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Zeitschriftenartikel zum Thema "Public Health and Health Services not elsewhere classified"
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Duron, Rebecca, Michael Mugavero und Andrew Westfall. „2497“. Journal of Clinical and Translational Science 1, S1 (September 2017): 81. http://dx.doi.org/10.1017/cts.2017.286.
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OBJECTIVES/SPECIFIC AIMS: Approximately 50% of people who have been diagnosed with HIV are either not linked to a care provider or not retained in medical care. This has substantial implications for both individual and public health outcomes. On an individual level, being retained in care is necessary for continuous receipt of antiretroviral therapy and sustained viral suppression. The public health implications of poor retention in HIV care are also serious, as it is estimated that people with HIV who are not retained in medical care are responsible for a majority of HIV transmissions, even more than the number of transmissions attributable to those who are HIV infected but undiagnosed. State departments of health routinely collect surveillance data including positive HIV test results, CD4 counts and viral load measures for monitoring trends in HIV infection. A shift in the use of these surveillance measures, guided by the CDC, has brought forth the opportunity to use these data for direct patient services and, more specifically, to direct re-engagement and retention in care efforts. Although the risk factors for poor retention in HIV care have been characterized using information from individual or multiple clinics, this study seeks to incorporate state surveillance data into the retention measures. METHODS/STUDY POPULATION: This retrospective cohort study was performed at the University of Alabama at Birmingham 1917 HIV/AIDS Clinic among patients with at least one attended HIV primary care visit during the calendar year of 2015. Retention during the calendar year of 2016 was then measured as whether or not a patient had 2 or more completed clinic visits which were separated by more than 90 days (in accordance with the Health Resources and Services Administration or HRSA guidelines, a National HIV Quality Indicator). For patients who did not have any primary care visit in 2016, the Alabama Department of Public Health will provide a status of care (out of care, in care elsewhere, died, moved out of state, and cannot locate) based on HIV laboratory results reported from all clinics and labs across the state and/or mortality information. A multinominal regression model of the status of care will be fitted to demographic, clinical, laboratory, and behavioral patient reported outcomes captured during an index visit in 2015. RESULTS/ANTICIPATED RESULTS: Data were recently obtained and is currently being analyzed on 3107 patients included in this study. We anticipate that there will be differences in the factors significantly associated with patients classified as out of care, poorly retained (patients who have only one completed clinic visit), and retained in care by the HRSA measure during calendar year 2016. DISCUSSION/SIGNIFICANCE OF IMPACT: By incorporating state surveillance data into our analysis, we expect to obtain a more precise picture of the risk factors for poor retention among HIV patients. For the first time, we will be able to determine if patients lost to our HIV clinic (~10% annually) are entirely lost to medical care or are seeking care elsewhere as indicated by HIV lab data reported to public health via surveillance. Identified risk factors will then be able to better inform the efforts to proactively improve the efficiency for HIV patient retention and re-engagement, and therefore lead to better individual outcomes for HIV patients and reduce the incidence of new HIV cases.
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Brand, Nathan R., Nicholas Wolf, John Flanigan, Richard Njoroge und Alfred Karagu. „Histology and Cytopathology Capacity in the Public Health Sector in Kenya“. Journal of Global Oncology, Nr. 4 (Dezember 2018): 1–7. http://dx.doi.org/10.1200/jgo.17.00122.
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Purpose Histology and cytopathology services are necessary for cancer diagnosis and treatment. However, the current capacity of Kenya’s pathology laboratories is unknown. A national survey was conducted among public sector pathology laboratories to assess their capacity to perform histology, fine-needle aspiration, and bone marrow aspiration. Methods Between April and June 2017, we identified all public hospitals that provide pathology services in Kenya. In total, two national and 13 county referral hospitals met the inclusion criteria and were sent a standardized, pretested, self-administered questionnaire. Results A total of 11 hospitals (73%) completed the survey. The reported total caseload of histology, fine-needle aspiration, and bone marrow aspiration for 2016 was 26,472. All of the facilities staffed a pathologist and were providing cancer-related diagnostic services. Nine (82%) of the hospitals maintain a register of diagnosed cancer cases, but only one (11%) of those uses an electronic system. Six (55%) of the surveyed hospitals were able to perform histology with a median turnaround time of 14 days. Six (55%) laboratories regularly referred some specimens elsewhere for interpretation, but three of these centers relied on patients for transportation of the specimen to the referral institution. No laboratories were accredited by an external organization; however, 10 (91%) of the laboratories were working toward achieving accreditation, but only for clinical pathology services. Conclusion This study describes the current status of histology and cytopathology capacity in Kenya’s public sector hospitals. It provides useful baseline information needed by the Ministry of Health to develop necessary capacity building and referral-strengthening interventions. A high proportion of hospitals are working to achieve accreditation points toward their commitment to providing quality services to the Kenyan public.
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Pipe, Andrew L., William Evans und Sophia Papadakis. „Smoking cessation: health system challenges and opportunities“. Tobacco Control 31, Nr. 2 (März 2022): 340–47. http://dx.doi.org/10.1136/tobaccocontrol-2021-056575.
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The systematic integration of evidence-based tobacco treatment has yet to be broadly viewed as a standard-of-care. The Framework Convention on Tobacco Control recommends the provision of support for tobacco cessation. We argue that the provision of smoking cessation services in clinical settings is a fundamental clinical responsibility and permits the opportunity to more effectively assist with cessation. The role of clinicians in prioritising smoking cessation is essential in all settings. Clinical benefits of implementing cessation services in hospital settings have been recognised for three decades—but have not been consistently provided. The Ottawa Model for Smoking Cessation has used an ‘organisational change’ approach to its introduction and has served as the basis for the introduction of cessation programmes in hospital and primary care settings in Canada and elsewhere. The significance of smoking cessation dwarfs that of many preventive interventions in primary care. Compelling evidence attests to the importance of providing cessation services as part of cancer treatment, but implementation of such programmes has been slow. We recognise that the provision of such services must reflect the realities and resources of a particular health system. In low-income and middle-income countries, access to treatment facilities pose unique challenges. The integration of cessation programmes with tuberculosis control services may offer opportunities; and standardisation of peri-operative care to include smoking cessation may not require additional resources. Mobile phones afford unique opportunities for interactive cessation programming. Health system change is fundamental to improving the provision of cessation services; clinicians can be powerful advocates for such change.
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Sices, Laura, Jeffrey S. Harman und Kelly J. Kelleher. „Health-Care Use and Expenditures for Children in Special Education with Special Health-Care Needs: Is Dual Classification a Marker for High Use?“ Public Health Reports 122, Nr. 4 (Juli 2007): 531–40. http://dx.doi.org/10.1177/003335490712200415.
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Objectives. Children with special health-care needs are an important group for policy and research planning. Special education engages a group of children with increased utilization of services related to education. While increased service utilization in education or health-care settings is often used to classify children as having special needs, considerable heterogeneity exists within each group. The extent to which being identified in two functionally defined systems—special education and health care—relates to health-care utilization is unknown. We sought to determine health-care and mental health utilization and expenditures for children dually classified as receiving special education and having special health-care needs (SHCN) compared with those who only have SHCN, only are in special education, or don't fall into either category. Methods. A nationally representative sample of children aged 5–17 years from the Medical Expenditure Panel Survey was used to compare mean health-care and mental health utilization and expenditures for the four groups. Results. Dually classified children had significantly higher mean utilization of health-care services than the other three groups ( p,0.05). Mean 12-month total health-care expenditures were highest for dually classified children ($3,891/year) ( p,0.05) and higher for children classified only as having SHCN ($1,426/year) than for children with neither classification ($644/year, p,0.05). Conclusions. Children dually classified as receiving special education and having SHCN represent a subgroup of children with SHCN with high levels of health-care utilization and expenditures. This information can assist policy makers in identifying characteristics that place children at risk for very high expenditures, and in allocating health-care resources.
