The association between work-life balance and health status among Korean workers.

PubMed

Choi, Eunsuk; Kim, Jiyun

2017-01-01

Although the relationship between work-life balance (WLB) and health is well known, it has been poorly studied in Korea. This study investigated factors related to WLB for Korean workers, including working time features and the relationships between WLB and health outcomes. Data were obtained from the third Korean Working Conditions Survey, which examined a representative working population. This study investigated general characteristics, working time characteristics, work related health, and WLB. A multivariate logistic regression was used to test the associations between WLB and health outcome variables, including general health status, mental health, work-related risks to health and safety, sickness absenteeism, presenteeism, musculoskeletal disease, headache/eyestrain, and fatigue. General characteristics including gender, age, working sector, occupation, and employment type were found to be related to WLB. Moreover, working time characteristics were found to be strongly related to WLB. In addition, WLB was significantly related to various health outcomes. Our findings indicate that WLB is strongly related to health outcomes among Korean workers. The results suggest that there is a need for interventions that focus on implementing working time strategies for better health.

Urbanization, socioeconomic status and health disparity in China.

PubMed

Miao, Jia; Wu, Xiaogang

2016-11-01

While urbanization is associated with a wide range of human welfare outcomes, its impacts on population health are much less obvious. This article aims to investigate how rapid urbanization in contemporary China affects health, and how it shapes health disparities between groups of different socioeconomic status (SES). Using data from eight waves of the China Health and Nutrition Survey (CHNS) spanning a period of 20 years from 1991 to 2011, we examine the confounding effects of urbanization on health and the income-health relationship and explore the underlying mechanism. Results from multilevel analysis show that living in more urbanized areas increases the risk of acquiring chronic diseases, and the health penalty of urbanization is more severe among those with a higher income. Lifestyle is the pathway through which urbanization affects health, and a high-fat diet and decreased physical activity diminish the health benefit brought by high income and accelerate health decline in more urbanized areas. These results suggest an urgent need to design and implement health promotion programs to encourage healthy lifestyles in China under rapid urbanization. Copyright © 2016 Elsevier Ltd. All rights reserved.

Complementary and alternative medicine among veterans and military personnel: a synthesis of population surveys.

PubMed

Davis, Margot T; Mulvaney-Day, Norah; Larson, Mary Jo; Hoover, Ronald; Mauch, Danna

2014-12-01

Recent reports reinforce the widespread interest in complementary and alternative medicine (CAM), not only among military personnel with combat-related disorders, but also among providers who are pressed to respond to patient demand for these therapies. However, an understanding of utilization of CAM therapies in this population is lacking. The goals of this study are to synthesize the content of self-report population surveys with information on use of CAM in military and veteran populations, assess gaps in knowledge, and suggest ways to address current limitations. The research team conducted a literature review of population surveys to identify CAM definitions, whether military status was queried, the medical and psychological conditions queried, and each specific CAM question. Utilization estimates specific to military/veterans were summarized and limitations to knowledge was classified. Seven surveys of CAM utilization were conducted with military/veteran groups. In addition, 7 household surveys queried military status, although there was no military/veteran subgroup analysis. Definition of CAM varied widely limiting cross-survey analysis. Among active duty and Reserve military, CAM use ranged between 37% and 46%. Survey estimates do not specify CAM use that is associated with a medical or behavioral health condition. Comparisons between surveys are hampered due to variation in methodologies. Too little is known about reasons for using CAM and conditions for which it is used. Additional information could be drawn from current surveys with additional subgroup analysis, and future surveys of CAM should include military status variable.

Longitudinal study of the feasibility of using ecological momentary assessment to study teacher stress: Objective and self-reported measures.

PubMed

McIntyre, Teresa M; McIntyre, Scott E; Barr, Christopher D; Woodward, Phillip S; Francis, David J; Durand, Angelia C; Mehta, Paras; Kamarck, Thomas W

2016-10-01

There is a lack of comprehensive research on Ecological Momentary Assessment (EMA) feasibility to study occupational stress, especially its long-term sustainability. EMA application in education contexts has also been sparse. This study investigated the feasibility of using EMA to study teacher stress over 2 years using both objective compliance data and a self-reported feasibility survey. It also examined the influence of individual and school factors on EMA feasibility. Participants were 202 sixth through eighth grade teachers from 22 urban middle schools in the southern United States. EMA was implemented via an iPod-based Teacher Stress Diary (TSD). Teachers recorded demands, stress responses, and resources during 12 days (6 waves) over 2 years. Feasibility was assessed via compliance data generated by the TSD (e.g., entry completion) and an EMA Feasibility Survey of self-reported user-friendliness and EMA interference. The results showed high compliance regarding entry and item completion, and completion time, which was sustained over time. User-friendliness was appraised as very high and EMA interference as low. Initial difficulties regarding timing and length of assessments were addressed via EMA method refinement, resulting in improved feasibility. Teachers' ethnicity, age, marital status, grade/course taught, class size, class load, and daily workload impacted feasibility. The results supported the feasibility of using EMA to study work stress longitudinally and the value of continued feasibility monitoring. They also support EMA use to study teacher stress and inform EMA implementation in schools. Some teacher and school factors need to be taken into consideration when deciding on EMA implementation in education contexts. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Radiation techniques used in patients with breast cancer: Results of a survey in Spain

PubMed Central

Algara, Manuel; Arenas, Meritxell; De las Peñas Eloisa Bayo, Dolores; Muñoz, Julia; Carceller, José Antonio; Salinas, Juan; Moreno, Ferran; Martínez, Francisco; González, Ezequiel; Montero, Ángel

2012-01-01

Aim To evaluate the resources and techniques used in the irradiation of patients with breast cancer after lumpectomy or mastectomy and the status of implementation of new techniques and therapeutic schedules in our country. Background The demand for cancer care has increased among the Spanish population, as long as cancer treatment innovations have proliferated. Radiation therapy in breast cancer has evolved exponentially in recent years with the implementation of three-dimensional conformal radiotherapy, intensity modulated radiotherapy, image guided radiotherapy and hypofractionation. Material and Methods An original survey questionnaire was sent to institutions participating in the SEOR-Mama group (GEORM). In total, the standards of practice in 969 patients with breast cancer after surgery were evaluated. Results The response rate was 70% (28/40 centers). In 98.5% of cases 3D conformal treatment was used. All the institutions employed CT-based planning treatment. Boost was performed in 56.4% of patients: electrons in 59.8%, photons in 23.7% and HDR brachytherapy in 8.8%. Fractionation was standard in 93.1% of patients. Supine position was the most frequent. Only 3 centers used prone position. The common organs of risk delimited were: homolateral lung (80.8%) and heart (80.8%). In 84% histograms were used. An 80.8% of the centers used isocentric technique. In 62.5% asymmetric fields were employed. CTV was delimited in 46.2%, PTV in 65% and both in 38.5%. A 65% of the centers checked with portal films. IMRT and hypofractionation were used in 1% and in 5.5% respectively. Conclusion In most of centers, 3D conformal treatment and CT-based planning treatment were used. IMRT and hypofractionation are currently poorly implemented in Spain. PMID:24377012

Effects of a workplace travel plan intervention encouraging active travel to work: outcomes from a three-year time-series study.

PubMed

Petrunoff, N; Wen, L M; Rissel, C

2016-06-01

To evaluate the effects of a three-year workplace travel plan intervention on increasing active travel to work. A time-series study with staff was conducted in 2011 (n = 804), 2012 (n = 904), 2013 (n = 872) and 2014 (n = 687). A travel plan was implemented at a large, outer-suburban worksite in Sydney, Australia. Implementation was assessed by reviewing annual reports including travel plan actions and their status. Annual cross-sectional on-line surveys assessed primary outcomes which included change in the proportion of staff travelling to work via active modes. Multivariate logistic regression was used to adjust for confounders. Strategies to encourage active travel were partially implemented. An average survey response rate was 23% (n = 817). The proportion of staff travelling actively to work increased by 4%-6% across intervention years compared to the baseline, and this increase was significant in 2012 (P = 0.04) and 2013 (P = 0.003). Compared to baseline, after adjusting for distances staff lived from work staff had 33% (95% CI 1%-74%) greater odds of travelling to work via active modes in 2012, and 50% (95% CI 15%-96%) greater odds in 2013. There was no evidence of change in physical activity levels. A workplace travel plan which only included strategies to encourage active travel to work achieved small but significant increases in active travel. Workplace travel plans appear to be a promising way to increase active travel to work. Copyright © 2016 The Royal Society for Public Health. All rights reserved.

Preparation for practice in family medicine: before and after duty hours.

PubMed

Carek, Peter J; Diaz, Vanessa; Dickerson, Lori M; Peterson, Lars; Johnson, Sharleen

2012-09-01

In July of 2003, the Accreditation Council for Graduate Medical Education (ACGME) adopted requirements limiting the duty hours of resident physicians. The impact of these restrictions on education and patient care activities is not clear. The purpose of this study is to examine the perception of graduates of family medicine residency programs immediately prior to and following implementation of duty hours regarding preparedness to practice and board certification status, as well as current patient care activities. Surveys of graduates of family medicine residency programs in South Carolina were conducted. Preparation for practice and professional activities of program graduates prior to (1999--2003) and following (2005--2009) implementation of duty hours were compared. Response rates were 54.4% and 53.1%, respectively. No significant differences by survey years in the average age, gender, or race was noted. Recent graduates felt as well prepared for practice in most curricular areas except surgery (OR=0.50 [0.27, 0.91]) and performed similar procedures with the following exceptions: central line placement (OR=0.32 [0.11, 0.95]), flexible sigmoidoscopy (OR=0.12 [0.02, 0.80]), ICU care (OR=0.39 [0.22, 0.70]), and ventilator management (OR=0.54 [0.29, 0.99]). Higher proportion of recent graduates do not take after hours call (22.3% versus 8.6%). Similarly, fewer recent graduates care for patients in nursing homes (22.0% versus 44.9%) and hospitals (46.2% versus 68.0%). Implementation of resident duty hours appears to have little overall association with self-reported preparedness for practice. An association was noted in the patient care services and procedures performed.

Evaluation of a community-based hypertension improvement program (ComHIP) in Ghana: data from a baseline survey.

PubMed

Lamptey, Peter; Laar, Amos; Adler, Alma J; Dirks, Rebecca; Caldwell, Aya; Prieto-Merino, David; Aerts, Ann; Pearce, Neil; Perel, Pablo

2017-04-28

Ghana faces an increasing burden of non-communicable disease with rates of hypertension estimated as high as 36% in adults. Despite these high rates, hypertension control remains very poor in Ghana (4%). The current project aims to implement and evaluate a community-based programme to raise awareness, and to improve treatment and control of hypertension in the Eastern Region of Ghana. In this paper, we present the findings of the baseline cross-sectional survey focusing on hypertension prevalence, awareness, treatment, and control. To evaluate the ComHIP project, a quasi-experimental design consisted of a before and after evaluations are being implemented in the intervention and comparison districts. A cohort study component is being implemented in the intervention district to assess hypertension control. Background anthropometric and clinical data collected as part of the baseline survey were analyzed in STATA Version 11. We examined the characteristics of individuals, associated with the baseline study outcomes using logistic regression models. We interviewed 2400 respondents (1200 each from the comparison and intervention districts), although final sample sizes after data cleaning were 1170 participants in the comparison district and 1167 in the intervention district. With the exception of ethnicity, the control and intervention districts compare favorably. Overall 32.4% of the study respondents were hypertensive (31.4% in the control site; and 33.4% in the intervention site); 46.2% of hypertensive individuals were aware of a previous diagnosis of hypertension (44.7% in the control site, and 47.7% in the intervention site), and only around 9% of these were being treated in either arm. Hypertension control was 1.3% overall (0.5% in the comparison site, and 2.1% in the intervention site). Age was a predictor of having hypertension, and so was increasing body mass index (BMI), waist, and hip circumferences. After adjusting for age, the risk factors with the greatest association with hypertension were being overweight (aOR = 2.30; 95% CI 1.53-3.46) or obese (aOR = 3.61; 95% CI 2.37-5.51). Older individuals were more likely to be aware of their hypertension status than younger people. After adjusting for age people with a family history of hypertension or CVD, or having an unhealthy waist hip ratio, were more likely to be aware of their hypertension status. The high burden of hypertension among the studied population, coupled with high awareness, yet very low level of hypertension treatment and control requires in-depth investigation of the bottlenecks to treatment and control. The low hypertension treatment and control rates despite current and previous general educational programs particularly in the intervention district, may suggest that such programs are not necessarily impactful on the health of the population.

An exploratory analysis for Lean and Six Sigma implementation in hospitals: Together is better?

PubMed

Lee, Jung Young; McFadden, Kathleen L; Gowen, Charles R

Despite the increasing interest for Lean and Six Sigma implementations in hospitals, there has been little empirical evidence that goes beyond descriptive case studies to address the current status and the effectiveness of the implementations. The aim of this study was to explore existing patterns of Lean and Six Sigma implementation in U.S. hospitals and compare the performance of the different patterns. We collected data from 215 U.S. hospitals via a survey that includes measurement items developed from related literature. Using the cross-sectional data, we conducted a cluster analysis, followed by t tests, chi-square tests, and regression analyses for cluster verification. The cluster analysis identifies two clusters, a Moderate Six Sigma group and a Lean Six Sigma group. Results show that the Lean Six Sigma group outperforms the Moderate Six Sigma group across many performance dimensions: responsiveness capability, patient safety, and possibly cost saving. In addition, the Lean Six Sigma group tends to be composed of larger, private teaching hospitals located in more urban areas, and they employ more resources for quality improvement. Our research contributes to the quality management literature by supporting the possible complementary relationship between Lean and Six Sigma in hospitals. Our study encourages practitioners and managers to pay more attention to Lean implementation. Although Lean seems to be conducted in a limited fashion in many hospitals, it should be expanded and combined with Six Sigma for better results.

Implementation status of accrual accounting system in health sector.

PubMed

Mehrolhassani, Mohammad Hossien; Khayatzadeh-Mahani, Akram; Emami, Mozhgan

2014-07-29

Management of financial resources in health systems is one of the major issues of concern for policy makers globally. As a sub-set of financial management, accounting system is of paramount importance. In this paper, which presents part of the results of a wider research project on transition process from a cash accounting system to an accrual accounting system, we look at the impact of components of change on implementation of the new system. Implementing changes is fraught with many obstacles and surveying these challenges will help policy makers to better overcome them. The study applied a quantitative manner in 2012 at Kerman University of Medical Science in Iran. For the evaluation, a teacher made valid questionnaire with Likert scale was used (Cranach's alpha of 0.89) which included 7 change components in accounting system. The study population was 32 subordinate units of Kerman University of Medical Sciences and for data analysis, descriptive and inferential statistics and correlation coefficient in SPSS version 19 were used. Level of effect of all components on the implementation was average downward (5.06±1.86), except for the component "management & leadership (3.46±2.25)" (undesirable from external evaluators' viewpoint) and "technology (6.61±1.92) and work processes (6.35±2.19)" (middle to high from internal evaluators' viewpoint). Results showed that the establishment of accrual accounting system faces infrastructural challenges, especially the components of leadership and management and followers. As such, developing effective measures to overcome implementation obstacles should target these components.

Key challenges in the development and implementation of telehealth projects.

PubMed

Joseph, Victor; West, Robert M; Shickle, Darren; Keen, Justin; Clamp, Susan

2011-01-01

A literature review was carried out to identify the key challenges in the implementation of telehealth. This was followed by a survey of organisations in England involved in telehealth projects in order to understand the challenges they faced. Ten of the 13 health or local authority organisations surveyed had telehealth projects and three were at the planning stage. The analysis revealed seven key challenges facing implementers of telehealth in England. Based on the findings from the literature review and the survey, a model was constructed and a checklist drawn up. The model contained the following elements: identifying issues, needs and partners; producing a strategy; securing funding; implementing changes; and monitoring and evaluating a telehealth project. The checklist was validated by using key informants from the organisations originally surveyed. The checklist may be useful to guide telehealth development and implementation in the future.

Impact of national smokefree environments laws on teachers, schools and early childhood centres.

PubMed

Watson, Donna; Glover, Marewa; McCool, Judith; Bullen, Chris; Adams, Brian; Min, Sandar

2011-12-01

New Zealand's (NZ) smokefree legislation, implemented on 1 January 2004, requires that all school and early childhood centre buildings and grounds are 100% smokefree; one aim being to prevent young people being influenced by seeing people (including teachers) smoke there. This study, conducted in 2008, investigated teachers'smoking behaviour and perceived adherence to the legislation. A national NZ cross-sectional survey of 2,004 teachers (oversampling Māori), who were randomly selected from the electoral roll of registered voters and sent postal invitations to complete an anonymous survey. The response rate was 70%. Current smokers numbered 7%, and proportionately more Maori and Pacific Island teachers (12% each) smoked than European/Other teachers (7%). Of current smokers, 37% smoked non-daily. Smokers smoked less on work than non-work days. Introducing smokefree legislation was associated with teachers changing when they smoked, cutting down, quitting or trying to quit. Perceived compliance with the legislation was high, although 30% of teachers reported seeing staff smoking. Proportionately, significantly more teachers from low than from high socioeconomic schools perceived poor compliance and staff visibly smoking. Smokefree legislation affects people's smoking behaviour. Smoking in NZ is becoming confined to population subgroups defined by socioeconomic status and ethnicity. Our findings argue for supporting cessation among those who work with children and young people, and for targeting support at school communities in areas of low socioeconomic status or with large populations of Māori or Pacific peoples.

Income-related health inequality of migrant workers in China and its decomposition: An analysis based on the 2012 China Labor-force Dynamics Survey data.

PubMed

Shao, Cenyi; Meng, Xuehui; Cui, Shichen; Wang, Jingru; Li, Chengcheng

2016-10-01

Although migrant workers are a vulnerable group in China, they demonstrably contribute to the country's economic growth and prosperity. This study aimed to describe and assess the inequality of migrant worker health in China and its association with socioeconomic determinants. The data utilized in this study were obtained from the 2012 China Labor-force Dynamics Survey conducted in 29 Chinese provinces. This study converted the self-rated health of these migrant workers into a general cardinal ill-health score. Determinants associated with migrant worker health included but were not limited to age, marital status, income, and education, among other factors. Concentration index, concentration curve, and decomposition of the concentration index were employed to measure socioeconomic inequality in migrant workers' health. Prorich inequality was found in the health of migrant workers. The concentration index was -0.0866, as a score indicator of ill health. Decomposition of the concentration index revealed that the factors most contributing to the observed inequality were income, followed by gender, age, marital status, and smoking history. It is generally known that there is an unequal socioeconomic distribution of migrant worker health in China. In order to reduce the health inequality, the government should make a substantial effort to strengthen policy implementation in improving the income distribution for vulnerable groups. After this investigation, it is apparent that the findings we have made warrant further investigation. Copyright © 2016. Published by Elsevier Taiwan LLC.

Intergenerational care: an exploration of consumer preferences and willingness to pay for care.

PubMed

Vecchio, N; Radford, K; Fitzgerald, J A; Comans, T; Harris, P; Harris, N

2017-05-25

To identify feasible models of intergenerational care programmes, that is, care of children and older people in a shared setting, to determine consumer preferences and willingness to pay. Feasible models were constructed in extensive consultations with a panel of experts using a Delphi technique (n = 23) and were considered based on their practical implementation within an Australian setting. This informed a survey tool that captured the preferences and willingness to pay for these models by potential consumers, when compared to the status quo. Information collected from the surveys (n = 816) was analysed using regression analysis to identify fundamental drivers of preferences and the prices consumers were willing to pay for intergenerational care programmes. The shared campus and visiting models were identified as feasible intergenerational care models. Key attributes of these models included respite day care; a common educational pedagogy across generations; screening; monitoring; and evaluation of participant outcomes. Although parents were more likely to take up intergenerational care compared to the status quo, adult carers reported a higher willingness to pay for these services. Educational attainment also influenced the likely uptake of intergenerational care. The results of this study show that there is demand for the shared campus and the visiting campus models among the Australian community. The findings support moves towards consumer-centric models of care, in line with national and international best practice. This consumer-centric approach is encapsulated in the intergenerational care model and enables greater choice of care to match different consumer demands.

Assessing the Relationship Between Mental Distress and Tobacco Use in Post-Katrina and Rita Louisiana.

PubMed

Mukherjee, Snigdha; Canterberry, Melanie; Yore, Jennifer B; Ledford, Edward Cannon; Carton, Thomas W

2017-08-24

The relationship between mental health status and smoking is complicated and often confounded by bi-directionality, yet most research on this relationship assumes exogeneity. The goal of this article is to implement an instrumental variable approach to (1) test the exogeneity assumption and (2) report on the association between mental health status and smoking post-disaster. This analysis utilizes the 2006 and 2007 Louisiana Behavioral Risk Factor Surveillance Survey to examine the link between mental distress and smoking in areas affected by Hurricanes Katrina and Rita. Residence in a hurricane-affected parish (county) was used as an instrumental variable for mental distress. Just over 22% of the sample resided in a hurricane-affected parish. Residents of hurricane-affected parishes were significantly more likely to report occasional and frequent mental distress. Residence in a hurricane-affected parish was not significantly associated with smoking status. With residence established as a salient instrumental variable for mental distress, the exogeneity assumption was tested and confirmed in this sample. A dose-response relationship existed between mental distress and smoking, with smoking prevalence increasing directly (and non-linearly) with mental distress. In this sample, the relationship between mental distress and smoking status was exogenous and followed a dose-response relationship, suggesting that the disasters did not result in an uptake of smoking initiation, but that the higher amounts of mental distress may lead to increased use among smokers. The findings suggest that tobacco control programs should devise unique strategies to address mentally distressed populations.

