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Journal articles on the topic "Other health not elsewhere classified"
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Kopacz, Marek S., Cathleen P. Kane, Brady Stephens, and Wilfred R. Pigeon. "Use ofICD-9-CMDiagnosis Code V62.89 (Other Psychological or Physical Stress, Not Elsewhere Classified) Following a Suicide Attempt." Psychiatric Services 67, no. 7 (July 2016): 807–10. http://dx.doi.org/10.1176/appi.ps.201500302.
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Rehm, Jürgen, Mindaugas Štelemėkas, Carina Ferreira-Borges, Huan Jiang, Shannon Lange, Maria Neufeld, Robin Room, Sally Casswell, Alexander Tran, and Jakob Manthey. "Classifying Alcohol Control Policies with Respect to Expected Changes in Consumption and Alcohol-Attributable Harm: The Example of Lithuania, 2000–2019." International Journal of Environmental Research and Public Health 18, no. 5 (March 2, 2021): 2419. http://dx.doi.org/10.3390/ijerph18052419.
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Due to the high levels of alcohol use, alcohol-attributable mortality and burden of disease, and detrimental drinking patterns, Lithuania implemented a series of alcohol control policies within a relatively short period of time, between 2008 and 2019. Based on their expected impact on alcohol consumption and alcohol-attributable harm, as well as their target population, these policies have been classified using a set of objective criteria and expert opinion. The classification criteria included: positive vs. negative outcomes, mainly immediate vs. delayed outcomes, and general population vs. specific group outcomes. The judgement of the alcohol policy experts converged on the objective criteria, and, as a result, two tiers of intervention were identified: Tier 1—highly effective general population interventions with an anticipated immediate impact; Tier 2—other interventions aimed at the general population. In addition, interventions directed at specific populations were identified. This adaptable methodological approach to alcohol control policy classification is intended to provide guidance and support for the evaluation of alcohol policies elsewhere, to lay the foundation for the critical assessment of the policies to improve health and increase life expectancy, and to reduce crime and violence.
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Ericson, U., E. Wirfält, I. Mattisson, B. Gullberg, and K. Skog. "Dietary intake of heterocyclic amines in relation to socio-economic, lifestyle and other dietary factors: estimates in a Swedish population." Public Health Nutrition 10, no. 6 (June 2007): 616–27. http://dx.doi.org/10.1017/s1368980007352518.
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AbstractObjectivesTo estimate the dietary intakes of heterocyclic amines (HCAs), to examine the intakes in relation to socio-economics, lifestyle and other dietary factors and to compare the classification of subjects by intake of HCA versus intake of meat and fish.DesignCross-sectional analysis within the Malmö Diet and Cancer (MDC) cohort. Data were obtained from a modified diet history, a structured questionnaire on socio-economics and lifestyle, anthropometric measurements and chemical analysis of HCAs. HCA intake was cross-classified against meat and fish intake. The likelihood of being a high consumer of HCAs was estimated by logistic regression analysis. Dietary intakes were examined across quintiles of HCA intake using analysis of variance.SettingBaseline examinations conducted in 1991–1994 in Malmö, Sweden.SubjectsA sub-sample of 8599 women and 6575 men of the MDC cohort.ResultsThe mean daily HCA intake was 583 ng for women and 821 ng for men. Subjects were ranked differently with respect to HCA intake compared with intake of fried and baked meat and fish (κ = 0.13). High HCA intake was significantly associated with lower age, overweight, sedentary lifestyle and smoking. Intakes of dietary fibre, fruits and fermented milk products were negatively associated with HCA intake, while intakes of selenium, vegetables, potatoes, alcohol (among men) and non-milk-based margarines (among women) were positively associated with HCA intake.ConclusionsThe estimated daily HCA intake of 690 ng is similar to values obtained elsewhere. The present study suggests that lifestyle factors (e.g. smoking, physical activity, fruit and vegetable intakes, and types of milk products and margarines) may confound associations between HCA intake and disease. The poor correlation between HCA intake and intakes of fried meat and fish facilitates an isolation of the health effects of HCAs.
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DeVivo, Renée, Lauren Zajac, Asim Mian, Anna Cervantes-Arslanian, Eric Steinberg, Michael L. Alosco, Jesse Mez, Robert Stern, and Ronald Killany. "Differentiating Between Healthy Control Participants and Those with Mild Cognitive Impairment Using Volumetric MRI Data." Journal of the International Neuropsychological Society 25, no. 08 (May 27, 2019): 800–810. http://dx.doi.org/10.1017/s135561771900047x.