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Macdonald, John. „Primary Health Care or Primary Medical Care: In Reality“. Australian Journal of Primary Health 13, Nr. 2 (2007): 18. http://dx.doi.org/10.1071/py07019.
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Despite considerable rhetoric, comprehensive primary health care remains largely a matter of a paper exercise. The theory promotes horizontal and vertical integration and the active participation of people in planning. Experience in Australia and elsewhere indicates that what is in place in health services is often primary medical care: the management of the needs of presenting individuals. The arguments for upstream interventions remain valid, bolstered by research on the social determinants of health. Two examples are given of primary health care that attempt to work upstream, before clinical interventions become necessary and illustrate the need for both horizontal and vertical integration. Consequences for policy and training are drawn.
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Dolja-Gore, Xenia, Deborah Loxton, Catherine D'Este und Julie E. Byles. „Transitions in health service use among women with poor mental health: a 7-year follow-up“. Family Medicine and Community Health 10, Nr. 2 (Juni 2022): e001481. http://dx.doi.org/10.1136/fmch-2021-001481.
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ObjectiveWomen suffering from mental health problems require varied needs of mental health service utilisation. Transition between general practitioner and mental health services use are available through the Better Access Scheme initiative, for those in need of treatment. The study’s aim was to identify trajectories of mental health service utilisation by Australian women.DesignThe Australian Longitudinal Study on Women’s Health data linked to the administrative medical claims dataset were used to identify subgroups of women profiled by their mental health service use from 2006 to 2013. Latent growth mixture model is a statistical method to profile subgroups of individuals based on their responses to a set of observed variables allowing for changes over time. Latent class groups were identified, and used to examine predisposing factors associated with patterns of mental health service use change over time.SettingThis study was conducted in Australia.ParticipantsNational representative sample of women of born in 1973–1978, who were aged between 28 and 33 years at the start of our study period.ResultsSix latent class trajectories of women’s mental health service use were identified over the period 2006–2013. Approximately, one-quarter of the sample were classified as the most recent users, while approximate equal proportions were identified as either early users, late/low user or late-high users. Additional, subgroups were defined as the consistent-reduced user and the late-high users, over time. Only 7.2% of the sample was classified as consistent high users who potentially used the services each year.ConclusionThese findings suggest that use of the Better Access Scheme mental health services through primary care was varied over time and may be tailored to each individual’s needs for the treatment of depressive symptoms.
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Emmett, Edward A. „Asbestos in High-Risk Communities: Public Health Implications“. International Journal of Environmental Research and Public Health 18, Nr. 4 (07.02.2021): 1579. http://dx.doi.org/10.3390/ijerph18041579.
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Asbestos-related diseases (ARDs)—mesothelioma, lung cancer, and asbestosis—are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, Montana; Wittenoom, Western Australia; Karain, Turkey; Ambler, Pennsylvania; and elsewhere. Community ARDs pose specific public health issues and challenges. Community exposure results in higher proportions of mesothelioma in women and a younger age distribution than occupational exposures. Exposure amount, age at exposure, fiber type, and genetic predisposition influence ARD expression; vulnerable groups include those with social and behavioral risk, exposure to extreme events, and genetic predispositions. To address community exposure, regulations should address all carcinogenic elongated mineral fibers. Banning asbestos mining, use, and importation will not reduce risks from asbestos already in place. Residents of high-risk communities are characteristically exposed through several pathways differing among communities. Administrative responsibility for controlling environmental exposures is more diffuse than for workplaces, complicated by diverse community attitudes to risk and prevention and legal complexity. The National Mesothelioma Registries help track the identification of communities at risk. High-risk communities need enhanced services for screening, diagnosis, treatment, and social and psychological support, including for retired asbestos workers. Legal settlements could help fund community programs. A focus on prevention, public health programs, particularization to specific community needs, and participation is recommended.
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Sophia Mei G, Letada Krystine, Bucalon Erika U., Enopia Jeminabelle N., Lambungog Lara M., Mama Bai Sharjah Ayen T. Taer, Giovanni G., Togonon Apple Joy T., Yana Aleya Bernadeene G. und Erwin M. Faller. „Emerging Roles of Community Pharmacist in Public Health: A Review on ASIA“. International Journal of Research Publication and Reviews 03, Nr. 12 (2022): 1133–53. http://dx.doi.org/10.55248/gengpi.2022.31229.
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This study's aim was to conduct a comprehensive review of previously published research publications related to the emerging roles of community pharmacists in public health in Asia. It aims to analyze the new roles that community pharmacists are being called upon to fill in Asian regions in public health with also a focus on maximizing the full capacity of pharmacist skills and development to public health, a continuing advocate, and first-line empowerment of providing pharmacy information queries. The written works of this study utilized a systematic search of existing literature, including articles reporting on the emerging roles of community pharmacists in public health, using the following databases: Cochrane, Google Scholar, Science Direct, PubMed/Medline, and Research Gate. Hand searching relevant articles on the research topic were employed to help ensure the confinement of all necessary existing literature/articles. The intervention or services types are classified based on the following: smoking cessation services, weight management services, alcohol reduction services, chronic disease management, drug misuse prevention and management services, and immunization and vaccination services; each comprises different major processes aiming to improve an individual's health status providing ways upon validation that are crucial for the betterment of public healthcare. In accordance with the studies, community pharmacist-led public-health programs markedly strengthened the efficiency, steadfastness, and cost-effectiveness of the allocation of public health resources whilst still optimizing the health of clients and patients, specifically whenever it arrives at assessing prospective issues and individuals who seek specialized care. Notwithstanding such, community pharmacy operations still necessitate modification to satisfy the evolving demands of consumers of modern medications. Training must attempt to boost pharmacists' confidence in supplying these services if community pharmacies are to elevate the public health services they serve. A proactive approach to the delivery of public health care by confident, well-trained pharmacists should have a favorable impact on client attitudes and health.
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Jean, Gillian, Estie Kruger und Marc Tennant. „Universal access to oral health care for Australian children: comparison of travel times to public dental services at consecutive census dates as an indicator of progressive realisation“. Australian Journal of Primary Health 26, Nr. 2 (2020): 109. http://dx.doi.org/10.1071/py19148.
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Progressive realisation of equitable access to health services is a fundamental measure of a state’s resolve to achieve universal health coverage. The World Health Organization has reprioritised the importance of oral health services as an integral element of the roadmap towards health equity. This study sought to determine whether there is an indication of progressive realisation of equitable spatial access to public dental services for Australians <18 years of age through a comparison of travel times to the nearest public dental clinic at successive census dates. The distribution of children classified by rural remoteness and level of socioeconomic disadvantage, as well as the location of public dental clinics at the 2011 and 2016 Australian Bureau of Statistics censuses, was mapped using geographic imaging software. OpenRouteService software was used to calculate the travel time by car between each statistical census district and the nearest public dental clinic. There has been an improvement in the percentage of the population <18 years of age living within a reasonable travel time of a public dental clinic. The most socioeconomically disadvantaged groups in more densely populated areas have better spatial access to publicly funded dental services than less disadvantaged groups. Children living in very remote areas continue to experience lengthy travel times to access fixed oral health services.
