Explaining suicide in an urban slum of Mumbai, India: a sociocultural autopsy.

PubMed

Parkar, Shubhangi R; Nagarsekar, Balkrishna; Weiss, Mitchell G

2009-01-01

Health demographic mortality studies use verbal autopsies to identify suicide as a cause of death. Psychological autopsies focus almost exclusively on associated high-risk psychiatric disorders. New approaches considering contextual factors are needed for preventing suicide and promoting mental health. This study examined explanations of suicide reported by surviving family members or close friends with reference to social, cultural, and environmental conditions as well as the challenges of life in the Malavani slum of Mumbai. An EMIC (Explanatory Model Interview Catalog) interview based on a cultural epidemiological framework considered underlying problems, perceived causes, and sociocultural contexts. It was administered to survivors of 76 people who had died by suicide (56.6% women). Accounts of underlying problems typically referred to various aspects of tension (73.7%). Perceived causes often identified multiple factors. The sociocultural contexts of suicide included the victimization of women, the personal and social impact of problem drinking, marital problems, physical health problems, mental tension, possession and sorcery. Women were particularly vulnerable to the impact of problem drinking by a spouse or father. This study demonstrates the value of an approach to sociocultural autopsy examining local contexts and explanations of suicide. Findings highlight needs for both mental health services and culturally sensitive social interventions.

Urea formaldehyde foam: a dangerous insulation

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

Keough, C.

1980-12-01

Insulating a home with urea formaldehyde foam can lead to severe health problems due to poisoning from formaldehyde gas. Respiratory problems, allergies, memory loss, and mental problems can result from exposure to foam insulation fumes. Research is now under way at the Chemical Industry Inst., Univ. of Washington, and other institutions to learn more about the health effects of formaldehyde foam and to develop possible remedies to these problems. Several states are either banning or controlling the use of this type of home insulation.

Rediscovering Recovery: Reconceptualizing Underlying Assumptions of Citizenship and Interrelated Notions of Care and Support

PubMed Central

Vandekinderen, Caroline; Roets, Griet; Roose, Rudi; Van Hove, Geert

2012-01-01

Over the last few decades, research, policy, and practice in the field of mental health care and a complementary variety of social work and social service delivery have internationally concentrated on recovery as a promising concept. In this paper, a conceptual distinction is made between an individual approach and a social approach to recovery, and underlying assumptions of citizenship and interrelated notions and features of care and support are identified. It is argued that the conditionality of the individual approach to recovery refers to a conceptualization of citizenship as normative, based on the existence of a norm that operates in every domain of our society. We argue that these assumptions place a burden of self-governance on citizens with mental health problems and risk producing people with mental health problems as nonrecyclable citizens. The social approach to recovery embraces a different conceptualization of citizenship as relational and inclusive and embodies the myriad ways in which the belonging of people with mental health problems can be constructed in practice. As such, we hope to enable social services and professionals in the field to balance their role in the provision of care and support to service users with mental health problems. PMID:23326216

Gender, sexual health and reproductive health promotion.

PubMed

Moeti, M R

1995-01-01

The underlying factors of poverty, migration, marginalization, lack of information and skills, disempowerment, and poor access to services which affect HIV/STD risk are also closely related to those which affect sexual and reproductive health. Reproductive health problems include unplanned and unwanted pregnancies, unsafe abortions, pregnancy-related illness and death, and STDs including HIV/AIDS. This interrelationship between factors is leading increasingly to the integration of HIV/STD education and prevention within the broader framework of sexual and reproductive health promotion. Such intervention allows the possible reinforcement of the impact of interventions upon important underlying factors and behaviors linked to individual, family, and community vulnerability to HIV/STDs as well as other reproductive health problems. Integration will also optimize the use of increasingly scarce resources and increase the likelihood of responses, interventions, and programs being sustainable. Sexual and reproductive health, placing HIV/STD prevention into context, and focus upon men are discussed.

Insufficient coping behavior under chronic stress and vulnerability to psychiatric disorders.

PubMed

Mohr, Christine; Braun, Silke; Bridler, René; Chmetz, Florian; Delfino, Juan P; Kluckner, Viktoria J; Lott, Petra; Schrag, Yann; Seifritz, Erich; Stassen, Hans H

2014-01-01

Epidemiological data indicate that 75% of subjects with major psychiatric disorders have their onset of illness in the age range of 17-24 years. An estimated 35-50% of college and university students drop out prematurely due to insufficient coping skills under chronic stress, while 85% of students receiving a psychiatric diagnosis withdraw from college/university prior to the completion of their education. In this study, we aimed at developing standardized means of identifying students with insufficient coping skills under chronic stress and at risk for mental health problems. A sample of 1,217 college students from 3 different sites in the USA and Switzerland completed 2 self-report questionnaires: the Coping Strategies Inventory (COPE) and the Zurich Health Questionnaire (ZHQ), which assesses 'regular exercises', 'consumption behavior', 'impaired physical health', 'psychosomatic disturbances' and 'impaired mental health'. The data were subjected to structure analyses by means of a neural network approach. We found 2 highly stable and reproducible COPE scales that explained the observed interindividual variation in coping behavior sufficiently well and in a socioculturally independent way. The scales reflected basic coping behavior in terms of 'activity-passivity' and 'defeatism-resilience', and in the sense of stable, socioculturally independent personality traits. Correlation analyses carried out for external validation revealed a close relationship between high scores on the defeatism scale and impaired physical and mental health. This underlined the role of insufficient coping behavior as a risk factor for physical and mental health problems. The combined COPE and ZHQ instruments appear to constitute powerful screening tools for insufficient coping skills under chronic stress and for risks of mental health problems.

[Economic problems in military public health].

PubMed

Petrov, G M; Moretskiĭ, A A

2000-03-01

There are discussed the problems of military treatment and prophylactic institution (TPI) functioning under conditions of market reform of Russian public health. Main marketing concepts in military health are determined and some recommendations on work improvement in TPI of the Armed Forces in the system of obligatory medical insurance are presented, granting population paid medical services. It is necessary to form a new type of director--military and medical manager.

Treatment for Sleep Problems in Children with Autism and Caregiver Spillover Effects

ERIC Educational Resources Information Center

Tilford, J. Mick; Payakachat, Nalin; Kuhlthau, Karen A.; Pyne, Jeffrey M.; Kovacs, Erica; Bellando, Jayne; Williams, D. Keith; Brouwer, Werner B. F.; Frye, Richard E.

2015-01-01

Sleep problems in children with autism spectrum disorders (ASD) are under-recognized and under-treated. Identifying treatment value accounting for health effects on family members (spillovers) could improve the perceived cost-effectiveness of interventions to improve child sleep habits. A prospective cohort study (N = 224) was conducted with…

Perceptions of caregivers about health and nutritional problems and feeding practices of infants: a qualitative study on exclusive breast-feeding in Kwale, Kenya

PubMed Central

2013-01-01

Background Despite the significant positive effect of exclusive breast-feeding on child health, only 32% of children under 6 months old were exclusively breast-fed in Kenya in 2008. The aim of this study was to explore perceptions and feeding practices of caregivers of children under 6 months old with special attention to the caregivers’ indigenous knowledge, perceptions about the health and nutritional problems of their infants, and care-seeking behaviors that affect feeding practices. Methods The study was exploratory and used an inductive approach. In all, 32 key informants, including mothers, mothers-in-law, and traditional healers, were interviewed in-depth. The number of participants in free-listing of perceived health problems of babies, in ranking of the perceived severity of these health problems, and in free-listing of food and drink given to children under 6 months old were 29, 28, and 32, respectively. Additionally, 28 babies under 6 months old were observed at home with regard to feeding practices. Data obtained using these methods were triangulated to formulate an ethnomedical explanatory model for mothers who do not practice exclusive breast-feeding. Results The informants stated that various types of food, drink, and medicine were given to infants under 6 months old. Direct observation also confirmed that 2- to 3-month-old babies were given porridge, water, juice, herbal medicine, and over-the-counter medicine. Mothers’ perceptions of insufficient breast milk production and a lack of proper knowledge about the value of breast milk were identified in key informant interviews, free-listing, and ranking as important factors associating with the use of food and drink other than breast milk; in addition, perceived ill health of babies appears to be associated with suboptimal practice of exclusive breast-feeding. Caregivers used various folk and popular medicines from the drugstore, their own backyard or garden, and traditional healers so that the mother or child would not be exposed to perceived risks during the vulnerable period after birth. Conclusions Mothers should be advised during their antenatal and postnatal care about exclusive breast-feeding. This should be done not as a single vertical message, but in relation to their concerns about the health and nutritional problems of their babies. PMID:23721248

Perceptions of caregivers about health and nutritional problems and feeding practices of infants: a qualitative study on exclusive breast-feeding in Kwale, Kenya.

PubMed

Matsuyama, Akiko; Karama, Mohamed; Tanaka, Junichi; Kaneko, Satoshi

2013-05-30

Despite the significant positive effect of exclusive breast-feeding on child health, only 32% of children under 6 months old were exclusively breast-fed in Kenya in 2008. The aim of this study was to explore perceptions and feeding practices of caregivers of children under 6 months old with special attention to the caregivers' indigenous knowledge, perceptions about the health and nutritional problems of their infants, and care-seeking behaviors that affect feeding practices. The study was exploratory and used an inductive approach. In all, 32 key informants, including mothers, mothers-in-law, and traditional healers, were interviewed in-depth. The number of participants in free-listing of perceived health problems of babies, in ranking of the perceived severity of these health problems, and in free-listing of food and drink given to children under 6 months old were 29, 28, and 32, respectively. Additionally, 28 babies under 6 months old were observed at home with regard to feeding practices. Data obtained using these methods were triangulated to formulate an ethnomedical explanatory model for mothers who do not practice exclusive breast-feeding. The informants stated that various types of food, drink, and medicine were given to infants under 6 months old. Direct observation also confirmed that 2- to 3-month-old babies were given porridge, water, juice, herbal medicine, and over-the-counter medicine. Mothers' perceptions of insufficient breast milk production and a lack of proper knowledge about the value of breast milk were identified in key informant interviews, free-listing, and ranking as important factors associating with the use of food and drink other than breast milk; in addition, perceived ill health of babies appears to be associated with suboptimal practice of exclusive breast-feeding. Caregivers used various folk and popular medicines from the drugstore, their own backyard or garden, and traditional healers so that the mother or child would not be exposed to perceived risks during the vulnerable period after birth. Mothers should be advised during their antenatal and postnatal care about exclusive breast-feeding. This should be done not as a single vertical message, but in relation to their concerns about the health and nutritional problems of their babies.

Using mHealth technologies to improve the identification of behavioral health problems in urban primary care settings.

PubMed

Staeheli, Martha; Aseltine, Robert H; Schilling, Elizabeth; Anderson, Daren; Gould, Bruce

2017-01-01

Behavioral health disorders remain under recognized and under diagnosed among urban primary care patients. Screening patients for such problems is widely recommended, yet is challenging to do in a brief primary care encounter, particularly for this socially and medically complex patient population. In 2013, intervention patients at an urban Connecticut primary clinic were screened for post-traumatic stress disorder, depression, and risky drinking (n = 146) using an electronic tablet-based screening tool. Screening data were compared to electronic health record data from control patients (n = 129) to assess differences in the prevalence of behavioral health problems, rates of follow-up care, and the rate of newly identified cases in the intervention group. Results from logistic regressions indicated that both groups had similar rates of disorder at baseline. Patients in the intervention group were five times more likely to be identified with depression (p < 0.05). Post-traumatic stress disorder was virtually unrecognized among controls but was observed in 23% of the intervention group (p < 0.001). The vast majority of behavioral health problems identified in the intervention group were new cases. Follow-up rates were significantly higher in the intervention group relative to controls, but were low overall. This tablet-based electronic screening tool identified significantly higher rates of behavioral health disorders than have been previously reported for this patient population. Electronic risk screening using patient-reported outcome measures offers an efficient approach to improving the identification of behavioral health problems and improving rates of follow-up care.

Mental health problems of undocumented migrants in the Netherlands: A qualitative exploration of recognition, recording, and treatment by general practitioners.

PubMed

Teunissen, Erik; Van Bavel, Eric; Van Den Driessen Mareeuw, Francine; Macfarlane, Anne; Van Weel-Baumgarten, Evelyn; Van Den Muijsenbergh, Maria; Van Weel, Chris

2015-06-01

To explore the views and experiences of general practitioners (GPs) in relation to recognition, recording, and treatment of mental health problems of undocumented migrants (UMs), and to gain insight in the reasons for under-registration of mental health problems in the electronic medical records. Qualitative study design with semi-structured interviews using a topic guide. Sixteen GPs in the Netherlands with clinical expertise in the care of UMs. GPs recognized many mental health problems in UMs. Barriers that prevented them from recording these problems and from delivering appropriate care were their low consultation rates, physical presentation of mental health problems, high number of other problems, the UM's lack of trust towards health care professionals, and cultural differences in health beliefs and language barriers. Referrals to mental health care organizations were often seen as problematic by GPs. To overcome these barriers, GPs provided personalized care as far as possible, referred to other primary care professionals such as social workers or mental health care nurses in their practice, and were a little less restrictive in prescribing psychotropics than guidelines recommended. GPs experienced a variety of barriers in engaging with UMs when identifying or suspecting mental health problems. This explains why there is a gap between the high recognition of mental health problems and the low recording of these problems in general practice files. It is recommended that GPs address mental health problems more actively, strive for continuity of care in order to gain trust of the UMs, and look for opportunities to provide mental care that is accessible and acceptable for UMs.

Malnutrition in healthcare institutions: a review of the prevalence of under-nutrition in hospitals and care homes since 1994 in England.

PubMed

Ray, Sumantra; Laur, Celia; Golubic, Rajna

2014-10-01

One in four hospital patients in the UK are estimated to be affected by 'hospital malnutrition' (under-nutrition). There is a need for robust epidemiological data relating to the frequency, distribution and determinants of this clinical problem of public health importance. This review aims to undertake a narrative synthesis of data on the descriptive epidemiology of under-nutrition, and to address some of the methodological limitations. A methodical review of literature was undertaken, tracking the reported prevalence and incidence of under-nutrition in hospital, in the UK, since 1994. The 16 articles retrieved and reviewed demonstrate that nutrition in hospital is a long standing problem in UK hospitals and care homes. The existing literature is comprised mainly of cross-sectional surveys describing the prevalence of under-nutrition in hospital which ranges from 11 to 45%. There is considerable heterogeneity in the published literature on hospital malnutrition (under-nutrition) and very few studies either measure or have estimated incidence. Under-nutrition in hospital continues to be under-addressed, yet a major public health problem in the UK. Defining the descriptive epidemiology of this problem is one of the first steps towards understanding its aetiology or planning and evaluating appropriate prevention or treatment strategies. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Pathways to potentially preventable hospitalizations for diabetes and heart failure: a qualitative analysis of patient perspectives.

PubMed

Sentell, Tetine L; Seto, Todd B; Young, Malia M; Vawer, May; Quensell, Michelle L; Braun, Kathryn L; Taira, Deborah A

2016-07-26

Potentially preventable hospitalizations (PPH) for heart failure (HF) and diabetes mellitus (DM) cost the United States over $14 billion annually. Studies about PPH typically lack patient perspectives, especially across diverse racial/ethnic groups with known PPH health disparities. English-speaking individuals with a HF or DM-related PPH (n = 90) at the largest hospital in Hawai'i completed an in-person interview, including open-ended questions on precipitating factors to their PPH. Using the framework approach, two independent coders identified patient-reported factors and pathways to their PPH. Seventy-two percent of respondents were under 65 years, 30 % were female, 90 % had health insurance, and 66 % had previously been hospitalized for the same problem. Patients' stories identified immediate, precipitating, and underlying reasons for the admission. Underlying background factors were critical to understanding why patients had the acute problems necessitating their hospitalizations. Six, non-exclusive, underlying factors included: extreme social vulnerability (e.g., homeless, poverty, no social support, reported by 54 % of respondents); health system interaction issues (e.g., poor communication with providers, 44 %); limited health-related knowledge (42 %); behavioral health issues (e.g., substance abuse, mental illness, 36 %); denial of illness (27 %); and practical problems (e.g., too busy, 6 %). From these findings, we developed a model to understand an individual's pathways to a PPH through immediate, precipitating, and underlying factors, which could help identify potential intervention foci. We demonstrate the model's utility using five examples. In a young, predominately insured population, factors well outside the traditional purview of the hospital, or even clinical medicine, critically influenced many PPH. Patient perspectives were vital to understanding this issue. Innovative partnerships and policies should address these issues, including linkages to social services and behavioral health.

Family Conflict, Emotional Security, and Child Development: Translating Research Findings into a Prevention Program for Community Families

ERIC Educational Resources Information Center

Cummings, E. Mark; Schatz, Julie N.

2012-01-01

The social problem posed by family conflict to the physical and psychological health and well-being of children, parents, and underlying family relationships is a cause for concern. Inter-parental and parent-child conflict are linked with children's behavioral, emotional, social, academic, and health problems, with children's risk particularly…

Hawaii's public mental health system.

PubMed

VanderVoort, Debra J

2005-03-01

The following article addresses the nature of and problems with the public mental health system in Hawaii. It includes a brief history of Hawaii's public mental health system, a description and analysis of this system, economic factors affecting mental health, as well as a needs assessment of the elderly, individuals with severe mental illness, children and adolescents, and ethnically diverse individuals. In addition to having the potential to increase suicide rates and unnecessarily prolong personal suffering, problems in the public mental health system such as inadequate services contribute to an increase in social problems including, but not limited to, an increase in crime rates (e.g., domestic violence, child abuse), divorce rates, school failure, and behavioral problems in children. The population in need of mental health services in Hawaii is under served, with this inadequacy of services due to economic limitations and a variety of other factors.

[Current problems in price formation in public health].

PubMed

Poliakov, I V; Uvarov, S A; Seleznev, V D; Zelenskaia, T M

1996-01-01

Adequate policy of price formation is one condition for effective development of public health under conditions of market economy. The authors present the fundamentals of price formation in public health under conditions of state financing, insurance, and self-support. Price formation should promote the activities of public health institutions, aimed at improving the quality of medical aid to the population and at the creation of conditions for the welfare of medical workers.

Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals.

PubMed

Thompson, Tess; Kreuter, Matthew W; Boyum, Sonia

2016-04-01

Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g., housing). Callers to 2-1-1 in Missouri (N= 1,090) with at least one behavioral risk factor or cancer screening need were randomly assigned to one of three health referral interventions: verbal referrals only, verbal referrals + a tailored mailed reminder, or verbal referrals + telephone health navigator. After 1 month, we assessed whether the nonhealth problems that prompted the 2-1-1 call had been resolved. Logistic regression estimated effects of having the problem resolved on calling a health referral. Callers were predominantly female (85%) and had a high school education or less (61%); nearly half (47%) had incomes under $10,000. The most common service requests were for utility assistance (35%), home/family problems (23%), and rent/mortgage assistance (12%). At follow-up, 38% of callers reported that all problems prompting their 2-1-1 call had been resolved, and 24% reported calling a health referral. Resolving all problems prompting the 2-1-1 call was associated with a higher odds of contacting a health referral (odds ratio = 1.44, 95% confidence interval [1.02, 2.05]) compared to people whose problems were not resolved. Multifaceted interventions that help meet non-health-related needs and provide support in reaching health-related goals may promote health in vulnerable populations. © 2015 Society for Public Health Education.

Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals

PubMed Central

Thompson, Tess; Kreuter, Matthew; Boyum, Sonia

2016-01-01

Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g. housing). Callers to 2-1-1 in Missouri (N=1090) with at least one behavioral risk factor or cancer screening need were randomly assigned to one of three health referral interventions: verbal referrals only, verbal referrals + a tailored mailed reminder, or verbal referrals + telephone health navigator. After one month, we assessed whether the non-health problems that prompted the 2-1-1 call had been resolved. Logistic regression estimated effects of having the problem resolved on calling a health referral. Callers were predominantly female (85%) and had a high school education or less (61%); nearly half (47%) had incomes under $10,000. The most common service requests were for utility assistance (35%), home/family problems (23%), and rent/mortgage assistance (12%). At follow-up, 38% of callers reported that all problems prompting their 2-1-1 call had been resolved, and 24% reported calling a health referral. Resolving all problems prompting the 2-1-1 call was associated with a higher odds of contacting a health referral (OR = 1.44, 95% CI 1.02-2.05) compared to people whose problems were not resolved. Multifaceted interventions that help meet non-health-related needs and provide support in reaching health-related goals may promote health in vulnerable populations. PMID:26293458

Directions in Mental Health Counseling, 1992.

ERIC Educational Resources Information Center

Directions in Mental Health Counseling, 1992

1992-01-01

A collection of 12 lessons, this volume covers a wide range of concerns in mental health counseling. Each piece begins with an editorial comment, followed by an introduction which outlines the scope of the problem under consideration. The main body of each paper presents a clear, easily understood analysis of the subject under consideration. A…

Directions in Mental Health Counseling, 1991.

ERIC Educational Resources Information Center

Directions in Mental Health Counseling, 1991

1991-01-01

A collection of 12 lessons, this volume covers a wide range of concerns in mental health counseling. Each piece begins with an editorial comment, followed by an introduction which outlines the scope of the problem under consideration. The main body of each lesson presents an analysis of the subject under consideration. A list of further sources…

Pairing Nurses and Social Workers in Schools: North Carolina's School-Based Child and Family Support Teams

ERIC Educational Resources Information Center

Gifford, Elizabeth J.; Wells, Rebecca; Bai, Yu; Troop, Tony O.; Miller, Shari; Babinski, Leslie M.

2010-01-01

When children are struggling in school, underlying causes often include physical or behavioral health problems, poverty, abuse, and/or neglect. Children's poor physical health status has been linked to deficits in memory and reading ability. Children with behavioral problems are much more likely than others to have lower grades, miss school, be…

Association of Adolescent Dimensional Borderline Personality Pathology with Past and Current Nonsuicidal Self-Injury and Lifetime Suicidal Behavior: A Clinical Multicenter Study.

PubMed

Kaess, Michael; Brunner, Romuald; Parzer, Peter; Edanackaparampil, Manju; Schmidt, Johannes; Kirisgil, Melek; Fischer, Gloria; Wewetzer, Christoph; Lehmkuhl, Gerd; Resch, Franz

Descriptive diagnoses of nonsuicidal self-injury (NSSI) and suicide attempts (SAs) may detract from underlying dimensional borderline personality pathology (D-BPP). This study aimed to investigate D-BPP in adolescent inpatients with NSSI and SAs. A consecutive sample of 359 adolescent inpatients was assessed for current and past NSSI and life-time SAs. D-BPP and current mental health problems were measured using the Dimensional Assessment of Personality Pathology and the Strengths and Difficulties Questionnaire, respectively. D-BPP was significantly associated with both current (p < 0.001) and past NSSI (p = 0.025) and life-time SAs (p < 0.001) compared to their non-self-harming peers. Patients with current and past NSSI did not differ in terms of D-BPP or current mental health problems. A multivariate model did not show any additional influence of current mental health problems over and above D-BPP in predicting NSSI and SAs. It can be hypothesized that D-BPP underlies adolescent self-harm and may persist even after its termination, promoting a higher burden of mental health problems. © 2016 S. Karger AG, Basel.

The politics of public health policy.

PubMed

Oliver, Thomas R

2006-01-01

Politics, for better or worse, plays a critical role in health affairs. The purpose of this article is to articulate a role for political analysis of public health issues, ranging from injury and disease prevention to health care reform. It begins by examining how health problems make it onto the policy agenda. Perceptions regarding the severity of the problem, responsibility for the problem, and affected populations all influence governmental responses. Next, it considers how bounded rationality, fragmented political institutions, resistance from concentrated interests, and fiscal constraints usually lead political leaders to adopt incremental policy changes rather than comprehensive reforms even when faced with serious public health problems. It then identifies conditions under which larger-scale transformation of health policy can occur, focusing on critical junctures in policy development and the role of policy entrepreneurs in seizing opportunities for innovation. Finally, it reviews the challenges confronting officials and agencies who are responsible for implementing and administering health policies. Public health professionals who understand the political dimensions of health policy can conduct more realistic research and evaluation, better anticipate opportunities as well as constraints on governmental action, and design more effective policies and programs.

Planning continuing training.

PubMed

Nacef, T; Argellies, J L

1982-01-01

Suggests new direction in the approach to planning continued training of medical personnel. Under this new scheme, health problems themselves will be the sole basis for the planning of the continuing training program. This approach assures the involvement of health professionals at various levels and fosters a multiprofessional involvement in continuing training. It is also recommended that the preventive aspects of medicine be stressed far more than is typical of traditional hospital services. The method for decision making in program planning includes 6 steps: 1) choice of health problem to be solved (includes considerations of severity of the problems and the degree to which continuing training will be of value); 2) analysis of the number and type of health personnel needed; 3) determination of desired skill acquisition; 4) analysis of teaching/educational requirements; 5) inventory of resources (time, facilities, staff, instructional materials) available; 6) evaluation. Coordination at different levels, both national and regional, ensures the cohesion of the multiprofessional continuing training system. Regional cell groups, composed of 2 paramedicals and a doctor administer continuing training sessions under policy established at a national level by a national advisory committee. This approach makes continuing training an important and immediate component of health policy aimed at delivering basic health services to the entire population.

Diagnostic Accuracy of the Work Functioning Impairment Scale (WFun): A Method to Detect Workers Who Have Health Problems Affecting their Work and to Evaluate Fitness for Work.

PubMed

Nagata, Tomohisa; Fujino, Yoshihisa; Saito, Kumi; Uehara, Masamichi; Oyama, Ichiro; Izumi, Hiroyuki; Kubo, Tatsuhiko

2017-06-01

This study evaluated the diagnostic accuracy of the Work Functioning Impairment Scale (WFun), a questionnaire to detect workers with health problems which affect their work, using an assessment by an occupational health nurse as objective standard. The WFun was completed by 294 employees. The nurse interviewed to assess 1) health problems; 2) effects of health on their work; necessity for 3) treatment, 4) health care instruction, and 5) consideration of job accommodation. The odds ratio in the high work functioning impairment group compared with the low was highly statistically significant with 9.05, 10.26, 5.77, 9.37, and 14.70, respectively. The WFun demonstrated the high detectability with an area under the receiver operating characteristic of 0.75, 0.81, 0.72, 0.79, and 0.83, respectively. This study suggests that the WFun is useful in detecting those who have health problems affecting their work.

Insurance Protection for Catastrophic Health Expenses for Individuals under Age 65. Hearings before the Subcommittee on Health of the Committee on Ways and Means. House of Representatives, One Hundredth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Ways and Means.

The hearing reported in this document sought to obtain information concerning the nature and extent of the problem of Americans who do not have financial access to necessary health services and are at risk for catastrophic expenses, and to examine possible solutions to the problem. Witnesses included representatives from American Airlines, the…

Drinking to Excess: Recognize and Treat Alcohol Problems

MedlinePlus

... injury and accidents, disease, and other health problems. Heavy drinking is one of the leading causes of ... shown effective at reducing alcohol craving in many heavy drinkers. Additional medications are under study as possible ...

The influence of chronic health problems and work-related factors on loss of paid employment among older workers.

PubMed

Leijten, Fenna R M; de Wind, Astrid; van den Heuvel, Swenne G; Ybema, Jan Fekke; van der Beek, Allard J; Robroek, Suzan J W; Burdorf, Alex

2015-11-01

With an ageing society and increasing retirement ages, it is important to understand how employability can be promoted in older workers with health problems. The current study aimed to determine whether (1) different chronic health problems predict transitions from paid employment to disability benefits, unemployment and early retirement, and (2) how work-related factors modify these associations. Self-report questionnaire data was used from the Dutch longitudinal Study on Transitions in Employment, Ability and Motivation with 3 years of follow-up (2010-2013), among employees aged 45-64 years (N=8149). The influence of baseline chronic health problems and work-related factors on transitions from paid employment to disability benefits, unemployment and early retirement during follow-up was estimated in a competing risks proportional hazards model. Relative excess risk of transitions due to the interaction between chronic health problems and work-related factors was assessed. Severe headache, diabetes mellitus and musculoskeletal, respiratory, digestive and psychological health problems predicted an increased risk of disability benefits (HR range 1.78-2.79). Circulatory (HR=1.35) and psychological health problems (HR=2.58) predicted unemployment, and musculoskeletal (HR=1.23) and psychological health problems (HR=1.57) predicted early retirement. Work-related factors did not modify the influence of health problems on unemployment or early retirement. Psychosocial work-related factors, especially autonomy, modified the influence of health problems on disability benefits. Specifically, among workers with health problems, higher autonomy, higher support and lower psychological job demands reduced the risk of disability benefits by 82%, 49%, and 11%, respectively. All health problems affected disability benefits to a similar extent, but psychological health problems especially predicted unemployment and early retirement. For older workers with health problems, promoting an optimal work environment has the potential to contribute to sustainable employment. 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.

Adolescent mental health and earnings inequalities in adulthood: evidence from the Young-HUNT Study.

PubMed

Evensen, Miriam; Lyngstad, Torkild Hovde; Melkevik, Ole; Reneflot, Anne; Mykletun, Arnstein

2017-02-01

Previous studies have shown that adolescent mental health problems are associated with lower employment probabilities and risk of unemployment. The evidence on how earnings are affected is much weaker, and few have addressed whether any association reflects unobserved characteristics and whether the consequences of mental health problems vary across the earnings distribution. A population-based Norwegian health survey linked to administrative registry data (N=7885) was used to estimate how adolescents' mental health problems (separate indicators of internalising, conduct, and attention problems and total sum scores) affect earnings (≥30 years) in young adulthood. We used linear regression with fixed-effects models comparing either students within schools or siblings within families. Unconditional quantile regressions were used to explore differentials across the earnings distribution. Mental health problems in adolescence reduce average earnings in adulthood, and associations are robust to control for observed family background and school fixed effects. For some, but not all mental health problems, associations are also robust in sibling fixed-effects models, where all stable family factors are controlled. Further, we found much larger earnings loss below the 25th centile. Adolescent mental health problems reduce adult earnings, especially among individuals in the lower tail of the earnings distribution. Preventing mental health problems in adolescence may increase future earnings. 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/.

Self-recognition of mental health problems in a rural Australian sample.

PubMed

Handley, Tonelle E; Lewin, Terry J; Perkins, David; Kelly, Brian

2018-06-01

Although mental health literacy has increased in recent years, mental illness is often under-recognised. There has been little research conducted on mental illness in rural areas; however, this can be most prominent in rural areas due to factors such as greater stigma and stoicism. The aim of this study is to create a profile of those who are most and least likely to self-identify mental health problems among rural residents with moderate- to-high psychological distress. Secondary analysis of a longitudinal postal survey. Rural and remote New South Wales, Australia. Four-hundred-and-seventy-two community residents. Participants completed the K10 Psychological Distress Scale, as well as the question 'In the past 12 months have you experienced any mental health problems?' The characteristics of those who reported moderate/high distress scores were explored by comparing those who did and did not experience mental health problems recently. Of the 472 participants, 319 (68%) with moderate/high distress reported a mental health problem. Reporting a mental health problem was higher among those with recent adverse life events or who perceived more stress from life events while lower among those who attributed their symptoms to a physical cause. Among a rural sample with moderate/high distress, one-third did not report a mental health problem. Results suggest a threshold effect, whereby mental health problems are more likely to be acknowledged in the context of additional life events. Ongoing public health campaigns are necessary to ensure that symptoms of mental illness are recognised in the multiple forms that they take. © 2018 National Rural Health Alliance Ltd.

Nail Ridges: Cause for Concern?

MedlinePlus

... of a health problem? Answers from Lawrence E. Gibson, M.D. It depends on the direction of ... indicate an underlying health condition. With Lawrence E. Gibson, M.D. Habif TP. Nail diseases. In: Clinical ...

University staff experiences of students with mental health problems and their perceptions of staff training needs.

PubMed

Gulliver, Amelia; Farrer, Louise; Bennett, Kylie; Ali, Kathina; Hellsing, Annika; Katruss, Natasha; Griffiths, Kathleen M

2018-06-01

University students experience high levels of mental health problems; however, very few seek professional help. Teaching staff within the university are well placed to assist students to seek support. To investigate university teaching staff experiences of, and training needs around, assisting students with mental health problems. A total of 224 teaching staff at the Australian National University completed an anonymous online survey (16.4% response rate from n ∼ 1370). Data on mental health training needs, and experiences of assisting students with mental health problems were described using tabulation. Qualitative data were analysed using thematic analysis. Most teaching staff (70.1-82.2%) reported at least moderate confidence in their ability to provide emotional support for students. However, many staff (60.0%) felt under-equipped overall to deal with student mental health problems; almost half (49.6%) reported they did not have access to formal training. Specific actions described in assisting students included referrals, offering support, or consulting others for advice. Given the high rates of students who approach staff about mental health problems, there is a critical need to provide and promote both formal mental health response training and explicit guidelines for staff on when, how, and where to refer students for help.

Can items used in 4-year-old well-child visits predict children's health and school outcomes?

PubMed

Smithers, Lisa G; Chittleborough, Catherine R; Stocks, Nigel; Sawyer, Michael G; Lynch, John W

2014-08-01

To examine whether items comprising a preschool well-child check for use by family doctors in Australia with 4-5-year old children predicts health and academic outcomes at 6-7 years. The well-child check includes mandatory (anthropometry, eye/vision, ear/hearing, dental, toileting, allergy problems) and non-mandatory (processed food consumption, low physical activity, motor, behaviour/mood problems) items. The predictive validity of mandatory and non-mandatory items measured at 4-5 years was examined using data from the Longitudinal Study of Australian Children. Outcomes at 6-7 years included overweight/obesity, asthma, health care/medication needs, general health, mental health problems, quality of life, teacher-reported mathematics and literacy ability (n = 2,280-2,787). Weight or height >90th centile at 4-5 years predicted overweight/obesity at 6-7 years with 60% sensitivity, 79% specificity and 40% positive predictive value (PPV). Mood/behaviour problems at 4-5 predicted mental health problems at 6-7 years with 86% sensitivity, 40% specificity and 8% PPV. Non-mandatory items improved the discrimination between children with and without mental health problems at 6-7 years (area under the receiver operating characteristic curve 0.75 compared with 0.69 for mandatory items only), but was weak for most outcomes. Items used in a well-child health check were moderate predictors of overweight/obesity and mental health problems at 6-7 years, but poor predictors of other health and academic outcomes.

Academic Failure in Secondary School: The Inter-Related Role of Health Problems and Educational Context.

PubMed

Needham, Belinda L; Crosnoe, Robert; Muller, Chandra

2004-01-01

This study explores whether the interplay of health problems and school environment predicts academic failure, an individual event with consequences for the life course, as well as for society at large. This exploration proceeds in three steps: 1) we examine whether physical and mental health problems are an academic risk factor during secondary school; 2) we investigate the academic mechanisms underlying this risk status; and 3) we explore whether this risk status varies by school context. A series of logistic regressions reveals that self-rated health and emotional distress are both associated with greater likelihood of failing one or more classes in the next year and that absenteeism, trouble with homework, and student-teacher bonding account for much of these associations. Associations of physical and mental health problems with academic failure vary only slightly across schools, however. We discuss the implications of these findings for both research and policy and argue that the examination of overlap among different domains of adolescent functioning can advance the sociological understanding of health, education, and social problems in general.

A community health report card: comprehensive assessment for tracking community health (CATCH).

PubMed

Studnicki, J; Steverson, B; Myers, B; Hevner, A R; Berndt, D J

1997-01-01

A systematic method for assessing the health status of communities has been under development at the University of South Florida since 1991. The system, known as CATCH, draws 226 indicators from multiple sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered community problem list. The CATCH results from II Floridian counties have focused attention on high priority health problems and provided a framework for measuring the impact of health expenditures on community health status outcomes. The method and plans to create an automated data warehouse to support its expansion and enrichment are described.

The Health and Safety Act--and Schools

ERIC Educational Resources Information Center

Borrows, T. P.

1975-01-01

Describes some of the problems likely to be encountered by British science teachers and school science departments in the implementation of laboratory standards under the Health and Safety at Work etc. Act 1974. (MLH)

Terrorism-related trauma in Africa, an increasing problem.

PubMed

Alfa-Wali, Maryam; Sritharan, Kaji; Mehes, Mira; Abdullah, Fizan; Rasheed, Shahnawaz

2015-06-01

Global terrorist activities have increased significantly over the past decade. The impact of terrorism-related trauma on the health of individuals in low- and middle-income countries is under-reported. Trauma management in African countries in particular is uncoordinated, with little or no infrastructure to cater for emergency surgical needs. This article highlights the need for education, training and research to mitigate the problems related to terrorism and surgical public health. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Apartheid medicine. Health and human rights in South Africa.

PubMed

Nightingale, E O; Hannibal, K; Geiger, H J; Hartmann, L; Lawrence, R; Spurlock, J

Human rights and health care under apartheid in South Africa were studied. Human rights violations, such as detention without charge or trial, assault and torture in police custody, and restriction orders, have had devastating effects on the health of persons experiencing them. These violations have occurred in the context of a deliberate policy of discriminatory health care favoring the white minority over the black majority. South Africa's medical societies have had mixed responses to the health problems raised by human rights violations and inequities in the health care system. The amelioration of health care for all and prevention of human rights violations depend on ending apartheid and discrimination and greater government attention to these problems.

How financial hardship is associated with the onset of mental health problems over time.

PubMed

Kiely, Kim M; Leach, Liana S; Olesen, Sarah C; Butterworth, Peter

2015-06-01

Poor mental health has been consistently linked with the experience of financial hardship and poverty. However, the temporal association between these factors must be clarified before hardship alleviation can be considered as an effective mental health promotion and prevention strategy. We examined whether the longitudinal associations between financial hardship and mental health problems are best explained by an individual's current or prior experience of hardship, or their underlying vulnerability. We analysed nine waves (years: 2001-2010) of nationally representative panel data from the Household, Income, and Labour Dynamics in Australia survey (n = 11,134). Two components of financial hardship (deprivation and cash-flow problems) and income poverty were coded into time-varying and time-invariant variables reflecting the contemporaneous experience of hardship (i.e., current), the prior experience of hardship (lagged/12 months), and any experience of hardship during the study period (vulnerability). Multilevel, mixed-effect logistic regression models tested the associations between these measures and mental health. Respondents who reported deprivation and cash-flow problems had greater risk of mental health problems than those who did not. Individuals vulnerable to hardship had greater risk of mental health problems, even at the times they did not report hardship. However, their risk of mental health problems was greater on occasions when they did experience hardship. The results are consistent with the argument that economic and social programmes that address and prevent hardship may promote community mental health.

The clinical profile of employees with mental health problems working in social firms in the UK.

PubMed

Milton, Alyssa; Parsons, Nicholas; Morant, Nicola; Gilbert, Eleanor; Johnson, Sonia; Fisher, Adrian; Singh, Swaran; Cunliffe, Di; Marwaha, Steven

2015-08-01

UK social firms are under-researched but are a potentially important vocational option for people with mental health problems. To describe the clinical profile, satisfaction levels and experiences of social firms employees with mental health problems. Clinical, work and service use characteristics were collected from social firms' employees with mental health problems in England and Wales. Workplace experience and satisfaction were explored qualitatively. Predominantly, social firms' employees (N = 80) report that they have a diagnosis of depression (56%) and anxiety (41%). People with schizophrenia (20%) or bipolar disorder (5%) were a minority. Respondents had low symptom and disability levels, high quality of life and job satisfaction and experienced reductions in secondary mental health service use over time. High-workplace satisfaction was related to flexibility, manager and colleague support and workplace accommodations. The clinical profile, quality of life and job satisfaction level of employees with mental health problems suggest social firms could be a useful addition to UK vocational services for some people. Current employees mainly have common mental disorders, and social firms will need to shift their focus if they are to form a substantial pathway for the vocational recovery of people currently using community mental health teams.

Differences in Problems Paying Medical Bills between African Americans and Whites from 2007 and 2009: the Underlying Role of Health Status.

PubMed

Wiltshire, Jacqueline C; Elder, Keith; Allison, Jeroan J

2016-06-01

Although the proportion of people reporting problems paying medical bills has declined in the aftermath of the Great Recession, it is unclear if this decline has been caused by self-rationing of care, particularly among disadvantaged groups. We examined African American-White differences in problems paying medical bills prevalence along with factors which may account for observed differences. We used cross-sectional data from 2007 (N = 13,064) and 2010 (N = 11,873) waves of the nationally representative, Health Tracking Household Survey. Logistic regression analyses, accounting for complex survey design and weights, were performed to compute population-based estimates. Overall, the prevalence of problems paying medical bills was 18.3 % in 2007 and 19.8 % in 2010. African Americans more frequently reported having problems paying medical bills than Whites. Among African Americans, problems paying medical bills decreased from 30 % in 2007 to 25 % in 2010, which was largely explained by fewer problems reported by those in poor/fair health. Problems paying medical bills significantly declined from 44 % in 2007 to 33 % in 2010 for African Americans in poor/fair health, but remained almost constant for those in good health and very good/excellent health. Our findings suggest that African Americans in poor health may be rationing or forgoing necessary care as a result of the recession, which could increase existing health disparities and future health spending. Efforts to reduce racial/ethnic disparities may depend on the extent to which the lingering effects of the Great Recession are mitigated.

Global Health in the Social Studies Classroom

ERIC Educational Resources Information Center

Smith, David J.

2005-01-01

It may surprise students to realize that health problems in other countries affect them, too. Where people live and the conditions under which they live directly affect their health. The health of a population can also offer insight into a region's social, political, and economic realities. As a powerful lens into how human societies function,…

How does race get "under the skin"?: inflammation, weathering, and metabolic problems in late life.

PubMed

Das, Aniruddha

2013-01-01

Using nationally representative data from the 2005-2006 U.S. National Social Life, Health, and Aging Project, this study queries the mechanisms underlying worse metabolic outcomes--blood-sugar control and cardiovascular health--among black than white men ages 57-85. Results indicate that contrary to much of the academic literature as well as media accounts-implicitly rooted in a "culture of irresponsibility" model--older black men's social isolation, poor health behaviors, or obesity may not play a major role in their worse metabolic problems. Instead, these outcomes seem to derive more consistently from a factor almost unexamined in the literature--chronic inflammation, arguably a biological "weathering" mechanism induced by these men's cumulative and multi-dimensional stress. These findings highlight the necessity of focusing attention not simply on proximal behavioral interventions, but on broader stress-inducing social inequalities, to reduce men's race disparities in health. Copyright © 2012 Elsevier Ltd. All rights reserved.

Helping the decision maker effectively promote various experts' views into various optimal solutions to China's institutional problem of health care provider selection through the organization of a pilot health care provider research system.

PubMed

Tang, Liyang

2013-04-04

The main aim of China's Health Care System Reform was to help the decision maker find the optimal solution to China's institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China's health care system, and it could efficiently collect the data for determining the optimal solution to China's institutional problem of health care provider selection from various experts, then the purpose of this study was to apply the optimal implementation methodology to help the decision maker effectively promote various experts' views into various optimal solutions to this problem under the support of this pilot system. After the general framework of China's institutional problem of health care provider selection was established, this study collaborated with the National Bureau of Statistics of China to commission a large-scale 2009 to 2010 national expert survey (n = 3,914) through the organization of a pilot health care provider research system for the first time in China, and the analytic network process (ANP) implementation methodology was adopted to analyze the dataset from this survey. The market-oriented health care provider approach was the optimal solution to China's institutional problem of health care provider selection from the doctors' point of view; the traditional government's regulation-oriented health care provider approach was the optimal solution to China's institutional problem of health care provider selection from the pharmacists' point of view, the hospital administrators' point of view, and the point of view of health officials in health administration departments; the public private partnership (PPP) approach was the optimal solution to China's institutional problem of health care provider selection from the nurses' point of view, the point of view of officials in medical insurance agencies, and the health care researchers' point of view. The data collected through a pilot health care provider research system in the 2009 to 2010 national expert survey could help the decision maker effectively promote various experts' views into various optimal solutions to China's institutional problem of health care provider selection.

Patterns of Adolescent Regulatory Responses during Family Conflict and Mental Health Trajectories

PubMed Central

Koss, Kalsea J.; Cummings, E. Mark; Davies, Patrick T.; Cicchetti, Dante

2016-01-01

Four distinct patterns of adolescents’ behavioral, emotional, and physiological responses to family conflict were identified during mother-father-adolescent (M=13.08 years) interactions. Most youth displayed adaptively-regulated patterns comprised of low overt and subjective distress. Under-controlled adolescents exhibited elevated observable and subjective anger. Over-controlled adolescents were withdrawn and reported heightened subjective distress. Physiologically reactive adolescents had elevated cortisol coupled with low overt and subjective distress. Regulation patterns were associated with unique mental health trajectories. Under-controlled adolescents had elevated conduct and peer problems whereas over-controlled adolescents had higher anxiety and depressive symptoms. Physiologically reactive adolescents had low concurrent, but increasing levels of depressive, anxiety, and peer problem symptoms. Findings underscore the importance of examining organizations of regulatory strategies in contributing to adolescent mental health. PMID:28498540

Four Characteristics for Regional Continuing Education in Medical Allied Health

ERIC Educational Resources Information Center

Koewing, J. Robert; And Others

1976-01-01

The Area Health Education Centers (AHEC) Program (created under the Comprehensive Health Manpower Act of 1971) is briefly described followed by a discussion of the University of North Carolina's regional planning efforts for continuing education. Major planning problems--aggregate numbers, continuing education suppliers, geographic distribution,…

Nurses and health information technology: working with and around computers.

PubMed

Peace, Jane

2011-01-01

Information technology is nearly ubiquitous in health care settings. Nurses need basic computer skills and information literacy to effectively practice nursing. In addition, nurses must be prepared not only to work around complex health information technology, but also to communicate with individuals who can address the underlying problems.

An Analysis of Health Manpower Models: Volume I.

ERIC Educational Resources Information Center

Bonder, Seth; And Others

Objectives of the project were to identify and describe problem areas and policy issues confronting health manpower planning agencies at all levels, compile an inventory of models and evaluate their usefulness, and to evaluate the potential usefulness of two models (developed under contract to the Bureau of Health Resources Development) designed…

77 FR 31689 - Proposed Information Collection (Deployment Risk and Resilience Inventory (DRRI)) Activities...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-29

... for Post Traumatic Stress Disorder (PTSD) and other health problems that Operation Enduring Freedom... (Deployment Risk and Resilience Inventory (DRRI)) Activities Under OMB Review AGENCY: Veterans Health... Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Health...

Description and Evaluation of the 1980 Summer Scholars Program.

ERIC Educational Resources Information Center

Mares, Kenneth R.; And Others

The University of Missouri, under a contract with the Health Resources Administration, has planned and developed an Area Health Education Center (AHEC), whose purpose is to address the problem of underrepresentation of minority and educationally disadvantaged students in educational programs for health professions. Activities range from early…

Gambling: Electronic friends or a threat to one's health and personal development?

PubMed Central

Svensson, Ove

2011-01-01

Gambling has become quite common in Sweden. The Swedish National Institute of Public Health (2010) has reported that about 70% of the Swedish population has gambled at least once during the last 12 months. Half of the population had gambled with money by 18 years of age and about 11% had gambled for the first time when they were 12-years-old or younger. In the report from the Swedish National Institute of Public Health, gambling problems are related to health problems and risky alcohol consumption. The highest problem rate is found among men aged 18 to 24; almost 1 in 10 had some gambling problems. The share of problem gamblers is found to be twice as high among the under-age gamblers as it is among the population as a whole. Young people gamble less but develop gambling problems to a larger extent than adult gamblers. In this article young people's gambling and their gambling careers are analysed as a natural part of their internalisation of other adult habits. PMID:21629581

Treat the source not the symptoms: why thinking about sleep informs the social determinants of health.

PubMed

Hale, Lauren; Hale, Benjamin

2010-06-01

Based on theoretical and empirical work, we argue that autonomy is likely an important underlying source of healthy sleep. The implication is that 'treatment' for sleep problems cannot be understood as an individual-level behavioral problem but must instead be addressed in concert with larger scale social factors that may be inhibiting high-quality sufficient sleep in large segments of the population. When sleep is understood as a proxy for health, the implications extend even further. Policies and interventions that facilitate the autonomy of individuals therefore may not only help reduce individual sleep problems but also have broader consequences for ameliorating social disparities in health.

Do Paternal Arrest and Imprisonment Lead to Child Behaviour Problems and Substance Use? A Longitudinal Analysis

ERIC Educational Resources Information Center

Kinner, Stuart A.; Alati, Rosa; Najman, Jake M.; Williams, Gail M.

2007-01-01

Background: Children of prisoners are at increased risk of impaired health, behavioural problems and substance misuse; however, the causal pathways to these problems are unclear. Under some circumstances, parental imprisonment may result in improved outcomes for the child. This study investigates the impact of paternal arrest and imprisonment on…

An exploratory study of the health harms and utilisation of health services of frequent legal high users under the interim regulated legal high market in central Auckland.

PubMed

Wilkins, Chris; Prasad, Jitesh; Wong, K C; Rychert, Marta; Graydon-Guy, Thomas

2016-03-11

To explore health problems and the accessing of health services by frequent legal high users under an interim regulated legal market in central Auckland. Frequent legal high users (monthly+) were recruited from outside eight randomly-selected, licensed, legal high stores in central Auckland from 23 April-7 May, 2014. Eligible participants were emailed a unique invitation to complete an on-line survey; 105 completed the survey. Twenty-seven percent had suffered mental illness during their lifetimes. Eighty percent used synthetic cannabinoids (SC), and 20% 'party pills'. Forty-seven percent of SC users used daily or more often. Other drugs used included alcohol (80%), cannabis (59%), 'ecstasy' (18%) and methamphetamine (15%). Fifty-eight percent of SC users were classified as SC dependent. The most common problems reported from SC use were: insomnia (29%); 'vomiting/nausea' (25%); 'short temper/agitation' (21%); 'anxiety' (21%); 'strange thoughts' (16%); and 'heart palpitations' (14%). The health services most commonly accessed by SC users were: a 'doctor/GP' (9%); 'counsellor' (9%); 'DrugHelp/MethHelp' websites (7%); 'Alcohol & Drug Helpline' (4%); 'ambulance' (3%); 'A&E' (3%); and hospitalisation (3%). Frequent use of interim licensed SC products was associated with health problems, including dependency. Further research is required to determine the health risks of these products.

The Prevalence of Overweight and Obesity in Children Under 5 Years in Tehran, Iran, in 2012: A Population-Based Study

PubMed Central

Salehiniya, Hamid; Yazdani, Kamran; Barekati, Hamed; Asadi Lari, Mohsen

2016-01-01

Background: Overweight and obesity in children are a serious problem. They are increasingly prevalent and associated with a wide range of health problems in adulthood. Monitoring their status is essential for effective planning in the health system. Objectives: This study aimed to assess the prevalence of overweight and obesity in children below 5 years in Tehran in 2012. Patients and Methods: This cross-sectional study employed data provided by the urban health equity assessment in Tehran. The sample comprised a total of 4656 children under 5 years, recruited via multistage sampling. Data were collected through questionnaires and anthropometric measures of height and weight. The WHO child growth standards were used to determine overweight and obesity. Data were analyzed using chi-square tests, with SPSS version 11.5. Results: The prevalence of overweight and obesity in children were 12% and 23.7% respectively. The prevalence of overweight was significantly higher in girls than boys and the prevalence of obesity was significantly higher in boys than girls (P = 0.001). Obesity was more prevalent in children from high economic percentiles, but this finding was not statistically significant. Conclusions: The prevalence of overweight and obesity in children under 5 years is high. Overweight and obesity should be considered an epidemic and serious health problem in Tehran. They certainly require more attention and intervention. PMID:26889459

Informal Payments for Health Care in Iran: Results of a Qualitative Study

PubMed Central

PARSA, Mojtaba; ARAMESH, Kiarash; NEDJAT, Saharnaz; KANDI, Mohammad Jafar; LARIJANI, Bagher

2015-01-01

Abstract Background Informal payments to health care providers have been reported in many African, Asian and European countries. This study aimed to investigate different aspects of these payments that are also known as under-the-table payments in Iran. Methods This is an in-depth interview-based qualitative study conducted on 12 purposively chosen clinical specialists. The interviewees answered 9 questions including the ones about, definitions of informal payments, the specialties and hospitals mostly involved with the problem, how they are paid, factors involved, motivation of patients for the payments, impact of the payments on the health care system and physician-patient relationship and the ways to face up with the problem. The findings of the study were analyzed using qualitative content analysis method. Results Six topics were extracted from the interviews including definitions, commonness, varieties, motivations, outcomes and preventive measures. It was revealed that under-the-table payments are the money taken (either in private or public portions) from patients in addition to what formally is determined. This problem is mostly seen in surgical services and the most important reason for it is unrealistic tariffs. Conclusion Regarding the soaring commonness of informal payments rooted in underpayments of health expenditures in some specialties, which deeply affect the poor, the government has to boost the capitation and to invest on health sectors through supporting the health insurance companies and actualizing the health care costs in accord with the real price of the health care delivered. PMID:26060779

Attention problems and pathological gaming: resolving the 'chicken and egg' in a prospective analysis.

PubMed

Ferguson, Christopher J; Ceranoglu, T Atilla

2014-03-01

Pathological gaming (PG) behaviors are behaviors which interfere with other life responsibilities. Continued debate exists regarding whether symptoms of PG behaviors are a unique phenomenon or arise from other mental health problems, including attention problems. Development of attention problems and occurrence of pathological gaming in 144 adolescents were followed during a 1-year prospective analysis. Teens and their parents reported on pathological gaming behaviors, attention problems, and current grade point average, as well as several social variables. Results were analyzed using regression and path analysis. Attention problems tended to precede pathological gaming behaviors, but the inverse was not true. Attention problems but not pathological gaming predicted lower GPA 1 year later. Current results suggest that pathological gaming arises from attention problems, but not the inverse. These results suggest that pathological gaming behaviors are symptomatic of underlying attention related mental health issues, rather than a unique phenomenon.

Family and Racial Factors Associated with Suicide and Emotional Distress among Latino Students

ERIC Educational Resources Information Center

Garcia, Carolyn; Skay, Carol; Sieving, Renee; Naughton, Sandy; Bearinger, Linda H.

2008-01-01

Background: Latino youth experience disproportionate rates of mental health problems including suicide and depression. Better understanding of underlying risk and protective factors on the part of school-based health professionals, teachers, and health care providers in their lives is warranted. The aims of this secondary analysis of 2004…

Drinking despite health problems among individuals with liver disease across the United States.

PubMed

Elliott, Jennifer C; Stohl, Malka; Hasin, Deborah S

2017-07-01

Heavy drinking is harmful for individuals with liver disease. However, some of these individuals drink despite knowledge of the risks. The current study aims to identify factors underlying drinking despite health problems among individuals with liver disease. The current study utilizes a subsample of individuals reporting past-year liver disease and at least one drink in the past year (n=331), taken from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a large nationally representative survey of the United States. Participants reported on drinking despite health problems, symptoms of psychopathology, and family history of alcohol problems in a cross-sectional survey. Drug use disorders (Adjusted Odds Ratio [AOR]=2.68), as well as borderline, antisocial, and schizotypal personality disorders (AORs=2.50-4.10), were associated with increased likelihood of drinking despite health problems among individuals with liver disease, all ps<0.05. Any anxiety disorder trended toward significance (AOR=2.22), p=0.06, but major depressive disorder was not associated with increased risk, (AOR=0.99), ps=0.97. Individuals with a family history of alcohol problems were also more likely to drink despite health problems (AOR=2.79), p<0.05. Several types of psychopathology, as well as a family history of alcohol problems, increased the likelihood of drinking despite health problems among individuals with liver disease. These findings highlight the need to intervene with heavily drinking individuals with liver disease, who may be drinking due to familial risk and/or comorbid psychopathology. Copyright © 2017 Elsevier B.V. All rights reserved.

Intergenerational effects of endocrine-disrupting compounds: a review of the Michigan polybrominated biphenyl registry.

PubMed

Curtis, Sarah W; Conneely, Karen N; Marder, Mary E; Terrell, Metrecia L; Marcus, Michele; Smith, Alicia K

2018-06-11

Endocrine-disrupting compounds (EDCs) are a broad class of chemicals present in many residential products that can disrupt hormone signaling and cause health problems in humans. Multigenerational cohorts, like the Michigan polybrominated biphenyl registry, are ideal for studying the effects of intergenerational exposure. Registry participants report hormone-related health problems, particularly in those exposed before puberty or those in the second generation exposed through placental transfer or breastfeeding. However, more research is needed to determine how EDCs cause health problems and the mechanisms underlying intergenerational exposure. Utilizing existing data in this registry, along with genetic and epigenetic approaches, could provide insight to how EDCs cause human disease and help to determine the risk to exposed populations and future generations.

Caregiver burden mediates between caregiver's mental health condition and elder's behavioral problems among Japanese family caregivers.

PubMed

Honda, Ayumi; Abe, Yasuyo; Aoyagi, Kiyoshi; Honda, Sumihisa

2014-03-01

In Japan, the prevalence of depression has been reported to occur among 1 in 4 family caregivers. The purpose of this study was to investigate the self-rated burden associated with mental health conditions among caregivers. We studied 95 caregivers aged 38-87 years in a cross-sectional study. The General Health Questionnaire (GHQ-12) score of 4 or more was defined as poor mental health. The proportion of caregivers with poor mental health was 24%. Caregivers with a high GHQ-12 score had the number of caregiver burdens increased by 2.5-fold compared to those with a low GHQ-12 score (p = 0.001). The proportion of caregivers with a high GHQ-12 score was significantly higher with an increasing number of behavioral problems among care recipients (p = 0.003). A mediational model was used to identify the underlying mechanism of the relationship between the number of behavioral problems and poor mental health in caregivers. Consequently, we found that mental health conditions in caregivers were associated with both the number of caregiver burdens and behavioral problems among care recipients. It is vital to provide support not only to the caregivers but also to their elderly relatives, paying particular attention to early identification of poor mental health in caregivers so as to administer effective interventions, and to offer useful advice concerning how to deal with behavioral problems.

Helping the decision maker effectively promote various experts’ views into various optimal solutions to China’s institutional problem of health care provider selection through the organization of a pilot health care provider research system

PubMed Central

2013-01-01

Background The main aim of China’s Health Care System Reform was to help the decision maker find the optimal solution to China’s institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China’s health care system, and it could efficiently collect the data for determining the optimal solution to China’s institutional problem of health care provider selection from various experts, then the purpose of this study was to apply the optimal implementation methodology to help the decision maker effectively promote various experts’ views into various optimal solutions to this problem under the support of this pilot system. Methods After the general framework of China’s institutional problem of health care provider selection was established, this study collaborated with the National Bureau of Statistics of China to commission a large-scale 2009 to 2010 national expert survey (n = 3,914) through the organization of a pilot health care provider research system for the first time in China, and the analytic network process (ANP) implementation methodology was adopted to analyze the dataset from this survey. Results The market-oriented health care provider approach was the optimal solution to China’s institutional problem of health care provider selection from the doctors’ point of view; the traditional government’s regulation-oriented health care provider approach was the optimal solution to China’s institutional problem of health care provider selection from the pharmacists’ point of view, the hospital administrators’ point of view, and the point of view of health officials in health administration departments; the public private partnership (PPP) approach was the optimal solution to China’s institutional problem of health care provider selection from the nurses’ point of view, the point of view of officials in medical insurance agencies, and the health care researchers’ point of view. Conclusions The data collected through a pilot health care provider research system in the 2009 to 2010 national expert survey could help the decision maker effectively promote various experts’ views into various optimal solutions to China’s institutional problem of health care provider selection. PMID:23557082

The quality of Indigenous identification in administrative health data in Australia: insights from studies using data linkage

PubMed Central

2012-01-01

Background Missing or incorrect Indigenous status in health records hinders monitoring of Indigenous health indicators. Linkage of administrative data has been used to improve the ascertainment of Indigenous status. Data linkage was pioneered in Western Australia (WA) and is now being used in other Australian states. This systematic review appraises peer-reviewed Australian studies that used data linkage to elucidate the impact of under-ascertainment of Indigenous status on health indicators. Methods A PubMed search identified eligible studies that used Australian linked data to interrogate Indigenous identification using more than one identifier and interrogated the impact of the different identifiers on estimation of Indigenous health indicators. Results Eight papers were included, five from WA and three from New South Wales (NSW). The WA papers included a self-identified Indigenous community cohort and showed improved identification in hospital separation data after 2000. In CVD hospitalised patients (2000–05), under-identification was greater in urban residents, older people and socially more advantaged Indigenous people, with varying algorithms giving different estimates of under-count. Age-standardised myocardial infarction incidence rates (2000–2004) increased by about 10%-15% with improved identification. Under-ascertainment of Indigenous identification overestimated secular improvements in life expectancy and mortality whereas correcting infectious disease notifications resulted in lower Indigenous/ non-Indigenous rate ratios. NSW has a history of poor Indigenous identification in administrative data systems, but the NSW papers confirmed the usefulness of data linkage for improving Indigenous identification and the potential for very different estimates of Indigenous disease indicators depending upon the algorithm used for identification. Conclusions Under-identification of Indigenous status must be addressed in health analyses concerning Indigenous health differentials – they cannot be ignored or wished away. This problem can be substantially diminished through data linkage. Under-identification of Indigenous status impacts differently in different disease contexts, generally resulting in under-estimation of absolute and relative Indigenous health indicators, but may perversely overestimate Indigenous rates and differentials in the setting of stigma-associated conditions such as sexually-transmitted and blood-borne virus infections. Under-numeration in Census surveys also needs consideration to address the added problem of denominator undercounts. PMID:23157943

Addressing the migration of health professionals: the role of working conditions and educational placements.

PubMed

Witt, Julia

2009-11-18

This article provides a brief overview of the global health-worker shortage, which could undermine the Millennium Development Goal to halt and begin to reverse the spread of HIV/AIDS. The current situation suggests that long-term solutions to shortages can only be found by addressing the problem from a global perspective; that is, to eliminate shortages through substantial investments in training and retaining health workers in developed and developing countries, and not through policies that do not work towards solving this underlying problem, such as ones that restrict migration.

Health-related needs of people with multiple chronic diseases: differences and underlying factors.

PubMed

Hopman, Petra; Schellevis, François G; Rijken, Mieke

2016-03-01

To examine the health-related needs of people with multiple chronic diseases in the Netherlands compared to people with one chronic disease, and to identify different subgroups of multimorbid patients based on differences in their health problems. Participants were 1092 people with one or more chronic diseases of a nationwide prospective panel study on the consequences of chronic illness in the Netherlands. They completed the EQ-6D, a multi-dimensional questionnaire on health problems (October 2013). Chi-square tests and analyses of variance were performed to test for differences between multimorbid patients and patients with one chronic disease. To identify subgroups of multimorbid patients, cluster analysis was performed and differences in EQ-6D scores between clusters were tested with Chi-square tests. Multimorbid patients (51 % of the total sample) experience more problems in most health domains than patients with one chronic disease. Almost half (44 %) of the multimorbid people had many health problems in different domains. These people were more often female, had a smaller household size, had a lower health literacy, and suffered from more chronic diseases. Remarkably, a small subgroup of multimorbid patients (4 %, mostly elderly males) is characterized by all having cognitive problems. Based on the problems they experience, we conclude that patients with multimorbidity have relatively many and diverse health-related needs. Extensive health-related needs among people with multimorbidity may relate not only to the number of chronic diseases they suffer from, but also to their patient characteristics. This should be taken into account, when identifying target groups for comprehensive support programmes.