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AbstractObjective:To determine whether volumetric measures of the hippocampus, entorhinal cortex, and other cortical measures can differentiate between cognitively normal individuals and subjects with mild cognitive impairment (MCI).Method:Magnetic resonance imaging (MRI) data from 46 cognitively normal subjects and 50 subjects with MCI as part of the Boston University Alzheimer’s Disease Center research registry and the Alzheimer’s Disease Neuroimaging Initiative were used in this cross-sectional study. Cortical, subcortical, and hippocampal subfield volumes were generated from each subject’s MRI data using FreeSurfer v6.0. Nominal logistic regression models containing these variables were used to identify subjects as control or MCI.Results:A model containing regions of interest (superior temporal cortex, caudal anterior cingulate, pars opercularis, subiculum, precentral cortex, caudal middle frontal cortex, rostral middle frontal cortex, pars orbitalis, middle temporal cortex, insula, banks of the superior temporal sulcus, parasubiculum, paracentral lobule) fit the data best (R2= .7310, whole model test chi-square = 97.16,p< .0001).Conclusions:MRI data correctly classified most subjects using measures of selected medial temporal lobe structures in combination with those from other cortical areas, yielding an overall classification accuracy of 93.75%. These findings support the notion that, while volumes of medial temporal lobe regions differ between cognitively normal and MCI subjects, differences that can be used to distinguish between these two populations are present elsewhere in the brain.
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Kim, Seongmi, Jung Yoon Jung, Geon Sik Cho, Jong Young Lee, Hye Jin Lee, Jinho Jeong, and Ahnul Ha. "Trends in Utilization of Visual Field Tests for Glaucoma Patients: A Nationwide Study Using the Korean Health Insurance Review and Assessment Database." Korean Journal of Ophthalmology 36, no. 2 (April 5, 2022): 114–22. http://dx.doi.org/10.3341/kjo.2021.0108.
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Purpose: To analyze 10-year trends in utilization of visual field tests for adult glaucoma or glaucoma-suspect patients using the Korean Health Insurance Review and Assessment data.Methods: Health claims for the years 2010 to 2019, as recorded via Korea’s Health Insurance Review and Assessment service, were accessed. We identified glaucoma patients using the glaucoma diagnostic codes H40 (glaucoma) and H42 (glaucoma in other diseases classified elsewhere). For verification of the glaucoma diagnosis, information on any antiglaucoma medication prescriptions and ocular surgery history also was obtained. Visual field testing data was isolated using procedural codes E6690 (kinetic perimetry) and E6691 (standard automated perimetry [SAP]) performed in tertiary hospitals. Any changes in visual field test utilization were identified using regression trend analysis.Results: From 2010 to 2019, the total number of SAP procedures performed in tertiary hospitals for either glaucoma or glaucoma-suspect patients increased gradually from 93,459 to 216,433. With regard to kinetic perimetry examinations, the total number decreased gradually from 6,364 to 3,792. The yearly average SAP number per patient showed a slight increase, from 1.168 to 1.248 (ß = 0.008, R2 = 0.669, p = 0.004). Meanwhile, the yearly average number of kinetic perimeter examinations per patient showed a significant decrease, from 1.093 to 0.940 (ß = -0.013, R2 = 0.580, p = 0.010).Conclusions: Between 2010 and 2019, the yearly average number of SAP procedures performed per glaucoma or glaucoma-suspect patient increased in Korea. Meanwhile, the yearly average number of kinetic perimetry examinations per patient significantly decreased.
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Patten, Scott B., and Joel Paris. "The Bipolar Spectrum—A Bridge Too Far?" Canadian Journal of Psychiatry 53, no. 11 (November 2008): 762–68. http://dx.doi.org/10.1177/070674370805301108.
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Objectives: To review the literature evaluating outcomes resulting from expansion of the bipolar disorder (BD) diagnostic category. We were particularly interested in identifying high-level evidence for improved clinical outcomes as documented by randomized controlled trials (RCTs) or cohort studies. Methods: The English-language literature was searched using Ovid MEDLINE for studies of BD referenced against the key word spectrum. We used bibliographies and other databases to extend this search when no relevant RCTs or relevant cohort studies were identified. Results: In the MEDLINE searches, abstracts and titles of 86 studies were examined and 48 were found to be related to the topic of bipolar spectrum disorders (BSD). No RCTs or prospective cohort studies evaluating modified diagnostic or therapeutic practices were identified. The literature about the BSD consists mostly of expert opinion emphasizing: various links between bipolar and unipolar mood disorders; a proposal that a greater proportion of the population without a mood disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders should be diagnosed under the BD category; and, proposals that syndromes currently classified elsewhere should be subsumed under the BD category. Conclusions: Our search failed to uncover high-level evidence demonstrating the clinical utility of proposed diagnostic realignments. The widespread acceptance of the expanded spectrum concept appears to be based on interpretation of descriptive epidemiologic data by high-profile experts.