Changes in the status of harvested rice fields in the Sacramento Valley, California: Implications for wintering waterfowl.

USGS Publications Warehouse

Miller, Michael R.; Garr, Jay D.; Coates, Peter S.

2010-01-01

Harvested rice fields provide critical foraging habitat for wintering waterfowl in North America, but their value depends upon post-harvest treatments. We visited harvested ricefields in the Sacramento Valley, California, during the winters of 2007 and 2008 (recent period) and recorded their observed status as harvested (standing or mechanically modified stubble), burned, plowed, or flooded. We compared these data with those from identical studies conducted during the 1980s (early period). We documented substantial changes in field status between periods. First, the area of flooded rice increased 4-5-fold, from about 15% to >40% of fields, because of a 3-4-fold increase in the percentage of fields flooded coupled with a 37-41% increase in the area of rice produced. Concurrently, the area of plowed fields increased from 35% of fields, burned fields declined from about 40% to 1%, and fields categorized as harvested declined from 22-54% to <15%. The increased flooding has likely increased access to food resources for wintering waterfowl, but this benefit may not be available to some goose species, and may be at least partially countered by the increase of plowed fields, especially those left dry, and the decrease of fields left as harvested.We encourage waterfowl managers to implement a rice field status survey in the Sacramento Valley and other North American rice growing regions as appropriate to support long-term monitoring programs and wetland habitat conservation planning for wintering waterfowl.

What are the living conditions and health status of those who don’t report their migration status? a population-based study in Chile

PubMed Central

2012-01-01

Background Undocumented immigrants are likely to be missing from population databases, making it impossible to identify an accurate sampling frame in migration research. No population-based data has been collected in Chile regarding the living conditions and health status of undocumented immigrants. However, the CASEN survey (Caracterizacion Socio- Economica Nacional) asked about migration status in Chile for the first time in 2006 and provides an opportunity to set the base for future analysis of available migration data. We explored the living conditions and health of self-reported immigrants and respondents who preferred not to report their migration status in this survey. Methods Cross-sectional secondary analysis of CASEN survey in Chile in 2006. Outcomes: any disability, illness/accident, hospitalization/surgery, cancer/chronic condition (all binary variables); and the number of medical/emergency attentions received (count variables). Covariates: Demographics (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (education level, employment status and household income), and material standard of living (overcrowding, sanitation, housing quality). Weighted regression models were estimated for each health outcome, crude and adjusted by sets of covariates, in STATA 10.0. Results About 1% of the total sample reported being immigrants and 0.7% preferred not to report their migration status (Migration Status - Missing Values; MS-MV). The MS-MV lived in more deprived conditions and reported a higher rate of health problems than immigrants. Some gender differences were observed by health status among immigrants and the MS-MV but they were not statistically significant. Regressions indicated that age, sex, SES and material factors consistently affected MS-MVs’ chance of presenting poor health and these patterns were different to those found among immigrants. Great heterogeneity in both the MS-MV and the immigrants, as indicated by wide confidence intervals, prevented the identification of other significantly associated covariates. Conclusion This is the first study to look at the living conditions and health of those that preferred not to respond their migration status in Chile. Respondents that do not report their migration status are vulnerable to poor health and may represent undocumented immigrants. Surveys that fail to identify these people are likely to misrepresent the experiences of immigrants and further quantitative and qualitative research is urgently required. PMID:23170824

What are the living conditions and health status of those who don't report their migration status? A population-based study in Chile.

PubMed

Cabieses, Baltica; Pickett, Kate E; Tunstall, Helena

2012-11-21

Undocumented immigrants are likely to be missing from population databases, making it impossible to identify an accurate sampling frame in migration research. No population-based data has been collected in Chile regarding the living conditions and health status of undocumented immigrants. However, the CASEN survey (Caracterizacion Socio- Economica Nacional) asked about migration status in Chile for the first time in 2006 and provides an opportunity to set the base for future analysis of available migration data. We explored the living conditions and health of self-reported immigrants and respondents who preferred not to report their migration status in this survey. Cross-sectional secondary analysis of CASEN survey in Chile in 2006. any disability, illness/accident, hospitalization/surgery, cancer/chronic condition (all binary variables); and the number of medical/emergency attentions received (count variables). Covariates: Demographics (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (education level, employment status and household income), and material standard of living (overcrowding, sanitation, housing quality). Weighted regression models were estimated for each health outcome, crude and adjusted by sets of covariates, in STATA 10.0. About 1% of the total sample reported being immigrants and 0.7% preferred not to report their migration status (Migration Status - Missing Values; MS-MV). The MS-MV lived in more deprived conditions and reported a higher rate of health problems than immigrants. Some gender differences were observed by health status among immigrants and the MS-MV but they were not statistically significant. Regressions indicated that age, sex, SES and material factors consistently affected MS-MVs' chance of presenting poor health and these patterns were different to those found among immigrants. Great heterogeneity in both the MS-MV and the immigrants, as indicated by wide confidence intervals, prevented the identification of other significantly associated covariates. This is the first study to look at the living conditions and health of those that preferred not to respond their migration status in Chile. Respondents that do not report their migration status are vulnerable to poor health and may represent undocumented immigrants. Surveys that fail to identify these people are likely to misrepresent the experiences of immigrants and further quantitative and qualitative research is urgently required.

Patient Safety Activity Under the Social Insurance Medical Fee Schedule in Japan: An Overview of the 2010 Nationwide Survey.

PubMed

Hirose, Masahiro; Kawamura, Toshihiko; Igawa, Mikio; Imanaka, Yuichi

2017-11-16

Little is known about patient safety performance under the social insurance medical fee schedule in Japan. The Health Ministry in Japan introduced the preferential patient safety countermeasure fee (PPSCF) to promote patient safety in 2006 and revised the PPSCF system in 2010. This study aims to address the patient safety performance status at hospitals implementing the PPSCF. A nationwide questionnaire survey targeting 2674 hospitals with the PPSCF was performed in 2010 to 2011. The 627 participant hospitals were divided into the following three groups: 178 hospitals implementing PPSCF 1 with 400 beds or more (group A), 286 hospitals implementing PPSCF 1 with 399 beds or fewer (group B), and 163 hospitals implementing PPSCF 2 (group C). The mean numbers (standard errors) of patient safety managers were 1.45 (0.07) in group A, 1.12 (0.04) in group B, and 0.37 (0.12) in group C (P < 0.001). The participation number and rates of all staff for the patient safety seminar were 1721 (167) and 1.64 (0.10) in group A, 580 (26) and 1.94 (0.09) in group B, and 349 (31) and 1.98 (0.17) in group C (P < 0.001, P = 0.105).These results can be explained because hospitals with PPSCF 1 (groups A and B) must assign at least one full-time patient safety manager, whereas hospitals with PPSCF 2 (group C) are not required to do so. Patient safety performance at hospitals with PPSCF 1 was more active than that at hospitals with PPSCF 2. However, when the values were converted to per capita or per 100 beds, there were no differences across the three groups. The PPSCF encourages hospitals to perform actions for patient safety by providing incentives under the social insurance medical fee schedule in Japan.

Monitoring the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel

PubMed Central

Zurn, Pascal; Rø, Otto Christian; Gedik, Gulin; Ronquillo, Kenneth; Joan Co, Christine; Vaillancourt-Laflamme, Catherine; dela Rosa, Jennifer; Perfilieva, Galina; Dal Poz, Mario Roberto

2013-01-01

Abstract Objective To present the findings of the first round of monitoring of the global implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”), a voluntary code adopted in 2010 by all 193 Member States of the World Health Organization (WHO). Methods WHO requested that its Member States designate a national authority for facilitating information exchange on health personnel migration and the implementation of the Code. Each designated authority was then sent a cross-sectional survey with 15 questions on a range of topics pertaining to the 10 articles included in the Code. Findings A national authority was designated by 85 countries. Only 56 countries reported on the status of Code implementation. Of these, 37 had taken steps towards implementing the Code, primarily by engaging relevant stakeholders. In 90% of countries, migrant health professionals reportedly enjoy the same legal rights and responsibilities as domestically trained health personnel. In the context of the Code, cooperation in the area of health workforce development goes beyond migration-related issues. An international comparative information base on health workforce mobility is needed but can only be developed through a collaborative, multi-partnered approach. Conclusion Reporting on the implementation of the Code has been suboptimal in all but one WHO region. Greater collaboration among state and non-state actors is needed to raise awareness of the Code and reinforce its relevance as a potent framework for policy dialogue on ways to address the health workforce crisis. PMID:24347705

Strength and Comprehensiveness of District School Wellness Policies Predict Policy Implementation at the School Level

PubMed Central

Henderson, Kathryn E; Falbe, Jennifer; Novak, Sarah A.; Wharton, Christopher; Long, Michael; O'Connell, Meghan L.; Fiore, Susan S.

2013-01-01

Background In 2006, all local education agencies in the United States participating in federal school meal programs were required to establish school wellness policies. The aim of this study was to document the strength and comprehensiveness of one state's written district policies using a quantitative coding tool, and test whether the strength and comprehensiveness of the written policy predicted school level implementation and practices. Methods School wellness policies from 151 Connecticut districts were evaluated using a quantitative coding system. In each district, school principal surveys were collected before and after the writing and expected implementation of wellness policies. Socio-demographic variables were assessed for each district, including enrollment, population density, political climate, racial composition and socio-economic status. Changes in school-level policy implementation before and after the federal wellness policy requirement were compared across districts by wellness policy strength, and policies were compared based on district-level demographic factors. Results Statewide, fuller implementation of nutrition and physical activity policies at the school level was reported after adoption of written policies in 2006. Districts with stronger, more comprehensive policies were more successful in implementing those policies at the school level. Some socio-demographic characteristics predicted the strength of wellness policies; larger, urban districts and districts with a greater ratio of registered Democrats to Republicans wrote stronger policies. Conclusions Written school wellness policies have the potential to promote significant improvements in the school environment. Future regulation of school wellness policies should focus on the importance of writing strong and comprehensive policies. PMID:22568461

Implementation of new educational methods: how to overcome obstacles?

PubMed

Mimica, Mladen

2010-03-01

A presentation of new educational methods was organized for students and teachers of the Faculty of Medicine in Mostar in 2006. Afterwards, the teachers and the students were given a questionnaire to fill on their attitude towards actual, traditional versus new educational methods. According to the results of the questionnaire, a lot of students and the majority of teachers prefer status quo, and, moreover, only 1/3 of teachers support implementation of the new educational methods. Due to the results of this survey, implementation of new educational methods was postponed for the following two years. Since the management of the Faculty of Medicine in Mostar was well aware of the fact that new educational methods help in teaching students about fundamental principles of critical thinking, life-long learning and constructive intellectual conflicts, it was concluded that implementation of new methods should be a necessity. In this academic year (2008/2009), after discussion at the Faculty Council, a new course "Modern educational methods" has been introduced into the curriculum. As the first phase, a new transitional method named "Contradiction with Evidence Based Solution" has been introduced in the workshop session. The proposed new method is a combination of the old, traditional presentation done by a teacher, and new methods which are student-centred. Realistic expectation is that implementation of other new educational methods would be easier after introduction of this transitional method. This implementation trial should be seen as a pilot project that could be introduced to other faculties, at first to those of the University of Mostar, and afterwards to other universities in the region.

[SWOT Analysis of the National Survey on Current Status of Major Human Parasitic Diseases in China].

PubMed

ZHU, Hui-hui; ZHOU, Chang-hai; CHEN, Ying-dan; ZANG, Wei; XIAO, Ning; ZHOU, Xiao-nong

2015-10-01

The National Survey on Current Status of Major Human Parasitic Diseases in China has been carried out since 2014 under the organization of the National Health and Family Planning Commission of the People's Republic of China. The National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (NIPD, China CDC) provided technical support and was responsible for quality control in this survey. This study used SWOT method to analyze the strengths, weaknesses, opportunities and threats that were encountered by he NIPD, China CDC during the completion of the survey. Accordingly, working strategies were proposed to facilitate the future field work.

Research on scheduling of robotic transient survey for Antarctic Survey Telescopes (AST3)

NASA Astrophysics Data System (ADS)

Liu, Qiang; Wei, Peng; Shang, Zhao-Hui; Ma, Bin; Hu, Yi

2018-01-01

Antarctic Survey Telescopes (AST3) are designed to be fully robotic telescopes at Dome A, Antarctica, which aim for highly efficient time-domain sky surveys as well as rapid response to special transient events (e.g., gamma-ray bursts, near-Earth asteroids, supernovae, etc.). Unlike traditional observations, a well-designed real-time survey scheduler is needed in order to implement an automatic survey in a very efficient, reliable and flexible way for the unattended telescopes. We present a study of the survey strategy for AST3 and implementation of its survey scheduler, which is also useful for other survey projects.

Iron deficiency is associated with food insecurity in pregnant females in the United States: National Health and Nutrition Examination Survey 1999-2010.

PubMed

Park, Clara Y; Eicher-Miller, Heather A

2014-12-01

Food-insecure pregnant females may be at greater risk of iron deficiency (ID) because nutrition needs increase and more resources are needed to secure food during pregnancy. This may result in a higher risk of infant low birth weight and possibly cognitive impairment in the neonate. The relationships of food insecurity and poverty income ratio (PIR) with iron intake and ID among pregnant females in the United States were investigated using National Health and Nutrition Examination Survey 1999-2010 data (n=1,045). Food security status was classified using the US Food Security Survey Module. One 24-hour dietary recall and a 30-day supplement recall were used to assess iron intake. Ferritin, soluble transferrin receptor, or total body iron classified ID. Difference of supplement intake prevalence, difference in mean iron intake, and association of ID and food security status or PIR were assessed using χ(2) analysis, Student t test, and logistic regression analysis (adjusted for age, race, survey year, PIR/food security status, education, parity, trimester, smoking, C-reactive protein level, and health insurance coverage), respectively. Mean dietary iron intake was similar among groups. Mean supplemental and total iron intake were lower, whereas odds of ID, classified by ferritin status, were 2.90 times higher for food-insecure pregnant females compared with food-secure pregnant females. Other indicators of ID were not associated with food security status. PIR was not associated with iron intake or ID. Food insecurity status may be a better indicator compared with income status to identify populations at whom to direct interventions aimed at improving access and education regarding iron-rich foods and supplements. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Determining the predictors of innovation implementation in healthcare: a quantitative analysis of implementation effectiveness.

PubMed

Jacobs, Sara R; Weiner, Bryan J; Reeve, Bryce B; Hofmann, David A; Christian, Michael; Weinberger, Morris

2015-01-22

The failure rates for implementing complex innovations in healthcare organizations are high. Estimates range from 30% to 90% depending on the scope of the organizational change involved, the definition of failure, and the criteria to judge it. The innovation implementation framework offers a promising approach to examine the organizational factors that determine effective implementation. To date, the utility of this framework in a healthcare setting has been limited to qualitative studies and/or group level analyses. Therefore, the goal of this study was to quantitatively examine this framework among individual participants in the National Cancer Institute's Community Clinical Oncology Program using structural equation modeling. We examined the innovation implementation framework using structural equation modeling (SEM) among 481 physician participants in the National Cancer Institute's Community Clinical Oncology Program (CCOP). The data sources included the CCOP Annual Progress Reports, surveys of CCOP physician participants and administrators, and the American Medical Association Physician Masterfile. Overall the final model fit well. Our results demonstrated that not only did perceptions of implementation climate have a statistically significant direct effect on implementation effectiveness, but physicians' perceptions of implementation climate also mediated the relationship between organizational implementation policies and practices (IPP) and enrollment (p <0.05). In addition, physician factors such as CCOP PI status, age, radiological oncologists, and non-oncologist specialists significantly influenced enrollment as well as CCOP organizational size and structure, which had indirect effects on implementation effectiveness through IPP and implementation climate. Overall, our results quantitatively confirmed the main relationship postulated in the innovation implementation framework between IPP, implementation climate, and implementation effectiveness among individual physicians. This finding is important, as although the model has been discussed within healthcare organizations before, the studies have been predominately qualitative in nature and/or at the organizational level. In addition, our findings have practical applications. Managers looking to increase implementation effectiveness of an innovation should focus on creating an environment that physicians perceive as encouraging implementation. In addition, managers should consider instituting specific organizational IPP aimed at increasing positive perceptions of implementation climate. For example, IPP should include specific expectations, support, and rewards for innovation use.

Integration of Multiplex Bead Assays for Parasitic Diseases into a National, Population-Based Serosurvey of Women 15-39 Years of Age in Cambodia

PubMed Central

Priest, Jeffrey W.; Jenks, M. Harley; Moss, Delynn M.; Mao, Bunsoth; Buth, Sokhal; Wannemuehler, Kathleen; Soeung, Sann Chan; Lucchi, Naomi W.; Udhayakumar, Venkatachalam; Gregory, Christopher J.; Huy, Rekol; Muth, Sinuon; Lammie, Patrick J.

2016-01-01

Collection of surveillance data is essential for monitoring and evaluation of public health programs. Integrated collection of household-based health data, now routinely carried out in many countries through demographic health surveys and multiple indicator surveys, provides critical measures of progress in health delivery. In contrast, biomarker surveys typically focus on single or related measures of malaria infection, HIV status, vaccination coverage, or immunity status for vaccine-preventable diseases (VPD). Here we describe an integrated biomarker survey based on use of a multiplex bead assay (MBA) to simultaneously measure antibody responses to multiple parasitic diseases of public health importance as part of a VPD serological survey in Cambodia. A nationally-representative cluster-based survey was used to collect serum samples from women of child-bearing age. Samples were tested by MBA for immunoglobulin G antibodies recognizing recombinant antigens from Plasmodium falciparum and P. vivax, Wuchereria bancrofti, Toxoplasma gondii, Taenia solium, and Strongyloides stercoralis. Serologic IgG antibody results were useful both for generating national prevalence estimates for the parasitic diseases of interest and for confirming the highly focal distributions of some of these infections. Integrated surveys offer an opportunity to systematically assess the status of multiple public health programs and measure progress toward Millennium Development Goals. PMID:27136913

Age and educational inequalities in smoking cessation due to three population-level tobacco control interventions: findings from the International Tobacco Control (ITC) Netherlands Survey.

PubMed

Nagelhout, Gera E; Crone, Matty R; van den Putte, Bas; Willemsen, Marc C; Fong, Geoffrey T; de Vries, Hein

2013-02-01

This study aimed to examine age and educational inequalities in smoking cessation due to the implementation of a tobacco tax increase, smoke-free legislation and a cessation campaign. Longitudinal data from 962 smokers aged 15 years and older were used from three survey waves of the International Tobacco Control (ITC) Netherlands Survey. The 2008 survey was performed before the implementation of the interventions and the 2009 and 2010 surveys were performed after the implementation. No significant age and educational differences in successful smoking cessation were found after the implementation of the three tobacco control interventions, although smokers aged 15-39 years were more likely to attempt to quit. Of the three population-level tobacco control interventions that were implemented simultaneously in the Netherlands, only the smoke-free legislation seemed to have increased quit attempts. The price increase of cigarettes may have been only effective in stimulating smoking cessation among younger smokers. Larger tax increases, stronger smoke-free legislation and media campaigns about the dangers of (second-hand) smoking are needed in the Netherlands.

Relationships between Health Status, Self Esteem and Social Support among Adolescents: Gender and Race Group Differences.

ERIC Educational Resources Information Center

Landsberger, Betty H.

To locate possible causes for the gender and race differences observed in adolescent health status, an analysis was made of the relationship between the scores of a national sample of 12- to 17-year-old adolescents on selected items of the National Center for Health Statistics' Health Examination Survey. Thirty survey items indicating social…

A bill to amend the Agricultural Marketing Act of 1946 to require monthly reporting to the Secretary of Agriculture of items contained in the cold storage survey and the dairy products survey of the National Agricultural Statistics Service.

THOMAS, 111th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2010-05-26

Senate - 05/26/2010 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A Status Report on Homeless Families in America's Cities. A 29-City Survey.

ERIC Educational Resources Information Center

Waxman, Laura DeKoven; Reyes, Lilia M.

This survey assesses the status of homelessness among families in cities. The data were collected from city officials during April 1987. The findings include the following: (1) the number of homeless families increased by 31 percent during the last two years; (2) families represented one-third of the homeless and a single parent headed two-thirds…

A Status Report on Hunger and Homelessness in America's Cities: 1988. A 27-City Survey.

ERIC Educational Resources Information Center

Waxman, Laura DeKoven; Reyes, Lilia M.