[Willingness to implement mental health measures among small-scale enterprise employers in Ohta ward, Tokyo, Japan].

PubMed

Ikeda, Tomoko; Nakata, Akinori; Kobori, Shun-ichi; Hojo, Minoru; Sugishita, Chieko

2002-09-01

Due to the increase in mental health problems among Japanese workers in recent years, effective approaches to address these problems are of growing concern. Although such an effort is now under way in largescale enterprises (LSEs), small-scale enterprises (SSEs) are lagging behind LSEs for a number of reasons. In the present study, to know the reason, the presidents of 263 SSEs (fewer than 50 employees) in the Ohta ward of Tokyo were surveyed with a self-administered questionnaire from October 1999 to March 2000 (response rate, 51.0%). The main business types were manufacturing (71.2%), transportation & storage (6.1%), and construction (5.3%). The results revealed that employers attribute the mental health problems of employees to "Job content/Aptitude for job (78.6%)", "Communication among employees (71.0%)", "Physical problems/Illness (50.4%)", "Family problems (33.6%)". These results are very similar to those obtained in the same enterprises employees survey in 1996, suggesting that employers perceive the factors responsible for employees' mental health problems with substantial accuracy. Sixty-nine point five percent of the employers answered that they need mental health measures for employees. And 62.7% of employers agreed to take mental health measures in their enterprises. Taken together, it is considered that employers are willing to improve their employees' mental health problems. Nevertheless, 95% of employers are doing nothing to improve the situation. The major reasons cited were 1) Cannot obtain a consultant or counselor (44.8%), 2) Lack of time (43.1%), 3) Manpower shortage (41.4%), 4) Difficulty in ensuring employees' privacy (36.2%), and 5) Lack of financial resources (30.2%). The results of the present study suggest that perception of the mental health problems among employers and employees of SSEs in the Ohta area were close to each other. Effective strategies are needed to improve mental health problems in SSEs.

Urinary Incontinence: Management and Treatment Options

ERIC Educational Resources Information Center

Griebling, Tomas L.

2009-01-01

Urinary incontinence, defined as the involuntary leakage of urine, is a common health problem in both women and men. Children may also suffer from this condition. Management and treatment of urinary incontinence depends primarily on the specific type of incontinence and the underlying problem causing the leakage for a given patient. Because…

Intervention Strategies for Dealing with Multi-Problem Families.

ERIC Educational Resources Information Center

Kloss, James; And Others

This paper describes the Primary Prevention Project (PPP), a demonstration program of the Mendota Mental Health Institute in Madison, Wisconsin which provides services to multi-problem families with children under 3 years of age in order to prevent abuse and neglect, developmental delay, or future socio-emotional difficulty. The project's…

Prevention for elderly people: demand-oriented or problem-oriented?

PubMed

Kupper, Nicolette M; Schreurs, Hanneke; Ten Klooster, Peter M; Bode, Christina; van Ameijden, Erik J C

2011-09-01

To examine the association between self-expressed information needs and corresponding observed health and lifestyle issues in elderly people. Data were used from the 2006 community health survey in Utrecht, a medium-sized city in the Netherlands. Data of 1634 people aged 55 years and older were available for analyses (response 64%). Multivariate logistic regression analyses were used to examine possible associations between expressed information needs and variables on demographics, lifestyle risk behaviours, physical and psychosocial health. Several significant associations were found between information needs and corresponding health and lifestyle problems. However, the explanatory power of the observed problems was generally low, explaining only 7% of the informational needs on lifestyle, and 17% and 28% of the informational needs on physical and psychosocial health, respectively. The findings suggest that prevention amongst the elderly should not be solely based on information needs, but also on observed lifestyle and health. Implications for the use of different approaches of prevention and behavioural models underlying interventions are discussed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

CONCERN FOR AGRICULTURAL MIGRANTS IN MARYLAND.

ERIC Educational Resources Information Center

Governor's Committee on Migratory Labor, College Park, MD.

PROBLEMS, PROGRESS, AND ACTIVITIES OF THE AGENCIES AND ORGANIZATIONS OF THE MARYLAND GOVERNOR'S COMMITTEE FOR MIGRATORY LABOR ARE PRESENTED. EFFECTIVE HEALTH EDUCATION SHOULD BE DEVELOPED TO HELP MIGRANTS ACHIEVE BETTER HEALTH CONDITIONS THROUGH THEIR OWN ACTIVITIES AND EFFORTS. HOUSING AND LIVING CONDITIONS ARE IMPROVING UNDER REGULATIONS ADOPTED…

A Health Plan to Reduce Poverty

ERIC Educational Resources Information Center

Weil, Alan

2007-01-01

Noting that the failures of the U.S. health care system are compounding the problems faced by low-income Americans, Alan Weil argues that any strategy to reduce poverty must provide access to health care for all low-income families. Although nearly all children in families with incomes under 200 percent of poverty are eligible for either Medicaid…

Back to basics: informing the public of co-morbid physical health problems in those with mental illness.

PubMed

Ahire, Mrinalini; Sheridan, Judith; Regbetz, Shane; Stacey, Phillip; Scott, James G

2013-02-01

Those with mental illness are at increased risk of physical health problems. The current study aimed to examine the information available online to the Australian public about the increased risk and consequences of physical illness in those with mental health problems and the services available to address these co-morbidities. A structured online search was conducted with the search engine Google Australia (www.google.com.au) using generic search terms 'mental health information Australia', 'mental illness information Australia', 'depression', 'anxiety', and 'psychosis'. The direct content of websites was examined for information on the physical co-morbidities of mental illness. All external links on high-profile websites [the first five websites retrieved under each search term (n = 25)] were examined for information pertaining to physical health. Only 4.2% of websites informing the public about mental health contained direct content information about the increased risk of physical co-morbidities. The Australian Government's Department of Health and Ageing site did not contain any information. Of the high-profile websites, 62% had external links to resources about physical health and 55% had recommendations or resources for physical health. Most recommendations were generic. Relative to the seriousness of this problem, there is a paucity of information available to the public about the increased physical health risks associated with mental illness. Improved public awareness is the starting point of addressing this health inequity.

Qualitative methods: beyond the cookbook.

PubMed

Harding, G; Gantley, M

1998-02-01

Qualitative methods appear increasingly in vogue in health services research (HSR). Such research, however, has utilized, often uncritically, a 'cookbook' of methods for data collection, and common-sense principles for data analysis. This paper argues that qualitative HSR benefits from recognizing and drawing upon theoretical principles underlying qualitative data collection and analysis. A distinction is drawn between problem-orientated and theory-orientated research, in order to illustrate how problem-orientated research would benefit from the introduction of theoretical perspectives in order to develop the knowledge base of health services research.

Mental health promotion and socio-economic disadvantage: lessons from substance abuse, violence and crime prevention and child health.

PubMed

Toumbourou, J W; Hemphill, S A; Tresidder, J; Humphreys, C; Edwards, J; Murray, D

2007-12-01

Mental health promotion aimed at populations with low socio-economic status (SES) may benefit by investigating prevention strategies that effectively address related child and adolescent problems. Evidence from a number of literature reviews and program evaluations was synthesised. First, the impact of SES on development from childhood to adulthood is considered in light of research on substance abuse, violence, crime, and child development problems. Second, evaluations of interventions are reviewed to identify those that have shown outcomes in research studies (efficacy) or in real-world settings (effectiveness) in reducing developmental problems associated with low SES. Low SES is measured in different ways including low levels of education and/or income or definitions that combine several variables into a new indicator of low SES. Factors associated with low SES are also associated to varying extent with the development of violence and crime, substance abuse and child health problems. Interventions that address underlying determinants of low SES show strong efficacy in decreasing adolescent crime and violence and effectiveness in improving child health outcomes. Although there is limited efficacy evidence that substance abuse prevention can be effectively addressed by targeting low SES, programs designed to improve educational pathways show some efficacy in reducing aspects of adolescent substance use. Mental health promotion strategies can draw on the approaches outlined here that are associated with the prevention of child and adolescent problems within low SES communities. Alternatively, such interventions could be supported in mental health promotion policy as they may assist in preventing related problems that undermine mental health.

Childhood Obesity: Trends and Potential Causes

ERIC Educational Resources Information Center

Anderson, Patricia M.; Butcher, Kristin F.

2006-01-01

The increase in childhood obesity over the past several decades, together with the associated health problems and costs, is raising grave concern among health care professionals, policy experts, children's advocates, and parents. Patricia Anderson and Kristin Butcher document trends in children's obesity and examine the possible underlying causes…

Use of Observational Learning Enhanced Instruction in Low Language Competency Audiences

ERIC Educational Resources Information Center

Zain-ul-abdin, Khawaja

2013-01-01

This dissertation investigates the use of observational learning enhanced health instruction to mitigate problems of low language competency among learners. Low language competency can cause improper comprehension of medical instruction and health education, resulting in misdiagnosis, reduced recall, under reporting of medical conditions and…

Under the Weather: Farmworker Health. A Compendium of Farmworker Testimony before the National Advisory Council on Migrant Health (Fort Lupton, Colorado, September 7, 1991; San Diego, California, April 4, 1992; Portland, Oregon, October 23, 1992).

ERIC Educational Resources Information Center

Galarneau, Charlene A., Ed.

This document highlights farmworkers' testimonies concerning farmworker health taken during three hearings. Six consistent themes emerged from farmworker accounts: (1) health and health care; (2) work conditions; (3) pesticide exposure; (4) housing; (5) women; and (6) children and youth. Farmworkers frequently mentioned injuries, eye problems, and…

Risk adjusting community rated health plan premiums: a survey of risk assessment literature and policy applications.

PubMed

Giacomini, M; Luft, H S; Robinson, J C

1995-01-01

This paper surveys recent health care reform debates and empirical evidence regarding the potential role for risk adjusters in addressing the problem of competitive risk segmentation under capitated financing. We discuss features of health plan markets affecting risk selection, methodological considerations in measuring it, and alternative approaches to financial correction for risk differentials. The appropriate approach to assessing risk differences between health plans depends upon the nature of market risk selection allowed under a given reform scenario. Because per capita costs depend on a health plan's population risk, efficiency, and quality of service, risk adjustment will most strongly promote efficiency in environments with commensurately strong incentives for quality care.

The formaldehyde problem in wood-based products : an annotated bibliography

Treesearch

F. H. Max Nestler

1977-01-01

Urea-formaldehyde-type adhesives have the inherent characteristic of giving off free formaldehyde under some conditions of use. The vapor can build up to concentrations which can be a nuisance, uncomfortable, or an actual health hazard. The "formaldehyde problem" is reviewed, from literature sources, in five respects : oriqins, analytical, control and removal...

Protecting Our Youth, Preserving Our Future: Sovereignty's Impact on Children in Need of Treatment.

ERIC Educational Resources Information Center

Epperley, Linda A.

Under Oklahoma's new "in need of treatment" (INT) procedure, juvenile commitments have increased 10 times since 1983. About 8% of commitments are American Indian children. Generally, the mental health dilemma of Indian communities is characterized by multiple and interacting problems, acute symptoms masked by related problems such as…

Addressing the Common Pathway Underlying Hypertension and Diabetes in People Who Are Obese by Maximizing Health: The Ultimate Knowledge Translation Gap

PubMed Central

Dean, Elizabeth; Lomi, Constantina; Bruno, Selma; Awad, Hamzeh; O'Donoghue, Grainne

2011-01-01

In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM), and obesity and the low profile of noninvasive (nondrug) compared with invasive (drug) interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance. PMID:21423684

Understanding the Mental Health Needs of Children under Five in One Inner City Authority

ERIC Educational Resources Information Center

Hackett, Latha; Theodosiou, Louise; Bond, Caroline; Blackburn, Claire; Lever, Rachel

2012-01-01

There is increasing awareness of mental health problems among young children, and early years settings are encouraged to take a wider family support role in order to prevent mental health difficulties. Local population studies are needed to inform delivery of universal through to targeted services. In the current study, parents and teachers of 2%…

Improving Health among Elementary School Children: A Comparison of Aerobic and Mind-Body Exercise

ERIC Educational Resources Information Center

Wang, Chunyun

2012-01-01

Introduction: Children today are under much more stress than a few decades ago due to academic pressure, family financial hardship, competition with peers, and stressed parents. Consequently, stress-related health issues and behavioral problems, such as cardiovascular diseases, headaches, insomnia, anxiety, depression, violent or withdrawal…

Health Instruction Packages: Record-Keeping in Allied Health.

ERIC Educational Resources Information Center

Andrews, Roberta L.; And Others

Text, illustrations, and exercises are utilized in this set of four learning modules designed to instruct nurses and nursing students in writing objective clinical reports. The first module, "Nursing Notes in POMR" by Roberta L. Andrews, discusses the four components of a nursing report written under the Problem-Oriented Medical Record…

Race, Biology, and Health Care: Reassessing a Relationship.

ERIC Educational Resources Information Center

Byrd, W. Michael

1990-01-01

Traces the history and underlying causes of health care discrimination and deprivation for Blacks compared with other Americans. This disparity is a result of policymakers' attempt to frame the problem in nonracial terms, physicians' attitudes, and scientific myths about Black inferiority. Calls for an elimination of institutional racism in health…

Factors associated with acceptance of peers with mental health problems in childhood and adolescence.

PubMed

Swords, Lorraine; Heary, Caroline; Hennessy, Eilis

2011-09-01

Research suggests that children's reactions to peers with mental health problems are related to the maintenance and outcomes of these problems. However, children's perceptions of such peers, particularly those with internalising problems, are neither well researched nor understood. The present study aimed to test a series of models relating socio-demographic and attributional variables to the acceptance of hypothetical boys and girls with attention deficit hyperactivity disorder (ADHD) and depression. A sample of 595 participants, drawn from five different age-groups spanning early childhood to late adolescence, completed a booklet of questions in response to two vignettes describing the behaviour of hypothetical target peers with depression and ADHD. The sample was drawn from schools randomly selected in the east of Ireland. The models indicated that age and gender of the participant, and the perceived responsibility of the target character for his/her condition, were the three most important predictors of acceptance in all models. However, the relationship between these variables and acceptance varied depending on the gender of the target child and the condition (depression or ADHD) in the models tested. The findings of the study suggest that the relationships between socio-demographic and attributional variables and acceptance of peers with mental health problems depend on the type of mental health problem under consideration. The findings have implications for the development of information and education programmes to improve the integration of children with mental health problems. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

The health of Inuit children under age 6 in Canada.

PubMed

Findlay, Leanne C; Janz, Teresa A

2012-01-01

Previous research has suggested that Inuit children experience poor health as compared to their non-Aboriginal counterparts, although social determinants such as family and social conditions, lifestyle or behaviour, and cultural factors may be at play. The purpose of the current study was to examine the parent-reported health of Inuit children under 6 years of age living in Canada. Data from the 2006 Aboriginal Children's Survey were used to examine measures of Inuit child health as rated by parents including child health, limitations to physical activity, chronic conditions, ear infections, and dental problems. Associations between social determinants of health and parent-rated Inuit child health were also explored. Most Inuit children under age 6 were reported by their parents or guardians to be in excellent or very good health. The most common chronic conditions identified were asthma, speech and language difficulties, allergies, lactose intolerance, and hearing impairment. Several social determinants of health were associated with child health, including parental education, household income, breastfeeding, and perceived housing conditions. The findings show that social determinants of health, including both socio-economic and household characteristics, are associated with Inuit child health.

Mental health trajectories from childhood to young adulthood affect the educational and employment status of young adults: results from the TRAILS study.

PubMed

Veldman, Karin; Reijneveld, Sijmen A; Ortiz, Josue Almansa; Verhulst, Frank C; Bültmann, Ute

2015-06-01

Young adults at work without basic educational level (BEL), and young adults in Neither Employment, Education nor Training (NEET) are at high risk of adverse employment outcomes. Evidence lacks on the impact of mental health problems during childhood, adolescence and young adulthood on employment outcomes of young adults. Therefore, the aims of this study were to (1) identify trajectories of mental health problems from childhood to young adulthood and (2) investigate the relation between these trajectories and the educational or employment status of young adults. Data were used from the Tracking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 9-year follow-up. Trajectories of mental health problems measured at ages 11, 13.5, 16 and 19 years were identified in 1711 young adults with latent class growth models. Young adults with high-stable trajectories of total problems, from childhood to young adulthood, were more likely to work without BEL or be in NEET at age 19, than to be at school or to work with BEL (28.0% vs 16.0%, p=0.01). The same was found for externalising problems (35.3% vs 23.2%, p=0.02). For internalising and attention problems, no statistically significant differences were found. Young adults with high-stable trajectories of mental health problems from age 11 to 19, were at risk of adverse employment outcomes. Interventions reducing mental health problems in childhood may improve the educational or employment status of young adults and their chances for successfully entering the labour market. 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.

Mental health associations with eczema, asthma and hay fever in children: a cross-sectional survey.

PubMed

Hammer-Helmich, Lene; Linneberg, Allan; Obel, Carsten; Thomsen, Simon Francis; Tang Møllehave, Line; Glümer, Charlotte

2016-10-14

This study aimed to examine the association of eczema, asthma and hay fever with mental health in a general child population and to assess the influence of parental socioeconomic position on these associations. We conducted a cross-sectional health survey of children aged 3, 6, 11 and 15 years in the City of Copenhagen, Denmark. Individual questionnaire data on eczema, asthma, and hay fever and mental health problems assessed using the Strengths and Difficulties Questionnaire (SDQ) was linked to register data on demographics and parental socioeconomic position. 9215 (47.9%) children were included in the analyses. Linear regression analyses showed that children with current eczema symptoms had higher SDQ scores (mean difference, 95% CI) of emotional problems (0.26, 0.12 to 0.39), conduct problems (0.19, 0.09 to 0.29) and hyperactivity problems (0.32, 0.16 to 0.48); children with current asthma symptoms had higher SDQ scores of emotional problems (0.45, 0.32 to 0.58), conduct problems (0.28, 0.18 to 0.38) and hyperactivity problems (0.52, 0.35 to 0.69); and children with current hay fever symptoms had higher SDQ scores of emotional problems (0.57, 0.42 to 0.72), conduct problems (0.22, 0.11 to 0.33), hyperactivity problems (0.44, 0.26 to 0.61) and peer problems (0.14, 0.01 to 0.26), compared with children without current symptoms of the relevant disease. For most associations, parental socioeconomic position did not modify the effect. Children with eczema, asthma or hay fever had more emotional, conduct and hyperactivity problems, but not peer problems, compared with children without these diseases. Atopic diseases added equally to the burden of mental health problems independent of socioeconomic position. 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/.

What China's experiment in community building can tell us about tackling health disparities: community building and mental health in mid-life and older life: evidence from China.

PubMed

Muennig, Peter

2014-04-01

Disparities in physical and mental health between advantaged and disadvantaged communities are among the largest threats to population health worldwide. These disparities appear to be growing, probably in part because we do not understand how to address their underlying causes. Many believe the underlying causes are thought to arise directly or indirectly from the psychosocial problems underlying poverty, such as hunger, poor housing, drug use, or crime. One logical solution is therefore to provide more community services targeted at addressing these problems within the most disadvantaged communities. However, to date, data on the efficacy of this approach is lacking. China serves as a possible laboratory for studying the efficacy of community-based programs. This is because the extensive community-based programs present prior to economic reforms in 1978 were removed, and then later re-instated in a quasi-experimental manner. In this issue, Yuying Shen uses multi-level models to explore the impact of this experiment on community mental health in a multi-level associational study. She finds that the quantity (but not their length of time in the community) of such services is positively associated with mental health. This study opens the door to more rigorous analyses that might motivate formal social experiments at the community level worldwide. If successful, such experiments might not only transform what we currently know not just about improving health in disadvantaged communities, but also prove transformative for health policy as a discipline. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Efficacy of mental health prevention and promotion strategies in higher education].

PubMed

Martineau, Marc; Beauchamp, Guy; Marcotte, Diane

Recent studies inform of increases in reported mental health problems in higher education students worldwide, with suicide and homicide being the most dramatic outcomes. Improving first-hand intervention and implementing mental health prevention and promotion strategies in colleges and universities are amongst the most commonly mentioned means of addressing these concerns. While institutions increasingly favor mental health promotion, most programs have not been properly evaluated and most strategies cannot be replicated. The article analyses results obtained from literature reviews and meta-analysis focusing on mental health prevention and promotion strategies targeting college and university students. Mindfulness, cognitive-behavioral and relaxation strategies, as well as social ability training, appeared to be the most effective if they were practiced under supervision. The implementation of supervised mental health prevention strategies within a setting-based systematic and multifactorial promotion frame could significantly decrease mental health problems in higher education students.

'Can he have the test for bipolar, doctor? His dad's got it': exploring the potential of general practitioners to work with children and young people presenting in primary care with common mental health problems - a clinical initiative.

PubMed

Roberts, Jane H; Bernard, Paul M

2012-06-01

Background General practitioners (GPs) play a key role in assessing and managing adult mental health problems, but this input is not seen in their management of child and adolescent mental health. Mental health problems in 5-19-year-olds are common, yet detection rates in primary care are low. The symptoms of most adult diagnoses of mental health problems are present by mid-adolescence, yet the typical time from onset to diagnosis is 5-15 years. The role of general practice in this area has been underexplored. Aim This pilot study explores the potential of GPs to respond to common mental health problems in children and adolescents. Design Children and young people who would have ordinarily been referred to Child and Adolescent Mental Health Services (CAMHS) were seen in a GP setting. In a UK general practice surgery serving a disadvantaged population. Method Children and young people were seen for an initial biopsychosocial assessment and formulation of the presenting concerns. GP-based interventions were offered as appropriate or referred to CAMHS. Results Data from the first 50 children (2-19 years) are presented. Twenty younger children (10 years and under) and 30 older children (11 years and above) were seen. Eighteen referrals were made to CAMHS. GP interventions included watchful waiting, brief behavioural interventions, non-directive counselling, brief cognitive- behavioural therapy (CBT) and liaison with colleagues in education, CAMHS and the voluntary sector. Conclusion This clinical pilot demonstrates that with adequate time, access to supervision and practice support, children and young people experiencing emotional and behavioural problems associated with common mental health issues can be helped in primary care.

Child temperament moderates the impact of parental separation on adolescent mental health: The trails study.

PubMed

Sentse, Miranda; Ormel, Johan; Veenstra, René; Verhulst, Frank C; Oldehinkel, Albertine J

2011-02-01

The potential effect of parental separation during early adolescence on adolescent externalizing and internalizing problems was investigated in a longitudinal sample of adolescents (n = 1274; mean age = 16.27; 52.3% girls). Pre-separation mental health problems were controlled for. Building on a large number of studies that overall showed a small effect of parental separation, it was argued that separation may only or especially have an effect under certain conditions. It was examined whether child temperament (effortful control and fearfulness) moderates the impact of parental separation on specific mental health domains. Hypotheses were derived from a goal-framing theory, with a focus on goals related to satisfying the need for autonomy and the need to belong. Controlling for the overlap between the outcome domains, we found that parental separation led to an increase in externalizing problems but not internalizing problems when interactions with child temperament were ignored. Moreover, child temperament moderated the impact of parental separation, in that it was only related to increased externalizing problems for children low on effortful control, whereas it was only related to increased internalizing problems for children high on fearfulness. The results indicate that person-environment interactions are important for understanding the development of mental health problems and that these interactions can be domain-specific. PsycINFO Database Record (c) 2011 APA, all rights reserved.

21 CFR 336.50 - Labeling of antiemetic drug products.

Code of Federal Regulations, 2010 CFR

2010-04-01

... years of age. “Do not take this product, unless directed by a doctor, if you have a breathing problem... Section 336.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... under 12 years of age. “Do not give this product to children who have a breathing problem such as...

Feasibility and Impact of Implementing Motivational Enhancement Therapy--Cognitive Behavioral Therapy as a Substance Use Treatment Intervention in School-Based Settings

ERIC Educational Resources Information Center

Belur, Vinetha; Dennis, Michael L.; Ives, Melissa L.; Vincent, Robert; Muck, Randolph

2014-01-01

The expansion of behavioral health services to school-based health centers under the Affordable Care Act (Public Law 111-148) presents an opportunity to improve access to substance use disorders treatment for youth and reduce their substance use, and emotional, health, and school problems. We explore the feasibility of implementing five to seven…

[TEEN MOTHER AND NEWBORN NUTRITIONAL STATUS IN A GROUP OF TEENAGERS OF THE CITY OF MEDELLIN].

PubMed

Restrepo-Mesa, Sandra Lucia; Zapata López, Natalia; Parra Sosa, Beatriz Elena; Escudero Vásquez, Luz Estela; Betancur Arrovaye, Laura

2015-09-01

in developing countries, including Colombia, teen pregnancy is a public health problem. It brings social, health and nutritional consequences for the mother/son binomial. to assess demographic, socioeconomic, food security, health and nutritional status characteristics in a group of pregnant teenagers and their newborns. a cross sectional analytical study was performed in 294 pregnant teenagers in their third trimester of pregnancy enrolled in the prenatal care programs of the public network of hospitals in Medellin-Colombia between 2011 and 2012. Association between the mother's body mass index, iron nutritional status and newborn's weight at birth using explicative variables was assessed. monthly incomes under a minimum salary were associated with low mother's weight and newborns small for gestational age. Low gestational weight was higher in pregnant women under 15 years of age and with a gynecological age under five years. The prevalence of anemia was low in the first trimester and increased at the end of pregnancy; 5.6% had adequate iron reserves. Low weight at birth was associated with infections and mother's low weight in the third trimester of pregnancy. teenage pregnancy is a complex problem associated with negative effects in the nutritional, health and social status of the girl and their newborn. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Birth of a health service.

PubMed

Anderson, G

On April 18th, independent Zimbabwe celebrated its 3rd birthday. In 1980, within days after taking power, Robert Mugabe's government announced that health care was to be free to everyone earning less then Z150 (60 British pounds) a month--the vast majority of the population. Although the free services are a good public relations policy, more important was the decision to expand the health services at grassroots level and to shift emphasis from an urban based curative system to rural based preventive care. Zimbabwe desperately needs doctors. According to the World Health Organization (WHO), the country has some 1400 registered doctors, roughly 1 for every 6000 people. Yet, of the 1400, under 300 work in the government health services and many of those are based in Harare, the capital. Of Zimbabwe's 28 district hospitals, only 14 have a full-time doctor. In some rural areas, there is 1 doctor/100,000 or more people. The nature of the country's health problems, coupled with the government's severe shortage of cash, shows why nursing is so crucial to Zimbabwe's development. If the rural communities, which make up 85% of the population, were to have easy access to a qualified nurse, or even a nursing assistant, the quality of life would double. The only thing that is more important is a clean water supply. Possibly the most important role for nurses in Zimbabwe is that of education. Nurses can spread awareness of basic hygiene, raise the skill of local people in dealing with minor health problems independently, carry out immunization programs, offer contraceptive advice, give guidance on breastfeeding and infant nutrition, and work with practitioners of traditional African medicines to make sure they possess basic scientific knowledge. Rebuilding after the war was not a major problem for the Mugabe health ministry, for in many areas there was simply nothing to rebuild. There were never any health services. A far greater problem has been the top heavy structure of the health service established initially under British and then Rhodesia Front rule. The system was geared to providing for the primarily white urban elite.

Looking In: Exploring One's Personal Health Values.

ERIC Educational Resources Information Center

Read, Donald A.

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

Dental Disease in Infants and Toddlers: A Transdisciplinary Health Concern and Approach

ERIC Educational Resources Information Center

Finn, Emanuel; Wolpin, Scott

2005-01-01

This article describes the consequences of dental disease among children under age 3. "Early childhood carries" (ECC) is preventable but is still a major public health problem--especially in poor and medically underserved communities--due to lack of awareness about prevention. The authors explain that in transdisciplinary care, practitioners work…

Prevalence of Shigella among diarrheic children under-5 years of age attending at Mekelle health center, north Ethiopia.

PubMed

Kahsay, Atsebaha Gebrekidan; Teklemariam, Zelalem

2015-12-15

Shigellosis is recognized as a major global public health problem especially in developing countries particularly in children under-5 years of age. Therefore; the objective of this study was to determine the prevalence of Shigella among diarrheic children under-5 years of age attending at Mekelle health center, north Ethiopia. A cross-sectional study was conducted among diarrheic children under-5 years of age from March to May, 2012. Structured questionnaire was used to collect the data. Study participants were recruited by convenience sampling technique. Shigella was isolated and identified using standard bacteriological techniques. A total of 241 study participants were included in the study. The overall prevalence of Shigella in this study was 13.3% (32/241). High prevalence of Shigella (22.6%) was revealed from the age group of 12-23 months. No Shigella was isolated from the age group of 0-5 months. Majority of the isolates of Shigella were from bloody and mucoid diarrhea. There was high prevalence of Shigella infection in this study. Children among the age group of 12-23 months were highly affected. Therefore; responsible bodies should work hard on preventive measures to reduce or eradicate the problem occurred due to shigellosis.

Prospective relationship between poor sleep and substance-related problems in a national sample of adolescents

PubMed Central

Wong, Maria M.; Roberson, Gail; Dyson, Rachel

2014-01-01

Background Previous studies showed that poor sleep prospectively predicted alcohol related problems and illicit drug use in adolescents and young adults (Wong et al., 2010, 2012). However, more works needs to be done to elucidate the nature of these problems. The purpose of this study was to examine whether sleep difficulties and hours of sleep prospectively predicted several serious substance related problems, e.g., binge drinking, driving under the influence of alcohol, risky sexual behavior. Methods Study participants were 6504 adolescents from the National Longitudinal Study of Adolescent Health (ADD HEALTH). Data were collected from interviews and questionnaires. The current study analyzed data from the first three waves of data (T1: 1994–95; T2: 1996; T3: 2001–02). In all analyses, we used sleep difficulties at a previous wave to predict substance-related problems at a subsequent wave, while controlling for substance-related problems at a previous wave. Results Holding T1 alcohol-related problems constant, sleep difficulties at T1 significantly predicted alcohol-related interpersonal problems, binge drinking, gotten drunk or very high on alcohol, driving under the influence of alcohol, getting into a sexual situation one later regretted due to drinking, ever using any illicit drugs and drugs-related problems at T2. T1 hours of sleep negatively predicted T2 alcohol-related interpersonal problems and binge drinking. The relationship between T2 sleep variables and T3 substance-related problems were consistent with previous waves, though the effect was weaker. Conclusions Sleep difficulties and hours of sleep are a significant predictor of a number of substance-related problems. It may be useful to educate adolescents about the importance of sleep, sleep hygiene and the potential consequences of poor sleep on drinking and related behaviors. PMID:25598438

Medical benefits in young adulthood: a population-based longitudinal study of health behaviour and mental health in adolescence and later receipt of medical benefits.

PubMed

Sagatun, Åse; Heyerdahl, Sonja; Wentzel-Larsen, Tore; Lien, Lars

2015-05-12

To examine the extent to which smoking, alcohol, physical activity and mental health problems in 15-16-year-olds are associated with receipt of medical benefits in young adulthood, after adjustment for confounders. Prospective population-based cohort survey linked to national registers. In the 'Youth studies' from the Norwegian Institute of Public Health, 15 966 10th graders in 6 Norwegian counties answered a health behaviour and mental health questionnaire; 88% were linked to National Insurance Administration Registers (FD-Trygd). Time to receipt of medical benefits, based on FD-Trygd. Follow-up was from age 18 years until participants were aged 22-26 years. We performed Cox regression analyses to examine the extent to which variations in health behaviour and mental health problems during 10th grade were associated with receipt of medical benefits during follow-up. Daily smoking at age 15-16 years was associated with a significant increase in hazard of receiving health benefits at follow-up compared with not smoking for boys, HR (95% CI) 1.56 (1.23 to 1.98), and for girls 1.47 (1.12 to 1.93). Physical activity was associated with a decrease in hazard compared with inactivity from 23% to 53% in boys and from 21% to 59% in girls, while use of alcohol showed a mixed pattern. The hazard for benefits use rose with increasing levels of emotional symptoms, peer problems, conduct problems and hyperactivity-inattention problems (Strengths and Difficulties Questionnaire) at 15-16 years among both genders. Health behaviour and mental health problems in adolescence are independent risk factors for receipt of medical benefits in young adulthood. 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.

Organizational health in health organizations: towards a conceptualization.

PubMed

Orvik, Arne; Axelsson, Runo

2012-12-01

This article is introducing a new concept of organizational health and discussing its possible implications for health organizations and health management. The concept is developed against the background of New Public Management, which has coincided with increasing workplace health problems in health organizations. It is based on research mainly in health promotion and health management. Organizational health is defined in terms of how an organization is able to deal with the tensions of diverse and competing values. This requires a dialectical perspective, integration as well as disintegration, and a tricultural approach to value tensions. The concept of organizational health is pointing towards an inverse value pyramid and a hybrid- and value-based form of management in health organizations. An application of this concept may clarify competing values and help managers to deal with the value tensions underlying workplace health problems on an organizational as well as an individual and group level. More empirical research is required, however, to link more closely the different aspects of organizational health in health organizations. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

[Early-summer meningo-encephalitis (ESME) and ESME-vaccination: status 2000].

PubMed

Kunze, U; Bernhard, G; Böhm, G; Groman, E

2000-01-01

Tick-borne encephalitis (TBE) is a public health problem very well under control in Austria because of a vaccination programme using a safe, efficient and well tolerated vaccine and a carefully designed social marketing concept. The Austrian vaccine underwent another technological updating and is now marketed under a new brand name (TicoVac) on the basis of an EU registration. A second product is also available (Encepur), but some limitations of use have to be taken into account. To improve the epidemiological situation even further (only 41 hospital cases in 1999) special attention has to be given to the age group 50 years and older as this is the segment of the population where the majority of cases is observed. TBE is a growing international health problem as awareness increases and cases are identified in many European countries, even in regions where TBE so far was not diagnosed. An "International Scientific Working-group on Tick-borne encephalitis (ISW-TBE)" was established to coordinate research and public health activities.

Reflections on curative health care in Nicaragua.

PubMed Central

Slater, R G

1989-01-01

Improved health care in Nicaragua is a major priority of the Sandinista revolution; it has been pursued by major reforms of the national health care system, something few developing countries have attempted. In addition to its internationally recognized advances in public health, considerable progress has been made in health care delivery by expanding curative medical services through training more personnel and building more facilities to fulfill a commitment to free universal health coverage. The very uneven quality of medical care is the leading problem facing curative medicine now. Underlying factors include the difficulty of adequately training the greatly increased number of new physicians. Misdiagnosis and mismanagement continue to be major problems. The curative medical system is not well coordinated with the preventive sector. Recent innovations include initiation of a "medicina integral" residency, similar to family practice. Despite its inadequacies and the handicaps of war and poverty, the Nicaraguan curative medical system has made important progress. PMID:2705603

Mental health risks among nurses under abusive supervision: the moderating roles of job role ambiguity and patients' lack of reciprocity.

PubMed

Qian, Jing; Wang, Haiwan; Han, Zhuo Rachel; Wang, Jun; Wang, Hui

2015-01-01

While the nursing profession has been associated with mental health problems and the research into the antecedents of mental health has steadily grown, the relationship between abusive supervision and mental health issues of anxiety and depression remains largely unknown. This study aims to examine the relationship between abusive supervision and mental health problems. And we also aim to investigate whether this relationship is moderated by role ambiguity and the patients' lack of reciprocity. A total of 227 frontline nurses from two public hospitals completed the survey questionnaire. (1) Abusive supervision was positively associated with poor mental health; (2) the positive relationship was moderated by nurses' perceived role ambiguity in such a way that the relationship was stronger when the perceived role ambiguity is high; (3) the positive relationship was moderated by the patients' lack of reciprocity in such a way that the relationship was stronger when patients' lack of reciprocity was high. To conclude, the present study showed that abusive supervision was positively associated with mental health problems of anxiety and depression among samples of Chinese nurses. Findings of this study also highlighted that this relationship was contingent upon perceived role ambiguity and patients' reciprocity.

Skin Problems in Construction

MedlinePlus

... credit: Contains public sector information published by the Health and Safety Executive and licensed under the Open Government Licence v1.0 materials you use at work. Find out more about construction hazards. To receive ...

Agrichemical safety practices on farms in the western Cape.

PubMed

London, L

1994-05-01

In order to study agrichemical safety practices in a rural farming area in the western Cape, an audit of 45 randomly sampled farms was performed over 3 months in 1992. A response rate of 87% was achieved, and the survey results suggest that approximately 9% of permanent and 14% of seasonal farm workers are employed in jobs with potential exposure to agrichemicals. While protective equipment was widely available, gloves and masks were seldom used, with little enforcement or commercial support from the suppliers of the equipment. Farm workers receive little training on pesticide safety, but interest in the possibility of further training for workers was high. In the absence of a system of pesticide disposal, the presence of residual, unwanted and outdated stocks of pesticides in farmers' stores, and to a lesser extent the presence of empty containers, are identified as important problems. Current pesticide storage practices require improvement by simple industrial hygiene measures. Health facilities available to workers on most farms are extremely limited, particularly in the light of statutory requirements for occupational safety and health under the Machinery and Occupational Safety Act. It is argued that collective solutions to problems of pesticide safety are possible within the ambit of a public health response, particularly given the willingness of the farming community to identify and address potential health problems. As a result, initiatives to meet these needs are currently under way in the region.

[Violence against women in transnational communities in San Luis Potosí, Mexico: a public health problem].

PubMed

Flores, Yesica Yolanda Rangel

2016-08-01

Violence against women is a worldwide problem due to its impact on quality of life for those living under the complicity of a patriarchal culture and a state that makes such violence invisible. This article aims to give visibility to the contexts of violence affecting female "partners of migrants" in their places of origin, problematizing how such violence assaults their physical and mental health. This was a qualitative study with an interpretative anthropological focus, drawing on a sample of 21 women from rural and urban areas in San Luis Potosí, Mexico. Interviews were based on daily life history and discourse analysis. According to the results, women experience more violence when their spouses migrate, new forms of violence are committed against them, and the violence occurs in both the household and the community. Violence against women is a public health problem that should be treated through a framework that is sensitive to the social and cultural dynamics characterizing the contexts in which health programs are implemented.

Supporting the Health of College Solo Singers: The Relationship of Positive Emotions and Stress to Changes in Salivary IgA and Cortisol during Singing

ERIC Educational Resources Information Center

Beck, Robert J.; Gottfried, Terry L.; Hall, David J.; Cisler, Caitlin A.; Bozeman, Kenneth W.

2006-01-01

Singers appear to experience health benefits from singing, but their art makes physical demands that may leave them prone to health problems. The study sought to measure singers' immunocompetence under practice and performance conditions. Salivary IgA and cortisol measurements were assayed from multiple pre-post saliva samples obtained from 10…

Containing U.S. health care costs: What bullet to bite?

PubMed Central

Jencks, Stephen F.; Schieber, George J.

1992-01-01

In this article, the authors provide an overview of the problem of health care cost containment. Both the growth of health care spending and its underlying causes are discussed. Further, the authors define cost containment, provide a framework for describing cost-containment strategies, and describe the major cost-containment strategies. Finally, the role of research in choosing such a strategy for the United States is examined. PMID:25372928

Differentiation of direct and indirect socioeconomic effects on suicide attempts in South Korea

PubMed Central

Ki, Myung; Seong Sohn, Eui; An, Byungduck; Lim, Jiseun

2017-01-01

Abstract Despite the wide recognition of the inverse association between socioeconomic position (SEP) and suicidal behaviors, its underlying process and potential mediators are little known. This study investigated the pathway from SEP to suicide attempts with attention to potential mediators. From the Korean Health and Nutrition Examination Survey 2007–2013, which is a nationwide cross-sectional survey of the health and nutritional status, a total of 34,565 participants (≥30 years) were included in the analysis. To unfold the pathways linking SEP to suicide attempts, the direct and indirect effects of 3 SEP measures (educational attainment, household income, and occupational group) and 3 mediators (physical illness, mental health problems, and problematic drinking) were differentiated using structured equation model (SEM). Most of direct and indirect effects of educational attainment, household income, and occupational group on suicide attempts were significant; Nonemployment status had the largest total (β = 0.291, P < .01) and direct effects (β = 0.212, P < .01), while educational attainment had the largest indirect effect (β = −0.124, P < .01). Educational attainment was mainly mediated by physical illness and problem drinking, whereas household income and occupational group were mainly mediated by anxious or depressed mood and problem drinking. Physical illness played a major role in explaining suicide attempts, compared to mental health problem and problem drinking. Overall, experience of socioeconomic disadvantage increased suicide attempts independently of mental and physical problems. An extension of suicide prevention program is required for comprehensively targeting people with general problems such as physical illness and low SEP, complemented to narrowly targeting high risk group with, such as mental health problem. PMID:29390510

The health of Inuit children under age 6 in Canada

PubMed Central

Findlay, Leanne C.; Janz, Teresa A.

2012-01-01

Objectives Previous research has suggested that Inuit children experience poor health as compared to their non-Aboriginal counterparts, although social determinants such as family and social conditions, lifestyle or behaviour, and cultural factors may be at play. The purpose of the current study was to examine the parent-reported health of Inuit children under 6 years of age living in Canada. Study design and methods Data from the 2006 Aboriginal Children's Survey were used to examine measures of Inuit child health as rated by parents including child health, limitations to physical activity, chronic conditions, ear infections, and dental problems. Associations between social determinants of health and parent-rated Inuit child health were also explored. Results Most Inuit children under age 6 were reported by their parents or guardians to be in excellent or very good health. The most common chronic conditions identified were asthma, speech and language difficulties, allergies, lactose intolerance, and hearing impairment. Several social determinants of health were associated with child health, including parental education, household income, breastfeeding, and perceived housing conditions. Conclusions The findings show that social determinants of health, including both socio-economic and household characteristics, are associated with Inuit child health. PMID:22973565

A public health decision support system model using reasoning methods.

PubMed

Mera, Maritza; González, Carolina; Blobel, Bernd

2015-01-01

Public health programs must be based on the real health needs of the population. However, the design of efficient and effective public health programs is subject to availability of information that can allow users to identify, at the right time, the health issues that require special attention. The objective of this paper is to propose a case-based reasoning model for the support of decision-making in public health. The model integrates a decision-making process and case-based reasoning, reusing past experiences for promptly identifying new population health priorities. A prototype implementation of the model was performed, deploying the case-based reasoning framework jColibri. The proposed model contributes to solve problems found today when designing public health programs in Colombia. Current programs are developed under uncertain environments, as the underlying analyses are carried out on the basis of outdated and unreliable data.

Rising to a New Paradigm: Infusing Health and Wellness into the Music Curriculum

ERIC Educational Resources Information Center

Pierce, Deborah L.

2012-01-01

Musicians, like athletes, daily face the stark reality of physical and psychological health issues that can negatively affect or end their careers. Research shows compelling reasons for making changes to the value systems and in the educational process under which musicians are trained to help alleviate these problems. Changes would include…

Officials Warn of a Crisis in Student Health Insurance as Medical Costs Soar and Companies Revise Policies.

ERIC Educational Resources Information Center

Collison, Michele N-K

1989-01-01

As costs rise and companies discontinue coverage of college students under parents' policies, students are choosing to forego insurance rather than pay for it themselves, so suggest speakers at the American College Health Association's annual meeting. Colleges offering group-insurance policies to students are also having problems renewing them.…

Mental health selection and income support dynamics: multiple spell discrete-time survival analyses of welfare receipt.

PubMed

Kiely, Kim M; Butterworth, Peter

2014-04-01

The higher occurrence of common psychiatric disorders among welfare recipients has been attributed to health selection, social causation and underlying vulnerability. The aims of this study were to test for the selection effects of mental health problems on entry and re-entry to working-age welfare payments in respect to single parenthood, unemployment and disability. Nationally representative longitudinal data were drawn from the Household Income and Labour Dynamics in Australia survey. Multiple spell discrete-time survival analyses were conducted using multinomial logistic regression models to test if pre-existing mental health problems predicted transitions to welfare. Analyses were stratified by sex and multivariate adjusted for mental health problems, father's occupation, socioeconomic position, marital status, employment history, smoking status and alcohol consumption, physical function and financial hardship. All covariates were modelled as either lagged effects or when a respondent was first observed to be at risk of income support. Mental health problems were associated with increased risk of entry and re-entry to disability, unemployment and single parenting payments for women, and disability and unemployment payments for men. These associations were attenuated but remained significant after adjusting for contemporaneous risk factors. Although we do not control for reciprocal causation, our findings are consistent with a health selection hypothesis and indicate that mental illness may be a contributing factor to later receipt of different types of welfare payments. We argue that mental health warrants consideration in the design and targeting of social and economic policies.

A population-based model for priority setting across the care continuum and across modalities

PubMed Central

Segal, Leonie; Mortimer, Duncan

2006-01-01

Background The Health-sector Wide (HsW) priority setting model is designed to shift the focus of priority setting away from 'program budgets' – that are typically defined by modality or disease-stage – and towards well-defined target populations with a particular disease/health problem. Methods The key features of the HsW model are i) a disease/health problem framework, ii) a sequential approach to covering the entire health sector, iii) comprehensiveness of scope in identifying intervention options and iv) the use of objective evidence. The HsW model redefines the unit of analysis over which priorities are set to include all mutually exclusive and complementary interventions for the prevention and treatment of each disease/health problem under consideration. The HsW model is therefore incompatible with the fragmented approach to priority setting across multiple program budgets that currently characterises allocation in many health systems. The HsW model employs standard cost-utility analyses and decision-rules with the aim of maximising QALYs contingent upon the global budget constraint for the set of diseases/health problems under consideration. It is recognised that the objective function may include non-health arguments that would imply a departure from simple QALY maximisation and that political constraints frequently limit degrees of freedom. In addressing these broader considerations, the HsW model can be modified to maximise value-weighted QALYs contingent upon the global budget constraint and any political constraints bearing upon allocation decisions. Results The HsW model has been applied in several contexts, recently to osteoarthritis, that has demonstrated both its practical application and its capacity to derive clear evidenced-based policy recommendations. Conclusion Comparisons with other approaches to priority setting, such as Programme Budgeting and Marginal Analysis (PBMA) and modality-based cost-effectiveness comparisons, as typified by Australia's Pharmaceutical Benefits Advisory Committee process for the listing of pharmaceuticals for government funding, demonstrate the value added by the HsW model notably in its greater likelihood of contributing to allocative efficiency. PMID:16566841

Mental health problems and acculturative issues among married immigrant women in Korea: A qualitative study.

PubMed

Choi, Yun-Jung

2016-01-01

Through this research the author explored immigrant women's mental health problems with the goal of deepening understanding to develop a framework for preventing mental disorders and improving their mental health. A qualitative research design was used to examine the women's lived experiences. The data were collected from February 2014 to October 2014. Twenty women were recruited from multicultural community service centers. Inclusion criteria were the ability to communicate and the absence of acute physical or psychological problems; participants were excluded if they were under 18 years old or separated. Individual in-depth interviews were conducted with participants regarding their experiences of living in Korean society. The data were analyzed using the grounded theory approach. A conceptual framework-Embracing Cultural Conflict Model-was constructed based on the personal-family-community context as well as the paradigm of the immigrant woman using eleven concepts. The conceptual framework suggests that multicultural programs and services should take into account a historical understanding of Korean society and family, address problem-solving strategies including improving mental health literacy, build support from both the Korean family and family of origin, and offer multicultural activities to satisfy homeland-related cultural needs.

Does coping help? A reexamination of the relation between coping and mental health.

PubMed

Aldwin, C M; Revenson, T A

1987-08-01

In a longitudinal community survey of 291 adults, we explored the relation between coping strategies and psychological symptoms. Respondents completed the revised Ways of Coping Scale (Folkman & Lazarus, 1985) for a self-named stressful episode. Factor analysis produced eight coping factors: three problem focused, four emotion focused, and one (support mobilization) that contained elements of both. Multiple regression analyses indicated bidirectionality in the relation between coping and psychological symptoms. Those in poorer mental health and under greater stress used less adaptive coping strategies, such as escapism, but coping efforts still affected mental health independent of prior symptom levels and degree of stress. We compared main versus interactive effects models of stress buffering. Main effects were confined primarily to the emotion-focused coping scales and showed little or negative impacts of coping on mental health; interactive effects, though small, were found with the problem-focused scales. The direction of the relation between problem-focused scales and symptoms may depend in part on perceived efficacy, or how the respondent thought he or she handled the problem. Implications for the measurement of adaptive coping mechanisms and their contextual appropriateness are discussed.

The Impact of Austerity on Mental Health Service Provision: A UK Perspective.

PubMed

Cummins, Ian

2018-06-01

This is a discussion paper which examines the impact of austerity policies on the provision of mental health services in the United Kingdom. Austerity is a shorthand for a series of policies introduced by the Conservative and Liberal Democrat Coalition government in the UK from 2010 onwards. In response to the fiscal crisis following the bail out of the banks in 2008, it was argued that significant reductions in public spending were required. The background to these policies is examined before a consideration of their impact on mental health services. These policies had a disproportionate impact on people living in poverty. People with health problems including mental problems are overrepresented in this group. At the same time, welfare and community services are under increasing financial pressures having to respond to increased demand within a context of reduced budgets. There is increasing recognition of the role that social factors and adverse childhood experiences have in the development and trajectory of mental health problems. Mental health social workers, alongside other professionals, seek to explain mental distress by the use of some variant of a biopsychosocial model. The extent of mental health problems as a one of their measures of the impact of inequality. More unequal societies create greater levels of distress. There is a social gradient in the extent of mental health problems-the impact of severe mental illness means that many individuals are unable to work or, if they can return to work, they find it difficult to gain employment because of discrimination. The paper concludes that austerity and associated policies have combined to increase the overall burden of mental distress and marginalisation within the UK.

Innovative Use of the Law to Address Complex Global Health Problems Comment on "The Legal Strength of International Health Instruments - What It Brings toGlobal Health Governance?"

PubMed

Walls, Helen L; Ooms, Gorik

2017-05-20

Addressing the increasingly globalised determinants of many important problems affecting human health is a complex task requiring collective action. We suggest that part of the solution to addressing intractable global health issues indeed lies with the role of new legal instruments in the form of globally binding treaties, as described in the recent article of Nikogosian and Kickbusch. However, in addition to the use of international law to develop new treaties, another part of the solution may lie in innovative use of existing legal instruments. A 2015 court ruling in The Hague, which ordered the Dutch government to cut greenhouse gas emissions by at least 25% within five years, complements this perspective, suggesting a way forward for addressing global health problems that critically involves civil society and innovative use of existing domestic legal instruments. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The genetic basis of alcoholism: multiple phenotypes, many genes, complex networks.

PubMed

Morozova, Tatiana V; Goldman, David; Mackay, Trudy F C; Anholt, Robert R H

2012-02-20

Alcoholism is a significant public health problem. A picture of the genetic architecture underlying alcohol-related phenotypes is emerging from genome-wide association studies and work on genetically tractable model organisms.

Morbidity, utilization of curative care and service entry point preferences in metropolitan Centro Habana, Cuba.

PubMed

Rodríguez, Armando; Díaz, Addys; Balcindes, Susana; García, René; Vos, Pol De; Stuyft, Patrick Van der

2016-11-03

First-line health services with a primary health care approach are a strong trigger for adequate health-care-seeking behavior. Research on the association between prevalence of chronic diseases and acute illnesses and use of health services emphasizes the importance of socioeconomic determinants in such patterns of utilization. In a cross-sectional study of 408 families in Centro Habana, Cuba, home interviews were conducted between April and June 2010 to analyze socio-demographic determinants of acute and chronic health problems and use of formal health services. Bivariate and logistic regression models were used. 529 persons reported a chronic disease. During the previous month, 155 of the latter reported an exacerbation and 50 experienced an unrelated acute health problem. 107 persons without chronic diseases reported acute health problems. Age was the strongest determinant of chronic disease prevalence. Adult women and the elderly were more likely to report acute problems. Acute patients with underlying chronic disease used formal services more often. No socio-demographic variable was associated with services use or consultation with the family physician. While the family physician is defined as the system's entry-point, this was the case for only 54% of patients that had used formal services, thus compromising the physician's role in counseling patients and summarizing their health issues. The importance of chronic diseases highlights the need to strengthen the family physician's pivotal role. New economic policies in Cuba, stimulating self-employment and private initiative, may increase the strain on the exclusively public health care system. Still, the Cuban health system has demonstrated its ability to adapt to new challenges, and the basic premises of Cuba's health policy are expected to be preserved.

Anticipating the needs of the U.S. aged in the 21st century: dilemmas in epidemiology, gerontology, and public policy.

PubMed

Lusky, R A

1986-01-01

Reductions in the prevalence of chronic disease, functional dependence, and associated social problems among aged Americans have been predicted on the basis of improving environmental and social conditions, more effective public health measures, and advances in medical care. Public policy makers have found such predictions attractive since improved health status in old age could significantly offset the increase in health care resources which would otherwise be required to meet the needs of the country's growing number of elderly. This paper reviews the epidemiologic model underlying such predictions. Key assumptions of the model are evaluated by examining the health and social well-being of elderly residing in a socioeconomically advantaged community with an age structure similar to that projected for the United States in the 21st century. Despite their long-standing advantages in education, employment, income, housing, health care, and community services, these elderly experienced age adjusted rates of health and social problems comparable to those found in nationwide samples of elderly. No evidence of a compression of health problems into the final years of life could be found. Considerable diversity in problem constellations suggested a need for sophisticated packages of health and support services. These findings suggest that any significant improvements in the health status of the aged due to general improvements in living conditions or health behavior are unlikely to emerge before the proportion of aged Americans doubles in the first quarter of the 21st century. If this is so, public policy in the U.S. must be directed to expanding and improving health and social services for the elderly in the foreseeable future. Attempts to hold expenditures on the aged constant, or to reduce such expenditures, would seriously compromise the health of the nation's elderly.

A multi-criteria decision analysis perspective on the health economic evaluation of medical interventions.

PubMed

Postmus, Douwe; Tervonen, Tommi; van Valkenhoef, Gert; Hillege, Hans L; Buskens, Erik

2014-09-01

A standard practice in health economic evaluation is to monetize health effects by assuming a certain societal willingness-to-pay per unit of health gain. Although the resulting net monetary benefit (NMB) is easy to compute, the use of a single willingness-to-pay threshold assumes expressibility of the health effects on a single non-monetary scale. To relax this assumption, this article proves that the NMB framework is a special case of the more general stochastic multi-criteria acceptability analysis (SMAA) method. Specifically, as SMAA does not restrict the number of criteria to two and also does not require the marginal rates of substitution to be constant, there are problem instances for which the use of this more general method may result in a better understanding of the trade-offs underlying the reimbursement decision-making problem. This is illustrated by applying both methods in a case study related to infertility treatment.

Developing regulations for occupational exposures to health hazards in Malaysia.

PubMed

Rampal, Krishna Gopal; Mohd Nizam, J

2006-11-01

In Malaysia exposures in the workplace are regulated under the Factories and Machinery Act (FMA), 1967 and also under the more comprehensive Occupational Safety and Health Act (OSHA) enacted in 1994. With OSHA 1994 the philosophy of legislating safety and health in the workplace changed from one that was very prescriptive and containing detailed technical provisions under FMA, 1967 to one that is more flexible and encourages self-regulation under OSHA 1994. OSHA 1994 is supported by regulations, codes of practices and guidelines to further clarify the provisions in the Act. Under the FMA 1967 emphasis was on safety while with OSHA 1994 there has been equal emphasis on addressing health hazards in the workplace. Regulations for occupational exposures are developed by the Department of Occupational Safety and Health with tripartite and stakeholder consultation. When developing these regulations International Labor Organization Conventions, laws of other countries and occupational exposure standards adopted internationally are reviewed. The government also conducts surveys to collect information on both exposures and health effects in workplaces to have better understanding on specific occupational health problems. Effective law enforcement is crucial in ensuring compliance to safety and health law. The challenge at the moment is to ensure all employers and employees, particularly those in the small and medium enterprises, understand and comply with the provisions stipulated in the legislation.

New York State Residential Treatment Center Admissions: Differences in Histories of Maltreatment, Behavioral Problems, and Mental Health Problems

ERIC Educational Resources Information Center

Baker, Amy J. L.; Purcell, James F.

2005-01-01

This study explored how the histories of young people entering residential treatment in New York State varied depending upon the age and gender of the residents. Specifically, we asked whether children who were admitted to residential treatment centers (RTCs) under 12 years of age had a different set of characteristics than young persons who were…

Benefits of maternal education for mental health trajectories across childhood and adolescence.

PubMed

Meyrose, Ann-Katrin; Klasen, Fionna; Otto, Christiane; Gniewosz, Gabriela; Lampert, Thomas; Ravens-Sieberer, Ulrike

2018-04-01

Mental health problems in children and adolescents are widespread and are a primary public health concern worldwide. During childhood and adolescence different challenges must be met. Whether the corresponding developmental tasks can be mastered successfully and in a psychologically healthy manner depends on the availability of resources. The aim of the current study was to examine the benefits of maternal education on the development of mental health in children and adolescents. Data from 2810 participants (48.7% female, 7- to 19-years old) of the longitudinal BELLA study (mental health module of the representative German KiGGS study) were analyzed from up to four measurement points (2003-2012). Individual growth modeling was employed to estimate the benefits of maternal education (Comparative Analysis of Social Mobility in Industrial Nations, CASMIN) for the trajectories of mental health problems (parent-reported Strengths and Difficulties Questionnaire, SDQ) in children and adolescents. Children of mothers with low education had significantly more mental health problems compared to children of mothers with high education. This difference due to maternal education applied for girls as well as boys and especially for participants who did not live with both biological parents. Further, the difference in mental health problems due to varying maternal education decreased with increasing age of the participants. Prevention programs should focus on children of mothers with lower education who additionally live in single- or step-parent families as a high-risk group. Knowledge of the underlying mechanism between education and mental health is highly important. Copyright © 2018 Elsevier Ltd. All rights reserved.

Attending unintended transformations of health care infrastructure

PubMed Central

Wentzer, Helle; Bygholm, Ann

2007-01-01

Introduction Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods Against a background of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure. These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results This paper develops a conceptual framework for addressing transformations of communication and workflow in health care as a result of implementing IT. Conclusion and discussion The purpose of the conceptual framework is to support the attention to and continuous screening for errors and unintended consequences of IT implementation into health care practices and outcomes. PMID:18043725

Short- and long-term health consequences of sleep disruption.

PubMed

Medic, Goran; Wille, Micheline; Hemels, Michiel Eh

2017-01-01

Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic-pituitary-adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health care professionals should be cognizant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption.

Short- and long-term health consequences of sleep disruption

PubMed Central

Medic, Goran; Wille, Micheline; Hemels, Michiel EH

2017-01-01

Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic–pituitary–adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health care professionals should be cognizant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption. PMID:28579842

Mental Health Differences between Young Adults with and without Same-Sex Contact: A Simultaneous Examination of Underlying Mechanisms

ERIC Educational Resources Information Center

Ueno, Koji

2010-01-01

Previous research has documented that sexual minorities are more likely than heterosexual people to experience mental health problems, but little is known about how these disparities emerge. Analysis of data from Miami-Dade County, Florida, shows that young adults reporting same-sex contact have higher levels of depressive symptoms and drug use…

‘Can he have the test for bipolar, doctor? His dad's got it’: exploring the potential of general practitioners to work with children and young people presenting in primary care with common mental health problems – a clinical initiative

PubMed Central

2012-01-01

Background General practitioners (GPs) play a key role in assessing and managing adult mental health problems, but this input is not seen in their management of child and adolescent mental health. Mental health problems in 5–19-year-olds are common, yet detection rates in primary care are low. The symptoms of most adult diagnoses of mental health problems are present by mid-adolescence, yet the typical time from onset to diagnosis is 5–15 years. The role of general practice in this area has been underexplored. Aim This pilot study explores the potential of GPs to respond to common mental health problems in children and adolescents. Design Children and young people who would have ordinarily been referred to Child and Adolescent Mental Health Services (CAMHS) were seen in a GP setting. In a UK general practice surgery serving a disadvantaged population. Method Children and young people were seen for an initial biopsychosocial assessment and formulation of the presenting concerns. GP-based interventions were offered as appropriate or referred to CAMHS. Results Data from the first 50 children (2–19 years) are presented. Twenty younger children (10 years and under) and 30 older children (11 years and above) were seen. Eighteen referrals were made to CAMHS. GP interventions included watchful waiting, brief behavioural interventions, non-directive counselling, brief cognitive– behavioural therapy (CBT) and liaison with colleagues in education, CAMHS and the voluntary sector. Conclusion This clinical pilot demonstrates that with adequate time, access to supervision and practice support, children and young people experiencing emotional and behavioural problems associated with common mental health issues can be helped in primary care. PMID:23730336

Social, economic, and political factors in progress towards improving child survival in developing nations.

PubMed

Lykens, Kristine; Singh, Karan P; Ndukwe, Elewichi; Bae, Sejong

2009-01-01

Child mortality is a persistent health problem faced by developing nations. In 2000 the United Nations (UN) established a set of high priority goals to address global problems of poverty and health, the Millennium Development Goals, which address extreme poverty, hunger, primary education, child mortality, maternal health, infectious diseases, environmental sustainability, and partnerships for development. Goal 4 aims to reduce by two thirds, between 2000 and 2015, the under-five mortality rate in developing countries. In sub-Saharan Africa from 2000 to 2006 these rates have only been reduced from 167 per 1,000 live births to 157, and 27 nations in this region have made no progress towards the goal. A country-specific database was developed from the UN Millennium Development Goal tracking project and other international sources which include age distribution, under-nutrition, per capita income, government expenditures on health, external resources for health, civil liberties, and political rights. A multiple regression analysis examined the extent to which these factors explain the variance in child mortality rates in developing countries. Nutrition, external resources, and per capita income were shown to be significant factors in child survivability. Policy options include developed countries' renewed commitment of resources, and developing nations' commitments towards governance, development, equity, and transparency.

The genetic basis of alcoholism: multiple phenotypes, many genes, complex networks

PubMed Central

2012-01-01

Alcoholism is a significant public health problem. A picture of the genetic architecture underlying alcohol-related phenotypes is emerging from genome-wide association studies and work on genetically tractable model organisms. PMID:22348705

Decision making under uncertainty and information processing in positive and negative mood states.

PubMed

Mohanty, Sachi Nandan; Suar, Damodar

2014-08-01

This study examines whether mood states (a) influence decision making under uncertainty and (b) affect information processing. 200 students at the Indian Institute of Technology Kharagpur participated in this study. Positive mood was induced by showing comedy movie clips to 100 participants and negative mood was induced by showing tragedy movie clips to another 100 participants. The participants were administered a questionnaire containing hypothetical situations of financial gains and losses, and a health risk problem. The participants selected a choice for each situation, and stated the reasons for their choice. Results suggested that the participants preferred cautious choices in the domain of gain and in health risk problems and risky choices in the domain of loss. Analysis of the reasons for the participants' choices suggested more fluency, originality, and flexibility of information in a negative mood compared to a positive mood. A negative (positive) mood state facilitated systematic (heuristic) information processing.