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Fisk, M. J. „A Comparison of Personal Response Services in Canada and the UK“. Journal of Telemedicine and Telecare 1, Nr. 3 (September 1995): 145–56. http://dx.doi.org/10.1177/1357633x9500100304.
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Personal response services operating over public telephone networks are now widespread in Western Europe and North America. They serve the needs of a million people in the UK and a further two to three million elsewhere. While most clients are elderly, the scope of such services is extending to people with support needs of all ages, especially where there are medical risks or a likelihood of falls. Such services are, therefore, on a convergent course with those concerned with telemedicine. A study of two personal response services was carried out, one based in Ottawa (Canada) and the other in Oldham (UK). The parallels and contrasts were examined through a survey involving personal interviews with samples of clients. Thirty-eight valid personal interviews were completed, 20 in Ottawa and 18 in Oldham, representing 14% and 53% respectively of all service clients in the survey areas. It is concluded that services established within the health sector (such as many in Canada) are better placed to accommodate change. Convergence with telemedicine will, as a result, be facilitated. In the UK, health authorities and trusts are likely to develop their own telemedicine services in competition with current providers of personal response services, thus delaying convergence.
Dissertationen zum Thema "Public Health and Health Services not elsewhere classified"
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Kane, Ros. „Providing sexual health services in England : meeting the needs of young people“. Thesis, London School of Hygiene and Tropical Medicine (University of London), 2005. http://eprints.lincoln.ac.uk/11992/.
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There is an on-going debate among health professionals, policy-makers and politicians, as to the optimal way of delivering sexual health services to young people. There is as yet, no consensus on their best patterns of organisation or configuration. This study uses qualitative and quantitative research methods, to explore both the views of young people accessing sexual health services, expressed through in-depth interview, and variations in client satisfaction with different characteristics of service delivery, expressed through completion of a questionnaire. The key research questions are: How does young people’s satisfaction with sexual health services vary with the age-dedication of the service; that is, whether it serves young people only, or all ages? How does young people’s satisfaction with sexual health services vary with the integration of the service; that is, whether family planning and genito-urinary services are offered separately, or together? How does young people’s satisfaction with sexual health services vary with the location of the service; that is, in community or hospital based services? In the qualitative component, in-depth interviews were conducted with 25 young people recruited from a purposively selected sample of young people’s services. In the survey, a total sample of 1166 was achieved. Of these, 36% were attending an integrated contraceptive and STI service and 64% were attending a more traditional ‘separate’ service. 48% attended a service dedicated to young people and 52% an all-age service. 50% attended a hospital-based service and 50% a service located in the community. Of the total sample, 22% were male and 78% female. The analysis has been done not on a comparison of services in their entirety, but on a comparison of key features of their organisation, that is, whether they are provided separately as contraceptive and STI sessions or services, or whether these aspects of sexual health provision are integrated in sessions or services (integration); on whether they are run exclusively for young people or for all ages (dedication); and on whether they are located in the community or in a hospital setting (location). Recommendations are made for future service development and delivery and implications for policy are discussed.
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(9183161), Sariya Udayachalerm. „Opioid Prescribing and Health Outcomes in Opioid Naive Patients in Indiana: Analysis of A Statewide Health Information Exchange Database“. Thesis, 2020.
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Widespread use of prescription opioids has been a major public health concern since 1999. Many consequences are associated with the problem, such as opioid misuse, abuse, and drug overdose deaths. Opioids are not the only medications involved with drug overdose deaths. Due to stricter control of prescription opioids, those who misused opioids are associated with initiation of another illicit drug abuse. This results in increased drug overdose death involving heroin and semisynthetic/synthetic opioids. Another risk factor for increased overdose death is concurrent use of opioids with other central nervous system (CNS) depressants and some anticonvulsants. Concurrent use of opioids and benzodiazepine, z-drugs (zolpidem and zaleplon), gabapentin, and/or pregabalin is associated with increased risk of respiratory depression and drug overdose death. To combat problematic opioid use, many mitigation strategies were introduced. However, opioid-related problems remain.
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(9779018), Annie Banbury. „Digital futures: Ehealth, health literacy and chronic disease self-management skills for older people“. Thesis, 2018. https://figshare.com/articles/thesis/Digital_futures_Ehealth_health_literacy_and_chronic_disease_self-management_skills_for_older_people/13446056.
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Increasing numbers of Australian older people are living with chronic disease. Their ability to effectively self-manage their conditions is an important issue, not only for their own health but also for the government, who are concerned with spiralling healthcare costs. CDSM is informed, in part, by an individual’s health literacy which are non-disease-specific skills relating to finding, appraising and using health information, and encompass factors such as communicating with health care providers, navigating complex health systems and having social support to engage in managing health. New technologies provide the opportunity to deliver healthcare in innovative ways. However, there is a paucity of evidence on their use, particularly in community care.
The purpose of this study was to: (1) understand what home-based group videoconference (VC) interventions have been developed for the e-health setting; (2) identify the mechanisms of delivering group education and social support by VC for older people; and (3) examine the impact of such a program in delivering patient education on health literacy, chronic disease self-management (CDSM) and social support.
E-health, an umbrella term which includes telehealth, provides healthcare from a distance using telecommunications techniques. The Australian Government considers e-health as a key component in the future delivery of healthcare. E-health and telehealth are emerging vehicles to provide health information on CDSM as well as the opportunity to develop innovative patient education methods. Telehealth disrupts usual care, for example, using videoconferencing (VCing) for a consultation can negate the need for health professionals and patients to be physically in the same space. A particularly underexplored area is the use of group videoconferencing (VCing) for CDSM and health literacy patient education that is delivered into the patients’ homes.
Group work is an effective method for providing CDSM knowledge and skills. However, there are known barriers for patients in accessing groups; these include timing, mobility, transport, and fear of meeting new people. Group VCing may provide the opportunity to overcome some of these barriers to enable wider access to group settings.
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This study, the Telehealth Literacy Project (THLP) was situated in the real world setting, working in collaboration with an aged care industry partner provider with community-dwelling older people aged between 49 and 90. It was nested within a wider telehealth remote monitoring study and explored the methodology of using group VCing to engage with older people. In order to answer the research questions, an intervention was developed specifically to test the methodology of group VCing. This thesis is focused on answering the research questions on the methodology of using group VCing and not on critiquing the intervention. In addition it reports only data from the THLP.
A mixed method research design was employed during the study, including a systematic review, co-creation of the intervention with health professionals and participants and for the program evaluation, pre- and post-intervention quantitative measures (with control and intervention groups) and qualitative interviews. An evaluation framework was developed from the literature comprising overarching concepts of feasibility, acceptability and effectiveness
In the THLP there were two groups, an intervention group comprising 52 participants who opted-into the weekly VC group intervention and a control group of 60 participants who chose not to take part in the intervention but who completed a baseline questionnaire. Following baseline data analysis those who opted-in to take part in the intervention were grouped by similar levels of health literacy. Each week intervention participants would meet in a virtual room and take part in discussions with the researcher on different health literacy and generic CDSM issues. Slides and videos were used to facilitate discussion with an emphasis on participants being engaged in conversation with each other to promote social support.