In 1988 officials in 27 major cities were surveyed on the following topics: (1) ability to meet demand for emergency food assistance and shelter; (2) causes and demographics of hunger and homelessness; (3) status of low-income housing; and (4) outlook for 1989. Summary findings included the following: (1) demand for emergency food assistance…

Telecommunications Research in the United States and Selected Foreign Countries: A Preliminary Survey. Volume II, Individual Contributions.

ERIC Educational Resources Information Center

National Academy of Engineering, Washington, DC. Committee on Telecommunications.

At the request of the National Science Foundation, the Panel on Telecommunications Research of the Committee on Telecommunications of the National Academy of Engineering has made a preliminary survey of the status and trends of telecommunications research in the United States and selected foreign countries. The status and trends were identified by…

An Investigation of the Status of Piano Teacher Training in Taiwan from the Perspective of Undergraduate Piano Pedagogy Course Offerings

ERIC Educational Resources Information Center

Chiang, Ju-Yu

2009-01-01

The purpose of this study was to determine the status of piano teacher training in Taiwan. A survey questionnaire and two groups of interviewees facilitated research to conduct the study. The information gained from survey questionnaires documents the content of undergraduate piano pedagogy courses in Taiwanese universities and colleges. The…

Weight Status in Iranian Children with Autism Spectrum Disorders: Investigation of Underweight, Overweight and Obesity

ERIC Educational Resources Information Center

Memari, Amir Hossein; Kordi, Ramin; Ziaee, Vahid; Mirfazeli, Fatemeh Sadat; Setoodeh, Mohammad S.

2012-01-01

The purpose of this study was to survey the weight status of children and adolescents with autism spectrum disorders (ASDs) in Iranian pupils and further to investigate the most likely associated factors such as demographics, autism severity and medications. The survey was designed to provide a random sample of 113 children and adolescents (boys =…

Trends in the nutritional status of Salvadorian children: the post-war experience.

PubMed Central

Grummer-Strawn, L. M.; Cáceres, J. M.; Herrera de Jaimes, B. P.

1996-01-01

This article examines trends in the nutritional status of children in EI Salvador between 1988 and 1993 (before and after the signing of a peace accord that ended the civil war.) The data derive from two national surveys, each of which included measurements of the height and weight of children aged 3-59 months. The prevalence of low weight-for-age (< -2 SD) dropped from 15% in 1988 to 10.5% in 1993. The prevalence of low weight-for-height (< -2 SD) was minimal in both surveys: falling from 3.9% to 2.9%. The prevalence of low height-for-age (< -2 SD) fell from 28.1% to 22%. These declines in malnutrition indicators resulted from an upward shift in the distributions of weight and height of children, not from thinner lower tails of the distributions. The quality of anthropometric data appears to be high for both surveys: < 1% of surveyed children had heights or weights outside the expected range. This analysis demonstrates the value of repeated surveys of nutritional status. PMID:8823958

EMRs and Clinical IS Implementation in Hospitals: A Statewide Survey

ERIC Educational Resources Information Center

Jaana, Mirou; Ward, Marcia M.; Bahensky, James A.

2012-01-01

Purpose: Present an overview of clinical information systems (IS) in hospitals and analyze the level of electronic medical records (EMR) implementation in relation to clinical IS capabilities and organizational characteristics. Methods: We developed a survey instrument measuring clinical IS implementation and classified clinical IS across 5 EMR…

Factors associated with implementation of a multicomponent responsible beverage service program – results from two surveys in 290 Swedish municipalities

PubMed Central

2013-01-01

Background The purpose of this study was to investigate which factors affected the implementation of a multicomponent Responsible Beverage Service (RBS) program in 290 Swedish municipalities and whether the amount of such factors influenced the level of implementation of the program. Methods This study used variation in the presence of implementation-promoting factors to predict the level of implementation of the RBS program in municipalities throughout Sweden. The presence of such factors and the level of implementation of the program were studied by means of two surveys in all Swedish municipalities (N=290). Logistic regression and Spearman’s correlation analyses were used to analyze the relationship between implementation-promoting factors and the level of implementation of the RBS program. Results The response rates of the two surveys were 96% and 98%, respectively. One main finding was that program fidelity was low. Only 13% of the municipalities surveyed had implemented the RBS program as a whole, as stated in the specification of requirements. In municipalities reporting a higher amount of implementation-promoting factors, a significantly higher level of implementation of the program was shown. Evaluation and feedback was the only factor that correlated significantly with the level of implementation of the RBS program as a whole. Conclusion Evaluation and feedback constitutes an important implementation-promoting factor also in complex programs like the RBS program. Program fidelity is significant for the outcome of an intervention and must be a major focus of the implementation processes. PMID:23497692

The National Aquatic Resource Surveys (NARS)

EPA Pesticide Factsheets

The National Aquatic Resource Surveys (NARS) are statistical surveys designed to assess the status of and changes in quality of the nation’s coastal waters, lakes and reservoirs, rivers and streams, and wetlands.

The Quality Indicator Survey: background, implementation, and widespread change.

PubMed

Lin, Michael K; Kramer, Andrew M

2013-01-01

The Quality Indicator Survey (QIS) is the most comprehensive regulatory change to the nursing home survey process since the Omnibus Budget Reconciliation Act of 1987 (OBRA-87). In this article we describe the policy evolution that led to the QIS, summarize the QIS method and implementation, and profile the QIS survey results. Following over a decade of development, in 2007 the Centers for Medicare and Medicaid Services (CMS) began the national rollout of QIS. The intent was to improve consistency in the nursing home survey and to render the survey process more resident-centered and aligned with the intent of OBRA-87. We reviewed policy reports and firsthand accounts from the lead developer of the QIS methodology and leader of the national training contract for QIS. Changes in survey findings are profiled based on analysis of the publicly available Nursing Home Compare database from 2004 to 2010. Nineteen states implemented the QIS between 2007 and 2010, with nearly 20% of U.S. nursing homes receiving QIS surveys in 2010. Nursing homes surveyed with the QIS received more survey deficiencies on average than in the traditional survey; however, average numbers of deficiencies across states became more similar over the early implementation of QIS, with lower-than-average geographic areas experiencing increases and higher-than-average geographic areas experiencing decreases in survey deficiencies. The explicit and structured questioning of residents in the QIS is associated with increases in deficiencies related to choice, dignity, dental care, and nurse staffing. We describe ways in which the QIS affected the regulatory agencies, providers, and resident communities, although these effects are difficult to quantify. CMS's implementation of QIS is a significant step toward a more resident-centered, comprehensive, and consistent survey process. Substantial changes, however, are required not only among regulators but also among nursing homes. We argue that these new expectations and norms surrounding quality assessment and quality assurance are an important component of achieving culture change in U.S. nursing homes.

STATE-LEVEL DIETARY DIVERSITY AS A CONTEXTUAL DETERMINANT OF NUTRITIONAL STATUS OF CHILDREN IN INDIA: A MULTILEVEL APPROACH.

PubMed

Borkotoky, Kakoli; Unisa, Sayeed; Gupta, Ashish Kumar

2018-01-01

This study aimed to identify the determinants of nutritional status of children in India with a special focus on dietary diversity at the state level. Household-level consumption data from three rounds of the Consumer Expenditure Survey of the National Sample Survey Organization (1993-2012) were used. Information on the nutritional status of children was taken from the National Family Health Survey (2005-06). Dietary diversity indices were constructed at the state level to examine diversity in quantity of food consumed and food expenditure. Multilevel regression analysis was applied to examine the association of state-level dietary diversity and other socioeconomic factors with the nutritional status of children. It was observed that significant variation in childhood stunting, wasting and underweight could be explained by community- and state-level factors. The results indicate that dietary diversity has increased in India over time, and that dietary diversity at the state level is significantly associated with the nutritional status of children. Moreover, percentage of households with a regular salaried income in a state, percentage of educated mothers and mothers receiving antenatal care in a community are important factors for improving the nutritional status of children. Diversity in complementary child feeding is another significant determinant of nutritional status of children. The study thus concludes that increasing dietary diversity at the state level is an effective measure to reduce childhood malnutrition in India.

The MRC dyspnoea scale by telephone interview to monitor health status in elderly COPD patients.

PubMed

Paladini, Luciana; Hodder, Rick; Cecchini, Isabella; Bellia, Vincenzo; Incalzi, Raffaele Antonelli

2010-07-01

Dyspnoea is the most common symptom associated with poor quality of life in patients affected by Chronic Obstructive Pulmonary Disease (COPD). While COPD severity is commonly staged by lung function, the Medical Research Council (MRC) dyspnoea scale has been proposed as a more clinically meaningful method of quantifying disease severity in COPD. We wished to assess whether this scale might also be useful during telephone surveys as a simple surrogate marker of perceived health status in elderly patients with COPD. We conducted a comprehensive health status assessment by telephone survey of 200 elderly patients who had a physician diagnosis of COPD. The telephone survey contained 71 items and explored such domains as educational level, financial status, living arrangements and social contacts, co-morbid illness, and the severity and the impact of COPD on health status. Patients were categorized according to the reported MRC score: mild dyspnoea (MRC scale of 1), moderate dyspnoea (MRC scale of 2 and 3), or severe dyspnoea (MRC of 4 and 5). Deterioration in most of the recorded indicators of health status correlated with an increasingly severe MRC score. This was most evident for instrumental activities of daily living (IADL), perceived health and emotional status, pain-related limitations, limitations in social life, hospital admissions in preceding year and prevalence of most co-morbidities. The MRC dyspnoea scale is a reliable index of disease severity and health status in elderly COPD patients which should prove useful for remote monitoring of COPD and for rating health status for epidemiological purposes.

National Natality Survey/National Maternal and Infant Health Survey (NMIHS)

Cancer.gov

The survey provides data on socioeconomic and demographic characteristics of mothers, prenatal care, pregnancy history, occupational background, health status of mother and infant, and types and sources of medical care received.

Background of the National Aquatic Resource Surveys

EPA Pesticide Factsheets

The National Aquatic Resource Surveys (NARS) are statistical surveys designed to assess the status of and changes in quality of the nation’s coastal waters, lakes and reservoirs, rivers and streams, and wetlands.

[Evaluation of nutritional status of school-age children after implementation of "Nutrition Improvement Program" in rural area in Hunan, China].

PubMed

Deng, Zhu-Juan; Mao, Guang-Xu; Wang, Yu-Jun; Liu, Li; Chen, Yan

2016-09-01

To investigate the nutritional status of school-age children in rural area in Hunan, China from 2012 to 2015 and to evaluate the effectiveness of the "Nutrition Improvement Program for Compulsory Education Students in Rural Area" (hereinafter referred to as "Nutrition Improvement Program"). The nutritional status of school-age children aged 6-14 years was evaluated after the implementation of the "Nutrition Improvement Program" and the changing trend of the children's nutritional status was analyzed. The statistical analysis was performed on the monitoring data of the school-age children aged 6-14 years in rural area in Hunan, China from 2012 to 2015, which came from "The Nutrition and Health Status Monitoring and Evaluation System of Nutrition Improvement Program for Compulsory Education Students in Rural Area". In 2015, female students aged 6-7 years in rural area in Hunan, China had a significantly greater body length than the rural average in China (P<0.05). However, the other age groups had significantly smaller body length and weight than the rural averages in China (P<0.05). After the implementation of "Nutrition Improvement Program", the prevalence rate of growth retardation decreased (P<0.05), but the prevalence rate of emaciation increased (P<0.05). At the same time, the prevalence rate of overweight/obesity increased (P<0.05) and the prevalence rate of anemia decreased (P<0.05). The implementation of "Nutrition Improvement Program" has achieved some success, but the nutritional status of school-age children has not improved significantly. Overweight/obesity and malnutrition are still present. Therefore, to promote the nutritional status of school-age children it is recommended to improve the measures for the "Nutrition Improvement Program".

10 CFR 75.35 - Material status reports.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Material status reports. 75.35 Section 75.35 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) SAFEGUARDS ON NUCLEAR MATERIAL-IMPLEMENTATION OF US/IAEA AGREEMENT Reports § 75.35 Material status reports. (a) A material status report must be submitted for each...

Use of the Illinois 5Essentials Survey Data. Policy Research: IERC 2014-2

ERIC Educational Resources Information Center

Klostermann, Brenda K.; White, Bradford R.; Lichtenberger, Eric J.; Holt, Janet K.

2014-01-01

The purpose of this study is to examine how Illinois school districts are utilizing the Illinois 5Essentials Survey results, particularly for school improvement, to determine challenges to successful implementation, and to make recommendations for improvements to the 5E Survey and implementation process for statewide use. We also summarize…

Developing a general conceptual framework for avian conservation science

USGS Publications Warehouse

Sauer, J.R.

2003-01-01

Avian conservation science in North America has produced a variety of monitoring programs designed to provide information on population status of birds. Waterfowl surveys provide population estimates for breeding ducks over most of the continent, the North American Breeding Bird Survey (BBS) provides indexes to population change for >400 breeding bird species, and many other surveys exist that index bird populations at a variety of scales and seasons. However, many fundamental questions about bird population change remain unanswered. I suggest that analyses of monitoring data provide limited understanding of causes of population change, and that the declining species paradigm (Caughley 1994) is sometimes an inefficient approach to increasing our understanding of causes of population change. In North America, the North American Bird Conservation Initiative (NABCI) provides an opportunity to implement alternative approaches that use management, modeling of population responses to management, and monitoring in combination to increase our understanding of bird populations. In adaptive resources management, modeling provides predictions about consequences of management, and monitoring data allow us to assess the population consequences of management. In this framework, alternative hypotheses about response of populations to management can be evaluated by formulating a series of models with differing structure, and management and monitoring provide information about which model best predicts population response.

Understanding the Perception of Islamic Medicine Among the Malaysian Muslim Community.

PubMed

Ahmad, Khadher; Ariffin, Mohd Farhan Md; Deraman, Fauzi; Ariffin, Sedek; Abdullah, Mustaffa; Razzak, Monika Munirah Abd; Yusoff, M Y Zulkifli Mohd; Achour, Meguellati

2017-10-26

This study was conducted to identify and describe the patients' perceptions of Islamic medicine based on gender, age, marital, educational level and working status among the Malaysian Muslim population. A nationwide interviewer-administered questionnaire survey was conducted in 2013. An open-ended questionnaire pertaining to Islamic medicine was used to increase the probability of capturing maximum data. This survey implemented a multistage design, stratified by state, proportionate to the size of the state population and was representative of the Malaysian population. Post-survey classification of results was performed accordingly. Complex data analysis was carried out using SPSS 16.0. The discussion was identified and categorised into various sections. The paper concludes that Islamic medicine has a major influence in the Malaysian Muslim community compared to other alternatives. Further, its potential for growth and importance especially for treating spiritual ailments cannot be denied. The respondents indicated that two factors motivate Islamic medicine in Malaysia: (1) the Muslim community opts for alternative healing because of their dissatisfaction with conventional methods; (2) Islamic medicine focuses only on healing spiritual-related problems. The average perception of respondents is that the function of Islamic medicine in healing physical diseases is undervalued and that it is not suitable to replace the functions of modern health institutions.

Results of Surveys for Special Status Reptiles at the Site 300 Facilities of Lawrence Livermore National Laboratory

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

Woollett, J J

2008-09-18

The purpose of this report is to present the results of a live-trapping and visual surveys for special status reptiles at the Site 300 Facilities of Lawrence Livermore National Laboratory (LLNL). The survey was conducted under the authority of the Federal recovery permit of Swaim Biological Consulting (PRT-815537) and a Memorandum of Understanding issued from the California Department of Fish and Game. Site 300 is located between Livermore and Tracy just north of Tesla road (Alameda County) and Corral Hollow Road (San Joaquin County) and straddles the Alameda and San Joaquin County line (Figures 1 and 2). It encompasses portionsmore » of the USGS 7.5 minute Midway and Tracy quadrangles (Figure 2). Focused surveys were conducted for four special status reptiles including the Alameda whipsnake (Masticophis lateralis euryxanthus), the San Joaquin Whipsnake (Masticophis Hagellum ruddock), the silvery legless lizard (Anniella pulchra pulchra), and the California horned lizard (Phrynosoma coronanum frontale).« less

Stress, Depression and Coping among Latino Migrant and Seasonal Farmworkers

PubMed Central

Burke Winkelman, Sloane; Chaney, Elizabeth H.; Bethel, Jeffrey W.

2013-01-01

Research shows that one in four migrant farmworkers experienced an episode of one or more mental health disorders such as stress, depression, or anxiety in their lifetime. The purpose of this mixed methods study was to explore experiences and perceptions related to stress and depression among Latino migrant and seasonal farmworkers (MSFWs), and to identify their coping behaviors for dealing with these mental health conditions. Using a mixed methods research approach, three focus group interviews of a sample of Latino MSFWs (N = 29) were conducted and a quantitative survey was implemented (N = 57) at community sites in eastern North Carolina. Four major themes emerged from the focus group data: (1) physical stress related to working conditions; (2) mental stress related to family situations, work environment, documentation status, and lack of resources; (3) depression related to separation from family and the lack of resources; and (4) use of positive and negative mechanisms for coping with stress and depression. A discussion of these themes, results from the survey findings, implications for intervention and outreach programs, along with recommendations for further research, are provided. PMID:23644829

Changes in body size, shape and nutritional status of middle-class Bengali boys of Kolkata, India, 1982--2002.

PubMed

Dasgupta, Parasmani; Saha, Rana; Nubé, Maarten

2008-03-01

Growth changes over time among school-aged boys in Kolkata, India, have been investigated using two surveys: 1982--1983 (n=816) and 1999--2002 (n=1187). The two surveys were implemented according to highly similar protocols which strongly adds to the reliability and accuracy of the results of the study. Age-specific average height, weight and BMI all increased during these two decades (by respectively, 3.2cm, 6.1kg and 2.1kg/m2), while relative sitting height and sitting height-subischial leg length ratio decreased for almost all ages between 7.0 and 16.0 years. Moreover, the prevalence of stunting and thinness declined (stunting from 11.2% to 4.9%, p<0.01, thinness from 50.5% to 22%, p<0.01), while the prevalence of overweight increased (from 4.7% to 17.2%, p<0.01). Through analysis of variance, the relationships between various socio-economic factors and anthropometric traits are analyzed. Factors strongly related with positive changes in anthropometric traits are maternal education and family expenditure.

Exploring the impacts of personal factors on self-leadership in a hospital setting.

PubMed

Ugurluoglu, Ozgur; Saygılı, Meltem; Ozer, Ozlem; Santas, Fatih

2015-01-01

Self-leadership may be defined as a self-effecting process that individuals experience by maintaining the motivation they require for fulfilling their roles and duties. The self-leadership process comprises three key strategies: behaviour-oriented strategies, natural reward strategies and constructive thought pattern strategies. What is intended herein is to inquire about the implementation of self-leadership within organisations and to examine the effects of such variables as age, gender, total terms of employment, marital status and education on self-leadership strategies. The primary data collection instrument was a survey distributed to 450 personnel working at a state hospital in Kırıkkale, Turkey, and feedback thereto was received from 308 (68.4%) of those surveyed. As a result of the findings taken from the analyses, age, total terms of employment and receipt of education in leadership affect the use of self-leadership strategies. Although age and total terms of employment display a negative-directional correlation with the self-leadership strategies, female employees and those who receive education in leadership are more inclined towards self-leadership strategies. Copyright © 2013 John Wiley & Sons, Ltd.

A Status Report on Hunger and Homelessness in America's Cities: 1989. A 27-City Survey.

ERIC Educational Resources Information Center

United States Conference of Mayors, Washington, DC.

This document comprises a report on the status of hunger and homelessness during 1989 in 27 major American cities. A survey was used to gather the following information: (1) demand for emergency food and shelter assistance and the capacity to meet the demand; (2) causes of hunger and homelessness and the demographics of the affected populations;…

National Aquatic Resource Surveys

EPA Pesticide Factsheets

EPA reports information on the condition of our nation's waters using probabilistic surveys. The National Aquatic Resource Surveys assess the status of and changes in water quality of the nation's coastal waters, lakes, rivers and streams, and wetlands.