Caregiver burden in Alzheimer's disease patients in Spain.

PubMed

Peña-Longobardo, Luz María; Oliva-Moreno, Juan

2015-01-01

Alzheimer's disease constitutes one of the leading causes of burden of disease, and it is the third leading disease in terms of economic and social costs. To analyze the burden and problems borne by informal caregivers of patients who suffer from Alzheimer's disease in Spain. We used the Survey on Disabilities, Autonomy and Dependency to obtain information on the characteristics of disabled people with Alzheimer's disease and the individuals who provide them with personal care. Additionally, statistical multivariate analyses using probit models were performed to analyze the burden placed on caregivers in terms of health, professional, and leisure/social aspects. 46% of informal caregivers suffered from health-related problems as a result of providing care, 90% had leisure-related problems, and 75% of caregivers under 65 years old admitted to suffering from problems related to their professional lives. The probability of a problem arising for an informal caregiver was positively associated with the degree of dependency of the person cared for. In the case of caring for a greatly dependent person, the probability of suffering from health-related problems was 22% higher, the probability of professional problems was 18% higher, and there was a 10% greater probability of suffering from leisure-related problems compared to non-dependents. The results show a part of the large hidden cost for society in terms of problems related to the burden lessened by the caregivers. This information should be a useful tool for designing policies focused toward supporting caregivers and improving their welfare.

Prospective monitoring of health problems among recreational runners preparing for a half marathon

PubMed Central

Baumann, Antje; Zech, Astrid; Verhagen, Evert

2018-01-01

Objectives While the health benefits of running are legitimately advocated, participation in running can also lead to health problems. There is a high range of reported prevalence rates especially of running-related overuse injuries in high-level athletes and during competition. Little consensus exists for acute injuries and illnesses especially in recreational runners. Therefore, the aim of this study was to record the prevalence of health problems in recreational long-distance runners preparing for an event. Methods Recreational runners aged 18–65 years who were registered 13 weeks prior to a half-marathon running event were invited to take part in this study. Participants were prospectively monitored weekly over 13 weeks by applying a standardised surveillance system for injuries and illnesses (Oslo Sports Trauma Research Center questionnaire). From this, prevalence and severity of acute and overuse injuries, as well as illnesses, were calculated. Results We received 3213 fully answered questionnaires from 327 participants (40.7% female, 40.9±11.7 years of age, 31.5±21.1 km weekly mileage, 8.3±7.8 years of running experience). At any point in time over the preparation phase, 37.3% of the participants had health problems. Overuse injuries were the major burden (18%). They were followed by illnesses (14.1%) and acute injuries (7.9%). The median weekly severity score was 56.5 (IQR 37.0–58.0). Conclusion The high prevalence of health problems in our cohort suggests that future efforts are needed to further specify the underlying mechanism and develop adequate prevention strategies for recreational runners. PMID:29387447

Risk-Adjustment Simulation: Plans May Have Incentives To Distort Mental Health And Substance Use Coverage

PubMed Central

Montz, Ellen; Layton, Tim; Busch, Alisa B.; Ellis, Randall P.; Rose, Sherri; McGuire, Thomas G.

2016-01-01

Under the Affordable Care Act, the risk-adjustment program is designed to compensate health plans for enrolling people with poorer health status so that plans compete on cost and quality rather than the avoidance of high-cost individuals. This study examined health plan incentives to limit covered services for mental health and substance use disorders under the risk-adjustment system used in the health insurance Marketplaces. Through a simulation of the program on a population constructed to reflect Marketplace enrollees, we analyzed the cost consequences for plans enrolling people with mental health and substance use disorders. Our assessment points to systematic underpayment to plans for people with these diagnoses. We document how Marketplace risk adjustment does not remove incentives for plans to limit coverage for services associated with mental health and substance use disorders. Adding mental health and substance use diagnoses used in Medicare Part D risk adjustment is one potential policy step toward addressing this problem in the Marketplaces. PMID:27269018

Modeling the effects of indoor passive smoking at home, work, or other households on adult cardiovascular and mental health: the Scottish Health Survey, 2008-2011.

PubMed

Shiue, Ivy

2014-03-13

Passive smoking has contributed increased risks of cardiovascular disease, mental health, and mortality, but the cumulative effects from work or other households were less studied. Therefore, it was aimed to model the effects of indoor passive smoking from own home, work, and other households in a country-wide, population-based setting. Data in the Scottish Health Survey between 2008 and 2011 after the law banning smoking in public places were analyzed. Information including demographics, lifestyle factors, and self-reported cardiovascular disease and mental health was obtained by household interview. Analyses included chi-square test and survey-weighted logistic regression modeling. After full adjustment, it was observed that being exposed to indoor passive smoking, in particular in more than two places of exposure, was significantly associated with risks of stroke, angina, heart attack, abnormal heart rhythms, and GHQ ≥ 12. The significance remained for angina, GHQ ≥ 12 and probably heart attack in never smokers. The cumulative risks also impacted on sleep problems, self-recognition, making decisions, self-confidence, under strain constantly, depressed, happiness and self-worth. The significance remained for sleep problems, self-confidence, under strain constantly, depressed, and happiness in never smokers. Elimination of indoor passive smoking from different sources should still be a focus in future public health programs.

Understanding health care providers' reluctance to adopt a national electronic patient record: an empirical and legal analysis.

PubMed

Zwaanswijk, M; Ploem, M C; Wiesman, F J; Verheij, R A; Friele, R D; Gevers, J K M

2013-03-01

Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch n-EPR also raised considerable controversy, which eventually caused the Dutch government to stop its contribution to the national infrastructure. To explain Dutch health care providers' reluctance in adopting the n-EPR, we investigated their perceptions of problems associated with the n-EPR and their legal position regarding then-EPR. We hereby aim to provide suggestions about approaches that could promote successful implementation. The study consisted of two parts. The empirical part of the study was conducted in three health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, 17 stakeholders working in these organisations were interviewed to investigate health care providers' perceptions of problems associated with the n-EPR. In the legal part of the study, legal documents were analysed to study health care providers' legal position regarding the n-EPR and any associated problems. The respondents expressed concerns about the confidentiality and safety of information exchange and the reliability and quality of patient data in the n-EPR, and indicated that their liability in case of medical errors was not sufficiently clear. The perceived problems could partly be attributed to legal uncertainties. It is recommended to start the implementation of an n-EPR in limited geographical areas. This will allow health care providers to experience benefits of electronic information exchange before being asked to participate in information exchange at a larger scale. The problems that health care providers perceive in the n-EPR should be minimised. Legislation underlying the n-EPR should provide sufficient clarity about health care professionals' responsibilities and liabilities.

Why it's time for a national health program in the United States.

PubMed Central

Waitzkin, H

1989-01-01

The United States lacks a coherent national health program. Current programs leave major gaps in coverage and recently have become more restrictive. Influential policies that have failed to correct crucial problems of the health-care system include competitive strategies, corporate intervention, and public-sector cutbacks with bureaucratic expansion. A national health program that combines elements of national health insurance and a national health service is a policy that would help solve current health-care problems. Previous proposals for national health insurance contained weaknesses that would need correction under a national program. Based on the experiences of other economically advanced countries, a national health program could provide universal entitlement to health care while controlling costs and improving the health-care system through structural reorganization. Current proposals for a national health program contain several basic principles dealing with the scope of services, copayments, financing, cost controls, physician and professional associations, personnel and distribution, prevention, and participation in policy making. Support for a national health program is growing rapidly. Such a program would help protect all people who live in this country from unnecessary illness, suffering, and early death. PMID:2735021

Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation.

PubMed

Robinson, N J; Brennan, M L; Cobb, M; Dean, R S

2016-02-01

Preventive-medicine consultations account for a large proportion of the veterinary caseload and previous research has suggested these consultations are fundamentally different from those in which the animal is presented for a specific health problem. There has been recent controversy around some aspects of preventive medicine for cats and dogs, and the full health benefits of the preventive-medicine consultation remain unclear. The aim of this study was to compare characteristics of the consultation and the problems discussed during the consultation between preventive-medicine consultations and other types of consultations. Data were gathered during direct observation of small-animal consultations in seven first-opinion practices in the United Kingdom. Data collected included type of clinical examination performed, patient signalment, and details of all problems discussed (including whether the problem was presenting or non-presenting, new or pre-existing, who had raised the problem, body system affected and whether an action was taken). A two-level multivariable logistic-regression model was developed, with canine and feline patients at Level 1 nested within consulting veterinary surgeons at Level 2, and a binary outcome variable of preventive-medicine consultation versus specific health-problem consultation. A total of 1807 patients were presented, of which 690 (38.2%) presented for a preventive-medicine consultation. Dogs were the most frequently presented species (n=1168; 64.6%) followed by cats (n=510; 28.2%), rabbits (n=86; 4.8%) and patients of other species (n=43; 2.4%). The five variables remaining in the multi-level model were whether multiple patients were presented, patient age, clinical examination type, weighing and number of problems discussed. Species, breed, sex, neutering status and practice did not remain in the final model. Many non-presenting problems, including both preventive-medicine problems and specific-health problems, were discussed and acted upon during all types of consultations. Dental and behavioural non-presenting problems were discussed more frequently during preventive-medicine consultations compared with specific health-problem consultations. Preventive-medicine consultations represent an opportunity for veterinary surgeons to discuss other aspects of preventive medicine, and to detect and manage new and ongoing health problems. A greater evidence base is needed to understand whether detecting and managing underlying disease during the preventive-medicine consultation has a positive impact on lifelong patient health and welfare. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Mobilizing Black America: Solutions to Black Health Problems

DTIC Science & Technology

1993-04-01

infant-mortality rate for Malaysia (a third world country). (3) Acquired Immune Deficiency Syndrome (AIDS). AIDS is exacting a heavy toll on African...blood cholesterol, obesity , unhealthy diets, and smoking are the leading causes (major risk factors) of these killers. The underlying problems associated...coronary heart disease, hypertension, stroke, some cancers, diabetes, and obesity is to eat foods that are low in saturated-fat and sodium. Blacks consume

The Assessment of Psychopathology and Behavioral Problems in Children: A Review of Scales Suitable for Epidemiological and Clinical Research (1967-1979). Mental Health Service System Reports, Series AN: Epidemiology, No. 1.

ERIC Educational Resources Information Center

Orvaschel, Helen; And Others

Forty-four scales are described that access psychopathology and/or behavior problems in children (under 18 years of age). Excluded are tests of intelligence, intellectual functioning, brain development, cognitive development, perception, and projective tests. Scales included in this review are suitable for clinical and epidemiological research,…

Optimal Tuner Selection for Kalman-Filter-Based Aircraft Engine Performance Estimation

NASA Technical Reports Server (NTRS)

Simon, Donald L.; Garg, Sanjay

2011-01-01

An emerging approach in the field of aircraft engine controls and system health management is the inclusion of real-time, onboard models for the inflight estimation of engine performance variations. This technology, typically based on Kalman-filter concepts, enables the estimation of unmeasured engine performance parameters that can be directly utilized by controls, prognostics, and health-management applications. A challenge that complicates this practice is the fact that an aircraft engine s performance is affected by its level of degradation, generally described in terms of unmeasurable health parameters such as efficiencies and flow capacities related to each major engine module. Through Kalman-filter-based estimation techniques, the level of engine performance degradation can be estimated, given that there are at least as many sensors as health parameters to be estimated. However, in an aircraft engine, the number of sensors available is typically less than the number of health parameters, presenting an under-determined estimation problem. A common approach to address this shortcoming is to estimate a subset of the health parameters, referred to as model tuning parameters. The problem/objective is to optimally select the model tuning parameters to minimize Kalman-filterbased estimation error. A tuner selection technique has been developed that specifically addresses the under-determined estimation problem, where there are more unknown parameters than available sensor measurements. A systematic approach is applied to produce a model tuning parameter vector of appropriate dimension to enable estimation by a Kalman filter, while minimizing the estimation error in the parameters of interest. Tuning parameter selection is performed using a multi-variable iterative search routine that seeks to minimize the theoretical mean-squared estimation error of the Kalman filter. This approach can significantly reduce the error in onboard aircraft engine parameter estimation applications such as model-based diagnostic, controls, and life usage calculations. The advantage of the innovation is the significant reduction in estimation errors that it can provide relative to the conventional approach of selecting a subset of health parameters to serve as the model tuning parameter vector. Because this technique needs only to be performed during the system design process, it places no additional computation burden on the onboard Kalman filter implementation. The technique has been developed for aircraft engine onboard estimation applications, as this application typically presents an under-determined estimation problem. However, this generic technique could be applied to other industries using gas turbine engine technology.

The application of Signalling Theory to health-related trust problems: The example of herbal clinics in Ghana and Tanzania.

PubMed

Hampshire, Kate; Hamill, Heather; Mariwah, Simon; Mwanga, Joseph; Amoako-Sakyi, Daniel

2017-09-01

In contexts where healthcare regulation is weak and levels of uncertainty high, how do patients decide whom and what to trust? In this paper, we explore the potential for using Signalling Theory (ST, a form of Behavioural Game Theory) to investigate health-related trust problems under conditions of uncertainty, using the empirical example of 'herbal clinics' in Ghana and Tanzania. Qualitative, ethnographic fieldwork was conducted over an eight-month period (2015-2016) in eight herbal clinics in Ghana and ten in Tanzania, including semi-structured interviews with herbalists (N = 18) and patients (N = 68), plus detailed ethnographic observations and twenty additional key informant interviews. The data were used to explore four ST-derived predictions, relating to herbalists' strategic communication ('signalling') of their trustworthiness to patients, and patients' interpretation of those signals. Signalling Theory is shown to provide a useful analytical framework, allowing us to go beyond the primary trust problem addressed by other researchers - cataloguing observable indicators of trustworthiness - and providing tools for tackling the trickier secondary trust problem, where the trustworthiness of those indicators must be ascertained. Signalling Theory also enables a basis for comparative work between different empirical contexts that share the underlying condition of uncertainty. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Workload and awkward posture problems among small-scale strawberry farmers in Japan.

PubMed

Kumudini, Ganga; Hasegawa, Tetsuya

2009-12-01

Farmers handle heavy workloads, often in awkward postures and experiencing some work related problems. Farmers perceive them as no more than inevitable consequences of farming activities. Although many problems can be prevented or reduced by simple and inexpensive modifications to work, these problems are increasing among farmers. The main focus of the paper was to investigate workload and awkward postures among strawberry farmers and suggest possible solutions to overcome the identified problems. Questionnaires, direct observations and intertwining methods were used to collect the data. Low-level strawberry beds and long working hours were recognized as critical factors that led to farmers' health problems including suffering from low back pain, heavy fatigue, unsteady feeling after work, etc. There was a substantial increase in fatigue in busy seasons compared with slack seasons. When compared with the other workers such as office, technical, sales and blue-collar workers, female farmers' general fatigue level was considerably high. Findings indicated that strawberry farming was a stressful occupation and farmers were strained under heavy workload, monotonous and repetitive work and poor working conditions with frequent fatigue symptoms and severe influence on health.

Undocumented Immigration, Drug Problems, and Driving Under the Influence in the United States, 1990-2014.

PubMed

Light, Michael T; Miller, Ty; Kelly, Brian C

2017-09-01

To examine the influence of undocumented immigration in the United States on 4 different metrics of drug and alcohol problems: drug arrests, drug overdose fatalities, driving under the influence (DUI) arrests, and DUI deaths. We combined newly developed state-level estimates of the undocumented population between 1990 and 2014 from the Center for Migration Studies with arrest data from the Federal Bureau of Investigation Uniform Crime Reports and fatality information from the Fatality Analysis Reporting System and the Centers for Disease Control and Prevention Underlying Cause of Death database. We used fixed-effects regression models to examine the longitudinal association between increased undocumented immigration and drug problems and drunk driving. Increased undocumented immigration was significantly associated with reductions in drug arrests, drug overdose deaths, and DUI arrests, net of other factors. There was no significant relationship between increased undocumented immigration and DUI deaths. This study provides evidence that undocumented immigration has not increased the prevalence of drug or alcohol problems, but may be associated with reductions in these public health concerns.

Developmental association of prosocial behaviour with aggression, anxiety and depression from infancy to preadolescence.

PubMed

Nantel-Vivier, Amélie; Pihl, Robert O; Côté, Sylvana; Tremblay, Richard E

2014-10-01

Research on associations between children's prosocial behaviour and mental health has provided mixed evidence. The present study sought to describe and predict the joint development of prosocial behaviour with externalizing and internalizing problems (physical aggression, anxiety and depression) from 2 to 11 years of age. Data were drawn from the National Longitudinal Survey of Children and Youth (NLSCY). Biennial prosocial behaviour, physical aggression, anxiety and depression maternal ratings were sought for 10,700 children aged 0 to 9 years at the first assessment point. While a negative association was observed between prosociality and physical aggression, more complex associations emerged with internalizing problems. Being a boy decreased the likelihood of membership in the high prosocial trajectory. Maternal depression increased the likelihood of moderate aggression, but also of joint high prosociality/low aggression. Low family income predicted the joint development of high prosociality with high physical aggression and high depression. Individual differences exist in the association of prosocial behaviour with mental health. While high prosociality tends to co-occur with low levels of mental health problems, high prosociality and internalizing/externalizing problems can co-occur in subgroups of children. Child, mother and family characteristics are predictive of individual differences in prosocial behaviour and mental health development. Mechanisms underlying these associations warrant future investigations. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

Liberalising trade in health services: constraints and prospects for South Asian countries.

PubMed

Khatun, Fahmida; Ahamad, Mazbahul

2015-01-01

This paper attempts to examine the prospects and challenges associated with liberalising trade in health services in five South Asian countries, namely Bangladesh, India, Nepal, Pakistan and Sri Lanka. Country-specific secondary information, a brief literature review of empirical studies and debriefing sessions with key stakeholders are employed to explore the issues related to liberalising health services trade. The health sectors in India, Nepal and Pakistan are scheduled under General Agreement on Trade in Services (GATS) classification, whereas those in Bangladesh and Sri Lanka are not. In Bangladesh, there is opportunity for investment in joint venture hospitals under Mode 3. Nonetheless, India is the largest trader in health services under all four modes. In Sri Lanka, cross-border trade in healthcare services is found to be insignificant. Moreover, expertise in eye treatment in Nepal could also attract foreign investment in medical services under Mode 3. In contrast, Pakistan exhibits no potential under Mode 4, because of a lack of healthcare professionals. In this view, the prospects of trade in health services within the South Asian region under the four GATS modes are constrained by infrastructural, regulatory, perception-related, logistical and cultural problems. Considering the level of development and commercial opportunities, regional integration in the health sector could be explored in such areas as telemedicine, medical tourism, cross-border investment and capacity building of health personnel. These developments call for stronger and pro-active government-to-government collaboration in the South Asian Association of Regional Cooperation (SAARC) region in a transparent and accountable manner. Copyright © 2013 John Wiley & Sons, Ltd.

Effects of early menarche on physical and psychosocial health problems in adolescent girls and adult women

PubMed Central

2016-01-01

The menarcheal age of Korean women has been rapidly decreasing for the last 50 years, and the average menarcheal age of women born in the 1990s is approaching 12.6 years. In addition, interest in early puberty has been increasing recently owing to the rapid increase in precocious puberty. Generally, out of concern for short stature and early menarche, idiopathic central precocious puberty in female adolescents is treated with gonadotropin-releasing hormone analogs. Studies to date have described the association between early menarche and psychosocial problems such as delinquency and risky sexual behavior, as well as physical health problems such as obesity, diabetes, cardiovascular diseases, and breast cancer throughout the lifespan of women. However, the pathophysiological mechanism underlying this association has not been clarified thus far. In this article, we review and discuss the existing literature to describe the current understanding of the effects of early menarche on the physical and psychosocial health of adolescent girls and adult women. PMID:27721839

Mental health issues in Australian nursing homes.

PubMed

Lie, David

2003-07-01

Mental illness is common, under detected and often poorly managed in residential aged care facilities. These concerns have achieved greater prominence as the worldwide population ages. Over 80% of people in nursing home care fulfill criteria for one or more psychiatric disorders in an environment that often presents significant difficulties for assessment and treatment. This article aims to provide an overview of the important mental health issues involved in providing medical care for patients with behavioural and psychological problems in residential aged care facilities. Recent developments in education and training, service development and assessment and treatment strategies show some promise of improving the outcome for aged care residents with mental health problems. This is of especial relevance for primary care physicians who continue to provide the bulk of medical care for this population.

Why doctors should care about animal cruelty.

PubMed

Sherley, Miranda

2007-01-01

Animal cruelty is a significant problem for society, and there are good reasons why doctors should be particularly concerned by it. Increasing evidence for links between animal cruelty and child or spousal abuse is an area of growing concern internationally and of real importance to health professionals. This article aims to raise awareness of the relevance of animal cruelty to medical practice. The links between animal cruelty and human health are discussed broadly and some wider ethical issues raised. Animal cruelty impacts on human health in disparate ways: intentional and unintentional acts of cruelty may reflect underlying mental health problems that need to be addressed. Cruelty within the family setting is an important sentinel for domestic violence and should prompt an assessment for possible child abuse. Furthermore, animal cruelty raises important questions about the nature of empathy, and the type of society that we wish to live in.

Shifting visions: "delegation" policies and the building of a "rights-based" approach to maternal mortality.

PubMed

Freedman, Lynn P

2002-01-01

"Rights-based" approaches fold human rights principles into the ongoing work of health policy making and programming. The example of delegation of anesthesia provision for emergency obstetric care is used to demonstrate how a rights-based approach, applied to this problem in the context of high-mortality countries, requires decision makers to shift from an individual, ethics-based, clinical perspective to a structural, rights-based, public health perspective. This fluid and context-sensitive approach to human rights also applies at the international level, where the direction of overall maternal mortality reduction strategy is set. By contrasting family planning programs and maternal mortality programs, this commentary argues for choosing the human rights approach that speaks most effectively to the power dynamics underlying the particular health problem being addressed. In the case of maternal death in high-mortality countries, this means a strategic focus on the health care system itself.

The Role of Personal and Job Resources in the Relationship between Psychosocial Job Demands, Mental Strain, and Health Problems

PubMed Central

Mayerl, Hannes; Stolz, Erwin; Waxenegger, Anja; Rásky, Éva; Freidl, Wolfgang

2016-01-01

Recent research highlights the importance of both job resources and personal resources in the job demands-resources model. However, the results of previous studies on how these resources are related to each other and how they operate in relation to the health-impairment process of the job demands-resources model are ambiguous. Thus, the authors tested an alternative model, considering job and personal resources to be domains of the same underlying factor and linking this factor to the health-impairment process. Survey data of two Austrian occupational samples (N1 = 8657 and N2 = 9536) were analyzed using confirmatory factor analysis (CFA) and structural equation modeling (SEM). The results revealed that job and personal resources can be considered as indicators of a single resources factor which was negatively related to psychosocial job demands, mental strain, and health problems. Confirming previous studies, we further found that mental strain mediated the relationship between psychosocial job demands and health problems. Our findings suggest that interventions aimed at maintaining health in the context of work may take action on three levels: (1) the prevention of extensive job demands, (2) the reduction of work-related mental strain, and (3) the strengthening of resources. PMID:27582717

Spa therapy (balneotherapy) relieves mental stress, sleep disorder, and general health problems in sub-healthy people

NASA Astrophysics Data System (ADS)

Yang, Bei; Qin, Qi-zhong; Han, Ling-li; Lin, Jing; Chen, Yu

2018-02-01

To investigate the relieving effects of hot spring balneotherapy on mental stress, sleep disorder, general health problems, and women's health problems in sub-healthy people, we recruited 500 volunteers in sub-health in Chongqing, and 362 volunteers completed the project, including 223 in the intervention group and 139 in the control group. The intervention group underwent hot spring balneotherapy for 5 months, while the control group did not. The two groups took questionnaire investigation (general data, mental stress, emotional status, sleep quality, general health problems, as well as some women's health problems) and physical examination (height, weight, waist circumference, blood pressure, blood lipid, blood sugar) 5 months before and after the intervention, respectively. After intervention, sleep disorder (difficulty in falling asleep ( P = 0.017); dreaminess, nightmare suffering, and restless sleep ( P = 0.013); easy awakening ( P = 0.003) and difficulty in falling into sleep again after awakening( P = 0.016); and mental stress ( P = 0.031) and problems of general health (head pain ( P = 0.026), joint pain( P = 0.009), leg or foot cramps ( P = 0.001), blurred vision ( P = 0.009)) were relieved significantly in the intervention group, as compared with the control group. While other indicators (fatigue, eye tiredness, limb numbness, constipation, skin allergy) and women's health problems (breast distending pain; dysmenorrhea, irregular menstruation) were relieved significantly in the self-comparison of the intervention group before and after intervention ( P < 0.05), but showed no statistically significant difference between two groups ( P > 0.05). All indications (except bad mood, low mood, and worry or irritability) in the intervention group significantly improved, with effect size from 0.096 to 1.302. Multiple logistic regression analysis showed that the frequency, length, and location of balneotherapy in the intervention group were the factors influencing emotion, sleep, and health condition ( P < 0.05). Relief of insomnia, fatigue, and leg or foot cramps was greater in old-age group than in young-aged group ( P < 0.05). Physical examination found that waist circumferences in women of various ages under 55 years were significantly reduced in the intervention group ( P < 0.05), while that in men did not significantly change ( P > 0.05). Spa therapy (balneotherapy) relieves mental stress, sleep disorder, general health, and reduces women's waist circumferences in sub-healthy people.

A survey of health problems of Nepalese female migrants workers in the Middle-East and Malaysia.

PubMed

Simkhada, Padam; van Teijlingen, Edwin; Gurung, Manju; Wasti, Sharada P

2018-01-18

Nepal is a key supplier of labour for countries in the Middle East, India and Malaysia. As many more men than women leave Nepal to work abroad, female migrant workers are a minority and very much under-researched. The aim of the study was to explore the health problems of female Nepalese migrants working in the Middle-East and Malaysia. The study was conducted among 1010 women who were registered as migrant returnees at an organisation called Pourakhi Nepal. Secondary data were extracted from the records of the organisation covering the five-year period of July 2009 to July 2014. The 1010 participants were aged 14 to 51 with a median age of 31 (IQR: 38-25) years. A quarter of respondents (24%) reported having experienced health problems while in the country of employment. Fever, severe illness and accidents were the most common health problems reported. Working for unlimited periods of time and not being able to change one's place of work were independently associated with a greater likelihood of health problems. Logistic regression shows that migrant women who are illiterate [OR = 1.56, 95% CI: 1.02 to 2.38, p = 0.042], who had changed their workplace [OR = 1.63, 95% CI: 1.14 to 2.32, p = 0.007], who worked unlimited periods of time [OR = 1.64, 95% CI: 1.44 to 1.93, p = 0.020], had been severely maltreated or tortured in the workplace [OR = 1.84, 95% CI: 1.15 to 2.92, p = 0.010], were not being paid on time [OR = 2.38, 95% CI: 1.60 to 3.55, p = 0.038] and migrant women who had family problems at home [OR = 3.48, CI 95%: 1.22 to 9.98, p = 0.020] were significantly associated with health problems in their host country in the Middle East. Female migrant workers face various work-related health risks, which are often related to exploitation. The Government of Nepal should initiate awareness campaigns about health risks and rights in relation to health care services in the host countries. Recruiting agencies/employers should provide information on health risks and training for preventive measures. Raising awareness among female migrant workers can make a change in their working lives.

Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey

PubMed Central

2013-01-01

Background The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. Methods A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. Results The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose–response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. Conclusions An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for such problems compared with data from metropolitan centres. Using a measure of Provisional Service Need those with greater needs were more likely to access specialist services, even in remote regions, although a substantial proportion of those with the highest service need sought no professional help. Geographic and financial barriers to service use were identified and perception of service adequacy was relatively low, especially among those with the highest levels of distress and greatest adversity. PMID:23631501

Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey.

PubMed

Perkins, David; Fuller, Jeffrey; Kelly, Brian J; Lewin, Terry J; Fitzgerald, Michael; Coleman, Clare; Inder, Kerry J; Allan, John; Arya, Dinesh; Roberts, Russell; Buss, Richard

2013-04-30

The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose-response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for such problems compared with data from metropolitan centres. Using a measure of Provisional Service Need those with greater needs were more likely to access specialist services, even in remote regions, although a substantial proportion of those with the highest service need sought no professional help. Geographic and financial barriers to service use were identified and perception of service adequacy was relatively low, especially among those with the highest levels of distress and greatest adversity.

Establishing priorities for psychological interventions in pediatric settings: A decision-tree approach using the DISABKIDS-10 Index as a screening instrument

PubMed Central

Silva, Neuza; Moreira, Helena; Canavarro, Maria Cristina; Carona, Carlos

2018-01-01

Most children and adolescents with chronic health conditions have impaired health-related quality of life and are at high risk of internalizing and externalizing problems. However, few patients present clinically significant symptoms. Using a decision-tree approach, this study aimed to identify risk profiles for psychological problems based on measures that can be easily scored and interpreted by healthcare professionals in pediatric settings. The participants were 736 children and adolescents between 8–18 years of age with asthma, epilepsy, cerebral palsy, type-1diabetes or obesity. The children and adolescents completed self-report measures of health-related quality of life (DISABKIDS-10) and psychological problems (Strengths and Difficulties Questionnaire). Sociodemographic and clinical data were collected from their parents/ physicians. Children and adolescents were classified into the normal (78.5%) or borderline/clinical range (21.5%) according to the Strengths and Difficulties Questionnaire cut-off values for psychological problems. The overall accuracy of the decision-tree model was 78.1% (sensitivity = 71.5%; specificity = 79.9%), with 4 profiles predicting 71.5% of borderline/clinical cases. The strongest predictor of psychological problems was a health-related quality of life standardized score below the threshold of 57.5 for patients with cerebral palsy, epilepsy or obesity and below 70.0 for patients with asthma or diabetes. Other significant predictors were low socio-economic status, single-parent household, medication intake and younger age. The model showed adequate validity (risk = .28, SE = .02) and accuracy (area under the Receiver Operating Characteristic curve = .84; CI = .80/.87). The identification of pediatric patients at high risk for psychological problems may contribute to a more efficient allocation of health resources, particularly with regard to their referral to specialized psychological assessment and intervention. PMID:29852026

Orbivirus of livestock

USDA-ARS?s Scientific Manuscript database

The Arthropod Borne Animal Diseases Unit (ABADRU) mission is to solve major endemic, emerging, and exotic arthropod-borne disease problems in livestock. The ABADRU has four 5-year project plans under two ARS National Research Programs; Animal Health NP103 and Veterinary, Medical, and Urban Entomolog...

Improving Skilled Birth Attendance in Ghana: An Evidence-Based Policy Brief.

PubMed

Apanga, Paschal Awingura; Awoonor-Williams, John Koku

2017-01-01

This commentary has the objective of improving skilled birth attendance in Ghana to reduce maternal and neonatal mortality and morbidity. We have provided evidence of causes of low-skilled birth attendance in Ghana. Physical accessibility of health care, sociocultural factors, economic factors and health care system delivery problems were found as the main underlying causes of low levels of skilled birth attendance in Ghana. The paper provides potential strategies in addressing maternal and child health issues in Ghana.

The Juvenile Justice Behavioral Health Services Cascade: A new framework for measuring unmet substance use treatment services needs among adolescent offenders.

PubMed

Belenko, Steven; Knight, Danica; Wasserman, Gail A; Dennis, Michael L; Wiley, Tisha; Taxman, Faye S; Oser, Carrie; Dembo, Richard; Robertson, Angela A; Sales, Jessica

2017-03-01

Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies. This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade ("Cascade"), for measuring unmet substance use treatment needs to illustrate how the cascade approach can be useful in understanding service delivery issues and identifying strategies to improve treatment engagement and outcomes for youth under community JJ supervision. We discuss the organizational and systems barriers for linking delinquent youth to BH services, and explain how the Cascade can help understand and address these barriers. We provide a detailed description of the sequential steps and measures of the Cascade, and then offer an example of its application from the Juvenile Justice - Translational Research on Interventions for Adolescents in the Legal System project (JJ-TRIALS), a multi-site research cooperative funded by the National Institute on Drug Abuse. As illustrated with substance abuse treatment, the Cascade has potential for informing and guiding efforts to improve behavioral health service linkages for adolescent offenders, developing and testing interventions and policies to improve interagency and cross-systems coordination, and informing the development of measures and interventions for improving the implementation of treatment in complex multisystem service settings. Clinical Trials Registration number - NCT02672150. Copyright © 2017 Elsevier Inc. All rights reserved.

The Juvenile Justice Behavioral Health Services Cascade: A New Framework for Measuring Unmet Substance Use Treatment Services Needs among Adolescent Offenders

PubMed Central

Knight, Danica; Wasserman, Gail A.; Dennis, Michael L.; Wiley, Tisha; Taxman, Faye S.; Oser, Carrie; Dembo, Richard; Robertson, Angela A.; Sales, Jessica

2017-01-01

Overview Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies. Methods and Results This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade (“Cascade”), for measuring unmet substance use treatment needs to illustrate how the cascade approach can be useful in understanding service delivery issues and identifying strategies to improve treatment engagement and outcomes for youth under community JJ supervision. We discuss the organizational and systems barriers for linking delinquent youth to BH services, and explain how the Cascade can help understand and address these barriers. We provide a detailed description of the sequential steps and measures of the Cascade, and then offer an example of its application from the Juvenile Justice – Translational Research on Interventions for Adolescents in the Legal System project (JJ-TRIALS), a multi-site research cooperative funded by the National Institute on Drug Abuse. Conclusion As illustrated with substance abuse treatment, the Cascade has potential for informing and guiding efforts to improve behavioral health service linkages for adolescent offenders, developing and testing interventions and policies to improve interagency and cross-systems coordination, and informing the development of measures and interventions for improving the implementation of treatment in complex multisystem service settings. PMID:28132705

The Quality Assurance Project assists the vitamin A capsule program in Antique Province, Philippines.

PubMed

Blumenfeld, S

1994-01-01

Vitamin A deficiency remains an important problem in some parts of the Philippines. The Department of Health, with assistance from the Helen Keller Institute (HKI), established a vitamin A supplementation program in Antique Province providing for the administration of vitamin A capsules to malnourished children. Although the HKI cut off its assistance in 1992, continuation of the capsule supplementation program was an element of the National Nutrition Plan for 1992-96, and remains an element of the Antique Provincial health services program under the Philippines' devolved health services scheme. The Quality Assurance Program (QAP) in May 1993 began helping the Provincial Health Office improve the quality of the vitamin A program. A systems analysis was first undertaken to identify significant deviations from provider performance standards which had been adapted by the province from Nutrition Service guidelines. Many problems were observed, including lack of knowledge of the high-priority categories of children, incomplete counseling, and frequent mistakes in determining children's nutritional status. The provincial health office staff recommended that six of the province's seventeen municipalities participate in the quality improvement effort. The intent of the QAP staff was not only to help the provincial staff improve the quality of its vitamin A program by resolving some immediate operational problems, but to provide the health care workers with a quality improvement experience that they would intuitively transfer to other programs for which they were responsible. The coaching/facilitating approach of modern quality management allowed health workers to explore their own approaches to solving the problems chosen.

Health and safety measures available for young labourers in the cottage industries of Karachi.

PubMed

Baig, Lubna A; Rasheed, Shahida; Zameer, Mehvash; Zameer, Mehwash

2005-01-01

To determine the health problems faced by labourers, 18 years and under, working in the cottage industries of Karachi and know the safety measures available and utilized at these places. Cross-sectional study using two-stage cluster sampling. From February 2002 to March 2003, 95 cottage industries from 10 different locations of five districts of Karachi were included. All workers, 18 years and below, present were interviewed. The environmental and safety gadgets present at the industry were inspected by the surveyors and the manager was interviewed for presence of health and safety benefits for the workers. A total of 280 workers were interviewed, 26 (9.3%) children were between 9-12 years, 82 (29.3%) were between 13-15 and 172 (61.4%) were between 16-18 years of age. Health benefit was given to only one 13-year-old worker in silk industry; appropriate gadgets were absent in 93 (97.8%) industries, present only in 2 industries (one silk and one loom). First Aid box was present in only one loom industry. Two hundred and forty workers (85.7%) were unaware of the materials they were using. One hundred and ninety-three (69%) children were working in improper light, 199(71%) workers experienced high level of noise, 232(83%) were working in high temperature and 155(55.3%) were working with improper ventilation. Health problems faced included joint pains (n=64, 22.85%), backache (n=85, 30.35%), vertigo (n=48, 17.14%), numbness of fingers (n=77, 27.5%) and fatigue experienced by 143 (51.07%) children. The children and adolescents employed in cottage industry are suffering from health problems due to lack of knowledge on their part, and improper ergonomics, environmental and safety conditions at the workplace. The cottage industry should be regulated and brought under labour law. The health sector non-governmental organizations should make concerted efforts for the rehabilitation of this workforce by creating awareness and providing opportunities for education and development of skills.

Factors associated with different smoking status in European adolescents: results of the SEYLE study.

PubMed

Banzer, Raphaela; Haring, C; Buchheim, A; Oehler, S; Carli, V; Wasserman, C; Kaess, M; Apter, A; Balazs, J; Bobes, J; Brunner, R; Corcoran, P; Cosman, D; Hoven, C W; Kahn, J P; Keeley, H S; Postuvan, V; Podlogar, T; Sisask, M; Värnik, A; Sarchiapone, M; Wasserman, D

2017-11-01

Early onset and long-term smoking are associated with physical and psychological health problems. The aim of the presented analysis was to investigate risk and influencing factors for different smoking status in a big sample of European adolescents. In the context of the "saving and empowering young lives in Europe" (SEYLE) study we surveyed 12,328 adolescents at the age of 13-17 from 11 countries. The survey took place in a school-based context using a questionnaire. Overall 58% reported the onset of ever-smoking under the age of 14 and 30.9% smoke on a daily basis. Multinomial logistic regression model showed significant positive associations between adolescent smoking and internalizing problems (suicidal behavior, direct self-injurious behavior, anxiety), externalizing problems (conduct problems, hyperactivity, substance consumption) and family problems (parental substance consumption, broken home). Our data show that smoking among adolescents is still a major public health problem and adolescents who smoke are at higher risk for mental problems. Further, adolescent smoking is associated with broken home families and parental behaviors. Therefore, early preventive measures are necessary not only for adolescents, but also for their parents.

Climate change and adaptation of the health sector: The case of infectious diseases.

PubMed

Confalonieri, Ulisses E C; Menezes, Júlia Alves; Margonari de Souza, Carina

2015-01-01

Infectious diseases form a group of health problems highly susceptible to the influences of climate. Adaptation to protect human population health from the changes in infectious disease epidemiology expected to occur as a consequence of climate change involve actions in the health systems as well as in other non-health sectors. In the health sector strategies such as enhanced and targeted epidemiological and entomological surveillance and the development of epidemic early warning systems informed by climate scenarios are needed. Measures in other sectors such as meteorology, civil defense and environmental sanitation will also contribute to a reduction in the risk of infection under climate change.

Mental health problems of Iranian female adolescents and its association with pubertal development: a nationwide study.

PubMed

Rabbani, Ali; Mahmoudi-Gharaei, Javad; Mohammadi, Mohammad Reza; Motlagh, Mohammad Esmaeil; Mohammad, Kazem; Ardalan, Gelayol; Maftoon, Farzaneh; Shahryari, Safiyeh; Khodaei, Shahnaz; Sotoudeh, Aria; Ziaaldini, Hassan; Kamali, Kobra; Motaghian, Molouk

2012-01-01

Mental health problems including emotional and behavioral problems during puberty may be under influence of different risk factors including cultures, living in urban or rural areas and ethnic factors which may vary between different countries. The main aim of this study is to investigate the profile of emotional and behavioral problems and the role of factors such as age, stage of puberty, ethnicity, rurality and living in urban area, as risk factors in Iranian girls. As a part of a large national study we evaluated the emotional and behavioral problems in different stages of puberty in a community sample of Iranian adolescent girls from public schools that were selected by clustered random sampling method. In all subjects, demographic characteristics, and pubertal stages were measured. Emotional and behavioral problems were evaluated using Strength and Difficulties Questionnaire (SDQ). The associations of age, pubertal development indices, socioeconomic and demographic factors with the behavioral problems were assessed. A total number of 4576 students enrolled the study and responded to the questions. The mean age of participants was 13.83 ± 2.19 years. The mean total score of difficulties in participants was 14.34 ± 5.81. According to these results 813 (17.8%) adolescents had total problem scores higher than Goodman's cutoff points and the most frequent problem domain was conduct problems (20.5%). According to the results the most related variable with the total difficulty score of SDQ were ethnicity, residency in urban areas and development of menstrual cycle respectively. The results of this study showed that the most correlated factors with mental health problems in Iranian girls during puberty are ethnicity, urbanity and development of menstrual cycle.

China's public health-care system: facing the challenges.

PubMed Central

Liu, Yuanli

2004-01-01

The severe acute respiratory syndrome (SARS) crisis in China revealed not only the failures of the Chinese health-care system but also some fundamental structural deficiencies. A decentralized and fragmented health system, such as the one found in China, is not well-suited to making a rapid and coordinated response to public health emergencies. The commercial orientation of the health sector on the supply-side and lack of health insurance coverage on the demand-side further exacerbate the problems of the under-provision of public services, such as health surveillance and preventive care. For the past 25 years, the Chinese Government has kept economic development at the top of the policy agenda at the expense of public health, especially in terms of access to health care for the 800 million people living in rural areas. A significant increase in government investment in the public health infrastructure, though long overdue, is not sufficient to solve the problems of the health-care system. China needs to reorganize its public health system by strengthening both the vertical and horizontal connections between its various public health organizations. China's recent policy of establishing a matching-fund financed rural health insurance system presents an exciting opportunity to improve people's access to health care. PMID:15500285

Right to property, inheritance, and contract and persons with mental illness.

PubMed

Bhugra, Dinesh; Pathare, Soumitra; Joshi, Rajlaxmi; Nardodkar, Renuka; Torales, Julio; Tolentino, Edgardo Juan L; Dantas, Rubens; Ventriglio, Antonio

2016-08-01

Discrimination against people with mental illness is rife across the globe. Among different types of discrimination is the policy in many countries where persons with mental illness are forbidden to inherit property, and they are not able to enter into a contract in a large number of countries. Using various databases, legislations dealing with law of contract, law of succession/inheritance, and law relating to testamentary capacity (wills) of all UN Member states (193 countries) were studied. With respect to federal countries, the laws of the most populous state as a representative state in the respective country were studied. Only 40 Member States (21%) recognize/allow persons with mental health problems to enter into contracts. Of these, however, only 16 Member States (9%) recognize the right of persons with mental health problems to enter into a contract without any restrictions. The remaining 24 Member States (12%) allow a contract entered into by a person with mental health problems to be invalidated under certain conditions. These countries also make the validity of the contract subject to the capacity to consent or based on the level of understanding of the person with mental health problems. They may allow persons with mental health problems to enter into contracts only for transactions of an insignificant nature or of personal rights. Only 9% of the countries allow people with mental illness to enter into contracts in an unrestricted way. Furthermore, there remain variations between high income and low income states. In spite of international laws in many countries, laws remain discriminatory.

Prevalence and Factors Associated with Anemia among Children under 5 Years of Age—Uganda, 2009

PubMed Central

Menon, Manoj P.; Yoon, Steven S.

2015-01-01

Anemia in children under 5 years of age, defined by the World Health Organization as a hemoglobin concentration < 11 g/dL, is a global public health problem. According to the 2006 Demographic Health Survey, the prevalence of anemia among children under five in Uganda was 72% in 2006. The 2009 Uganda Malaria Indicator Survey was conducted in late 2009 and revealed that over 60% of children less than 5 years of age were anemic and that over half of children tested positive for malaria via a rapid diagnostic test. Children with concomitant malaria infection, and in households without any type of mosquito net were more likely to be anemic, confirming that children under 5 years, are vulnerable to both the threat of malaria and anemia and the beneficial effect of malaria prevention tools. However, prevention and treatment of other factors associated with the etiology of anemia (e.g., iron deficiency) are likely necessary to combat the toll of anemia in Uganda. PMID:26055748

Problem solving, loneliness, depression levels and associated factors in high school adolescents.

PubMed

Sahin, Ummugulsum; Adana, Filiz

2016-01-01

To determine problem solving, loneliness, depression levels and associated factors in high school adolescents. This cross-sectional study was conducted in a city west of Turkey (Bursa) in a public high school and the population was 774 and the sampling was 394 students. Students to be included in the study were selected using the multiple sampling method. A personal Information Form with 23 questions, Problem Solving Inventory (PSI), Loneliness Scale (UCLA), Beck Depression Inventory (BDI) were used as data collection tools in the study. Basic statistical analyses, t-test, Kruskall Wallis-H, One Way Anova and Pearson Correlation test were used to evaluate the data. Necessary permissions were obtained from the relevant institution, students, parents and the ethical committee. The study found significant differences between "problem solving level" and family type, health assessment, life quality and mothers', fathers' siblings' closeness level; between "loneliness level" and gender, family income, health assessment, life quality and mothers', fathers', siblings' closeness level; between "depression level" and life quality, family income, fathers' closeness level. Unfavorable socio-economic and cultural conditions can have an effect on the problem solving, loneliness and depression levels of adolescents. Providing structured education to adolescents at risk under school mental health nursing practices is recommended.

Mental Health Referrals Reduce Recidivism in First-Time Juvenile Offenders, But How Do We Determine Who is Referred?

PubMed

Zeola, Michael P; Guina, Jeffrey; Nahhas, Ramzi W

2017-03-01

While psychiatric disorders are common among juvenile delinquents, many mental health problems go undetected, increasing the likelihood for persistent difficulties. This is the first known study to examine mental health referral rates and recidivism in the juvenile justice system. In addition to the study, we review juvenile justice mental health screening to improve detection and treatment. Juvenile criminal records in conjunction with behavioral health screenings were analyzed to determine differences in referrals and recidivism among first time offenders. Recidivism rates were significantly lower (p = 0.04) and time to recidivism was significantly longer (p = 0.03) for those referred specifically for mental health services than for those without any referrals, even after adjusting for offense severity. While black youths had a significantly higher recidivism rate (p = 0.02) and a shorter time to recidivism (p = 0.009) than white youths, there was no significant difference between races when referred specifically for mental health services. Among the groups studied, black youths had the most profound positive effect from mental health referrals (p < 0.0001). This study indicates the importance of detecting mental health problems among juvenile delinquents, especially for black offenders. The apparent protective effect of mental health interventions necessitates screening that better identifies underlying psychosocial factors rather than strict reliance upon diagnostic criteria and self-report. Broader or even universal mental health referrals for juvenile offenders could reduce future legal system involvement and costs to society. We review potential reasons that mental health problems go undetected and provide recommendations.

Preventing postnatal maternal mental health problems using a psychoeducational intervention: the cost-effectiveness of What Were We Thinking.

PubMed

Ride, Jemimah; Lorgelly, Paula; Tran, Thach; Wynter, Karen; Rowe, Heather; Fisher, Jane

2016-11-18

Postnatal maternal mental health problems, including depression and anxiety, entail a significant burden globally, and finding cost-effective preventive solutions is a public policy priority. This paper presents a cost-effectiveness analysis of the intervention, What Were We Thinking (WWWT), for the prevention of postnatal maternal mental health problems. The economic evaluation, including cost-effectiveness and cost-utility analyses, was conducted alongside a cluster-randomised trial. 48 Maternal and Child Health Centres in Victoria, Australia. Participants were English-speaking first-time mothers attending participating Maternal and Child Health Centres. Full data were collected for 175 participants in the control arm and 184 in the intervention arm. WWWT is a psychoeducational intervention targeted at the partner relationship, management of infant behaviour and parental fatigue. The evaluation considered public sector plus participant out-of-pocket costs, while outcomes were expressed in the 30-day prevalence of depression, anxiety and adjustment disorders, and quality-adjusted life years (QALYs). Incremental costs and outcomes were estimated using regression analyses to account for relevant sociodemographic, prognostic and clinical characteristics. The intervention was estimated to cost $A118.16 per participant. The analysis showed no statistically significant difference between the intervention and control groups in costs or outcomes. The incremental cost-effectiveness ratios were $A36 451 per QALY gained and $A152 per percentage-point reduction in 30-day prevalence of depression, anxiety and adjustment disorders. The estimate lies under the unofficial cost-effectiveness threshold of $A55 000 per QALY; however, there was considerable uncertainty surrounding the results, with a 55% probability that WWWT would be considered cost-effective at that threshold. The results suggest that, although WWWT shows promise as a preventive intervention for postnatal maternal mental health problems, further research is required to reduce the uncertainty over its cost-effectiveness as there were no statistically significant differences in costs or outcomes. ACTRN12613000506796; results. 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/.

microRNA Regulation of DEP-induced Inflammation in Airway Epithelial Cells

EPA Science Inventory

Morbidity and mortality attributable to air pollution continues to be a growing problem worldwide. Despite several studies on the health effects of ambient air pollution, underlying molecular mechanisms of susceptibility and disease remain elusive. The epigenome controls gene exp...

[Health care economic guidance in Germany from the example Morbi-RSA].

PubMed

Litmathe, Jens

2016-04-01

Increasing costs in health care represent still a major challenge in most industrial contries. A lot of attempts especially in Germany have been made to manage such problems and for a fair allocation oft he underlying resources. One of this ist the Morbi-RSA. The current review reflects all historical, medical and economical aspects of the Morbi-RSA and gives a perspective to possible future developments.

Washington's Infant Toddler Early Intervention Program Study: Enrollment of Washington Children with Disabilities and Special Health Care Needs in Washington State Public Programs on December 1, 1995.

ERIC Educational Resources Information Center

Keenan, Trisha; And Others

This document presents tables, graphs, and narrative text providing information on the number and characteristics of infants and toddlers, under the age of 3, with disabilities and special health problems who were enrolled in Washington State's infant and toddler early intervention program in 1995. Major findings of the report include the…

[Promotion of Occupational Mental Health with Psychiatrists].

PubMed

Tanaka, Katsutoshi

2015-01-01

The promotion of occupational mental health is stipulated by laws and precedents, including the Labor Standards Act, Industrial Safety and Health Act, and Labor Contract Act. These laws and precedents are used to formulate actual mental health activities and responses to individuals with mental health disorders to some extent. Among mental health-related undertakings, the most important role that occupational health staff should play as healthcare professionals is to support business operators' obligations regarding safety. This role is to prevent health problems in the workplace, not to manage corporate risk. However, the health and safety obligations imposed on business operators under the current precedents are far beyond the levels that non-specialists can handle. The active participation of psychiatrists is needed to promote workplace mental health today.

Inequity and health. Is malnutrition really caused by poor nutrition?

PubMed

Bharmal, F Y

2000-08-01

To look at inequities leading to malnutrition and from the wider picture to find root causes and deal with them in order to alleviate malnutrition. Literature review. The health of the population is adversely affected by the inequities in the country. Women and children being most vulnerable are worst affected. The prevalence of Protein Energy Malnutrition (P.E.M.) in children under five years of age is 51 percent. Such a magnitude of malnutrition in a country, where availability of food per capita is more than adequate, points towards the fact that the inequities within the country are at the root of the problem. Poor income is not the only predictor of malnutrition, gender, urban-rural differences in access, utilization and quality of health care also influence health. In addition, there are some underlying factors such as illiteracy, unawareness of the mother about healthy behaviors, lack of decision-making power of women, along with deep-rooted cultural values of a patriarchal system. Malnutrition is caused by a multitude of factors, some of which are biological, others are environmental, cultural or social. Education of the invisible half of the population, who actually look after the children and the family, is an important strategy to alleviate this problem.

Reproductive and Obstetric Factors Are Key Predictors of Maternal Anemia during Pregnancy in Ethiopia: Evidence from Demographic and Health Survey (2011)

PubMed Central

Alemu, Taddese; Umeta, Melaku

2015-01-01

Anemia is a major public health problem worldwide. In Ethiopia, a nationally representative and consistent evidence is lacking on the prevalence and determinants during pregnancy. We conducted an in-depth analysis of demographic and health survey for the year 2011 which is a representative data collected from all regions in Ethiopia. Considering maternal anemia as an outcome variable, predicting variables from sociodemographic, household, and reproductive/obstetric characteristics were identified for analyses. Logistic regression model was applied to identify predictors at P < 0.05. The prevalence of anemia among pregnant women was 23%. Maternal age, region, pregnancy trimester, number of under five children, previous history of abortion (termination of pregnancy), breastfeeding practices, and number of antenatal care visits were key independent predictors of anemia during pregnancy. In conclusion, the level of anemia during pregnancy is a moderate public health problem in Ethiopia. Yet, special preventive measures should be undertaken for pregnant women who are older in age and having too many under five children and previous history of abortion. Further evidence is expected to be generated concerning why pregnant mothers from the eastern part of the country and those with better access to radio disproportionately develop anemia more than their counterparts. PMID:26417454

Pathways between under/unemployment and health among racialized immigrant women in Toronto.

PubMed

Premji, Stephanie; Shakya, Yogendra

2017-02-01

We sought to document pathways between under/unemployment and health among racialized immigrant women in Toronto while exploring the ways in which gender, class, migration and racialization, as interlocking systems of social relations, structure these relationships. We conducted 30 interviews with racialized immigrant women who were struggling to get stable employment that matched their education and/or experience. Participants were recruited through flyers, partner agencies and peer researcher networks. Most interviews (21) were conducted in a language other than English. Interviews were transcribed, translated as appropriate and analyzed using NVivo software. The project followed a community-based participatory action research model. Under/unemployment negatively impacted the physical and mental health of participants and their families. It did so directly, for example through social isolation, as well as indirectly through representation in poor quality jobs. Under/unemployment additionally led to the intensification of job search strategies and of the household/caregiving workload which also negatively impacted health. Health problems, in turn, contributed to pushing participants into long-term substandard employment trajectories. Participants' experiences were heavily structured by their social location as low income racialized immigrant women. Our study provides needed qualitative evidence on the gendered and racialized dimensions of under/unemployment, and adverse health impacts resulting from this. Drawing on intersectional analysis, we unpack the role that social location plays in creating highly uneven patterns of under/unemployment and negative health pathways for racialized immigrant women. We discuss equity informed strategies to help racialized immigrant women overcome barriers to stable work that match their education and/or experience.

Minority Women and Advocacy for Women's Health

PubMed Central

Kumanyika, Shiriki K.; Morssink, Christiaan B.; Nestle, Marion

2001-01-01

US minority health issues involve racial/ethnic disparities that affect both women and men. However, women's health advocacy in the United States does not consistently address problems specific to minority women. The underlying evolution and political strength of the women's health and minority health movements differ profoundly. Women of color comprise only one quarter of women's health movement constituents and are, on average, socioeconomically disadvantaged. Potential alliances may be inhibited by vestiges of historical racial and social divisions that detract from feelings of commonality and mutual support. Nevertheless, insufficient attention to minority women's issues undermines the legitimacy of the women's health movement and may prevent important advances that can be achieved only when diversity is fully considered. PMID:11527764

Social inequality in health: dichotomy or gradient? A comparative study of problematizations in national public health programmes.

PubMed

Vallgårda, Signild

2008-01-01

Recent public health programmes from four countries: Denmark, England, Norway, and Sweden, are studied to analyse how social inequality in health is described, explained and suggested to be tackled, i.e., the problematization or the discursive process whereby the issue is framed and made accessible to political action. Social inequality in health is defined in these programmes both as a disadvantaged minority with major health problems, in contrast to the rest of the population, i.e., as a dichotomy; and as a gradient in which health problems are seen as increasing with lower social class or educational level. The causes of health inequality are identified as behaviour, social relations and underlying social structures. Policies aimed at reducing health inequality can be characterized as either in accordance with a residual welfare state model, targeting the disadvantaged, or a universal model, addressing the whole population. All countries have policies that are mixtures of these problematizations, but with some systematic differences between the countries. In this field England resembles the Scandinavian countries, as much as they resemble each other dispelling the idea of a Nordic or Scandinavian welfare state model.

Some problems of human adaptation and ecology under the aspect of general pathology

NASA Technical Reports Server (NTRS)

Kaznacheyev, V. P.

1980-01-01

The main problems of human adaptation at the level of the body and the population in connection with the features of current morbidity of the population and certain demographic processes are analyzed. The concepts of health and adaptation of the individual and human populations are determined. The importance of the anthropo-ecological approach to the investigation of the adaptation process of human populations is demonstrated. Certain features of the etiopathogenesis of diseases are considered in connection with the population-ecological regularities of human adaptation. The importance of research on general pathology aspects of adaptation and the ecology of man for planning, and organization of public health protection is discussed.

Sexually transmitted diseases in modern China: a historical survey.

PubMed Central

Dikötter, F

1993-01-01

This paper points to the congruence between political and social variables and the epidemiology of sexually transmitted diseases (STDs) in modern China. STDs became a major health problem after the fall of the empire in 1911 and were only reluctantly addressed by a weak nationalist government during the 1930s. During the 1950s and 60s, the communist regime brought STDs under control, but problems have reappeared since reforms were implemented during the 1980s. Cultural values and social attitudes have also structured medical responses to venereal disease. From the reform movements between the two World Wars to the more recent communist health campaigns, medical theory has often been confused with moral prescription. PMID:8244349

[Cuts, austerity and health. SESPAS report 2014].

PubMed

Segura Benedicto, Andreu

2014-06-01

Since 2009, the economic recession has led to cuts in spending on social welfare policy and in health care. The most important risks to health depend on negative changes in social determinants. Notable among these determinants are unemployment and the large proportion of people at risk of poverty, which affects 30% of children younger than 14 years. Social inequalities have increased significantly, much more than health inequalities, probably because the value of retirement pensions has been maintained until now. Most of the population is fairly satisfied with the public health system, although it is under considerable pressure. Mortality statistics have not been affected so far, but there has been an increase in mood disorders and mental health problems. Health services utilization has decreased and the number of publicly prescribed drugs has fallen dramatically. This restriction accounts for much of the decrease in public spending on health, since the hospital care budget has not decreased, despite the fall in primary care and public health spending. The crisis could encourage community health and the inclusion of health in all policies. It is the responsibility of professionals and public health institutions monitoring the trend in health problems and their determinants to avoid irreversible situations as far as possible. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Is the impact of atopic disease on children and adolescents’ health related quality of life modified by mental health? Results from a population-based cross-sectional study

PubMed Central

2013-01-01

Background Eczema, asthma and hay fever are global health problems and their prevalence has increased considerably over the last decades. All appear to share an underlying atopic diathesis but their aetiology is considered to be multifactorial. They have been linked to decreases in health related quality of life (HRQoL) in adults, children/adolescents and/or parents of children. Research also suggests an association of the three conditions with mental health, which in turn is related to HRQoL decreases. We aimed to assess whether the impact of any of the three conditions on HRQoL is modified by presence of mental health problems. Methods The impact of occurrence of the three conditions within the past four weeks and 12 months on HRQoL, as measured by the ‘Quality of Life in Children – Revised’ (KINDL-R) questionnaire was analysed by use of the complex sample general linear model in a population-based sample (N = 6518) of children and adolescents aged 11 – 17. Analyses were adjusted for the other atopic conditions, sociodemographic and clinical variables and stratified for mental health as measured by the Strengths and Difficulties Questionnaire (SDQ) (normal n = 5697, borderline n = 609, abnormal n = 193). Results Eczema and hay fever within the past four weeks were significantly associated with decreased total or certain subscales of KINDL-R after adjusting for all other variables when no mental health abnormalities were present while asthma was associated with better HRQoL in these individuals. However, when mental health problems were present, eczema was positively associated with several subscales and the positive impact of asthma was stronger. The presence of mental health problems accentuated the negative relationship between hay fever and HRQoL (stronger negative impact). However, due to decreasing numbers in the group with mental health problems only few associations reached statistical significance. Conclusions While the results suggest mental health to have a modifying effect on the relationship between some atopic conditions and HRQoL caution needs to be exercised in interpreting the results: First, the groups with borderline or abnormal mental health were comparably smaller than the group with normal mental health. In the group with normal mental health small effects were more likely to become significant than in the other two groups. Secondly some problems regarding the validity of the self-report SDQ still remain. PMID:23835154

Is the impact of atopic disease on children and adolescents' health related quality of life modified by mental health? Results from a population-based cross-sectional study.

PubMed

Matterne, Uwe; Apfelbacher, Christian

2013-07-08

Eczema, asthma and hay fever are global health problems and their prevalence has increased considerably over the last decades. All appear to share an underlying atopic diathesis but their aetiology is considered to be multifactorial. They have been linked to decreases in health related quality of life (HRQoL) in adults, children/adolescents and/or parents of children. Research also suggests an association of the three conditions with mental health, which in turn is related to HRQoL decreases. We aimed to assess whether the impact of any of the three conditions on HRQoL is modified by presence of mental health problems. The impact of occurrence of the three conditions within the past four weeks and 12 months on HRQoL, as measured by the 'Quality of Life in Children--Revised' (KINDL-R) questionnaire was analysed by use of the complex sample general linear model in a population-based sample (N=6518) of children and adolescents aged 11-17. Analyses were adjusted for the other atopic conditions, sociodemographic and clinical variables and stratified for mental health as measured by the Strengths and Difficulties Questionnaire (SDQ) (normal n=5697, borderline n=609, abnormal n=193). Eczema and hay fever within the past four weeks were significantly associated with decreased total or certain subscales of KINDL-R after adjusting for all other variables when no mental health abnormalities were present while asthma was associated with better HRQoL in these individuals. However, when mental health problems were present, eczema was positively associated with several subscales and the positive impact of asthma was stronger. The presence of mental health problems accentuated the negative relationship between hay fever and HRQoL (stronger negative impact). However, due to decreasing numbers in the group with mental health problems only few associations reached statistical significance. While the results suggest mental health to have a modifying effect on the relationship between some atopic conditions and HRQoL caution needs to be exercised in interpreting the results: First, the groups with borderline or abnormal mental health were comparably smaller than the group with normal mental health. In the group with normal mental health small effects were more likely to become significant than in the other two groups. Secondly some problems regarding the validity of the self-report SDQ still remain.

The role of anxiety sensitivity in the relation between anxious arousal and cannabis and alcohol use problems among low-income inner city racial/ethnic minorities.

PubMed

Paulus, Daniel J; Manning, Kara; Hogan, Julianna B D; Zvolensky, Michael J

2017-05-01

The current study explored anxiety sensitivity as a factor accounting for the association between anxious arousal and problems related to use of cannabis and alcohol among a health disparity sample (low income minorities). Specifically, participants were 130 low-income racial/ethnic minorities who reported daily cannabis use (M age =37.7 SD=10.0; 28.5% female). There were significant indirect associations of anxious arousal via anxiety sensitivity in relation to: cannabis use problems, cannabis withdrawal symptoms, use of cannabis to cope, as well as hazardous drinking, alcohol use problems, and alcohol consumption. These data indicate anxiety sensitivity is a possible mechanism underlying the relation between anxious arousal and substance use problems among low-income racial/ethnic minorities. Future work could evaluate the efficacy of cannabis and alcohol use treatments incorporating anxiety sensitivity reduction techniques to facilitate amelioration of anxiety and substance use and offset mental health inequalities for this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

5 CFR 792.102 - General.

Code of Federal Regulations, 2014 CFR

2014-01-01

... EMPLOYEES' HEALTH, COUNSELING, AND WORK/LIFE PROGRAMS Alcoholism and Drug Abuse Programs and Services for... drug abuse required under subchapter VI of chapter 73 of title 5, United States Code. Federal agencies... with alcohol and drug problems. Short-term counseling or referral, or offers thereof, constitute the...