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Telemi, Edvin, Nikolay L. Martirosyan, Mauricio J. Avila, Ashley L. Lukefahr, Christopher Le, and G. Michael Lemole. "Suprasellar pleomorphic xanthoastrocytoma: A case report." Surgical Neurology International 10 (April 24, 2019): 72. http://dx.doi.org/10.25259/sni-83-2019.
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Background: Pleomorphic xanthoastrocytoma (PXA) is a rare form of astrocytic neoplasm most commonly found in children and young adults. This neoplasm, which is classified as a Grade II tumor by the World Health Organization classification of tumors of the central nervous system, carries a relatively favorable outcome. It is usually found supratentorially in cortical regions of the cerebral hemispheres, and as such, presenting symptoms are similar to other supratentorial cortical neoplasms; with seizures being a common initial symptom. Due to the rarity of this type of neoplasm, PXA arising elsewhere in the brain is often not included in the initial differential diagnosis. Case Description: This report presents an extremely rare patient with PXA arising in the suprasellar region who presented with progressive peripheral vision loss. Magnetic resonance imaging of the brain demonstrated a heterogeneous suprasellar mass with cystic and enhancing components initially; the most likely differential diagnosis was craniopharyngioma. The patient underwent endoscopic endonasal resection of the tumor. Microscopically, the tumor was consistent with a glial neoplasm with variable morphology. Based on these findings along with further immunohistochemical workup, the patient was diagnosed with a PXA arising in the suprasellar region. At the 1-year follow-up, the patient remained free of recurrence. Although rare PXA originating in other uncommon locations, such as the spinal cord, cerebellum, the ventricular system, and the pineal region have been previously described. Conclusion: Although rare, PXA should be included in the differential diagnosis for solid-cystic tumors arising in the suprasellar region in young adults.
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Rajeshreddy V., S. G. S., and Lokesh V. Patil. "Causality assessment and the severity of the adverse drug reactions in tertiary care hospital: a pharmacovigilance study." International Journal of Basic & Clinical Pharmacology 6, no. 12 (November 23, 2017): 2800. http://dx.doi.org/10.18203/2319-2003.ijbcp20175073.
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Background: Adverse drug reactions (ADRs) constitute a major clinical problem in terms of human suffering and increased health care costs. To study the adverse drug reactions reported in a tertiary care hospital and study of causality assessment and severity of adverse drug reaction (ADR) cases reported.Methods: A prospective observational study was conducted as part of pharmacovigilance program over 12months between September 2015 and August 2016. Adverse drug reactions reported from hospital were filled into Suspected ADR - CDSCO forms and submitted to pharmacovigilance unit. Causal relationship was assessed and categorized by Naranjo’s algorithm and WHO - UMC causality scale. The severity of each ADR was assessed using Modified Hartwig and Siegel scale.Results: Total 120 cases were reported over 12 months. Among them, 66% were in males and 55% were in females. The majority of ADRs were due to antimicrobial agents (40.78%) followed by haematinics (12%) and anti-epileptics (10%). Maximum number of patients (30.25%) reported with dermatological manifestations. Highest number of ADRs was reported from the department of medicine (45%). As per Naranjo’s scale, 54% reports were assessed as probable and 46% classified as possible. Majority of cases were mild to moderate in severity.Conclusions: The pattern of ADRs reported in our hospital is similar with the pattern of studies conducted in other hospitals elsewhere. This study provides a database of ADRs due to commonly used drugs in our hospital, which will help clinicians for their optimum and safe use. Hence effective pharmacovigilance is required for the use of these drugs and their safety assessment.
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Holst, Søren, Dorte Lystrup, and John L. Taylor. "Firesetters with intellectual disabilities in Denmark." Journal of Intellectual Disabilities and Offending Behaviour 10, no. 4 (November 28, 2019): 72–81. http://dx.doi.org/10.1108/jidob-10-2019-0021.