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(9790934), Cally Jennings. „Internet delivered physical activity interventions for primary and secondary prevention: Increasing website usage and improving behaviour change outcomes“. Thesis, 2011. https://figshare.com/articles/thesis/Internet_delivered_physical_activity_interventions_for_primary_and_secondary_prevention_Increasing_website_usage_and_improving_behaviour_change_outcomes/13459277.
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"Research highlights the increasing burden of physical inactivity and chronic disease ... The overall purpose of this research was to explore the utility and effectiveness of internet delivered physical activity behaviour change programs in primary and secondary prevention ... The second step was to examine predictors of website usage within a current publicly accessible physical activity website (10,000 Steps) aimed at primary prevention "--Abstract.
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(9777044), Meghan Ambrens. „The evaluation of technology-delivered fall prevention programmes for community-dwelling older people“. Thesis, 2021. https://figshare.com/articles/thesis/The_evaluation_of_technology-delivered_fall_prevention_programmes_for_community-dwelling_older_people/20063669.
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Background: Falls and fall-related injury among older people are a major public health burden. Exercise-based fall prevention programmes are effective in reducing falls in older community-dwelling people. However, this effectiveness is hampered by low participation and adherence. Digital technologies are a novel and potentially effective method for delivering tailored fall prevention exercise programmes to older people.
Aims and objectives: This thesis aims to evaluate the effectiveness, acceptability and cost-effectiveness of technology-driven fall prevention programmes in older community-dwelling people. The following research questions were examined: Are eHealth-delivered exercise programmes effective at improving balance in people aged 65 years and older living in the community compared to a control? Is a home-based balance exercise programme delivered through a tablet-based technology acceptable to older people living in the community? Is an e-Health balance exercise programme a cost-effective way to reduce falls and injurious falls in community-living older people compared to usual care?
Methods: A series of related studies were conducted to answer these questions, including: a systematic review with meta-analysis, a qualitative study, and a health economic evaluation. The systematic review and meta-analysis evaluated randomised controlled trials of eHealth-delivered exercise programmes for community-dwelling people aged 65 years and over, published in English. The primary outcomes were static and dynamic balance. Secondary outcomes included fall risk and fear of falling. The standardised mean differences (SMDs, Hedges’s g) were calculated with 95% confidence intervals from random effects meta-analyses.
The qualitative study recruited 50 participants from StandingTall, a large randomised controlled trial which delivered a home-based fall prevention programme via a tablet-computer. Participants were selected using purposive sampling and to ensure maximum variability. Data was collected via one-on-one interviews by qualified research staff at one of three different time points (1 month, 6 months and 12 months) over 12 months. Interviews were transcribed verbatim, verified for accuracy and then analysed thematically.
The economic evaluation was a within-trial evaluation of StandingTall. Five hundred and three people aged 70 years or over participated. Cost-effectiveness was measured as the incremental cost per fall, and per injurious fall, prevented. General linear models were used with a gamma distribution for costs and a Poisson regression for rates of falls and injurious falls. Incremental Cost-Effectiveness Ratios (ICERs) were calculated to assess the additional expenditure required to generate an additional unit of benefit. One-way sensitivity analysis and sub-group analyses were performed.
Results: The systematic review and meta-analysis identified nine trials of 498 participants. Eight trials measured static balance, with the pooled effect indicating that eHealth-delivered exercise programmes have a significant effect on static balance (eight trials; SMD = 0.40; 95% CI 0.14 to 0.67). All nine trials measured dynamic balance to find there was no effect on dynamic balance (nine trials; SMD=0.22; 95% CI -0.09 to 0.54). Three trials measured fall risk to find there was no evidence of an effect of eHealth-delivered exercise programmes on fall risk compared to control (SMD=0.28, 95% CI -0.06 to 0.63; I2 = 42.9%, p = 0.173). Three trials measured fear of falling to find there was no evidence of an effect of eHealth-delivered exercise programmes on fear of falling compared to control (SMD = -0.07, 95 % CI -0.34 to 0.20; I2 = 0.0%, p = 0.950).
The qualitative study identified eight themes, which fall into two categories: experiences of using StandingTall and the design of StandingTall. Overall, participants appreciated the flexibility of StandingTall’s tablet-based online delivery, and described an improvement in physical awareness and confidence with everyday activities. Participants also reported various challenges with the technology, and determined that computer literacy is essential for successful engagement. Despite this participants found the overall design of StandingTall as user-friendly, clear, and easy-to-understand.
The economic evaluation found the total programme delivery and care resource cost was $8,321 (standard deviation, SD 18,958) to intervention participants and $6,829 (SD 15,019) to control participants. The incremental cost per fall prevented was $4,785 and per injurious fall prevented was $6,585.
Discussion and conclusion: Falls present a major age-related health challenge for society, and one which is likely to grow in significance as life expectancy increases. This body of research has provided preliminary evidence to demonstrate that balance exercise programmes delivered using technology are an effective, cost-effective and acceptable way of improving balance in older people. This, in combination with the ubiquitous availability of technology, could allow rapid scale-up and implementation of eHealth fall prevention programmes to large populations.
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(9784946), Lisa Caffery. „Rural health equity: A case study“. Thesis, 2021. https://figshare.com/articles/thesis/Rural_health_equity_A_case_study/19105205.
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This research explored the notion of rural health equity and the complexities of formulating innovative and equitable health solutions at the small-scale rural and remote settlement level. Outcomes included improved identification of rural determinants of health and development of new rural health equity data-capture approaches, screening tools and rapid assessments.
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(3436478), Brigid Lynch. „Implementing skin cancer screening clinics in a rural community: A case study of diffusion theory“. Thesis, 2001. https://figshare.com/articles/thesis/Implementing_skin_cancer_screening_clinics_in_a_rural_community_A_case_study_of_diffusion_theory/20022704.
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Skin cancer screening clinics were introduced into a number of towns throughout Queensland as part of the Melanoma Screening Trial (MST), a study investigating the efficacy of screening for melanoma. The MST requires 60% of these towns' populations aged over 30 years to be screened for
melanoma within a three year intervention phase. The aim of this case study is to assess the relationship between Rogers' (1995) diffusion of innovations and the health promotion strategies implemented to encourage attendance at skin cancer screening clinics.
Data were obtained from a number of sources, including administrative files, progress reports, interviews and focus groups and were positioned within a comparative theory/practice matrix. Pattern matching logic was used to
assess the relationship between the health promotion strategies and the theoretical construct of diffusion of innovations.
All components of diffusion of innovations (Rogers, 1995) were addressed by the health promotion strategies encouraging attendance at the skin cancer screening clinics. The delivery of the skin cancer screening clinics was in accordance with principles identified by past diffusion research. The skin cancer screening clinics conformed to most predictors of diffusion success and were delivered within a "real" environment, as suggested by past community -based interventions. A number of changes to existing health promotion strategies and the addition of some new strategies have been suggested to improve the rate of diffusion of skin cancer screening clinics in
the future.