Micronutrient Deficits Are Still Public Health Issues among Women and Young Children in Vietnam

PubMed Central

Laillou, Arnaud; Pham, Thuy Van; Tran, Nga Thuy; Le, Hop Thi; Wieringa, Frank; Rohner, Fabian; Fortin, Sonia; Le, Mai Bach; Tran, Do Thanh; Moench-Pfanner, Regina; Berger, Jacques

2012-01-01

Background The 2000 Vietnamese National Nutrition Survey showed that the population's dietary intake had improved since 1987. However, inequalities were found in food consumption between socioeconomic groups. As no national data exist on the prevalence of micronutrient deficiencies, a survey was conducted in 2010 to assess the micronutrient status of randomly selected 1526 women of reproductive age and 586 children aged 6–75 mo. Principal Findings In women, according to international thresholds, prevalence of zinc deficiency (ZnD, 67.2±2.6%) and vitamin B12 deficiency (11.7±1.7%) represented public health problems, whereas prevalence of anemia (11.6±1.0%) and iron deficiency (ID, 13.7±1.1%) were considered low, and folate (<3%) and vitamin A (VAD, <2%) deficiencies were considered negligible. However, many women had marginal folate (25.1%) and vitamin A status (13.6%). Moreover, overweight (BMI≥23 kg/m2 for Asian population) or underweight occurred in 20% of women respectively highlighting the double burden of malnutrition. In children, a similar pattern was observed for ZnD (51.9±3.5%), anemia (9.1±1.4%) and ID (12.9±1.5%) whereas prevalence of marginal vitamin A status was also high (47.3±2.2%). There was a significant effect of age on anemia and ID prevalence, with the youngest age group (6–17 mo) having the highest risk for anemia, ID, ZnD and marginal vitamin A status as compared to other groups. Moreover, the poorest groups of population had a higher risk for zinc, anemia and ID. Conclusion The prevalence of anemia and ID in Vietnam has been markedly reduced over the last decade, but a large part of the population is still at risk for other deficiencies such as zinc, vitamin A, folate and vitamin B12 especially the youngest children aged 6–17 mo. Consequently specific interventions to improve food diversity and quality should be implemented, among them food fortification of staple foods and condiments and improvement of complementary feeding. PMID:22529954

Client-Server Connection Status Monitoring Using Ajax Push Technology

NASA Technical Reports Server (NTRS)

Lamongie, Julien R.

2008-01-01

This paper describes how simple client-server connection status monitoring can be implemented using Ajax (Asynchronous JavaScript and XML), JSF (Java Server Faces) and ICEfaces technologies. This functionality is required for NASA LCS (Launch Control System) displays used in the firing room for the Constellation project. Two separate implementations based on two distinct approaches are detailed and analyzed.

The national employment guarantee scheme and inequities in household spending on food and non-food determinants of health in rural India.

PubMed

Dilip, T R; Dandona, Rakhi; Dandona, Lalit

2013-10-15

Inequities in a population in spending on food and non-food items can contribute to disparities in health status. The Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) was launched in rural India in 2006, aimed at providing at least 100 days of manual work to a member in needy households. We used nationally representative data from the consumer expenditure surveys of 2004-05 and 2009-10 and the employment survey of 2009-10 conducted by National Sample Survey Organisation to assess the effect of MGNREGS in reducing inequities in consumption of food and non-food items between poor and non-poor households in the states of India. Variations among the states in implementation of MGNREGS were examined using the employment and unemployment survey data, and compared with official programme data up to 2012-13. Inequity in spending on food and non-food items was assessed using the ratio of monthly per capita consumer expenditure (MPCE) between the most vulnerable (labourer) and least vulnerable categories of households. The survey data suggested 1.42 billion person-days of MGNRGES employment in the 2009-10 financial year, whereas the official programme data reported 2.84 billion person-days. According to the official data, the person-days of MGNRGES employment decreased by 43.3% from 2009-10 to 2012-13 for the 9 large less developed states of India. Survey data revealed that the average number of MGNREGS work days in a year per household varied from 42 days in Rajasthan to less than 10 days in 14 of the 20 major states in India in 2009-10. Rajasthan with the highest implementation of MGNRGES among the 9 less developed states of India had the highest relative decline of 10.4% in the food spending inequity from 2004-05 to 2009-10 between the most vulnerable and less vulnerable households. The changes in inequity for non-food spending did not have any particular pattern across the less developed states. In the most vulnerable category, the households in Rajasthan that got 100 or more days of work in a year under MGNREGS had a 25.9% increase in MPCE. MGNREGS seems to have contributed to the reduction in food consumption inequity in rural Rajasthan in 2009-10, and has the potential of making a similar contribution with higher level of implementation of this programme in other states. Non-food consumption inequities benefited less from MGNRGES until 2009-10. The reported decrease in the MGNRGES employment person-days in the less developed states of India from 2009-10 to 2012-13 is of concern.

Analysis of a Telephone Survey: A Case Study.

ERIC Educational Resources Information Center

Haines, Jenny M.; And Others

This study analyzes the cost effectiveness of a telephone survey, using data collected from a survey of 110 Tennessee public school superintendents. The subject of the survey was the status and need for elementary guidance. A telephone survey approach was selected based on time and cost factors, since information had to be completed in the…

Users Manual for the Geospatial Stream Flow Model (GeoSFM)

USGS Publications Warehouse

Artan, Guleid A.; Asante, Kwabena; Smith, Jodie; Pervez, Md Shahriar; Entenmann, Debbie; Verdin, James P.; Rowland, James

2008-01-01

The monitoring of wide-area hydrologic events requires the manipulation of large amounts of geospatial and time series data into concise information products that characterize the location and magnitude of the event. To perform these manipulations, scientists at the U.S. Geological Survey Center for Earth Resources Observation and Science (EROS), with the cooperation of the U.S. Agency for International Development, Office of Foreign Disaster Assistance (USAID/OFDA), have implemented a hydrologic modeling system. The system includes a data assimilation component to generate data for a Geospatial Stream Flow Model (GeoSFM) that can be run operationally to identify and map wide-area streamflow anomalies. GeoSFM integrates a geographical information system (GIS) for geospatial preprocessing and postprocessing tasks and hydrologic modeling routines implemented as dynamically linked libraries (DLLs) for time series manipulations. Model results include maps that depicting the status of streamflow and soil water conditions. This Users Manual provides step-by-step instructions for running the model and for downloading and processing the input data required for initial model parameterization and daily operation.

Low Adherence to Mediterranean Diet in Portugal: Pregnant Women Nutrition in Portugal and its Repercussions.

PubMed

Pereira-da-Silva, Luis; Pinto, Elisabete

2016-10-01

Portuguese population is drifting away from the Mediterranean diet-like pattern. In this context, the current nutritionalstatus of women of childbearing age and of pregnant Portuguese women and their growing fetuses is critically reviewed. A narrative critical review was performed on recent published high quality studies assessing diet and nutritional status of women of childbearing age and pregnant women and its influence on the nutritional status of their offspring. Data from five multinational ecological studies that included Portugal, two national official surveys on food availability, seven national studies on the diet and nutritional status of women of childbearing age and pregnant women, and five national studies on the effect of nutritional maternal factors on their growing fetuses were selected and analyzed. The prevalence of overweight/obesity has dramatically increased in Portuguese women of childbearing age and pregnant women, associated with the described trend of low adherence to Mediterranean diet. Variations in energy and macronutrients intakes during pregnancy seem to have no significantly impact on the nutritional status of growing fetuses. On contrary, pre-pregnancy overweight/obesity has been associated with increased offspring adiposity at birth, and an excessive gestational weight gain may be associated with offspring's overweight status in childhood. Factors potentially contributing to low adherence to the Mediterranean diet, deserving further investigation, include European Union agriculture policies that have implemented the production of non-Mediterranean food groups at low cost, and insufficient financial capacity to afford foods of quality reported by Portuguese population. Retrieving traditional Mediterranean dietary habits should be incorporated into strategies for prevention and treatment ofoverweight/obesity in Portugal, especially in women of childbearing age.

Patient Smoking Cessation Advice by Health Care Providers: The Role of Ethnicity, Socioeconomic Status, and Health

PubMed Central

Houston, Thomas K.; Scarinci, Isabel C.; Person, Sharina D.; Greene, Paul G.

2005-01-01

Objectives. We assessed differences by ethnicity in ever receiving advice from providers to quit smoking. We evaluated whether socioeconomic status and health status were moderators of the association. Methods. We used 2000 Behavioral Risk Factor Surveillance Survey data, a population-based cross-sectional survey. Results. After adjusting for complex survey design, 69% of the 14089 current smokers reported ever being advised to quit by a provider. Hispanics (50%) and African Americans (61%) reported receiving smoking counseling less frequently compared with Whites (72%, P<.01 for each). Ethnic minority status, lower education, and poorer health status remained significantly associated with lower rates of advice to quit after adjustment for number of cigarettes, time from last provider visit, income, comorbidities, health insurance, gender, and age. Smoking counseling differences between African Americans and Whites were greater among those with lower income and those without health insurance. Compared with Whites, differences for both Hispanics and African Americans were also greater among those with lower education. Conclusion. We found lower rates of smoking cessation advice among ethnic minorities. However, we also found complex interactions of ethnicity with socioeconomic factors. PMID:15914833

A national general pediatric clerkship curriculum: the process of development and implementation.

PubMed

Olson, A L; Woodhead, J; Berkow, R; Kaufman, N M; Marshall, S G

2000-07-01

To describe a new national general pediatrics clerkship curriculum, the development process that built national support for its use, and current progress in implementing the curriculum in pediatric clerkships at US allopathic medical schools. CURRICULUM DEVELOPMENT: A curriculum project team of pediatric clerkship directors and an advisory committee representing professional organizations invested in pediatric student education developed the format and content in collaboration with pediatric educators from the Council on Medical Student Education in Pediatrics (COMSEP) and the Ambulatory Pediatric Association (APA). An iterative process or review by clerkship directors, pediatric departmental chairs, and students finalized the content and built support for the final product. The national dissemination process resulted in consensus among pediatric educators that this curriculum should be used as the national curricular guideline for clerkships. MONITORING IMPLEMENTATION: Surveys were mailed to all pediatric clerkship directors before dissemination (November 1994), and in the first and third academic years after national dissemination (March 1996 and September 1997). The 3 surveys assessed schools' implementation of specific components of the curriculum. The final survey also assessed ways the curriculum was used and barriers to implementation. The final curriculum provided objectives and competencies for attitudes, skills, and 18 knowledge areas of general pediatrics. A total of 216 short clinical cases were also provided as an alternative learning method. An accompanying resource manual provided suggested strategies for implementation, teaching, and evaluation. A total of 103 schools responded to survey 1; 84 schools to survey 2; and 85 schools responded to survey 3 from the 125 medical schools surveyed. Before dissemination, 16% of schools were already using the clinical cases. In the 1995-1996 academic year, 70% of schools were using some or all of the curricular objectives/competencies, and 45% were using the clinical cases. Two years later, 90% of schools surveyed were using the curricular objectives, 88% were using the competencies, 66% were using the clinical cases. The extent of curriculum use also increased. Schools using 11 or more of the 18 curriculum's knowledge areas increased from 50% (1995-1996) to 73% (1996-1997). This new national general pediatric clerkship curriculum developed broad support during its development and has been implemented very rapidly nationwide. During this period the COMSEP and the APA have strongly supported its implementation with a variety of activities. This development and implementation process can be a model for other national curricula.

Managing urban stormwater for urban sustainability: Barriers and policy solutions for green infrastructure application.

PubMed

Dhakal, Krishna P; Chevalier, Lizette R

2017-12-01

Green infrastructure (GI) revitalizes vegetation and soil, restores hydro-ecological processes destroyed by traditional urbanization, and naturally manages stormwater on-site, offering numerous sustainability benefits. However, despite being sustainable and despite being the object of unrelenting expert advocacy for more than two decades, GI implementation remains slow. On the other hand, the practice of traditional gray infrastructure, which is known to have significant adverse impacts on the environment, is still ubiquitous in urban areas throughout the world. This relationship between knowledge and practice seems unaccountable, which has not yet received adequate attention from academia, policy makers, or research communities. We deal with this problem in this paper. The specific objective of the paper is to explore the barriers to GI, and suggest policies that can both overcome these barriers and expedite implementation. By surveying the status of implementation in 10 US cities and assessing the relevant city, state and federal policies, we identified 29 barriers and grouped them into 5 categories. The findings show that most of the barriers stem from cognitive limitations and socio-institutional arrangements. Accordingly, we suggest 33 policies, also grouped into 5 categories, which span from conducting public education and awareness programs to changing policies and governance structures. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Great Recession and Health Spending among Uninsured U.S. Immigrants: Implications for the Affordable Care Act Implementation

PubMed Central

Bustamante, Arturo Vargas; Chen, Jie

2014-01-01

Objective We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence. Data Source Uninsured U.S. citizens and noncitizens from the 2005–2006 and 2008–2009 Medical Expenditure Panel Survey. Study Design The probability of reporting any health spending and the natural logarithm of health spending are our main dependent variables. We compare health spending across population categories before/during the GR. Subsequently, we implement two-part regression analyses of total and specific health-spending measures. We predict average health spending before/during the GR with a smearing estimation. Principal Findings The probability of reporting any spending diminished for recent immigrants compared to citizens during the GR. For those with any spending, recent immigrants reported higher spending during the GR (27 percent). Average reductions in total spending were driven by the decline in the share of the population reporting any spending among citizens and noncitizens. Conclusions Our study findings suggest that recent immigrants could be forgoing essential care, which later translates into higher spending. It portrays the vulnerability of a population that would remain exposed to income shocks, even after the Affordable Care Act (ACA) implementation. PMID:24962550

Occupational health and safety services for immigrant workers in Japanese workplaces.

PubMed

Uchino, Asuka; Muto, Takashi; Muto, Shigeki

2010-01-01

The objective of this study was to clarify the status of occupational health and safety services for immigrant workers, the barriers to employing immigrant workers and the needs of the managers in workplaces to keep immigrant workers healthy and safe. This study was a cross-sectional survey. We sent self-administered questionnaires to 126 workplaces in the western part of Shizuoka Prefecture, Japan in August 2006. The questionnaire included the characteristics of the workplace, barriers to employing immigrant workers, current actions to keep immigrant workers healthy and safe, the implementation rate of health checkups and important issues to keep immigrant workers healthy and safe. Implementation rates of health and safety education, creating job instruction manuals written in their native languages, creating safety signs written in their native languages, and the use of translators were 62.5%, 50.0%, 41.1% and 37.5%, respectively. Implementation rates of general health checkups, special health checkups and follow up after health checkups were 80.8%, 73.6% and 67.3%, respectively. The most important issue which the managers considered kept immigrant workers healthy and safe was health checkups (69.6%). In conclusion, several occupational health and safety services were conducted for immigrant workers without a margin to compare with Japanese workers.

Global Evidence on the Association between POS Advertising Bans and Youth Smoking Participation

PubMed Central

Shang, Ce; Huang, Jidong; Cheng, Kai-Wen; Li, Qing; Chaloupka, Frank J.

2016-01-01

Background: Point-of-sale (POS) tobacco advertising has been linked to youth smoking susceptibility and experimental smoking. However, there is limited evidence of the association between POS advertising bans and youth smoking participation. This study aims to examine how such bans are associated with current smoking, daily smoking, and regular smoking (≥1 cigarettes per day) participation among youth. Methods: one to two waves (primarily one wave) of the Global Youth Tobacco Survey were conducted in 130 countries between 2007 and 2011. These surveys were linked to the WHO “MPOWER” data using country and year identifiers to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and smoking participation in the past month. Weighted logistic regressions were employed to analyze this association while controlling for age, gender, parents’ smoking status, 6 MPOWER policy scores, and GDP per capita. Results and Conclusions: We find that in countries with POS advertising bans, current smoking (OR = 0.73, p ≤ 0.1), daily smoking (OR = 0.70, p ≤ 0.1), and regular smoking (OR = 0.75, p ≤ 0.05) participation in the past month is significantly lower, suggesting that POS promotion bans can potentially reduce youth smoking. This study provides evidence to support the implementation of POS promotion regulations by the US FDA and implementation of the WHO FCTC guidelines regarding restrictions on tobacco POS promotion. PMID:27005651

An intelligent ground operator support system

NASA Technical Reports Server (NTRS)

Goerlach, Thomas; Ohlendorf, Gerhard; Plassmeier, Frank; Bruege, Uwe

1994-01-01

This paper presents first results of the project 'Technologien fuer die intelligente Kontrolle von Raumfahrzeugen' (TIKON). The TIKON objective was the demonstration of feasibility and profit of the application of artificial intelligence in the space business. For that purpose a prototype system has been developed and implemented for the operation support of the Roentgen Satellite (ROSAT), a scientific spacecraft designed to perform the first all-sky survey with a high-resolution X-ray telescope and to investigate the emission of specific celestial sources. The prototype integrates a scheduler and a diagnosis tool both based on artificial intelligence techniques. The user interface is menu driven and provides synoptic displays for the visualization of the system status. The prototype has been used and tested in parallel to an already existing operational system.

ESAC RFI Survey in the SMOS 1400-1427MHz Passive Band

NASA Astrophysics Data System (ADS)

Castillo-Fraile, Manuel; Uranga, Ekhi

2016-08-01

The SMOS (Soil Moisture and Ocean Salinity) satellite was launched on 2 November 2009, and it is the ESA second Earth Explorer Opportunity mission. After 6 years of successful Operations, the status of the SMOS mission is excellent, and it is providing very reliable acquisition, nominal and NRT data processing, archiving, and dissemination services of Level 1 and Level 2 processed data around the entire Planet. However, SMOS observations are significantly affected by RF interferences in several World areas. In this context, a new RFI detection and monitoring tool has been implemented at ESAC to provide to the national radiofrequency authorities with a proper detection and localization method of the illegal ground emitters in order to ensure the protection of the SMOS 1400- 1427MHz Passive Band for scientific applications.

Visions for a Pan-European digital data infrastructure for groundwater quantity and quality data relevant for implementation of the Water Framework Directive.

NASA Astrophysics Data System (ADS)

Hinsby, Klaus; Broers, Hans Peter

2014-05-01

The EU Water Framework and Groundwater Directives stipulate that EU member states (MS) should ensure good groundwater chemical and quantitative by 2015. For the assessment of good chemical status the MS have to establish Natural Background Levels (NBLs) and Threshold Values (TVs) for groundwater bodies at risk and compare current concentration levels to these. In addition the MS shall ensure trend reversals in cases where contaminants or water levels show critical increasing or decreasing trends. The EU MS have to demonstrate that the quantitative and chemical status of its groundwater bodies does not put drinking water, ecosystems or other legitimate uses at risk. Easy on-line access to relevant visualizations of groundwater quality and quantity data of e.g. nitrate, chloride, arsenic and water tables in Europe's major aquifer types compiled from national databases would be of great importance for managers, authorities and scientists conducting risk and status assessments. The Water Resources Expert Group of the EuroGeoSurveys propose to develop Pan-European interactive on-line digital maps and visualizations of concentrations levels and trends, as well as calculated natural background levels and threshold values for the most important aquifer types of Europe mainly derived based on principles established in the former EU project "BRIDGE" - Background cRiteria for the IDentification of Groundwater Thresholds. Further, we propose to develop Pan-European digital and dynamic maps and cross sections in close collaboration with ecologists, which delineate dependent or associated terrestrial and aquatic ecosystems across Europe where groundwater quantity and quality plays a significant role in sustaining good ecological status of the ecosystem, and where the water resources and ecosystems are most vulnerable to climate change. Finally, integrated water resources management requires integrated consideration of both deep and shallow groundwater and surface water issues and interaction. It is therefore proposed to map regions of Europe that use coupled groundwater-surface water models in integrated water resources and river basin management. In the presentation we will show selected examples of data visualizations of importance to integrated water resources and river basin management and the implementation of the Water Framework Directive.

Monitoring and evaluating the adherence to a complementary food supplement (Ying Yang Bao) among young children in rural Qinghai, China: a mixed methods evaluation study

PubMed Central

Wu, Qiong; Zhang, Yanfeng; Chang, Suying; Wang, Wei; Helena van Velthoven, Michelle; Han, Huijun; Xing, Min; Chen, Li; Du, Xiaozhen; Scherpbier, Robert W

2017-01-01

Background Large investments are currently made in community–based complementary food supplement (Ying Yang Bao, YYB) programs to improve nutrition of young children in rural areas in China. However, there is a lack of knowledge about the experience and challenges of implementing YYB programs in China. We aimed to: 1) monitor distribution of YYB; 2) assess children’s adherence to and acceptability of YYB; and 3) evaluate community–based strategies to improve the program. Methods This mixed methods evaluation study combined data from surveys and focus groups that took place during a controlled interventional evaluation trial. The trial aimed to evaluate the effectiveness of community–based YYB distribution on improving children's health status in rural areas in China. We conducted five cross–sectional surveys with caregivers of children aged 6–23 months (baseline survey (N = 1804) in August 2012 and four follow–up cross–sectional surveys: 1) N = 494 in January 2013; 2) N = 2187 in August 2013; 3) N = 504 in January 2014; and 4) N = 2186 in August 2014) in one rural county in Qinghai Province. We used a two–stage cluster sampling technique to select mothers with eligible children for each survey. Information was collected from caregivers on household characteristics, YYB consumption and acceptability in the surveys. High adherence in each survey was defined as children who consumed at least four YYB sachets during the previous week. A logistic regression model was developed to obtain odds ratios (OR) with 95% confidence intervals of factors associated with high adherence. Also, we conducted 10 focus groups with73 caregivers and health workers involved in the YYB distribution. Content analysis was used to explore qualitative findings, which were used to gain deeper insight into the quantitative results. Results Around 90% of caregivers had ever received YYB and more than 80% of children ever took YYB. Caregivers mainly knew about YYB through their village doctors. High adherence to YYB increased from 49.4% in the first follow–up survey (January 2013) to 81.4% in the last follow–up survey (August 2014; P < 0.0001). Repeated training sessions with village doctors could increase adherence. However, due to unplanned YYB stock–out, caregivers did not receive YYB for six months, which may have led to a decrease of high adherence from 64.1% in the second follow–up survey (August 2013) to 53.6% in the third follow–up survey (January 2014; P < 0.0001). Self–reported acceptability increased from 43.2% to 71.8%, partly due to improving the taste of YYB, which was the main reason that children disliked taking YYB. Unfortunately, more than 60% of caregivers did not perceive positive health improvement in their children after taking YYB. Multivariate analysis showed that children with diarrhea (OR = 1.216, 95% CI 1.025–1.442), cough or fever (OR = 1.222, 95% CI 1.072–1.393) during the past two weeks had significantly lower adherence. Conclusions This evaluation study showed that program monitoring in rural West China was critically important for understanding program implementation and adherence trends. This led to strategic changes to the intervention over time: improving the taste of YYB; strengthening health education of village doctors and caregivers; and ensuring continuity of YYB supply. Future programs need to monitor program implementation in other settings in China and elsewhere. PMID:28702176

Monitoring and evaluating the adherence to a complementary food supplement (Ying Yang Bao) among young children in rural Qinghai, China: a mixed methods evaluation study.