5 CFR 792.102 - General.

Code of Federal Regulations, 2013 CFR

2013-01-01

... EMPLOYEES' HEALTH, COUNSELING, AND WORK/LIFE PROGRAMS Alcoholism and Drug Abuse Programs and Services for... drug abuse required under subchapter VI of chapter 73 of title 5, United States Code. Federal agencies... with alcohol and drug problems. Short-term counseling or referral, or offers thereof, constitute the...

microRNA Profiling Reveals Differential Response to Ozone between Asthmatic and Healthy Donors

EPA Science Inventory

Introduction: Morbidity and mortality attributable to air pollution continue to be growing problems worldwide. People with underlying pulmonary diseases, such as asthma, are susceptible to the negative health effects of air pollutant exposure. Asthma is characterized by an increa...

After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department

MedlinePlus

... the person’s physical and mental health. Emergency department staff should look for underlying physical problems that may ... that can cause emotional distress. While emergency department staff prefer to assess people who are sober, they ...

Becoming an Independent Community Mental Health Center: Perils of the Process

PubMed Central

Adams, Milton S.

1978-01-01

Over the past 12 years, since the inception of the Community Mental Health Center (CMHC) movement, there has been increasing concern that local communities have more input; in fact, that they actually have the opportunity to operate the mental health programs that they deem necessary for their communities.1 Under the Amendments to the Community Mental Health Act (P.L.94-63) 1975, CMHCs were given such options as independence or governance. The whole process of governance presents numerous problems as well as opportunities. An overview of the vicissitudes of this process is presented in this paper. PMID:702582

Medical liability and health care reform.

PubMed

Nelson, Leonard J; Morrisey, Michael A; Becker, David J

2011-01-01

We examine the impact of the Affordable Care Act (ACA) on medical liability and the controversy over whether federal medical reform including a damages cap could make a useful contribution to health care reform. By providing guaranteed access to health care insurance at community rates, the ACA could reduce the problem of under-compensation resulting from damages caps. However, it may also exacerbate the problem of under-claiming in the malpractice system, thereby reducing incentives to invest in loss prevention activities. Shifting losses from liability insurers to health insurers could further undermine the already weak deterrent effect of the medical liability system. Republicans in Congress and physician groups both pushed for the adoption of a federal damages cap as part of health care reform. Physician support for damages caps could be explained by concerns about the insurance cycle and the consequent instability of the market. Our own study presented here suggests that there is greater insurance market stability in states with caps on non-economic damages. Republicans in Congress argued that the enactment of damages caps would reduce aggregate health care costs. The Congressional Budget Office included savings from reduced health care utilization in its estimates of cost savings that would result from the enactment of a federal damages cap. But notwithstanding recent opinions offered by the CBO, it is not clear that caps will significantly reduce health care costs or that any savings will be passed on to consumers. The ACA included funding for state level demonstration projects for promising reforms such as offer and disclosure and health courts, but at this time the benefits of these reforms are also uncertain. There is a need for further studies on these issues.

The Health Profile of Street Children in Africa: A Literature Review

PubMed Central

Cumber, Samuel Nambile; Tsoka-Gwegweni, Joyce Mahlako

2015-01-01

The United Nations Children’s Fund has labeled street children as children in difficult circumstances, which represent a minority population that has been under-represented for too long in health research. This is a concern because street children are at risk of carrying a greater disease burden. Their homeless lifestyle makes them more vulnerable to health risks and problems than children who live at home; as they roam the streets begging for food and money to obtain basic needs and are found sleeping in half-destroyed houses, abandoned basements, under bridges and in the open air. This paper presents health results from a systematic review of literature from 17 databases and including 16 countries in Africa. The review revealed that there are more boys than girls living on the street in their adolescence and who mainly have left home due to poverty and abuse. These children in these countries are vulnerable to poor health due to factors such as homelessness, risky sexual behavior, substance abuse and violence. Among the health problems identified are growth and nutritional disorders, physical injuries, violence, sexual abuse, communicable diseases including diarrheal diseases, malaria, respiratory diseases, neglected tropical diseases, mental health issues, substance abuse, reproductive health disorders, mortality, sexually transmitted diseases and HIV/AIDS. Primary interventions that could prevent poor health and improve the health status of street children include provision of safe shelter, proper nutrition, access to health care, health education, and sexual reproductive health, protection from any form of abuse, violence and substance abuse. Enforcing state policies and laws in all African countries is required to protect street children from neglect, abuse and to increase their access to education. More research on the health risks and health status of street children is still required, particularly in Sub-Saharan Africa, which carries the greatest disease burden and poverty. PMID:28299148

How do supervisors perceive and manage employee mental health issues in their workplaces?

PubMed

Kirsh, Bonnie; Krupa, Terry; Luong, Dorothy

2018-01-01

Organizations have become increasingly concerned about mental health issues in the workplace as the economic and social costs of the problem continue to grow. Addressing employees' mental health problems and the stigma that accompanies them often falls to supervisors, key people in influencing employment pathways and the social climate of the workplace. This study examines how supervisors experience and perceive mental illness and stigma in their workplaces. It was conducted under the mandate of the Mental Health Commission of Canada's Opening Minds initiative. The study was informed by a theoretical framework of stigma in the workplace and employed a qualitative approach. Eleven supervisors were interviewed and data were analyzed for major themes using established procedures for conventional content analysis. Themes relate to: perceptions of the supervisory role relative to managing mental health problems at the workplace; supervisors' perceptions of mental health issues at the workplace; and supervisors' experiences of managing mental health issues at work. The research reveals the tensions supervisors experience as they carry out responsibilities that are meant to benefit both the individual and workplace, and protect their own well-being as well. This study emphasizes the salience of stigma and mental health issues for the supervisor's role and illustrates the ways in which these issues intersect with the work of supervisors. It points to the need for future research and training in areas such as balancing privacy and supports, tailoring disclosure processes to suit individuals and workplaces, and managing self-care in the workplace.

The effect of health payment reforms on cost containment in Taiwan hospitals: the agency theory perspective.

PubMed

Chang, Li

2011-01-01

This study aims to determine whether the Taiwanese government's implementation of new health care payment reforms (the National Health Insurance with fee-for-service (NHI-FFS) and global budget (NHI-GB)) has resulted in better cost containment. Also, the question arises under the agency theory whether the monitoring system is effective in reducing the risk of information asymmetry. This study uses panel data analysis with fixed effects model to investigate changes in cost containment at Taipei municipal hospitals before and after adopting reforms from 1989 to 2004. The results show that the monitoring system does not reduce information asymmetry to improve cost containment under the NHI-FFS. In addition, after adopting the NHI-GB system, health care costs are controlled based on an improved monitoring system in the policymaker's point of view. This may suggest that the NHI's fee-for-services system actually causes health care resource waste. The GB may solve the problems of controlling health care costs only on the macro side.

Health, Morality, and Housing: The “Tenement Problem” in Chicago

PubMed Central

Garb, Margaret

2003-01-01

In this article, I trace the history of Chicago’s Health Department, exploring when and how housing conditions came to be considered a serious social problem requiring municipal regulation. Although journalists and labor leaders were among the first Chicagoans to link tenement housing to the spread of contagious disease, Health Department officials quickly began regulating the city’s housing stock under their own authority. I argue that in attempting to eliminate the dangers of contagious disease, a long-standing public health threat, health officials drew new attention to the dangers of multifamily dwellings and set a precedent for government regulation of living conditions in tenement dwellings. PMID:12948956

Health consequences of shift-work: the case of iranian hospital security personnel.

PubMed

Abedini, Roghayeh; Soltanzadeh, Ahmad; Faghih, Mohammad Amin; Mohammadi, Heidar; Kamalinia, Mojtaba; Mohraz, Majid Habibi; Arassi, Maziyar; Veyseh, Peyman Piran; Aghaei, Hamed; Hosseini, Seyed Younes

2015-01-01

Shift-work, which is an ergonomics issue in workplaces, can negatively affect workers. The security personnel of medical centers in Iran have multiple responsibilities and consequently are exposed to such unwanted situations as observing patients, disputing with patient's attendants, unwanted shift schedules, and being away from family for long periods. This study assessed health problems of Iranian hospital security personnel (shift-worker personnel) using the Survey of Shift-workers (SOS) questionnaire (Persian version). This cross-sectional study was conducted in seven medical centers (4 hospitals and 3 clinics). A total of 416 workers were surveyed: shift-workers (exposed group) (n=209) and non-shift-workers (unexposed group) (n=207). The prevalence of adverse health effects was higher in shift-workers than day-workers. The level of education and mean Body Mass Index (BMI) in shift-workers were significantly higher compared with day-workers. The prevalence of gastrointestinal disorders, cardiovascular and psychological problems were also significantly higher in shift-workers compared with day-workers. Overall, the prevalence of health problems among the security personnel of medical centers was high. Hence, it is recommended that personnel be put under periodic monitoring and receive medical counseling and treatment if there is any disorder.

Taking power, politics, and policy problems seriously: the limits of knowledge translation for urban health research.

PubMed

Murphy, Kelly; Fafard, Patrick

2012-08-01

Knowledge translation (KT) is a growing movement in clinical and health services research, aimed to help make research more relevant and to move research into practice and policy. This paper examines the conventional model of policy change presented in KT and assesses its applicability for increasing the impact of urban health research on urban health policy. In general, KT conceptualizes research utilization in terms of the technical implementation of scientific findings, on the part of individual decision-makers who can be "targeted" for a KT intervention, in a context that is absent of political interests. However, complex urban health problems and interventions infrequently resemble this single decision, single decision-maker model posited by KT. In order to clarify the conditions under which urban health research is more likely or not to have an influence on public policy development, we propose to supplement the conventional model with three concepts drawn from the social science: policy stages, policy networks, and a discourse analysis approach for theorizing power in policy-making.

The Mandwa project: an experiment in community participation.

PubMed

Antia, N H

1988-01-01

The project at Mandwa was designed to study the problems of health in rural India and the delivery of health care by the existing public and private health systems. The results demonstrate the important role of socioeconomic and political factors not only in vital areas such as nutrition, water supply, sanitation, and housing, but also in the delivery of health services. The private sector showed a predominantly curative and monetary orientation, while the public sector demonstrated a lack of accountability to the people it was designed to serve. Under these conditions, an attempt was made to test the possibility of training local women in self-help with a minimal supportive service. The results reveal that adequate knowledge and technology exist for most of the prevalent problems of health and illness in developing countries, and that semiliterate villagers have the capacity to use these effectively if they are provided in a simple manner. This experiment also demonstrates the opposition from local vested interests to any change of the status quo, even in the relatively noncontroversial field of health.

Assessment of Oral Status in Pediatric Patients with Special Health Care Needs receiving Dental Rehabilitation Procedures under General Anesthesia: A Retrospective Analysis.

PubMed

Solanki, Neeraj; Kumar, Anuj; Awasthi, Neha; Kundu, Anjali; Mathur, Suveet; Bidhumadhav, Suresh

2016-06-01

Dental problems serve as additional burden on the children with special health care needs (CSHCN) because of additional hospitalization pressure, they face for the treatment of various serious medical problems. These patients have higher incidence of dental caries due to increased quantity of sugar involved in the drug therapies and lower salivary flow in the oral cavity. Such patients are difficult to treat with local anesthesia or inhaled sedatives. Single-sitting dental treatment is possible in these patients with general anesthesia. Therefore, we conducted this retrospective analysis of oral health status of CSHCN receiving various dental treatments in a given population. A total of 200 CSHCN of age 14 years or less reporting in the pediatric wing of the general hospital from 2005 to 2014 that underwent comprehensive dental treatment under general anesthesia were included in the study. Patients with history of any additional systemic illness, any malignancy, any known drug allergy, or previous history of any dental treatment were excluded from the study. Complete mouth rehabilitation was done in these patients under general anesthesia following standard protocols. Data regarding the patient's disability, type, duration, and severity of disability was collected and analyzed. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Chi-square test, Student's t-test, and one-way analysis of variance were used to assess the level of significance. Statistically significant results were obtained while analyzing the subject's decayed missing filled/decayed extracted filled teeth indices divided based on age. Significant difference was observed only in cases where patients underwent complete crown placement even when divided based on type of disability. While analyzing the prevalence, statistically significant results were observed in patients when divided based on their age. In CSHCN, dental pathologies and caries indices are increased regardless of the type or extent of disability. Children with special health care needs should be given special oral health care, and regular dental checkup should be conducted as they are more prone to have dental problems.

New systems of care for substance use disorders: treatment, finance, and technology under health care reform.

PubMed

Pating, David R; Miller, Michael M; Goplerud, Eric; Martin, Judith; Ziedonis, Douglas M

2012-06-01

This article outlined ways in which persons with addiction are currently underserved by our current health care system. However, with the coming broad scale reforms to our health care system, the access to and availability of high-quality care for substance use disorders will increase. Addiction treatments will continue to be offered through traditional substance abuse care systems, but these will be more integrated with primary care, and less separated as treatment facilities leverage opportunities to blend services, financing mechanisms, and health information systems under federally driven incentive programs. To further these reforms, vigilance will be needed by consumers, clinicians, and policy makers to assure that the unmet treatment needs of individuals with addiction are addressed. Embedded in this article are essential recommendations to facilitate the improvement of care for substance use disorders under health care reform. Ultimately, as addiction care acquires more of the “look and feel” of mainstream medicine, it is important to be mindful of preexisting trends in health care delivery overall that are reflected in recent health reform legislation. Within the world of addiction care, clinicians must move beyond their self-imposed “stigmatization” and sequestration of specialty addiction treatment. The problem for addiction care, as it becomes more “mainstream,” is to not comfortably feel that general slogans like “Treatment Works,” as promoted by Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment during its annual Recovery Month celebrations, will meet the expectations of stakeholders outside the specialty addiction treatment community. Rather, the problem is to show exactly how addiction treatment works, and to what extent it works-there have to be metrics showing changes in symptom level or functional outcome, changes in health care utilization, improvements in workplace attendance and productivity, or other measures. At minimum, clinicians will be required to demonstrate that their new systems of care and future clinical activity are in conformance with overall standards of “best practice” in health care.

'Health psychology' or 'psychology for health'? A history of psychologists' engagement with health in South Africa.

PubMed

Yen, Jeffery; Vaccarino, Oriana

2018-03-01

In contrast to the institutionalization of health psychology in North America and Europe, much psychological work on health issues in South Africa emerged as part of a critical revitalization of South African psychology as a whole, coinciding with the dismantling of Apartheid and global shifts in health discourse. The field's development reflects attempts to engage with urgent health problems in the context of rapid sociopolitical changes that followed democratic transition in the 1990s, and under new conditions of knowledge production. We provide an account of these issues, as well as reflections on the field's future, as inflected through the experiences of 12 South African psychologists whose careers span the emergence of health-related psychology to the present day.

Dissemination of an evidence-based intervention to parents of children with behavioral problems in a developing country.

PubMed

Fayyad, John A; Farah, Lynn; Cassir, Youmna; Salamoun, Mariana M; Karam, Elie G

2010-08-01

This project describes the dissemination of an evidence-based parenting skills intervention by training social and health workers with little or no mental health background so that they themselves train mothers of children with behavioral problems in impoverished communities in a developing country. The Strengths and Difficulties Questionnaire was completed by mothers to screen for children with behavioral problems and was repeated at the end of the intervention. Pre- and post-tests of knowledge and parenting attitudes were administered to mothers. Mental health workers trained social and health workers in social development centers and dispensaries. Each social and health worker trained mothers of children with behavioral problems under supervision utilizing an Arabic adaptation of the treatment manual for externalizing disorders "Helping Challenging Children" developed by the Integrated Services Taskforce of the World Psychiatric Association Child Mental Health Presidential Programme. A total of 20 workers and 87 mothers participated in the training. The proportion of children who obtained an SDQ total difficulties score in the abnormal range decreased from 54.4 to 19.7% after the training. Whereas 40.2% of mothers used severe corporal punishment with their children before the intervention, this decreased to 6.1% post-intervention. Three-fourths of mothers related that the program helped them develop new parenting skills. This pilot project demonstrated the feasibility of dissemination of a manual-based intervention and training of workers who have little background in mental health to offer effective services to families in impoverished communities who otherwise would have not received them. Successful replication in other developing countries would pave the way to incorporating such programs in national policies given their potential sustainability and cost-effectiveness.

Violence against women

PubMed Central

Bohra, Neena; Sharma, Indira; Srivastava, Shruti; Bhatia, M. S.; Chaudhuri, Uday; Parial, Sonia; Sharma, Avdesh; Kataria, Dinesh

2015-01-01

Violence against women (VAW) is a major public health problem in the country. The problem is grossly under-reported. A number of factors have been blamed for crimes against women. An inefficient law enforcing machinery has often been targeted for the increasing number of cases being reported. There is little recognition that psychiatric morbidity can perpetuate such crimes. Of late, there appears to a continuous increase in the number of crimes committed against women; especially the very serious ones like gang rapes. The latter have shaken the very conscience of people. Even harsher legislation does not seem to have made any effect. One wonders how this could be possible in a society heading toward high education, economic and technological development. Media has played a pivotal role by highlighting the problem to the masses. The need for the hour is for mental health professionals to take the challenge and present a comprehensive proposal for definite action to prevent all forms of VAW. PMID:26330651

[The Child and Adolescent Health Survey--a foundation for prevention, health promotion and health goals].

PubMed

Bergmann, K E; Thefeld, W; Kurth, B M

2002-12-01

At the beginning of the 21st century, the German Health Interview and Examination Survey of Children and Adolescents will for the first time provide the data essential for programmes of disease prevention and health promotion as well as for the development of health targets. This it will create key information for an evidence-based health policy. The results of the study can be projected to the general population of children and adolescents in Germany. The data will be collected conjunct at the level of the individual subject. They will facilitate valid and distinct description of prevalent physical, psychological and social health problems, as well as on who has them under which circumstances and settings. Information on the impact, e.g., in terms of utilisation of the health system or impairments of quality of life, will also be available from the same subjects. In addition, indicators of risks to health in later life are included. Hence, the data will support prevention of health problems in infancy, childhood and adolescence as well as of chronic diseases in later life. Finally, the data shall be a basis for the definition of new reference values for many variables. This will improve valid and clear judgement not only in epidemiological studies but also in medical care.

Principal-agent theory: a framework for improving health care reform in Tennessee.

PubMed

Sekwat, A

2000-01-01

Using a framework based on principal-agent theory, this study examines problems faced by managed care organizations (MCOs) and major health care providers under the state of Tennessee's current capitation-based managed care programs called TennCare. Based on agency theory, the study proposes a framework to show how an effective collaborative relationship can be forged between the state of Tennessee and participating MCOs which takes into account the major concerns of third-party health care providers. The proposed framework further enhances realization of the state's key health care reform goals which are to control the rising costs of health care delivery and to expand health care coverage to uninsured and underinsured Tennesseans.

ARSH 1: Reproductive and sexual health problems of adolescents and young adults: a cross sectional community survey on knowledge, attitude and practice.

PubMed

Nair, M K C; Leena, M L; Thankachi, Yamini; George, Babu; Russell, Paul Swamidhas Sudhakar

2013-11-01

To understand the problems faced and the difference in knowledge, attitude and practice of young people across the age group of 10-24 y on reproductive and sexual health issues and to get their suggestions regarding adolescent care services. This cross sectional community survey involving three districts in Kerala was conducted among adolescents and young adults of 10-24 y using a population proportion to sample size technique. The main problems faced by the young people between 10 and 24 y of age were financial, substance abuse in family, poor academic performance, difference of opinion, disease in self/family, mental problems, lack of talent, strict parents, difficulty in mingling, love failure, broken family, loneliness and problems at school/office in the descending order. As the age advances higher percentage of both boys (43.4%) and girls (61.7%) discuss reproductive sexual health issues among themselves. There was a statistically significant difference in personal hygiene practices like changing napkins/cloths more than once a day (94.3%), cleaning genital organs with soap every day (71.7%), washing after urination (69.2%), washing from front to back after defecation (62.2%) and washing hands with soap after defecation (73.2%) between 10-14, 15-19, and 20-24 y age group with higher percentages in the older groups. In order to make the service more useful, more of the older group participants suggested giving information on adolescent services to parents, adolescents and society as a whole by creating better societal acceptance and keeping confidentiality in service delivery. This study has shown an overall inadequacy in reproductive health knowledge in all age groups, but increasing knowledge gain and better attitude and practices on reproductive and sexual health as the age increases. The suggestions made by the group regarding need for adolescent reproductive sexual health (ARSH) and counseling services with privacy and confidentiality ensured, is useful for planning ARSH services under National Rural Health Mission.

Perceived unmet need and barriers to care amongst street-involved people who use illicit drugs.

PubMed

Hyshka, Elaine; Anderson, Jalene Tayler; Wild, T Cameron

2017-05-01

Research on perceived unmet need for care for mental health and substance use problems focuses on general populations to the detriment of hidden populations. This study describes prevalence and correlates of perceived unmet need for care in a community-based sample of street-involved people who use illicit drugs and identifies barriers to care. A sample of 320 street-involved people who use drugs participated in a structured, interviewer-assisted survey in Edmonton, Canada. The survey included the Perceived Need for Care Questionnaire, which assessed unmet need for care for mental health and substance use problems across seven service types. Logistic regression examined the associations between perceived unmet need, extent of socioeconomic marginalisation and problem severity. Barriers underlying unmet service needs were also examined. Most (82%) participants reported unmet need for one or more services during the past year. Odds of reporting one or more unmet needs were elevated amongst participants reporting substantial housing instability (adjusted odds ratio = 2.37; 95% confidence interval 1.19-4.28) and amongst participants meeting criteria for drug dependence (adjusted odds ratio = 1.22; 95% confidence interval 1.03-1.50), even after adjustment for sociodemographic covariates. Structural, rather than motivational barriers were the most commonly reported reasons underlying unmet service needs. Street-involved people who use drugs experience very high rates of perceived unmet need for care for mental health and substance use problems. General population studies on perceived unmet need are insufficient for understanding needs and barriers to care in hidden populations.[Hyshka E, Anderson JT, Wild TC. Perceived unmet need and barriers to care amongst street-involved people who use illicit drugs. Drug Alcohol Rev 2017;36:295-304]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

[Cervix uteri cancer: a critical approach to its prevention].

PubMed

de Oliveira, Michele Mandagara; da Silva, Emilia Nalva Ferreira; Pinto, Ione Carvalho; Coimbra, Valéria Cristina Christello

2004-08-01

This article is a pilot study of one of the authors master dissertation about problems related to the preventive measures of cervix cancer. Four women with cancer that were hospitalized at the gynecological ward or under chemotherapy treatment at a hospital in the city of Pelotas, RS, Brazil, were interviewed. Data were collected from April to June 2001, and of the women interviewed only one was examined preventively according to the guidelines of the Ministry of Health. Therefore, health professionals should be urged to promote care as well as health education.

Best interests: what problems in family law should health care law avoid?

PubMed

Holm, Søren

2008-09-01

This article comments briefly on three specific issues in Shazia Choudhry's paper "'Best Interests' What can healthcare law learn from family law?" The three issues are: (1) the implications of 'best interests' and 'welfare science' for women within the family law and the health care law context, (2) the risk of capture by the 'welfare science' industry, and (3) the proposal that a committee of medical experts and medical ethicists should be set up to provide reports to the Court of Protection on cases brought under the Mental Capacity Act 2005 (MCA). I argue that the risk of capture by 'welfare science' is equally large in health care law and that a committee of the kind envisaged by Choudhry is unlikely to contribute significantly to conflict resolution under the MCA.

STOPPING DECEPTIVE HEALTH CLAIMS: THE NEED FOR A PRIVATE RIGHT OF ACTION UNDER FEDERAL LAW.

PubMed

Hoffmann, Diane; Schwartz, Jack

2016-01-01

This Article offers a thorough analysis of an important public health issue, namely how to confront the growing problem of deceptive claims regarding foods and dietary supplements, including increasingly prevalent but unverifiable claims. The authors call for the creation of a limited private right of action under the Federal Trade Commission (FTC) Act for deceptive health-related claims for these products. The proposal responds to the growing market for these products and the inadequacy of current laws and enforcement actions to prevent such claims. In crafting the limited private right of action, the authors attempt to enhance consumer protection without undermining federal agency primacy in enforcement. The Article ends with an appendix setting forth proposed language for a statutory amendment to the FTC Act incorporating the authors' proposal.

Organizing for Social Partnership: Higher Education in Cross-Sector Collaboration

ERIC Educational Resources Information Center

Siegel, David J.

2010-01-01

The most complex social challenges--such as post-secondary access and success for under-represented students, diversification of the workforce, poverty, environmental degradation, and global health--exceed the problem-solving capacity of single organizations or societal sectors. "Organizing for Social Partnership" provides colleges and…

COMPUTER AIDED DESIGN OF REPLACEMENT SOLVENTS UNDER VARYING ENVIRONMENTAL CONSTRAINTS

EPA Science Inventory

There is a great need to replace many solvents that are commonly used by industry and the public, but whose continued use entails a number of human health and environmental risks. One problem hampering solvent replacement is the thought that replacement, particularly for environm...

Stressful Segregation Housing and Psychosocial Vulnerability in Prison Suicide Ideators

ERIC Educational Resources Information Center

Bonner, Ronald L.

2006-01-01

Psychosocially vulnerable prisoners under stressful conditions of confinement are ill prepared to cope and at risk for developing suicide intention. The present study examined the relationships of depression, hopelessness, reasons for living, mental health problem history, suicide attempt lethality history, and stressful segregation housing with…

Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems.

PubMed

Harvey, Samuel B; Modini, Matthew; Joyce, Sadhbh; Milligan-Saville, Josie S; Tan, Leona; Mykletun, Arnstein; Bryant, Richard A; Christensen, Helen; Mitchell, Philip B

2017-03-01

It has been suggested that certain types of work may increase the risk of common mental disorders, but the exact nature of the relationship has been contentious. The aim of this paper is to conduct the first comprehensive systematic meta-review of the evidence linking work to the development of common mental health problems, specifically depression, anxiety and/or work-related stress and to consider how the risk factors identified may relate to each other. MEDLINE, PsychInfo, Embase, the Cochrane Collaboration and grey literature databases were systematically searched for review articles that examined work-based risk factors for common mental health problems. All included reviews were subjected to a quality appraisal. 37 review studies were identified, of which 7 were at least moderate quality. 3 broad categories of work-related factors were identified to explain how work may contribute to the development of depression and/or anxiety: imbalanced job design, occupational uncertainty and lack of value and respect in the workplace. Within these broad categories, there was moderate level evidence from multiple prospective studies that high job demands, low job control, high effort-reward imbalance, low relational justice, low procedural justice, role stress, bullying and low social support in the workplace are associated with a greater risk of developing common mental health problems. While methodological limitations continue to preclude more definitive statements on causation between work and mental disorders, there is now a range of promising targets for individual and organisational-level interventions aimed at minimising mental health problems in the workplace. 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/.

Spa therapy (balneotherapy) relieves mental stress, sleep disorder, and general health problems in sub-healthy people.

PubMed

Yang, Bei; Qin, Qi-Zhong; Han, Ling-Li; Lin, Jing; Chen, Yu

2018-02-01

To investigate the relieving effects of hot spring balneotherapy on mental stress, sleep disorder, general health problems, and women's health problems in sub-healthy people, we recruited 500 volunteers in sub-health in Chongqing, and 362 volunteers completed the project, including 223 in the intervention group and 139 in the control group. The intervention group underwent hot spring balneotherapy for 5 months, while the control group did not. The two groups took questionnaire investigation (general data, mental stress, emotional status, sleep quality, general health problems, as well as some women's health problems) and physical examination (height, weight, waist circumference, blood pressure, blood lipid, blood sugar) 5 months before and after the intervention, respectively. After intervention, sleep disorder (difficulty in falling asleep (P = 0.017); dreaminess, nightmare suffering, and restless sleep (P = 0.013); easy awakening (P = 0.003) and difficulty in falling into sleep again after awakening(P = 0.016); and mental stress (P = 0.031) and problems of general health (head pain (P = 0.026), joint pain(P = 0.009), leg or foot cramps (P = 0.001), blurred vision (P = 0.009)) were relieved significantly in the intervention group, as compared with the control group. While other indicators (fatigue, eye tiredness, limb numbness, constipation, skin allergy) and women's health problems (breast distending pain; dysmenorrhea, irregular menstruation) were relieved significantly in the self-comparison of the intervention group before and after intervention (P < 0.05), but showed no statistically significant difference between two groups (P > 0.05). All indications (except bad mood, low mood, and worry or irritability) in the intervention group significantly improved, with effect size from 0.096 to 1.302. Multiple logistic regression analysis showed that the frequency, length, and location of balneotherapy in the intervention group were the factors influencing emotion, sleep, and health condition (P < 0.05). Relief of insomnia, fatigue, and leg or foot cramps was greater in old-age group than in young-aged group (P < 0.05). Physical examination found that waist circumferences in women of various ages under 55 years were significantly reduced in the intervention group (P < 0.05), while that in men did not significantly change (P > 0.05). Spa therapy (balneotherapy) relieves mental stress, sleep disorder, general health, and reduces women's waist circumferences in sub-healthy people.

Privacy-Enhanced and Multifunctional Health Data Aggregation under Differential Privacy Guarantees

PubMed Central

Ren, Hao; Li, Hongwei; Liang, Xiaohui; He, Shibo; Dai, Yuanshun; Zhao, Lian

2016-01-01

With the rapid growth of the health data scale, the limited storage and computation resources of wireless body area sensor networks (WBANs) is becoming a barrier to their development. Therefore, outsourcing the encrypted health data to the cloud has been an appealing strategy. However, date aggregation will become difficult. Some recently-proposed schemes try to address this problem. However, there are still some functions and privacy issues that are not discussed. In this paper, we propose a privacy-enhanced and multifunctional health data aggregation scheme (PMHA-DP) under differential privacy. Specifically, we achieve a new aggregation function, weighted average (WAAS), and design a privacy-enhanced aggregation scheme (PAAS) to protect the aggregated data from cloud servers. Besides, a histogram aggregation scheme with high accuracy is proposed. PMHA-DP supports fault tolerance while preserving data privacy. The performance evaluation shows that the proposal leads to less communication overhead than the existing one. PMID:27626417

Privacy-Enhanced and Multifunctional Health Data Aggregation under Differential Privacy Guarantees.

PubMed

Ren, Hao; Li, Hongwei; Liang, Xiaohui; He, Shibo; Dai, Yuanshun; Zhao, Lian

2016-09-10

With the rapid growth of the health data scale, the limited storage and computation resources of wireless body area sensor networks (WBANs) is becoming a barrier to their development. Therefore, outsourcing the encrypted health data to the cloud has been an appealing strategy. However, date aggregation will become difficult. Some recently-proposed schemes try to address this problem. However, there are still some functions and privacy issues that are not discussed. In this paper, we propose a privacy-enhanced and multifunctional health data aggregation scheme (PMHA-DP) under differential privacy. Specifically, we achieve a new aggregation function, weighted average (WAAS), and design a privacy-enhanced aggregation scheme (PAAS) to protect the aggregated data from cloud servers. Besides, a histogram aggregation scheme with high accuracy is proposed. PMHA-DP supports fault tolerance while preserving data privacy. The performance evaluation shows that the proposal leads to less communication overhead than the existing one.

Social support as a mediator between problem behaviour and gambling: a cross-sectional study among 14-16-year-old Finnish adolescents.

PubMed

Räsänen, Tiina; Lintonen, Tomi; Tolvanen, Asko; Konu, Anne

2016-12-22

During the adolescent period, risk-taking behaviour increases. These behaviours can compromise the successful transition from adolescence to adulthood. The purpose of this study was to examine social support as a mediator of the relation between problem behaviour and gambling frequency among Finnish adolescents. Data were obtained from the national School Health Promotion Study (SHPS) from the years 2010 and 2011 (N=102 545). Adolescents were classified in the most homogeneous groups based on their problem behaviour via latent class analysis. Path analysis indicated that social support was negatively associated with problem behaviour, and problem behaviour and social support were negatively related (except for social support from friends among boys) to gambling. Social support from parents and school mediated, albeit weakly, the relations between problem behaviour and gambling among girls and boys. Problem behaviour may affect gambling through social support from school and parents. Thus prevention and intervention strategies should focus on strengthening adolescents' social support. In addition, because of the clustering of different problem behaviours instead of concentrating on a single form of problem behaviour multiple-behaviour interventions may have a much greater impact on public health. 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/.

Problem posing and cultural tailoring: developing an HIV/AIDS health literacy toolkit with the African American community.

PubMed

Rikard, R V; Thompson, Maxine S; Head, Rachel; McNeil, Carlotta; White, Caressa

2012-09-01

The rate of HIV infection among African Americans is disproportionately higher than for other racial groups in the United States. Previous research suggests that low level of health literacy (HL) is an underlying factor to explain racial disparities in the prevalence and incidence of HIV/AIDS. The present research describes a community and university project to develop a culturally tailored HIV/AIDS HL toolkit in the African American community. Paulo Freire's pedagogical philosophy and problem-posing methodology served as the guiding framework throughout the development process. Developing the HIV/AIDS HL toolkit occurred in a two-stage process. In Stage 1, a nonprofit organization and research team established a collaborative partnership to develop a culturally tailored HIV/AIDS HL toolkit. In Stage 2, African American community members participated in focus groups conducted as Freirian cultural circles to further refine the HIV/AIDS HL toolkit. In both stages, problem posing engaged participants' knowledge, experiences, and concerns to evaluate a working draft toolkit. The discussion and implications highlight how Freire's pedagogical philosophy and methodology enhances the development of culturally tailored health information.

Better executive function under stress mitigates the effects of recent life stress exposure on health in young adults

PubMed Central

Shields, Grant S.; Moons, Wesley G.; Slavich, George M.

2017-01-01

Executive function is a neuropsychological construct that enables controlled cognitive processing, which has been hypothesized to enhance individuals’ resilience to stress. However, little empirical work has directly examined how executive function under different conditions mitigates the negative effects of stress exposure on health. To address this issue, we recruited 110 healthy young adults and assessed their recent life stress exposure, executive function in either a stressful or non-stressful context, and current health complaints. Based on existing research, we hypothesized that individuals exhibiting better executive function following a laboratory-based stressor (but not a control task) would demonstrate weaker associations between recent stress exposure and health because they perceived recent life stressors as being less severe. Consistent with this hypothesis, better executive function during acute stress, but not in the absence of stress, was associated with an attenuated link between participants’ recent life stress exposure and their current health complaints. Moreover, this attenuating effect was mediated by lesser perceptions of stressor severity. Based on these data, we conclude that better executive function under stress is associated with fewer health complaints and that these effects may occur by reducing individuals’ perceptions of stressor severity. The data thus suggest the possibility of reducing stress-related health problems by enhancing executive function. PMID:28114849

Better executive function under stress mitigates the effects of recent life stress exposure on health in young adults.

PubMed

Shields, Grant S; Moons, Wesley G; Slavich, George M

2017-01-01

Executive function is a neuropsychological construct that enables controlled cognitive processing, which has been hypothesized to enhance individuals' resilience to stress. However, little empirical work has directly examined how executive function under different conditions mitigates the negative effects of stress exposure on health. To address this issue, we recruited 110 healthy young adults and assessed their recent life stress exposure, executive function in either a stressful or non-stressful context, and current health complaints. Based on existing research, we hypothesized that individuals exhibiting better executive function following a laboratory-based stressor (but not a control task) would demonstrate weaker associations between recent stress exposure and health because they perceived recent life stressors as being less severe. Consistent with this hypothesis, better executive function during acute stress, but not in the absence of stress, was associated with an attenuated link between participants' recent life stress exposure and their current health complaints. Moreover, this attenuating effect was mediated by lesser perceptions of stressor severity. Based on these data, we conclude that better executive function under stress is associated with fewer health complaints and that these effects may occur by reducing individuals' perceptions of stressor severity. The data thus suggest the possibility of reducing stress-related health problems by enhancing executive function.

Criteria for selecting children with special needs for dental treatment under general anaesthesia.

PubMed

de Nova García, M Joaquín; Gallardo López, Nuria E; Martín Sanjuán, Carmen; Mourelle Martínez, M Rosa; Alonso García, Yolanda; Carracedo Cabaleiro, Esther

2007-11-01

To study criteria for helping to select children with special needs for dental treatment under general anaesthesia. Group of 30 children (aged under 18) examined on the Course at the Universidad Complutense de Madrid (UCM) (Specialisation on holistic dental treatment of children with special needs) and subsequently referred to the Disabled Children's Oral Health Unit (DCOHU) within Primary Health Care Area 2 of the Madrid Health Service (SERMAS) where dental treatment under general anaesthesia was given during 2005. Relevant data were taken from their case histories with regard to their general health, oral health and behaviour. In most of the children (22 children), it was possible to carry out a complete dental diagnosis. With regard to medical diagnoses, the most frequent pathology was cerebral palsy (8 children), but it was not possible to establish a link between the pathology and the use of general anaesthesia. With regard to oral health, most of the children received restorative treatment in all 4 quadrants (26 children). On the basis of scales for behavioural evaluation and movement, most of the children (17 children) showed clearly negative behaviour, with movements that interrupted or hindered examination. With the exception of certain specific medical problems, the reasons for using general anaesthesia for dental treatment in children with special needs are extensive treatment needs and bad behaviour, both of which can be judged objectively.

Affective personality as cognitive-emotional presymptom profiles regulatory for self-reported health predispositions.

PubMed

Archer, T; Adolfsson, B; Karlsson, E

2008-08-01

Three studies that examined the links between affective personality, as constructed from responses to the Positive Affect (PA) and Negative Affect (NA) Scale (PANAS), and individuals' self-report of self-esteem, intrinsic motivation and Beck's Depression Inventory (BDI) depression in high school students and persons in working occupations are described. Self-report estimations of several other neuropsychiatric and psychosocial variables including, the Uppsala Sleep Inventory (USI), the Hospital Anxiety and Depression (HAD) test, Dispositional optimism, Locus of control, the Subjective Stress Experience test (SSE) and the Stress-Energy (SE) test, were also derived. Marked effects due to affective personality type upon somatic and psychological stress, anxiety and depression, self-esteem, internal and external locus of control, optimism, stress and energy, intrinsic motivation, external regulation, identified regulation, major sleep problems, problems falling asleep, and psychophysiological problems were observed; levels of self-esteem, self-motivation and BDI-depression all produced substantial effects on health and well-being. Regression analyses indicated PA was predicted by dispositional optimism (thrice), energy (thrice), and intrinsic motivation, and counter predicted by depression (twice) and stress (twice); and NA by anxiety (twice), stress (twice), psychological stress, identified regulation, BDI depression and psychophysiological problems, and counter predicted by internal locus of control and self-esteem. BDI-depression was predicted by negative affect, major sleep problems and psychophysiological problems (Study III), self-esteem by dispositional optimism and energy, and counter predicted by anxiety, depression and stress (Study I), and intrinsic motivation by dispositional optimism, energy, PA and self-esteem (Study II). These convergent findings are interpreted from a perspective of the cognitive-emotional expressions underlying behavioural or presymptomatic profiles presenting predispositions for health or ill health.

Local sustainability and scaling up for user fee exemptions: medical NGOs vis-à-vis health systems.

PubMed

Olivier de Sardan, Jean-Pierre; Diarra, Aïssa; Koné, Félix Yaouaga; Yaogo, Maurice; Zerbo, Roger

2015-01-01

Free healthcare obviously works when a partner from abroad supplies a health centre or a health district with medicines and funding on a regular basis, provides medical, administrative and managerial training, and gives incentive bonuses and daily subsistence allowances to staff. The experiments by three international NGO in Burkina Faso, Mali and Niger have all been success stories. But withdrawing NGO support means that health centres that have enjoyed a time of plenty under NGO management will return to the fold of health centres run by the state in its present condition and the health system in its present condition, with the everyday consequences of late reimbursements and stock shortages. The local support given by international NGOs has more often than not an effect of triggering an addiction to aid instead of inducing local sustainability without infusion. In the same way, scaling up to the entire country a local pilot experiment conducted under an NGO involves its insertion into a national bureaucratic machine with its multiple levels, all of which are potential bottlenecks. Only experiments carried out under the "ordinary" management of the state are capable of laying bare the problems associated with this process. Without reformers 'on the inside' (within the health system itself and among health workers), no real reform of the health system induced by reformers 'from the outside' can succeed.

Developing countries and trade in health services: which way is forward?

PubMed

Timmermans, Karin

2004-01-01

International trade in health services appears to be increasing It may receive a further boost when liberalized and bound under international trade agreements, such as the General Agreement on Trade in Services (GATS). Liberalization of trade in health services can create opportunities, but may also exacerbate preexisting problems. Moreover, once liberalization is locked in under international trade agreements, reversing policies becomes difficult, especially for developing countries. Making undue commitments to liberalize health services under GATS may therefore result in the loss of policy space. Yet the GATS agreement contains considerable flexibility to fine-tune commitments in accordance with national (health) objectives. But flexibility entails complexity, and for GATS the complexity is compounded by the fact that some of its rules are still being developed. Moreover, flexibility is meaningless unless used, and used well, which calls for a profound analysis of the alternatives and their implications. This article provides an overview of considerations related to (international) trade in health services and key features of GATS that are relevant to public health. It highlights that policymakers have something at stake in GATS negotiations; thus, they should take an interest in liberalization of trade in health services, analyze its implications, and give input and guidance to their country's trade negotiators. Moreover, to convey their concerns and aspirations effectively, they must learn the trade language, while staying focused on (public) health objectives.

Prospective Effects of Family Cohesion on Alcohol-Related Problems in Adolescence: Similarities and Differences by Race/Ethnicity.

PubMed

Reeb, Ben T; Chan, Sut Yee Shirley; Conger, Katherine J; Martin, Monica J; Hollis, Nicole D; Serido, Joyce; Russell, Stephen T

2015-10-01

Research increasingly finds that race/ethnicity needs to be taken into account in the modelling of associations between protective factors and adolescent drinking behaviors in order to understand family effects and promote positive youth development. The current study examined racial/ethnic variation in the prospective effects of family cohesion on adolescent alcohol-related problems using a nationally representative sample. Data were drawn from the first two waves of the National Longitudinal Study of Adolescent to Adult Health and included 10,992 (50% female) non-Hispanic Asian, non-Hispanic Black, Latino, and non-Hispanic White 7th-12th graders. Consistent with Hirschi's social control theory of youth delinquency, higher levels of family cohesion predicted lower levels of future adolescent alcohol-related problems, independent of race/ethnicity, sex, age, baseline alcohol-related problems, and family socioeconomic status. Findings from moderation analyses indicated that the magnitude of associations differed across groups such that the protective effect of family cohesion was strongest among White adolescents. For Latino adolescents, family cohesion was not associated with alcohol-related problems. Future longitudinal cross-racial/ethnic research is needed on common and unique mechanisms underlying differential associations between family processes and adolescent high-risk drinking. Understanding these processes could help improve preventive interventions, identify vulnerable subgroups, and inform health policy aimed at reducing alcohol-related health disparities.

Developing an evidence-based approach to Public Health Nutrition: translating evidence into policy.

PubMed

Margetts, B; Warm, D; Yngve, A; Sjöström, M

2001-12-01

The aim of this paper is to highlight the importance of an evidence-based approach to the development, implementation and evaluation of policies aimed at improving nutrition-related health in the population. Public Health Nutrition was established to realise a population-level approach to the prevention of the major nutrition-related health problems world-wide. The scope is broad and integrates activity from local, national, regional and international levels. The aim is to inform and develop coherent and effective policies that address the key rate-limiting steps critical to improving nutrition-related public health. This paper sets out the rationale for an evidence-based approach to Public Health Nutrition developed under the umbrella of the European Network for Public Health Nutrition.

Local sustainability and scaling up for user fee exemptions: medical NGOs vis-à-vis health systems

PubMed Central

2015-01-01

Free healthcare obviously works when a partner from abroad supplies a health centre or a health district with medicines and funding on a regular basis, provides medical, administrative and managerial training, and gives incentive bonuses and daily subsistence allowances to staff. The experiments by three international NGO in Burkina Faso, Mali and Niger have all been success stories. But withdrawing NGO support means that health centres that have enjoyed a time of plenty under NGO management will return to the fold of health centres run by the state in its present condition and the health system in its present condition, with the everyday consequences of late reimbursements and stock shortages. The local support given by international NGOs has more often than not an effect of triggering an addiction to aid instead of inducing local sustainability without infusion. In the same way, scaling up to the entire country a local pilot experiment conducted under an NGO involves its insertion into a national bureaucratic machine with its multiple levels, all of which are potential bottlenecks. Only experiments carried out under the "ordinary" management of the state are capable of laying bare the problems associated with this process. Without reformers 'on the inside' (within the health system itself and among health workers), no real reform of the health system induced by reformers 'from the outside' can succeed. The problems relating to the sustainability of public policies in Africa, especially when the policies benefit from development aid, in the area of health among others, are familiar to researchers and policy-makers. However, as far as user fee exemptions are concerned, debates about these problems have extended well beyond the narrow circle of experts and into the public domain in the countries concerned. Throughout our research, we have observed that the sustainability of free healthcare policies is a major concern of all the actors (health workers, users, managers and senior administrative staff), and an issue that has generated widespread scepticism, especially in Mali and Niger [1,2]. There is general unease about the state's ability to reimburse health centres and to provide essential inputs. The scepticism is fuelled by a two-fold negative experience: decades of incoherent public policies at national level, plagued by bad management and uncertain funding, on the one hand; and the endless U-turns by donors, the double binds of frequent contradictions in their funding policies and the short-term nature of the programmes they enact, on the other [3]. The first years of exemption policies, which were beset by late reimbursements and more or less chronic stock shortages, only added to the scepticism. The disquiet appears to be justified: despite their positive impact in terms of health centre attendance, without funding guaranteed over time, efficient management, secure supply channels and motivated staff, free healthcare policies fall foul of a host of adverse effects at every level of the health pyramid. PMID:26559444

Additional Insights Into Problem Definition and Positioning From Social Science Comment on "Four Challenges That Global Health Networks Face".

PubMed

Quissell, Kathryn

2017-09-10

Commenting on a recent editorial in this journal which presented four challenges global health networks will have to tackle to be effective, this essay discusses why this type of analysis is important for global health scholars and practitioners, and why it is worth understanding and critically engaging with the complexities behind these challenges. Focusing on the topics of problem definition and positioning, I outline additional insights from social science theory to demonstrate how networks and network researchers can evaluate these processes, and how these processes contribute to better organizing, advocacy, and public health outcomes. This essay also raises multiple questions regarding these processes for future research. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

China's "market economics in command": footwear workers' health in jeopardy.

PubMed

Chen, M S; Chan, A

1999-01-01

This study of occupational safety and health (OSH) problems in the footwear industry in China, the world's largest shoemaker, is based on four years of research in China supplemented by research in Taiwan, Australia, and the United States. With the advent of the economic reforms of the early 1980s, the Chinese state is being driven by an economic imperative under which the profit motive overrides other concerns, causing a deterioration in OSH conditions. Footwear workers are being exposed to high levels of benzene, toluene, and other toxic solvents contained in the adhesives used in the shoe-making process. Many workers have been afflicted with aplastic anemia, leukemia, and other health problems. Most of China's current permissible exposure limits to toxins are either outdated or underenforced. As a result, the Chinese state's protection of footwear workers' health is inadequate. The article aims to draw the attention of the international OSH community to the importance of setting specific exposure standards for the footwear industry worldwide.

Cultural Adaptation, Parenting and Child Mental Health Among English Speaking Asian American Immigrant Families.

PubMed

Huang, Keng-Yen; Calzada, Esther; Cheng, Sabrina; Barajas-Gonzalez, R Gabriela; Brotman, Laurie Miller

2017-08-01

Contrary to the "model minority" myth, Asian American children, especially those from low-income immigrant families, are at risk for both behavioral and emotional problems early in life. Little is known, however, about the underlying developmental mechanisms placing Asian American children at risk, including the role of cultural adaptation and parenting. This study examined cultural adaptation, parenting practices and culture related parenting values and child mental health in a sample of 157 English speaking Asian American immigrant families of children enrolled in early childhood education programs in low-income, urban neighborhoods. Overall, cultural adaptation and parenting cultural values and behaviors were related to aspects of child mental health in meaningful ways. Parents' cultural value of independence appears to be especially salient (e.g., negatively related to behavior problems and positively related to adaptive behavior) and significantly mediates the link between cultural adaptation and adaptive behavior. Study findings have implications for supporting Asian American immigrant families to promote their young children's mental health.

Guided self-help interventions for mental health disorders in children with neurological conditions: study protocol for a pilot randomised controlled trial.

PubMed

Bennett, Sophie; Heyman, Isobel; Coughtrey, Anna; Simmonds, Jess; Varadkar, Sophia; Stephenson, Terence; DeJong, Margaret; Shafran, Roz

2016-11-04

Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under-recognised and under-treated in clinical settings. Evidence-based guided self-help interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self-help intervention for the treatment of mental health disorders in children with neurological conditions. A pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children's Hospital will be randomised to receive guided self-help for common mental health disorders or to a 12-week waiting list control. Participants in the treatment group will receive 10 sessions of guided self-help delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive-compulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and researchers through publication in journals and presentation at conferences. This is the first study to investigate guided self-help interventions for mental health problems in children with neurological conditions, a group which is currently under-represented in mental health research. The intervention is modular and adapted from an empirically supported cognitive behavioural treatment. The generalisability and broad inclusion criteria are strengths but may also lead to some weaknesses. Current Controlled Trials: ISRCTN21184717 . Registered on 25 September 2015.

The influence of mastery on mother's health in middle years: Moderating role of stressful life context.

PubMed

King, Victoria; Wickrama, K A S; Klopack, Erick; Lorenz, Frederick O

2018-06-07

Using data from 416 middle-aged mothers gathered over the course of a decade, this study examined the influence of mastery trajectories (the initial level and change), on change in physical health. Mastery is defined as one's ability to control and influence his/her life and environment to reach a desired outcome or goal. Both the initial level and change in mastery from 1991 to 1994 were associated with decreased physical health problems over the middle years (1991-2001). Contextual moderation of this association by stressful life contexts including negative life events and work-family conflict was investigated. Moderation analysis showed that under conditions of low contextual life stressors, the level and increase in mastery significantly contributed to decreases in physical health problems in middle-aged mothers. Alternatively, conditions of high contextual life stressors inhibited the ability of mastery to influence physical health of mothers, suggesting that the positive health impact of mastery on physical health is mitigated by stressful life experiences. Implications for the need to maintain important personal resources, such as mastery, during times of stress are discussed. Copyright © 2018 John Wiley & Sons, Ltd.

Optimal distribution of medical backpacks and health surveillance assistants in Malawi.

PubMed

Kunkel, Amber G; Van Itallie, Elizabeth S; Wu, Duo

2014-09-01

Despite recent progress, Malawi continues to perform poorly on key health indicators such as child mortality and life expectancy. These problems are exacerbated by a severe lack of access to health care. Health Surveillance Assistants (HSAs) help bridge this gap by providing community-level access to basic health care services. However, the success of these HSAs is limited by a lack of supplies and long distances between HSAs and patients. To address this issue, we used large-scale weighted p-median and capacitated facility location problems to create a scalable, three-tiered plan for optimal allocation of HSAs, HSA designated medical backpacks, and backpack resupply centers. Our analysis uses real data on the location and characteristics of hospitals, health centers, and the general population. In addition to offering specific recommendations for HSA, backpack, and resupply center locations, it provides general insights into the scope of the proposed HSA backpack program scale-up. In particular, it demonstrates the importance of local health centers to the resupply network. The proposed assignments are robust to changes in the underlying population structure, and could significantly improve access to medical supplies for both HSAs and patients.

A systemic approach to occupational and environmental health.

PubMed

Spitzer, Skip

2005-01-01

As the corporate role in occupational and public health receives increased scrutiny, it is essential to recognize that it is not sufficient to identify specific acts of malfeasance or influence, or even to campaign to address them. A more comprehensive and systemic framework for understanding the role of corporations requires consideration of corporate power and its effects as endemic features of national socioeconomic systems and the rapidly integrating global order. The underlying social structures that produce social and environmental problems, and undermine reform, make systemic change necessary. Identifying this "structure of harm" provides important implications for researchers, policymakers, activists, and others trying to address environmental and social problems, particularly with regard to integrating efforts to address immediate impacts with those for longer-term, systemic change.

Need for appropriate formulations for children: the national institute of child health and human development-pediatric formulations initiative, part 1.

PubMed

Giacoia, George P; Taylor-Zapata, Perdita; Mattison, Donald

2007-01-01

The development and compounding of pharmacotherapeutic formulations that are suitable for infants and young children can be a challenging problem. This problem results from the lack of knowledge on the acceptability of different dosage forms and formulations in children in relation to age and developmental status, as well as the lack of reliable documentation of formulations used in pediatric clinical trials. As part of its mandate under the Best Pharmaceuticals for Children Act to improve pediatric therapeutics, the National Institute of Child Health and Human Development has sponsored the Pediatric Formulation Initiative. The goal of this ongoing initiative is to address the issues and concnerns associated with pediatric therapeutics by convening groups of researchers and experts in pediatric formulations from academia, pharmaceutical companies, the National Institutes of Health, and the U.S. Food and Drug Administration.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana.

PubMed

Mupara, Lucia U; Lubbe, Johanna C

2016-01-01

Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Proceedings of the 6. international conference on stability and handling of liquid fuels. Volume 2

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

Giles, H.N.

Volume 2 of these proceedings contain 42 papers arranged under the following topical sections: Fuel blending and compatibility; Middle distillates; Microbiology; Alternative fuels; General topics (analytical methods, tank remediation, fuel additives, storage stability); and Poster presentations (analysis methods, oxidation kinetics, health problems).

AIDS on Campus: A Legal Compendium.

ERIC Educational Resources Information Center

Strohm, Leslie Chambers, Ed.

During the 1980s, AIDS emerged as a leading cause of death among young adults. Subsequently, no college or university can expect to escape from this problem. These collected articles were targeted for university, and health-science-center administrators. The information contained here is grouped under eight headings. Section 1, the medical…

Neoagarotetraose protects mice against intense exercise induced stress by modulating gut microbial composition and function

USDA-ARS?s Scientific Manuscript database

Exhaustive exercise stress has emerged as an important health issue, and gastrointestinal problems are a common concern during intense exercise. In this study, we investigated potential anti-fatigue effects of neoagarotetraose (NAT) in mice under intense exercise stress. Exhaustive exercise stress s...

Early Intervention for Abused and Neglected Infants and Toddlers

ERIC Educational Resources Information Center

Zero to Three (J), 2006

2006-01-01

Children who suffer abuse or neglect, or have parents who suffer from mental health problems (especially maternal depression), substance abuse, or family violence, have as high a probability of experiencing developmental delays as do children with medical conditions that are automatically eligible for Part C services under the Individuals with…

A Guide to Orientation Materials for Indochinese Refugees and Their Sponsors. A Selected, Annotated Bibliography.

ERIC Educational Resources Information Center

Center for Applied Linguistics, Washington, DC. Language and Orientation Resource Center.

This is an annotated bibliography of orientation materials for Indochinese refugees and their sponsors. The materials have been grouped under fourteen headings: community services, consumer education, culture, education, employment, family planning and child care, finances, health, housing, legal problems, nutrition, sponsorship and resettlement,…

Swarm motility inhibitory and antioxidant activities of pomegranate peel processed under three drying conditions

USDA-ARS?s Scientific Manuscript database

Contaminated fruits and vegetables cause global health problems and reduced economic productivity resulting in significant loss to food industry. Pomegranate (Punica granatum) peels provides a rich source of bioactive phytochemicals namely, punicalins (PC: a and ß) punicalagins (PG: a and ß) and ell...

Lead Paint Poisonings: How Can Innovative Technology Make a Difference?

EPA Science Inventory

Lead is a toxic metal that may cause a range of health effects, from behavioral problems and learning disabilities, to seizures and death. Children six years old and under are most at risk. Exposure to lead usually occurs due to the presence of deteriorating lead-based paint (LBP...

5 CFR 792.102 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... EMPLOYEES' HEALTH AND COUNSELING PROGRAMS Regulatory Requirements for Alcoholism and Drug Abuse Programs and..., alcoholism, and/or drug abuse required under 42 U.S.C. 290dd-1(a) and 290ee-1(a). Federal departments and... employees with alcohol and/or drug problems. Short-term counseling and/or referral, or offers thereof, shall...

5 CFR 792.102 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... EMPLOYEES' HEALTH AND COUNSELING PROGRAMS Regulatory Requirements for Alcoholism and Drug Abuse Programs and..., alcoholism, and/or drug abuse required under 42 U.S.C. 290dd-1(a) and 290ee-1(a). Federal departments and... employees with alcohol and/or drug problems. Short-term counseling and/or referral, or offers thereof, shall...

5 CFR 792.102 - General.

Code of Federal Regulations, 2012 CFR

2012-01-01

... EMPLOYEES' HEALTH AND COUNSELING PROGRAMS Regulatory Requirements for Alcoholism and Drug Abuse Programs and..., alcoholism, and/or drug abuse required under 42 U.S.C. 290dd-1(a) and 290ee-1(a). Federal departments and... employees with alcohol and/or drug problems. Short-term counseling and/or referral, or offers thereof, shall...

Use of the Pediatric Symptom Checklist for the detection of psychosocial problems in preventive child healthcare

PubMed Central

Reijneveld, Sijmen A; Vogels, Anton GC; Hoekstra, Femke; Crone, Matty R

2006-01-01

Background Early detection and treatment of psychosocial problems by preventive child healthcare may lead to considerable health benefits, and a short questionnaire could support this aim. The aim of this study was to assess whether the Dutch version of the US Pediatric Symptom checklist (PSC) is valid and suitable for the early detection of psychosocial problems among children. Methods We included 687 children (response 84.3%) aged 7–12 undergoing routine health assessments in nine Preventive Child Health Services across the Netherlands. Child health professionals interviewed and examined children and parents. Before the interview, parents completed an authorised Dutch translation of the PSC and the Child Behavior Checklist (CBCL). The CBCL and data on the child's current treatment status were used as criteria for the validity of the PSC. Results The consistency of the Dutch PSC was good (Cronbach alpha 0.89). The area under the ROC curve using the CBCL as a criterion was 0.94 (95% confidence interval 0.92 to 0.96). At the US cut-off (28 and above), the prevalence rate of an increased score and sensitivity were lower than in the USA. At a lower cut-off (22 and above), sensitivity and specificity were similar to that of the US version (71.7% and 93.0% respectively). Information on the PSC also helped in the identification of children with elevated CBCL Total Problems Scores, above solely clinical judgment. Conclusion The PSC is also useful for the early detection of psychosocial problems in preventive child healthcare outside the USA, especially with an adjusted cut-off. PMID:16872535

Missed opportunities in educating Aboriginal Australians about bowel cancer screening: whose job is it anyway?

PubMed

Christou, Aliki; Thompson, Sandra C

2013-12-01

A culturally relevant educational flipchart targeting Aboriginal people was distributed across Western Australia to support education on bowel cancer screening and encourage participation in the National Bowel Cancer Screening Program. Respondents sampled from the flipchart distribution list were surveyed on the appropriateness, usefulness, and the extent to and manner in which they used the flipchart for educating Aboriginal clients. Despite praising the resource, few respondents used the flipchart as intended for various reasons, including the view that Aboriginal health education was the responsibility of Aboriginal health workers. Greater recognition by all health service providers is needed of their potential role in Aboriginal health education. Promoting a national health program of under-appreciated importance for a marginalised population is challenging. Effective utilisation of an educational tool is predicated on factors beyond its production quality and wide dissemination. Intended users require awareness of the underlying problem, and adequate time for and specific training in implementation of the tool.

Patient education - A route to improved patient experience in Chinese hospitals?

PubMed

Hu, Yinhuan; Zhang, Zixia

2015-06-23

Poor patient experience may trigger serious doctor-patient conflicts in China. Health system challenges related to access and financing may cause frustration in patients, but inadequate health literacy is an additional factor. This letter argues from two aspects that patient education is an effective and feasible pathway to improve patient experience, but its effects are influenced by underlying systemic problems and contextual factors in China. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Translating access into utilization: lessons from the design and evaluation of a health insurance Web site to promote reproductive health care for young women in Massachusetts.

PubMed

Janiak, Elizabeth; Rhodes, Elizabeth; Foster, Angel M

2013-12-01

Following state-level health care reform in Massachusetts, young women reported confusion over coverage of contraception and other sexual and reproductive health services under newly available health insurance products. To address this gap, a plain-language Web site titled "My Little Black Book for Sexual Health" was developed by a statewide network of reproductive health stakeholders. The purpose of this evaluation was to assess the health literacy demands and usability of the site among its target audience, women ages 18-26 years. We performed an evaluation of the literacy demands of the Web site's written content and tested the Web site's usability in a health communications laboratory. Participants found the Web site visually appealing and its overall design concept accessible. However, the Web site's literacy demands were high, and all participants encountered problems navigating through the Web site. Following this evaluation, the Web site was modified to be more usable and more comprehensible to women of all health literacy levels. To avail themselves of sexual and reproductive health services newly available under expanded health insurance coverage, young women require customized educational resources that are rigorously evaluated to ensure accessibility. To maximize utilization of reproductive health services under expanded health insurance coverage, US women require customized educational resources commensurate with their literacy skills. The application of established research methods from the field of health communications will enable advocates to evaluate and adapt these resources to best serve their targeted audiences. © 2013.

Dog-bites, rabies and One Health: Towards improved coordination in research, policy and practice.

PubMed

Rock, Melanie J; Rault, Dawn; Degeling, Chris

2017-08-01

Dog-bites and rabies are neglected problems worldwide, notwithstanding recent efforts to raise awareness and to consolidate preventive action. As problems, dog-bites and rabies are entangled with one another, and both align with the concept of One Health. This concept emphasizes interdependence between humans and non-human species in complex socio-ecological systems. Despite intuitive appeal, One Health applications and critiques remain under-developed with respect to social science and social justice. In this article, we report on an ethnographic case-study of policies on dog bites and rabies, with a focus on Calgary, Alberta, Canada, which is widely recognized as a leader in animal-control policies. The fieldwork took place between 2013 and 2016. Our analysis suggests that current policies on rabies prevention may come at the expense of a 'bigger picture' for One Health. In that 'bigger picture,' support is needed to enhance coordination between animal-control and public-health policies. Such coordination has direct relevance for the well-being of children, not least Indigenous children. Copyright © 2017 Elsevier Ltd. All rights reserved.