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Purpose The purpose of this paper is to gather epidemiologicalinformation concerning firesetters with intellectual disabilities (ID) in Denmark to identify the assessment and treatment needs of this population and inform further research in this area. Design/methodology/approach The records held by the Danish Ministry of Justice concerning all firesetters with ID convicted of deliberate firesetting were reviewed for the period January 2001 to December 2010 inclusive. File information was extracted for 83 offenders concerning: demographic and personal characteristics; mental health characteristics; offending behaviour; offence-specific factors; and motives for offending. A sub-group of seven offenders were interviewed to explore some of the themes that emerged from the file review. Findings The majority of study participants were male and were classified as having mild ID and around 50 per cent had additional mental health problems. Many came from disturbed and deprived backgrounds. Two-thirds had set more than one fire and over 60 per cent had convictions for offences other than firesetting. Alcohol was involved in the firesetting behaviour in a significant proportion of cases (25 per cent). The motives for setting fires were – in descending order – communication (of anger, frustration and distress), fire fascination and vandalism. Interviews with participants indicated the important communicative function of firesetting, the difficulties people had in talking about and acknowledging their firesetting behaviour, and lack of access to targeted interventions. Research limitations/implications Interventions for Danish firesetters with ID, as for firesetters with ID elsewhere, need to target the communicative function of this behaviour, along with offenders’ lack of insight and initial reluctance to accept responsibility for their behaviour and associated risks. Adjunctive treatment is required to address the psychiatric comorbidity experienced by many of these offenders, along with the alcohol use/misuse that is associated with many of these offences. Originality/value This is the first study concerning nature and needs of firesetters with ID in Denmark.
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Shehzad, Sofia. "HOSPITAL WASTE MANAGEMENT -A GROWING HEALTH CONCERN." Journal of Gandhara Medical and Dental Science 4, no. 2 (September 20, 2018): 1. http://dx.doi.org/10.37762/jgmds.4-2.227.
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In this era of startling developments in the medical field there remains a serious worry about the hazardous potential of various by products which if not properly addressed can lead to consequences of immense public concern. Hospitals and other health care facilities generate waste products which are evidently hazardous to all those exposed to its potentially harmful effects. Need for effective legislation ensuring its safe disposal is supposed to be an integral part of any country's health related policy. This issue is of special importance in developing countries like Pakistan which in spite of framing various regulations for safeguarding public health, seem to overlook its actual implementation. The result unfortunately is the price wehave to pay not only in terms of rampant spread of crippling infections but a significant spending of health budget on combating epidemics which could easily have been avoided through effective waste disposal measures in the first place. Waste classified under the heading 'bio-hazardous' includes any infectious or potentially infectious material which can be injurious or harmful to humans and other living organisms. Amongst the many potential sources are the hospitals or other health delivery centres which are ironically supposed to be the centres of infection control and treatment. Whilst working in these setups, health care workers such as doctors, nurses, paramedical staff and sanitation workers are actually the ones most exposed and vulnerable to these challenges. Biomedical waste may broadly be classified into Infectious and toxic waste. Infectious waste includes sharps, blood, body fluids and tissues etcwhile substances such as radioactive material and by-products of certain drugs qualify as toxic waste. Furthermore health institutions also have to cater for general municipal waste such as carton boxes, paper and plastics. The World Health Organisation has its own general classification of hospital waste divided into almost eight categories of which almost 15% (10% infectious and 5% toxic) is estimated to be of a hazardous nature while the remaining 85% is general non hazardous content.1A recent study from Faisalabad, Pakistan has estimated hospital waste generation around 1 to 1.5 kg / bed /day for public sector hospitals in the region,2while figures quoted from neighbouring India are approximately 0.5 to 2 KG / hospital bed /day.3 Elsewhere in the world variable daily hospital waste production has been observed ranging from as low as 0.14 to 0.49 kg /day in Korea4 and 0.26 to 0.89 kg/day in Greece5to as high as 2.1 to 3.83 kg/day in Turkey6 and 0.84 to 5.8 kg/day in Tanzania.7Ill effects of improper management of hospital waste can manifest as nosocomial infections or occupational hazards such as needle stick injuries. Pathogens or spores can be borne either through the oro-faecal or respiratory routes in addition to direct inoculation through contact with infected needles or sharps. Environmental pollution can result from improper burning of toxic material leading to emission of dioxins, particulate matter or furans into the air. The habitat can also be affected by illegal dumping and landfills or washing up of medical waste released into the sea or river. Potential organisms implicated in diseases secondary to mismanagement of hospital waste disposal include salmonella, cholera, shigella, helminths, strep