PubMed

Wu, Qiong; Zhang, Yanfeng; Chang, Suying; Wang, Wei; Helena van Velthoven, Michelle; Han, Huijun; Xing, Min; Chen, Li; Du, Xiaozhen; Scherpbier, Robert W

2017-06-01

Large investments are currently made in community-based complementary food supplement (Ying Yang Bao, YYB) programs to improve nutrition of young children in rural areas in China. However, there is a lack of knowledge about the experience and challenges of implementing YYB programs in China. We aimed to: 1) monitor distribution of YYB; 2) assess children's adherence to and acceptability of YYB; and 3) evaluate community-based strategies to improve the program. This mixed methods evaluation study combined data from surveys and focus groups that took place during a controlled interventional evaluation trial. The trial aimed to evaluate the effectiveness of community-based YYB distribution on improving children's health status in rural areas in China. We conducted five cross-sectional surveys with caregivers of children aged 6-23 months (baseline survey (N = 1804) in August 2012 and four follow-up cross-sectional surveys: 1) N = 494 in January 2013; 2) N = 2187 in August 2013; 3) N = 504 in January 2014; and 4) N = 2186 in August 2014) in one rural county in Qinghai Province. We used a two-stage cluster sampling technique to select mothers with eligible children for each survey. Information was collected from caregivers on household characteristics, YYB consumption and acceptability in the surveys. High adherence in each survey was defined as children who consumed at least four YYB sachets during the previous week. A logistic regression model was developed to obtain odds ratios (OR) with 95% confidence intervals of factors associated with high adherence. Also, we conducted 10 focus groups with73 caregivers and health workers involved in the YYB distribution. Content analysis was used to explore qualitative findings, which were used to gain deeper insight into the quantitative results. Around 90% of caregivers had ever received YYB and more than 80% of children ever took YYB. Caregivers mainly knew about YYB through their village doctors. High adherence to YYB increased from 49.4% in the first follow-up survey (January 2013) to 81.4% in the last follow-up survey (August 2014; P  < 0.0001). Repeated training sessions with village doctors could increase adherence. However, due to unplanned YYB stock-out, caregivers did not receive YYB for six months, which may have led to a decrease of high adherence from 64.1% in the second follow-up survey (August 2013) to 53.6% in the third follow-up survey (January 2014; P  < 0.0001). Self-reported acceptability increased from 43.2% to 71.8%, partly due to improving the taste of YYB, which was the main reason that children disliked taking YYB. Unfortunately, more than 60% of caregivers did not perceive positive health improvement in their children after taking YYB. Multivariate analysis showed that children with diarrhea (OR = 1.216, 95% CI 1.025-1.442), cough or fever (OR = 1.222, 95% CI 1.072-1.393) during the past two weeks had significantly lower adherence. This evaluation study showed that program monitoring in rural West China was critically important for understanding program implementation and adherence trends. This led to strategic changes to the intervention over time: improving the taste of YYB; strengthening health education of village doctors and caregivers; and ensuring continuity of YYB supply. Future programs need to monitor program implementation in other settings in China and elsewhere.

2012 national survey on bicyclist and pedestrian attitudes and behavior : traffic tech : technology transfer series

DOT National Transportation Integrated Search

2013-09-01

In 2012, NHTSA conducted a national telephone survey to obtain a status report on attitudes, knowledge, and behavior related to outdoor walking and bicycling. This study updates national telephone survey data collected by NHTSA in 2002. The survey ad...

Paid employment and common mental disorders in 50-64-year olds: analysis of three cross-sectional nationally representative survey samples in 1993, 2000 and 2007.

PubMed

Perera, G; Di Gessa, G; Corna, L M; Glaser, K; Stewart, R

2017-08-24

Associations between employment status and mental health are well recognised, but evidence is sparse on the relationship between paid employment and mental health in the years running up to statutory retirement ages using robust mental health measures. In addition, there has been no investigation into the stability over time in this relationship: an important consideration if survey findings are used to inform future policy. The aim of this study is to investigate the association between employment status and common mental disorder (CMD) in 50-64-year old residents in England and its stability over time, taking advantage of three national mental health surveys carried out over a 14-year period. Data were analysed from the British National Surveys of Psychiatric Morbidity of 1993, 2000 and 2007. Paid employment status was the primary exposure of interest and CMD the primary outcome - both ascertained identically in all three surveys (CMD from the revised Clinical Interview Schedule). Multivariable logistic regression models were used. The prevalence of CMD was higher in people not in paid employment across all survey years; however, this association was only present for non-employment related to poor health as an outcome and was not apparent in those citing other reasons for non-employment. Odds ratios for the association between non-employment due to ill health and CMD were 3.05 in 1993, 3.56 in 2000, and 2.80 in 2007, after adjustment for age, gender, marital status, education, social class, housing tenure, financial difficulties, smoking status, recent physical health consultation and activities of daily living impairment. The prevalence of CMD was higher in people not in paid employment for health reasons, but was not associated with non-employment for other reasons. Associations had been relatively stable in strength from 1993 to 2007 in those three cross-sectional nationally representative samples.

A global survey on occupational health services in selected international commission on occupational health (ICOH) member countries.

PubMed

Rantanen, Jorma; Lehtinen, Suvi; Valenti, Antonio; Iavicoli, Sergio

2017-10-05

The United Nations General Assembly (UNGA), the International Labour Organization (ILO), the World Health Organization (WHO), the International Commission on Occupational Health (ICOH), and the European Union (EU) have encouraged countries to organize occupational health services (OHS) for all working people irrespective of the sector of economy, size of enterprise or mode of employment of the worker. The objective of this study was to survey the status of OHS in a sample of countries from all continents. A questionnaire focusing on the main aspects of OHS was developed on the basis of ILO Convention No. 161 and several other questionnaire surveys used in various target groups of OHS. The questionnaire was sent to 58 key informants: ICOH National Secretaries. A total of 49 National Secretaries responded (response rate 84.5%), from countries that employ 70% of the total world labour force. The majority of the respondent countries, 67%, had drawn up an OHS policy and implement it with the help of national occupational safety and health (OSH) authorities, institutes of occupational health or respective bodies, universities, and professional associations. Multidisciplinary expert OHS resources were available in the majority (82%) of countries, but varied widely in quantitative terms. The average OHS coverage of workers was 24.8%, with wide variation between countries. In over two thirds (69%) of the countries, the content of services was mixed, consisting of preventive and curative services, and in 29% preventive only. OHS financing was organized according to a mixed model among 63% and by employers only among 33% of the respondents. The majority of countries have drawn up policies, strategies and programmes for OHS. The infrastructures and institutional and human resources for the implementation of strategies, however, remain insufficient in the majority of countries (implementation gap). Qualitatively, the content and multidisciplinary nature of OHS corresponds to international guidance, but the coverage, comprehensiveness and content of services remain largely incomplete due to a lack of infrastructure and shortage of multiprofessional human resources (capacity gap). The estimated coverage of services in the study group was low; only a quarter of the total employed population (coverage gap).

40 CFR 49.10042 - Approval status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for the Cow... Tribal rules or measures in the implementation plan for the Reservation of the Cow Creek Band of Umpqua...

Do Program Implementation Factors or Fidelity Affect Chronic Disease Self-Management Education Programs' Outcomes?

PubMed

Brady, Teresa J; Murphy, Louise B; O'Colmain, Benita J; Hobson, Reeti Desai

2017-09-01

To evaluate whether implementation factors or fidelity moderate chronic disease self-management education program outcomes. Meta-analysis of 34 Arthritis Self-Management Program and Chronic Disease Self-Management Program studies. Community. N = 10 792. Twelve implementation factors: program delivery fidelity and setting and leader and participant characteristics. Eighteen program outcomes: self-reported health behaviors, physical health status, psychological health status, and health-care utilization. Meta-analysis using pooled effect sizes. Modest to moderate statistically significant differences for 4 of 6 implementation factors; these findings were counterintuitive with better outcomes when leaders and participants were unpaid, leaders had less than minimum training, and implementation did not meet fidelity requirements. Exploratory study findings suggest that these interventions tolerate some variability in implementation factors. Further work is needed to identify key elements where fidelity is essential for intervention effectiveness.

Dental Homes for Children With Autism: A Longitudinal Analysis of Iowa Medicaid's I-Smile Program.

PubMed

Chi, Donald L; Momany, Elizabeth T; Mancl, Lloyd A; Lindgren, Scott D; Zinner, Samuel H; Steinman, Kyle J

2016-05-01

Medicaid-enrolled children with autism spectrum disorder (ASD) encounter significant barriers to dental care. Iowa's I-Smile Program was implemented in 2006 to improve dental use for all children in Medicaid. This study compared dental home and preventive dental utilization rates for Medicaid-enrolled children by ASD status and within three time periods (pre-implementation, initial implementation, maturation) and determined I-Smile's longitudinal influence on ASD-related dental use disparities. Data from 2002-2011 were analyzed for newly Medicaid-enrolled children aged 3-17 years (N=30,059); identified each child's ASD status; and assessed whether the child had a dental home or utilized preventive dental care. Log-linear regression models were used to generate rate ratios. Analyses were conducted in 2015. In 2003-2011, 9.8% of children with ASD had dental homes compared with 8% of children without ASD; 36.3% of children with ASD utilized preventive care compared to 45.7% of children without ASD. There were no significant differences in dental home rates by ASD status during pre-implementation, initial implementation, or maturation. There were no significant differences in preventive dental utilization by ASD status during pre-implementation or initial implementation, but children with ASD were significantly less likely to utilize preventive care during maturation (rate ratio=0.79, p<0.001). Longitudinal trends in dental home and preventive dental utilization rates were not significant (p=0.54 and p=0.71, respectively). Among newly Medicaid-enrolled children in Iowa's I-Smile Program, those with ASDs were not less likely than those without ASD to have dental homes but were significantly less likely to utilize preventive dental care. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Dental Homes for Children With Autism

PubMed Central

Chi, Donald L.; Momany, Elizabeth T.; Mancl, Lloyd A.; Lindgren, Scott D.; Zinner, Samuel H.; Steinman, Kyle J.

2015-01-01

Introduction Medicaid-enrolled children with autism spectrum disorder (ASD) encounter significant barriers to dental care. Iowa’s I-Smile Program was implemented in 2006 to improve dental use for all children in Medicaid. This study compared dental home and preventive dental utilization rates for Medicaid-enrolled children by ASD status and within three time periods (pre-implementation, initial implementation, maturation) and determined I-Smile’s longitudinal influence on ASD-related dental use disparities. Methods Data from 2002–2011 were analyzed for newly Medicaid-enrolled children aged 3–17 years (N=30,059), identified each child’s ASD status, and assessed whether the child had a dental home or utilized preventive dental care. Log-linear regression models were used to generate rate ratios. Analyses were conducted in 2015. Results In 2003–2011, 9.8% of children with ASD had dental homes compared with 8% of children without ASD; 36.3% of children with ASD utilized preventive care compared to 45.7% of children without ASD. There were no significant differences in dental home rates by ASD status during pre-implementation, initial implementation, or maturation. There were no significant differences in preventive dental utilization by ASD status during pre-implementation or initial implementation, but children with ASD were significantly less likely to utilize preventive care during maturation (rate ratio=0.79, p<0.001). Longitudinal trends in dental home and preventive dental utilization rates were not significant (p=0.54 and p=0.71, respectively). Conclusions Among newly Medicaid-enrolled children in Iowa’s I-Smile Program, those with ASDs were not less likely than those without ASD to have dental homes but were significantly less likely to utilize preventive dental care. PMID:26514624

The Teaching of Ethics and Professionalism in Plastic Surgery Residency: A Cross-Sectional Survey.

PubMed

Bennett, Katelyn G; Ingraham, John M; Schneider, Lisa F; Saadeh, Pierre B; Vercler, Christian J

2017-05-01

The ethical practice of medicine has always been of utmost importance, and plastic surgery is no exception. The literature is devoid of information on the teaching of ethics and professionalism in plastic surgery. In light of this, a survey was sent to ascertain the status of ethics training in plastic surgery residencies. A 21-question survey was sent from the American Council of Academic Plastic Surgeons meeting to 180 plastic surgery program directors and coordinators via email. Survey questions inquired about practice environment, number of residents, presence of a formal ethics training program, among others. Binary regression was used to determine if any relationships existed between categorical variables, and Poisson linear regression was used to assess relationships between continuous variables. Statistical significance was set at a P value of 0.05. A total of 104 members responded to the survey (58% response rate). Sixty-three percent were program directors, and most (89%) practiced in academic settings. Sixty-two percent in academics reported having a formal training program, and 60% in private practice reported having one. Only 40% of programs with fewer than 10 residents had ethics training, whereas 78% of programs with more than 20 residents did. The odds of having a training program were slightly higher (odds ratio, 1.1) with more residents (P = 0.17). Despite the lack of information in the literature, formal ethics and professionalism training does exist in many plastic surgery residencies, although barriers to implementation do exist. Plastic surgery leadership should be involved in the development of standardized curricula to help overcome these barriers.

An explorative cross-sectional study examining self-reported health and nutritional status of disadvantaged people using food banks in Germany.

PubMed

Depa, Julia; Hilzendegen, Carolin; Tinnemann, Peter; Stroebele-Benschop, Nanette

2015-11-24

Even in high-income countries some population groups depend on food banks to support their food intake. We aimed to explore and compare health and nutritional status of food bank clients (Tafel e.V.) in different cities in Germany. In a cross-sectional study, self-reported health and nutritional status of food bank clients living in three cities (Berlin - capital, Ludwigsburg- affluent city, Fulda - small town) which differ in size, available income and poverty rate, were assessed and compared to survey variables of the low socioeconomic status population of national surveys (DEGS and GEDA). Across cities, food bank clients (N = 276, response rate of 21.5 %) did not differ in main socio-demographic characteristics (age, nationality, education, professional qualification, household income). Smoking, having at least one chronic illness, estimating their own health status as moderate to poor and low consumption of fruits and vegetables were common characteristics. Comparing selected variables with the low socioeconomic status population of DEGS and GEDA, differences were found for a higher prevalence of diabetes among food bank clients and a worse self-reported health status. Considerably lower fruit consumption and lower hypertension prevalence among female and lower overweight rates among male food bank clients were found. Although people using food banks vary in socio-demographic background, no differences for main demographics across the cities were found. In addition, the study suggests that for some health- and nutrition-related variables, national surveys in Germany might underestimate socioeconomic differences.

The labour market, psychosocial outcomes and health conditions in cancer survivors: protocol for a nationwide longitudinal survey 2 and 5 years after cancer diagnosis (the VICAN survey).

PubMed

Bouhnik, Anne-Deborah; Bendiane, Marc-Karim; Cortaredona, Sebastien; Sagaon Teyssier, Luis; Rey, Dominique; Berenger, Cyril; Seror, Valerie; Peretti-Watel, Patrick

2015-03-24

Today, a growing need exists for greater research into cancer survivorship, focusing on different spheres of the day-to-day life of diagnosed patients. This article describes the design and implementation of VICAN (VIe après le CANcer), a national survey on French cancer survivors. The target population included patients aged 18-82, diagnosed with cancer between January and June 2010, and registered in one of the three main French Health Insurance Schemes. It was restricted to 12 tumour sites. Sampling was stratified using a non-proportional allocation, based on age at diagnosis (18-52 and 53-82) and tumour site. Data were collected from telephone interviews with patients 2 and 5 years after diagnosis, a medical survey completed by the physician who initiated cancer treatment, and information from the national medicoadministrative database on reimbursement data and hospital discharge records. First data collection, 2 years after diagnosis, occurred between March and December 2012. Second data collection, 5 years after diagnosis, will be conducted in 2015. Analyses will be conducted on various outcomes: quality of life, health status and psychosocial conditions, with a particular focus on the impact of cancer diagnosis on the labour market. The variety of measurements included in the survey will enable us to control a wide range of factors. The methodology of the VICAN survey was approved by three national ethics commissions. Results of the study will be disseminated through national and international research conferences, and in articles published in international peer-reviewed journals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Food security in South Africa: a review of national surveys

PubMed Central

Labadarios, Demetre; Steyn, Nelia Patricia; Gericke, Gerda; Maunder, Eleni Maria Winifred; Davids, Yul Derek; Parker, Whadi-ah

2011-01-01

Abstract Objective To assess the status of food security – i.e. access to food, food availability and food utilization – in South Africa. Methods A systematic search of national surveys that used the Community Childhood Hunger Identification Project (CCHIP) index to measure food security in South Africa over a period of 10 years (1999–2008) was conducted. Anthropometric data for children aged 1–9 years were used to assess food utilization, and household food inventory data were used to assess food availability. Findings Only three national surveys had used the CCHIP index, namely, the 1999 and 2005 National Food Consumption Surveys (NFCS) and the 2008 South African Social Attitudes Survey. These surveys showed a relatively large decrease in food insecurity between 1999 and 2008. However, the consistent emerging trend indicated that in poorer households women were either feeding their children a poor diet or skipping meals so their children could eat. In terms of food access and availability, the 1999 NFCS showed that households that enjoyed food security consumed an average of 16 different food items over 24 hours, whereas poorer households spent less money on food and consumed fewer than 8 different food items. Moreover, children had low mean scores for dietary diversity (3.58; standard deviation, SD: ± 1.37) and dietary variety (5.52; SD: ± 2.54) scores. In terms of food utilization, the NFCS showed that stunting in children decreased from 21.6% in 1999 to 18% in 2005. Conclusion The South African government must implement measures to improve the undesirably high level of food insecurity in poorer households. PMID:22271946

Faculty Status, Tenure, and Professional Identity: A Pilot Study of Academic Librarians in New England

ERIC Educational Resources Information Center

Freedman, Shin

2014-01-01

Faculty status, tenure, and professional identity have been long-lasting issues for academic librarians for nearly forty years, yet there is little agreement on the benefits of faculty status. This paper examines faculty status and tenure for academic librarians and presents the results of a survey inquiry into professional identity, current and…

Parent Practices in Facilitating Self-Determination Skills: The Influences of Culture, Socioeconomic Status, and Children's Special Education Status

ERIC Educational Resources Information Center

Zhang, Dalun

2005-01-01

This survey study investigated the influences of culture, socioeconomic status, and children's special education status on parents' engagement in fostering self-determination behaviors. Major findings included (a) children from Caucasian families were more involved in personal independence activities than Asian and African American children; (b)…

Placement and Follow-Up Report: Graduate Survey Responses and State Defined Placement Status of Occupational Programs for the Academic Year 1982-83. Research Report No. 84-31.

ERIC Educational Resources Information Center

Baldwin, Anne

Annually, a study is conducted by Miami-Dade Community College to determine the education and employment status of vocational program graduates and their reactions to various aspects of college services and courses. Study findings are based on a survey for former students, Department of Labor and Employment Security Files, State University System…

Money Income and Poverty Status in the United States: 1987. (Advance Data from the March 1988 Current Population Survey). Current Population Reports: Consumer Income.

ERIC Educational Resources Information Center

Current Population Reports, 1988

1988-01-01

This report presents data from the March 1988 Current Population Survey (CPS) on the income and poverty status of families and persons in the United States for the calender year 1987. The following family characteristics are examined: (1) family income; (2) family composition, race, and Hispanic origin; (3) educational attainment of householder;…

Part-Time Physicians…Prevalent, Connected, and Satisfied

PubMed Central

Levine, Rachel B.; Manwell, Linda Baier; Mundt, Marlon P.; Linzer, Mark

2008-01-01

Objective The health care workforce is evolving and part-time practice is increasing. The objective of this work is to determine the relationship between part-time status, workplace conditions, and physician outcomes. Design Minimizing error, maximizing outcome (MEMO) study surveyed generalist physicians and their patients in the upper Midwest and New York City. Measurements and Main Results Physician survey of stress, burnout, job satisfaction, work control, intent to leave, and organizational climate. Patient survey of satisfaction and trust. Responses compared by part-time and full-time physician status; 2-part regression analyses assessed outcomes associated with part-time status. Of 751 physicians contacted, 422 (56%) participated. Eighteen percent reported part-time status (n = 77, 31% of women, 8% of men, p < .001). Part-time physicians reported less burnout (p < .01), higher satisfaction (p < .001), and greater work control (p < .001) than full-time physicians. Intent to leave and assessments of organizational climate were similar between physician groups. A survey of 1,795 patients revealed no significant differences in satisfaction and trust between part-time and full-time physicians. Conclusions Part-time is a successful practice style for physicians and their patients. If favorable outcomes influence career choice, an increased demand for part-time practice is likely to occur. PMID:18214623

The Impact of School Socioeconomic Status on Student Lunch Consumption after Implementation of the Texas Public School Nutrition Policy

ERIC Educational Resources Information Center

Cullen, Karen Weber; Watson, Kathleen B.; Fithian, Ashley R.