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(8071232), Patrick Raymond Glass. „THE EFFECTS OF COMPUTER SIMULATION ON REDUCING THE INCIDENCE OF MEDICAL ERRORS ASSOCIATED WITH MASS DISTRIBUTION OF CHEMOPROPHYLAXIS AS A RESULT OF A BIOTERRORISM EVENT“. Thesis, 2019.
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The objective of research is to develop a computer simulation modeltoprovide a means to effectively and efficiently reduce medication errors associated with points of distribution sitesby identifying and manipulating screeners with a high probability of generating errors.Points of distribution sites are used to rapidly distribute chemoprophylaxis to a large population in response to a pandemic event or a bioterrorism attack. Because of the nature of therapid response, points of distribution sites require the use of peer-trained helpers who volunteer their services.The implications are that peer-trained helperscould have a variety of experience or education levels. Thesefactors increase the risk of medical errors. Reducing medical errors is accomplished through changing the means in which healthcare providers are trained and focusing on a team approach to healthcare delivery. Computer simulations have been used in the past to identify sources of inefficiency and potential of error. Data for the model werecollected over the course of two semesters. Of the 349 data points collected from the first semester, only 137 data points were usable for the purposes of modelbuilding. When the experiment was conducted again for the second semester, similar results werefound. The control simulation was run 20 times with each screener generating errors with a probability of 0.101 following a Bernoulli distribution. The variable simulation was run 30 times with each screener generating the same probability of errors; however, the researcher identified the screeners generating the errors and immediately stopped them from processing additional agents once they reached five errors. An ANOVA was conducted on the percent errors generated from each simulation run. The results of the ANOVA showedsignificant difference between individuals within the groups. A simulation model wasbuilttoreflect the differences in medical error rates between screeners. By comparing the results of the simulation as the screeners are manipulated in the system, the model can be used to show how medical errors can be reduced in points of distribution sites
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(9824183), Anthea Oorloff. „Caring for a child with food allergies: The experience of parents living in regional Queensland in managing their child’s condition“. Thesis, 2021. https://figshare.com/articles/thesis/Caring_for_a_child_with_food_allergies_The_experience_of_parents_living_in_regional_Queensland_in_managing_their_child_s_condition/19743559.
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This research explored the experience of parents who have a child with newly diagnosed food allergies in regional Queensland. The findings add to the knowledge of strategies that parents can adopt to manage their child's medical, nutritional, and psychosocial needs and how healthcare professionals can support them during this time.
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(9777767), Tess Armstrong. „The influence of analytical thinking on altering gambling beliefs and behaviours“. Thesis, 2021. https://figshare.com/articles/thesis/The_influence_of_analytical_thinking_on_altering_gambling_beliefs_and_behaviours/16836538.
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Gamblers are known to engage in an array of cognitive distortions that fuel poor gambling decisions. Dual process theory suggests that people have preferences for either intuitive or analytical thinking; and these preferences can predict or influence the choices they make. This thesis explored the interplay between a gambler’s cognitive style (their preference for intuitive vs. analytical thinking), their gambling beliefs, and their consequent gambling behaviour. In order to demonstrate the protective nature of analytical thinking, a measure of protective gambling beliefs was developed that was then incorporated into three additional studies designed to assess how an intuitive cognitive style contributes to poor gambling decisions, and conversely the potential for increased analytical thinking to generate safer gambling. The main findings showed that 1) preferences for intuitive (and lack of analytical) thinking contributes to beliefs about gambling that fuel problem gambling and greater gambling consumption; 2) Using general analytic primes at point of play is counterproductive in generating safer gambling, and counter to expectations, resulted in an increase in positive expectations regarding gambling outcomes; 3) Ongoing analytical training that is specific to gambling, in contrast, resulted in protective belief changes and a reduction in time spent gambling. These findings have implication for generating effective interventions and clinical tools that help demystify the decision-making process for gamblers who may be experiencing harm because of intuitive thinking that contributes to poor gambling choices.
Bücher zum Thema "Public Health and Health Services not elsewhere classified"
1
Knight, Paul V. From gut feeling to evidence base: drivers and barriers to the development of health care for older people. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199689644.003.0001.
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Key points• Major advances in medicine, policy, and services for older people have been made over the past fifty years.• The numbers of older people in the UK and elsewhere are increasing and will continue to do so.• This increase has concomitant sociological, medical, and economic challenges that need to be met because they affect the provision of services at all levels.• These challenges are occurring at a time when resources are becoming scarcer and budgets shrinking.• Governments are faced with orchestrating infrastructure and policy in this demanding and complex scenario.• Managers are attempting to do more with less.• Clinicians and other medical professionals are trying to base treatments on sound evidence-based strategies.• There is recognition of the need to include older people and the general public in these processes.• Research may provide us with information that can help resolve these problems.
Buchteile zum Thema "Public Health and Health Services not elsewhere classified"
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Colon, Beverly A. „School-Based Health Services“. In Community Schools in Action. Oxford University Press, 2005. http://dx.doi.org/10.1093/oso/9780195169591.003.0017.
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In order to be successful in school, children must be able to see and hear and must be free of troubling health problems. Our experience with community schools confirms the idea that locating health services within a school provides easy access for students who are not receiving health care elsewhere. However, many problems, such as working with children who lack health insurance and typically end up in the emergency room for episodic care, have to be overcome. More and more of these children and their parents in our schools are recent undocumented immigrants who fear dealing with the health care system. An even larger number of children are simply from “working poor” families in which parents work off the books or for employers that do not or cannot provide health insurance. For those families who are enrolled in public health insurance plans (most typically Medicaid), having that insurance card in hand does not necessarily provide access to care if the family does not know how to negotiate the health care system. Adolescents raise another issue altogether. It has been well documented that adolescents are the largest group of uninsured children. They generally want help with issues they do not want anyone to know about, such as birth control, sexually transmitted diseases, and depression and suicidal thoughts. However, they can, and do, access school-based health centers (SBHCs) for these health needs. The goal of SBHCs is to improve the overall physical and emotional health of children and adolescents. They do this in two important ways—by providing prevention services and by providing direct health care. The majority of school-based clinics are started by a health care provider who has approached a particular school and formed a relationship with the school’s administrators. Such SBHCs are organizationally external to the school system, administered by local health care facilities such as hospitals and community health centers. Once the clinic is in the school, constant outreach to administrators, teachers, and parents must be maintained to remind them that the health center is on-site. The biggest challenge such providers face is the integration of the health services with the activities of the school.
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Ho, Wing Tung, und Ben Yuk Fai Fong. „Public-Private Partnership in Health and Long-Term Care“. In Sustainable Health and Long-Term Care Solutions for an Aging Population, 103–24. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-2633-9.ch006.
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An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.
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Ho, Wing Tung, und Ben Yuk Fai Fong. „Public-Private Partnership in Health and Long-Term Care“. In Healthcare Policy and Reform, 276–97. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-6915-2.ch014.
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An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.
4
Hou, Zhiyuan, und Na He. „Governance and management of public health programmes“. In Oxford Textbook of Global Public Health, herausgegeben von Roger Detels, Quarraisha Abdool Karim, Fran Baum, Liming Li und Alastair H. Leyland, 391–408. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198816805.003.0051.