pneumonia, measles, tuberculosis, herpesvirus, anthrax, meningitis, HIV, hepatitis and candida etc. These infections can cause a considerable strain on the overall health and finances of the community or individuals affected. The basic principal of Public health management i.e 'prevention is better than cure' cannot be more stressed in this scenario as compared to any other health challenge. Health facilities must have a clear policy on hazardous waste management. To ensure a safe environment hospitals need to adopt and implement international and local systems of waste disposal. Hospital waste management plan entails policy and procedures addressing waste generation, accumulation, handling, transportation, storage, treatment and disposal. Waste needs to be collected in marked containers usually colour coded and leak proof. Segregation at source is of vital importance. The standard practice in many countries is the Basic Three Bin System ie to segregate the waste into RED bags/ boxes for sharps, YELLOW bags for biological waste and BLUE or BLACK ones for general/ municipal waste. All hospital staff needs to be trained in the concept of putting the right waste in relevant containers/ bags. They need to know that more than anything else this practice is vital for their own safety. The message can be reinforced through appropriate labelling on the bins and having posters with simple delineations to avoid mixing of different waste types. Sharps essentially should be kept in rigid, leak and puncture-resistant containers which are tightly lidded and labelled. Regular training sessions for nurses and cleaning staff can be organised as they are the personnel who are more likely to deal with waste disposition at the level of their respective departments. Next of course is transportation of waste products to the storage or disposal. Sanitary staff and janitors must be aware of the basic concepts of waste handling and should wear protective clothing, masks and gloves etc, besides ensuring regular practice of disinfection and sterilization techniques.8Special trolleys or vehicles exclusively designed and reserved for biomedical waste and operated by trained individuals should be used for transportation to the dumping or treatment site. Biomedical waste treatment whether on site or off site is a specialised entity involving use of chemicals and equipment intended for curtailing the hazardous potential of the material at hand. Thermal treatment via incinerators, not only results in combustion of organic substances but the final product in the form of non-toxicash is only 10 to 15% of the original solid mass of waste material fed to the machine. Dedicated autoclaves and microwaves can also be used for the purpose of disinfection. Chemicals such as bleach, sodium hydroxides, chlorine dioxide and sodiumhypochlorite are also effective disinfectants having specialised indications. Countries around the world have their own regulations for waste management. United Kingdom practices strict observance of Environmental protection act 1990, Waste managementlicensing regulations 1994 and Hazardous waste regulations 2005 making it one of thesafest countries in terms of hazardous waste disposal. Similar regulations specific for each state have been adopted in United States following passage of the Medical Waste tracking act 1988. In Pakistan, every hospital must comply with the Waste Management Rules 2005 (Environment Protection Act 1997), though actual compliance is far from satisfactory. It is high time that the government and responsible community organisations shape up to seriously tackle the issue of bio hazardous waste management through enforcement of effective policies and standard operating procedures for safeguarding the health and lives of the public in general and health workers in particular.
Books on the topic "Other health not elsewhere classified"
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Britain, Great. Manufacture of Other Transport Equipment Not Elsewhere Classified. Stationery Office Books, 1996.
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Grant, Jon E., and Marc N. Potenza. Overview of the Impulse Control Disorders Not Elsewhere Classified and Limitations of Knowledge. Edited by Jon E. Grant and Marc N. Potenza. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195389715.013.0012.
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Several disorders have been classified together in the American Psychiatric Association’s Diagnostic and Statistical Manual (4th ed.; DSM-IV) as impulse control disorders not elsewhere classified. These impulse control disorders have been grouped together based on perceived similarities in clinical presentation and hypothesized similarities in pathophysiologies. The question exists whether these disorders belong together or whether they should be categorized elsewhere. Examination of the family of impulse control disorders generates questions regarding the distinct nature of each disorder: whether each is unique or whether they represent variations of each other or other psychiatric disorders. Neurobiology may cut across disorders, and identifying important intermediary phenotypes will be important in understanding impulse control disorders and related entities. The distress of patients with impulse control disorders highlights the importance of examining these disorders. More comprehensive information has significant potential for advancing prevention and treatment strategies for those who suffer from disorders characterized by impaired impulse control.
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Canada. Occupational Analysis and Classification Systems Division., ed. Canadian classification and dictionary of occupations, occupations in major groups: 91, transport equipment operating, 93, material handling, 95, other crafts and equipment operating, 99, occupations not elsewhere classified. [Ottawa]: Employment and Immigration Canada, 1986.