Caring by Numbers: Evaluation of Inconsistencies and Incompleteness in the Reporting of Racial and Ethnic Data.

PubMed

Hartzler, Beth Marie; Snyder, Angela

2017-12-01

Significant health disparities throughout the lifespan have long been evident within the American, non-White population. These differences include increased incidence of infant mortality, childhood hospitalization, diabetes, mental and behavioral health problems, cardiovascular disease, and late-stage cancer diagnoses. These types of disparities could be addressed by identifying those individuals at greatest risk for chronic disease or higher mortality rates and improving their health literacy and access to care. However, this is only possible if health management organizations and care providers have accurate racial and ethnic information. As an initial step at better understanding the problem, a survey of demographic data for Ohio Medicaid beneficiaries was conducted. The results of the study revealed inconsistencies and omissions in reported race and ethnicity for nearly 10% of records received from the state. This trend was most evident among older adults and those joining under the Affordable Care Act's Medicaid Expansion. Collectively, these results suggest that the first step in correcting health disparities may be to ensure that accurate information is available about the target population.

Keynote Address (November 2016): Zika Virus Disease in the Americas: A Storm in the Making.

PubMed

Etienne, Carissa; Santos, Thais Dos; Espinal, Marcos A

2017-07-01

More than 700,000 cases of Zika virus (ZIKAV) disease have been officially reported to the Pan American Health Organization (PAHO) from 48 countries and territories of the Americas. The response led by the PAHO and partners suggests major lessons of this outbreak. A seemingly innocuous pathogen became the new villain, causing fear, economic losses and, most importantly, debilitating birth defects and neurological problems, reaffirming the well-known war principle of never to underestimate one's opponent. The ZIKAV tested public health capacities under the International Health Regulations, highlighting the need for continued investment in health security. Last but not least, the lack of appropriate tools was another reminder of the pressing need for innovative solutions to persistent problems. Latin America and the Caribbean have approximately 500 million persons living in areas at risk for transmission of ZIKAV. The fight against ZIKAV is not a 100-m race, but rather a marathon in which science and public health need to work hand in hand for the benefit of our peoples.

[Health education, patient education and health promotion: educational methods and strategies].

PubMed

Sandrin, Brigitte

2013-01-01

The purpose of this paper is to help public health actors with an interest in health promotion and health care professionals involved in therapeutic education to develop and implement an educational strategy consistent with their vision of health and health care. First, we show that the Ottawa Charter for Health Promotion and the French Charter for Popular Education share common values. Second, an examination of the career and work of Paulo Freire, of Ira Shor's pedagogical model and of the person-centered approach of Carl Rogers shows how the work of educational practitioners, researchers and theorists can help health professionals to implement a truly "health-promoting" or "therapeutic" educational strategy. The paper identifies a number of problems facing health care professionals who become involved in education without reflecting on the values underlying the pedagogical models they use.

Factors affecting children's oral health: perceptions among Latino parents.

PubMed

Cortés, Dharma E; Réategui-Sharpe, Ludmila; Spiro Iii, Avron; García, Raul I

2012-01-01

The objective of this study is to understand factors that influence the oral health-related behaviors of Latino children, as reported by their parents. Focus groups and in-depth interviews assessed parental perceptions, experiences, attributions, and beliefs regarding their children's oral health. Guiding questions focused on a) the participant's child dental experiences; b) the impact of dental problems on the child's daily activities, emotions, self-esteem; c) parental experiences coping with child's dental problems; and d) hygienic and dietary habits. Participants were purposively sampled from dental clinics and public schools with a high concentration of Latinos; 92 urban low-income Latino Spanish-speaking parents participated. Transcriptions of the audio files were thematically analyzed using a grounded theory approach. Parents' explanations of their children's dental experiences were categorized under the following themes: caries and diet, access to dental care, migration experiences, and routines. Findings revealed fundamental multilevel (i.e., individual/child, family, and community) factors that are important to consider for future interventions to reduce oral health disparities: behaviors leading to caries, parental knowledge about optimal oral health, access to sugary foods within the living environment and to fluoridated water as well as barriers to oral health care such as lack of health insurance or limited health insurance coverage, among others. © 2011 American Association of Public Health Dentistry.

Mental health consequences of international migration for Vietnamese Americans and the mediating effects of physical health and social networks: results from a natural experiment approach.

PubMed

Fu, Hongyun; VanLandingham, Mark J

2012-05-01

Although the existing literature on immigrant mental health is extensive, major substantive and methodological gaps remain. Substantively, there is little population-based research that focuses on the mental health consequences of migration for Vietnamese Americans. More generally, although a wide range of mental health problems among immigrants has been identified, the potential causal or mediating mechanisms underlying these problems remain elusive. This latter substantive shortcoming is related to a key methodological challenge involving the potentially confounding effects of selection on migration-related outcomes. This article addresses these challenges by employing a "natural experiment" design, involving comparisons among three population-based samples of Vietnamese immigrants, never-leavers, and returnees (N=709). Data were collected in Ho Chi Minh City and in New Orleans between 2003 and 2005. The study investigates the long-term impact of international migration on Vietnamese mental health, and the potential mediating effects of social networks and physical health on these migration-related outcomes. The results reveal both mental health advantages and disadvantages among Vietnamese immigrants relative to the two groups of Vietnamese nationals. Selection can be ruled out for some of these differences, and both social networks and physical health are found to play important explanatory roles.

An assessment of the occupational and environmental health needs in seven Southeastern European and West-Central Asian countries.

PubMed

Coman, Alexandru; Cherecheş, Răzvan M; Ungureanu, Marius I; Marton-Vasarhelyi, Emanuela O; Valentine, Marissa A; Sabo-Attwood, Tara; Gray, Gregory C

2015-12-01

Eastern European and Central Asian countries are undergoing rapid socioeconomic and political reforms. Many old industrial facilities are either abandoned, or use outdated technologies that severely impact the environment. Emerging industries have less regulation than in developed countries and environmental and occupational problems seem to be increasing. Under a US National Institutes of Health pilot grant, we developed an interdisciplinary One Health research network in Southeastern Europe and West-Central Asia to identify environmental and occupational problems. From 2012 to 2014, this GeoHealth Hub engaged 11 academic centers and 16 public health institutions in eight different countries: Albania, Armenia, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Romania, and the United States with a goal of strengthening environmental and occupational research and training capacities. Employing face-to-face interviews and large group meetings, we conducted an evidenced-based needs and opportunities assessment focused on aquatic health, food safety, and zoonotic diseases. Comprehensive reviews of the published literature yielded priority research areas for each of the seven GeoHealth Hub countries including heavy metal and pesticide contamination, tick-borne diseases, rabies, brucellosis, and inadequate public health surveillance. Copyright © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Agency problems in hospitals participating in self-management project under global budget system in Taiwan.

PubMed

Yan, Yu-Hua; Hsu, Shuofen; Yang, Chen-Wei; Fang, Shih-Chieh

2010-02-01

The main purposes of this study are to clarify the agency problems in the hospitals participating in self-management project within the context of Global Budgeting Payment System regulated by Taiwan government, and also to provide some suggestions for hospital administrator and health policy maker in reducing the waste of healthcare resources resulting from agency problems. For the purposes above, this study examines the relationships between two agency problems (ex ante moral hazard and ex post moral hazard) aroused among the hospitals and Bureau of National Health Insurance in Taiwan's health care sector. This study empirically tested the theoretical model at organization level. The findings suggest that the hospital's ex ante moral hazards before participating the self-management project do have some influence on its ex post moral hazards after participating the self-management project. This study concludes that the goal conflict between the agents and the principal certainly exist. The principal tries hard to control the expenditure escalation and keep the financial balance, but the agents have to subsist within limited healthcare resources. Therefore, the agency cost would definitely occur due to the conflicts between both parties. According to the results of the research, some suggestions and related management concepts were proposed at the end of the paper.

The state of health services in China and India: a larger context.

PubMed

Bardhan, Pranab

2008-01-01

In this paper the problems of health services in China and India are related to some structural features of the two economies. Some similarities and differences exist across these two countries in terms of political economy, with differential results. Both countries have experienced remarkable economic growth during the past quarter-century, but this has not always translated into improvements in health for the poor. Although China used to have an egalitarian basic public health service, the system has become quite inegalitarian during the past quarter-century, with the disintegration of the communes and adoption of fee-based services under a system of decentralized public finance. India's health system has remained inegalitarian throughout.

[Economics, politics, and public health in Porfirian Mexico (1876-1910)].

PubMed

Carrillo, Ana María

2002-01-01

The article examines the scientific, political, and economic elements that permitted the birth of modern public health in Mexico under the Porfirio Díaz administration (1876-1910). Firstly, a portion of Mexican physicians were open to the discoveries of microbiology, immunology, and epidemiology. Secondly, the State's growing concentration of power in public health matters ran parallel to its concentration of disciplinary political power and enabled this new knowledge to be placed at the service of collective health problem prevention. Lastly, both imperialism and the Porfirian elite needed to protect their business interests. The article evaluates public health achievements and limitations during the Porfirian period, abruptly interrupted by the revolution begun in 1910.

Analysis of the mass media coverage of the Gates Foundation grand challenges in global health initiative.

PubMed

Verma, G

2009-03-01

The Grand Challenges were launched in 2003 by the Gates Foundation and other collaborators to address the health needs of developing countries. This paper outlines the current problem with health research and development in the context of inequality as conveyed by the 90/10 divide. The paper then looks at the focus and nature of press reporting of global health issues by analysing how press articles have portrayed the Grand Challenges in Global Health initiative. Analysis of the mass media illustrates that the focus of reporting on the Grand Challenges tends to be on utilitarian themes, leaving issues related to justice and equity comparatively under-reported.

National health education programs to promote healthy eating and physical activity.

PubMed

Donato, Karen A

2006-02-01

The national education programs and campaigns described here are examples of the many unique kinds of federal efforts under way to promote the pillars of healthy eating and increased physical activity included in the "Healthier US Initiative." They are similar in that: 1) they are based on the best available science that a health problem exists, and 2) that healthy eating and physical active behaviors will improve health status. They are unique in their implementation, for example, in private/public partnerships, coordinating committees of professional associations, and congressionally mandated interventions. Most importantly, they provide the impetus to get a particular health issue on the public agenda.

The impact of psychosocial and organizational working conditions on the mental health of female cleaning personnel in Norway.

PubMed

Gamperiene, Migle; Nygård, Jan F; Sandanger, Inger; Waersted, Morten; Bruusgaard, Dag

2006-11-01

This study examined the association between psychosocial and organizational work conditions and mental health among women employed in the cleaning profession in Norway. Self-report questionnaires were mailed to 661 cleaning staff personnel from seven cleaning organizations in seven different cities across Norway. The response rate was 64%, of which 374 (88%) respondents were women. The questionnaires assessed socio-demographic information and employment history, work organization, and psychosocial working conditions. The Hopkins Symptoms Checklist (HSCL-25) was included to assess mental health. On average, respondents were 43 years old and reported 10.8 years of experience working in the cleaning industry. The proportion of women scoring a HSCL-25 equal to or above 1.75 was 17.5%, which was higher than the average prevalence of mental health problems among working Norwegian women (8.4%). A factor analysis of the questions specific to the psychosocial work environment identified the following four underlying dimensions: leadership, co-workers, time pressure/control, and information/knowledge. Two of these, poor satisfaction with leadership (OR = 3.6) and poor satisfaction with co-workers (OR = 2.3), were significantly related to mental health. In addition, having contact with colleagues less than once a day (OR = 2.4) and not being ethnically Norwegian (OR = 3.0) increased the risk for mental health problems. Mental health problems are frequent among female cleaning professionals in Norway. Our results indicate that quality of leadership, collaboration with co-workers, and ethnicity were significantly associated with mental health.

The impact of psychosocial and organizational working conditions on the mental health of female cleaning personnel in Norway

PubMed Central

Gamperiene, Migle; Nygård, Jan F; Sandanger, Inger; Wærsted, Morten; Bruusgaard, Dag

2006-01-01

Background This study examined the association between psychosocial and organizational work conditions and mental health among women employed in the cleaning profession in Norway. Methods Self-report questionnaires were mailed to 661 cleaning staff personnel from seven cleaning organizations in seven different cities across Norway. The response rate was 64%, of which 374 (88%) respondents were women. The questionnaires assessed socio-demographic information and employment history, work organization, and psychosocial working conditions. The Hopkins Symptoms Checklist (HSCL-25) was included to assess mental health. Results On average, respondents were 43 years old and reported 10.8 years of experience working in the cleaning industry. The proportion of women scoring a HSCL-25 equal to or above 1.75 was 17.5%, which was higher than the average prevalence of mental health problems among working Norwegian women (8.4%). A factor analysis of the questions specific to the psychosocial work environment identified the following four underlying dimensions: leadership, co-workers, time pressure/control, and information/knowledge. Two of these, poor satisfaction with leadership (OR = 3.6) and poor satisfaction with co-workers (OR = 2.3), were significantly related to mental health. In addition, having contact with colleagues less than once a day (OR = 2.4) and not being ethnically Norwegian (OR = 3.0) increased the risk for mental health problems. Conclusion Mental health problems are frequent among female cleaning professionals in Norway. Our results indicate that quality of leadership, collaboration with co-workers, and ethnicity were significantly associated with mental health. PMID:17078871

Sleep Disturbances, Psychosocial Difficulties, and Health Risk Behavior in 16,781 Dutch Adolescents.

PubMed

Verkooijen, Sanne; de Vos, Nelleke; Bakker-Camu, Betty J W; Branje, Susan J T; Kahn, René S; Ophoff, Roel A; Plevier, Carolien M; Boks, Marco P M

2018-03-09

To investigate the prevalence of adolescent sleep disturbances and their relation to psychosocial difficulties and health risk behaviors with the use of data from a province-wide health survey (n = 16,781). Psychosocial difficulties were measured with the Strength and Difficulties Questionnaire. Additional assessments included self-reported sleep disturbances, suicidality, and health risk behaviors including current use of tobacco, alcohol, and drugs, physical inactivity, and compulsive use of multimedia. We used multilevel analyses to investigate the relationhips, including differences, between boys and girls, as well as the mediating role of emotional problems. Just under 20% of adolescents reported sleep disturbances in the previous month. These sleep disturbances were associated with psychosocial problems (odds ratio [OR], 6.42; P < .001), suicidality (OR, 3.90-4.14; P < .001), and all health risk behaviors (OR, 1.62-2.66; P < .001), but not with physical inactivity. We found moderation by gender for the relations between sleep and suicide attempts (OR, 0.38; P < .002) and between sleep and cannabis use (OR, 0.52; P = .002), indicating attenuated relationships in girls compared with boys. Emotional problems partially mediated the relationships between sleep disturbances and multimedia use. This study reiterates the high prevalence of sleep disturbances during adolescence. These sleep disturbances were strongly related to psychosocial problems and a wide range of health risk behaviors. Although the direction of causality cannot be inferred, this study emphasizes the need for awareness of impaired sleep in adolescents. Moreover, the gender differences in associated suicide attempts and cannabis use call for further research into tailored intervention strategies. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

'First, do no harm': are disability assessments associated with adverse trends in mental health? A longitudinal ecological study.

PubMed

Barr, B; Taylor-Robinson, D; Stuckler, D; Loopstra, R; Reeves, A; Whitehead, M

2016-04-01

In England between 2010 and 2013, just over one million recipients of the main out-of-work disability benefit had their eligibility reassessed using a new functional checklist-the Work Capability Assessment. Doctors and disability rights organisations have raised concerns that this has had an adverse effect on the mental health of claimants, but there are no population level studies exploring the health effects of this or similar policies. We used multivariable regression to investigate whether variation in the trend in reassessments in each of 149 local authorities in England was associated with differences in local trends in suicides, self-reported mental health problems and antidepressant prescribing rates, while adjusting for baseline conditions and trends in other factors known to influence mental ill-health. Each additional 10,000 people reassessed in each area was associated with an additional 6 suicides (95% CI 2 to 9), 2700 cases of reported mental health problems (95% CI 548 to 4840), and the prescribing of an additional 7020 antidepressant items (95% CI 3930 to 10100). The reassessment process was associated with the greatest increases in these adverse mental health outcomes in the most deprived areas of the country, widening health inequalities. The programme of reassessing people on disability benefits using the Work Capability Assessment was independently associated with an increase in suicides, self-reported mental health problems and antidepressant prescribing. This policy may have had serious adverse consequences for mental health in England, which could outweigh any benefits that arise from moving people off disability benefits. 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/

"I feel it is not enough…" Health providers' perspectives on services for victims of intimate partner violence in Malaysia.

PubMed

Colombini, Manuela; Mayhew, Susannah; Ali, Siti Hawa; Shuib, Rashidah; Watts, Charlotte

2013-02-18

This study explores the views and attitudes of health providers in Malaysia towards intimate partner violence (IPV) and abused women and considers whether and how their views affect the provision or quality of services. The impact of provider attitudes on the provision of services for women experiencing violence is particularly important to understand since there is a need to ensure that these women are not re-victimised by the health sector, but are treated sensitively. In-depth interviews were conducted with 54 health care providers responsible for providing services to survivors of IPV and working in health care facilities in two Northern States in Malaysia. A thematic framework analysis method was employed to analyse the emerging themes. Interviews were coded and managed by using NVIVO (N7), a qualitative software package. We found that when providers follow the traditional role of treating and solving IPV as "medical problem", they tend to focus on the physical aspect of the injury, minimise the underlying cause of the problem and ignore emotional care for patients. Providers frequently felt under-trained and poorly supported in their role to help women beyond merely treating their physical injuries. What emerged from the findings is that time shortages may well impact on the ability of medical officers to identify cases of abuse, with some saying that time limitations made it more difficult to detect the real problem behind the injury. However, data from the interviews seem to suggest that time constraints may or may not end up resulting in limited care, depending on the individual interest of medical professionals on violence issues. Promoting empathetic health care provision is challenging. More awareness training and sensitisation could help, especially if courses focus on women's needs and strengths and how health providers can validate these and contribute to a longer term process of change for victims of violence. Clear guidance on how to record history of abuse, ask questions sensitively and validate experiences is also important together with training on good communication skills such as listening and being empathetic.

[Realistic possibilities of utilization of a personal computer in the office of a general practitioner].

PubMed

Masopust, V

1991-04-01

In May 1990 work on the programme "Computer system of the health community doctor Mic DOKI was" completed which resolves more than 70 basic tasks pertaining to the keeping of health documentation by health community doctors; it resolves automatically the entire administrative work in the health community, makes it possible to evaluate the activity of doctors and nurses it will facilitate the work of control organs of future health insurance companies and contribute to investigations of the health status of the population. Despite some problems ensuing from the contemporary economic situation of the country, the validity of contemporary health regulations and minimal training of our health personnel in the use of personal computers computerization of the health community system can be considered an asset to the reform of the health services which is under way.

Protective factors for child development at age 2 in the presence of poor maternal mental health: results from the All Our Babies (AOB) pregnancy cohort.

PubMed

McDonald, Sheila W; Kehler, Heather L; Tough, Suzanne C

2016-11-10

To identify the combination of factors most protective of developmental delay at age 2 among children exposed to poor maternal mental health. Observational cohort study. Pregnant women were recruited from primary healthcare offices, the public health laboratory service and community posters in Calgary, Alberta, Canada. 1596 mother-child dyads who participated in the All Our Babies study and who completed a follow-up questionnaire when their child was 2 years old. Among participants who completed the 2-year questionnaire and had complete mental health data (n=1146), 305 women (27%) were classified as high maternal mental health risk. Child development at age 2 was described and a resilience analysis was performed among a subgroup of families at maternal mental health risk. The primary outcome was child development problems. Protective factors were identified among families at risk, defined as maternal mental health risk, a composite measure created from participants' responses to mental health life course questions and standardised mental health measures. At age 2, 18% of children were classified as having development problems, 15% with behavioural problems and 13% with delayed social-emotional competencies. Among children living in a family with maternal mental health risk, protective factors against development problems included higher social support, higher optimism, more relationship happiness, less difficulty balancing work and family responsibilities, limiting the child's screen time to <1 hour per day and the child being able to fall asleep in <30 min and sleeping through the night by age 2. Among families where the mother has poor mental health, public health and early intervention strategies that support interpersonal relationships, social support, optimism, work-life balance, limiting children's screen time and establishing good sleep habits in the child's first 2 years show promise to positively influence early child development. 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/.

Is provision of healthcare sufficient to ensure better access? An exploration of the scope for public-private partnership in India.

PubMed

Dutta, Sabitri; Lahiri, Kausik

2015-04-08

India's economic growth rate in recent years has been fairly impressive. But, it has been consistently failing to make considerable progress in achieving health related Millennium Development Goal (MDG) targets. Lack of coherence between provisions and utilization becomes the face of the problem. Inadequacies in outreach, access and affordability coupled with escalating healthcare costs have aggravated the problem. Here the application of Public-Private Partnership (PPP) model seems to have enormous potential to ease the impasse. This paper tries to find the gap between the provisions and access in healthcare. The paper attempts to construct a Health Infrastructure Index (HII) and Health Attainment Index (HAI) for different states of India. Considering the presence of regional variations found in health infrastructure and attainment among the states, two states, viz. Maharashtra (MAH) and West Bengal (WB) have been chosen. Then contributions of health programs like Rashtriya Swasthya Bima Yojana (RSBY), National Rural Telemedicine Network (NRTN) and Fair Price Shops (FPS), all PPP initiatives, have been assessed for both the states by carrying out comprehensive benefit-cost analysis. The health infrastructure for population per unit area captures the outreach/delivery issue and the health attainment reveals the true scenario about how far the infrastructure has been accessed by the people; and the gap between the two, as the paper finds, is the root of the problem. The combined effect of RSBY and NRTN will leave both MAH and WB higher benefits in terms of health attainment. The contributions of RSBY and NRTN have been assessed for both the states by carrying out comprehensive benefit-cost analysis. FPS comes up with immense benefits for WB. It is yet to be implemented in MAH. The outreach and access problems arising from deficiencies in infrastructure, human resources and financial ability are expected to be well-addressed by the spread of RSBY and NRTN jointly. The FPS mechanism under PPP initiative can be an effective tool in solving affordability problem by reducing the cost of treatment. © 2015 by Kerman University of Medical Sciences.

Is provision of healthcare sufficient to ensure better access? An exploration of the scope for public-private partnership in India

PubMed Central

Dutta, Sabitri; Lahiri, Kausik

2015-01-01

Background: India’s economic growth rate in recent years has been fairly impressive. But, it has been consistently failing to make considerable progress in achieving health related Millennium Development Goal (MDG) targets. Lack of coherence between provisions and utilization becomes the face of the problem. Inadequacies in outreach, access and affordability coupled with escalating healthcare costs have aggravated the problem. Here the application of Public-Private Partnership (PPP) model seems to have enormous potential to ease the impasse. Methods: This paper tries to find the gap between the provisions and access in healthcare. The paper attempts to construct a Health Infrastructure Index (HII) and Health Attainment Index (HAI) for different states of India. Considering the presence of regional variations found in health infrastructure and attainment among the states, two states, viz. Maharashtra (MAH) and West Bengal (WB) have been chosen. Then contributions of health programs like Rashtriya Swasthya Bima Yojana (RSBY), National Rural Telemedicine Network (NRTN) and Fair Price Shops (FPS), all PPP initiatives, have been assessed for both the states by carrying out comprehensive benefit-cost analysis. Results: The health infrastructure for population per unit area captures the outreach/delivery issue and the health attainment reveals the true scenario about how far the infrastructure has been accessed by the people; and the gap between the two, as the paper finds, is the root of the problem. The combined effect of RSBY and NRTN will leave both MAH and WB higher benefits in terms of health attainment. The contributions of RSBY and NRTN have been assessed for both the states by carrying out comprehensive benefit-cost analysis. FPS comes up with immense benefits for WB. It is yet to be implemented in MAH. Conclusion: The outreach and access problems arising from deficiencies in infrastructure, human resources and financial ability are expected to be well-addressed by the spread of RSBY and NRTN jointly. The FPS mechanism under PPP initiative can be an effective tool in solving affordability problem by reducing the cost of treatment PMID:26188811

Veneto Region, Italy. Health system review.

PubMed

Toniolo, Franco; Mantoan, Domenico; Maresso, Anna

2012-01-01

The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. This HiT is one of the first to be written on a subnational level of government and focuses on the Veneto Region of northern Italy. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Veneto Region is one of Italy's richest regions and the health of its resident population compares favourably with other regions in Italy. Life expectancy for both men and women, now at 79.1 and 85.2 years, respectively, is slightly higher than the national average, while mortality rates are comparable to national ones. The major causes of death are tumours and cardiovascular diseases. Under Italy's National Health Service, the organization and provision of health care is a regional responsibility and regions must provide a nationally defined (with regional input) basic health benefit package to all of their citizens; extra services may be provided if budgets allow. Health care is mainly financed by earmarked central and regional taxes, with regions receiving their allocated share of resources from the National Health Fund. Historically, health budget deficits have been a major problem in most Italian regions, but since the early 2000s the introduction of efficiency measures and tighter procedures on financial management have contributed to a significant decrease in the Veneto Regions health budget deficit.The health system is governed by the Veneto Region government (Giunta) via the Departments of Health and Social Services, which receive technical support from a single General Management Secretariat. Health care is provided by 21 local health and social care units, 2 hospital enterprises, 2 national hospitals for scientific research and private accredited providers. Major national health reform legislation in the 1990s started the process of regionalization of the health system and the introduction of managerial methods and quasi-market mechanisms into the National Health Service, a process that has been consolidated since the early 2000s under the framework of fiscal federalism. Future challenges for the Veneto Region include the sustainable provision of the basic health benefit package; the adaptation of services to meet changes in demand, particularly those associated with the ageing population and the incidence of chronic diseases; and the ever-present problem of keeping the regional health budget balanced. World Health Organization 2012, on behalf of the European Observatory on health systems and Policies.

Towards evidence-based critical thinking medicine? Uses of best evidence in flawless argumentations.

PubMed

Jenicek, Milos

2006-08-01

Uses of informal logic and critical thinking methodology are increasingly taught, learnt and advantageously applied in such diverse domains as law, the military, business, and education. Health sciences are also following this trend. However, production and critical appraisal of evidence as already practiced in Evidence-Based Medicine must be coupled with equally rigorous uses in order to ensure appropriate health problem understanding and decision-making. Making most proposals and decisions in medicine is the conclusion of an argumentation process that lies behind any communication between health professionals working with patients, performing research or sharing ideas about health problems, their interpretations and solutions with numerous stakeholders in public life. Modern critical thinking and decision making in medicine is not instantly mastered, but is instead a learnt experience as anything else in professional and social interactions. The modern argument as outlined, illustrated and applied to health problems in this essay is an extension of a previously established way of thinking in Evidence-Based Medicine. Ideally, health professionals, their patients and all other stakeholders should speak the same language and it is up to us to make this possible. Evidence and critical thinking - based medicine might be a solution. As modern critical thinkers, we are at the forefront and we must see to it that patients and professional and general communities benefit from this more so even than from other remarkable historical and current contributions to the well-being of those under our care.

Community characteristics as predictors of perceived HMO quality.

PubMed

Ahern, M M; Hendryx, M S

1998-06-01

We model the impact of community characteristics on people's perceptions of the quality of their health care experiences in HMOs. We focus on three community characteristics: sense of community, population density, and population diversity. Sense of community refers to people's perception of interconnection, shared responsibility, and common goals. Population density and population diversity are community characteristics that affect transactions costs in terms of time and energy, and affect people's perceptions of their community. We use data from a 1993 Florida poll to estimate the relationship between HMO members' perceptions of problems with health care experiences (cost, choice, access, satisfaction) and community characteristics. We find that all three community variables are significantly associated with perceptions of health care problems. We also find that effects of community variables operate differently for those in HMOs vs. those under traditional insurance. This study is consistent with research showing that community characteristics impact the health status of community institutions. Results suggest that providers may be able to improve care by being more responsive to individuals' need for community, that providers and communities can mutually gain by collaborating to improve community health, and that it may be cost-beneficial to factor community issues more strongly into health care policy.

Sexual dysfunction and male infertility.

PubMed

Lotti, Francesco; Maggi, Mario

2018-05-01

Infertility affects up to 12% of all men, and sexual dysfunction occurs frequently in men of reproductive age, causing infertility in some instances. In infertile men, hypoactive sexual desire and lack of sexual satisfaction are the most prevalent types of sexual dysfunction, ranging from 8.9% to 68.7%. Erectile dysfunction and/or premature ejaculation, evaluated with validated tools, have a prevalence of one in six infertile men, and orgasmic dysfunction has a prevalence of one in ten infertile men. In addition, infertile men can experience a heavy psychological burden. Infertility and its associated psychological concerns can underlie sexual dysfunction. Furthermore, general health perturbations can lead to male infertility and/or sexual dysfunction. Erectile dysfunction and male infertility are considered proxies for general health, the former underlying cardiovascular disorders and the latter cancerous and noncancerous conditions. The concept that erectile dysfunction in infertile men might be an early marker of poor general health is emerging. Finally, medications used for general health problems can cause sperm abnormalities and sexual dysfunction. The treatment of some causes of male infertility might improve semen quality and reverse infertility-related sexual dysfunction. In infertile men, an investigation of sexual, general, and psychological health status is advisable to improve reproductive problems and general health.

Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy – A Review

PubMed Central

Ulrich, F.; Petermann, F.

2016-01-01

In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various health-damaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child. PMID:27904164

Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy - A Review.

PubMed

Ulrich, F; Petermann, F

2016-11-01

In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various health-damaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child.

Violence and health: preliminary elements for thought and action.

PubMed

Franco Agudelo, S

1992-01-01

Violence is one of the most serious problems that society, and the public health sector in particular, has to deal with today. This article begins with a discussion of the concept of violence itself, bringing out its historical and cultural dimensions and emphasizing its essential relationship to the exercise of force in the interest of power under conditions of inequality. Violence must be seen as a process that includes its origins, the conditions that allow it to happen, its different forms of expression, and its individual and collective consequences. The violence-health relationship is seen as having different levels: violence threatens or denies not only health but the entire vital human process. The author analyzes the different forms of violence: violence that impairs health (torture, disappearances, rape, child abuse, elderly abuse) and violence that kills (suicide, homicide, war). Recent data show that the problem is on the increase and pervades everyday life. The author then examines the mechanisms by which violence impinges on health care institutions, especially the health services, training institutions, and agencies responsible for orienting and financing the sector. Finally, the health sector is revealed as not only a victim or patient of violence, but, unfortunately, sometimes an agent of violence, which means that changes are needed in approaches, attitudes, and behavior.

Needs for mental health care and service provision in single homeless people.

PubMed

Salize, H J; Horst, A; Dillmann-Lange, C; Killmann, U; Stern, G; Wolf, I; Henn, F; Rössler, W

2001-04-01

Specific problems in sampling methodology, case-finding strategies and a standardised needs assessment in mentally ill homeless people have contributed to their being neglected as a mental health care clientele. We assessed a representative sample of homeless people (n=102) in the highly industrialised city of Mannheim (Germany) regarding their prevalence of mental disorders (using the SCID) and their needs for mental health care (using the NCA). We found high prevalences, with 68.6% of all assessed homeless persons having a current mental disorder. Thus, needs for mental health care were very common, with unmet needs predominating in all problem areas, which was supported by a very weak service utilization. Thus, even in a region with a comprehensive community mental health care network, like the study area, mentally ill homeless people are widely under-provided. Results suggest that the traditional shelter system for homeless people carries most of the mental health care burden for their clientele and must be supported by adequate interventions from community-based mental health care services. A closer connection of both sectors and a better co-ordination of the care offers seems to be a prerequisite for helping to reduce unmet mental health care needs in this specific high-risk group.

Lessons from the Clinton plan: incremental market reform, not sweeping government control.

PubMed

Antos, Joseph

2008-01-01

The Clinton health reform attempt in the mid-1990s and the U.S. experience since then suggest some clear lessons for the next U.S. president. Public confidence in a major reform proposal must be won, and congressional support must be garnered, even if the election is a landslide. Insisting on universal coverage as a precondition may undercut the ability to enact other policies needed to improve the health system. Excessive regulation and price controls are likely to exacerbate underlying problems. The next president should take full advantage of market incentives to promote a high-value health system.

Correlates of health care utilization under targeted interventions: The case of female sex workers in Andhra Pradesh, India.

PubMed

Sharma, Varun; Suryawanshi, Dipak; Saggurti, Niranjan; Bharat, Shalini

2017-11-01

Accessibility and frequency of use of health care services among female sex workers (FSWs) are constrained by various factors. In this analysis, we examined the correlates of frequency of using health care services under targeted interventions among FSWs. A sample of FSWs (N = 1,973) was obtained from a second round (2012) of Behavioral Tracking Survey, conducted in five districts of Andhra Pradesh, a high-HIV-prevalence state in southern India. We used negative binomial regression models to analyze frequency of utilization of health care services among FSWs. Based on our analysis, we suggest that various predisposing and enabling factors were found to be significantly associated with the visit to NGO clinics for treatment of any health problem, any sexually transmitted infection symptom, and the number of condoms received from the peer worker or condom depot. We suggest the need for further research with respect to various correlates of frequency of using health care among FSWs to develop effective intervention strategies in countries that have high HIV prevalence among FSWs and targeted interventions need more diligent implementation to reach the unreached.

People living on the street from the health point of view.

PubMed

Hino, Paula; Santos, Jaqueline de Oliveira; Rosa, Anderson da Silva

2018-01-01

To know the Brazilian scientific production of the last ten years (2007 to 2016) about people who experience street situations under the health gaze. Integrative literature review using the descriptors: street people, health policy and public health. We analyzed 21 articles available in the Virtual Health Library. Four categories of analysis emerged. There was an increase in the frequency of published work on the subject, showing that the experience of living on the street makes people vulnerable to various diseases and health problems and, in addition, increases the difficulties of access to health services. There was an increase in the discussion of this topic due to the increase in the number of published studies. Despite the existence of public health policies directed to this social group, much still needs to be done to guarantee the health of this population.

The Deployment Health Surveillance Program: vision and challenges of health surveillance for Australian military cohorts.

PubMed

Barton, Christopher A; Dobson, Annette; Treloar, Susan A; McClintock, Christine; McFarlane, Alexander C

2008-12-01

The Australian Government has supported the establishment of a Deployment Health Surveillance Program for the Australian Defence Force. Although some health screening mechanisms already exist for Australian Defence Force personnel, until now health data have been used largely for clinical management at an individual level and have not been aggregated to identify trends in health and risk factors in the shorter or longer term. We identify challenges for and potential benefits of health surveillance in the military context, describe features of the Program and progress to date. Retrospective and cross-sectional projects based on deployments to the Near North Area of Influence since 1997 are under way. A planned prospective model of health surveillance for those deploying to the Middle East promises more timely attention to any emerging health problems for military personnel and veterans.

Filipino child health in the United States: do health and health care disparities exist?

PubMed

Javier, Joyce R; Huffman, Lynne C; Mendoza, Fernando S

2007-04-01

Filipinos are the second largest Asian subgroup in the United States, but few studies have examined health and health care disparities in Filipino children. The objectives of this review are 1) to appraise current knowledge of Filipino children's health and health care and 2) to present the implications of these findings for research, clinical care, and policy. We identified articles for review primarily via a Medline search emphasizing the terms Filipino and United States crossed with specific topics in child and adolescent health that fall under one of Healthy People 2010's 28 focus areas. Filipino children are underrepresented in medical research. Studies that compare Filipino children and adolescents with white children or children of other Asian Pacific Islander subgroups suggest disparities with regard to gestational diabetes, rates of neonatal mortality and low birth weight, malnutrition in young children, overweight, physical inactivity and fitness, tuberculosis, dental caries, and substance abuse. Studies that compare Filipino adults with white adults describe adult Filipino health problems similar to those of Filipino children, including higher rates of diabetes, hypertension, and metabolic syndrome. Health care disparities remain to be determined. Health and health care disparities appear to exist for Filipino children, but more research is needed to confirm these findings. Practitioners serving this population need to consider social and cultural factors that can increase or diminish risk for health problems. There are priorities in research and policy that, if pursued, may improve the health care and health outcomes of Filipino children.

Mathematical Skills in Undergraduate Students. A Ten-Year Survey of a Plant Physiology Course

ERIC Educational Resources Information Center

Llamas, A.; Vila, F.; Sanz, A.

2012-01-01

In the health and life sciences and many other scientific disciplines, problem solving depends on mathematical skills. However, significant deficiencies are commonly found in this regard in undergraduate students. In an attempt to understand the underlying causes, and to improve students' performances, this article describes a ten-year survey…

Drawing the Line: The Cultural Cartography of Utilization Recommendations for Mental Health Problems

ERIC Educational Resources Information Center

Olafsdottir, Sigrun; Pescosolido, Bernice A.

2009-01-01

In the 1990s, sociologists began to rethink the failure of utilization models to explain whether and why individuals accessed formal treatment systems. This effort focused on reconceptualizing the underlying assumptions and processes that shaped utilization patterns. While we have built a better understanding of how social networks structure…

Cannabis Use and Memory Brain Function in Adolescent Boys: A Cross-Sectional Multicenter Functional Magnetic Resonance Imaging Study

ERIC Educational Resources Information Center

Jager, Gerry; Block, Robert I.; Luijten, Maartje; Ramsey, Nick F.

2010-01-01

Objective: Early-onset cannabis use has been associated with later use/abuse, mental health problems (psychosis, depression), and abnormal development of cognition and brain function. During adolescence, ongoing neurodevelopmental maturation and experience shape the neural circuitry underlying complex cognitive functions such as memory and…

Veterinary Safety's Conflicts in the EAEU

ERIC Educational Resources Information Center

Kalymbek, Bakytzhan; Shulanbekova, Gulmira K.; Madiyarova, Ainur S.; Mirambaeva, Gulnaz Zh.

2016-01-01

This article is devoted to the problem of veterinary safety of the countries under the Eurasian Economic Union. Animal health's measures are provided in order to prevent the entry and spread of infectious animal diseases, including common to humans and animals, as well as goods not conforming to the common veterinary and sanitary requirements.…

Numerical Modeling of Inverse Problems under Uncertainty for Damage Detection in Aircraft Structures

DTIC Science & Technology

2013-08-01

et al . (2007): Structural health monitoring with piezoelectric wafer active sensors for space applications, AIAA JOURNAL, V. 45, p. 2838-2850. [4...International Journal of Heat and Mass Transfer, v. 55, p. 2219 -2228. 4. Myers, MR; Jorge, AB; Mutton, MJ; Walker, DG (2012): High heat flux point

The Importance of Tooth Decay Prevention in Children under Three

ERIC Educational Resources Information Center

Milgrom, Peter; Huebner, Colleen; Chi, Donald

2010-01-01

Tooth decay and tooth loss was once the norm but public health interventions have led to major improvements for most people. Nevertheless, not all children have benefited. Dental disease in young children is unacceptably high. Tooth decay is preventable. Early childhood educators are often the first to notice the problem. Professional…

Rotating annual crops with perennial grassland may increase micronutrient content of foodstuffs

USDA-ARS?s Scientific Manuscript database

Some essential nutrients that plants provide to people and animals are minerals that must be derived from the soil. Several of these minerals are under-consumed by large numbers of people and likely contribute to costly health problems. Several factors influence mineral uptake by plants and some o...

Partnership in mental health and child welfare: social work responses to children living with parental mental illness.

PubMed

Sheehan, Rosemary

2004-01-01

Mental illness is an issue for a number of families reported to child protection agencies. Parents with mental health problems are more vulnerable, as are their children, to having parenting and child welfare concerns. A recent study undertaken in the Melbourne Children's Court (Victoria, Australia) found that the children of parents with mental health problems comprised just under thirty percent of all new child protection applications brought to the Court and referred to alternative dispute resolution, during the first half of 1998. This paper reports on the study findings, which are drawn from a descriptive survey of 228 Pre-Hearing Conferences. A data collection schedule was completed for each case, gathering information about the child welfare concerns, the parents' problems, including mental health problems, and the contribution by mental health professionals to resolving child welfare concerns. The study found that the lack of involvement by mental health social workers in the child protection system meant the Children's Court was given little appreciation of either a child's emotional or a parent's mental health functioning. The lack of effective cooperation between the adult mental health and child protection services also meant decisions made about these children were made without full information about the needs and the likely outcomes for these children and their parents. This lack of interagency cooperation between mental health social work and child welfare also emerged in the findings of the Icarus project, a cross-national project, led by Brunel University, in England. This project compared the views and responses of mental health and child welfare social workers to the dependent children of mentally ill parents, when there were child protection concerns. It is proposed that adult mental health social workers involve themselves in the assessment of, and interventions in, child welfare cases when appropriate, and share essential information about their adult, parent clients. Children at risk of abuse and neglect are the responsibility of all members of the community, and relevant professional groups must accept this responsibility.

[Gynecological clinical study in girls and adolescent victims of sexual abuse].

PubMed

Sam Soto, Selene; Gayón Vera, Eduardo; García Piña, Corina A

2008-07-01

In spite of a very important under-registration, sexual abuse represents a social and public health problem worldwide. In Mexico, estimated prevalence of sexual abuse in women is 17.3%, half of them in youngsters under 15 years old. Most of cases have a late gynecological evaluation, due to a delay in a formal complaint. Gynecologist or pediatrician are the specialists who most frequently perform the genital examination of girls suspected of sexual abuse, due to this a complete knowledge of the topic is necessary in order to make an accurate diagnosis, register the physical findings and give prompt medical and psychological treatment as well as follow up to the patient. Despite the low risk of acquiring a sexually transmitted infection, it is important to evaluate the use of prophylactic treatment and the prevention of unwanted pregnancy with emergency contraception. Big efforts are being made by preventive programs on sexual abuse, sexually transmitted infections and unwanted pregnancy, all of which are serious problems in Mexican children and youths, and should constitute a fundamental part of the public politics on sexual health.

Zinc and Vitamin Supplementation in an Under-5 Indigenous Population of Guatemala: Influence of Lay Health Promoters in Decreasing Incidence of Diarrhea.

PubMed

Grossmann, Vicki M; Turner, Barbara S; Snyder, Denise; Stewart, Robert D; Bowen, Toni; Cifuentes, Ariadna A; Cliff, Cheryl

2015-09-01

Malnutrition is an urgent problem in the developing world, especially for children under 5 years of age. The article describes the utilization of a standard of practice designed to prevent illness in a malnourished, under-5 indigenous population and reinforced by weekly basic health messages taught by lay community health promoters. The two villages were chosen for observation after administration of the standard of care among the Maya-Kíché, the most numerous Mayan group in Guatemala. The standard of practice, 20 mg of daily oral zinc, was administered for 10 days in the home and followed by daily vitamin supplementation that continued throughout the 3 months of the project. All patients received four monthly clinic visits, with one of the village groups receiving weekly health promoter visits. Data evaluated after the quality improvement project showed significant differences in adherence to the zinc regimen (χ(2) = 3.677, p ≤ .05) as well as lower rates of diarrheal illnesses (χ(2) = 5.850, p ≤ .05), with both of these improved in the health promoter group. This study suggests that the training and implementation of para-health professionals from the lay community in response to specific health care needs could be considered a best practice in developing countries. Public health professionals are key to health promoter training and direction, and their importance in the global setting cannot be understated. © The Author(s) 2014.

PEDIATRIC MENTAL HEALTH PROBLEMS AND ASSOCIATED BURDEN ON FAMILIES

PubMed Central

Houtrow, Amy J.; Okumura, Megumi J.

2011-01-01

Approximately 20% of children in the United States have mental health problems. The factors associated with childhood mental health problems and the associated burdens on families are not well understood. Therefore, our goals were to profile mental health problems in children to identify disparities, and to quantify and identify correlates of family burden. We used the National Survey of Children’s Health, 2003 (N=85,116 children aged 3–17 years) for this analysis. The prevalence, unadjusted and adjusted odds ratios of mental health problems and family burden were calculated for children by child-, family- and health systems- level characteristics. The prevalence of mental health problems among children aged 3–17 years was 18%. The odds of mental health problems were higher for boys, older children, children living in or near relative poverty, those covered by public insurance, children of mothers with fair or poor mental health, children living in homes without two parents, children without a personal doctor or nurse, and children with unmet health care needs. Among families with children with mental health problems, 28% reported family burden. Correlates of family burden included White race, severity, older age, higher income, non-two parent family structure, and having a mother with mental health problems. In conclusion, childhood mental health problems are common and disproportionally affect children with fewer family and health care resources. Families frequently report burden, especially if the mental health problem is moderate to severe, but the correlates of family burden are not the same correlates associated with mental health problems. Understanding those highest at risk for mental health problems and family burden will help assist clinicians and policy makers to ensure appropriate support systems for children and families. PMID:22135697

Work-family conflict and health in Swedish working women and men: a 2-year prospective analysis (the SLOSH study).

PubMed

Leineweber, Constanze; Baltzer, Maria; Magnusson Hanson, Linda L; Westerlund, Hugo

2013-08-01

Research has suggested that gender is related to perceptions of work-family conflict (WFC) and an underlying assumption is that interference of paid work with family life will burden women more than men. There is, however, mixed evidence as to whether men and women report different levels of WFC. Even less studies investigate gender differences in health outcomes of WFC. Also the number of longitudinal studies in this field is low. Based on the Swedish Longitudinal Occupational Survey of Health, we prospectively examined the effects of WFC on three different health measures representing a wide spectrum off ill health (i.e. self-rated health, emotional exhaustion and problem drinking). Logistic regression analyses were used to analyse multivariate associations between WFC in 2008 and health 2 years later. The results show that WFC was associated with an increased risk of emotional exhaustion among both men and women. Gender differences are suggested as WFC was related to an increased risk for poor self-rated health among women and problem drinking among men. Interaction analyses revealed that the risk of poor self-rated health was substantially more influenced by WFC among women than among men. We conclude that, despite the fact that women experience conflict between work and family life slightly more often than men, both men's and women's health is negatively affected by this phenomenon.

Man-machine interfaces in health care

NASA Technical Reports Server (NTRS)

Charles, Steve; Williams, Roy E.

1991-01-01

The surgeon, like the pilot, is confronted with an ever increasing volume of voice, data, and image input. Simultaneously, the surgeon must control a rapidly growing number of devices to deliver care to the patient. The broad disciplines of man-machine interface design, systems integration, and teleoperation will play a role in the operating room of the future. The purpose of this communication is to report the incorporation of these design concepts into new surgical and laser delivery systems. A review of each general problem area and the systems under development to solve the problems are presented.

Health planning in the United States and the decline of public-interest policymaking.

PubMed

Melhado, Evan M

2006-01-01

In the 1960s and 1970s, health planning formed a major theme of American health policy. Planners aimed to improve health services and make them broadly available while using resources efficiently. This article provides a history, both intellectual and political, of the origins of planning, its rise, and--in the face of mounting problems--its decline. The story also illustrates broader changes in the culture of policymaking in American health care. From the Progressive Era through the 1960s, reform-minded experts in health worked to advance the public interest. Thereafter, they increasingly left behind public-interest ideals and their underlying extramarket values in favor of organizing and improving health care markets. Whatever the deficiencies of traditional policymaking may be, this study suggests the need to resurrect extramarket values in health policy.

Assessment of Arsenic Contamination of Groundwater and Health Problems in Bangladesh

PubMed Central

Khalequzzaman, Md.; Faruque, Fazlay S.; Mitra, Amal K.

2005-01-01

Excessive amounts of arsenic (As) in the groundwater in Bangladesh and neighboring states in India are a major public health problem. About 30% of the private wells in Bangladesh exhibit high concentrations of arsenic. Over half the country, 269 out of 464 administrative units, is affected. Similar problems exist in many other parts of the world, including the Unites States. This paper presents an assessment of the health hazards caused by arsenic contamination in the drinking water in Bangladesh. Four competing hypotheses, each addressing the sources, reaction mechanisms, pathways, and sinks of arsenic in groundwater, were analyzed in the context of the geologic history and land-use practices in the Bengal Basin. None of the hypotheses alone can explain the observed variability in arsenic concentration in time and space; each appears to have some validity on a local scale. Thus, it is likely that several bio-geochemical processes are active among the region’s various geologic environments, and that each contributes to the mobilization and release of arsenic. Additional research efforts will be needed to understand the relationships between underlying biogeochemical factors and the mechanisms for arsenic release in various geologic settings. PMID:16705819

The effect of a transition into poverty on child and maternal mental health: a longitudinal analysis of the UK Millennium Cohort Study.

PubMed

Wickham, Sophie; Whitehead, Margaret; Taylor-Robinson, David; Barr, Ben

2017-03-01

Whether or not relative measures of income poverty effectively reflect children's life chances has been the focus of policy debates in the UK. Although poverty is associated with poor child and maternal mental health, few studies have assessed the effect of moving into poverty on mental health. To inform policy, we explore the association between transitions into poverty and subsequent mental health among children and their mothers. In this longtitudinal analysis, we used data from the UK Millennium Cohort Study, a large nationally representative cohort of children born in the UK between Sept 1, 2000, and Jan 11, 2002, who participated in five survey waves as they progressed from 9 months of age to 11 years of age. Our analysis included all children and mothers who were free from mental health problems and not in poverty when the children were aged 3 years. We only included singletons (ie, not twins or other multiple pregnancies) and children for whom the mother was the main respondent to the study. The main outcomes were child socioemotional behavioural problems (Strengths and Difficulties Questionnaire) at ages 5 years, 7 years, and 11 years and maternal psychological distress (Kessler 6 scale). Using discrete time-hazard models, we followed up families without mental health problems at baseline and estimated odds ratios for subsequent onset of maternal and child mental health problems associated with first transition into poverty, while adjusting for confounders, including employment transitions. We further assessed whether or not change in maternal mental health explained any effect on child mental health. Of the 6063 families in the UK Millennium Cohort study at 3 years who met our inclusion criteria, 844 (14%) had a new transition into poverty compared with 5219 (86%) who remained out of poverty. After adjustment for confounders, transition into poverty increased the odds of socioemotional behavioural problems in children (odds ratio 1·41 [95% CI 1·02-1·93]; p=0·04) and maternal psychological distress (1·44 [1·21-1·71]; p<0·0001). Controlling for maternal psychological distress reduced the effect of transition into poverty on socioemotional behavioural problems in children (1·30 [0·94-1·79]; p=0·11). In a contemporary UK cohort, first transition into income poverty during early childhood was associated with an increase in the risk of child and maternal mental health problems. These effects were independent of changes in employment status. Transitions to income poverty do appear to affect children's life chances and actions that directly reduce income poverty of children are likely to improve child and maternal mental health. The Wellcome Trust and The Farr Institute for Health Informatics Research (Medical Research Council). Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Type 2 Diabetes Patients Benefit from the COMODITY12 mHealth System: Results of a Randomised Trial.

PubMed

Kardas, Przemysław; Lewandowski, Krzysztof; Bromuri, Stefano

2016-12-01

Patient acceptance is one of the major barriers toward widespread use of mHealth systems. The aim of this study was to assess system operability and whole trial feasibility, including patients' experience with their use of COMMODITY12 mHealth system under. Secondary study aims included assessment of several metabolic parameters as well as patient adherence to the treatment. This was a prospective parallel-arm randomized controlled trial in outpatients diagnosed with DM2, being treated in the primary care settings in Lodz region, Poland, with 6 weeks period of follow-up. Patients opinions were collected with 7-item questionnaire, assessing different aspects of system use, as well as EuroQol-5D-5 L questionnaire, assessing health-related quality of life. Sixty patients (female, 24, male, 36, mean age +/- SD 59.5 +/- 6.8) completed study. All four layers of the COMMODITY12 system proved to work smooth under real-life conditions, without major problems. All dimensions of experience with system use were assessed well, with maximum values for clearness of instructions, and ease of use (4.80, and 4.63, respectively). Health related quality of life, as assessed with cumulative utility measure, improved significantly in COMMODITY12 system users (P < 0.05). mHealth system modestly improved glycaemic and blood pressure control, assuring high level of patient adherence with overall adherence reaching 92.9 %. Study proved that the COMODITY12 system is well accepted by type 2 diabetes patients taking part in clinical trial, leading to several clinical benefits, and improved quality of life. Nevertheless, before future commercialisation of the system, several minor problems identified during the study need to be addressed.

Health reform for the 21st century? It may have to wait until the 21st century.

PubMed

Budetti, P P

1997-01-15

To assess the likelihood of health care legislation in the forthcoming 105th Congress in 5 areas: health care coverage, tax and Employee Retirement Income Security Act (ERISA) policy, Medicaid, Medicare, and managed care. Informal, semistructured conversations that took place in the months prior to the 1996 elections. Congressional health staff and administration officials. Unofficial, off-the-record personal opinions. Health care coverage initiatives to benefit children and unemployed persons are likely to be proposed, but have little chance of enactment; children are seen as well provided for under current Medicaid law, the strong economy and high employment levels lower concern for unemployed issues, and the effort required to pass the Kassebaum-Kennedy legislation needs time to settle. Tax proposals, such as medical savings accounts (MSAs), and ERISA amendments have no constituency; also, the MSA demonstration in Kassebaum-Kennedy will forestall further action. Medicaid is far less an issue than in the previous Congress, because spending has fallen unexpectedly, the bitter fight over block grants makes them unlikely to be revisited, and the administration is likely to enhance state flexibility through waivers. Medicare will be the subject of substantial action to defer impending insolvency temporarily, but there is virtually no chance that definitive long-term solutions will be enacted even though the underlying fiscal problems are thoroughly understood and recognized. Managed care will be the venue for numerous proposals designed to address specific consumer and quality issues. Four bitter years of fighting over health care issues has raised awareness of the problems, but has produced a political chemistry that is too rancorous to permit passage of significant legislation in the near future.

Feeling old today? Daily health, stressors, and affect explain day-to-day variability in subjective age.

PubMed

Kotter-Grühn, Dana; Neupert, Shevaun D; Stephan, Yannick

2015-01-01

Subjective age is an important correlate of health, well-being, and longevity. So far, little is known about short-term variability in subjective age and the circumstances under which individuals feel younger/older in daily life. This study examined whether (a) older adults' felt age fluctuates on a day-to-day basis, (b) daily changes in health, stressors, and affect explain fluctuations in felt age, and (c) the daily associations between felt age and health, stressors, or affect are time-ordered. Using an eight-day daily diary approach, N = 43 adults (60-96 years, M = 74.65, SD = 8.19) filled out daily questionnaires assessing subjective age, health, daily stressors, and affect. Data were analysed using multilevel modelling. Subjective age, health, daily stressors, affect. Intra-individual variability in felt age was not explained by time but by short-term variability in other variables. Specifically, on days when participants experienced more than average health problems, stress, or negative affect they felt older than on days with average health, stress, or negative affect. No time-ordered effects were found. Bad health, many stressors, and negative affective experiences constitute circumstances under which older adults feel older than they typically do. Thus, daily measures of subjective age could be markers of health and well-being.

Nonurgent patients in emergency departments: rational or irresponsible consumers? Perceptions of professionals and patients.

PubMed

Durand, Anne-Claire; Palazzolo, Sylvie; Tanti-Hardouin, Nicolas; Gerbeaux, Patrick; Sambuc, Roland; Gentile, Stéphanie

2012-09-25

For several decades, overcrowding in emergency departments (EDs) has been intensifying due to the increased number of patients seeking care in EDs. Demand growth is partly due to misuse of EDs by patients who seek care for nonurgent problems. This study explores the reasons why people with nonurgent complaints choose to come to EDs, and how ED health professionals perceive the phenomenon of "nonurgency". Semi-structured interviews were conducted in 10 EDs with 87 nonurgent patients and 34 health professionals. Interviews of patients revealed three themes: (1) fulfilled health care needs, (2) barriers to primary care providers (PCPs), and (3) convenience. Patients chose EDs as discerning health consumers: they preferred EDs because they had difficulties obtaining a rapid appointment. Access to technical facilities in EDs spares the patient from being overwhelmed with appointments with various specialists. Four themes were identified from the interviews of health professionals: (1) the problem of defining a nonurgent visit, (2) explanations for patients' use of EDs for nonurgent complaints, (3) consequences of nonurgent visits, and (4) solutions to counter this tendency. Studies on the underlying reasons patients opt for the ED, as well as on their decision-making process, are lacking. The present study highlighted discrepancies between the perceptions of ED patients and those of health professionals, with a special focus on patient behaviour. To explain the use of ED, health professionals based themselves on the acuity and urgency of medical problems, while patients focused on rational reasons to initiate care in the ED (accessibility to health care resources, and the context in which the medical problem occurred). In spite of some limitations due to the slightly outdated nature of our data, as well as the difficulty of categorizing nonurgent situations, our findings show the importance of conducting a detailed analysis of the demand for health care. Understanding it is crucial, as it is the main determining factor in the utilization of health care resources, and provides promising insights into the phenomenon of ED usage increase. For reforms to be successful, the process of decision-making for unscheduled patients will have to be thoroughly investigated.

Applications of system dynamics modelling to support health policy.

PubMed

Atkinson, Jo-An M; Wells, Robert; Page, Andrew; Dominello, Amanda; Haines, Mary; Wilson, Andrew

2015-07-09

The value of systems science modelling methods in the health sector is increasingly being recognised. Of particular promise is the potential of these methods to improve operational aspects of healthcare capacity and delivery, analyse policy options for health system reform and guide investments to address complex public health problems. Because it lends itself to a participatory approach, system dynamics modelling has been a particularly appealing method that aims to align stakeholder understanding of the underlying causes of a problem and achieve consensus for action. The aim of this review is to determine the effectiveness of system dynamics modelling for health policy, and explore the range and nature of its application. A systematic search was conducted to identify articles published up to April 2015 from the PubMed, Web of Knowledge, Embase, ScienceDirect and Google Scholar databases. The grey literature was also searched. Papers eligible for inclusion were those that described applications of system dynamics modelling to support health policy at any level of government. Six papers were identified, comprising eight case studies of the application of system dynamics modelling to support health policy. No analytic studies were found that examined the effectiveness of this type of modelling. Only three examples engaged multidisciplinary stakeholders in collective model building. Stakeholder participation in model building reportedly facilitated development of a common 'mental map' of the health problem, resulting in consensus about optimal policy strategy and garnering support for collaborative action. The paucity of relevant papers indicates that, although the volume of descriptive literature advocating the value of system dynamics modelling is considerable, its practical application to inform health policy making is yet to be routinely applied and rigorously evaluated. Advances in software are allowing the participatory model building approach to be extended to more sophisticated multimethod modelling that provides policy makers with more powerful tools to support the design of targeted, effective and equitable policy responses for complex health problems. Building capacity and investing in communication to promote these modelling methods, as well as documenting and evaluating their applications, will be vital to supporting uptake by policy makers.

Treatment for Sleep Problems in Children with Autism and Caregiver Spillover Effects.

PubMed

Tilford, J Mick; Payakachat, Nalin; Kuhlthau, Karen A; Pyne, Jeffrey M; Kovacs, Erica; Bellando, Jayne; Williams, D Keith; Brouwer, Werner B F; Frye, Richard E

2015-11-01

Sleep problems in children with autism spectrum disorders (ASD) are under-recognized and under-treated. Identifying treatment value accounting for health effects on family members (spillovers) could improve the perceived cost-effectiveness of interventions to improve child sleep habits. A prospective cohort study (N = 224) was conducted with registry and postal survey data completed by the primary caregiver. We calculated quality of life outcomes for the child and the primary caregiver associated with treatments to improve sleep in the child based on prior clinical trials. Predicted treatment effects for melatonin and behavioral interventions were similar in magnitude for the child and for the caregiver. Accounting for caregiver spillover effects associated with treatments for the child with ASD increases treatment benefits and improves cost-effectiveness profiles.

TREATMENT FOR SLEEP PROBLEMS IN CHILDREN WITH AUTISM AND CAREGIVER SPILLOVER EFFECTS

PubMed Central

Tilford, J. Mick; Payakachat, Nalin; Kuhlthau, Karen; Pyne, Jeffrey M.; Kovacs, Erica; Bellando, Jayne; Williams, D. Keith; Brouwer, Werner; Frye, Richard E.

2015-01-01

Sleep problems in children with autism spectrum disorders (ASD) are under-recognized and under-treated. Identifying treatment value accounting for health effects on family members (spillovers) could improve the perceived cost-effectiveness of interventions to improve child sleep habits. A prospective cohort study (N=224) was conducted with registry and postal survey data completed by the primary caregiver. We calculated quality of life outcomes for the child and the primary caregiver associated with treatments to improve sleep in the child based on prior clinical trials. Predicted treatment effects for melatonin and behavioral interventions were similar in magnitude for the child and for the caregiver. Accounting for caregiver spillover effects associated with treatments for the child with ASD increases treatment benefits and improves cost-effectiveness profiles. PMID:26126749

The control of malaria vectors in the context of the Health for All by the Year 2000 Global Strategy.

PubMed

Slooff, R

1987-12-01

The changing picture of malaria worldwide needs to be viewed in the context of other developments before we can determine the directions to take to be able to provide the thrusts required in malaria vector control. As a result of population growth, increasing urbanization and continuing pressure on scarce natural resources, the epidemiology of malaria and its manifestation as a public health problem are undergoing profound modifications, indeed in several parts of the world. This picture is further complicated by the spread of resistance to pesticides in the vector and to drugs in Plasmodium falciparum. In the immediate future, these trends will continue. In addition, the appearance of suitable vaccines is a highly probable event to be taken into consideration. The WHO Global Strategy of Health For All by the Year 2000 aims at the improvement of levels of health through primary health care. Among other things, this implies a greater reliance on community involvement and on intersectoral collaboration for health. In this light, the major malaria problems in the year 2000 will be: (1) "hard core" endemic areas with inadequate infrastructure and poor socio-economic development; (2) resource development areas, in particular those under illegal or poor controlled exploitation; (3) expanding urban areas and (4) increased mobility of non-immunes, particularly if uncontrolled. In order to cope with these problems, thrusts are required towards the development of vector control strategies, covering the following fields: (1) tools for vector control integrated in primary health care, (2) new chemicals, (3) improved and new biologicals, (4) environmental management and the adoption of health safeguards in resource development projects and (5) manpower development.

Usability Methods for Ensuring Health Information Technology Safety: Evidence-Based Approaches. Contribution of the IMIA Working Group Health Informatics for Patient Safety.

PubMed

Borycki, E; Kushniruk, A; Nohr, C; Takeda, H; Kuwata, S; Carvalho, C; Bainbridge, M; Kannry, J

2013-01-01

Issues related to lack of system usability and potential safety hazards continue to be reported in the health information technology (HIT) literature. Usability engineering methods are increasingly used to ensure improved system usability and they are also beginning to be applied more widely for ensuring the safety of HIT applications. These methods are being used in the design and implementation of many HIT systems. In this paper we describe evidence-based approaches to applying usability engineering methods. A multi-phased approach to ensuring system usability and safety in healthcare is described. Usability inspection methods are first described including the development of evidence-based safety heuristics for HIT. Laboratory-based usability testing is then conducted under artificial conditions to test if a system has any base level usability problems that need to be corrected. Usability problems that are detected are corrected and then a new phase is initiated where the system is tested under more realistic conditions using clinical simulations. This phase may involve testing the system with simulated patients. Finally, an additional phase may be conducted, involving a naturalistic study of system use under real-world clinical conditions. The methods described have been employed in the analysis of the usability and safety of a wide range of HIT applications, including electronic health record systems, decision support systems and consumer health applications. It has been found that at least usability inspection and usability testing should be applied prior to the widespread release of HIT. However, wherever possible, additional layers of testing involving clinical simulations and a naturalistic evaluation will likely detect usability and safety issues that may not otherwise be detected prior to widespread system release. The framework presented in the paper can be applied in order to develop more usable and safer HIT, based on multiple layers of evidence.