2009-01-01

Background: This study compares the impact of the Texas Public School Nutrition Policy on lunch consumption of low- and middle-income students in sixth through eighth grades. Methods: Students in 1 middle socioeconomic status (SES) and 1 low SES school completed lunch food records before (2001/2002) and after (2005/2006) implementation of the…

Status of Standards Implementation in Anchorage Secondary Schools: A Concerns Based Acceptance Model (CBAM) Review, 2001-2002.

ERIC Educational Resources Information Center

Fenton, Ray

The Concerns Based Acceptance Model (CBAM) has been a key element in developing and assessing the implementation of science and mathematics programs over the past 20 years. CBAM provides an organized approach to assessing where people stand as they learn about, and accept, changes in organizations. This study examined the status of the adoption of…

Status of endangered and threatened plant species on Nevada Test Site: a survey. Part 1. Endangered species

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

Rhoads, W.A.; Williams, M.P.

1977-04-01

Eight plant species which occur on NTS and one which occurs just outside the west boundary have been suggested by the Fish and Wildlife Service (FWS) as endangered plants in Nevada under the Endangered Species Act of 1973. This survey provides a basis for suggesting that seven of the nine species remain as candidates for the endangered status, and that two be removed from the threatened status. The following species are recommended for the endangered status: Astragalus beatleyae, Astragalus nyensis, Lathyrus hitchcockianus, Trifolium andersonii ssp. beatleyae, Frasera pahutensis, Phacelia beatleyae, and Camissonia megalantha. Two recommended for the threatened status aremore » Penstemon pahutensis and Arctomecon merriamii. In addition we suggest that two species not previously listed for Nevada by FWS be considered as endangered. These are Phacelia parishii, found for the first time since 1941 on NTS, and Galium hilendiae ssp. kingstonense, previously listed as a candidate for endangered status for California but not for Nevada.« less

Uptake of enhanced recovery practices by SAGES members: a survey.

PubMed

Keller, Deborah S; Delaney, Conor P; Senagore, Anthony J; Feldman, Liane S

2017-09-01

The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement enhanced recovery pathways (ERPs) to improve clinical outcomes and patient satisfaction. An initial step was to survey SAGES member on their knowledge, use, and impediments to enhanced recovery. An online survey designed by SMART committee members to define SAGES member's awareness and use of enhanced recovery principles and practice was emailed to all SAGES members. Reminders were sent 2 and 3 weeks later, encouraging completion of the survey. The web-based survey included 48 questions and took an estimated 20 min to complete. A total of 229 members completed the survey. Respondents were primarily general/MIS surgeons (82.6%) working in an urban location (85.5%), with a bell-shaped age distribution (median 35-44). Almost half regularly used some elements of ERPs (48.7%), but 30% were unfamiliar with the concept. Wide variety in the specific ERP elements used and discharge criteria were reported. The majority had to create and implement their own plan (70.4%). Roadblocks to implementation were inconsistencies with partners/covering physicians (56.3%), nursing education (46.6%), and resources (34.7%). When implemented, members saw improvements in length of stay (88%), patient satisfaction (54.7%), postoperative pain (53.3%), time to return of bowel function (52.7%), and readmissions (16.7%). A need for education and standardization was especially seen in preoperative care, with 74.4% fasting patients from midnight the night before surgery. Wide variations were also reported in pain management practices. An overwhelming majority (89%) reported that having a protocol endorsed by a national organization, such as SAGES, would help with implementation. From this survey of SAGES members, there is a need for education, tools, and standardized protocols to increase awareness, support implementation, and encourage wider utilization of ERP. The overwhelming majority stated having a protocol endorsed by a national organization, such as SAGES, would facilitate implementation.

Receiving HIV Serostatus Disclosure from Partners Before Sex: Results from an Online Survey of Chinese Men Who Have Sex with Men.

PubMed

Tang, Weiming; Liu, Chuncheng; Cao, Bolin; Pan, Stephen W; Zhang, Ye; Ong, Jason; Fu, Hongyun; Ma, Baoli; Fu, Rong; Yang, Bin; Ma, Wei; Wei, Chongyi; Tucker, Joseph D

2018-02-22

HIV serostatus disclosure before sex can facilitate serosorting, condom use and potentially decrease the risk of HIV acquisition. However, few studies have evaluated HIV serostatus disclosure from partners before sex. We examined the rate and correlates of receiving HIV serostatus disclosure from regular and casual male partners before sex among an online sample of men who have sex with men (MSM) in China. An online cross-sectional study was conducted among MSM in eight Chinese cities in July 2016. Participants completed questions covering sociodemographic information, sexual behaviors, HIV testing (including HIV self-testing) history, self-reported HIV status, and post-test violence. In addition, participants were asked whether they received HIV serostatus disclosure from their most recent partners before sex. Overall, 2105 men completed the survey. Among them, 85.9% were never married, and 35.4% had high school or less education. A minority (20.6%, 346/1678; 17.8%, 287/1608) of men received HIV serostatus disclosure from their most recent regular and casual male partners, respectively. Multivariate analysis indicated that participants who ever self-tested for HIV were more likely to have received HIV status disclosure from regular [adjusted OR (aOR) = 1.92, 95% CI 1.50-2.44] and casual (aOR = 2.34, 95% CI 1.80-3.04) male partners compared to never self-tested participants. Compared to participants who had not received HIV status disclosure from regular partners, participants who received disclosure from regular male partners had higher likelihood in experiencing post-test violence (aOR = 5.18, 95% CI 1.53-17.58). Similar results were also found for receiving HIV serostatus disclosure from casual partners. This study showed that HIV serostatus disclosure from partners was uncommon among Chinese MSM. Interventions and further implementation research to facilitate safe disclosure are urgently needed for MSM.

Comparison of self-report influenza vaccination coverage with data from a population based computerized vaccination registry and factors associated with discordance.

PubMed

Jiménez-García, Rodrigo; Hernandez-Barrera, Valentín; Rodríguez-Rieiro, Cristina; Carrasco Garrido, Pilar; López de Andres, Ana; Jimenez-Trujillo, Isabel; Esteban-Vasallo, María D; Domínguez-Berjón, Maria Felicitas; de Miguel-Diez, Javier; Astray-Mochales, Jenaro

2014-07-31

We aim to compare influenza vaccination coverages obtained using two different methods; a population based computerized vaccination registry and self-reported influenza vaccination status as captured by a population survey. The study was conducted in the Autonomous Community of Madrid (ACM), Spain, and refers to the 2011/12 influenza vaccination campaign. Information on influenza vaccination status according to a computerized registry was extracted from the SISPAL database and crossed with the electronic clinical records in primary care (ECRPC). Self-reported vaccine uptake was obtained from subjects living in the ACM included in the 2011-12 Spanish National Health Survey (SNHS). Independent study variables included: age, sex, immigrant status and the presence of high risk chronic conditions. Vaccination coverages were calculated according to study variables. Crude and adjusted prevalence ratios were computed to assess concordance. The study population included 5,245,238 adults living in the ACM in year 2011 with an individual ECRPC and 1449 adult living the ACM and interviewed in the SNHS from October 2011 to June 2012. The weighted vaccination coverage for the study population according to self-reported data was 19.77% and 15.04% from computerized registries resulting in a crude prevalence ratio (cPR) of 1.31 (95% CI 1.20-1.44) so self-reported data significantly overestimated 31% the registry coverage. Self-reported coverages are always higher than registry based coverages when the study population is stratified by the study variables. Self-reported overestimation was higher among men than women, younger age groups, immigrants and those without chronic conditions. Both methods provide the most concordant estimations for the target population of the influenza vaccine. Self-report influenza vaccination uptake overestimates vaccination registries coverages. The validity of self-report seems to be negatively affected by socio-demographic variables and the absence of chronic conditions. Possible strategies must be considered and implemented to improve both coverage estimation methods. Copyright © 2014 Elsevier Ltd. All rights reserved.

Inequalities in medicine use in Central Eastern Europe: an empirical investigation of socioeconomic determinants in eight countries.

PubMed

Vogler, Sabine; Österle, August; Mayer, Susanne

2015-11-05

Equitable access to essential medicines is a major challenge for policy-makers world-wide, including Central and Eastern European countries. Member States of the European Union situated in Central and Eastern Europe have publicly funded pharmaceutical reimbursement systems that should promote accessibility and affordability of, at least essential medicines. However, there is no knowledge whether socioeconomic inequalities exist in these countries. Against this backdrop, this study analyses whether socioeconomic determinants influence the use of prescribed and non-prescribed medicines in eight Central and Eastern European countries (Bulgaria, Czech Republic, Hungary, Latvia, Poland, Romania, Slovenia, Slovakia). Further, the study discusses observed (in)equalities in medicine use in the context of the pharmaceutical policy framework and the implementation in these countries. The study is based on cross-sectional data from the first wave of the European Health Interview Survey (2007-2009). Multivariate logistic regression analyses were carried out to determine the association between socioeconomic status (measured by employment status, education, income; controlled for age, gender, health status) and medicine use (prescribed and non-prescribed medicines). This was supplemented by a pharmaceutical policy analysis based on indicators in four policy dimensions (sustainable funding, affordability, availability and accessibility, and rational selection and use of medicines). Overall, the analysis showed a gradient favouring individuals from higher socioeconomic groups in the consumption of non-prescribed medicines in the eight surveyed countries, and for prescribed medicines in three countries (Latvia, Poland, Romania). The pharmaceutical systems in the eight countries were, to varying degrees, characterized by a lack of (public) funding, thus resulting in high and growing shares of private financing (including co-payments for prescribed medicines), inefficiencies in the selection of medicines into reimbursement and limitations in medicines availability. Pharmaceutical policies aiming at reducing inequalities in medicine use require not only a consideration of the role of co-payments and other private expenditure but also adequate investment in medicines and transparent and clear processes regarding the inclusion of medicines into reimbursement.

Correlational Analysis of neck/shoulder Pain and Low Back Pain with the Use of Digital Products, Physical Activity and Psychological Status among Adolescents in Shanghai

PubMed Central

Li, Jipeng; Li, Yangyang; Zhang, Yongxing; Zhao, Qinghua

2013-01-01

Purpose This study investigates the neck/shoulder pain (NSP) and low back pain (LBP) among current high school students in Shanghai and explores the relationship between these pains and their possible influences, including digital products, physical activity, and psychological status. Methods An anonymous self-assessment was administered to 3,600 students across 30 high schools in Shanghai. This questionnaire examined the prevalence of NSP and LBP and the level of physical activity as well as the use of mobile phones, personal computers (PC) and tablet computers (Tablet). The CES-D (Center for Epidemiological Studies Depression) scale was also included in the survey. The survey data were analyzed using the chi-square test, univariate logistic analyses and a multivariate logistic regression model. Results Three thousand sixteen valid questionnaires were received including 1,460 (48.41%) from male respondents and 1,556 (51.59%) from female respondents. The high school students in this study showed NSP and LBP rates of 40.8% and 33.1%, respectively, and the prevalence of both influenced by the student’s grade, use of digital products, and mental status; these factors affected the rates of NSP and LBP to varying degrees. The multivariate logistic regression analysis revealed that Gender, grade, soreness after exercise, PC using habits, tablet use, sitting time after school and academic stress entered the final model of NSP, while the final model of LBP consisted of gender, grade, soreness after exercise, PC using habits, mobile phone use, sitting time after school, academic stress and CES-D score. Conclusions High school students in Shanghai showed high prevalence of NSP and LBP that were closely related to multiple factors. Appropriate interventions should be implemented to reduce the occurrences of NSP and LBP. PMID:24147114

Sexual Function and Health-Related Quality of Life in Long-Term Rectal Cancer Survivors

PubMed Central

Sun, Virginia; Grant, Marcia; Wendel, Christopher S.; McMullen, Carmit K.; Bulkley, Joanna E.; Herrinton, Lisa J.; Hornbrook, Mark C.; Krouse, Robert S.

2016-01-01

Introduction Sexual dysfunction is a treatment sequela in rectal cancer (RC) survivors. Differences in health-related quality of life (HRQOL) may occur based on ostomy status (permanent ostomy versus anastomosis). Aim To describe alterations in sexual function and HRQOL based on ostomy status in long-term (≥ 5 years) RC survivors. Methods RC survivors with an ostomy (N=181) or anastomosis (N=394) were surveyed using validated HRQOL and functional status tools. We compared sexuality outcomes between the ostomy and anastomosis group, and reported differences adjusted for clinical and demographic characteristics. Qualitative data from one open-ended question on survivors’ greatest challenges since their surgery were analyzed to explore sexuality, symptoms, and relationships. Main Outcome Measures Whether sexually active, satisfaction with sexual activity, and select sexual dysfunction items from the Modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O). Results Survivors with a permanent ostomy were more likely to have been sexually inactive after surgery if it occurred before year 2000, and experience dissatisfaction with appearance, interference with personal relationships and intimacy, and lower overall HRQOL. Female RC survivors with an ostomy were more likely to have problems with vaginal strictures and vaginal pain after surgery that persisted at the time of survey (5+ years later). Radiation treatment, tumor stage, soilage of garments in bed, and higher Charlson-Deyo co-morbidity scores were negatively associated with outcomes. Six qualitative themes emerged: loss of and decreased sexual activity; psychological issues with sexual activity, physical issues with sexual activity; partner rejection; ostomy interference with sexual activity; and positive experiences with sexuality. Conclusions Sexual dysfunction is a common long-term sequela of RC treatment, with more problems observed in survivors with a permanent ostomy. This warrants widespread implementation of targeted interventions to manage sexual dysfunction and improve HRQOL for these survivors. PMID:27318020

Sexual Function and Health-Related Quality of Life in Long-Term Rectal Cancer Survivors.

PubMed

Sun, Virginia; Grant, Marcia; Wendel, Christopher S; McMullen, Carmit K; Bulkley, Joanna E; Herrinton, Lisa J; Hornbrook, Mark C; Krouse, Robert S

2016-07-01

Sexual dysfunction is a treatment sequela in survivors of rectal cancer (RC). Differences in health-related quality of life (HRQOL) can occur based on ostomy status (permanent ostomy vs anastomosis). To describe alterations in sexual function and HRQOL based on ostomy status in long-term (≥5 years) survivors of RC. Survivors of RC with an ostomy (n = 181) or anastomosis (n = 394) were surveyed using validated HRQOL and functional status tools. We compared sexuality outcomes between the ostomy and anastomosis groups and reported differences adjusted for clinical and demographic characteristics. Qualitative data from one open-ended question on survivors' greatest challenges since their surgery were analyzed to explore sexuality, symptoms, and relationships. Whether sexually active, satisfaction with sexual activity, and select sexual dysfunction items from the Modified City of Hope Quality of Life-Colorectal. Survivors with a permanent ostomy were more likely to have been sexually inactive after surgery if it occurred before 2000 and experience dissatisfaction with appearance, interference with personal relationships and intimacy, and lower overall HRQOL. Female survivors of RC with an ostomy were more likely to have problems with vaginal strictures and vaginal pain after surgery that persisted at the time of the survey (≥5 years later). Radiation treatment, tumor stage, soilage of garments in bed, and higher Charlson-Deyo comorbidity scores were negatively associated with outcomes. Six qualitative themes emerged: loss of and decreased sexual activity, psychological issues with sexual activity, physical issues with sexual activity, partner rejection, ostomy interference with sexual activity, and positive experiences with sexuality. Sexual dysfunction is a common long-term sequela of RC treatment, with more problems observed in survivors with a permanent ostomy. This warrants widespread implementation of targeted interventions to manage sexual dysfunction and improve HRQOL for these survivors. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The Status of Implementation of Good Manufacturing Practices (GMP) Shredded Fish Production in UMKM Az-Zahrah, Makassar

NASA Astrophysics Data System (ADS)

Latif, Rindam; Dirpan, Andi; Indriani, Sylvia

2017-12-01

Good manufacturing practices (GMP) describes the requirements that an industry should follow throughout the production process starting from sorting raw materials to handling final products. The purpose of this research is to disclose each phase of GMP in making shredded fish and to assess the status of the practices implemented by the UMKM Az-zahrah in producing its product. This descriptive study is conducted by doing interview with owner followed by observation and documentation of all activities related to the production process in order to assess the status of GMP applied by the UMKM Az-zahrah. In assessing the status, we referred to Permenperin RI No.75 / M-Ind / Per / 7/2010 and KBPOM regulation no. HK 03.1.23.04.12.22007 Year 2012. The findings indicate some deviation occurred when UMKM Az-zahrah implemented it, those are (1) there is a pet in production room (2) production employees are not yet wearing work uniform (3) production room has directly access to toilet (4) there is no health label about health and nutritional claims. The status of applied GMP in the UMKM Az-zahrah is at D level (less good) with rating IV.

Hepatitis C serosorting among people who inject drugs in rural Puerto Rico.

PubMed

Duncan, Ian; Curtis, Ric; Reyes, Juan Carlos; Abadie, Roberto; Khan, Bilal; Dombrowski, Kirk

2017-06-01

Due to the high cost of treatment, preventative measures to limit Hepatitis C (HCV) transmission among people who inject drugs (PWID) are encouraged by many public health officials. A key one of these is serosorting, where PWID select risk partners based on concordant HCV status. Research on the general U.S. population by Smith et al. (2013) found that knowledge of one's own HCV status facilitated serosorting behaviors among PWID, such that respondents with knowledge of their own status were more likely to ask potential partners about their status prior to sharing risk. Our objective was to see if this held true in rural Puerto Rico. We replicate this study using a sample of PWID in rural Puerto Rico to draw comparisons. We used respondent driven sampling to survey 315 participants, and have a final analytic sample of 154. The survey was heavily modeled after the National HIV Behavioral Survey, which was the dataset used by the previous researchers. We found that among PWID in rural Puerto Rico, unlike in the general population, knowledge of one's own HCV status had no significant effect on the selection of one's most recent injection partner, based on his/her HCV status. We conclude that PWID in rural Puerto Rico differ from the general U.S. population when it comes to serosorting behaviors, and that these differences should be taken into account in future outreaches and intervention strategies.

The feasibility of implementing food-based dietary guidelines in the South African primary-school curriculum.

PubMed

Nguyen, Kim A; de Villiers, Anniza; Fourie, Jean M; Bourne, Lesley T; Hendricks, Michael K

2015-01-01

To explore the perceptions of educators from the Western Cape Province about the feasibility of implementing South African food-based dietary guidelines (FBDG) in the national curriculum of primary schools. Combined quantitative and qualitative methods. We report on the quantitative component. Twelve public primary schools of different socio-economic status in three education districts of the Western Cape: Metro Central, Metro East and Cape Winelands. Educators (n 256) participated in the self-completed questionnaire survey. Educators assessed that FBDG were appropriate to South African schoolchildren (94%), could be used as an education tool (97%) and fill gaps in the current curriculum about healthy dietary habits (91%). Besides Life Orientation, FBDG could be taught in other learning areas from grades 3 to 7 (9-13 years old). Important barriers to implementing FBDG in the curriculum were educators' workload (61%), insufficient time (46%), learners' disadvantaged background (43%) and educators' lack of knowledge (33%). Other approaches to teach children about FBDG included linking these to the National School Nutrition Programme (82%), school tuck shops (79%), parent meetings (75%), school nutrition policy (73%) and school assembly (57%). Educators in high-income schools perceived that learners' lifestyle was significantly worse (P < 0·001) and that tuck shops and the school assembly were the best means to teach pupils about FBDG (P < 0·001 and P < 0·05). Implementing FBDG in the national school curriculum is seen as important together with optimizing the school physical environment. Key factors required for successful implementation in the curriculum are sufficient educational materials, adequate time allocation and appropriate educator training.

Making cognitive decision support work: Facilitating adoption, knowledge and behavior change through QI.