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Governance is central to improve health systems performance and achieve Universal Health Coverage. Good governance can enable the effective use of health finances, workforce, medicines, and information to deliver better health services and outcomes. Theories of principal-agent and network governance are introduced to better understand health governance at system level. In health governance system, the government, private sector, and civil society are the governing triangle, and form a whole-of-society governance approach for health. We introduce the governing triangle and its role in health governance, governance mechanisms and tools, and the levels of governance, respectively. The triangle plays health governance functions at four levels to collectively pursue health goals: the supranational or national or organizational or programme levels. At each level, tools of governance are central to health governance functions and enabling relationships among triangles. Tools of governance can be classified into nine governance dimensions: accountability, regulation, participation, and consensus in decision-making, formulating policy/strategic direction, organizational adequacy/system design, generating information/intelligence, partnerships for coordination and collaboration, engagement of community, communication, and transparency. Assessment frameworks are further introduced for evaluating whether health governance is effective. And several cases of health governance are introduced for better understanding.
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Burns, Tom. „Planning and providing mental health services for a community“. In New Oxford Textbook of Psychiatry, 1452–63. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199696758.003.0185.
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The aim of this chapter is to assist clinicians and managers review and plan services effectively for their local population. Severe psychiatric disorders manifest themselves in social relations and often disrupt social structures; they have wide-ranging consequences and services need to be comprehensive. Health and social care have been intertwined in psychiatry from its origins—it is neither feasible nor sensible to ignore the wider context of their management. The last 30 years have seen an explosion of Mental Health Services Research alongside the shrinking and closure of mental hospitals (see Chapter 7.6). Policy considerations, particularly cost containment and public safety, have influenced the research agenda which is disproportionately Anglophone (from the United States, United Kingdom, and Australasia) and focused on new services developed as alternatives to institutional care with staffing and motivation that are not easily generalizable. More routine practices, crucial for safe and effective care, have been relatively neglected by researchers. This chapter is mainly devoted to describing the essential components of a mental health service—its ‘building blocks’. It will then consider how they relate to one another, how they can be prioritized, and how integrated into an effective local service linking into other essential services. Lastly it will stress how their inevitable evolution should be monitored. Services for adults (increasingly referred to as ‘adults of working age’ indicating 18–65 years) will be used as the template. In many settings these may be the only services, stretching to accommodate all comers. In better resourced health care systems a range of specialized services have evolved from this basic model and are described elsewhere in this section (refugees 7.10.1, homeless 7.10.2, and ethnic minorities 7.10.3).
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Saks, Mike, und Judith Allsop. „Regulation, risk and health support work“. In Support Workers and the Health Professions, 79–100. Policy Press, 2020. http://dx.doi.org/10.1332/policypress/9781447352105.003.0005.
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The limited regulation of support workers as compared to health professional workers and the ensuing risks are discussed in this chapter from a neo-Weberian standpoint. It is argued from the example of the United Kingdom, and especially England, that it may be in the public interest, in terms of protecting users of services and their carers from harm, to extend the existing regulatory framework in a number of modern societies. This is particularly so at a time when health professions themselves are coming under increasing challenge in the wake of adverse events and the subsequent publicity to which they have been exposed. The range of actions taken to mitigate risk include extending state regulatory controls, establishing registers for additional occupations, increasing employer and professional managerial controls in the public and private sector, and implementing additional requirements for continuing educational development. Health support workers, who are numerically the largest group of health personnel, remain under regulated and under researched. Regulatory confusion too often prevails in the complex division of labour in health care in relation to the risks of support workers to users – not to mention vulnerable support workers themselves in terms of their precarious work conditions, as discussed elsewhere in this volume.
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Grant, Marquis C. „An Analytical Study of the Provision of Mental Health Services for Students With Disabilities in Public School Settings“. In Advances in Educational Marketing, Administration, and Leadership, 278–91. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-5695-5.ch011.
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Students with disabilities often do not receive supportive services if they have coexisting mental health disorders. Students classified with emotional or behavioral disorders for an individualized education plan may be supported by a functional behavior assessment and, in some cases, a behavior intervention plan, but mental health is not included as a related service. Without appropriate mental health services, students face poorer outcomes. Results from a survey of special education teachers and behavior support specialists along with a secondary analysis of existing data revealed that respondents did not receive any mental health training that would allow them to support students with mental health needs. Moreover, funding, legal issues, and policies were emerging themes that likely contributed to the lack of appropriate mental health support in public school systems.
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Flath, David. „Public Economy, Part 1“. In The Japanese Economy, 282–97. 4. Aufl. Oxford University PressOxford, 2022. http://dx.doi.org/10.1093/oso/9780192865342.003.0011.
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Abstract This is the first of two chapters describing the scope and funding of Japan’s public sector. This one discusses Japanese government expenditures. It begins by documenting the goods and services not only provided by the Japanese government but produced by it. These are mostly the labor services of the government employees, including the lean but efficient bureaucracy, a high-status cadre motivated by prospects of amakudari upon leaving government service. Attention is then turned to the aspects of politics and voting that affect Japan’s overall scale of government spending: that Japan is a parliamentary democracy long dominated by a single political party, with a unitary and centralized system of government in which rural prefectures are overrepresented. Given all this, public choice considerations favor disproportionate provision of government services per person in the rural prefectures. In Japan as elsewhere, much but not all government spending is devoted to the provision of public goods—goods like national defense that are non-congested and indivisible. Advantages and disadvantages of government provision as opposed to private provision of public goods are described. Also, the tension that arises among allies in the provision of mutual defense which is a public good shared by both are discussed with reference to the Japan–US alliance. The chapter ends with discussion of the main categories of Japanese government spending—defense, social security, health insurance, and education.
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Himanshu, Peter Lanjouw und Nicholas Stern. „Human Development“. In How Lives Change. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198806509.003.0010.
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This chapter documents that in Palanpur advances in human development have been slower than might have been expected on the basis of observed growth in incomes. Although there have been some improvements in human development indicators, particularly since the mid-1980s, the rate of improvement has been slower than in the rest of Uttar Pradesh and the rest of India. Improvements in literacy rates lag behind achievements recorded elsewhere, as do improvements in health and nutritional outcomes. Public services function poorly and in some respects are showing a decline. Inequities on the basis of income, caste, and gender are strong. With public services generally failing, there is an increased dependence on the private sector, but access is governed by ability to pay. A striking finding is that despite myriad reasons for concern there appears to be little protest within the village against the poor quality and availability of services.
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Sowers, Jeannie. „Environmental Activism in the Middle East and North Africa“. In Environmental Politics in the Middle East, 27–52. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190916688.003.0002.
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Environmental activism has intensified across the Middle East and North Africa over the past few decades, focusing primarily on environmental issues that affect public health and livelihoods. While intrusive security states limit information and stifle civil society, expanding educational opportunities, growing cities, and new means of communication have enabled environmental activism. This includes small-scale, informal, and localized activism to demand access to natural resources and environmental services; the spread of environmental nongovernmental organizations; and the coordinated popular resistance campaign that includes direct action, media outreach, and lobbying. State elites and official media often portray environmental mobilization as a threat to national security and state integrity, but sometimes tolerate it as an informal enforcement mechanism to pressure polluting firms and nonresponsive officials. As elsewhere, state and corporate actors also increasingly deploy their own discourses and interventions, generally focused on technocratic solutions rather than questions of political economy and environmental justice.
Konferenzberichte zum Thema "Public Health and Health Services not elsewhere classified"
1
Janay, Abdullahi Ibrahim, und Bülent Kılıç. „The World Bank and its Roles toward Health: Common Criticisms“. In 6th International Students Science Congress. Izmir International Guest Student Association, 2022. http://dx.doi.org/10.52460/issc.2022.053.