Local Barriers and Solutions to Improve Care-Seeking for Childhood Pneumonia, Diarrhoea and Malaria in Kenya, Nigeria and Niger: A Qualitative Study

PubMed Central

Bedford, K. Juliet A.; Sharkey, Alyssa B.

2014-01-01

We present qualitative research findings on care-seeking and treatment uptake for pneumonia, diarrhoea and malaria among children under 5 in Kenya, Nigeria and Niger. The study aimed to determine the barriers caregivers face in accessing treatment for these conditions; to identify local solutions that facilitate more timely access to treatment; and to present these findings as a platform from which to develop context-specific strategies to improve care-seeking for childhood illness. Kenya, Nigeria and Niger are three high burden countries with low rates of related treatment coverage, particularly in underserved areas. Data were collected in Homa Bay County in Nyanza Province, Kenya; in Kebbi and Cross River States, Nigeria; and in the Maradi and Tillabéri regions of Niger. Primary caregivers of children under 5 who did not regularly engage with health services or present their child at a health facility during illness episodes were purposively selected for interview. Data underwent rigorous thematic analysis. We organise the identified barriers and related solutions by theme: financial barriers; distance/location of health facilities; socio-cultural barriers and gender dynamics; knowledge and information barriers; and health facility deterrents. The relative importance of each differed by locality. Participant suggested solutions ranged from community-level actions to facility-level and more policy-oriented actions, plus actions to change underlying problems such as social perceptions and practices and gender dynamics. We discuss the feasibility and implications of these suggested solutions. Given the high burden of childhood morbidity and mortality due to pneumonia, diarrhoea and malaria in Kenya, Nigeria and Niger, this study provides important insights relating to demand-side barriers and locally proposed solutions. Significant advancements are possible when communities participate in both problem identification and resolution, and are engaged as important partners in improving child health and survival. PMID:24971642

STD/AIDS prevention in Portuguese-speaking Africa: a review of the recent literature in the social sciences and health.

PubMed

Monteiro, Simone

2009-03-01

The article reviews academic literature in the social sciences and health on the problems and challenges of STD/AIDS prevention in Portuguese-speaking African countries. Based on a bibliographic survey of the SciELO, PubMed, and Sociological Abstracts databases between 1997 and 2007, the research under review was organized into two groups, according to content. The first group of studies sought to understand STD/AIDS vulnerability among social groups by examining local cultural and socioeconomic factors as related to gender dynamics, sexuality, color/race, religion and health care. The second group encompassed critical assessments of shortcomings in the STD/AIDS educational messages delivered by governments and international agencies. Attention is called to the way in which the presence of traditional medicine systems and the occurrence of civil wars in the post-colonial period impact the STD/AIDS epidemic in the African countries under study.

Neglecting legumes has compromised human health and sustainable food production.

PubMed

Foyer, Christine H; Lam, Hon-Ming; Nguyen, Henry T; Siddique, Kadambot H M; Varshney, Rajeev K; Colmer, Timothy D; Cowling, Wallace; Bramley, Helen; Mori, Trevor A; Hodgson, Jonathan M; Cooper, James W; Miller, Anthony J; Kunert, Karl; Vorster, Juan; Cullis, Christopher; Ozga, Jocelyn A; Wahlqvist, Mark L; Liang, Yan; Shou, Huixia; Shi, Kai; Yu, Jingquan; Fodor, Nandor; Kaiser, Brent N; Wong, Fuk-Ling; Valliyodan, Babu; Considine, Michael J

2016-08-02

The United Nations declared 2016 as the International Year of Pulses (grain legumes) under the banner 'nutritious seeds for a sustainable future'. A second green revolution is required to ensure food and nutritional security in the face of global climate change. Grain legumes provide an unparalleled solution to this problem because of their inherent capacity for symbiotic atmospheric nitrogen fixation, which provides economically sustainable advantages for farming. In addition, a legume-rich diet has health benefits for humans and livestock alike. However, grain legumes form only a minor part of most current human diets, and legume crops are greatly under-used. Food security and soil fertility could be significantly improved by greater grain legume usage and increased improvement of a range of grain legumes. The current lack of coordinated focus on grain legumes has compromised human health, nutritional security and sustainable food production.

(De-) criminalization of attempted suicide in India: A review

PubMed Central

Ranjan, Rajeev; Kumar, Saurabh; Pattanayak, Raman Deep; Dhawan, Anju; Sagar, Rajesh

2014-01-01

Attempted suicide is a serious problem requiring mental health interventions, but it continues to be treated as a criminal offence under the section 309 of Indian Penal Code. The article reviews the international legal perspective across various regions of the world, discusses the unintended consequences of section 309 IPC and highlights the need for decriminalization of attempted suicide in India. The Mental Health Care Bill, 2013, still under consideration in the Rajya Sabha (upper house), has proposed that attempted suicide should not be criminally prosecuted. Decriminalization of suicidal attempt will serve to cut down the undue stigma and avoid punishment in the aftermath of incident, and lead to a more accurate collection of suicide-related statistics. From a policy perspective, it will further emphasize the urgent need to develop a framework to deliver mental health services to all those who attempt suicide. PMID:25535437

[Child nutritional status in contexts of urban poverty: a reliable indicator of family health?

PubMed

Huergo, Juliana; Casabona, Eugenia Lourdes

2016-03-01

This work questions the premise that the nutritional status of children under six years of age is a reliable indicator of family health. To do so, a research strategy based in case studies was carried out, following a qualitative design (participant observation and semistructured interviews using intentional sampling) and framed within the interpretivist paradigm. The anthropometric measurements of 20 children under six years of age attending the local Child Care Center in Villa La Tela, Córdoba were evaluated. Nutritional status was understood as an object that includes socially determined biological processes, and was therefore posited analytically as a cross between statistical data and its social determination. As a statistic, child nutritional status is merely descriptive; to assist in the understanding of its social determination, it must be placed in dialectical relationship with the spheres of sociability proposed to analyze the reproduction of health problems.

Delivery of child health services in Indigenous communities: implications for the federal government's emergency intervention in the Northern Territory.

PubMed

Bailie, Ross S; Si, Damin; Dowden, Michelle C; Connors, Christine M; O'Donoghue, Lynette; Liddle, Helen E; Kennedy, Catherine M; Cox, Rhonda J; Burke, Hugh P; Thompson, Sandra C; Brown, Alex D H

2008-05-19

To describe delivery of child health services in Australian Aboriginal communities, and to identify gaps in services required to improve the health of Aboriginal children. Cross-sectional baseline audit for a quality improvement intervention. 297 children aged at least 3 months and under 5 years in 11 Aboriginal communities in the Northern Territory, Far West New South Wales and Western Australia in 2006. Adherence to guideline-scheduled services including clinical examinations, brief interventions or advice on health-related behaviour and risks, and enquiry regarding social conditions; and recorded follow-up of identified problems. Documentation of delivery of specific clinical examinations (26%-80%) was relatively good, but was poorer for brief interventions or advice on health-related behaviour and risks (5%-36%) and enquiry regarding social conditions (3%-11%). Compared with children in Far West NSW and WA, those attending NT centres were significantly more likely to have a record of growth faltering, underweight, chronic ear disease, anaemia, or chronic respiratory disease (P < 0.005). Only 11%-13% of children with identified social problems had an assessment report on file. An action plan was documented for 22% of children with growth faltering and 13% with chronic ear disease; 43% of children with chronic respiratory disease and 31% with developmental delay had an assessment report on file. Existing systems are not providing for adequate follow-up of identified medical and social problems for children living in remote Aboriginal communities; development of systems for immediate and longer-term sustainable responses to these problems should be a priority. Without effective systems for follow-up, screening children for disease and adverse social circumstances will result in little or no benefit.

Social impacts of technological diffusion: prenatal diagnosis and induced abortion in Brazil.

PubMed

Novaes, H M

2000-01-01

Scientific and technological development plays an essential part in shaping contemporary societies, and medicine and health care are considered to be particularly receptive to the incorporation of new concepts, techniques and products, producing impacts not only on the health problems for which they were originally intended, but also varied 'side-effects', less frequently recognised and studied. In this study the point of departure was the hypothesis that the intensive diffusion in Brazil of prenatal ultrasound would create new problems for individuals (pregnant women, their families and health professionals) and society in coping with foetal malformations, due to the existence of a very restrictive induced abortion legislation. The objective of the research was to study the social visibility of these problems, in the written mass media. The period under analysis went from 1991 to 1996. The four most important daily newspapers and two medical council journals were studied, with a criteria oriented selection of articles, and their macrotextual thematic analysis. The results indicate that the basic elements in the relationships between medical technology, prenatal diagnosis, foetal malformations and induced abortions stayed the same along the period - a restrictive Penal Code, the public recognition of the disseminated and usually tolerated practice of induced abortion, done in risky conditions for the majority of women, with very evident consequences on maternal health, a divided Congress, a divided 'public opinion', religious opposition and new scientific and technological practices in health care. Nevertheless, tension between these 'contradictory' factors increases, so much so, that new elements are introduced which make an accommodation possible, without implying in major changes of position. This is achieved through the development of new alliances between Science, the judiciary and obstetrical leaders, which benefit individual initiatives, instead of leading to a public recognition of the problem and changes in the law.

In search of the silver bullet: regulatory models to address childhood obesity.

PubMed

Rothenberg, Joan R

2010-01-01

The concern over obesity today has evolved beyond an issue of personal vanity to a serious national health issue affecting millions of Americans. Obesity in children is especially alarming. Overweight children and adolescents are at risk for health problems throughout their lives. While under-nutrition or diet insufficiencies were once major obstacles in the development of healthy infants and children, the epidemic of childhood obesity marks the start of the 21st century with equally menacing health consequences. Childhood obesity creates an increased burden of disease on our economy with increased indirect economic costs of time lost from work for parents and time lost from school for the child. Data raise the possibility that the current generation of children could suffer greater illness or experience a shorter lifespan than that of their parents. Some experts believe that government mandated restrictions on dietary choices would alleviate the obesity problem, while others find such actions to be an unwarranted government intrusion. Still, as concerns about obesity continue to grow, especially regarding children, some say government intervention of some type is necessary to solve the problem. This paper examines the history and factors involved in the childhood obesity epidemic, explores regulatory options for its resolution, and provides an overview of obesity as a serious challenge to public health, and the health of children in particular. The federal agencies who share the responsibility for regulating food in the United States and their efforts to address the obesity problem are discussed as a background to various state and federal regulatory models influencing dietary choices. The effectiveness of proposed regulations and alternatives to government intervention suggest that the resolution of the childhood obesity issue requires a coordinated, multilevel approach.

Growing concerns and controversies to Taiwan's National Health Insurance-what are the lessons from mainland China, South Korea and Singapore?

PubMed

Lee, Yen-Han; Ang, Ting Fang Alvin; Chiang, Timothy C; Kaplan, Warren A

2018-01-01

It has been over 20 years since Taiwan's implementation of its National Health Insurance (NHI) program. Under this program, the health insurance coverage rate has reached approximately 99% of the population. Despite guaranteeing the residents of Taiwan equal access regardless of socioeconomic status and background, critical problems and controversies persist, and they continue to challenge the NHI. We analyze the primary issues facing the NHI program with emphasis on financial and consumer behavioral aspects. Furthermore, we apply models from mainland China, South Korea and Singapore to discuss what Taiwan could learn from the systems employed by these countries to modify the NHI. Targeting the needs of the NHI, we have three policy recommendations: separating the NHI scheme into different target populations, strengthening the NHI referral system and regulating the access of overseas citizens to health services while in Taiwan. After two decades in existence, problems persist and there is a continuing need to improve Taiwan's NHI. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana

PubMed Central

Mupara, Lucia U.; Lubbe, Johanna C.

2016-01-01

Background Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. Design A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. Results The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. Conclusions The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana. PMID:26899774

Problem Gambling Family Impacts: Development of the Problem Gambling Family Impact Scale.

PubMed

Dowling, N A; Suomi, A; Jackson, A C; Lavis, T

2016-09-01

Although family members of problem gamblers frequently present to treatment services, problem gambling family impacts are under-researched. The most commonly endorsed items on a new measure of gambling-related family impacts [Problem Gambling Family Impact Measure (PG-FIM: Problem Gambler version)] by 212 treatment-seeking problem gamblers included trust (62.5 %), anger (61.8 %), depression or sadness (58.7 %), anxiety (57.7 %), distress due to gambling-related absences (56.1 %), reduced quality time (52.4 %), and communication breakdowns (52.4 %). The PG-FIM (Problem Gambler version) was comprised of three factors: (1) financial impacts, (2) increased responsibility impacts, and (3) psychosocial impacts with good psychometric properties. Younger, more impulsive, non-electronic gaming machine (EGM) gamblers who had more severe gambling problems reported more financial impacts; non-EGM gamblers with poorer general health reported more increased responsibility impacts; and more impulsive non-EGM gamblers with more psychological distress and higher gambling severity reported more psychosocial impacts. The findings have implications for the development of interventions for the family members of problem gamblers.

Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review.

PubMed

Gaillard, Romy; Santos, Susana; Duijts, Liesbeth; Felix, Janine F

2016-01-01

Obesity is a major public health problem among women of reproductive age. In a narrative review, we examined the influence of maternal obesity during pregnancy on fetal outcomes and childhood adiposity, cardio-metabolic, respiratory and cognitive-related health outcomes. We discuss results from recent studies, the causality and potential underlying mechanisms of observed associations and challenges for future epidemiological studies. Evidence from observational studies strongly suggests that maternal pre-pregnancy obesity and excessive gestational weight gain are associated with increased risks of fetal pregnancy complications and adverse childhood cardio-metabolic, respiratory and cognitive-related health outcomes. It remains unclear whether these associations are due to intrauterine mechanisms or explained by confounding family-based sociodemographic, lifestyle and genetic factors. The underlying mechanisms have mainly been assessed in animal studies and small human studies, and are yet to be further explored in large human studies. Key Message: Maternal obesity is an important modifiable factor during pregnancy that is associated with a variety of adverse offspring health outcomes. Further studies are needed to explore the causality and underlying mechanisms of the observed associations. Ultimately, preventive strategies focused on reducing maternal obesity and excessive weight gain during pregnancy may reduce common diseases in future generations. © 2016 S. Karger AG, Basel.

Mental Health Problems and Symptoms among Male Adolescents Attending a Teen Health Clinic.

ERIC Educational Resources Information Center

Smith, Peggy B.; Buzi, Ruth S.; Weinman, Maxine L.

2001-01-01

Examined the frequency and nature of mental health problems and symptoms among a group of 51 inner city male adolescents attending a teen health clinic. Results indicated participants experienced significant mental health problems and symptoms, such as relationship problems, problems with time and money, and symptoms of anger, depression, and…

Quality of Big Data in health care.

PubMed

Sukumar, Sreenivas R; Natarajan, Ramachandran; Ferrell, Regina K

2015-01-01

The current trend in Big Data analytics and in particular health information technology is toward building sophisticated models, methods and tools for business, operational and clinical intelligence. However, the critical issue of data quality required for these models is not getting the attention it deserves. The purpose of this paper is to highlight the issues of data quality in the context of Big Data health care analytics. The insights presented in this paper are the results of analytics work that was done in different organizations on a variety of health data sets. The data sets include Medicare and Medicaid claims, provider enrollment data sets from both public and private sources, electronic health records from regional health centers accessed through partnerships with health care claims processing entities under health privacy protected guidelines. Assessment of data quality in health care has to consider: first, the entire lifecycle of health data; second, problems arising from errors and inaccuracies in the data itself; third, the source(s) and the pedigree of the data; and fourth, how the underlying purpose of data collection impact the analytic processing and knowledge expected to be derived. Automation in the form of data handling, storage, entry and processing technologies is to be viewed as a double-edged sword. At one level, automation can be a good solution, while at another level it can create a different set of data quality issues. Implementation of health care analytics with Big Data is enabled by a road map that addresses the organizational and technological aspects of data quality assurance. The value derived from the use of analytics should be the primary determinant of data quality. Based on this premise, health care enterprises embracing Big Data should have a road map for a systematic approach to data quality. Health care data quality problems can be so very specific that organizations might have to build their own custom software or data quality rule engines. Today, data quality issues are diagnosed and addressed in a piece-meal fashion. The authors recommend a data lifecycle approach and provide a road map, that is more appropriate with the dimensions of Big Data and fits different stages in the analytical workflow.

The Norwegian Polio Study 1994: a nation-wide survey of problems in long-standing poliomyelitis.

PubMed

Wekre, L L; Stanghelle, J K; Lobben, B; Oyhaugen, S

1998-04-01

'The Norwegian Polio Study 1994' was performed to make a nation-wide survey of the medical and social situation, and of the needs of anterior poliomyelitis (polio). A questionnaire, consisting of 133 questions with sub-questions, was sent to a total of 2392 polio victims, most of them registered in 'The National Society of Polio Victims' in Norway. 1449 persons (61%) answered. Sixty-six per cent were between 45 and 64 years of age, 25% were above 64 years and 9% were under 45 years. When specifying new health problems, 85% stated that they had experienced increased weakness in muscles affected by polio, while 58% had experienced increased weakness in previous non-affected muscles. Other health problems related to polio were fatigue during exercise (80%), general fatigue (57%), joint pain (58%), muscular pain (58%) and cold intolerance (62%). The participants indicated an increasing need of aids, but 80% were still independent of help from others and 57% were still employed, fully or part time. Only 17% were satisfied with the public health services for polio survivors, while 67% of those who had undergone comprehensive examination at some central hospital were satisfied. This study indicates an obvious need of building up expertise in multidisciplinary evaluation and treatment of post polio problems in countries where acute polio has been eliminated.

Are you treating youngsters who are or should be receiving mental health services?

PubMed

Waldman, H B

1996-01-01

Psychiatrists now recognize that the disorders of children are serious, treatable conditions and as precursors of adult psychopathology. These conditions can seriously influence the patient's behavior when undergoing dental treatment. The dentist will probably assume that the behavior problems are directly related to the nature of the dental service, rather than particular underlying personality characteristics of preschool and school-age children. It is important that practitioners recognize and understand these conditions as they attempt to provide adequate treatment. No national epidemiological studies have been conducted in this country that would provide valid indicators of either the prevalence or incidence of mental disorders among children. Local studies, however, have been done that diagnosable disorders in children range from 17.6 percent to 22 percent, including 3 percent to 5 percent who have severe emotional or behavioral problems. The prevalence of many mental disorders is greater in males than in females, ranging from a ratio of 2:1 to 9:1. Lifetime prevalence of mental disorders, first diagnosed in infancy, childhood, and adolescence range as high as 15,000 cases per 100,000 persons. It is important for the dentist to recognize that (1) even the youngest of children seen in a dental practice may be in need of mental health services, (2) management problems may stem from mental health problems, and (3) families are unaware or unwilling to admit that a child may need help.

Problematic Internet Use in University Students: associated factors and differences of gender.

PubMed

Fernández-Villa, Tania; Alguacil Ojeda, Juan; Almaraz Gómez, Ana; Cancela Carral, José María; Delgado-Rodríguez, Miguel; García-Martín, Miguel; Jiménez-Mejías, Eladio; Llorca, Javier; Molina, Antonio José; Ortíz Moncada, Rocío; Valero-Juan, Luiz Félix; Martín, Vicente

2015-12-15

The aim of this paper is to make a descriptive analysis of Problematic Internet Use in college students, evaluating the possible association with health problems and addictive behaviors, as well as gender differences in user types. A total of 2,780 students participated in the study between 2011 and 2014, 29% of them being males (age 20.8 ± 5.1 years) and 71% females (age 20.3 ± 4.4 years). The prevalence of Problematic Internet Use (PIU) assessed by the Internet Addiction Test was 6.08%. Being under 21 years of age and studying for degrees in subjects other than the health sciences were associated factors with a higher frequency of this problem, no differences by gender or type of address were found. The results show a significant association with some health problems (migraines, back pain, excess weight or obesity, insufficient rest), psychological aspects (risk of eating disorders, risk of mental disorder, depression), family problems and discrimination; with no associations with substance use (alcohol, cannabis or tobacco) being found. Concerning the time of Internet use, weekly hours were significantly higher in women than in men, both the total time as for leisure. The analysis of the profile use in problematic users revealed that males are related to aspects of entertainment such as games or shopping online and females are related to aspects of socialization, such as chats and social networks.

Group discussions with structured reminiscence and a problem-based method as an intervention to prevent depressive symptoms in older people.

PubMed

Djukanović, Ingrid; Carlsson, Jörg; Peterson, Ulla

2016-04-01

To evaluate the effect of group discussions, in which structured reminiscence and a problem-based method were used, on depressive symptoms, quality of life and self-rated health among older people. Depressive symptoms in older people have a considerable impact on self-rated health and quality of life, with a high rate of co-morbidity and mortality. As the ageing population is growing, late-life depression is becoming an important public health problem and there is a need to find preventive interventions to avert unnecessary suffering. The study was quasi-experimental, with a one-group pretest-post-test design and follow-up after one year. Initially, a questionnaire was sent to the total population of 55-80-year-old retirees in a community in the northeast of Sweden, (n = 679). The questionnaire concerned demographics and covered areas such as health, depression and quality of life. The intervention consisted of group discussions where structured reminiscence and a problem-based method were used. The participants (n = 18) met 10 times under the guidance of a group-leader, a registered nurse educated in the method. Each session had different themes with a focus on positive memories but also on the present situation and the future. Parametric, nonparametric tests and content analysis were used. Participants evaluated the intervention positively, showed a decrease in depressive symptoms, an increase in self-rated health and experienced an increased autonomy. No long- lasting effect was seen. Group discussions where structured reminiscence and a problem-based method are used might be an option to prevent depressive symptoms in older people. This method might provide an opportunity for older people with depressive symptoms to improve their quality of life, however, to maintain the positive outcome the intervention should probably be continuous. © 2016 John Wiley & Sons Ltd.

Evaluating risk factors for protein-energy malnutrition in children under the age of six years: a case-control study from Iran

PubMed Central

Sharghi, Afshan; Kamran, Aziz; Faridan, Mohammad

2011-01-01

Introduction: Protein-energy malnutrition is one of the most important public health problems in Iran. It not only accounts for more than half of child mortality but can also produce somatic and mental impairment in survivors. The main aim of this study was to identify risk factors for protein-energy malnutrition in children under 6 years of age in Namin city. Methods: This was a population-based, multicenter case-control study. Seventy-six children with malnutrition and 76 children without malnutrition were randomly recruited for case and control groups. The prevalence of risk factors in the two groups was compared. Data were gathered from a health center database and interviews with mothers and health workers. The Wilcoxon signed-rank test and logistic regression were used for data analysis. Results: Female gender, poverty, short maternal height, and use of unhygienic latrines in the home were significantly associated with childhood malnutrition (P < 0.05). Conclusion: The results of this study indicate four main factors (poverty, small maternal height, female gender, and absence of hygienic latrines in the home) as underlying factors in malnutrition of children under the age of 6 years. PMID:21887115

College Health: Health Services and Common Health Problems

MedlinePlus

... Guides Quizzes Parents About Us Donate General Health Sexual Health Medical Conditions Nutrition & Fitness Emotional Health College Health: ... disabilities, nutrition issues or eating disorders, relationship problems, sexual health issues, alcohol or drug problems, or sports injuries. ...

Protein energy malnutrition in India: the plight of our under five children.

PubMed

Bhutia, Dechenla Tshering

2014-01-01

Protein energy malnutrition (PEM) is a major public health problem in India. This affects the child at the most crucial period of time of development, which can lead to permanent impairment in later life. PEM is measured in terms of underweight (low weight for age), stunting (low height for age) and wasting (low weight for height). The prevalence of stunting among under five is 48% and wasting is 19.8% and with an underweight prevalence of 42.5%, it is the highest in the world. Undernutrition predisposes the child to infection and complements its effect in contributing to child mortality. Lalonde model (1974) is used to look into the various determinants of PEM in under five children and its interrelation in causation of PEM. The determinants of PEM are broadly classified under four distinct categories: Environmental factors including the physical and social environment, behavioral factors, health-care service related and biological factors. The socio-cultural factors play an important role wherein, it affects the attitude of the care giver in feeding and care practices. Faulty feeding practice in addition to poor nutritional status of the mother further worsens the situation. The vicious cycle of poor nutritional status of the mother leading to low birth weight child further exposes the child to susceptibility to infections which aggravates the situation. However, it is seen that percapita income of the family did not have much bearing on the poor nutritional status of the child rather lack of proper health-care services adversely contributed to poor nutritional status of the child. PEM is a critical problem with many determinants playing a role in causing this vicious cycle of undernutrition. With almost half of under five children undernourished in India, the Millennium Development Goal (MDG) of halving the prevalence of underweight by 2015 seems a distant dream.

Behavioral health needs and problem recognition by older adults receiving home-based aging services.

PubMed

Gum, Amber M; Petkus, Andrew; McDougal, Sarah J; Present, Melanie; King-Kallimanis, Bellinda; Schonfeld, Lawrence

2009-04-01

Older adults' recognition of a behavioral health need is one of the strongest predictors of their use of behavioral health services. Thus, study aims were to examine behavioral health problems in a sample of older adults receiving home-based aging services, their recognition of behavioral health problems, and covariates of problem recognition. The study design was cross-sectional. Older adults (n = 141) receiving home-based aging services completed interviews that included: Structured Clinical Interview for DSM-IV; Brief Symptom Inventory-18; attitudinal scales of stigma, expectations regarding aging, and thought suppression; behavioral health treatment experience; and questions about recognition of behavioral health problems. Thirty (21.9%) participants received an Axis I diagnosis (depressive, anxiety, or substance); another 17 (12.1%) were diagnosed with an adjustment disorder. Participants were more likely to recognize having a problem if they had an Axis I diagnosis, more distress on the BSI-18, family member or friend with a behavioral health problem, and greater thought suppression. In logistic regression, participants who identified a family member or friend with a behavioral health problem were more likely to identify having a behavioral health problem themselves. Findings suggest that older adults receiving home-based aging services who recognize behavioral health problems are more likely to have a psychiatric diagnosis or be experiencing significant distress, and they are more familiar with behavioral health problems in others. This familiarity may facilitate treatment planning; thus, older adults with behavioral health problems who do not report familiarity of problems in others likely require additional education. (c) 2008 John Wiley & Sons, Ltd.

Public health programs as surrogates for social action in Suriname, South America.

PubMed

Peplow, Daniel; Augustine, Sarah

2015-01-01

This paper addresses the merits of public health activism that advocates for social change in which health is the outcome of interest. We acknowledge that while efforts at the individual level are important, social network models consider the underlying mechanisms that lie outside the public health sector. This paper considers the inequitable health of Indigenous people who bear a disproportionate share of the negative health consequences due to economic development programs that follow an assimilation model. This paper discusses a combination of theoretical constructs to understand and solve the problems at hand. It concludes that while the attention paid to technological and behavioral solutions at the individual level yields important health outcomes, attention should also be paid to structural causes that address social, political and economic barriers to prevent disease, disability and premature death. © The Author(s) 2014.

Study of health related responses to air pollution of persons with chronic obstructive pulmonary disease in Houston, Texas. Final report

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

Johnson, D.E.; Prevost, R.J.; Kimball, K.T.

1979-03-01

The study is a longitudinal epidemiological study of the health problems of Houston residents of diverse backgrounds who have been determined to have allergic asthma, chronic bronchitis, and/or pulmonary emphysema. Throughout this report, persons with one or more of these three health problems are classified as having Chronic Obstructive Pulmonary Disease, or COPD. The use of the term COPD provides a consistent shortform for indicating the disease state of participants and is intended to be interpreted only as defined here, i.e., that each study participant has been determined to have one or more of the pulmonary disorders listed. Persons withmore » COPD were selected as a study group because they are especially sensitive to respiratory stimulants. The overall objective was to determine what variations, if any, in the health status of persons determined to have COPD might be attributed to daily variations in their outdoor environment. To this purpose, the specific objectives have been to determine: (1) The daily occurrence of clinical manifestations of the underlying respiratory diseases and (2) The strength of associations among the various health related and environmental variables.« less

Clinical Aspects of Foot Health in Individuals with Alzheimer's Disease.

PubMed

López-López, Daniel; Grela-Fariña, Marta; Losa-Iglesias, Marta Elena; Calvo-Lobo, César; Rodríguez-Sanz, David; Palomo-López, Patricia; Becerro-de-Bengoa-Vallejo, Ricardo

2018-02-07

Alzheimer's disease (AD) shows a marked presence of physiologic changes and the start or aggravation of underlying diseases such as physical frailty in diverse anatomical regions. It is believed to have a particularly harmful effect on the health of the foot. We examined the foot health status in older persons with AD, with a specific focus on the extent to which people with AD may be using inadequate footwear in old age. Seventy-three community-dwelling people with probable, mild to moderate AD aged 65-95 years were recruited from a center of excellence for AD. A single trained physician evaluated health status and foot conditions. Current shoe and foot length and width measurements were taken using a calibrated Brannock device. The results indicate that sixty-five participants (89.04%) suffered from feet problems. Also, only twenty-two subjects (30.14%) used the correct shoes in width and size related with the morphology of their feet. Fifty-one participants (69.86%) were using incorrect shoes in length or width. The present study revealed that peoples with AD had a high presence of foot health problems. Also, the use of inappropriate shoes revealed measurable differences of association between shoe size and the morphology of the foot.

21 CFR 338.50 - Labeling of nighttime sleep-aid drug products.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for more than 2 weeks, consult your doctor. Insomnia may be a symptom of serious underlying medical illness.” (3) “Do not take this product, unless directed by a doctor, if you have a breathing problem such....50 Section 338.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN...

A Model for Healthy Change in Our Nation's Schools

ERIC Educational Resources Information Center

Geddis, Alicia M.

2011-01-01

The general health of school-age children is in the national spotlight, and school lunches are falling under scrutiny. Many of the food options that schools offer seem to be contributing to the obesity problem. Schools can play a critical role in promoting healthier eating habits through their wellness policies and participation in the National…

Returning to School after a Concussion: Facilitating Problem Solving through Effective Communication

ERIC Educational Resources Information Center

Bradley-Klug, Kathy L.; Garofano, Jeffrey; Lynn, Courtney; DeLoatche, Kendall Jeffries; Lam, Gary Yu Hin

2015-01-01

Concussions are a major public health concern in the United States, especially among children and adolescents. Although there is a growing body of literature regarding the underlying physiologic processes that occur after a concussion, there is no consensus regarding the risk factors for a concussion or the reasons for significant differences in…

Connecting with Frequent Adolescent Visitors to the School Nurse through the Use of Intentional Interviewing

ERIC Educational Resources Information Center

Pavletic, Adria C.

2011-01-01

Nurses as accessible, helping adults within schools have daily opportunities to reach adolescents with unmet mental health needs. Understanding the relationship between frequent clinic visits or somatic complaints as a sign of underlying problems, which may be organic or psychoemotional in origin, requires the unique skill set of the school nurse.…

Patterns of Risk: The Nutritional Status of the Rural Poor.

ERIC Educational Resources Information Center

Shotland, Jeffrey; Loonin, Deanne

Nutrition and health are underlying influences to education performance. This report is a collection and analysis of data on nutrition and the rural poor in the United States. It presents an empirical assessment of critical nutritional and social-service problems experienced by the rural poor population. The first section of the report uses data…

The Alcohol Perception (AP) Project: A Study of the Perceptions of Adolescents toward Alcohol

ERIC Educational Resources Information Center

Hernandez, Marlow; DeGraff, Shawna; Suciu, Gabriel; Perez, Alina; Dodds, John; Burton, Kelli

2011-01-01

Four million individuals under the age of 21 admit to consuming alcohol in any given month. This is a significant statistic considering alcohol is responsible for most health problems related to drugs among adolescents. Research has shown that the high influence of alcohol advertising may encourage adolescents to emulate the behaviors seen in…

Problem Formulation for Human Health Risk Assessments of Pathogens in Land-Applied Biosolids (External Review Draft)

EPA Science Inventory

This is a draft document and as such has not been formally disseminated by the U.S. EPA; it does not represent - and should not be construed to represent - any U.S. EPA policy or determination. Under applicable information quality guidelines, the document is being released for a...

Ageing in India: Financial hardship from health expenditures.

PubMed

Lee, Ting-Hsuan J; Saran, Indrani; Rao, Krishna D

2018-04-01

India's rapidly ageing population raises concerns about the burden of health care payments among older individuals who may have both limited income and greater health care needs. Using a nationally representative household survey, we investigate the association between age and financial hardship due to health expenditures. We find that both the probability of experiencing health problems and mean total out-of-pocket health expenditures increase with age. Second, the probability of households experiencing catastrophic health expenditures increases with each additional member aged 60 and above-33% of households with one 60+ member and 38% of households with 2 or more 60+ members experienced catastrophic health expenditures, compared to only 20% in households with all members under the age of 60 years. Lastly, we show that individuals aged 60 and above had a much higher probability of becoming impoverished as a result of health expenditures-the probability of impoverishment for 60+ individuals was 3 percentage points higher than for individuals under the age of 60. Overall, around 4.8% of the older population, representing 4.1 million people, fell into poverty. The results suggest that there is an urgent need for public investments in financial protection programs for older people in India. Copyright © 2017 John Wiley & Sons, Ltd.

Perception of primary school teachers to school children's mental health problems in Southwest Ethiopia.

PubMed

Kerebih, Habtamu; Abrha, Hailay; Frank, Reiner; Abera, Mubarek

2016-11-12

Teachers perception of child mental health problems and their attitude to school-based mental health services helps in designing early intervention strategies aimed at promoting the service. However, little is known in this regard among primary school teachers in Ethiopia. Therefore, this study assessed perceptions and attitude of primary school teachers to child mental health problem and school-based mental health programs in Jimma town, southwest Ethiopia in 2013. A cross-sectional study design was implemented among 568 primary school teachers in Jimma town, from 1 to 30 October 2013. Perceptions and attitude of teachers to children with mental health problems and school mental health related information were assessed using a structured self- administered questionnaire. About 40% of teachers recognized the list of psychopathology items presented to them as child mental health problems while 54.4% of them rated child mental health problem as severe. Externalizing behaviors were perceived as the most severe problems. Teaching experience and teaching in public schools were significantly associated with the perception of severe type of child mental health problems. About 95% of teachers acknowledged that school-based mental health programs are important but limited availability was reported. Despite the high problem severity ratings, teachers' perception of the psychopathology as a mental health problem in children was low. There was also a favorable attitude on the importance and the need of school-based child mental health programs. Thus, creating mental health awareness for teachers and establishing school mental health services to intervene in child mental health problem is crucial.

A Changing Landscape for Vitamin A Programs: Implications for Optimal Intervention Packages, Program Monitoring, and Safety.

PubMed

Klemm, Rolf D W; Palmer, Amanda C; Greig, Alison; Engle-Stone, Reina; Dalmiya, Nita

2016-06-01

Vitamin A deficiency (VAD) remains a widespread public health problem in the developing world, despite changes in under-5 mortality rates, morbidity patterns, and intervention options. This article considers the implications of a changing epidemiologic and programmatic landscape for vitamin A (VA) programs. We review progress to prevent VAD and its health consequences, assess gaps in VA status and intervention coverage data, and assess data needed to guide decisions regarding the optimal mix, targeting, and dose of VA interventions to maximize benefit and minimize risk. Vitamin A supplementation programs have contributed to the reduction in under-5 mortality rates, but alone, do not address the underlying problem of inadequate dietary VA intakes and VAD among preschool-aged children in the developing world. A combination of VA interventions (eg, supplementation, fortified foods, multiple micronutrient powders, and lipid-based nutrient supplements) will be required to achieve VA adequacy in most settings. Current efforts to measure the coverage of multiple VA interventions, as well as whether and how much VA children are receiving, are few and fragmented. Where intervention overlap exists, further effort is needed to monitor VA intakes, ensuring that targeted groups are consuming adequate amounts but not exceeding the tolerable upper intake level. Vitamin A status data will also be critical for navigating the changing landscape of VA programs. Data from these monitoring efforts will help to guide decisions on the optimal mix, targeting, and exposure to VA interventions to maximize public health benefit while minimizing any potential risk. © The Author(s) 2016.

Amelogenesis Imperfecta; Genes, Proteins, and Pathways

PubMed Central

Smith, Claire E. L.; Poulter, James A.; Antanaviciute, Agne; Kirkham, Jennifer; Brookes, Steven J.; Inglehearn, Chris F.; Mighell, Alan J.

2017-01-01

Amelogenesis imperfecta (AI) is the name given to a heterogeneous group of conditions characterized by inherited developmental enamel defects. AI enamel is abnormally thin, soft, fragile, pitted and/or badly discolored, with poor function and aesthetics, causing patients problems such as early tooth loss, severe embarrassment, eating difficulties, and pain. It was first described separately from diseases of dentine nearly 80 years ago, but the underlying genetic and mechanistic basis of the condition is only now coming to light. Mutations in the gene AMELX, encoding an extracellular matrix protein secreted by ameloblasts during enamel formation, were first identified as a cause of AI in 1991. Since then, mutations in at least eighteen genes have been shown to cause AI presenting in isolation of other health problems, with many more implicated in syndromic AI. Some of the encoded proteins have well documented roles in amelogenesis, acting as enamel matrix proteins or the proteases that degrade them, cell adhesion molecules or regulators of calcium homeostasis. However, for others, function is less clear and further research is needed to understand the pathways and processes essential for the development of healthy enamel. Here, we review the genes and mutations underlying AI presenting in isolation of other health problems, the proteins they encode and knowledge of their roles in amelogenesis, combining evidence from human phenotypes, inheritance patterns, mouse models, and in vitro studies. An LOVD resource (http://dna2.leeds.ac.uk/LOVD/) containing all published gene mutations for AI presenting in isolation of other health problems is described. We use this resource to identify trends in the genes and mutations reported to cause AI in the 270 families for which molecular diagnoses have been reported by 23rd May 2017. Finally we discuss the potential value of the translation of AI genetics to clinical care with improved patient pathways and speculate on the possibility of novel treatments and prevention strategies for AI. PMID:28694781

Amelogenesis Imperfecta; Genes, Proteins, and Pathways.

PubMed

Smith, Claire E L; Poulter, James A; Antanaviciute, Agne; Kirkham, Jennifer; Brookes, Steven J; Inglehearn, Chris F; Mighell, Alan J

2017-01-01

Amelogenesis imperfecta (AI) is the name given to a heterogeneous group of conditions characterized by inherited developmental enamel defects. AI enamel is abnormally thin, soft, fragile, pitted and/or badly discolored, with poor function and aesthetics, causing patients problems such as early tooth loss, severe embarrassment, eating difficulties, and pain. It was first described separately from diseases of dentine nearly 80 years ago, but the underlying genetic and mechanistic basis of the condition is only now coming to light. Mutations in the gene AMELX , encoding an extracellular matrix protein secreted by ameloblasts during enamel formation, were first identified as a cause of AI in 1991. Since then, mutations in at least eighteen genes have been shown to cause AI presenting in isolation of other health problems, with many more implicated in syndromic AI. Some of the encoded proteins have well documented roles in amelogenesis, acting as enamel matrix proteins or the proteases that degrade them, cell adhesion molecules or regulators of calcium homeostasis. However, for others, function is less clear and further research is needed to understand the pathways and processes essential for the development of healthy enamel. Here, we review the genes and mutations underlying AI presenting in isolation of other health problems, the proteins they encode and knowledge of their roles in amelogenesis, combining evidence from human phenotypes, inheritance patterns, mouse models, and in vitro studies. An LOVD resource (http://dna2.leeds.ac.uk/LOVD/) containing all published gene mutations for AI presenting in isolation of other health problems is described. We use this resource to identify trends in the genes and mutations reported to cause AI in the 270 families for which molecular diagnoses have been reported by 23rd May 2017. Finally we discuss the potential value of the translation of AI genetics to clinical care with improved patient pathways and speculate on the possibility of novel treatments and prevention strategies for AI.

Study on Rural Ecological Conservation and Health Care Plan to Respond Aging Population

NASA Astrophysics Data System (ADS)

Zhao, Jing Yu; Fu, Fei

2018-05-01

The problem of aging is a problem that the society must face now. Under the rapid development and expansion of modern cities, the traditional village which is the back garden of the city depends on its advantages and characteristics of the farmland water network ecological infrastructure to develop the health planning. It is an important way to develop economic and ecological protection. However, the study of this direction is still in its infancy in china. This paper attempts to establish an adaptive POE evaluation model for elderly open space through the investigation and analysis, and further explore the physiological and psychological needs of the elderly for the environment. Based on the above survey data, this paper studies the planning and planning strategy of the health industry in the natural villages in the suburbs of Dujiangyan. From the point of view of sustainable development, it is more effective to protect and develop the ecological infrastructure of villages.

Nutritional challenges for children in societies in transition.

PubMed

Cai, Wei

2014-05-01

This review is to explore the childhood nutrition and health in relation to socioeconomic changes in transitional countries, and to describe the good experiences and policies in these countries to combat childhood nutritional challenges. Double burden of malnutrition - the coexistence of under-nutrition and over-nutrition in the same population - is a prominent public health concern in transitional countries. With rapid industrialization, these countries are facing a growing epidemic of overweight/obesity in children and adolescents. The increasing prevalence of childhood overweight/obesity is a likely consequence of behavioral changes, and accompanied with an increasing incidence of noncommunicable chronic diseases. Although remarkable improvement of childhood nutrition was achieved, the stunting growth and micronutrient deficiency remain to be child health issues in transitional countries. The social transition caused a broad range of nutrition-associated problems. Previous successful experiences indicated that if appropriate action is undertaken, the child nutritional problems accompanied with economic transition could be controlled to some extent. However, greater efforts are needed to improve the status of childhood nutrition in transitional countries.

DEVELOPMENT AND IMPLEMENTATION OF A PRACTICAL PUBLIC HEALTH TRAINING SYSTEM IN CHINA.

PubMed

Liu, Changjiang; Zhang, Junyue; Chen, Guoyuan; Yang, Kedi

2015-03-01

Public health education is becoming an increasing priority among educators of medicine. In China, little attention has been paid to public health education reform. A new public health training system was introduced in China in 2007. We conducted this study during 2006-2012 to evaluate the graduate core competencies under the new system. Data were collected from 231 graduates and 49 public health agencies. The 144 graduates who enrolled in 2006 and were trained under the old system constituted the control group; the 87 graduates who enrolled in 2007 and were trained under the new system constituted the experimental group. Surveys of graduate core competencies found analyzing and solving problems in the laboratory, conducting on-site practice and learning new technologies were the top three abilities most expected by public health agencies. After 5-year practical ability training, the graduates in the experimental group had better performance; on-site practical ability and laboratory practical ability increased significantly by 24.5% and 20.0%, respectively. Three other important competencies also improved: designing epidemiologic surveys, collecting information from the literature and doing statistical analyses. However, preventing and controlling common diseases and dealing with emergencies remained weak. These results show the new training system should be continued, but revisions are needed to improve this training system, especially in the areas of preventing and controlling common diseases and dealing with emergencies.

Future respiratory hospital admissions from wildfire smoke under climate change in the Western US

NASA Astrophysics Data System (ADS)

Coco Liu, Jia; Mickley, Loretta J.; Sulprizio, Melissa P.; Yue, Xu; Peng, Roger D.; Dominici, Francesca; Bell, Michelle L.

2016-12-01

Background. Wildfires are anticipated to be more frequent and intense under climate change. As a result, wildfires may emit more air pollutants that can harm health in communities in the future. The health impacts of wildfire smoke under climate change are largely unknown. Methods. We linked projections of future levels of fine particulate matter (PM2.5) specifically from wildfire smoke under the A1B climate change scenario using the GEOS-Chem model for 2046-2051, present-day estimates of hospital admission impacts from wildfire smoke, and future population projections to estimate the change in respiratory hospital admissions for persons ≥65 years by county (n = 561) from wildfire PM2.5 under climate change in the Western US. Results. The increase in intense wildfire smoke days from climate change would result in an estimated 178 (95% confidence interval: 6.2, 361) additional respiratory hospital admissions in the Western US, accounting for estimated future increase in the elderly population. Climate change is estimated to impose an additional 4990 high-pollution smoke days. Central Colorado, Washington and southern California are estimated to experience the highest percentage increase in respiratory admissions from wildfire smoke under climate change. Conclusion. Although the increase in number of respiratory admissions from wildfire smoke seems modest, these results provide important scientific evidence of an often-ignored aspect of wildfire impact, and information on their anticipated spatial distribution. Wildfires can cause serious social burdens such as property damage and suppression cost, but can also raise health problems. The results provide information that can be incorporated into development of environmental and health policies in response to climate change. Climate change adaptation policies could incorporate scientific evidence on health risks from natural disasters such as wildfires.

[Primary care in maternal-child health].

PubMed

Pedreira Massa, J L

1986-07-01

The theoretical and methodological elements of primary health care (PHC) include a philosophy of work and an epistemological focus toward the processes of health and illness, as well as a practical medical anthropological knowledge of the culture-specific aspects of disease. The work methodology of PHC requires care of the individual as a bio-psycho-socio-affective being integrated into a particular environment; none of the aspects of being should be neglected or given priority. Care should also be integrated in the sense of providing preventive health care as well as curative and rehabilitative services, in all phases from training of health personnel to record keeping. The primary health care team is multidisciplinary in constitution and interdisciplinary in function. PHC assumes that health care will be accessible to users and that continuity of care will be provided. The need for community participation in all phases of health care has been reiterated in several international health declarations. A well-functioning PHC system will require new types of pre- and postgraduate health education in a changing social and professional system and continuing education under adequate supervision for health workers. Research capability for identifying community health problems, a rigorous evaluation system, and epidemiologic surveillance are also needed. All of these elements are applicable to the field of maternal and child health as well as to PHC. The most appropriate place to intervene in order to correct existing imbalances in access to health care for mothers and children is in the PHC system. Examples of areas that should be stressed include vaccinations, nutrition, psychomotor development, early diagnosis and treatment for handicapped children, prevention of childhood accidents, school health and absenteeism, all aspects of health education, adoption and alternatives to abandonment of children, alcoholism and addiction, adolescent pregnancy and family planning, dental health, and mental problems. Trained primary care pediatricians working within the community as part of the PHC system will be required to confront and solve complex health problems. The training needed does not signify a new speciality or subspeciality, but rather a training methodology and a new type of professional practice.

Associations between work-related stress in late midlife, educational attainment, and serious health problems in old age: a longitudinal study with over 20 years of follow-up.

PubMed

Nilsen, Charlotta; Andel, Ross; Fors, Stefan; Meinow, Bettina; Darin Mattsson, Alexander; Kåreholt, Ingemar

2014-08-27

People spend a considerable amount of time at work over the course of their lives, which makes the workplace important to health and aging. However, little is known about the potential long-term effects of work-related stress on late-life health. This study aims to examine work-related stress in late midlife and educational attainment in relation to serious health problems in old age. Data from nationally representative Swedish surveys were used in the analyses (n = 1,502). Follow-up time was 20-24 years. Logistic regressions were used to examine work-related stress (self-reported job demands, job control, and job strain) in relation to serious health problems measured as none, serious problems in one health domain, and serious problems in two or three health domains (complex health problems). While not all results were statistically significant, high job demands were associated with higher odds of serious health problems among women but lower odds of serious health problems among men. Job control was negatively associated with serious health problems. The strongest association in this study was between high job strain and complex health problems. After adjustment for educational attainment some of the associations became statistically nonsignificant. However, high job demands, remained related to lower odds of serious problems in one health domain among men, and low job control remained associated with higher odds of complex health problems among men. High job demands were associated with lower odds of complex health problems among men with low education, but not among men with high education, or among women regardless of level of education. The results underscore the importance of work-related stress for long-term health. Modification to work environment to reduce work stress (e.g., providing opportunities for self-direction/monitoring levels of psychological job demands) may serve as a springboard for the development of preventive strategies to improve public health both before and after retirement.

Children with mental versus physical health problems: differences in perceived disease severity, health care service utilization and parental health literacy.

PubMed

Dey, Michelle; Wang, Jen; Jorm, Anthony Francis; Mohler-Kuo, Meichun

2015-03-01

To compare children with mental and physical health problems regarding (1) perceived disease severity; (2) the impact of their condition on their families; (3) their utilization of health care services (including satisfaction with care); and (4) parents' health literacy about their child's condition and its treatment. Furthermore, we examined whether parents' health literacy differs between types of mental health condition. Parental reports about their 9- to 14-year-old children with mental (n = 785) or physical health problems (n = 475) were analyzed from the population-based National Survey of Children with Special Health Care Needs in Switzerland. Mental health problems were perceived as being more severe (p < 0.001) and exerting a larger impact upon the family (e.g., financial impact) than physical health problems. Furthermore, fewer parents of children with a mental health problem mentioned having a particular person or place to contact if they needed information or advice regarding the child's condition (p = 0.004) and were satisfied with the health care services their child received (p < 0.001). The odds of low health literacy was higher among parents with children suffering from mental health problems vs. parents of children with physical health problems (OR in the adjusted model = 1.92; 95 % CI 1.47-2.50; p < 0.001); this finding held generally for mental health problem (although only a trend was observable for internalizing problems). The large impact of children's mental health conditions on themselves and their families might be reduced by adapting the provision of health care and by increasing parents' health literacy.

The nutrition transition in China: a cross-sectional analysis.

PubMed

Popkin, B M; Keyou, G; Zhai, F; Guo, X; Ma, H; Zohoori, N

1993-05-01

Diets and activity patterns are changing rapidly in low-income countries, and problems of undernutrition and overnutrition commonly exist side by side. China has conquered problems of food scarcity at the national level and has undergone a remarkable transition in the structure of its diet in the last decade. In this paper, we use data from the 1989 China Health and Nutrition Survey and national data from the State Statistical Bureau to explore China's recent history with respect to nutrition and to identify patterns of under- and overnutrition. In particular, we see that higher income levels, particularly in urban areas, are associated with consumption of a diet higher in fat and with problems of obesity. At the same time, undernutrition is a problem in important segments of Chinese society. There is a need for the Chinese government to consider ways to address these problems of deficit and excess jointly.

Practice nurses mental health provide space to patients to discuss unpleasant emotions.

PubMed

Griep, E C M; Noordman, J; van Dulmen, S

2016-03-01

WHAT IS KNOWN ON THE SUBJECT?: A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Patients with mild psychosocial and psychological problems provide signs of worrying or express a clear unpleasant emotion in 94% of consultations with a practice nurse mental health. Nurses' responses to patients' signs of worrying or clear unpleasant emotions were mostly characterized by providing space for patients to talk about these emotions, by using minimal responses. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Practice nurses' mental health have passive listening skills, and to a lesser extent, use active listening techniques. Accurate emotion detection and the ability to pick out emotional signs during consultations must also be considered as an important skill for health providers to improve patient-centred communication. Patients with physical problems are known to express their emotional concerns in an implicit way only. Whether the same counts for patients presenting mental health problems in primary care is unknown. This study aims to examine how patients with mild psychosocial and psychological complaints express their concerns during consultations with the practice nurse mental health and how practice nurses respond to these expressions. Fifteen practice nurses mental health working in Dutch general practices participated in the study. Their consultations with 116 patients with mild psychosocial or psychological complaints were video recorded. patients' explicitly expressed emotional concerns and more implicit expressions of underlying emotional problems (cues) as well as nurses' responses to these expressions were rated using the Verona Coding Definition of Emotional Sequences. Almost all consultations contained at least one cue or concern (94%). Nurses' responses were mostly characterized by providing space for patients to talk about their cue or concern in a non-explicit way (62%), by using minimal responses (42%). Practice nurses mental health have passive listening skills, and to a lesser extent, use active listening techniques. However, there are no strict rules which way of responding is the best and patients value responses differently. © 2015 John Wiley & Sons Ltd.

Respiratory health screening for opiate misusers in a specialist community clinic: a mixed-methods pilot study, with integrated staff and service user feedback

PubMed Central

Mitchell, Caroline Anne; Pitt, Alice; Hulin, Joe; Lawson, Rod; Ashby, Fleur; Appelqvist, Ivan; Delaney, Brigitte

2016-01-01

Objectives Increased rates of illicit drug inhalation are thought to expose opiate misusers (OMUs) to an enhanced risk of respiratory health problems. This pilot study aimed to determine the feasibility of undertaking respiratory screening of OMUs in a community clinic. Setting Single-centre UK community substance misuse clinic. Participants All clinic attendees receiving treatment for opiate misuse were eligible to participate. 36 participants (mean age=37) were recruited over a 5-week period. The sample included 26 males and 10 females. Outcome measures Spirometry without bronchodilation; health related quality of life EQ-5D-3L; Asthma Control Test; Mini Asthma Quality of Life; Clinical COPD Questionnaire and the Treatment Outcome Profile were used to assess the respiratory health of participants. Findings were discussed with staff and service users in 2 patient and public involvement events and feedback was analysed thematically. Results 34 participants reported that they had smoked heroin. 8 participants diagnosed with asthma, scored under 13 on the Asthma Control Test, suggesting poorly controlled asthma. Participants (n=28), without a diagnosis of asthma completed the Lung Function Questionnaire. Of these, 79% produced scores under 18, indicating symptoms associated with the development of chronic obstructive pulmonary disease. Spirometry showed 14% of all participants had forced expiratory volume in 1 s/forced vital capacity <0.7 (without bronchodilator), indicating potential obstructive lung disease. Feedback from service users and staff suggested a willingness and capacity to deliver respiratory health screening programmes. Insight towards the difficulties service users have in accessing services and the burden of respiratory health was also provided. Conclusions It is feasible to undertake respiratory health screening of OMUs in a community clinic. Larger screening studies are warranted to determine the prevalence of respiratory health problems in this population. Research regarding asthma medicines adherence and access to healthcare among OMUs is also required. PMID:27742632

Quality of life assessment in children: a review of conceptual and methodological issues in multidimensional health status measures.

PubMed Central

Pal, D K

1996-01-01

STUDY OBJECTIVE: To clarify concepts and methodological problems in existing multidimensional health status measures for children. DESIGN: Thematic review of instruments found by computerised and manual searches, 1979-95. SUBJECTS: Nine health status instruments. MAIN RESULTS: Many instruments did not satisfy criteria of being child centered or family focussed; few had sufficient psychometric properties for research or clinical use; underlying conceptual assumptions were rarely explicit. CONCLUSIONS: Quality of life measures should be viewed cautiously. Interdisciplinary discussion is required, as well as discussion with children and parents, to establish constructs that are truly useful. PMID:8882220

How temporary insurance for high-risk individuals may play out under health reform.

PubMed

Chollet, Deborah J

2010-06-01

The Patient Protection and Affordable Care Act guarantees that people with health problems will be able to buy private health insurance as of 2014. In the interim, a new federal high-risk program will accept those who are denied private insurance and have not found coverage from any other source. Such sources include a state high-risk pool or, in a handful of states, a designated carrier of last resort. However, restricted eligibility for the federal program suggests that state high-risk pools, in particular, will continue to be critical yet problematic sources of coverage for the next few years.

The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome.

PubMed

Kohro, Takahide; Furui, Yuji; Mitsutake, Naohiro; Fujii, Ryo; Morita, Hiroyuki; Oku, Shinya; Ohe, Kazuhiko; Nagai, Ryozo

2008-03-01

Similar to the healthcare systems in other industrialized countries, the Japanese healthcare system is facing the problem of increasing medical expenditure. In Japan, this situation may be primarily attributed to advanced technological developments, an aging population, and increasing patient demand. Japan also faces the problem of a declining youth population due to a low birth rate. Taken together, these problems present the healthcare system with a very difficult financial situation. Several reforms have been undertaken to contain medical expenditure, such as increasing employee copayment for health insurance from 10% to 20% in 1997 and from 20% to 30% in 2003 in order to curb unnecessary visits to medical institutions. Since the aging of the Japanese population is inevitable, a suitable method to contain medical expenditure may be to screen individuals who are likely to develop lifestyle-related diseases and conduct early intervention programs for them to prevent the development of diseases such as myocardial infarction or stroke that are costly to treat. If this goal is attained, it may contribute to the containment of medical expenditure as well as to improving the quality of life of the elderly. Therefore, the Japanese Ministry of Health, Labor and Welfare has decided to introduce a nationwide health screening and intervention program specifically targeting the metabolic syndrome commencing April 2008. Here, we discuss (1) the background of the Japanese healthcare system and the problems facing it, (2) the underlying objective and details of the new screening program, and (3) the expected impact of the program.

Poor Pre-Pregnancy and Antepartum Mental Health Predicts Postpartum Mental Health Problems among US Women: A Nationally Representative Population-Based Study

PubMed Central

Witt, Whitney P.; Wisk, Lauren E.; Cheng, Erika R.; Hampton, John M.; Creswell, Paul; Hagen, Erika W.; Spear, Hilary A.; Maddox, Torsheika; DeLeire, Thomas

2011-01-01

Purpose Mental health problems disproportionately affect women, particularly during childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. Methods We examined data on 1,863 mothers from eleven panels of the 1996-2006 Medical Expenditure Panel Survey (MEPS). Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of “fair” or “poor.” Results 9.5% of women reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor pre-pregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between pre-pregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. Conclusions While poor antepartum mental health is the strongest predictor of postpartum mental health problems, pre-pregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health, as they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond. PMID:21349740

Perceived problem solving, stress, and health among college students.

PubMed

Largo-Wight, Erin; Peterson, P Michael; Chen, W William

2005-01-01

To study the relationships among perceived problem solving, stress, and physical health. The Perceived Stress Questionnaire (PSQ), Personal Problem solving Inventory (PSI), and a stress-related physical health symptoms checklist were used to measure perceived stress, problem solving, and health among undergraduate college students (N = 232). Perceived problem-solving ability predicted self-reported physical health symptoms (R2 = .12; P < .001) and perceived stress (R2 = .19; P < .001). Perceived problem solving was a stronger predictor of physical health and perceived stress than were physical activity, alcohol consumption, or social support. Implications for college health promotion are discussed.

Trajectories of pure and co-occurring internalizing and externalizing problems from age 2 to age 12: findings from the National Institute of Child Health and Human Development Study of Early Child Care.

PubMed

Fanti, Kostas A; Henrich, Christopher C

2010-09-01

How and why do internalizing and externalizing problems, psychopathological problems from different diagnostic classes representing separate forms of psychopathology, co-occur in children? We investigated the development of pure and co-occurring internalizing and externalizing problems from ages 2 to 12 with the use of latent class growth analysis. Furthermore, we examined how early childhood factors (temperament, cognitive functioning, maternal depression, and home environment) and early adolescent social and behavioral adjustment variables were related to differential trajectories of pure and co-occurring internalizing and externalizing problems. The sample (National Institute of Child Health and Human Development Study of Early Child Care) consisted of 1,232 children (52% male). Mother reports on the Child Behavior Checklist (Achenbach, 1991, 1992) were used to construct the trajectories of externalizing and internalizing problems. Analyses identified groups of children exhibiting pure and co-occurring internalizing and externalizing problems. Children exhibiting continuous externalizing or continuous co-occurring internalizing and externalizing problems across the 10-year period under investigation were more likely to (a) engage in risky behaviors, (b) be associated with deviant peers, (c) be rejected by peers, and (d) be asocial with peers at early adolescence. However, children exhibiting pure internalizing problems over time were only at higher risk for being asocial with peers as early adolescents. Moreover, the additive effects of individual and environmental early childhood risk factors influenced the development of chronic externalizing problems, although pure internalizing problems were uniquely influenced by maternal depression. Results also provided evidence for the concepts of equifinality and multifinality.

The value of public health research and the division between basic vs. applied science.

PubMed

Almeida-Filho, Namoar; Goldbaum, Moisés

2003-02-01

We question the movement towards exclusion of population and social health research from the field of science. The background under analysis is contemporary Brazil, where the scientific field that hosts this kind of research is known as Collective Health. First, the problem is formalized on logical grounds, evaluating the pertinence of considering unscientific the many objects and methods of public health research. Secondly, the cases of pulmonary tuberculosis and external causes are brought in as illustrations of the kind of scientific problem faced in health research today. The logical and epistemological basis of different forms of "scientific segregation" based on biomedical reductionism is analyzed, departing from three theses: (i) the ethics of the general application of science; (ii) the inappropriateness of monopolies for objectivity in the sciences; (iii) the specificity of scientific fields. In the current panorama of health research in Brazil, a residual hegemonic position that defends a narrow and specific definition of the object of knowledge was found. The denial of validity and specificity to objects, methods and research techniques that constitute social and population research in health is linked to elements of irrationality in reductionism approaches. Nevertheless, efforts should be directed to overcome this scientific division, in order to develop a pluralist and interdisciplinary national science, committed to the health care realities of our country.

Osteoporosis: A Future Public Health Problem for Israel? Medical and Legal Obligations.

PubMed

Weisz, George M

2017-04-01

Starvation in early life can lead to premature metabolic syndrome and bone demineralization. Osteoporosis in the Jewish population may not yet be a recognized syndrome, but the harsh conditions to which Holocaust survivors were exposed may have increased the incidence of the condition. Immigrants and refugees who came to Israel from East Africa and Yemen - whether decades ago or more recently - may have been at increased risk of under-nutrition during pregnancy, affecting both the mother and consequently the offspring. This malnutrition may be further exacerbated by rapid overfeeding in the adopted developed country. This problem was also recognized at the turn of the 21st century in poor and underdeveloped countries and is becoming a global public health issue. In this review, the risks for premature metabolic syndrome and bone demineralization are enumerated and preventive measures outlined.

Lost opportunities for intervention: undetected markers for the development of serious juvenile delinquency.

PubMed

Stouthamer-Loeber, Magda; Loeber, Rolf

2002-01-01

Persistent serious delinquency in young males rarely starts without a history of problem behaviour in childhood. This paper addresses the following questions: (1) At what age does persistent serious offending emerge for the first time? (2) What proportion of persistent serious delinquent boys qualifies for a diagnosis of a disruptive behaviour disorder? (3) What proportion of persistent serious delinquent boys receive help for their behavioural or educational problems, either from mental health professionals or from personnel at school? Eight waves of assessments from the oldest sample (ages 13 to 18.5) of the Pittsburgh Youth Study were used to classify boys as persistent serious violent offenders, persistent serious property offenders, persistent non-serious offenders, and non-offenders based on their self-reports. Juvenile court records, diagnostic information and information about help for mental health problems were used. Almost half of the boys who eventually become a persistent serious offender already have an onset of their serious delinquent behaviour by age 12. Two-thirds of the boys who come to the attention of the juvenile court already had behaviour problems for at least five years, and one-third were diagnosed as having a disruptive behaviour disorder by age 13. However, less than half of the persistent serious delinquents had received any help from either mental health professionals or from personnel in schools. Early behaviour problems and a diagnosis of disruptive behaviour disorder constitute targets for intervention. The relatively low rate of interventions for boys with these problems and who later become persistent serious offenders indicates a high under-utilization of opportunities to prevent serious delinquency by parents and professionals.