PubMed

Weir, Charlene; Brunker, Cherie; Butler, Jorie; Supiano, Mark A

2017-07-01

This paper evaluates the role of facilitation in the successful implementation of Computerized Decision Support (CDS). Facilitation processes include education, specialized computerized decision support, and work process reengineering. These techniques, as well as modeling and feedback enhance self-efficacy, which we propose is one of the factors that mediate the effectiveness of any CDS. In this study, outpatient clinics implemented quality improvement (QI) projects focused on improving geriatric care. Quality Improvement is the systematic process of improving quality through continuous measurement and targeted actions. The program, entitled "Advancing Geriatric Education through Quality Improvement" (AGE QI), consisted of a 6-month, QI based, intervention: (1) 2h didactic session, (2) 1h QI planning session, (3) computerized decision support design and implementation, (4) QI facilitation activities, (5) outcome feedback, and (6) 20h of CME. Specifically, we examined the impact of the QI based program on clinician's perceived self-efficacy in caring for older adults and the relationship of implementation support and facilitation on perceived success. The intervention was implemented at 3 institutions, 27 community healthcare system clinics, and 134 providers. This study reports the results of pre/post surveys for the forty-nine clinicians who completed the full CME program. Self-efficacy ratings for specific clinical behaviors related to care of older adults were assessed using a Likert based instrument. Self-ratings of efficacy improved across the following domains (depression, falls, end-of-life, functional status and medication management) and specifically in QI targeted domains and were associated with overall clinic improvements. Published by Elsevier Inc.

Successful implementation of clinical practice guidelines for pressure risk management in a home nursing setting.

PubMed

Kapp, Suzanne

2013-10-01

This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines for the Prediction and Prevention of Pressure Ulcers. In 2007 a pilot study was conducted. Nurse perspectives (n=21) were obtained via survey and a client profile (n=218) was generated. Audit of the uptake and continued use of the pressure risk screening tool, during the pilot study and later once implemented as standard practice organizational wide, was conducted. Nurses at the pilot site successfully implemented the practice guidelines, pressure risk screening was adopted and supporting resources were well received. Most clients were at low risk of pressure ulcer development. The pilot site maintained and extended their pilot study success, ensuring more than 90% of clients were screened for pressure risk over the 18 months which followed. All other sites performed less well initially, however subsequently improved, meeting the pilot sites success after 18 months. Two years later, the organization continues to screen more than 90% of all clients for pressure risk. Implementation of clinical practice guidelines was successful in the pilot project and pressure risk screening became a well-adopted practice. Success continued following organizational wide implementation. Pilot study findings suggest it may be prudent to monitor the pressure ulcer risk status of low risk clients so as to prevent increasing risk and pressure ulcer development among this group. © 2012 John Wiley & Sons Ltd.

Implementation Status of Accrual Accounting System in Health Sector

PubMed Central

Mehrolhassani, Mohammad Hossien; Khayatzadeh-Mahani, Akram; Emami, Mozhgan

2015-01-01

Introduction: Management of financial resources in health systems is one of the major issues of concern for policy makers globally. As a sub-set of financial management, accounting system is of paramount importance. In this paper, which presents part of the results of a wider research project on transition process from a cash accounting system to an accrual accounting system, we look at the impact of components of change on implementation of the new system. Implementing changes is fraught with many obstacles and surveying these challenges will help policy makers to better overcome them. Methods: The study applied a quantitative manner in 2012 at Kerman University of Medical Science in Iran. For the evaluation, a teacher made valid questionnaire with Likert scale was used (Cranach’s alpha of 0.89) which included 7 change components in accounting system. The study population was 32 subordinate units of Kerman University of Medical Sciences and for data analysis, descriptive and inferential statistics and correlation coefficient in SPSS version 19 were used. Results: Level of effect of all components on the implementation was average downward (5.06±1.86), except for the component “management & leadership (3.46±2.25)” (undesirable from external evaluators’ viewpoint) and “technology (6.61±1.92) and work processes (6.35±2.19)” (middle to high from internal evaluators’ viewpoint). Conclusions: Results showed that the establishment of accrual accounting system faces infrastructural challenges, especially the components of leadership and management and followers. As such, developing effective measures to overcome implementation obstacles should target these components. PMID:25560337

Early Use of the NMDA Receptor Antagonist Ketamine in Refractory and Superrefractory Status Epilepticus

PubMed Central

Zeiler, F. A.

2015-01-01

Refractory status epilepticus (RSE) and superrefractory status epilepticus (SRSE) pose a difficult clinical challenge. Multiple cerebral receptor and transporter changes occur with prolonged status epilepticus leading to pharmacoresistance patterns unfavorable for conventional antiepileptics. In particular, n-methyl-d-aspartate (NMDA) receptor upregulation leads to glutamate mediated excitotoxicity. Targeting these NMDA receptors may provide a novel approach to otherwise refractory seizures. Ketamine has been utilized in RSE. Recent systematic review indicates 56.5% and 63.5% cessation in seizures in adults and pediatrics, respectively. No complications were described. We should consider earlier implementation of ketamine or other NMDA receptor antagonists, for RSE. Prospective study of early implementation of ketamine should shed light on the role of such medications in RSE. PMID:25649724

Social networks and implementation of evidence-based practices in public youth-serving systems: a mixed-methods study

PubMed Central

2011-01-01

Background The present study examines the structure and operation of social networks of information and advice and their role in making decisions as to whether to adopt new evidence-based practices (EBPs) among agency directors and other program professionals in 12 California counties participating in a large randomized controlled trial. Methods Interviews were conducted with 38 directors, assistant directors, and program managers of county probation, mental health, and child welfare departments. Grounded-theory analytic methods were used to identify themes related to EBP adoption and network influences. A web-based survey collected additional quantitative information on members of information and advice networks of study participants. A mixed-methods approach to data analysis was used to create a sociometric data set (n = 176) for examination of associations between advice seeking and network structure. Results Systems leaders develop and maintain networks of information and advice based on roles, responsibility, geography, and friendship ties. Networks expose leaders to information about EBPs and opportunities to adopt EBPs; they also influence decisions to adopt EBPs. Individuals in counties at the same stage of implementation accounted for 83% of all network ties. Networks in counties that decided not to implement a specific EBP had no extra-county ties. Implementation of EBPs at the two-year follow-up was associated with the size of county, urban versus rural counties, and in-degree centrality. Collaboration was viewed as critical to implementing EBPs, especially in small, rural counties where agencies have limited resources on their own. Conclusions Successful implementation of EBPs requires consideration and utilization of existing social networks of high-status systems leaders that often cut across service organizations and their geographic jurisdictions. Trial Registration NCT00880126 PMID:21958674

Contributions for Repositioning a Regional Strategy for Healthy Municipalities, Cities and Communities (HM&C): Results of a Pan-American Survey

PubMed Central

Rice, Marilyn; Vizzotti, Carlos; Frassia, Romina; Vizzotti, Pablo; Akerman, Marco

2010-01-01

This article presents the results of the 1st Regional Survey of Healthy Municipalities, Cities and Communities (HM&C) carried out in 2008 by the Pan American Health Organization (PAHO) and ISALUD University of Argentina. It discusses the responses obtained from 12 countries in the Americas Region. Key informants in Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Mexico, Paraguay, Peru, and Uruguay were selected and encouraged to answer the survey, while informants from Canada and Honduras answered voluntarily and were included in this analysis. The discussion of the results of the Survey provides insight into the current status of HM&C in the Region and suggests key topics for repositioning the Regional strategy relative to: (1) the conceptual identity and tools for HM&C; (2) challenging areas in the implementation process (scale, legal framework, and development of capacities); (3) related strategies and participatory processes such as the ways citizen empowerment in governance is supported; (4) the need to monitor and assess the impact of the HM&C strategy on the health and quality of life of the populations involved; and (5) the need for developing a strategic research and training agenda. The analysis and discussion of these results aims to provide useful input for repositioning the strategy in the Region and contributing to the emergence of a second generation of concepts and tools capable of meeting the developing priorities and needs currently faced by the HM&C strategy. PMID:20532989

Contributions for repositioning a regional strategy for Healthy Municipalities, Cities and Communities (HM&C): results of a pan-American survey.

PubMed

Meresman, Sergio; Rice, Marilyn; Vizzotti, Carlos; Frassia, Romina; Vizzotti, Pablo; Akerman, Marco

2010-09-01

This article presents the results of the 1st Regional Survey of Healthy Municipalities, Cities and Communities (HM&C) carried out in 2008 by the Pan American Health Organization (PAHO) and ISALUD University of Argentina. It discusses the responses obtained from 12 countries in the Americas Region. Key informants in Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Mexico, Paraguay, Peru, and Uruguay were selected and encouraged to answer the survey, while informants from Canada and Honduras answered voluntarily and were included in this analysis. The discussion of the results of the Survey provides insight into the current status of HM&C in the Region and suggests key topics for repositioning the Regional strategy relative to: (1) the conceptual identity and tools for HM&C; (2) challenging areas in the implementation process (scale, legal framework, and development of capacities); (3) related strategies and participatory processes such as the ways citizen empowerment in governance is supported; (4) the need to monitor and assess the impact of the HM&C strategy on the health and quality of life of the populations involved; and (5) the need for developing a strategic research and training agenda. The analysis and discussion of these results aims to provide useful input for repositioning the strategy in the Region and contributing to the emergence of a second generation of concepts and tools capable of meeting the developing priorities and needs currently faced by the HM&C strategy.

Graphic health warnings on tobacco packets and containers: compliance status in Bangladesh.

PubMed

Rahman, Syed Mahbubur; Alam, Md Shariful; Zubair, Abm; Shahriar, Md Hasan; Hossein, Monowar; Alam, Md Shahedul; Hefler, Marita

2018-06-12

This study describes and analyses compliance with tobacco product graphic health warning (GHW) legislation introduced in Bangladesh in March 2016. A survey based on a structured questionnaire was conducted in April 2016 (immediately following the law coming into force), and 8 months later in November 2016, in eight divisional cities in Bangladesh. Five stores from three categories of retailers of combustible and smokeless tobacco products were surveyed, providing a total of 120 completed questionnaires. The study investigated a range of measures including the image and text of GHW, their ratio and colour use, and prescribed rotation. Warning labels for 3312 tobacco items were assessed. In April 2016, 75% of tobacco products surveyed did not have GHWs. In November 2016, 19% were still found to not have the prescribed warnings. Even among products which did include GHW, there was significant non-compliance with the full range of requirements, in both survey periods. Compliance was highest for cigarette packets and lowest among smokeless tobacco products. In addition, awareness among tobacco retailers about the range of GHW requirements was low. Effective implementation of GHW labels in low-income and middle-income countries requires awareness-raising among key stakeholders, combined with focused monitoring and compliance strategies. This should take into account different product categories and manufacturers, as well as measures targeted at retailers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Inclusion of persons with disabilities in systems of social protection: a population-based survey and case-control study in Peru.

PubMed

Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vasquez, Alberto; Kuper, Hannah; Walsham, Matthew; Blanchet, Karl

2016-08-26

This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. Population based-survey with a nested case-control study. Morropon, a semiurban district located in Piura, northern Peru. For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case-control study, only one participant, case or control, per household was included in the study. Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconomic status, education, health and rehabilitation and social protection participation. The survey included 3684 participants, 1848 (50.1%) females, mean age: 36.4 (SD: 21.7). A total of 290 participants (7.9%; 95% CI 7.0% to 8.7%) were classified as having disability. Adults with disabilities were more likely to be single (OR=3.40; 95% CI 1.54 to 7.51) and not to be working (OR=4.36; 95% CI 2.26 to 8.40), while those who did work were less likely to receive the national minimum wage (ie, 750 PEN or about US$265; p=0.007). People with disabilities were more likely to experience health problems. There was no difference between those enrolled in any social protection programme among participants with and without disabilities. People with disabilities were found to have higher needs for social protection, but were not more likely to be enrolled in social protection programmes. The Peruvian social protection system should consider adding disability status to selection criteria in their cash transfer programmes as well as implementing disability-specific interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Socioeconomic Status and Unionization Attitudes in the United States.

ERIC Educational Resources Information Center

Cornfield, Daniel B.; Kim, Hyunhee

1994-01-01

Survey responses from a national sample of 1,195 nonunion, nonfarm workers suggest that corporations legitimize themselves by appealing to occupational identities of high-status workers, whereas unions legitimize themselves by appealing to social background identities (ethnic, racial, and gender identities) of low-status workers. Prounion…

The protective effect of marriage for survival: a review and update.

PubMed

Rendall, Michael S; Weden, Margaret M; Favreault, Melissa M; Waldron, Hilary

2011-05-01

The theory that marriage has protective effects for survival has itself lived for more than 100 years since Durkheim's groundbreaking study of suicide (Durkheim 1951 [1897]). Investigations of differences in this protective effect by gender, by age, and in contrast to different unmarried statuses, however, have yielded inconsistent conclusions. These investigations typically either use data in which marital status and other covariates are observed in cross-sectional surveys up to 10 years before mortality exposure, or use data from panel surveys with much smaller sample sizes. Their conclusions are usually not based on formal statistical tests of contrasts between men and women or between never-married, divorced/separated, and widowed statuses. Using large-scale pooled panel survey data linked to death registrations and earnings histories for U.S. men and women aged 25 and older, and with appropriate contrast tests, we find a consistent survival advantage for married over unmarried men and women, and an additional survival "premium" for married men. We find little evidence of mortality differences between never-married, divorced/separated, and widowed statuses.

Frequency and risk factors for donor reactions in an anonymous blood donor survey.

PubMed

Goldman, Mindy; Osmond, Lori; Yi, Qi-Long; Cameron-Choi, Keltie; O'Brien, Sheila F

2013-09-01

Adverse donor reactions can result in injury and decrease the likelihood of donor return. Reaction reports captured in the blood center's database provide an incomplete picture of reaction rates and risk factors. We performed an anonymous survey, mailed to 40,000 donors in 2008, including questions about symptoms, height, weight, sex, and donation status. Reaction rates were compared to those recorded in our database. Possible risk factors were assessed for various reactions. The response rate was 45.5%. A total of 32% of first-time and 14% of repeat donors reported having any adverse symptom, most frequently bruising (84.9 per 1000 donors) or feeling faint or weak (66.2 per 1000). Faint reactions were two to eight times higher than reported in our database, although direct comparison was difficult. Younger age, female sex, and first-time donation status were risk factors for systemic and arm symptoms. In females, low estimated blood volume (EBV) was a risk factor for systemic symptoms. Only 51% of donors who consulted an outside physician also called Canadian Blood Services. A total of 10% of first-time donors with reactions found adverse effects information inadequate. This study allowed us to collect more information about adverse reactions, including minor symptoms and delayed reactions. Based on our findings of the risk factors and frequency of adverse reactions, we are implementing more stringent EBV criteria for younger donors and providing more detailed information to donors about possible adverse effects and their management. © 2012 American Association of Blood Banks.

Monitoring the health of transgender and other gender minority populations: validity of natal sex and gender identity survey items in a U.S. national cohort of young adults.

PubMed

Reisner, Sari L; Conron, Kerith J; Tardiff, Laura Anatale; Jarvi, Stephanie; Gordon, Allegra R; Austin, S Bryn

2014-11-26

A barrier to monitoring the health of gender minority (transgender) populations is the lack of brief, validated tools with which to identify participants in surveillance systems. We used the Growing Up Today Study (GUTS), a prospective cohort study of U.S. young adults (mean age = 20.7 years in 2005), to assess the validity of self-report measures and implement a two-step method to measure gender minority status (step 1: assigned sex at birth, step 2: current gender identity). A mixed-methods study was conducted in 2013. Construct validity was evaluated in secondary data analysis of the 2010 wave (n = 7,831). Cognitive testing interviews of close-ended measures were conducted with a subsample of participants (n = 39). Compared to cisgender (non-transgender) participants, transgender participants had higher levels of recalled childhood gender nonconformity age < 11 years and current socially assigned gender nonconformity and were more likely to have ever identified as not completely heterosexual (p < 0.001). No problems with item comprehension were found for cisgender or gender minority participants. Assigned sex at birth was interpreted as sex designated on a birth certificate; transgender was understood to be a difference between a person's natal sex and gender identity. Participants were correctly classified as male, female, or transgender. The survey items performed well in this sample and are recommended for further evaluation in languages other than English and with diverse samples in terms of age, race/ethnicity, and socioeconomic status.

A community-wide media campaign to promote walking in a Missouri town.

PubMed

Wray, Ricardo J; Jupka, Keri; Ludwig-Bell, Cathy

2005-10-01

Engaging in moderate physical activity for 30 minutes five or more times per week substantially reduces the risk of coronary heart disease, stroke, colon cancer, diabetes, high blood pressure, and obesity, and walking is an easy and accessible way to achieve this goal. A theory-based mass media campaign promoted walking and local community-sponsored wellness initiatives through four types of media (billboard, newspaper, radio, and poster advertisements) in St Joseph, Mo, over 5 months during the summer of 2003. The Walk Missouri campaign was conducted in four phases: 1) formative research, 2) program design and pretesting, 3) implementation, and 4) impact assessment. Using a postcampaign-only, cross-sectional design, a telephone survey (N = 297) was conducted in St Joseph to assess campaign impact. Study outcomes were pro-walking beliefs and behaviors. One in three survey respondents reported seeing or hearing campaign messages on one or more types of media. Reported exposure to the campaign was significantly associated with two of four pro-walking belief scales (social and pleasure benefits) and with one of three community-sponsored activities (participation in a community-sponsored walk) controlling for demographic, health status, and environmental factors. Exposure was also significantly associated with one of three general walking behaviors (number of days per week walking) when controlling for age and health status but not when beliefs were introduced into the model, consistent with an a priori theoretical mechanism: the mediating effect of pro-walking beliefs on the exposure-walking association. These results suggest that a media campaign can enhance the success of community-based efforts to promote pro-walking beliefs and behaviors.

A Survey on Mental Health Status of Adult Population Aged 15 and above in the Province of Qom, Iran.

PubMed

Noorbala, Ahmad Ali; Bagheri Yazdi, Seyed Abbas; Faghihzadeh, Soghrat; Kamali, Koorosh; Faghihzadeh, Elham; Hajebi, Ahmad; Akhondzadeh, Shahin; Noroozinejad, Gholamhosein; Bagheri, Majid

2017-11-01

This research aims to determine the mental health status of population aged 15 and over in the province of Qom in 2015. The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Qom in Iran. An estimated sample size of 600 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Qom city. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. Data analysis in the current study was carried out using the SPSS-18 computer software. Using GHQ traditional scoring method, 16.2% of the subjects were shown to be at risk of mental disorders (19.7% of females and 12.6% of males). Urban areas (17%) were more at risk of mental disorders compared with rural residents (6.5%). Anxiety and somatization symptoms were more frequent than depression and social dysfunction among respondents. The obtained data revealed that the prevalence of mental disorders increased with age. Such disorders were more common in females, age group of 65 and above, people living in rural areas, divorced and widowed, illiterate, retired and unemployed individuals compared with the other groups. The results of this study showed that a sixth of the people in the province were suspected to have mental disorders. Therefore, it is mandatory for the provincial public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented. .

Identifying HIV most-at-risk groups in Malawi for targeted interventions. A classification tree model.

PubMed

Emina, Jacques B O; Madise, Nyovani; Kuepie, Mathias; Zulu, Eliya M; Ye, Yazoume

2013-05-28

To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. A cross-sectional survey. Malawi The study used a sample of 6395 women aged 15-49 years from the 2010 Malawi Health and Demographic Surveys. Individual HIV status: positive or not. Findings from the Pearson χ(2) and χ(2) Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15-24) never married or in union and living in rural areas. In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25-49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30-49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment.

The Role of Public and Private Insurance Expansions and Premiums for Low-income Parents: Lessons From State Experiences.

PubMed

Guy, Gery P; M Johnston, Emily; Ketsche, Patricia; Joski, Peter; Adams, E Kathleen

2017-03-01

Numerous states have implemented policies expanding public insurance eligibility or subsidizing private insurance for parents. To assess the impact of parental health insurance expansions from 1999 to 2012 on the likelihood that parents are insured; their children are insured; both the parent and child within a family unit are insured; and the type of insurance. Cross-sectional analysis of the 2000-2013 March supplements to the Current Population Survey, with data from the Medical Expenditure Panel Survey-Insurance Component and the Area Resource File. Cross-state and within-state multivariable regression models estimated the effects of health insurance expansions targeting parents using 2-way fixed effect modeling and difference-in-difference modeling. All analyses controlled for household, parent, child, and local area characteristics that could affect insurance status. Expansions increased parental coverage by 2.5 percentage points, and increased the likelihood of both parent and child being insured by 2.1 percentage points. Substantial variation was observed by type of expansion. Public expansions without premiums and special subsidized plan expansions had the largest effects on parental coverage and increased the likelihood of jointly insuring both the parent and child. Higher premiums were a substantial deterrent to parents' insurance. Our findings suggest that premiums and the type of insurance expansion can have a substantial impact on the insurance status of the family. These findings can help inform states as they continue to make decisions about expanding Medicaid under the Affordable Care Act to cover all family members.

Determinants of full vaccination status in children aged 12–23 months in Gurùé and Milange districts, Mozambique: results of a population-based cross-sectional survey

PubMed Central

Shemwell, Shellese A.; Peratikos, Meridith B.; González-Calvo, Lázaro; Renom-Llonch, Montse; Boon, Alexandre; Martinho, Samuel; Cherry, Charlotte B.; Green, Ann F.; Moon, Troy D.