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Ghebrehewet, Samuel, Alex G. Stewart, David Baxter, Paul Shears, David Conrad, and Merav Kliner, eds. Health Protection. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198745471.001.0001.
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This book is an accessible and practical core text on the three domains of health protection: Communicable Disease Control, Emergency Preparedness Resilience and Response (EPRR), and protection of the public from environmental hazards (Environmental Public Health). The editors have attempted to develop an “all hazards approach” to dealing with health protection situations. Most health protection books confine themselves to one of the three domains, whereas this book presents a practical and all hazards approach, with some account of the overarching principles of health protection on which day-to-day practice rests. The target audience is health protection practitioners, students, doctors, nurses and other non-medical professionals who may encounter health protection issues in their daily practice. From a clear introduction to the essential principles of health protection work, the book guides readers through how to manage real health protection incidents using a combination of case studies and quick reference action checklists. Each case study provides a common health protection scenario which develops in stages, in the same way as a real-life case or incident. As the story unfolds, the reader will learn about the nature and significance of the specific threat to population health, the practical steps and issues involved in an effective public health response and the health protection principles underpinning that response. Other chapters outline the general principles of health protection, providing a deeper understanding of key tools and mechanisms, as well as insights into new and emerging health protection issues. A series of individual checklists dealing with a broad range of commonly-faced diseases, hazards and incidents complete the book. These give concise and practically-focused information that can be used even by non-specialists in time-pressured situations. In particular, the variety of chapters covered throughout the book, on Communicable Diseases, Emergency Preparedness Resilience and Response, and Environmental Public Health, offer a unique perspective borne out of practical experience, not easily accessible elsewhere.
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Schwartz, Seth J., and Jennifer Unger, eds. The Oxford Handbook of Acculturation and Health. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780190215217.001.0001.
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The Oxford Handbook of Acculturation and Health brings together three very different, but complementary, streams of work: theoretical and methodological “basic” work on acculturation, and applied work linking acculturation to various health outcomes among international migrants and their families, and interventions applying acculturation-related principles to prevent or treat health behaviors or problems. In this volume, the work of landmark acculturation theorists and methodologists appears in the same volume as applied epidemiologic and intervention work on acculturation and public health. This volume highlights theoretical, methodological, and applied research on the study of acculturation in an effort to connect fundamental principles of acculturation theories with research linking these theories to health outcomes. Although the majority of acculturation and health research has been conducted on the experiences of Hispanic immigrants in the United States, the principles featured in this volume are also intended to apply to other immigrant groups in the United States and elsewhere.
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Jones, David K. Exchange Politics and the Future of Health Reform. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190677237.003.0006.
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This chapter examines the four key insights from the case study states, looking at the degree to which these lessons apply elsewhere. I ask what the Obama administration should have done differently in its intergovernmental negotiations with states and whether the decision to accept or reject control of an exchange matters. In other words, what are the policy implications of this decision? A Supreme Court case in 2015 would have dramatically raised the stakes of this decision, though the Court’s ruling in favor of the Obama administration ensures that any person with a qualifying income can receive financial assistance to purchase coverage on an exchange—regardless of their state’s decision. I conclude by examining the future of health insurances in particular, and health reform and U.S. federalism more broadly.
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Rajczi, Alex. The Ethics of Universal Health Insurance. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190946838.001.0001.
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Millions of Americans lack health insurance, and thousands suffer and die every year. Philosophers have argued that an ideal society would avoid these problems by guaranteeing affordable access to health insurance, but what about people’s concerns that a universal health insurance system would be inefficient, create excessive fiscal risk, or impose high taxes and other personal costs? This book examines the ethical issues raised by these objections. It shows that the ethical principles underlying these concerns are legitimate and that they might even justify opposition to poorly designed universal health insurance plans. However, the objections do not undercut the moral case for adopting a well-designed universal health insurance system that improves on the gains made in the Affordable Care Act. Addressing these objections is important because they are philosophically rich and interesting, and since the objections help drive actual disagreements about health policy, responding to them also contributes to the real-world case for universal access to health insurance. Understanding these issues in the health care debate has larger upshots as well. It leads us to a deeper understanding of progressive and conservative views on distributive justice, and it provides a framework for analyzing debates about any part of the social safety net—in America and elsewhere.
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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.