Improving access to health care for undocumented immigrants in the United States.

PubMed

Wallace, Steven P; Rodriguez, Michael; Padilla-Frausto, Imelda; Arredondo, Armando; Orozco, Emanuel

2013-01-01

To identify policies that increase access to health care for undocumented Mexican immigrants. Four focus groups (n=34 participants) were conducted with uninsured Mexican immigrants in Los Angeles, California. The feasibility and desirability of different policy proposals for increasing access were discussed by each group. Respondents raised significant problems with policies including binational health insurance, expanded employer-provided health insurance, and telemedicine. The only solution with a consensus that the change would be feasible, result in improved access, and they had confidence in was expanded access to community health centers (CHC's). Given the limited access to most specialists at CHC's and the continued barriers to hospital care for those without health insurance, the most effective way of improving the complete range of health services to undocumented immigrants is through immigration reform that will bring these workers under the other health care reform provisions.

Parity for mental health and substance abuse care under managed care.

PubMed

Frank, Richard G.; McGuire, Thomas G.

1998-12-01

BACKGROUND: Parity in insurance coverage for mental health and substance abuse has been a key goal of mental health and substance abuse care advocates in the United States during most of the past 20 years. The push for parity began during the era of indemnity insurance and fee for service payment when benefit design was the main rationing device in health care. The central economic argument for enacting legislation aimed at regulating the insurance benefit was to address market failure stemming from adverse selection. The case against parity was based on inefficiency related to moral hazard. Empirical analyses provided evidence that ambulatory mental health services were considerably more responsive to the terms of insurance than were ambulatory medical services. AIMS: Our goal in this research is to reexamine the economics of parity in the light of recent changes in the delivery of health care in the United States. Specifically managed care has fundamentally altered the way in which health services are rationed. Benefit design is now only one mechanism among many that are used to allocate health care resources and control costs. We examine the implication of these changes for policies aimed at achieving parity in insurance coverage. METHOD: We develop a theoretical approach to characterizing rationing under managed care. We then analyze the traditional efficiency concerns in insurance, adverse selection and moral hazard in the context of policy aimed at regulating health and mental health benefits under private insurance. RESULTS: We show that since managed care controls costs and utilization in new ways parity in benefit design no longer implies equal access to and quality of mental health and substance abuse care. Because costs are controlled by management under managed care and not primarily by out of pocket prices paid by consumers, demand response recedes as an efficiency argument against parity. At the same time parity in benefit design may accomplish less with respect to providing a remedy to problems related to adverse selection.

Categorizing health-related cues to action: using Yelp reviews of restaurants in Hawaii

NASA Astrophysics Data System (ADS)

Ariyasriwatana, W.; Buente, W.; Oshiro, M.; Streveler, D.

2014-10-01

Yelp, a social media site, undeniably has an influence on consumers' food choice in spite of its ability to reflect consumers' real voice being criticized. Since unhealthy food choices contribute to health problems, such as obesity and malnourishment, we attempted to examine these problems by better understanding consumers through health-related cues to action-a construct from the Health Belief Model (HBM)- on Yelp Honolulu's restaurant reviews. Our research revealed 13 main categories: Ingredient, Type of food, Taste, Lifestyle, Cooking, Option, Price, Portion, Well-being, Nutrition, Hygiene, Emotional attachment and indulgence, and Feeling. We argue that these categories may ultimately lead consumers to make healthier food choices. In search of the most appealing way to communicate with the target group, underlying concepts that derived from these categories can be tested. Marketers in food industry (or public health policy-makers) can craft their strategies for healthy food brands/products (or healthy eating scheme) based on the concept test research. Moreover, Yelp can apply these insights in the development of their algorithm and filter system in order to help consumers find healthy food if they wish to do so. Restaurants can also improve their strategy, menu, and communication execution to meet the growing demands of health conscious consumers.

Youth with chronic health problems: how do they fare in main-stream mentoring programs?

PubMed

Lipman, Ellen L; DeWit, David; DuBois, David L; Larose, Simon; Erdem, Gizem

2018-01-05

Youth with chronic physical health problems often experience social and emotional problems. We investigate the relationship between participation in the Big Brothers Big Sisters of Canada community-based mentoring programs (BBBS) and youth social and mood outcomes by youth health status. Youth newly enrolled in BBBS were classified by health status (one or more chronic physical health problems without activity limitation, n = 191; one or more chronic physical health problems with activity limitation, n = 94; no chronic health problem or activity limitation, n = 536) and mentoring status (yes/no) at 18 month follow-up. Youth outcomes measured at follow-up were social anxiety, depressed mood, and peer self-esteem. Youth with chronic health problems and activity limitation were more likely to live with two biological parents, use mental health or social services, and have parents who reported difficulties with depressed mood, social anxiety, family functioning and neighbourhood problems. At 18 month follow-up, mentored youth in this health status group experienced fewer symptoms of social anxiety and higher peer self-esteem compared to non-mentored youth. Mentored youth with chronic health problems without activity limitation and mentored youth with no health problems or limitations did not show significant improvements in social anxiety and peer self-esteem. Regardless of their health status, mentored youth reported fewer symptoms of depressed mood than non-mentored youth. Youth with chronic health problems, particularly those with activity limitation as well, demonstrate a capacity to experience social and mood benefits associated with mentoring.

Structural health monitoring of cylindrical bodies under impulsive hydrodynamic loading by distributed FBG strain measurements

NASA Astrophysics Data System (ADS)

Fanelli, Pierluigi; Biscarini, Chiara; Jannelli, Elio; Ubertini, Filippo; Ubertini, Stefano

2017-02-01

Various mechanical, ocean, aerospace and civil engineering problems involve solid bodies impacting the water surface and often result in complex coupled dynamics, characterized by impulsive loading conditions, high amplitude vibrations and large local deformations. Monitoring in such problems for purposes such as remaining fatigue life estimation and real time damage detection is a technical and scientific challenge of primary concern in this context. Open issues include the need for developing distributed sensing systems able to operate at very high acquisition frequencies, to be utilized to study rapidly varying strain fields, with high resolution and very low noise, while scientific challenges mostly relate to the definition of appropriate signal processing and modeling tools enabling the extraction of useful information from distributed sensing signals. Building on previous work by some of the authors, we propose an enhanced method for real time deformed shape reconstruction using distributed FBG strain measurements in curved bodies subjected to impulsive loading and we establish a new framework for applying this method for structural health monitoring purposes, as the main focus of the work. Experiments are carried out on a cylinder impacting the water at various speeds, proving improved performance in displacement reconstruction of the enhanced method compared to its previous version. A numerical study is then carried out considering the same physical problem with different delamination damages affecting the body. The potential for detecting, localizing and quantifying this damage using the reconstruction algorithm is thoroughly investigated. Overall, the results presented in the paper show the potential of distributed FBG strain measurements for real time structural health monitoring of curved bodies under impulsive hydrodynamic loading, defining damage sensitive features in terms of strain or displacement reconstruction errors at selected locations along the structure.

Survey of attitudes and behaviors toward alcohol and other drug use in allied health and physician assistant students.

PubMed

Baldwin, Jeffrey N; Davis-Hall, R Ellen; DeSimone, Edward M; Scott, David M; Agrawal, Sangeeta; Reardon, Thomas P

2008-01-01

Attitudes and behaviors toward alcohol and other drug (AOD) use were assessed among a subgroup of allied health (AH) and physician assistant (PA) students within two university-based health professions educational institutions in a midwestern state in 1999. AH/PA student response was 423 (77.5%); this included occupational therapy (n = 81; 60.4%), physical therapy [PT] (n = 222; 98.7%), PA (n = 68; 85.0%), and other AH programs (n = 52; 48.1%). In this AH/PA group, a family history of alcohol-related problems was reported by 40.1% and drug-related problems by 11.3%, with 42.5% of respondents reporting one or both. Such histories of family alcohol and drug problems were reported by 47.8% or 18.5% of PA students, respectively. Past-year alcohol, tobacco, and marijuana use were reported, respectively, by 88.1%, 26.1%, and 6.7%. The highest percentage use of marijuana was reported by PT students (9.0%). Past-year blackouts were reported by 21.9%, driving after three or more drinks or any drug use by 49.3%, attendance at class or work under the influence of AOD by 7.8%, patient care under the influence of AOD by 3.3%, lowered grades or job evaluations from AOD use by 5.0%, and AOD-related legal charges by 4.5%. "Heavy drinking" (defined as consumption of five or more drinks per occasion during the past 2 weeks) was reported by 33.2%. Inadequate AOD education was reported by 55.1%, with 63.6% of PT respondents so reporting. AH and PA educational systems should proactively address student AOD prevention, education, and assistance needs.

Influence of Child Factors on Health-Care Professionals' Recognition of Common Childhood Mental-Health Problems.

PubMed

Burke, Delia A; Koot, Hans M; de Wilde, Amber; Begeer, Sander

Early recognition of childhood mental-health problems can help minimise long-term negative outcomes. Recognition of mental-health problems, needed for referral and diagnostic evaluation, is largely dependent on health-care professionals' (HCPs) judgement of symptoms presented by the child. This study aimed to establish whether HCPs recognition of mental-health problems varies as a function of three child-related factors (type of problem, number of symptoms, and demographic characteristics). In an online survey, HCPs ( n  = 431) evaluated a series of vignettes describing children with symptoms of mental-health problems. Vignettes varied by problem type (Attention-Deficit/Hyperactivity Disorder (ADHD), Generalised Anxiety Disorder (GAD), Autism Spectrum Disorder (ASD), Conduct Disorder (CD) and Major Depressive Disorder), number of symptoms presented (few and many), and child demographic characteristics (ethnicity, gender, age and socio-economic status (SES)). Results show that recognition of mental-health problems varies by problem type, with ADHD best recognised and GAD worst. Furthermore, recognition varies by the number of symptoms presented. Unexpectedly, a child's gender, ethnicity and family SES did not influence likelihood of problem recognition. These results are the first to reveal differences in HCPs' recognition of various common childhood mental-health problems. HCPs in practice should be advised about poor recognition of GAD, and superior recognition of ADHD, if recognition of all childhood mental-health problems is to be equal.

Physical health problems among patients seeking treatment for alcohol use disorders: a study in six European cities.

PubMed

Gossop, Michael; Neto, Domingos; Radovanovic, Mirjana; Batra, Anil; Toteva, Sonya; Musalek, Michael; Skutle, Arvid; Goos, Cees

2007-06-01

The present study investigates physical health problems among patients with alcohol use disorders at alcohol treatment agencies in six European cities. The sample comprised 315 patients with a primary alcohol use disorder. Data were collected at admission to treatment using a structured research protocol, and ratings were made by a medically qualified physician subsequent to a physical examination of the patient. Physical health problems were extremely common: 79% of the sample had at least one problem, and 59% had two or more problems. Health problems were often serious, and 60% had at least one health problem that required treatment. The most common problems were gastrointestinal and liver disorders, but about a quarter of the sample had cardiovascular or neurological problems. Frequency of drinking, duration of alcohol use disorder, and severity of alcohol dependence were associated with increased physical morbidity. Current smoking status and age were also associated with poorer physical health. Older drinkers had more physical health problems although they were less severely alcohol dependent than their younger counterparts. The high prevalence of physical health problems among problem drinkers provides opportunities of screening for alcohol use disorders not only in specialist alcohol treatment services but also in other health-care settings. It is recommended that alcohol treatment agencies should provide a full routine health screen of patients at admission to treatment with provision or referral to appropriate treatment.

[The Common Risk Factor Approach - An Integrated Population- and Evidence-Based Approach for Reducing Social Inequalities in Oral Health].

PubMed

Heilmann, A; Sheiham, A; Watt, R G; Jordan, R A

2016-10-01

Worldwide, non-communicable diseases including dental caries and periodontal diseases, remain a major public health problem. Moreover, there is a social gradient in health across society that runs from the top to the bottom in a linear, stepwise fashion. Health promoting behaviours become more difficult to sustain further down the social ladder. Oral health inequalities also exist in Germany. Earlier explanations of social inequalities have mainly focused on individual lifestyle factors, ignoring the broader social determinants of health and disease. Until recently, the dominant approaches to general health promotion focused on actions to reduce specific diseases, separating oral health from general health. An alternative approach is the common risk factor approach (CRFA) where risk factors common to a number of major chronic diseases, including diseases of the mouth and teeth, are tackled. The CRFA focuses on the common underlying determinants of health to improve the overall health of populations, thereby reducing social inequalities. The main implication of the CRFA for oral health policies is to work in partnership with a range of other sectors and disciplines. Oral health issues need to be integrated with recommendations to promote general health. Improvements in oral health and a reduction in oral health inequalities are more likely by working in partnership across sectors and disciplines using strategies that focus upstream on the underlying determinants of oral diseases. © Georg Thieme Verlag KG Stuttgart · New York.

[Abortion in unsafe conditions. Concealment, illegality, corruption and negligence].

PubMed

Ortiz Ortega, A

1993-01-01

"Abortion practiced under conditions of risk" is a phrase used to refer to illegal abortion. The phrase does not highlight the disappearance of risk when legislation changes. Rather, it calls attention to the fact that legal restrictions significantly increase dangers while failing to discourage women determined to terminate pregnancies. The International Planned Parenthood Federation defines abortion under conditions of risk as the use of nonoptimal technology, lack of counseling and services to orient the woman's decision and provide postabortion counseling, and the limitation of freedom to make the decision. The phrase encompasses concealment, illegality, corruption, and negligence. It is designed to impose a reproductive health perspective in response to an unresolved social conflict. Steps have been developed to improve the situation of women undergoing abortion even without a change in its legal status. Such steps include training and purchase of equipment for treatment of incomplete abortions and development of counseling and family planning services. The central difficulty of abortion induced in conditions of risk derives from the laws imposing the need for secrecy. In Mexico, the abortion decision belongs to the government and the society, while individual absorb the consequences of the practice of abortion. Public decision making about abortion is dominated by the concept that the female has an obligation to carry any pregnancy to term. Women who interfere with male descendency and practice a sexuality distinct from reproduction are made to pay a price in health and emotional balance. Resolution of the problem of abortion will require new concepts in terms of legal status, public health issues, and the rights of women. The problem becomes more pressing as abortion becomes more common in a country anxious to advance in the demographic transition. Only a commitment to the reproductive health of women and the full development of their rights as citizens will permit a favorable outcome to the problem.

The geography of maternal and newborn health: the state of the art.

PubMed

Ebener, Steeve; Guerra-Arias, Maria; Campbell, James; Tatem, Andrew J; Moran, Allisyn C; Amoako Johnson, Fiifi; Fogstad, Helga; Stenberg, Karin; Neal, Sarah; Bailey, Patricia; Porter, Reid; Matthews, Zoe

2015-05-27

As the deadline for the millennium development goals approaches, it has become clear that the goals linked to maternal and newborn health are the least likely to be achieved by 2015. It is therefore critical to ensure that all possible data, tools and methods are fully exploited to help address this gap. Among the methods that are under-used, mapping has always represented a powerful way to 'tell the story' of a health problem in an easily understood way. In addition to this, the advanced analytical methods and models now being embedded into Geographic Information Systems allow a more in-depth analysis of the causes behind adverse maternal and newborn health (MNH) outcomes. This paper examines the current state of the art in mapping the geography of MNH as a starting point to unleashing the potential of these under-used approaches. Using a rapid literature review and the description of the work currently in progress, this paper allows the identification of methods in use and describes a framework for methodological approaches to inform improved decision-making. The paper is aimed at health metrics and geography of health specialists, the MNH community, as well as policy-makers in developing countries and international donor agencies.

Reframing inequality? The health inequalities turn as a dangerous frame shift.

PubMed

Lynch, Julia

2017-12-01

Politicians in many countries have embraced the notion that health inequalities derive from socioeconomic inequalities, but European governments have for the most part failed to enact policies that would reduce underlying social inequalities. Data are drawn from 84 in-depth interviews with policy-makers in four European countries between 2012 and 2015, qualitative content analysis of recent health inequalities policy documents, and secondary literature on the barriers to implementing evidence-based health inequalities policies. Institutional and political barriers are important barriers to effective policy. Both policy-making institutions and the ideas and practices associated with neoliberalism reinforce medical-individualist models of health, strengthen actors with material interests opposed to policies that would increase equity, and undermine policy action to tackle the fundamental causes of social (including health) inequalities. Medicalizing inequality is more appealing to most politicians than tackling income and wage inequality head-on, but it results in framing the problem of social inequality in a way that makes it technically quite difficult to solve. Policy-makers should consider adopting more traditional programs of taxation, redistribution and labor market regulation in order to reduce both health inequalities and the underlying social inequalities. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The right to health under international law and its relevance to the United States.

PubMed

Yamin, Alicia Ely

2005-07-01

In recent years, there have been considerable developments in international law with respect to the normative definition of the right to health, which includes both health care and healthy conditions. These norms offer a framework that shifts the analysis of issues such as disparities in treatment from questions of quality of care to matters of social justice. Building on work in social epidemiology, a rights paradigm explicitly links health with laws, policies, and practices that sustain a functional democracy and focuses on accountability. In the United States, framing a well-documented problem such as health disparities as a "rights violation" attaches shame and blame to governmental neglect. Further, international law offers standards for evaluating governmental conduct as well as mechanisms for establishing some degree of accountability.

Work–family conflict and health in Swedish working women and men: a 2-year prospective analysis (the SLOSH study)

PubMed Central

Baltzer, Maria; Magnusson Hanson, Linda L.; Westerlund, Hugo

2013-01-01

Background: Research has suggested that gender is related to perceptions of work–family conflict (WFC) and an underlying assumption is that interference of paid work with family life will burden women more than men. There is, however, mixed evidence as to whether men and women report different levels of WFC. Even less studies investigate gender differences in health outcomes of WFC. Also the number of longitudinal studies in this field is low. Methods: Based on the Swedish Longitudinal Occupational Survey of Health, we prospectively examined the effects of WFC on three different health measures representing a wide spectrum off ill health (i.e. self-rated health, emotional exhaustion and problem drinking). Logistic regression analyses were used to analyse multivariate associations between WFC in 2008 and health 2 years later. Results: The results show that WFC was associated with an increased risk of emotional exhaustion among both men and women. Gender differences are suggested as WFC was related to an increased risk for poor self-rated health among women and problem drinking among men. Interaction analyses revealed that the risk of poor self-rated health was substantially more influenced by WFC among women than among men. Conclusions: We conclude that, despite the fact that women experience conflict between work and family life slightly more often than men, both men’s and women’s health is negatively affected by this phenomenon. PMID:22683777

Health System Development and Performance in Korea and Japan: A Comparative Study of 2000–2013

PubMed Central

Dronina, Yuliya; Yoon, Young Min; Sakamaki, Hiroyuki; Nam, Eun Woo

2016-01-01

Background The Japanese and Korean healthcare systems are very similar and thus, they have the same problems and weaknesses. This study discusses the problems and proposes complementary solutions based on the results of a comparative analysis of conditions in the healthcare systems of the two countries. Methods This article presents a comparative analysis of the healthcare status of the two countries based on certain health criteria used worldwide, a literature review, and data from the Korean Ministry of Health and Welfare, Japanese Ministry of Health, Labour and Welfare, World Health Organization (WHO), World Bank, and Organization for Economic Cooperation and Development (OECD). Results The scores of the healthcare systems were calculated for quantitative comparison. The performance of the Japanese health system was the best, followed by the Korean health system. Both countries observed an increased life expectancy and decreased infant and under-five mortality rates during the last 14 years. However, lower fertility rates were found, which could lead to a decreased working population and a subsequent increase in the economic burden of governments and households. A higher alcohol consumption rate was found in Korea, which was related to the establishment of interpersonal relationships. Conclusion The reform of the healthcare systems in Korea and Japan led to an increased life expectancy; concurrently, reduced fertility rates led to an increasing aging population. As a result, increasing health costs require additional measures to improve health equity and strengthen health promotion. PMID:27358836

Implementation of a rehabilitation model for employees on long-term sick leave in the public sector: difficulties, counter-measures, and outcomes.

PubMed

Heijbel, Bodil; Josephson, Malin; Vingård, Eva

2013-01-01

The aim was threefold: 1) to describe the experiences of driving and implementing a workplace-based rehabilitation intervention in cooperation with the occupational health service (OHS); 2) to investigate which people received multimodal and/or vocational rehabilitation measures; 3) to find predictors of return to work (RTW). Altogether 779 employees on sick leave for 90 days or more with mainly musculoskeletal or psychological/stress-related problems, 90% women. The HAKuL model was introduced, implying an early team assessment at the OHS and good access to rehabilitation measures. The study is a prospective three-year study with a two-year follow-up. The rehabilitation intervention encountered challenges. Counter-measures were taken to facilitate coordination and communication. People with musculoskeletal problems often received both multimodal and vocational rehabilitation. Vocational rehabilitation was advocated for people who were under 55 years of age, and for those with stress-related problems. The strongest predictive factors for RTW were: having received only vocational rehabilitation and being under 45 years of age. The HAKuL model can be used in a wider context, but the study shows the need for coordination between multiple stakeholders. Supervisors should pay attention to people who have musculoskeletal problems and are older, as soon as problems emerge.

[An epidemiologic study of health care seeking behavior of children under 5 years of age by sex in developing countries].

PubMed

Tursz, A; Crost, M

1999-10-01

Since the end of the 1970's, excess mortality among girls, from the end of the neonatal period until the age of 4 years, has been observed in some South Asian countries. Explanatory hypotheses for this situation have in fact noted differences by sex in food allocation and in care during illness. In some North African and sub-Saharan countries in Africa, mortality data suggest the same type of phenomenon, but less reliable statistics and a lack of data analysis by sex on use of health services does not really allow clarification of the problem. The objective of this study was to analyse health seeking behaviour by sex and to identify explanatory factors for any differences found. A cross sectional study of 1560 consultations of under-5 children was carried out in 6 university and regional hospitals in 3 African countries: Algeria (the zones of Aïn Taya and Tigzirt); Togo (the zones of Lomé, Atakpamé and Kara) and the Congo (Brazzaville). Results confirm the existence of discrimination against girls. In ways which vary according to zones, and in comparison to boys, observations of girls show: under-representation among outpatients (29% in Tigzirt, 40% in Kara), especially when they have many siblings, of which some are sisters; longer duration of the development of symptoms before first resort (leading to increased severity of symptoms); less investment in health care; detrimental feeding practices. Higher SES of the father plays a favourable role, especially for girls, and children of both sexes benefit when the mother has a good educational level. The large regional differences demonstrate the complex interaction among explanatory factors: rurality, problems of access to the hospital, low economic level, low social status of women. This research opens the way so that, in Africa, research will no longer be carried out on health seeking behaviour and utilisation of health services without examining separately the situation of boys and girls, and analysing the possible causes of any differences.

What explains violated expectations of parent-child relationship in transition to parenthood?

PubMed

Flykt, Marjo; Palosaari, Esa; Lindblom, Jallu; Vänskä, Mervi; Poikkeus, Piia; Repokari, Leena; Tiitinen, Aila; Tulppala, Maija; Punamäki, Raija-Leena

2014-04-01

Parent-child relationship is created already in prenatal fantasies and expectations of the child-to-be. Negative violation of these expectations after the child is born is known to be harmful for the parent-child relationship. Yet, research is scarce about the medical and psychological factors contributing to violated expectations (VE). This study models the role of parent-, delivery- and infant-related underlying mechanisms for VE. It further compares parents with assisted reproductive treatment (ART) and spontaneous conception (SC), and primi- and multiparous couples. The couples (n = 743) separately filled in questionnaires concerning their prenatal expectations (T1) and 2 months postnatal representations (T2) of intimacy and autonomy in the relationship with their child, measured with Subjective Family Picture Test. A negative or positive discrepancy indicated violated expectations. The parent-related (mental health and marital quality), delivery-related (maternal and paternal birth experience, unplanned Caesarean, and amount of analgesia) and infant-related (infant health problems, difficult infant characteristics, and parental worry) factors were assessed at T2. Results show that among mothers, the associations were mostly indirect and mediated via mental health problems. Among fathers, the associations were direct, marital problems most crucially predicting VE. ART fathers were less susceptible to VE resulting from infant-related problems than SC fathers, but more susceptible to VE resulting from delivery problems. Delivery- and infant-related factors also predicted VE differently among primi- and multiparous mothers. Considering factors that contribute to VE is important when working with couples in transition to parenthood. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Unsuccessfully Treated Hypertension: A Major Public Health Problem With a Potential Solution.

PubMed

Furberg, Curt D; Sealey, Jean E; Blumenfeld, Jon D

2017-09-01

About one-half of all hypertensive adults do not have their blood pressure controlled. They are often prescribed medications that conform to national guidelines but they continue to have elevated blood pressure. This public health problem might be improved by applying plasma renin guided therapy. A contributor to the public health problem of unsuccessfully treated hypertension is that the circulating renin-angiotensin system (RAS) is not recognized in treatment guidelines as clinically relevant for the treatment of hypertension or as important as the body salt status for determining blood pressure levels. Another contributor to the problem is the lack of specificity in the package inserts for antihypertensive drugs. They do not specifically state under the heading "Indications" that RAS blockers are primarily most effective in hypertensive subjects with medium and high plasma renin levels; by contrast, natriuretic drugs are most effective in those with low plasma renin levels. Literature review. To address the problem of unsuccessfully treated hypertension, we recommend that the "Indications" section of package inserts for antihypertensive drugs be more specific. The primary indication for RAS blockers ought to be hypertension with medium and high plasma renin levels, and natriuretic agents for those with low plasma renin levels. Similar language ought to be added to treatment guidelines. Additionally, 3 other reasons for lack of blood pressure control also need to be addressed-failure to prescribe antihypertensive drugs to hypertensive subjects, failure of patients to fill prescriptions, and low drug adherence. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis.

PubMed

van Rijn, Rogier M; Carlier, Bouwine E; Schuring, Merel; Burdorf, Alex

2016-04-01

Given the importance of unemployment in health inequalities, re-employment of unemployed persons into paid employment may be a powerful intervention to increase population health. It is suggested that integrated programmes of vocational reintegration with health promotion may improve the likelihood of entering paid employment of long-term unemployed persons with severe mental health problems. However, the current evidence regarding whether entering paid employment of this population will contribute to a reduction in health problems remains unambiguous. This systematic review and meta-analysis aimed to assess the effects of re-employment programmes with regard to health and quality of life. Three electronic databases were searched (up to March 2015). Two reviewers independently selected articles and assessed the risk of bias on prespecified criteria. Measures of effects were pooled and random effect meta-analysis of randomised controlled trials was conducted, where possible. Sixteen studies were included. Nine studies described functioning as an outcome measure. Five studies with six comparisons provided enough information to calculate a pooled effect size of -0.01 (95% CI -0.13 to 0.11). Fifteen studies presented mental health as an outcome measure of which six with comparable psychiatric symptoms resulted in a pooled effect size of 0.20 (95% CI -0.23 to 0.62). Thirteen studies described quality of life as an outcome measure. Seven of these studies, describing eight comparisons, provided enough information to calculate a pooled effect size of 0.28 (95% CI 0.04 to 0.52). Re-employment programmes have a modest positive effect on the quality of life. No evidence was found for any effect of these re-employment programmes on functioning and mental health. 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/

Coping with post-war mental health problems among survivors of violence in Northern Uganda: Findings from the WAYS study.

PubMed

Amone-P'Olak, Kennedy; Omech, Bernard

2018-05-01

Cognitive emotion regulation strategies and mental health problems were assessed in a sample of war-affected youth in Northern Uganda. Univariable and multivariable regression models were fitted to assess the influence of CERS on mental health problems. Maladaptive cognitive emotion regulation strategies (e.g., rumination) were significantly associated with more mental health problems while adaptive cognitive emotion regulation strategies (e.g., putting into perspective) were associated with reporting fewer symptoms of mental health problems. The youth with significant scores on mental health problems (scores ≥ 85th percentile) reported more frequent use of maladaptive than adaptive strategies. Interventions to reduce mental health problems should focus on enhancing the use of adaptive strategies.

What are the health needs, familial and social problems of Thai migrants in a local community in Australia? A focus group study.

PubMed

Vatcharavongvan, Pasitpon; Hepworth, Julie; Lim, Joanne; Marley, John

2014-02-01

This study explored the health needs, familial and social problems of Thai migrants in a local community in Brisbane, Australia. Five focus groups with Thai migrants were conducted. The qualitative data were examined using thematic content analysis that is specifically designed for focus group analysis. Four themes were identified: (1) positive experiences in Australia, (2) physical health problems, (3) mental health problems, and (4) familial and social health problems. This study revealed key health needs related to chronic disease and mental health, major barriers to health service use, such as language skills, and facilitating factors, such as the Thai Temple. We concluded that because the health needs, familial and social problems of Thai migrants were complex and culture bound, the development of health and community services for Thai migrants needs to take account of the ways in which Thai culture both negatively impacts health and offer positive solutions to problems.

Conflicting health information: a critical research need.

PubMed

Carpenter, Delesha M; Geryk, Lorie L; Chen, Annie T; Nagler, Rebekah H; Dieckmann, Nathan F; Han, Paul K J

2016-12-01

Conflicting health information is increasing in amount and visibility, as evidenced most recently by the controversy surrounding the risks and benefits of childhood vaccinations. The mechanisms through which conflicting information affects individuals are poorly understood; thus, we are unprepared to help people process conflicting information when making important health decisions. In this viewpoint article, we describe this problem, summarize insights from the existing literature on the prevalence and effects of conflicting health information, and identify important knowledge gaps. We propose a working definition of conflicting health information and describe a conceptual typology to guide future research in this area. The typology classifies conflicting information according to four fundamental dimensions: the substantive issue under conflict, the number of conflicting sources (multiplicity), the degree of evidence heterogeneity and the degree of temporal inconsistency. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Does Racism Harm Health? Did Child Abuse Exist Before 1962? On Explicit Questions, Critical Science, and Current Controversies: An Ecosocial Perspective

PubMed Central

Krieger, Nancy

2003-01-01

Research on racism as a harmful determinant of population health is in its infancy. Explicitly naming a long-standing problem long recognized by those affected, this work has the potential to galvanize inquiry and action, much as the 1962 publication of the Kempe et al. scientific article on the “battered child syndrome” dramatically increased attention to—and prompted new research on—the myriad consequences of child abuse, a known yet neglected social phenomenon. To further work on connections between racism and health, the author addresses 3 interrelated issues: (1) links between racism, biology, and health; (2) methodological controversies over how to study the impact of racism on health; and (3) debates over whether racism or class underlies racial/ethnic disparities in health. PMID:12554569

Does Racism Harm Health? Did Child Abuse Exist Before 1962? On Explicit Questions, Critical Science, and Current Controversies: An Ecosocial Perspective

PubMed Central

Krieger, Nancy

2008-01-01

Research on racism as a harmful determinant of population health is in its infancy. Explicitly naming a long-standing problem long recognized by those affected, this work has the potential to galvanize inquiry and action, much as the 1962 publication of the Kempe et al. scientific article on the “battered child syndrome” dramatically increased attention to—and prompted new research on—the myriad consequences of child abuse, a known yet neglected social phenomenon. To further work on connections between racism and health, the author addresses 3 interrelated issues: (1) links between racism, biology, and health; (2) methodological controversies over how to study the impact of racism on health; and (3) debates over whether racism or class underlies racial/ethnic disparities in health. PMID:18687614

The influence of chronic health problems on work ability and productivity at work: a longitudinal study among older employees.

PubMed

Leijten, Fenna R M; van den Heuvel, Swenne G; Ybema, Jan Fekke; van der Beek, Allard J; Robroek, Suzan J W; Burdorf, Alex

2014-09-01

This study aimed to assess the influence of chronic health problems on work ability and productivity at work among older employees using different methodological approaches in the analysis of longitudinal studies. Data from employees, aged 45-64, of the longitudinal Study on Transitions in Employment, Ability and Motivation was used (N=8411). Using three annual online questionnaires, we assessed the presence of seven chronic health problems, work ability (scale 0-10), and productivity at work (scale 0-10). Three linear regression generalized estimating equations were used. The time-lag model analyzed the relation of health problems with work ability and productivity at work after one year; the autoregressive model adjusted for work ability and productivity in the preceding year; and the third model assessed the relation of incidence and recovery with changes in work ability and productivity at work within the same year. Workers with health problems had lower work ability at one-year follow-up than workers without these health problems, varying from a 2.0% reduction with diabetes mellitus to a 9.5% reduction with psychological health problems relative to the overall mean (time-lag). Work ability of persons with health problems decreased slightly more during one-year follow-up than that of persons without these health problems, ranging from 1.4% with circulatory to 5.9% with psychological health problems (autoregressive). Incidence related to larger decreases in work ability, from 0.6% with diabetes mellitus to 19.0% with psychological health problems, than recovery related to changes in work ability, from a 1.8% decrease with circulatory to an 8.5% increase with psychological health problems (incidence-recovery). Only workers with musculoskeletal and psychological health problems had lower productivity at work at one-year follow-up than workers without those health problems (1.2% and 5.6%, respectively, time-lag). All methodological approaches indicated that chronic health problems were associated with decreased work ability and, to a much lesser extent, lower productivity at work. The choice for a particular methodological approach considerably influenced the strength of the associations, with the incidence of health problems resulting in the largest decreases in work ability and productivity at work.

Bibliometric analysis of medicine-related publications on poverty (2005-2015).

PubMed

Sweileh, Waleed M; Al-Jabi, Samah W; Sawalha, Ansam F; AbuTaha, Adham S; Zyoud, Sa'ed H

2016-01-01

Poverty is a global problem. The war against poverty requires not only financial support, but also poverty-related research to pinpoint areas of high need of intervention. In line with international efforts to fight poverty and negative consequences, we carried out this study to give a bibliometric overview of medicine-related literature on poverty. Such a s study is an indicator of the extent of interaction of various international key players on the war against poverty-related health problems. Scopus was used to achieve the objective of this study. The time span set for this study was 2005-2015. Poverty-related articles under the subject area "Medicine" were used to give bibliometric indicators such as annual growth of publications, international collaboration, highly cited articles, active countries, institutions, journals, and authors. The total number of retrieved articles was 1583. The Hirsh-index of retrieved articles was 56. A modest and fluctuating increase was seen over the study period. Visualization map of retrieved articles showed that "HIV", infectious diseases, mental health, India, and Africa were most commonly encountered terms. No significant dominance of any particular author or journal was observed in retrieved articles. The United States of America had the largest share in the number of published articles. The World Health Organization and Centers for Disease Prevention and Control were among top active institutions/organizations. International collaboration was observed in less than one third of publications. Top cited articles focused on three poverty-related health issues, mainly, infectious diseases, malnutrition, and child development/psychology. Most of top articles were published in high impact journals. Data indicated that articles on poverty were published in high influential medical journals indicative of the importance of poverty as a global health problem. However, the number publications and the extent of international collaborations was lower than expected given the huge burden of poverty-related health problems.

Knowledge-based nursing diagnosis

NASA Astrophysics Data System (ADS)

Roy, Claudette; Hay, D. Robert

1991-03-01

Nursing diagnosis is an integral part of the nursing process and determines the interventions leading to outcomes for which the nurse is accountable. Diagnoses under the time constraints of modern nursing can benefit from a computer assist. A knowledge-based engineering approach was developed to address these problems. A number of problems were addressed during system design to make the system practical extended beyond capture of knowledge. The issues involved in implementing a professional knowledge base in a clinical setting are discussed. System functions, structure, interfaces, health care environment, and terminology and taxonomy are discussed. An integrated system concept from assessment through intervention and evaluation is outlined.

The Need to Reevaluate Nonresponding Ergonomic Patients

NASA Technical Reports Server (NTRS)

Scarpa, Philip J.; Field, Steven A.

1999-01-01

The Kennedy Space Center (KSC) Environmental Health (EH) contractor performs ergonomic evaluations under its Ergonomic Program. Any KSC employee may request one or the reviewing physician may request one for a patient during a visit to an onsite medical facility. As part of the ergonomic evaluation, recommendations are given to the patient to help reduce any ergonomic problems they experience. The recommendations, if implemented, are successful in the majority of KSC patients; however, a group of patients do not seem to improve. Those who don't improve may be identified by reevaluations, which are performed to implement maximum resolution of ergonomic problems.

Roundtable. Women's magazines under the guise of being frank about sexual problems are sensationalizing them to boost readership.

PubMed

Khawar, H

1995-01-01

Women's magazines in Pakistan edit their content to avoid matters related to female sexuality. Instead, they focus on fashion, child care, general health, and social problems. Only a few stories have emerged about sex clinics in Karachi, the covert homosexual culture, and exploits of well-known people. This reticence makes the dissemination of information about contraception and AIDS difficult. Even the cover models on the magazines must appear clothed in a manner deemed proper. Foreign magazines are available in Pakistan, but they cost more than the local publications.

The genetic pleiotropy of musculoskeletal aging

PubMed Central

Karasik, David; Cohen-Zinder, Miri

2012-01-01

Musculoskeletal aging is detrimental to multiple bodily functions and starts early, probably in the fourth decade of an individual's life. Sarcopenia is a health problem that is expected to only increase as a greater portion of the population lives longer; prevalence of the related musculoskeletal diseases is similarly expected to increase. Unraveling the biological and biomechanical associations and molecular mechanisms underlying these diseases represents a formidable challenge. There are two major problems making disentangling the biological complexity of musculoskeletal aging difficult: (a) it is a systemic, rather than “compartmental,” problem, which should be approached accordingly, and (b) the aging per se is neither well defined nor reliably measurable. A unique challenge of studying any age-related condition is a need of distinguishing between the “norm” and “pathology,” which are interwoven throughout the aging organism. We argue that detecting genes with pleiotropic functions in musculoskeletal aging is needed to provide insights into the potential biological mechanisms underlying inter-individual differences insusceptibility to the musculoskeletal diseases. However, exploring pleiotropic relationships among the system's components is challenging both methodologically and conceptually. We aimed to focus on genetic aspects of the cross-talk between muscle and its “neighboring” tissues and organs (tendon, bone, and cartilage), and to explore the role of genetics to find the new molecular links between skeletal muscle and other parts of the “musculoskeleton.” Identification of significant genetic variants underlying the musculoskeletal system's aging is now possible more than ever due to the currently available advanced genomic technologies. In summary, a “holistic” genetic approach is needed to study the systems's normal functioning and the disease predisposition in order to improve musculoskeletal health. PMID:22934054

Policy, politics and public health.

PubMed

Greer, Scott L; Bekker, Marleen; de Leeuw, Evelyne; Wismar, Matthias; Helderman, Jan-Kees; Ribeiro, Sofia; Stuckler, David

2017-10-01

If public health is the field that diagnoses and strives to cure social ills, then understanding political causes and cures for health problems should be an intrinsic part of the field. In this article, we argue that there is no support for the simple and common, implicit model of politics in which scientific evidence plus political will produces healthy policies. Efforts to improve the translation of evidence into policy such as knowledge transfer work only under certain circumstances. These circumstances are frequently political, and to be understood through systematic inquiry into basic features of the political economy such as institutions, partisanship and the organization of labour markets. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The just provision of health care: a reply to Elizabeth Telfer.

PubMed Central

Steiner, H

1976-01-01

Dr Hillel Steiner in this reply to Elizabeth Telfer takes each of her arguments for different arrangements of a health service and examines them--'four positions which can be located on a linear ideological spectrum'--and adds a fifth which could have the effect of 'turning the alleged linear spectrum into a circle'. Underlying both Elizabeth Telfer's article and Dr Steiner's reply, the base is inescapably a 'political' one, but cannot be abandoned in favour of purely philosophical concepts. Whatever the attitude of mind of the reader of these two papers to the provision of a health service, the stimulus to more careful assessments of our own National Health Service and its problems can only be good. PMID:1003436

Afghanistan's gender apartheid.

PubMed

Carlisle, D

This paper discusses the aftermath of gender apartheid in Afghanistan and its implications on the health care situation. Since 1996, when the radical Islamic Taliban movement took over two-thirds of Afghanistan, the country has faced severe restrictions. Women were told to stop working. Girls¿ schools were closed and access to health care was denied. To address this problem, Emma Bonino, the outspoken head of the European Community Humanitarian Office, has started an international campaign. Over the past 2 years the health care situation has somewhat improved. Women are now allowed to go to hospitals, provided that there are segregated male and female wards. In addition, female nurses are working in Afghan hospitals under certain conditions. The Taliban leaders have also allowed the health education program to continue.

Health information systems in the Islamic Republic of Iran: a case study in Kerman Province.

PubMed

Zolala, F

2011-09-01

Health information systems provide information for decision-making at all levels, from planning and management to evaluation of health services. Registration of vital events is the most basic level of any health information system. This case study used in-depth interviews, observations and examination of documents to explore the system of births and deaths registration in Kerman province. The findings were evaluated under 3 headings: data input, data processing and data usage. A range of problems were identified concerning legal requirements, staffing, data checking and publication of data. Different approaches are suggested to strengthen the system, such as introducing regulations to oblige different data sources to provide data and allocating sufficient resources, including human resources, and an improved technology infrastructure.

A review of childhood abuse, health, and pain-related problems: the role of psychiatric disorders and current life stress.

PubMed

Sachs-Ericsson, Natalie; Cromer, Kiara; Hernandez, Annya; Kendall-Tackett, Kathleen

2009-01-01

The current article reviews recent research demonstrating the relationship between childhood physical and sexual abuse and adult health problems. Adult survivors of childhood abuse have more health problems and more painful symptoms. We have found that psychiatric disorders account for some, but not all, of these symptoms, and that current life stress doubles the effect of childhood abuse on health problems. Possible etiologic factors in survivors' health problems include abuse-related alterations in brain functioning that can increase vulnerability to stress and decrease immune function. Adult survivors are also more likely to participate in risky behaviors that undermine health or to have cognitions and beliefs that amplify health problems. Psychiatric disorders, although not the primary cause of difficulties, do have a role in exacerbating health and pain-related problems. We conclude by outlining treatment recommendations for abuse survivors in health care settings.

Treating malnutrition in the community.

PubMed

Dera, Merceline; Woodham, Diane

2016-11-02

Malnutrition is a clinical and public health problem. It has adverse effects on the physical and psycho-social wellbeing of individuals by predisposing to disease, negatively affecting its outcome and reducing the likelihood of independence. An estimated 3 million people in the UK are affected by malnutrition, most of whom live in the community ( BAPEN, 2011 ). Despite the scale of this problem, it remains under-detected, under-treated, underresourced and often overlooked by those involved in the care of at risks individuals such as the elderly. In most cases malnutrition is a treatable condition that can be managed by optimising food intake and using oral nutritional supplements (ONS) where necessary. The main focus of this article is on the dangers of malnutrition for older people in the community and the use of ONS in the treatment and management of malnutrition.

Male Mating Competitiveness of a Wolbachia-Introgressed Aedes polynesiensis Strain under Semi-Field Conditions

PubMed Central

Bossin, Hervé; Dobson, Stephen L.

2011-01-01

Background Lymphatic filariasis (LF), a global public health problem affecting approximately 120 million people worldwide, is a leading cause of disability in the developing world including the South Pacific. Despite decades of ongoing mass drug administration (MDA) in the region, some island nations have not yet achieved the threshold levels of microfilaremia established by the World Health Organization for eliminating transmission. Previously, the generation of a novel Aedes polynesiensis strain (CP) infected with an exogenous type of Wolbachia has been described. The CP mosquito is cytoplasmically incompatible (i.e., effectively sterile) when mated with wildtype mosquitoes, and a strategy was proposed for the control of A. polynesiensis populations by repeated, inundative releases of CP males to disrupt fertility of wild females. Such a strategy could lead to suppression of the vector population and subsequently lead to a reduction in the transmission of filarial worms. Methodology/Principal Findings CP males and F1 male offspring from wild-caught A. polynesiensis females exhibit near equal mating competitiveness with F1 females under semi-field conditions. Conclusions/Significance While laboratory experiments are important, prior projects have demonstrated the need for additional testing under semi-field conditions in order to recognize problems before field implementation. The results reported here from semi-field experiments encourage forward progression toward small-scale field releases. PMID:21829750

Quantifying risk and accuracy in cancer risk assessment: the process and its role in risk management problem-solving.

PubMed

Turturro, A; Hart, R W

1987-01-01

A better understanding of chemical-induced cancer has led to appreciation of similarities to problems addressed by risk management of radiation-induced toxicity. Techniques developed for cancer risk assessment of toxic substances can be generalized to toxic agents. A recent problem-solving approach for risk management of toxic substances developed for the U.S. Department of Health and Human Services, and the role of risk assessment and how uncertainty should be treated within the context of this approach, is discussed. Finally, two different methods, research into the assumptions underlying risk assessment and the modification of risk assessment/risk management documents, are used to illustrate how the technique can be applied.

The impact of precarious employment on mental health: The case of Italy.

PubMed

Moscone, F; Tosetti, E; Vittadini, G

2016-06-01

Although there has been a sizeable empirical literature measuring the effect of job precariousness on the mental health of workers the debate is still open, and understanding the true nature of such relationship has important policy implications. In this paper, we investigate the impact of precarious employment on mental health using a unique, very large data set that matches information on job contracts for over 2.7 million employees in Italy followed over the years 2007-2011, with their psychotropic medication prescription. We examine the causal effects of temporary contracts, their duration and the number of contract changes during the year on the probability of having one or more prescriptions for medication to treat mental health problems. To this end, we estimate a dynamic Probit model, and deal with the potential endogeneity of regressors by adopting an instrumental variables approach. As instruments, we use firm-level probabilities of being a temporary worker as well as other firm-level variables that do not depend on the mental illness status of the workers. Our results show that the probability of psychotropic medication prescription is higher for workers under temporary job contracts. More days of work under temporary contract as well as frequent changes in temporary contract significantly increase the probability of developing mental health problems that need to be medically treated. We also find that moving from permanent to temporary employment increases mental illness; symmetrically, although with a smaller effect in absolute value, moving from temporary to permanent employment tends to reduce it. Policy interventions aimed at increasing the flexibility of the labour market through an increase of temporary contracts should also take into account the social and economic cost of these reforms, in terms of psychological wellbeing of employees. Copyright © 2016. Published by Elsevier Ltd.

Aristotle on drugs.

PubMed

Mercer, Tony

2013-01-01

This paper begins by examining the ethical issues in public health and attempts to resolve them. It then considers three different paradigms responding to heroin addiction and their underlying moral philosophy. Firstly it examines prohibition and abstinence only treatment as an example of deontological ethics and harm reduction approaches as an example of a utilitarian ethics. Policy and practice problems resulting from weaknesses in the underlying philosophies are examined along with the futile debate between abstinence only and harm reduction approaches. A third paradigm, 'recovery' is examined as an example of Aristotelian virtue ethics. The paper concludes by considering the wider implications of this case study in terms of the need for further bioethical enquiry in public health and proposes virtue ethics as a paradigm within which ethical issues can be identified and debated.

Association between school bullying levels/types and mental health problems among Taiwanese adolescents.

PubMed

Yen, Cheng-Fang; Yang, Pinchen; Wang, Peng-Wei; Lin, Huang-Chi; Liu, Tai-Ling; Wu, Yu-Yu; Tang, Tze-Chun

2014-04-01

Few studies have compared the risks of mental health problems among the adolescents with different levels and different types of bullying involvement experiences. Bullying involvement in 6,406 adolescents was determined through use of the Chinese version of the School Bullying Experience Questionnaire. Data were collected regarding the mental health problems, including depression, suicidality, insomnia, general anxiety, social phobia, alcohol abuse, inattention, and hyperactivity/impulsivity. The association between experiences of bullying involvement and mental health problems was examined. The risk of mental health problems was compared among those with different levels/types of bullying involvement. The results found that being a victim of any type of bullying and being a perpetrator of passive bullying were significantly associated with all kinds of mental health problems, and being a perpetrator of active bullying was significantly associated with all kinds of mental health problems except for general anxiety. Victims or perpetrators of both passive and active bullying had a greater risk of some dimensions of mental health problems than those involved in only passive or active bullying. Differences in the risk of mental health problems were also found among adolescents involved in different types of bullying. This difference in comorbid mental health problems should be taken into consideration when assessing adolescents involved in different levels/types of bullying. © 2014.

Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements.

PubMed

Flanagan, Meghan R; Foster, Carolyn C; Schleyer, Anneliese; Peterson, Gene N; Mandell, Samuel P; Rudd, Kristina E; Joyner, Byron D; Payne, Thomas H

2016-02-01

House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program. House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention. The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P = .002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P < .001). This innovative project serves as a model for successful engagement of house staff in institutional quality and safety initiatives with tangible institutional benefits. Copyright © 2016 Elsevier Inc. All rights reserved.

Cognitive Behaviour Therapy for Adolescent Offenders with Mental Health Problems in Custody

ERIC Educational Resources Information Center

Mitchell, Paul; Smedley, Kirsty; Kenning, Cassandra; McKee, Amy; Woods, Debbie; Rennie, Charlotte E.; Bell, Rachel V.; Aryamanesh, Mitra; Dolan, Mairead

2011-01-01

Many studies have identified high levels of mental health problems among adolescents in custody and there is increasing evidence that mental health problems in this population are associated with further offending and mental health problems into adulthood. Despite recent improvements in mental health provision within custodial settings there is…

Adverse Childhood Experiences, Coping Resources, and Mental Health Problems among Court-Involved Youth

ERIC Educational Resources Information Center

Logan-Greene, Patricia; Tennyson, Robert L.; Nurius, Paula S.; Borja, Sharon

2017-01-01

Background: Mental health problems are gaining attention among court-involved youth with emphasis on the role of childhood adversity, but assessment lags. Objective: The present study uses a commonly delivered assessment tool to examine mental health problems (current mental health problem, mental health interfered with probation goals, and…

A Review of Parental Involvement in Sex Education: The Role for Effective Communication in British Families

ERIC Educational Resources Information Center

Turnbull, Triece; van Wersch, Anna; van Schaik, Paul

2008-01-01

A review of recent literature (2000--2006) has been undertaken to investigate the role of sex education within the family context, in order to engage with the problems of sexual health in British society. The findings which emerged were categorized under the following five themes: (1) Parental roles regarding sex education; (2) The importance of…

Assessing Driving while Intoxicated (DWI) Offender Characteristics and Drinking Problems Utilizing the Numerical Drinking Profile (NDP)

ERIC Educational Resources Information Center

Barry, Adam E.; Misra, Ranjita; Dennis, Maurice

2006-01-01

Driving a vehicle under the influence of alcohol is a major public health concern. By distinguishing the type of individuals violating driving while intoxicated (DWI) sanctions, intervention programs will be better suited to reduce drinking and driving. The purpose of this study was to examine the personal characteristics of DWI offenders and…

Keeping Kids Safe: A Guide for Safe Food Handling & Sanitation for Child Care Providers.

ERIC Educational Resources Information Center

Food Safety and Inspection Service (USDA), Washington, DC.

Because children under age 5 are susceptible to food-borne illnesses and children in diapers present special sanitation and health problems, food safety and sanitation are emerging as important issues for child care providers. This booklet is designed to give providers and parents a quick and easy reference for food safety and sanitation. The…

Insomnia of childhood.

PubMed

Lipton, Jonathan; Becker, Ronald E; Kothare, Sanjeev V

2008-12-01

Insomnia is a major public health problem and is the most common sleep disturbance in both adults and children. The causes of sleeplessness are age-dependent and have potentially enormous effects on cognitive development, behavior, family dynamics, and the metabolic health of children. Here we review the epidemiology, cause, pathophysiology, and clinical approach to pediatric insomnia. Normal sleep is crucial for brain function, behavior, and normal metabolism. Consistently, sleep loss has been linked to behavioral and attention problems, impaired learning and memory, obesity, and psychiatric disorders. The neurological mechanisms that govern sleep initiation and maintenance are poorly understood. The types of insomnia are age-dependent and can occur as primary disorders, or in the context of another primary sleep disorder such as restless legs syndrome, or secondary to another underlying medical condition. Children with chronic diseases and especially children with neurodevelopmental disorders are at particular risk of insomnia. Pediatric insomnia is common and is a source of potential psychophysiological stress to both children and their caregivers. The causes of insomnia are various. Pediatricians should have a working knowledge of the causes of sleeplessness in order to promptly curtail the chronic effects of sleep loss and effectively screen for underlying, potentially treatable disorders.

Child mental health in Jordanian orphanages: effect of placement change on behavior and caregiving.

PubMed

MacKenzie, Michael J; Gearing, Robin E; Schwalbe, Craig S; Ibrahim, Rawan W; Brewer, Kathryne B; Al-Sharaihah, Rasha

2014-12-21

To assess the mental health and behavioral problems of children in institutional placements in Jordan to inform understanding of current needs, and to explore the effects of placement change on functioning and staff perceptions of goodness-of-fit. An assessment was completed of 134 children between 1.5-12 years-of-age residing in Jordanian orphanages. The Child Behavior Checklist was used to assess prevalence rates of problems across externalizing and internalizing behavior and DSM-IV oriented subscales. Also included was caregiver perceived goodness-of-fit with each child, caregiving behavior, and two placement change-clock variables; an adjustment clock measuring time since last move, and an anticipation clock measuring time to next move. 28% were in the clinical range for the internalizing domain on the CBCL, and 22% for the externalizing domain. The children also exhibited high levels of clinical range social problems, affective disorder, pervasive developmental disorder, and conduct problems. Internalizing problems were found to decrease with time in placement as children adjust to a prior move, whereas externalizing problems increased as the time to their next age-triggered move drew closer, highlighting the anticipatory effects of change. Both behavioral problems and the change clocks were predictive of staff perceptions of goodness-of-fit with the children under their care. These findings add to the evidence demonstrating the negative effects of orphanage rearing, and highlight the importance of the association between behavioral problems and child-caregiver relationship pathways including the timing of placement disruptions and staff perceptions of goodness-of-fit.

Family violence influences mental health of school girls in Iran: Results of a preliminary study.

PubMed

Fakhari, Ali; Tabatabavakili, Mehdi; Javid, Yousef Sayah; Farhang, Sara

2012-03-01

The family plays the first and may be the most important role in the development of individuals' personality, health and function. The current study aimed to evaluate different aspects of violence against a sample of school girls of Iranian population and its effect on their mental health. A cluster, randomized sample consisting of 399 school girls was selected from all of the high schools in Tabriz city, northwest of Iran. Students were asked to participate in this study anonymously. Signs and symptoms of depression and anxiety were assessed by the General health questionnaire-28 (GHQ-28) measuring their social function and physical situation as well. Another inquiry form involving questions about different kinds of violence and neglect gathered information about their situation during the recent year. The mean (SD) age of the students was 14.9 (0.8) and all were under 18. The mean (SD) total score of GHQ-28 was 24.18(13.61). The sub-threshold score in GHQ-28 (under 23) was observed in 44.1% of students which indicates considerable problems in mental health status. The type of reported violence was not significantly associated with an abnormal score of GHQ-28. A higher score of somatic symptoms was related to verbal violence at home by parents and the educational level of mother. High score on social dysfunction was predicted by lower educational level of mother. The depression scale was related to humility, neglect and discrimination at home. The factors were not predicting the score of anxiety or insomnia subscales. The current study observed a noticeable amount of problems in the mental health of teenage girls in a sample of the Iranian population. The educational level of the mother plays an important role in the mental health of school girls. Copyright © 2012 Elsevier B.V. All rights reserved.

[Women's health in violent situations: municipal administrative roles and decision-making in the Brazilian public health system].

PubMed

Porto, Madge; McCallum, Cecilia; Scott, Russell Parry; de Morais, Heloísa M Mendonça

2003-01-01

The aim of this study was to investigate the role of health management staff concerning the health of women facing violent situations and the impact these roles have on decisions concerning health measures targeting these women. The study employed a qualitative, descriptive methodology including 18 health management staff members from three municipalities classified as having fully autonomous municipal management systems under the Unified National Health System (SUS) in Greater Metropolitan Recife, Pernambuco State, Brazil. Staff members were divided into three distinct groups according to their opinions on women in violent situations and women's health interventions. However, the three groups were convergent with respect to their roles in determining decisions on health actions for these women. The health management staff's commitment to the feminist movement proved to be the most relevant factor. Common issues among staff members, such as the problem of public health and quality of living, or more technically, the cost-benefit issue, did appear as key arguments.

Managing Multiple Health Problems: Living with Multiple Health Problems

MedlinePlus

... treatments affect people with multiple health problems. Guiding Principles on Caring for Older Adults with Multiple Health ... interactions and other side effects. Each of the principles above is intended to help improve the health ...

Designing e-Health Interventions for Low-Health-Literate Culturally Diverse Parents: Addressing the Obesity Epidemic

PubMed Central

Kahlor, LeeAnn; Tyler, Diane; Gustafson, Jamie

2009-01-01

Abstract Child and adolescent obesity is a significant problem contributing to long-term trends in adult obesity. Educating parents about strategies for raising healthy children is complicated by the problem of low health literacy. E-health provides new opportunities to educate low-health-literate audiences, and this project was intended as formative research to guide design of interventions for low-health-literate parents. Focus groups were conducted with African American, Hispanic, and white parents (n = 43), 18 years of age or older, and at or below median income for the region. Each focus group included the following: a discussion of parents' general use of the Internet for health information, the demonstration of a Web site designed specifically for low-health-literate users, and asking participants about ideas under consideration for future interventions. Participants use search engines to look for health information and use heuristics, such as position in search results, to evaluate Web site quality. Some participants avoid information from .edu and .gov domains due to perceived complexity, and there was an almost-universal lack of trust in the government for health information. University researchers, by contrast, were trusted sources as information providers. Content and usability that meet the needs of extremely low-literate audiences may be perceived as slow and lacking depth by more literate and Internet-savvy users. E-health can be used to educate low-health-literate audiences, but interventions designed for these users must be layered in terms of content and usability to meet varying levels of functional and media literacy. PMID:19694596

Attitudinal barriers to help-seeking and preferences for mental health support among Australian fathers.

PubMed

Giallo, Rebecca; Dunning, Melissa; Gent, Angela

2017-07-01

To (a) identify attitudinal barriers to help-seeking for mental health difficulties among fathers of young children; (b) explore the relationships between perceived barriers to help-seeking and mental health difficulties (i.e. depressive, anxiety, stress symptoms); (c) identify socio-demographic factors associated with barriers to help-seeking; and (d) identify fathers' preferences for mental health support. One in 10 Australian fathers experience mental health difficulties in the early parenting period. Low rates of help-seeking and under-utilisation of health care services are key issues for the provision of mental health support to fathers at this important life stage. The sample consisted of 154 fathers of young children (aged 0-8 years) participating in an Australian online survey on parent wellbeing and parenting. The Barriers to Help-Seeking Scale assessed fathers' attitudinal barriers to help-seeking for mental health support. Socio-demographic factors related to fathers' employment, education, and family composition were assessed. The most common attitudinal barriers to help-seeking were: (a) the need for control and self-reliance in managing one's own problems, (b) a tendency to downplay or minimise problems, and (c) a sense of resignation that nothing will help. A range of demographic (i.e. age, educational attainment) factors were associated with these barriers. The most common preferences for support were internet-based information resources, followed by support provided by general practitioners and maternal child health nurses. These findings have important implications for health promotion, health services and clinical approaches to promoting the health and wellbeing of fathers.

Prevalence and assessment of malnutrition among children attending the Reproductive and Child Health clinic at Bagamoyo District Hospital, Tanzania.

PubMed

Juma, Omar Ali; Enumah, Zachary Obinna; Wheatley, Hannah; Rafiq, Mohamed Yunus; Shekalaghe, Seif; Ali, Ali; Mgonia, Shishira; Abdulla, Salim

2016-10-19

Malnutrition has long been associated with poverty, poor diet and inadequate access to health care, and it remains a key global health issue that both stems from and contributes to ill-health, with 50 % of childhood deaths due to underlying undernutrition. The purpose of this study was to determine the prevalence of malnutrition among children under-five seen at Bagamoyo District Hospital (BDH) and three rural health facilities ranging between 25 and 55 km from Bagamoyo: Kiwangwa, Fukayosi, and Yombo. A total of 63,237 children under-five presenting to Bagamoyo District Hospital and the three rural health facilities participated in the study. Anthropometric measures of age, height/length and weight and measurements of mid-upper arm circumference were obtained and compared with reference anthropometric indices to assess nutritional status for patients presenting to the hospital and health facilities. Overall proportion of stunting, underweight and wasting was 8.37, 5.74 and 1.41 % respectively. Boys were significantly more stunted, under weight and wasted than girls (p-value < 0.05). Children aged 24-59 months were more underweight than 6-23 months (p-value = <0.0001). But, there was no statistical significance difference between the age groups for stunting and wasting. Children from rural areas experienced increased rates of stunting, underweight and wasting than children in urban areas (p-value < 0.05). The results of this study concur with other studies that malnutrition remains a problem within Tanzania; however our data suggests that the population presenting to BDH and rural health facilities presented with decreased rates of malnutrition compared to the general population. Hospital and facility attending populations of under-five children in and around Bagamoyo suffer moderately high rates of malnutrition. Current nutrition programs focus on education for at risk children and referral to regional hospitals for malnourished children. Even though the general population has even greater malnutrition than the population presenting at the hospital, in areas of high malnutrition, hospital-based interventions should also be considered as centralized locations for reaching thousands of malnourished children under-five.

Utilization of Dental General Anaesthesia for Children

PubMed Central

Karim, Zarina Abdul; Musa, Normaizura; Noor, Siti Noor Fazliah Mohd

2008-01-01

Dental treatment under general anaesthesia may be needed for some children and adolescents due to medical or behaviour problem. The objective of the study is to identify the type of treatment that has been carried out under GA in Hospital Universiti Sains Malaysia (HUSM). A retrospective record review study from hospital records of dental patients (under 18 years old) receiving dental treatment under GA from 2003 until 2007 were retrieved from the database. Information such as the reason for GA, and the type of treatment provided was recorded in data sheet. The data were analyzed using SPSS 12.0.1 for Windows. It was checked and verified for errors. A total of 349 cases were treated of which 43.6% had medical problems. Patients were mostly diagnosed to have rampant caries (77.1%) and some of them have behavioural problems (34.4%). Treatment pattern in deciduous dentition revealed more extraction (97.8%) as compared to restoration (75.7%) whereas in permanent dentition more restoration was done (24.3%) as compared to extraction (2.2%). Majority of the restorations were done using Glass Ionomer Cements (47.5%). Biopsy (4.3%) contributed mainly to the surgery (24.1%) done during GA. General anesthesia is necessary when dental disease is interfering with health and general well-being of patient and it can facilitated dental treatment allowing dentists to benefit from improved treatment conditions and provide a higher quality of care. PMID:22570587

Unpacking the concept of patient satisfaction: a feminist analysis.