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The World Bank (WB) was established in 1944 for the purpose of issuing long-term loans to governments for reconstruction and economic development following the Second World War (1). Over the time perspectives on development have changed dramatically. In particular, the WB’s focus began to shift to investments in health, energy, telecommunication, transport and infrastructure to earn more profit. In the field of health, the WB has focused on three areas, especially in developing countries: health, nutrition, and population. WB now has a more sophisticated view of well-being, living standards, and poverty and is committing more than 1 billion USD annually for new health projects. (2). The WB’s roles include financing, provision of information, surveillance, technical assistance and training and policy advice (3). The WB has achieved some gains in the fight against poverty. Reducing poverty focuses in part encompassing policies to promote equality but inequalities are still increasing all over the World, especially in the developing countries (4). However, the WB has faced a lot of critiques related to health. Some critiques related to health sector polices and say the bank's conditions on borrowing countries emphasize privatization and public sector contraction. This involved reducing government expenditures (in some cases for health) which have deleterious health effects (2). Other critiques related to the way of raising funds called a user charge for using public sector health services and point to evidence showing that user charges result in a decline in the uptake of services, especially among the people who are most socioeconomically deprived. The bank is also criticized for introducing DALYs to global health assessments. Critics point out that the introduction of DALYs was not based on sound methodology and that the underlying assumptions for their usefulness are weak (2, 5). Finally, the WB is also accused of bribing or conniving top government officials in the developing countries where it projects (6). There is a need for strengthening across the WB in several areas. A critical area is for the WB to strengthen its ability to work on multi-stakeholder solutions through engagement with the public sector, private sector, and citizens, and support primarily the public sector for health services. Similarly, about half of low-income countries are classified as fragile and conflict-affected, posing particular challenges. Furthermore, progress in fighting against poverty and sharing prosperity is accompanied by rising inequality in many countries. So, the WB should increase its efforts to address these issues (4). Introducing evidence into policy making is also a key issue to be strengthened for the future (5). It is also needed to strengthen the monitoring and evaluation methods in the countries.
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Atmaca, Serhat, und Metin Bayrak. „The Impact of Government Spending On Economic Growth in Kazakhstan and Kyrgyzstan“. In International Conference on Eurasian Economies. Eurasian Economists Association, 2017. http://dx.doi.org/10.36880/c09.01974.
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The realization of economic growth in order to grow and develop an economy and increase social welfare is one of the basic aims of every society. For this reason, states are making great efforts to realize economic growth and make it sustainable. In this context, the impact of public expenditure on the economic growth of countries is a matter of research. Government spending can be classified economically as expenditure on capital and current expenditures, functionally as general public services, defense services, education services, public order and security services, economic affairs and services, environmental protection services, health services and other services. There are also investment expenditures made by the government for economic development. In particular, public investment expenditures complementary to private investments have positive effects on growth. The Kazakhstan and Kyrgyzstan economies, which are in the category of developing countries, are looking for ways to achieve development and growth and are implementing various practices and economic policies in this process. In this context, Kazakhstan and Kyrgyzstan have the main purpose of studying and analyzing the effects of the public expenditures that they think will be effective on economic growth. The various variables of public spending in the study were examined with the Karma Average Group (PMG) model, which shows how Kazakhstan and Kyrgyzstan's growth affected their growth in the short and long term. As a result, public spending has been influenced by economic growth and it has been determined which components are active on a country basis.
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Abou-Sido, Marah, Marwa Hamed, Suad Hussen, Monica Zolezzi und Sowndramalingam Sankaralingam. „Are Blood Pressure Devices Available in Qatar Community Pharmacies Validated For Accuracy?“ In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2021. http://dx.doi.org/10.29117/quarfe.2021.0119.
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Research purpose: Hypertension is a leading cause of cardiovascular morbidity and mortality in Qatar. Community pharmacist-managed home blood pressure monitoring (HBPM) services have been shown to provide better control of hypertension. Digital BP devices available and sold in community pharmacies are commonly used for HBPM services. Devices validated for accuracy are important for clinical decision-making. Non-validated devices are more likely to be inaccurate and could potentially lead to poor BP control and health risks. The objectives of our study are 1) to identify the proportion of validated BP devices available in community pharmacies in Qatar and 2) to determine the relationship between the validation status of devices and cuff location and price. Methodology: We visited 28 community pharmacies including the 2 major pharmacy chains in Qatar. The following data were collected about BP devices: brand/model, validation status, cuff location, and price. Findings: A total of 87 distinct models of BP devices from 19 different brands are available in Qatar community pharmacies. The three most commonly available brands are Beurer®, Omron®, and Rossmax®. Most models available are upper arm devices (75%) while the rest are wrist devices (25%). Among all models, only 57.5% are validated. Sixty percent of upper-arm devices and 50% of wrist devices are validated. Importantly, 60% of lower-priced (≤ QAR 250) devices are not validated while 83% of higher-priced (QAR 500-750) devices are validated. Research originality/value: This is a novel study that has investigated the validation status of BP devices available in community pharmacies for the first time. This information will serve both pharmacists and the public alike. In Qatar and elsewhere, there are no regulations on the accuracy of devices sold in community pharmacies. Therefore, regulations on the sale of BP devices should be implemented in the best interest of patient safety.
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Randeniya, M., R. Palliyaguru und D. Amaratunga. „Defining critical infrastructure for Sri Lanka“. In 10th World Construction Symposium. Building Economics and Management Research Unit (BEMRU), University of Moratuwa, 2022. http://dx.doi.org/10.31705/wcs.2022.26.
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In the last few decades, infrastructure has played a major role in supporting modern society. Moreover, there has been an increase in natural and human-induced disasters worldwide. In these situations, securing infrastructure is a major requirement. Confusion and misinformation can result if the boundaries of what constitutes critical infrastructure for a country are not clearly defined. Identification of critical infrastructure is the first step in the process of securing and protecting the available critical assets. This study aims to establish the infrastructure that can be classified as "critical infrastructure" in Sri Lanka. This includes establishing a clear margin for subsectors that fall within and operate within critical infrastructure and, consequently, ascertaining a clear definition for the critical infrastructure of the nation. This study adopted a mixed-method approach, which included an initial comprehensive literature analysis on infrastructure and the parameters involved in determining the criticality of infrastructure. Secondly, a questionnaire and semi-structured interviews were conducted to determine which infrastructure sectors would be most critical to Sri Lanka. The most significant infrastructures with the parameters of national security, economic sustainability, quality of life, public health, and safety, the criticality of infrastructure were ranked in both pre- and post-disaster scenarios, and an appropriate margin for the Sri Lankan critical infrastructure was demonstrated. The emergency services sector was found to have the most significant infrastructure in both pre- and post-disaster situations. Accordingly, the study reveals emergency services, water, energy, transportation, telecommunication, and finance as the critical infrastructures for Sri Lanka.
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Liu, Chengcheng. „Strategies on healthy urban planning and construction for challenges of rapid urbanization in China“. In 55th ISOCARP World Planning Congress, Beyond Metropolis, Jakarta-Bogor, Indonesia. ISOCARP, 2019. http://dx.doi.org/10.47472/subf4944.