2017-01-01

Abstract Background In 2011, 64% of children in Mozambique, ages 12–23 months, were fully immunized. Large provincial differences in vaccine uptake exist. Methods We conducted a survey of 1650 females with children aged 12–23 months in the districts of Gurùé and Milange. Implementation occurred from November to December 2014. Descriptive statistics and logistic regression using R-software 3.0.2 were used to examine factors associated with full vaccination status. ArcGIS version 10.3.1 (ESRI, Redlands, CA, USA) was used to map spatial patterns of vaccine uptake. Results Full vaccination was roughly 48%. Identifying ‘hospital’ as a location to get vaccinated was associated with having a fully vaccinated child (OR=1.87, 95% CI=1.02, 3.41, p=0.043). Households where health decisions are made solely by the male or the female had 38% (95% CI=0.32, 1.21) and 55% (95% CI=0.29, 0.69) lower odds, respectively, of their child being fully immunized. For every 10 km increase from the nearest health facility there was a 36% lower odds of the child being fully immunized (OR=0.64, 95% CI=0.44, 0.93, p<0.001). Conclusion Zambézia Province, as a whole and the districts of Gurùé and Milange specifically, is falling short of vaccination targets. Intensified efforts focused on the least educated, most distant and which take a more family-centered approach are needed to improve vaccine uptake. PMID:28810665

Adverse selection and supply-side factors in the enrollment in community-based health insurance in Northwest Ethiopia: A mixed methodology.

PubMed

Atafu, Asmamaw; Kwon, Soonman

2018-05-20

Since 2010, the Ethiopian government introduced different measures to implement community-based health insurance (CBHI) schemes to improve access to health service and reduce the catastrophic effect of health care costs. The aim of this study was to examine the determinants of enrollment in CBHI in Northwest Ethiopia. In this study, we utilized a mix of quantitative (multivariate logistic regression applied to population survey linked with health facility survey) and qualitative (focus group discussion and in-depth interview) methods to better understand the factors that affect CBHI enrollment. The study revealed important factors, such as household, informal association, and health facility, as barriers to CBHI enrollment. Age and educational status, self-rated health status, perceived quality of health services, knowledge, and information (awareness) about CBHI were among the characteristics of individual household head, affecting enrollment. Household size and participation in an informal association, such as local credit associations, were also positively associated with CBHI enrollment. Additionally, health facility factors like unavailability of laboratory tests were the main factor that hinders CBHI enrollment. This study showed a possibility of adverse selection in CBHI enrollment. Additionally, perceived quality of health services, knowledge, and information (awareness) are positively associated with CBHI enrollment. Therefore, policy interventions to mitigate adverse selection as well as provision of social marketing activities are crucial to increase enrollment in CBHI. Furthermore, policy interventions that enhance the capacity of health facilities and schemes to provide the promised services are necessary. Copyright © 2018 John Wiley & Sons, Ltd.

Measuring population health: costs of alternative survey approaches in the Nouna Health and Demographic Surveillance System in rural Burkina Faso

PubMed Central

Lietz, Henrike; Lingani, Moustapha; Sié, Ali; Sauerborn, Rainer; Souares, Aurelia; Tozan, Yesim

2015-01-01

Background There are more than 40 Health and Demographic Surveillance System (HDSS) sites in 19 different countries. The running costs of HDSS sites are high. The financing of HDSS activities is of major importance, and adding external health surveys to the HDSS is challenging. To investigate the ways of improving data quality and collection efficiency in the Nouna HDSS in Burkina Faso, the stand-alone data collection activities of the HDSS and the Household Morbidity Survey (HMS) were integrated, and the paper-based questionnaires were consolidated into a single tablet-based questionnaire, the Comprehensive Disease Assessment (CDA). Objective The aims of this study are to estimate and compare the implementation costs of the two different survey approaches for measuring population health. Design All financial costs of stand-alone (HDSS and HMS) and integrated (CDA) surveys were estimated from the perspective of the implementing agency. Fixed and variable costs of survey implementation and key cost drivers were identified. The costs per household visit were calculated for both survey approaches. Results While fixed costs of survey implementation were similar for the two survey approaches, there were considerable variations in variable costs, resulting in an estimated annual cost saving of about US$45,000 under the integrated survey approach. This was primarily because the costs of data management for the tablet-based CDA survey were considerably lower than for the paper-based stand-alone surveys. The cost per household visit from the integrated survey approach was US$21 compared with US$25 from the stand-alone surveys for collecting the same amount of information from 10,000 HDSS households. Conclusions The CDA tablet-based survey method appears to be feasible and efficient for collecting health and demographic data in the Nouna HDSS in rural Burkina Faso. The possibility of using the tablet-based data collection platform to improve the quality of population health data requires further exploration. PMID:26257048

The impact of rheumatoid arthritis on the burden of disease in urban China.

PubMed

Langley, Paul C; Mu, Rong; Wu, Michael; Dong, Peng; Tang, Boxiong

2011-01-01

The aim of this study is to assess the burden of disease associated with the impact of rheumatoid arthritis in urban China. Burden of disease is considered from four perspectives: (i) health-related quality-of-life (HRQoL); (ii) health status; (iii) employment status; and (iv) absenteeism and presenteeism. Data are from the 2009 National Health and Wellness Survey (NHWS) of urban China. This is an internet-based survey and details the health experience of 13,007 respondents. The survey is representative of the urban China population at 18 years of age and over (18.1% of the total population). Of those responding to the survey, a total of 353 reported that they had been diagnosed with rheumatoid arthritis--an unweighted estimate of 2.65%. The sample design allows a comparison of those reporting rheumatoid arthritis with those not reporting this disease and, hence, a quantitative assessment of the burden of disease. Estimates of the quantitative impact of the presence of rheumatoid arthritis are through a series of generalized linear regression models. HRQoL is evaluated through the SF-12 instrument together with responses to the first item of the SF-12, self-reported health status. The SF-12 instrument generates three measures of HRQoL: the physical component summary (PCS), the mental component summary (MCS) and SF-6D utilities. Health status is captured as a self-report on a 5-point scale. Employment status is considered in terms of self-reported labor force participation, while absenteeism and presenteeism are estimated from the Work Productivity Activity Index (WPAI). Apart from a binary variable capturing the presence or absence of rheumatoid arthritis, control variables were included to capture the impact of other potential determinants of HRQoL and health status. The presence of rheumatoid arthritis in urban China has a significant deficit impact on HRQoL as measured by the PCS and MCS components of the SF-12, SF-6D absolute utilities and on self-assessed health status. In the case of PCS, the deficit impact of rheumatoid arthritis is -2.289 (95%CI: -3.042 to -1.536); for MCS -1.472 (95%CI: -2.338 to -0.605) and for utilities -0.025 (95% CI: -0.036 to -0.014). In the case of health status the odds ratio for the presence of rheumatoid arthritis is 1.275 (95%CI 1.031-1.576). The presence of rheumatoid arthritis has a marked negative effect, just under 8%, on the likelihood of workforce participation. Finally, the presence of rheumatoid arthritis is associated with an increased likelihood of absenteeism and presenteeism. The NHWS survey has a number of limitations. As the NHWS is an internet-based survey, biases may be present due to the lack of internet penetration in the urban China population. The extent to which individuals and households have internet access is unknown. In addition, the NHWS relies upon respondents reporting they have been diagnosed with one or more specific disease states. These are not, given the nature of the survey, clinically verified. This also introduces a degree of uncertainty. Care should be taken in uncritically generalizing these results to the wider China population. The burden of disease associated with self-reported, diagnosed rheumatoid arthritis in urban China is substantial. Utilizing a series of multivariate models, substantial deficits are associated not only in reported HRQoL and health status but also in respect of employment status and, for those in employment, rates of absenteeism and presenteeism.

78 FR 2447 - Proposed Information Collection Request (ICR) for the Worker Classification Survey; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... ANNUALIZED Cost to Respondents:......... $93,670 * Includes sixty (60) pre-test cases. ** U.S. Department of... status. The primary tasks of the survey include: (1) design and cognitively test survey questions to be...

Development and Evaluation the Satisfaction of Using an Oral Health Survey Mobile Application.

PubMed

Detsomboonrat, Palinee; Pisarnturakit, Pagaporn Pantuwadee

2018-06-05

Surveying oral health at the community level should be done at regular intervals. Dental health personnel must assess the oral health status and needs of the community through the collection and interpretation of reliable health information. Thus, the aims of this study were (1) to develop a mobile application for oral health surveys, (2) to analyze the oral status of school children in Bangkok using the newly developed application, and (3) to evaluate user satisfaction with using the Oral Health Survey Mobile Application (OHSMA). The OHSMA Android app was created to facilitate the collection and transfer of oral health status data. The survey data on the oral health status of Grades 1-6 Thai schoolchildren were collected and analyzed using the OHSMA. A 5-point Likert scale questionnaire was used to evaluate the satisfaction of 125 dental students when using this new application compared with using paper forms. The prevalence of dental caries in 441 schoolchildren was 79.7%. The total mean decayed, missing, and filled for primary teeth (dmft) and decayed, missing, and filled for permanent teeth (DMFT) were 4.09 (d + D = 3.29, m + M = 0.15, and f + F = 0.65). Users indicated high satisfaction scores for three OHSMA features: font, color, and proper size. The results showed that paper forms were easier for inputting and recording the data compared with the OHSMA. However, the OHSMA was significantly easier for searching data and reporting data compared with paper forms (OHSMA 3.80, paper forms 3.35; p < 0.001, and OHSMA 3.80, paper forms 3.51; p < 0.001), respectively. Despite some limitations, this study suggests that the mobile application has the potential to collect valuable oral health survey data.

Gas Turbine Engine Production Implementation Study : Volume 1. Executive Summary.

DOT National Transportation Integrated Search

1973-07-01

The report presents an assessment of available information pertaining to implementing mass production of gas turbine powered automobiles. The status of the technology and implementation schedule visibility reported herein is that existing at the time...

Birds of a feather

USGS Publications Warehouse

Knick, Steven T.; Gondhaleker, Carmen

2014-01-01

Greater sage-grouse (Centrocercus urophasiunus, hereafter sage-grouse) are broadly distributed, occupy a diversity of sagebrush habitats, and face multiple threats. As a result of these threats, sage-grouse populations are declining and are now absent from almost one-half of their estimated range prior to Euro-American settlement. The risks to sage-grouse are significant enough to merit candidate status for this species for listing under the U.S. Endangered Species Act (Federal Register Notice, March 5, 2010). According to this decision by the U.S. Fish and Wildlife Service in 2010, population and habitat fragmentation coupled with lack of regulatory mechanisms warranted listing, although implementation of actions has been precluded by other priorities. Candidate status for listing under the Endangered Species Act and possible regulatory action in the near future provide strong motivation to better understand the dynamics of sage-grouse populations and their habitat requirements. The general approach currently taken by managers focuses on maintaining or enhancing sage-grouse populations across their distribution in regions containing the highest densities of breeding birds and their important seasonal habitats, also known as priority areas for conservation (PACs). The rationale behind this approach is that it permits limited resources to be applied in regions that have the greatest potential to benefit the largest proportion of sage-grouse. Development and other forms of land use can then proceed under standard regulations in areas outside PACs. Implementation of this approach requires detailed information about habitat, connections among sage-grouse populations, and approaches to restore and maintain sagebrush. These are important topics of study by the U.S. Geological Survey (USGS) and its research partners.

The status of academic integrity amongst nursing students at a nursing education institution in the Western Cape.

PubMed

Theart, Cecilia J; Smit, Ilze

2012-06-20

Honesty is regarded as a basic ethical value in all educational programmes, and academic integrity is of undisputed importance in educational environments. The literature reviewed revealed that academic dishonesty is wide-ranging and also encountered in the nursing education environment. This phenomenon is of concern to the nursing fraternity because of the proven positive correlation between unethical academic practices and future unethical professional behaviour. Limited research data regarding academic dishonesty at nursing education institutions in South Africa and this correlation motivated the present study. The purpose was to examine the status of academic integrity amongst nursing students at a nursing education institution in the Western Cape. Formulated objectives guided investigation of several variables which impact upon academic integrity, for example the incidence of and student perceptions around academic dishonesty. A quantitative, descriptive survey design was used, with a self-reported questionnaire (based on literature review and study objectives) designed to obtain information about academic dishonesty. Provision was also made for qualitative input from the respondents by including three open-ended questions. It was found that academic dishonesty was a reality at the nursing education institution where this study was done. Cheating associated with plagiarism and assignments was identified as the main problem area. An unacceptably high level of dishonesty in completion of practical records was also an area of concern. The main recommendations are development and implementation of a code of honour and implementation of comprehensive academic integrity policies at the nursing education institution, with practical measures aimed at combating cheating in tests and examinations.

Patient safety initiatives in Central and Eastern Europe: A mixed methods approach by the LINNEAUS collaboration on patient safety in primary care

PubMed Central

Godycki-Cwirko, Maciek; Esmail, Aneez; Dovey, Susan; Wensing, Michel; Parker, Dianne; Kowalczyk, Anna; Błaszczyk, Honorata; Kosiek, Katarzyna

2015-01-01

ABSTRACT Background: Despite patient safety being recognized as an important healthcare issue in the European Union, there has been variable implementation of patient safety initiatives in Central and Eastern Europe (CEE). Objective: To assess the status of patient safety initiatives in countries in CEE; to describe a process of engagement in Poland, which can serve as a template for the implementation of patient safety initiatives in primary care. Methods: A mixed methods design was used. We conducted a review of literature focusing on publications from CEE, an inventory of patient safety initiatives in CEE countries, interviews with key informants, international survey, review of national reporting systems, and pilot demonstrator project in Poland with implementation of patient safety toolkits assessment. Results: There was no published patient safety research from Albania, Belarus, Greece, Latvia, Lithuania, Romania, or Russia. Nine papers were found from Bulgaria, Croatia, the Czech Republic, Poland, Serbia, and Slovenia. In most of the CEE countries, patient safety had been addressed at the policy level although the focus was mainly in hospital care. There was a dearth of activity in primary care. The use of patient improvement strategies was low. Conclusion: International cooperation as exemplified in the demonstrator project can help in the development and implementation of patient safety initiatives in primary care in changing the emphasis away from a blame culture to one where greater emphasis is placed on improvement and learning. PMID:26339839

[Using TRM to Enhance the Accuracy of Ventilator-Associated Pneumonia Preventive Measures Implemented by Neonatal Intensive Care Unit Medical Staffs].

PubMed

Huang, Yu-Ting; Huang, Chao-Ya; Su, Hsiu-Ya; Ma, Chen-Te

2018-06-01

Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in the neonatal intensive care unit (NICU). The average VAP infection density was 4.7‰ in our unit between June and August 2015. The results of a status survey indicated that in-service education lacked specialization, leading to inadequate awareness among staffs regarding the proper care of newborns with VAP and a lack of related care guides. This, in turn, resulted in inconsistencies in care measures for newborns with VAP. To improve the accuracy of implementation of preventive measures for VAP among medical staffs and reduce the density of VAP infections in the NICU. Conduct a literature search and adopt medical team resources management methods; establish effective team communication; establish monitoring mechanisms and incentives; establish mandatory in-service specialization education contents and a VAP preventive care guide exclusively for newborns as a reference for medical staffs during care execution; install additional equipment and aids and set reminders to ensure the implementation of VAP preventive measures. The accuracy rate of preventive measure execution by medical staffs improved from 70.1% to 97.9% and the VAP infection density in the NICU decreased from 4.7‰ to 0.52‰. Team integration effectively improved the accuracy of implementation of VAP-prevention measures, reduced the density of VAP infections, enhanced quality of care, and ensured that newborns received care that was more in line with specialization needs.

Implementation of smoke-free homes in Poland.

PubMed

Kaleta, Dorota; Fronczak, Adam; Usidame, Bukola; Dziankowska-Zaborszczyk, Elżbieta; Makowiec-Dąbrowska, Teresa; Wojtysiak, Piotr

2016-01-01

Exposure to environmental tobacco smoke (ETS) constitutes a threat to the health of many people. In order to diminish ETS exposure, countries (including Poland) implemented legal restrictions of smoking in public places and worksites. Currently more attention is also paid to reduce overall and residential ETS exposure by voluntary smoke-free home policy adoption. The aim of current analysis was to evaluate the prevalence and determinants of implementing smoking bans at place of residence among economically active males and females in Poland. Data from cross-sectional, household study - Global Adult Tobacco Survey (GATS 2009-2010) were analyzed. The logistic regression model was applied for appropriate calculations. Out of 3696 studied subjects only 37.1% adopted total smoking ban within the home. Decreased likelihood of adopting total smoking bans was associated with current smoker status, low education attainment, lack of awareness on adverse health consequences of ETS, low level of support for tobacco control policies, and cohabitation with a smoker in both genders. Having smoke-free homes was also linked with age in women, place of residence and work smoking policy in indoor areas in men. Targeted activities to encourage adopting voluntary smoke-free rules among groups least likely to implement 100% smoking bans in the home and activities to decrease social acceptance of smoking in the presence of nonsmokers, children, pregnant woman are urgently needed. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

[Team approaches to critical bleeding (massive bleeding and transfusion) - chairmen's introductory remarks. Questionnaire survey on current status of hospital clinical laboratories evaluating critical hemorrhage].

PubMed

Kino, Shuichi; Suwabe, Akira

2014-12-01

In 2007, "the Guidelines for Actions against Intraoperative Critical Hemorrhage" were established by the Japanese Society of Anaesthesiologists and the Japanese Society of Blood transfusion and Cell Therapy. The documentation of in-hospital procedures for critical hemorrhage, especially about how to select RBC units, has widely standardized hospital practice. Patients with intraoperative critical hemorrhage sometimes suffer from massive blood loss. In this situation, some patients develop coagulopathy. To treat them, we need to evaluate their coagulation status based on laboratory test results. So, we performed a nationwide questionnaire survey on the current status of hospital clinical laboratories evaluating critical hemorrhage. From the results of this survey, it was recommended that central hospital laboratories should try to reduce the turn-around time required to test for coagulation parameters as much as possible for appropriate substitution therapy. (Review).

The ketogenic diet as broad-spectrum treatment for super-refractory pediatric status epilepticus: challenges in implementation in the pediatric and neonatal intensive care units.

PubMed

Cobo, Nicole H; Sankar, Raman; Murata, Kristina K; Sewak, Sarika L; Kezele, Michele A; Matsumoto, Joyce H

2015-02-01

Refractory status epilepticus carries significant morbidity and mortality. Recent reports have promoted the use of the ketogenic diet as an effective treatment for refractory status epilepticus. We describe our recent experience with instituting the ketogenic diet for 4 critically ill children in refractory status epilepticus, ranging in age from 9 weeks to 13.5 years after failure of traditional treatment. The ketogenic diet allowed these patients to be weaned off continuous infusions of anesthetics without recurrence of status epilepticus, though delayed ketosis and persistently elevated glucose measurements posed special challenges to effective initiation, and none experienced complete seizure cessation. The ease of sustaining myocardial function with fatty acid energy substrates compares favorably over the myocardial toxicity posed by anesthetic doses of barbiturates and contributes to the safety profile of the ketogenic diet. The ketogenic diet can be implemented successfully and safely for the treatment of refractory status epilepticus in pediatric patients. © The Author(s) 2014.

Investigating the roots of successful IT adoption processes - an empirical study exploring the shared awareness-knowledge of Directors of Nursing and Chief Information Officers.

PubMed

Liebe, J D; Hüsers, J; Hübner, U

2016-01-27

The majority of health IT adoption research focuses on the later stages of the IT adoption process: namely on the implementation phase. The first stage, however, which is defined as the knowledge-stage, remains widely unobserved. Following Rogers' Diffusion of Innovation Theory (DOI) this paper presents a research framework to examine the possible lack of shared IT awareness-knowledge, i.e. an information gradient, of two crucial stakeholders, the Chief Information Officer (CIO) and the Director of Nursing (DoN). This study shall answer the following research questions: (1.) Does this gradient exist? (2.) Which direction does it have? (3.) Are certain health IT (HIT) attributes associated with a potential gradient? (4.) Which determinants of diffusion go along with this gradient? Results of two surveys that focused on the topic "IT support of clinical workflows" from the viewpoint of CIOs and DoNs with corresponding datasets from 75 hospitals were used in a secondary data analysis. The gradient was operationalised by measuring the disagreement of CIOs and DoNs on the availability and implementation status of 29 IT functions. HIT attributes tested were relevance and market penetration of the IT functions, determinants of diffusion were inter-professional leadership and IT service density. The analysis revealed a significant disagreement on the availability of 9 out of 29 HIT functions. In 23 HIT functions, the CIOs reported a higher implementation status than the DoNs, which pointed to a trend for a unidirectional gradient. The disagreement was significantly lower when the relevance of the IT function was high. Both determinants of diffusion correlated significantly negative with the degree of disagreement. This is the first study to empirically examine shared awareness-knowledge of two IT-stakeholders that are crucial for triggering IT adoption on the frontline level in hospitals. It could be shown that a gradient and thus a lack of shared awareness-knowledge existed and was associated with certain factors. In conclusion, hospitals should implement improved cooperation between IT staff and clinicians and IT service density when establishing the prerequisites for successful IT adoption processes.