PubMed

Turris, Sheila A

2005-05-01

The aim of this paper is to present a feminist critique of the concept of patient satisfaction. Fiscal restraint, health care restructuring, shifting demographics, biomedical technological advances, and a significant shortage of health care professionals are stretching health care systems across North America to the breaking point. A simultaneous focus on consumerism and health service accountability is placing additional pressure on the system. The concept of patient satisfaction, with roots in the consumer movement of the 1960s, has both practical and political relevance in the current health care system and is commonly used to guide research related to consumer experiences of health care. Because the quality of health care encounters may lead to treatment-seeking delays, patient satisfaction research may be an effective vehicle for addressing this public health issue. However, there is wide agreement that patient satisfaction is an under-theorized concept. Using current conceptualizations of patient satisfaction, we end up all too often producing a checklist approach to 'achieving' patient satisfaction, rather than developing an understanding of the larger issues underlying individual experiences of health care. We focus on the symptoms rather than the problems. Without further theoretical refinement, the results of research into patient satisfaction are of limited use. To push forward theoretical development we might apply a variety of theoretical lenses to the analysis of both the concept and the results of patient satisfaction research. Feminism, in particular, offers a perspective that may provoke further refinement of patient satisfaction as a concept. Without a deeper understanding of the values and beliefs (or the worldview) that informs our approaches to researching patient satisfaction, researchers will be reacting to the most obvious indicators and failing to address the underlying issues related to individual experiences of health care.

Health problems in adolescents with alcohol use disorders: self-report, liver injury, and physical examination findings and correlates.

PubMed

Clark, D B; Lynch, K G; Donovan, J E; Block, G D

2001-09-01

Although adolescent alcohol consumption has been found to be positively correlated with self-reported health problems, few studies have examined other health indicators. This study compared adolescents with alcohol use disorders (AUDs) and a community reference group on self-reported health problems, serum liver enzymes, and physical examination findings. The relevance of negative emotionality to understanding these health problems was also investigated. The subjects were adolescents with AUDs recruited from clinical programs and classified as having DSM-IV alcohol dependence (n = 71) or alcohol abuse (n = 57) and reference adolescents without AUDs recruited from community sources (n = 131). The assessment of health status included self-reported health problems in 15 areas; serum liver enzyme assays, including gamma-glutamyl transpeptidase, alanine aminotransferase, and aspartate aminotransferase; and physical examination findings. Negative emotionality was determined by systematically combining scores from the Hamilton Anxiety Rating Scale, the Beck Depression Inventory, the Child Behavior Checklist, and the Multidimensional Personality Questionnaire. Adolescent AUDs were associated with more self-reported health problems, higher gamma-glutamyl transpeptidase and alanine aminotransferase levels, and more physical examination abnormalities. Negative emotionality was highly correlated with self-reported health problems, mediated the relationship between AUDs and self-reported health problems, and was not correlated with serum liver enzyme levels or physical examination abnormalities. These results indicated that AUDs during adolescence were associated with health problems, including modest but demonstrable liver injury. Self-reported health problems were probably best understood, in this context, as a negative emotionality manifestation.

The early NHS and the crisis of public health nursing.

PubMed

Webster, C

2000-01-01

Establishment of the NHS in 1948 is rightly seen as a major turning point in health care in the United Kingdom. Notwithstanding conditions of severe austerity, the NHS succeeded remarkably well in its basic remit to make all essential medical care available to the entire population, free at point of delivery. The benefits of the new system extended across the entire front of its services. However, it is important to recognise that the reforms of 1948 were uniformly advantageous. It has for instance long been recognised that the NHS failed to bring about the expected transformation in standards of general medical practice. In this short paper the author argues that public health represented a further major sphere of underdevelopment. The fact that, with minor exceptions, public health is the least studied aspect of the early NHS is itself suggestive of its status as the Cinderella of the modern health services. The author also underlines the adverse implications of this inferior position for domiciliary midwifery, district nursing and health visiting. These constituted small but strategically important sectors of nursing, all of which fell under public health administration in the new health service. The author concentrates on the first phase of the NHS, the period between 1948 and 1974, now often regarded as its golden age. For the purposes of this discussion, most of the evidence relates to the formative phase of the new service, when many major policy questions relating to public health were first confronted. It is suggested that the early neglect of public health and its constituent nursing functions has left a legacy of problems that have still not entirely been resolved. For the purposes of this paper the term will be used to embrace the totality of health functions administered by departments of local government in the period from 1948 to 1974. Most of these services fell within the public health departments of local government, headed by the Medical Office of Health (MOH). However, some important functions involving the nurses were located in other departments. Especially important was the School Health Service, which was reformed in 1944, ahead of the NHS. This was a largely independent service under the administration of Local Education Authorities. Some of the problems of public health nursing related to this fragmentation of responsibility.

System effectiveness of detection, brief intervention and refer to treatment for the people with post-traumatic emotional distress by MERS: a case report of community-based proactive intervention in South Korea.

PubMed

Yoon, Mi-Kyung; Kim, Soon-Young; Ko, Hye-Sun; Lee, Myung-Soo

2016-01-01

Korea has experienced diverse kind of disasters these days. Among them the 2015 middle eastern respiratory syndrome (MERS) outbreak imposed great psychological stress on almost all Korean citizens. Following the MERS outbreak, government is reviewing overall infectious disease management system and prioritizing the establishment of mental health service systems for infectious disease. This study makes suggestions for implementing disaster-related mental health service systems by analyzing the example of Gyeonggi Province, which proactively intervened with residents' psychological problems caused by the large-scale outbreak of an infectious disease. Mental health service system for MERS victims had the following two parts: a mental health service for people who had been placed in quarantine and a service provided to families of patients who had died or recovered patients. The government of Gyeonggi province, public health centers, regional and local Community Mental Health Centers and the National Center for Crisis Mental Health Management participated in this service system. Among 1221 Gyeonggi people placed in quarantine and who experienced psychological and emotional difficulties, 350 required continuing services; 124 of this group received continuing services. That is, 35 % of people who required psychological intervention received contact from service providers and received the required services. This study reflects a proactive monitoring system for thousands of people placed under quarantine for the first time in Korea. It is significant that the service utilization rate by a proactive manner, that is the professionals administering it actively approached and contacted people with problems rather than passively providing information was much higher than other general mental health situation in Korea. The core value of public mental health services is adequate public accessibility; it is therefore essential for governments to strengthen their professional competence and establish effective systems. These criteria should also be applied to psychological problems caused by disastrous infectious disease outbreaks.

Health Problems in Pregnancy

MedlinePlus

... problems. You may have problems because of a health condition you had before you got pregnant. You ... being pregnant with more than one baby, a health problem in a previous pregnancy, substance abuse during ...

Distributed Prognostics based on Structural Model Decomposition

NASA Technical Reports Server (NTRS)

Daigle, Matthew J.; Bregon, Anibal; Roychoudhury, I.

2014-01-01

Within systems health management, prognostics focuses on predicting the remaining useful life of a system. In the model-based prognostics paradigm, physics-based models are constructed that describe the operation of a system and how it fails. Such approaches consist of an estimation phase, in which the health state of the system is first identified, and a prediction phase, in which the health state is projected forward in time to determine the end of life. Centralized solutions to these problems are often computationally expensive, do not scale well as the size of the system grows, and introduce a single point of failure. In this paper, we propose a novel distributed model-based prognostics scheme that formally describes how to decompose both the estimation and prediction problems into independent local subproblems whose solutions may be easily composed into a global solution. The decomposition of the prognostics problem is achieved through structural decomposition of the underlying models. The decomposition algorithm creates from the global system model a set of local submodels suitable for prognostics. Independent local estimation and prediction problems are formed based on these local submodels, resulting in a scalable distributed prognostics approach that allows the local subproblems to be solved in parallel, thus offering increases in computational efficiency. Using a centrifugal pump as a case study, we perform a number of simulation-based experiments to demonstrate the distributed approach, compare the performance with a centralized approach, and establish its scalability. Index Terms-model-based prognostics, distributed prognostics, structural model decomposition ABBREVIATIONS

Workplace mental health: developing an integrated intervention approach.

PubMed

LaMontagne, Anthony D; Martin, Angela; Page, Kathryn M; Reavley, Nicola J; Noblet, Andrew J; Milner, Allison J; Keegel, Tessa; Smith, Peter M

2014-05-09

Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work-related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace.

Parental physical illness as a risk for psychosocial maladjustment in children and adolescents: epidemiological findings from a national survey in Germany.

PubMed

Barkmann, Claus; Romer, Georg; Watson, Maggie; Schulte-Markwort, Michael

2007-01-01

The authors assessed the risk for psychosocial maladjustment in a population-based sample of dependent children of parents with serious physical illness. In the context of The Hamburg Health Survey, a wide range of data on current life situation and health status was collected from a representative sample of families with children and adolescents between 4 and 18 years old (N=1,950). For 4- to 18-year-old children and adolescents in Germany, the prevalence of a serious physical illness in a parent was 4.1%. The adjusted risk of psychosocial maladjustment in this target group, depending on the case definition, is elevated, with internalizing problems being more prevalent than externalizing problems. Although problems for affected boys decline with puberty, they increase for girls. In this age-group, girls and boys appear to be under particular strain when the respective same-sex parent has a serious physical illness. Exposure to serious parental physical illness is an epidemiologically relevant risk factor for psychosocial maladjustment in children and adolescents that needs to be better recognized by medical professionals.

Perceived Problem Solving, Stress, and Health among College Students

ERIC Educational Resources Information Center

Largo-Wight, Erin; Peterson, P. Michael; Chen, W. William

2005-01-01

Objective: To study the relationships among perceived problem solving, stress, and physical health. Methods: The Perceived Stress Questionnaire (PSQ), Personal Problem solving Inventory (PSI), and a stress-related physical health symptoms checklist were used to measure perceived stress, problem solving, and health among undergraduate college…

Evolution of Cost-Free Resistance under Fluctuating Drug Selection in Pseudomonas aeruginosa

PubMed Central

McCloskey, Nicholas; Hinz, Aaron J.; Dettman, Jeremy; Kassen, Rees

2017-01-01

ABSTRACT Antibiotic resistance evolves rapidly in response to drug selection, but it can also persist at appreciable levels even after the removal of the antibiotic. This suggests that many resistant strains can both be resistant and have high fitness in the absence of antibiotics. To explore the conditions under which high-fitness, resistant strains evolve and the genetic changes responsible, we used a combination of experimental evolution and whole-genome sequencing to track the acquisition of ciprofloxacin resistance in the opportunistic pathogen Pseudomonas aeruginosa under conditions of constant and fluctuating antibiotic delivery patterns. We found that high-fitness, resistant strains evolved readily under fluctuating but not constant antibiotic conditions and that their evolution was underlain by a trade-off between resistance and fitness. Whole-genome sequencing of evolved isolates revealed that resistance was gained through mutations in known resistance genes and that second-site mutations generally compensated for costs associated with resistance in the fluctuating treatment, leading to the evolution of cost-free resistance. Our results suggest that current therapies involving intermittent administration of antibiotics are contributing to the maintenance of antibiotic resistance at high levels in clinical settings. IMPORTANCE Antibiotic resistance is a global problem that greatly impacts human health. How resistance persists, even in the absence of antibiotic treatment, is thus a public health problem of utmost importance. In this study, we explored the antibiotic treatment conditions under which cost-free resistance arises, using experimental evolution of the bacterium Pseudomonas aeruginosa and the quinolone antibiotic ciprofloxacin. We found that intermittent antibiotic treatment led to the evolution of cost-free resistance and demonstrate that compensatory evolution is the mechanism responsible for cost-free resistance. Our results suggest that discontinuous administration of antibiotic may be contributing to the high levels of antibiotic resistance currently found worldwide. PMID:28744479

Adolescent exposure to violence and adult physical and mental health problems.

PubMed

Franzese, Robert J; Covey, Herbert C; Tucker, Abigail S; McCoy, Leah; Menard, Scott

2014-12-01

Evidence on the relationship of adolescent exposure to violence (AEV) with adult physical and mental health problems is limited, with studies often focusing on earlier childhood rather than adolescence, and also on short term rather than long term outcomes. Information specifically on the relationship of AEV to seeking help for mental health problems in adulthood from either formal sources such as mental health professionals or informal sources such as friends and clergy is even more difficult to find. The present study investigates how adolescent exposure to violence (AEV), in the form of parental physical abuse, witnessing parental violence, and exposure to violence in the neighborhood, are related to self-reported adult physical problems and seeking formal or informal assistance with mental health, controlling for more general adolescent violent victimization and for self-reports and parent reports of mental health problems in adolescence. This study adds to the literature on AEV and adult physical problems, and provides a rare look at the relationship of AEV to adult help-seeking for mental health problems. The results suggest that AEV is associated with mental health problems in adolescence for both females and males, that for females AEV is related to physical problems and to seeking help for mental health problems in adulthood, but for males the only significant relationship involves inconsistent reports of witnessing parental violence and adult physical problems. Copyright © 2014 Elsevier Ltd. All rights reserved.

Health needs and priorities of Syrian refugees in camps and urban settings in Jordan: perspectives of refugees and health care providers.

PubMed

Al-Rousan, Tala; Schwabkey, Zaker; Jirmanus, Lara; Nelson, Brett D

2018-06-10

The United Nations has declared the Syrian refugee crisis to be the biggest humanitarian emergency of our era. Neighbouring countries, such as Jordan, strain to meet the health needs of Syrian refugees in addition to their own citizens given limited resources. This study aimed to determine the perspectives of Syrian refugees in Jordan, Jordanian health care providers and other stakeholders in addressing the public health issues of the refugee crisis. Qualitative and quantitative methodologies were used to explore Syrian refugee health needs and services in camp and urban settings in Jordan. Focus group discussions and key informant interviews were used to identify needs, challenges and potential solutions to providing quality health care to refugees. By-person factor analysis divided refugee participants into 4 unique respondent types and compared priorities for interventions. Focus group discussions and key informant interviews revealed a many different problems. Cost, limited resources, changing policies, livelihoods and poor health literacy impeded delivery of public and clinical health services. Respondent Type 1 emphasized the importance of policy changes to improve Syrian refugee health. Type 2 highlighted access to fresh foods and recreational activities for children. For Type 3, poor quality drinking-water was the primary concern, and Type 4 believed the lack of good, free education for Syrian children exacerbated their mental health problems. Syrian refugees identified cost as the main barrier to health care access. Both refugees and health care providers emphasized the importance of directing more resources to chronic diseases and mental health. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

Nutritional status and its correlates in Equatorial Guinean preschool children: results from a nationally representative survey.

PubMed

Custodio, Estefanía; Descalzo, Miguel Angel; Roche, Jesús; Sánchez, Ignacio; Molina, Laura; Lwanga, Magdalena; Bernis, Cristina; Villamor, Eduardo; Baylin, Ana

2008-03-01

In Equatorial Guinea, as a result of the recent growth of the oil industry, there is an opportunity to address important public health problems through public and private initiatives. To propose effective nutrition and public health strategies, it is important first to have reliable information on the nutritional status of the population and the underlying factors affecting it. To assess the nutritional status and the prevalence of anemia among Equatoguinean children in a nationally representative sample and to identify the risk factors associated with the nutritional problems detected. The study was a cross-sectional survey using a multistaged, stratified, cluster-selected sample. The survey included a sociodemographic, health, and dietary questionnaire and measurement of hematocrit and anthropometric features, from which nutritional indicators based on the National Center for Health Statistics (NCHS) reference and the World Health Organization (WHO) standards were calculated. Logistic regression models were used for the multivariate analysis. A total of 552 children aged 0 to 60 months were surveyed. The overall prevalence of stunting (< -2 height-for-age z-scores [HAZ]) was 29.7% based on the NCHS reference and 35.2% based on WHO standards; the risk factors associated with stunting were age (p < .0001), low socioeconomic status (p = .01), and fishing by a member of the household (p = .003) The prevalence of mild anemia (hemoglobin < 110 g/L) was 69.3%, and that of moderate or severe anemia (hemoglobin < 80 g/L) was 8.3%. The only significant risk factor associated with moderate to severe anemia was low household socioeducational level (p = .01). Stunting and anemia are public health problems in Equatorial Guinea. Integrated strategies, including fighting poverty and improving maternal education, should be undertaken.

Health of adolescent refugees resettling in high-income countries.

PubMed

Hirani, Kajal; Payne, Donald; Mutch, Raewyn; Cherian, Sarah

2016-07-01

Adolescent refugees are a vulnerable population with complex healthcare needs that are distinct from younger and older age groups. Physical health problems are common in this cohort with communicable diseases being the focus of attention followed by an emphasis on nutritional deficiencies and other chronic disorders. Adolescent refugees have also often experienced multiple traumatic stressors and are at a heightened risk of developing mental health problems. Navigating these problems at the time of pubertal development adds further challenges and can exacerbate or lead to the emergence of health risk behaviours. Educational difficulties and acculturation issues further compound these issues. Adolescents who have had experiences in detention or are unaccompanied by parents are particularly at risk. Despite a constantly growing number of adolescent refugees resettling in high-income countries, knowledge regarding their specific healthcare needs is limited. Research data are largely extrapolated from studies conducted within paediatric and adult cohorts. Holistic management of the medical and psychological issues faced by this group is challenging and requires an awareness of the socioeconomic factors that can have an impact on effective healthcare delivery. Legal and ethical issues can further complicate their management and addressing these in a culturally appropriate manner is essential. Early identification and management of the healthcare issues faced by adolescent refugees resettling in high-income countries are key to improving long-term health outcomes and future healthcare burden. This review article aims to increase knowledge and awareness of these issues among paediatricians and other health professionals. 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/

Harms of cervical cancer screening in the United States and the Netherlands.

PubMed

Habbema, Dik; Weinmann, Sheila; Arbyn, Marc; Kamineni, Aruna; Williams, Andrew E; M C M de Kok, Inge; van Kemenade, Folkert; Field, Terry S; van Rosmalen, Joost; Brown, Martin L

2017-03-01

We studied harms related to cervical cancer screening and management of screen-positive women in the United States (US) and the Netherlands. We utilized data from four US integrated health care systems (SEARCH), the US National Health Interview Survey, New Mexico state, the Netherlands national histopathology registry, and included studies on adverse health effects of cervical screening. We compared the number of Papanicolaou (Pap) smear tests, abnormal test results, punch biopsies, treatments, health problems (anxiety, pain, bleeding and discharge) and preterm births associated with excisional treatments. Results were age-standardized to the 2007 US population. Based on SEARCH, an estimated 36 million Pap tests were performed in 2007 for 91 million US women aged 21-65 years, leading to 2.3 million abnormal Pap tests, 1.5 million punch biopsies, 0.3 million treatments for precancerous lesions, 5 thousand preterm births and over 8 million health problems. Under the Netherlands screening practice, fewer Pap tests (58%), abnormal test results (64%), punch biopsies (75%), treatment procedures (40%), preterm births (60%) and health problems (63%) would have occurred. The SEARCH data did not differ much from other US data for 2007 or from more recent data up to 2013. Thus compared to the less intensive screening practice in the Netherlands, US practice of cervical cancer screening may have resulted in two- to threefold higher harms, while the effects on cervical cancer incidence and mortality are similar. The results are also of high relevance in making recommendations for HPV screening. Systematic collection of harms data is needed for monitoring and for better incorporation of harms in making screening recommendations. © 2016 UICC.

Mental health stigmatisation in deployed UK Armed Forces: a principal components analysis.

PubMed

Fertout, Mohammed; Jones, N; Keeling, M; Greenberg, N

2015-12-01

UK military research suggests that there is a significant link between current psychological symptoms, mental health stigmatisation and perceived barriers to care (stigma/BTC). Few studies have explored the construct of stigma/BTC in depth amongst deployed UK military personnel. Three survey datasets containing a stigma/BTC scale obtained during UK deployments to Iraq and Afghanistan were combined (n=3405 personnel). Principal component analysis was used to identify the key components of stigma/BTC. The relationship between psychological symptoms, the stigma/BTC components and help seeking were examined. Two components were identified: 'potential loss of personal military credibility and trust' (stigma Component 1, five items, 49.4% total model variance) and 'negative perceptions of mental health services and barriers to help seeking' (Component 2, six items, 11.2% total model variance). Component 1 was endorsed by 37.8% and Component 2 by 9.4% of personnel. Component 1 was associated with both assessed and subjective mental health, medical appointments and admission to hospital. Stigma Component 2 was associated with subjective and assessed mental health but not with medical appointments. Neither component was associated with help-seeking for subjective psycho-social problems. Potential loss of credibility and trust appeared to be associated with help-seeking for medical reasons but not for help-seeking for subjective psychosocial problems. Those experiencing psychological symptoms appeared to minimise the effects of stigma by seeking out a socially acceptable route into care, such as the medical consultation, whereas those who experienced a subjective mental health problem appeared willing to seek help from any source. 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/

Developing an Action Model for Integration of Health System Response to HIV/AIDS and Noncommunicable Diseases (NCDs) in Developing Countries

PubMed Central

Haregu, Tilahun Nigatu; Setswe, Geoffrey; Elliott, Julian; Oldenburg, Brian

2014-01-01

Introduction: Although there are several models of integrated architecture, we still lack models and theories about the integration process of health system responses to HIV/AIDS and NCDs. Objective: The overall purpose of this study is to design an action model, a systematic approach, for the integration of health system responses to HIV/AIDS and NCDs in developing countries. Methods: An iterative and progressive approach of model development using inductive qualitative evidence synthesis techniques was applied. As evidence about integration is spread across different fields, synthesis of evidence from a broad range of disciplines was conducted. Results: An action model of integration having 5 underlying principles, 4 action fields, and a 9-step action cycle is developed. The INTEGRATE model is an acronym of the 9 steps of the integration process: 1) Interrelate the magnitude and distribution of the problems, 2) Navigate the linkage between the problems, 3) Testify individual level co-occurrence of the problems, 4) Examine the similarities and understand the differences between the response functions, 5) Glance over the health system’s environment for integration, 6) Repackage and share evidence in a useable form, 7) Ascertain the plan for integration, 8) Translate the plan in to action, 9) Evaluate and Monitor the integration. Conclusion: Our model provides a basis for integration of health system responses to HIV/AIDS and NCDs in the context of developing countries. We propose that future empirical work is needed to refine the validity and applicability of the model. PMID:24373260

A test of the vulnerability model: temperament and temperament change as predictors of future mental disorders - the TRAILS study.

PubMed

Laceulle, Odilia M; Ormel, Johan; Vollebergh, Wilma A M; van Aken, Marcel A G; Nederhof, Esther

2014-03-01

This study aimed to test the vulnerability model of the relationship between temperament and mental disorders using a large sample of adolescents from the TRacking Adolescents Individual Lives' Survey (TRAILS). The vulnerability model argues that particular temperaments can place individuals at risk for the development of mental health problems. Importantly, the model may imply that not only baseline temperament predicts mental health problems prospectively, but additionally, that changes in temperament predict corresponding changes in risk for mental health problems. Data were used from 1195 TRAILS participants. Adolescent temperament was assessed both at age 11 and at age 16. Onset of mental disorders between age 16 and 19 was assessed at age 19, by means of the World Health Organization Composite International Diagnostic Interview (WHO CIDI). Results showed that temperament at age 11 predicted future mental disorders, thereby providing support for the vulnerability model. Moreover, temperament change predicted future mental disorders above and beyond the effect of basal temperament. For example, an increase in frustration increased the risk of mental disorders proportionally. This study confirms, and extends, the vulnerability model. Consequences of both temperament and temperament change were general (e.g., changes in frustration predicted both internalizing and externalizing disorders) as well as dimension specific (e.g., changes in fear predicted internalizing but not externalizing disorders). These findings confirm previous studies, which showed that mental disorders have both unique and shared underlying temperamental risk factors. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

The Effect of Health Promoting Intervention on Healthy Lifestyle and Social Support in Elders: A Clinical Trial Study

PubMed Central

Rahimi Foroushani, Abbas; Estebsari, Fatemeh; Mostafaei, Davoud; Eftekhar Ardebili, Hasan; Shojaeizadeh, Dvoud; Dastoorpour, Maryam; Jamshidi, Ensiyeh; Taghdisi, Mohammad Hossein

2014-01-01

Background: Many of the problems pertaining to old age originate from unhealthy lifestyle and low social support. Overcoming these problems requires precise and proper policy-making and planning. Objectives: The aim of the current research is to investigate the effect of health promoting interventions on healthy lifestyle and social support in elders. Patients and Methods: This study was conducted as a clinical trial lasting for 12 months on 464 elders aged above 60 years who were under the aegis of health homes in Tehran, Iran. Participants were selected through double stage cluster sampling and then divided into intervention and control groups (232 individuals in each). Tools for gathering data were a demographic checklist and two standard questionnaires called Health-Promoting Lifestyle Profile version 2 and personal resource questionnaire part 2. Data were analyzed using descriptive and analytical tests including paired t test, analysis of covariance (ANCOVA) and Pearson correlation coefficient. Results: The average age of elders in this study was 65.9 ± 3.6 years (ranging between 60 and 73 years old). Results showed that the differences between the mean post-test scores of healthy lifestyle and its six dimensions as well as perceived social support and its five dimensions in the control and intervention groups were statistically significant (P value < 0.0001). Conclusions: Aging is an inevitable stage of life. However, effective health promoting interventions can procrastinate it, reduce its consequences and problems, and turn it into a pleasant and enjoyable part of life. PMID:25389486

[Mental health status and related factors among first generation Japanese returnees from China and Chinese spouses living in Japan for ten years or more].

PubMed

Hu, Xiuying; Ishigaki, Kazuko; Yamamoto-Mitani, Noriko

2007-07-01

The purpose of this study was to examine mental health status and related factors among 1st generation Japanese returnees from China and Chinese spouses living in Japan for ten years or more. The subjects were 99 individuals (mean age= 63.9 years), all 1st generation Japanese returnees and their Chinese spouses, living in the Kanto region of Japan. The subjects completed a questionnaire survey, which included items regarding demographics, state of social activity in Japan, self-care behavior, the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence and physical health. The questionnaire survey also incorporated the General Health Questionnaire 12 (GHQ12). The results of the survey were first analyzed by T- and chi2-tests. Logistic regression analysis was then performed in order to identify factors related to the GHQ12. The participants scored high scores on the GHQ12, with 72.7% showing a potential for mental health problems (GHQ12 more than 3). Major complaints were "cannot do useful things" 74.7%, "don't feel happy" 72.7%, "feeling under psychological strain" 59.6%, "unable to make decisions" 57.6%, "feeling depressed" 56.6%, "feeling worried and cannot sleep" 55.5%. The results of the logistic regression analysis revealed that those with potential mental health problems had a higher language barrier (OR: 5.48, 95%CI: 1.52-19.82), fewer providers of health care information (OR: 5.25, 95%CI: 1.32-20.95), fewer voluntary conversations with young people (OR: 3.51, 95%CI: 1.05-11.74), and lower self-rated health (OR: 15.49, 95%CI: 4.11-58.48). In this study, Japanese returnees and their Chinese spouses were found to have mental health problems, significantly associated with a high language barrier, limited information on health care, few conversations with young people, and low self-rated health. Our findings suggest that this population requires immediate assistance to improve their mental health. Furthermore, comprehensive and culturally sensitive health care programs are necessary.

[Health status, use of health services and reported morbidity: application of correspondence analysis].

PubMed

Espinàs, J A; Riba, M D; Borràs, J M; Sánchez, V

1995-01-01

The study of the relationship between self-reported morbidity, health status and health care utilization presents methodological problems due to the variety of illnesses and medical conditions that one individual may report. In this article, correspondence analysis was use to analyse these relationships. Data from the Spanish National Health Survey pertaining to the region of Catalonia was studied. Statistical analysis included multi-way correspondence analysis (MCA) followed by cluster analysis. The first factor extracted is defined by self-assessed health perception; the second, by limitation of activities, and the third is related to self-reported morbidity caused by chronic and acute health problems. Fourth and fifth factors, capture residual variability and missing values. Acute problems are more related to perception of poor health while chronic problems are related to perception of fair health. Also, it may be possible to distinguish self-reported morbidity due to relapses of chronic diseases from true acute health problems. Cluster analysis classified individuals into four groups: 1) healthy people; 2) people who assess their health as being poor and those with acute health problems; 3) people with chronic health problems, limited activity and a perception of fair health; and 4) missing values. Correspondence analysis is a useful tool when analyzing qualitative variables like those in a health survey.

Designing e-health interventions for low-health-literate culturally diverse parents: addressing the obesity epidemic.

PubMed

Mackert, Michael; Kahlor, LeeAnn; Tyler, Diane; Gustafson, Jamie

2009-09-01

Child and adolescent obesity is a significant problem contributing to long-term trends in adult obesity. Educating parents about strategies for raising healthy children is complicated by the problem of low health literacy. E-health provides new opportunities to educate lowhealth-literate audiences, and this project was intended as formative research to guide design of interventions for low-health-literate parents. Focus groups were conducted with African American, Hispanic, and white parents (n = 43), 18 years of age or older, and at or below median income for the region. Each focus group included the following: a discussion of parents' general use of the Internet for health information, the demonstration of a Web site designed specifically for low-health-literate users, and asking participants about ideas under consideration for future interventions. Participants use search engines to look for health information and use heuristics, such as position in search results, to evaluate Web site quality. Some participants avoid information from .edu and .gov domains due to perceived complexity, and there was an almost-universal lack of trust in the government for health information. University researchers, by contrast, were trusted sources as information providers. Content and usability that meet the needs of extremely low-literate audiences may be perceived as slow and lacking depth by more literate and Internet-savvy users. E-health can be used to educate low-health-literate audiences, but interventions designed for these users must be layered in terms of content and usability to meet varying levels of functional and media literacy.

Feeling Healthy? A Survey of Physical and Psychological Wellbeing of Students from Seven Universities in the UK

PubMed Central

Ansari, Walid El; Stock, Christiane; Snelgrove, Sherrill; Hu, Xiaoling; Parke, Sian; Davies, Shân; John, Jill; Adetunji, Hamed; Stoate, Mary; Deeny, Pat; Phillips, Ceri; Mabhala, Andi

2011-01-01

University students’ physical and psychological health and wellbeing are important and comprise many variables. This study assessed perceived health status in addition to a range of physical and psychological wellbeing indicators of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these variables across males and females, and across the participating universities. The data was collected in 2007–2008. A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), self-reported physical and psychological health data, as well as questions on health awareness, health service use, social support, burdens and stressors and university study related questions. While females generally reported more health problems and psychological burdens, male students felt that they received/had fewer persons to depend on for social support. The comparisons of health and wellbeing variables across the different universities suggested some evidence of ‘clustering’ of the variables under study, whereby favourable situations would be exhibited by a cluster of the variables that is encountered at some universities; and conversely, the clustering of less favourable variables as exhibited at other universities. We conclude that the level of health complaints and psychological problems/burdens is relatively high and calls for increased awareness of university administrators, leaders and policy makers to the health and well-being needs of their students. The observed clustering effects also indicated the need for local (university-specific) health and wellbeing profiles as basis and guidance for relevant health promotion programmes at universities. PMID:21655121

[When health makes the headlines. Press, elite complicities and health globalisation in Bamako, Mali].

PubMed

Jaffré, Y

2007-08-01

To overcome the socio-medical failures observed in Africa's health services, researchers and practitioners of public health often mention the necessity to resort to counter-powers. But, what are precisely these counter-powers? To analyse the problem, we describe the treatment of health issues in the Bamako press during one year. The analysis of various processes (external references, lack of training, insufficient deontological standards, "elite" complicity among journalists and health directors) allows us to underline the complexity of the links between the press and health. The economic flows related to the economy of development "projects" in particular with AIDS, encourage the journalists to see themselves as "educationalists" of populations rather than spokesmen for their claims or difficulties. Two consequences follow. First of all the press counter-power has to be developed in the case one wishes to see it as the expression of "the voice of the voiceless" and a good help to make an "informal" evaluation of the quality of health cares by users. But, more generally within this context of globalisation of health, instead of encouraging the expression of a "popular" criticism, newspapers work out a system of mutual legitimacies and social connivances among local "elites". Far from contributing to the improvement of the health system by looking actively into the problem leading to a modernity under control, health journalism disconnects the discourse from its referent and contributes to discredit "political" language. This journalistic construction of the insignificance is one of the principal political effects of this medical journalism instrumentalized by institutions of development.

A multilevel modelling approach to analysis of patient costs under managed care.

PubMed

Carey, K

2000-07-01

The growth of the managed care model of health care delivery in the USA has led to broadened interest in the performance of health care providers. This paper uses multilevel modelling to analyse the effects of managed care penetration on patient level costs for a sample of 24 medical centres operated by the Veterans Health Administration (VHA). The appropriateness of a two level approach to this problem over ordinary least squares (OLS) is demonstrated. Results indicate a modicum of difference in institutions' performance after controlling for patient effects. Facilities more heavily penetrated by the managed care model may be more effective at controlling costs of their sicker patients. Copyright 2000 John Wiley & Sons, Ltd.

["No" for stacked young bodybuilders, "yes" for manthers: the biomedical discourse on anabolic steroids and health].

PubMed

Moraes, Danielle Ribeiro de; Castiel, Luis David; Ribeiro, Ana Paula Pereira da Gama Alves

2015-06-01

The article addresses the use of anabolic androgenic steroids (AAS), synthetic drugs whose abuse has been characterized as a public health problem, operated in the opposition between "medical" and "non-medical" uses. A qualitative approach was used to analyze the text in 76 biomedical articles published from 2002 to 2012. The discourse shows a persistent ban on non-medically regulated use of AAS by young people, while the limits on clinically qualified use appear to expand among older people, even given the contradictions straining the argument on the prevention of health risks. Moralizing biopolitical stances appear, based on gender distinctions or under the aegis of criminalizing drug use.

Persistence of mental health needs among children affected by Hurricane Katrina in New Orleans.

PubMed

Olteanu, Alina; Arnberger, Ruth; Grant, Roy; Davis, Caroline; Abramson, David; Asola, Jaya

2011-02-01

Hurricane Katrina made landfall in August 2005 and destroyed the infrastructure ofNew Orleans. Mass evacuation ensued. The immediate and long-lasting impact of these events on the mental health of children have been reported in survey research. This study was done to describe the nature of mental health need of children during the four years after Hurricane Katrina using clinical data from a comprehensive healthcare program. Medical and mental health services were delivered on mobile clinics that traveled to medically underserved communities on a regular schedule beginning immediately after the hurricane. Patients were self-selected residents of New Orleans. Most had incomes below the federal poverty level and were severely affected by the hurricane. Paper charts of pediatric mental health patients were reviewed for visits beginning with the establishment of the mental health program from 01 July 2007 through 30 June 2009 (n = 296). Demographics, referral sources, presenting problems, diagnoses, and qualitative data describing Katrina-related traumatic exposures were abstracted. Psychosocial data were abstracted from medical charts. Data were coded and processed for demographic, referral, and diagnostic trends. Mental health service needs continued unabated throughout this period (two to nearly four years post-event). In 2008, 29% of pediatric primary care patients presented with mental health or developmental/learning problems, including the need for intensive case management. The typical presentation of pediatric mental health patients was a disruptive behavior disorder with an underlying mood or anxiety disorder. Qualitative descriptive data are presented to illustrate the traumatic post-disaster experience of many children. School referrals for mental health evaluation and services were overwhelmingly made for disruptive behavior disorders. Pediatric referrals were more nuanced, reflecting underlying mood and anxiety disorders. Histories indicated that many missed opportunities for earlier identification and intervention. Mental health and case management needs persisted four years after Hurricane Katrina and showed no signs of abating. Many children who received mental health services had shown signs of psychological distress prior to the hurricane, and no causal inferences are drawn between disaster experience and psychiatric disorders. Post-disaster mental health and case management services should remain available for years post-event. To ensure timely identification and intervention of child mental health needs, pediatricians and school officials may need additional training.

A critical examination of community-based responses to household food insecurity in Canada.

PubMed

Tarasuk, V

2001-08-01

Over the past two decades, household food insecurity has emerged as a significant social problem and serious public health concern in the "First World." In Canada, communities initially responded by establishing ad hoc charitable food assistance programs, but the programs have become institutionalized. In the quest for more appropriate and effective responses, a variety of community development programs have recently been initiated. Some are designed to foster personal empowerment through self-help and mutual support; others promote community-level strategies to strengthen local control over food production. The capacity of current initiatives to improve household food security appears limited by their inability to overcome or alter the poverty that under-pins this problem. This may relate to the continued focus on food-based responses, the ad hoc and community-based nature of the initiatives, and their origins in publicly funded health and social service sectors.

Forward problem studies of electrical resistance tomography system on concrete materials

NASA Astrophysics Data System (ADS)

Ang, Vernoon; Rahiman, M. H. F.; Rahim, R. A.; Aw, S. R.; Wahab, Y. A.; Thomas W. K., T.; Siow, L. T.

2017-03-01

Electrical resistance tomography (ERT) is well known as non-invasive imaging technique, inexpensive, radiation free, visualization measurements of the multiphase flows and frequently applied in geophysical, medical and Industrial Process Tomography (IPT) applications. Application of ERT in concrete is a new exploration field, which can be used in monitoring and detecting the health and condition of concrete without destroying it. In this paper, ERT model under the condition of concrete is studied in which the sensitivity field model is produced and simulated by using COMSOL software. The affects brought by different current injection values with different concrete conductivity are studied in detail. This study able to provide the important direction for the further study of inverse problem in ERT system. Besides, the results of this technique hopefully can open a new exploration in inspection method of concrete structures in order to maintain the health of the concrete structure for civilian safety.

Sexual abuse and violence among adolescent girls in Botswana: a mental health perspective.

PubMed

Seloilwe, Esther Salang; Thupayagale-Tshweneagae, Gloria

2009-07-01

The presence of sexual abuse among societies in Botswana is a phenomenon whose occurrence is usually denied albeit the police report on it and legal frameworks have been established to combat it. Several factors influence the concealment of sexual abuse among adolescent girls, which includes cultural factors and social status of the perpetrators. This paper espouses the concept of sexual abuse among adolescent girls, the existence of the problem, its magnitude, the factors that increase vulnerability to violence and abuse, and how these factors intersect with HIV and AIDS. Two case studies using a discovery method were used to explore the phenomenon under the study. The findings of the study indicated that sexual abuse and violence have profound mental health consequences including guilt, anxiety, depression and anger. Future research is suggested to explore this problem on a wider scale and develop interventions that can assist victims and perpetrators to cope with the situation.

Treatment compliance under physician-industry relationship: a framework of health-care coordination in the USA.

PubMed

Chen, Jie; Vargas-Bustamante, Arturo

2013-07-01

Factors associated with treatment compliance have been well studied. However, no study has examined treatment compliance under the context of physician-industry relationship. This study developed a conceptual framework of physician-industry relationship and treatment compliance, and empirically tested patients' treatment compliance and affordability under the physician-industry relationship in the USA. We first proposed a conceptual framework to analyze different scenarios, where the physician-industry relationship could impact patients' treatment compliance and affordability, taking into consideration the role of health insurers. We then employed a nationally representative data set to investigate these relationships. Multivariable logistic regressions were employed to examine the physician-industry relationship and the physicians' perception of patients' treatment compliance. 2008 Health Tracking Physician Survey. Our results showed that physicians with closer industry relationships were more likely to report rejection of care by insurers [odds ratios (ORs): 1.24-1.85, P < 0.001], patients' non-compliance with treatment (OR: 1.34, P < 0.01) and patients' inability to pay (OR: 1.42, P < 0.01) as the major problems affecting their ability to provide high quality care, when compared with physicians without industry relationships. Our results shed light on the lack of articulation among industry, physicians and health insurers in the USA. It is important to make sure that different agents in the health-care marketplace, such as physicians, industry, and health insurers, coordinate more efficiently to provide quality and consistent care to patients.

Habitual snoring in school-aged children: environmental and biological predictors.

PubMed

Li, Shenghui; Jin, Xinming; Yan, Chonghuai; Wu, Shenghu; Jiang, Fan; Shen, Xiaoming

2010-10-19

Habitual snoring, a prominent symptom of sleep-disordered breathing, is an important indicator for a number of health problems in children. Compared to adults, large epidemiological studies on childhood habitual snoring and associated predisposing factors are extremely scarce. The present study aimed to assess the prevalence and associated factors of habitual snoring among Chinese school-aged children. A random sample of 20,152 children aged 5.08 to 11.99 years old participated in a cross-sectional survey, which was conducted in eight cities of China. Parent-administrated questionnaires were used to collect information on children's snoring frequency and the possible correlates. The prevalence of habitual snoring was 12.0% (14.5% for boys vs. 9.5% for girls) in our sampled children. Following factors were associated with an increased risk for habitual snoring: lower family income (adjusted odds ratio [OR] = 1.46), lower father's education (OR = 1.38 and 1.14 for middle school or under and high school of educational level, respectively), breastfeeding duration < 6 months (OR = 1.17), pregnancy maternal smoking (OR = 1.51), obesity (OR = 1.50), overweight (OR = 1.35), several respiratory problems associated with atopy and infection, such as chronic/allergic rhinitis (OR = 1.94), asthma (OR = 1.43), adenotonsillar hypertrophy (OR = 2.17), and chronic otitis media (OR = 1.31), and family history of habitual snoring (OR = 1.70). The prevalence of habitual snoring in Chinese children was similar to that observed in other countries. The potential predisposing factors covered socioeconomic characteristics, environmental exposures, chronic health problems, and family susceptibility. Compared to socioeconomic status and family susceptibility, environmental exposures and chronic health problems had greater impact, indicating childhood habitual snoring could be partly prevented by health promotion and environmental intervention.

Psychological coping styles and cortisol over the day in healthy older adults.

PubMed

O'Donnell, Katie; Badrick, Ellena; Kumari, Meena; Steptoe, Andrew

2008-06-01

Patterns of psychological coping are associated with a variety of health outcomes but the underlying pathways are not yet established. The purpose of this study was to assess the relationship between salivary cortisol output over the course of a day and coping style. Data were available from 350 men and 192 women with an average age of 60.9 years. Participants were drawn from the Whitehall II cohort, and had no history of cardiovascular disease. Individuals who were taking medication that might affect cortisol levels were also excluded. Saliva samples were provided on waking, then 0.5, 2.5, 8 and 12h after waking, and just before the participant went to sleep. Coping style was measured with a standard instrument, the COPE, and data were factor analysed to generate three factors: seeking social support, problem engagement and problem avoidance. The relationships between these factors and the cortisol awakening response (CAR), the slope of cortisol change over the day and total cortisol output over the day (excluding the waking period) were assessed using multiple linear regression. Cortisol output over the day was inversely associated with coping with stress by seeking social support (p=0.034) and by problem engagement (p=0.003), independently of age, gender, body mass index, smoking, depression, self-rated health, time of waking and income. Individuals who coped by problem engagement and seeking support had lower cortisol levels. Additionally, gender, BMI, smoking, self-rated health and time of waking were independently related to cortisol output over the day. There were no significant associations between coping and the CAR or cortisol slope over the day. The results indicate that adaptive coping styles are related to low levels of cortisol over the day, suggesting that neuroendocrine pathways may partly mediate relationships between psychological coping and health.

Counterfeit medicines in Peru: a retrospective review (1997-2014).

PubMed

Medina, Edwin; Bel, Elvira; Suñé, Josep María

2016-04-04

To consolidate and assess information on counterfeit medicines subject to pharmaceutical alerts issued by the Peruvian Medicines Regulatory Authority over 18 years (1997-2014) of health monitoring and enforcement. A retrospective review of drug alerts. A search of the website of the General Directorate of Medicines, Supplies and Drugs (DIGEMID) of the Ministry of Health of Peru for drug alerts issued between 1997 and 2014. Drug alerts related to counterfeit medicines. A total of 669 DIGEMID alerts were issued during the study period, 354 (52.91%) of which cover 1738 cases of counterfeit medicines (many alerts deal with several cases at a time). 1010 cases (58.11%) involved pharmaceutical establishments and 349 (20.08%) involved non-pharmaceutical commercial outlets. In 126 cases (7.25%), counterfeit medicines were seized in an unauthorised trade (without any marketing authorisation); in 253 cases (14.56%) the type of establishment or business associated with the seized product was not identified. Counterfeit medicines are a serious public health problem in Peru. A review of the data cannot determine whether counterfeit medicines in Peru increased during the study period, or if monitoring by different government health agencies highlighted the magnitude of the problem by providing more evidence. The problem is clearly structural, since the majority of cases (58.11% of the total) were detected in legitimate supply chains. Most counterfeit medicines involve staple pharmaceutical products and common dosage forms. Considerable work remains to be done to control the serious problem of counterfeit medicines in Peru. 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/

Has NICE got it right? An international perspective considering the case of Technology Appraisal No. 98 by the National Institute for Health and Clinical Excellence (NICE).

PubMed

Schlander, Michael

2008-04-01

The National Institute for Health and Clinical Excellence (NICE) has been widely recognised as setting an international standard for high-quality health technology assessments (HTAs) including economic evaluation. A previous critical analysis of NICE Technology Appraisal No. 98 (TA98), evaluating methylphenidate, dexamphetamine and atomoxetine for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children, revealed a number of issues, which must cast doubt on the robustness of the NICE approach when addressing a complex clinical decision problem. The exploration of potential underlying problems will be followed by a discussion of lessons for international healthcare policy-makers, and is intended to be an invitation to further debate and inquiry, not a presentation of definitive conclusions. Pertaining to the technology assessment report, potential problems were identified relating to an unnecessarily narrow scope, data search and selection strategy, the distinction between efficacy and effectiveness, data synthesis across studies and clinical effect measures, and limitations of the economic model. The appraisal process moderated the asserted 'clear conclusions' of the assessment but could not compensate for some of its gaps. It is suggested that key issues contributing to these problems may have included a separation of clinical and economic perspectives, a highly standardised reference case analysis that was followed schematically, the absence of an effective system for quality assurance of technology assessments, and transparency deficits of the economic evaluation. Further considerations for international policy-makers looking at NICE as a potential role model for HTAs are discussed, such as institutional context, the objectives of collectively financed healthcare and related value judgments, the reliance on QALYs as a universal and comprehensive measure of health benefits, the appropriate perspective for analysis, and process-related implications.

The Causes and Influence of Transitional Stress among Chinese Students in Japan.

ERIC Educational Resources Information Center

Jou, Yuh Huey; Fukada, Hiromi

1996-01-01

Classifies and discusses five stress variables affecting the mental health of Chinese students living in Taiwan. These include interpersonal problems, academic problems, health/living problems, financial anxiety, and environmental problems. Although detrimental to mental health, these factors exerted little influence on physical health or…

Breastfeeding knowledge among health workers in rural South Africa.

PubMed

Shah, Sonal; Rollins, Nigel C; Bland, Ruth

2005-02-01

The aim of the study was to conduct a rapid assessment of breastfeeding knowledge amongst health workers in an area of high HIV prevalence. A cross-sectional survey using semi-structured questionnaires and problem-based scenarios was carried out. Responses were compared to those recommended in the World Health Organization (WHO) Breastfeeding Counselling Course. The setting was a rural area of KwaZulu Natal, with a population of 220 000 people. At the time of the study approximately 36 per cent of pregnant women were HIV-infected and no programme to prevent mother-to-child transmission was in place. A convenient sample of 71 healthcare workers (14 doctors, 25 professional nurses, 16 staff nurses, and 16 community health workers) were included in the study. Over 50% of respondents had given breastfeeding advice to clients over the previous month. However, there were significant discrepancies in breastfeeding knowledge compared to WHO recommendations. Ninety-three per cent (n = 13) of doctors knew that breastfeeding should be initiated within 30 min of delivery, but 71 per cent (n = 10) would recommend water, and 50 per cent (n = 7) solids to breastfed infants under 6 months of age. Fifty-seven per cent (n = 8) considered glucose water necessary for neonatal jaundice, constipation, and for infants immediately after delivery. Only 44 per cent (n = 7) of staff nurses and 56 per cent (n = 14) of professional nurses knew that breastfeeding should be on demand. The majority would recommend water, formula milk, and solids to breastfed infants under 6 months of age, and glucose water for neonatal jaundice and immediately after delivery. Knowledge of community health workers differed most from WHO recommendations: only 37 per cent (n = 6) knew that breastfeeding should be initiated within 30 min of delivery, 68 per cent (n = 11) thought breastfeeding should be on schedule and not on demand, and the majority would recommend supplements to infants under 6 months of age. Few respondents suggested taking a feeding history or observing a breastfeed in response to the problem scenarios. The most commonly given responses to problems of babies who were perceived to be thirsty, unsatisfied, or crying after feeds was to supplement with other fluids or feeds. There is a need for systematic and ongoing training in breastfeeding and infant feeding counselling in the context of HIV, so that breastfeeding is not undermined by the current HIV pandemic, and exclusive breastfeeding continues to be promoted for all HIV-uninfected women, women of unknown status, and HIV-infected women who choose to breastfeed.

Health services utilization under Qassam rocket attacks.

PubMed

Goldberg, Lital; Dreiher, Jacob; Friger, Michael; Levin, Alexander; Shvartzman, Pesach

2013-08-01

The Qassam rocket attacks on southern Israel during the years 2000-2007 created a unique situation of life undera continuous threat. The effect of this unique situation on health services utilization has not been previously examined. To evaluate health utilization patterns in two primary care clinics in southern Israel: one under continuous attacks of Qassam rockets as compared with a similar clinic not under a rocket threat. We conducted a retrospective cross-sectional study in two primary care clinics in southern Israel, with 11,630 persons listed in the two clinics during the entire study period. The primary outcome measures were total annual number of visits per person to the clinic and for specific diagnoses, and the number of drug prescriptions issued, emergency room (ER) visits, hospitalization days, cardiac catheterizations and coronary bypass surgeries. In both clinics there was an increase over time in the mean annual number of visits per person. During the years of severe attacks there was an increase in visits with a chief complaint of depression and anxiety and an increase in the number of anxiolytic prescriptions in the study clinic compared with the control. During the same period there was a decrease in the number of ER visits in the study clinic compared with the control. The population under continuous life-threatening events showed more depression and anxiety problems. Under severe bombardment, the residents prefer not to leave home, unless necessary.

The New York Needle Trial: the politics of public health in the age of AIDS.

PubMed Central

Anderson, W

1991-01-01

During the past 5 years, the exchange of sterile needles and syringes for dirty injecting equipment has gained increasing acceptance outside the United States as a potential means of reducing the transmission of the human immunodeficiency virus (HIV) among intravenous drug users. This article describes the controversy over attempts to establish a needle and syringe exchange scheme in New York City between 1985 and 1991. The response to a health crisis is used as an indicator of patterns of social and institutional practice. Advocates of needle exchanges had reached a stalemate with the promoters of law enforcement, and the strategic reformulation of the policy problem in terms of the research process seemed to offer a solution. The article discusses the practical limitations on designing and carrying out a controversial health promotion policy; the use (under constraint) of a restrictive research process to constitute--rather than simply to guide or monitor--public policy; and the potential ethical hazards of health professionals' seeking a polemical recourse to the clinical trial. The efforts to establish a needle exchange in New York thus illustrate more general problems for AIDS prevention. Images p1511-a p1512-a p1513-a PMID:1951815

[Teenage fecundity rates in Chile: a serious public health problem].

PubMed

Molina C, Ramiro; Molina G, Temístocles; González A, Electra

2007-01-01

Teenage fecundity rates are an indicator of epidemiological discrimination in developing countries. To study fertility rates of girls under 14 years of age in Chile from 1993 to 2003. Information of children born alive from mothers aged 10 to 15 years, was obtained from the Chilean National Institute of Statistics. Age segmented population data was obtained from the Ministry of Health. Trends were analyzed by regions and single ages. The rates in communities of the Metropolitan Region were compared. Between 1993 and 2003, there was an increasing trend in fecundity rates, ratios and crude numbers. These rates duplicate from 14 to 15 years of age. In the Metropolitan Region, the fecundity ratios of communities with lower economical incomes is seven times greater than those with higher incomes. During 2003, the fecundity rates in Chile were 100 and 10 higher than those of Holland and Sweden in 1981. In developing countries with very low infant mortality rates such as Chile, the high fecundity rates of young girls is an indicator of a deficient human and social development. Sexual Education and Health Services for adolescents are essential to prevent this public health problem.

Mothers have heavy burden in West Africa.

PubMed

1998-01-01

This article summarizes findings from a study of women's health during pregnancy, delivery, and the postpartum periods in West African countries. The sample included about 20,300 reproductive-age women. One in three women reported a health problem of some kind during the course of pregnancy. One in 16 reported a very severe problem. 1 in 340 died as a result of the pregnancy. 33% of severe complications were due to obstructed labor. 21% were due to hemorrhage before or during delivery. Eclampsia and hypertensive complications were the cause of 10% of severe complications. Only 1.5% of complications were due to infections, but these infections were the cause of most maternal mortality. One woman in five reported a current unwanted pregnancy. 80% of pregnant women delivered in a health facility. 83% were full-term pregnancies. 22% of births weighed under 2500 g (low birth weight). Most women had at least two prenatal visits by the 8th month of pregnancy, but consultations were not successful in identifying complications. Researchers recommend improved training of health providers, strengthened care during the 3rd trimester, and training of motivated persons to assist at the birth.

Levels of health development: a new tool for comparative research and policy formulation.

PubMed

Hunter, S S

1990-01-01

Levels of health development are formed by mathematically clustering countries using six health status indicators: crude birth, crude death, infant mortality and child death rates, and male and female life expectancy. Stratifying two international samples of 128 and 163 countries into levels of health development--groups with similar health status profiles--improves the results of regression analyses used to identify economic, political, social, educational, health and other health determinants. For this reason, health development levels are a systematic framework for delineation of health determinants. Earlier large scale statistical studies have been limited in their success in part because they did not partition their data sets prior to analysis, or used inappropriate criteria that blurred rather than heightened developmental differences in underlying social systems. These developmental differences regulate the way in which health status inputs are converted into health status outputs, defining the relative importance of health determinants at various developmental levels. At lowest health development levels (countries with poorer health status), the under-development of economic, health and educational infrastructures creates a vacuum which allows international intervention (aid, investment, export/import activities) to play a dominant role in health status determination. At middle health development levels, health and educational infrastructures are better developed, but still secondary in importance as health status determinants to basic economic infrastructure. Demographic problems are particularly apparent at these levels. At higher health development levels, education, women's status, and political structure are especially important health status determinants. This research has facilitated the identification of health status determinants for use in health policy analysis. Recommendations for future research include use of findings in health policymaking by individual countries and by comparative researchers, and development of appropriate health systems models for each level of health development.

Prevalence and incidence of mental health problems among Dutch medical students and the study-related and personal risk factors: a longitudinal study.

PubMed

Borst, Jorien M; Frings-Dresen, Monique H W; Sluiter, Judith K

2016-11-01

A high prevalence of mental health problems (i.e. depression and/or anxiety) has been found in medical students in comparison with the general population. Therefore, the objective was first to study the prevalence and 1-year incidence of symptoms of depression, anxiety and any mental health problems among Dutch medical students and, second, to study which study-related and personal factors present a risk of these mental health problems. A 1-year prospective longitudinal study was performed among medical students of two medical faculties in the Netherlands (n=951). Health problems and study-related and personal factors were measured with an online questionnaire. Mental health problems were assessed by depression and/or anxiety symptoms (BSI-DEP and BSI-ANG). Univariate and multivariate hierarchical logistic regression analyses were performed to examine which of the study-related and personal factors predict mental health problems. At follow-up, 36%, 28% and 48% of the medical students reported symptoms of depression, anxiety and mental health problems, respectively. The incidence between 2010 and 2011 for depression was 20%, 17% for anxiety and 25% for mental health problems. Students who are worried about their own health during medical education are at an increased risk of future mental health problems (OR 2.0 [1.3-2.9], p=0.00). Excessive drinking behavior is a protective factor in this study (OR 0.7 [0.5-0.9], p=0.02). This study shows that only two out of nine factors are significantly associated with mental health problems among Dutch medical students, one risk factor and one protective factor.

Mental health treatment needs for medical students: a national longitudinal study.

PubMed

Midtgaard, Mirim; Ekeberg, Øivind; Vaglum, Per; Tyssen, Reidar

2008-10-01

We aimed to study the occurrence and predictors of medical students' mental health problems that required treatment. Medical students from all Norwegian universities (N=421) were surveyed in their first term (T1), and 3 (T2) and 6 (T3) years later. The dependent variable was "Mental health problems in need of treatment". Predictor variables included personality traits, medical school stress and negative life events. The lifetime prevalence of mental health problems was 15% at T1. At T2, of the 31% who reported problems during the first 3years, a majority had not sought help. At T3, 14% reported problems during the preceding year. Adjusted predictors of problems at T2 were previous mental health problems (p<.001), low level of intensity personality trait (extraversion) (p<.01), reality weakness personality trait (p<.01), perceived medical school stress (p<.05) and negative life events (p<.05). Mental health problems during the first 3years were predicted by previous problems, personality, medical school stress and negative life events. A third of the students reported mental health problems during the first 3years. Intervention should focus on both individual problems and contextual stress.

Magnitude, Severity, and Morphological Types of Anemia in Hospitalized Children Under the Age of Five in Southern Tanzania

PubMed Central

Genge, Christopher M; Yeyeye, Leonia; Twalib, Zainab; Kibopile, Wilfred; Rutalemba, Fredrick J; Shengena, Tito M

2017-01-01

Introduction Anemia is a significant public health problem among children and women globally. It is one of the most common causes of deaths among children admitted to hospitals in sub-Saharan Africa. Case fatality rates of 6 percent to 18 percent have been reported even in facilities that have blood transfusions services. The purpose of this study was to evaluate the magnitude, severity, and morphological types of anemia among hospitalized children under five years of age in the southern part of Tanzania. Methods A cross-sectional, hospital-based, retrospective analysis was conducted in February 2016 using hospital records of 303 children aged 0-59 months admitted to St. Benedict Ndanda Referral Hospital, Mtwara, Tanzania between 1 July 2015 and 31 December 2015.  Results The mean hemoglobin (Hb) level of the study population was 7.87 ± 2.84 g/dL, the median was 8.00g/dL, the interquartile range (IQR) was 4.40g/dL, and the prevalence of anemia was 83.17 percent. The magnitude of mild, moderate, and severe anemia was 9.13 percent, 44.84 percent, and 46.03 percent, respectively, and about half of all anemic children had normocytic anemia. Conclusion Severe anemia is a common health problem among hospitalized children under five years of age in the study area. We recommend screening all admitted children under the age of five for anemia, and clinicians should pay attention to and put more emphasis on intervention strategies for anemia when treating children admitted for other diseases. PMID:28948119

Workplace bullying and subsequent health problems.

PubMed

Nielsen, Morten Birkeland; Magerøy, Nils; Gjerstad, Johannes; Einarsen, Ståle

2014-07-01

Cross-sectional studies demonstrate that exposure to bullying in the workplace is positively correlated with self-reported health problems. However, these studies do not provide a basis to draw conclusions on the extent to which bullying leads to increased health problems or whether health problems increase the risk of being bullied. To provide better indications of a causal relationship, knowledge from prospective studies on the association between bullying in the workplace and health outcomes is therefore summarised. We conducted a systematic literature review of original articles from central literature databases on longitudinal associations between bullying in the workplace and health. Average associations between bullying and health outcomes are calculated using meta-analysis. A consistent finding across the studies is that exposure to bullying is significantly positively related to mental health problems (OR =1.68; 95% KI 1.35-2.09) and somatic symptoms (OR = 1.77; 95% KI 1.41-2.22) over time. Mental health problems are also associated with subsequent exposure to bullying (OR = 1.74; 95% KI 1.44-2.12). Bullying is positively related to mental health problems and somatic symptoms. The association between mental health problems and subsequent bullying indicates a self-reinforcing process between mental health and bullying. The methodological quality of the studies that were conducted is relatively sound. However, based on the existing knowledge base there are no grounds for conclusions regarding an unambiguous causal relationship between bullying and health.

Clinical Aspects of Foot Health in Individuals with Alzheimer’s Disease

PubMed Central

Grela-Fariña, Marta; Losa-Iglesias, Marta Elena; Rodríguez-Sanz, David

2018-01-01

Alzheimer’s disease (AD) shows a marked presence of physiologic changes and the start or aggravation of underlying diseases such as physical frailty in diverse anatomical regions. It is believed to have a particularly harmful effect on the health of the foot. We examined the foot health status in older persons with AD, with a specific focus on the extent to which people with AD may be using inadequate footwear in old age. Seventy-three community-dwelling people with probable, mild to moderate AD aged 65–95 years were recruited from a center of excellence for AD. A single trained physician evaluated health status and foot conditions. Current shoe and foot length and width measurements were taken using a calibrated Brannock device. The results indicate that sixty-five participants (89.04%) suffered from feet problems. Also, only twenty-two subjects (30.14%) used the correct shoes in width and size related with the morphology of their feet. Fifty-one participants (69.86%) were using incorrect shoes in length or width. The present study revealed that peoples with AD had a high presence of foot health problems. Also, the use of inappropriate shoes revealed measurable differences of association between shoe size and the morphology of the foot. PMID:29414905

At the crossroads: new paradigms of food security, public health nutrition and school food.

PubMed

Ashe, Leah M; Sonnino, Roberta

2013-06-01

Public health nutrition sits at the nexus of a global crisis in food, environmental and health systems that has generated - along with numerous other problems - an urgent and changing problem of food insecurity. The 'new' food insecurity, however, is different from the old: it is bimodal, encompassing issues of both under- and over-consumption, hunger and obesity, quantity and quality; it has assumed a decidedly urban dimension; and it implicates rich and poor countries alike. The complexity of the expressions of this challenge requires new approaches to public health nutrition and food policy that privilege systemic, structural and environmental factors over individual and mechanistic ones. In this context, the current paper argues that school food systems rise with buoyant potential as promising intervention sites: they are poised to address both modes of the food security crisis; integrate systemic, structural and environmental with behavioural approaches; and comprise far-reaching, system-wide efforts that influence the wider functioning of the food system. Based on a discussion of Bogotá and other pioneering policies that explicitly aim to create a broader food system with long-term foundations for good public health and food security, the paper suggests a new research and action agenda that gives special attention to school food in urban contexts.

Expanding the scope of health information systems. Challenges and developments.

PubMed

Kuhn, K A; Wurst, S H R; Bott, O J; Giuse, D A

2006-01-01

To identify current challenges and developments in health information systems. Reports on HIS, eHealth and process support were analyzed, core problems and challenges were identified. Health information systems are extending their scope towards regional networks and health IT infrastructures. Integration, interoperability and interaction design are still today's core problems. Additional problems arise through the integration of genetic information into the health care process. There are noticeable trends towards solutions for these problems.

Experience from mental health clinics held during medical service camps in Fiji.

PubMed

Sivakumaran, Hemalatha; George, Kuruvilla; Naker, Gunu; Nadanachandran, Kathir

2015-12-01

We aim to describe the experience and findings of mental health clinics held during medical service camps in the rural settings of Fiji. Descriptive data collated at the end of the medical camps across 2011-2014 are used to highlight the main findings. The exposure to mental health assessments and brief interventions at these camps was a validating experience for both individuals and medical students attending the clinics. The most common presentations can be categorised under symptoms of depression, anxiety and relationship problems. The accessibility of mental health support services is a challenge in Fiji. Medical service camps can form an important pathway in promoting mental health awareness, especially amongst the rural communities of Fiji, and a useful platform for medical students to acquire some clinical exposure. © The Royal Australian and New Zealand College of Psychiatrists 2015.