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In the past 40 years, China has experienced the largest and fastest urbanization development in the world. The infrastructure, urban environment and medical services of cities have been improved significantly. The health impacts are manifested in the decrease of the incidence of infectious diseases and the significant increase of the life span of residents. However, the development of urbanization in China has also created many problems, including the increasing pollution of urban environment such as air, water and soil, the disorderly spread of urban construction land, the fragmentation of natural ecological environment, dense population, traffic congestion and so on. With the process of urbanization and motorization, the lifestyle of urban population has changed, and the disease spectrum and the sequence of death causes have changed. Chronic noncommunicable diseases have replaced acute infectious diseases and become the primary threat to urban public health. According to the data published by the famous medical journal The LANCET on China's health care, the economic losses caused by five major non-communicable diseases (ischemic heart disease, cerebrovascular disease, diabetes mellitus, breast cancer and chronic obstructive pulmonary disease) will reach US$23 trillion between 2012 and 2030, more than twice the total GDP of China in 2015 (US$11.7 trillion). Therefore, China proposes to implement the strategy of "Healthy China" and develop the policy of "integrating health into ten thousand strategies". Integrate health into the whole process of urban and rural planning, construction and governance to form a healthy, equitable and accessible production and living environment. China is building healthy cities through the above four strategies. The main strategies from national system design to local planning are as follows. First of all, the top-level design of the country. There are two main points: one point, the formulation of the Healthy China 2030 Plan determines the first batch of 38 pilot healthy cities and practices the strategy of healthy city planning; the other point, formulate and implement the national health city policy and issue the National Healthy City. The evaluation index system evaluates the development of local work from five aspects: environment, society, service, crowd and culture, finds out the weak links in the work in time, and constantly improves the quality of healthy city construction. Secondly, the reform of territorial spatial planning. In order to adapt to the rapid development of urbanization, China urban plan promote the reform of spatial planning system, change the layout of spatial planning into the fine management of space, and promote the sustainable development of cities. To delimit the boundary line of urban development and the red line of urban ecological protection and limit the disorderly spread of urban development as the requirements of space control. The bottom line of urban environmental quality and resource utilization are studied as capacity control and environmental access requirements. The grid management of urban built environment and natural environment is carried out, and the hierarchical and classified management unit is determined. Thirdly, the practice of special planning for local health and medical distribution facilities. In order to embody the equity of health services, including health equity, equity of health services utilization and equity of health resources distribution. For the elderly population, vulnerable groups and patients with chronic diseases, the layout of community health care facilities and intelligent medical treatment are combined to facilitate the "last kilometer" service of health care. Finally, urban repair and ecological restoration design are carried out. From the perspective of people-oriented, on the basis of studying the comfortable construction of urban physical environment, human behavior and the characteristics of human needs, to tackle "urban diseases" and make up for "urban shortboard". China is building healthy cities through the above four strategies. Committed to the realization of a constantly developing natural and social environment, and can continue to expand social resources, so that people can enjoy life and give full play to their potential to support each other in the city.
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Bianco, Thais, Renata Drizlionoks, Gabrielle Fernandes de Paula Castanho, Gabriel Lucca de Oliveira Salvador und Maria Helena Louveira. „ANALYSIS AND CORRELATION OF IMAGING FINDINGS WITH THE ANATOMOPATHOLOGICAL STUDY OF BI-RADS 4A LESIONS“. In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1015.
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Introduction: The Breast Imaging Reporting and Data System (BI-RADS®) was developed in 1993 by the American College of Radiology to standardize reports based on imaging findings, classifying them into six categories. Its fourth edition proposed the subdivision of category 4 into three subcategories according to malignancy suspicion. Category 4A shows likelihood of malignancy between 2% and 10%, and diagnosis by biopsy is recommended. Frequent histological findings in the literature for 4A lesions include fibrocystic breast changes, fibroadenoma, columnar cell lesions with atypia, stromal sclerosis, inflammatory disorders, and proliferative epithelial lesions. Objectives: To show the most relevant radiological and histological findings for the BI-RADS® 4A subcategory, corroborating its likelihood ratio of malignancy. Methods: This is a cross-sectional study based on the review of medical records of patients submitted to the anatomopathological study of BI-RADS 4A lesions in public and private health services from Curitiba, Paraná, Southern Brazil, between March and September 2019. The findings were subsequently correlated with histopathological results. Results: A total of 727 core needle breast biopsies were performed – 78.6% guided by ultrasound and 21.4% by stereotaxy. Approximately 35.8% of ultrasound-guided procedures (group X) and 55.4% of stereotaxic biopsies (group Y) were classified as BI-RADS 4A. Among the main imaging findings in group X, solid nodules, solid cystic lesions, and solid heterogeneous areas stood out. Group Y presented clusters of heterogeneous, punctate, amorphous microcalcifications, and findings that did not fit the BI-RADS classification. Benign changes predominated among the histopathological findings in both groups. The malignancy rate according to guidelines of the European classification for anatomopathological results of breast lesions4 remained around 2% in group X and 8.7% in group Y. Conclusions: Based on the results obtained, we concluded that the malignancy rates of biopsies from patients classified as BI-RADS 4A were within the acceptable values established by the literature. However, they varied considerably according to the biopsy method chosen, presenting higher values in patients submitted to stereotaxy.
Berichte der Organisationen zum Thema "Public Health and Health Services not elsewhere classified"
1
Washbum, Brian E. Hawks and Owls. U.S. Department of Agriculture, Animal and Plant Health Inspection Service, Dezember 2016. http://dx.doi.org/10.32747/2016.7208741.ws.
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Hawks and owls can negatively impact a variety of human interests, including important natural resources, livestock and game bird production, human health and safety, and companion animals. Conflicts between raptors and people generally are localized and often site-specific. However, the economic and social impacts to the individuals involved can be severe. Despite the problems they may cause, hawks and owls provide important benefits and environmental services. Raptors are popular with birdwatchers and much of the general public. They also hunt and kill large numbers of rodents, reducing crop damage and other problems. Hawks and owls are classified into four main groups, namely accipiters, buteos, falcons, and owls. All hawks and owls in the United States are federally pro-tected under the Migratory Bird Treaty Act (16 USC, 703−711). Hawks and owls typically are protected under state wildlife laws or local ordinances, as well. These laws strictly prohibit the capture, killing, or possession of hawks or owls (or their parts) without a special permit (e.g., Feder-al Depredation Permit), issued by the USFWS. State-issued wildlife damage or depredation permits also may be required.
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Lessons Learned from the Cambodia Enterprise Infirmary Guidelines development process. Population Council, 2018. http://dx.doi.org/10.31899/sbsr2018.1002.
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Women of reproductive age in Cambodia, and many other developing countries, comprise a large part of factories’ workforce. Integrating family planning and reproductive health information and services into factories can improve workers’ health and help countries achieve FP2020 commitments. This case study looks at the process of how the Cambodian Ministry of Labor and Vocational Training launched, as formal policy, a set of workplace health infirmary guidelines for enterprises. What made this policy process unique for Cambodia—and what can be replicated by health advocates elsewhere—is that a group of organizations typically focused on public health policy successfully engaged on labor policy with a labor ministry. This case study describes the policy process, which was underpinned by the strategic use of evidence in decision-making and has been hailed by government, donors, civil society and industry as a success. The learnings presented in this case study should be useful to health advocates, labor advocates, and program designers.