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Mataix-Cols, David, and Odile A. van den Heuvel. Neuroanatomy of Obsessive Compulsive and Related Disorders. Edited by Gail Steketee. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195376210.013.0027.
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Obsessive-compulsive disorder (OCD) shares features and often co-occurs with other anxiety disorders, as well as with other psychiatric conditions classified elsewhere in the Diagnostic and Statistical Manual (DSM-IV), the so-called “OCD spectrum disorders.” Neurobiologically, it is unclear how all these disorders relate to one another. The picture is further complicated by the clinical heterogeneity of OCD. This chapter will review the literature on the common and distinct neural correlates of OCD vis-à-vis other anxiety and “OCD spectrum” disorders. Furthermore, the question of whether partially distinct neural systems subserve the different symptom dimensions of OCD will be examined. Particular attention will be paid to hoarding, which is emerging as a distinct entity from OCD. Finally, new insights from cognitive and affective neuroscience will be reviewed before concluding with a summary and recommendations for future research.
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Newman, James S., and David J. Rosenman. Hospital Medicine. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199755691.003.0376.
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Technologic advancements and other innovative efforts to improve the quality of hospital-based care have resulted in large and complicated networks of personnel, information systems, devices, medications, and countless other resources. In parallel with these changes, the medical acuity of the typical hospitalized patient has increased. The field of hospital medicine emerged in response to this combination of increasing hospital complexity, patient acuity, and professional demands. This chapter highlights several topics that may be unique to the hospital and are not discussed elsewhere in this textbook. They include interfaces among settings and people in the hospital, medication reconciliation, dismissal from the hospital, information systems, nutritional assessment and provision, geriatric assessment, complications of hospitalization, hospital-acquired infections, complications of surgery, the quality and safety movements, bioterrorism, and risks to health care workers.
Book chapters on the topic "Other health not elsewhere classified"
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He, Wenliang, Peng Li, and Guoyao Wu. "Amino Acid Nutrition and Metabolism in Chickens." In Advances in Experimental Medicine and Biology, 109–31. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-54462-1_7.
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AbstractBoth poultry meat and eggs provide high-quality animal protein [containing sufficient amounts and proper ratios of amino acids (AAs)] for human consumption and, therefore, play an important role in the growth, development, and health of all individuals. Because there are growing concerns about the suboptimal efficiencies of poultry production and its impact on environmental sustainability, much attention has been paid to the formulation of low-protein diets and precision nutrition through the addition of low-cost crystalline AAs or alternative sources of animal-protein feedstuffs. This necessitates a better understanding of AA nutrition and metabolism in chickens. Although historic nutrition research has focused on nutritionally essential amino acids (EAAs) that are not synthesized or are inadequately synthesized in the body, increasing evidence shows that the traditionally classified nutritionally nonessential amino acids (NEAAs), such as glutamine and glutamate, have physiological and regulatory roles other than protein synthesis in chicken growth and egg production. In addition, like other avian species, chickens do not synthesize adequately glycine or proline (the most abundant AAs in the body but present in plant-source feedstuffs at low content) relative to their nutritional and physiological needs. Therefore, these two AAs must be sufficient in poultry diets. Animal proteins (including ruminant meat & bone meal and hydrolyzed feather meal) are abundant sources of both glycine and proline in chicken nutrition. Clearly, chickens (including broilers and laying hens) have dietary requirements for all proteinogenic AAs to achieve their maximum productivity and maintain optimum health particularly under adverse conditions such as heat stress and disease. This is a paradigm shift in poultry nutrition from the 70-year-old “ideal protein” concept that concerned only about EAAs to the focus of functional AAs that include both EAAs and NEAAs.
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Gale, Katherine, Claudia Tye, Ali Kubba, and Sunanda Gupta. "Other disorders of women’s health." In Oxford Handbook of Women's Health Nursing, 145–85. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198842248.003.0007.
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This chapter covers other disorders that are not covered elsewhere in this book. It includes fibroids, endometriosis, chronic pelvic pain, benign ovarian tumours, vulval disorders (cysts, dermatosis, intraepithelial neoplasia, and vulval pain), and female genital mutilation. For each diagnosis it gives definitions, assessment, diagnosis, and treatment regimes. For endometriosis, both surgical and medical treatments are discussed.
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McElroy, Michael B. "Power from the Sun Abundant But Expensive." In Energy and Climate. Oxford University Press, 2016. http://dx.doi.org/10.1093/oso/9780190490331.003.0015.
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As discussed in the preceding chapter, wind resources available from nonforested, nonurban, land-based environments in the United States are more than sufficient to meet present and projected future US demand for electricity. Wind resources are comparably abundant elsewhere. As indicated in Table 10.2, a combination of onshore and offshore wind could accommodate prospective demand for electricity for all of the countries classified as top- 10 emitters of CO2. Solar energy reaching the Earth’s surface averages about 200 W m– 2 (Fig. 4.1). If this power source could be converted to electricity with an efficiency of 20%, as little as 0.1% of the land area of the United States (3% of the area of Arizona) could supply the bulk of US demand for electricity. As discussed later in this chapter, the potential source of power from the sun is significant even for sun- deprived countries such as Germany. Wind and solar energy provide potentially complementary sources of electricity in the sense that when the supply from one is low, there is a good chance that it may be offset by a higher contribution from the other. Winds blow strongest typically at night and in winter. The potential supply of energy from the sun, in contrast, is highest during the day and in summer. The source from the sun is better matched thus than wind to respond to the seasonal pattern of demand for electricity, at least for the United States (as indicated in Fig. 10.5).There are two approaches available to convert energy from the sun to electricity. The first involves using photovoltaic (PV) cells, devices in which absorption of radiation results directly in production of electricity. The second is less direct. It requires solar energy to be captured and deployed first to produce heat, with the heat used subsequently to generate steam, the steam applied then to drive a turbine. The sequence in this case is similar to that used to generate electricity in conventional coal, oil, natural gas, and nuclear- powered systems. The difference is that the energy source is light from the sun rather than a carbon- based fossil fuel or fissionable uranium.
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Rothman, Emily F. "Pornography as a US Public Health Problem." In Pornography and Public Health, 1–15. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780190075477.003.0001.
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Pornography is being indicted as a public health crisis in the United States and elsewhere, but the professional public health community is not behind the recent push to address pornography as a public health threat. While pornography may not be contributing directly to mortality or acute morbidity for a substantial percentage of people, it may be influencing other public health problems, such as sexual violence, dating abuse, compulsive behavior, and sexually transmitted infections. However, the evidence to support pornography as a causal factor is mixed, and there are numerous other factors that have more strongly established associations with these outcomes of interest. Throughout history, repressive forces have inflated the charges against sexually explicit material in order to advance a morality-based agenda. Nevertheless, a public health approach and tried public health practices, such as harm reduction and coalition-building, will be instrumental to addressing the emergence of mainstream Internet pornography.
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Kurmi, Om P., Kin Bong Hubert Lam, and Jon G. Ayres. "Air pollution and health." In Oxford Textbook of Medicine, edited by Jon G. Ayres, 1677–87. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0204.
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The term ‘occupational and environmental health’ includes any act of emission of any substance, likely to be hazardous in nature, which is either not originally present or is present in a higher concentration than normal in the natural atmosphere. Most air pollutants are generated from human activities (e.g. energy, transportation, industry, agriculture), but natural events in the living (e.g. methane emissions in wetlands) and non-living environment (e.g. volcanic eruptions) also contribute to atmospheric air pollution, although their relative importance has declined since the Industrial Revolution and the advent of modern fossil fuel-based economies. Pollutants may be classified as (1) primary (emitted directly into the atmosphere) or secondary (formed in the air through chemical reactions with other pollutants and gases); (2) indoor or outdoor; (3) gaseous or particulate.
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"Introduction." In Homelessness and Mental Health, edited by João Mauricio Castaldelli-Maia, Antonio Ventriglio, Dinesh Bhugra, João Mauricio Castaldelli-Maia, Antonio Ventriglio, and Dinesh Bhugra, 3–10. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198842668.003.0001.
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The numbers of individuals who can be classified as being homeless are, not surprisingly, affected by a variety of reasons which include economic factors such as poverty and unemployment, which may or may not be a result of rapid urbanization in many countries. There is considerable research evidence indicating that rates of psychiatric disorders are higher in homeless individuals, although, in some cases, psychiatric illness itself may lead to homelessness if no safety net is available. Homelessness and psychiatric disorders are both strongly affected by various social determinants and thus may feed into each other. Keeping these issues across the globe in mind, this volume aims to provide up-to-date research and policy evidence from across different countries and cultures. The bi-directional relationship between homelessness and mental ill health is still far from being completely understood, but the impact of social and psychological factors is of interest. Also, the result of transgenerational factors on people’s mental health is worth exploring. This volume aims to provide a cultural and international overview with contributors and editors from across various continents.
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Kamanga, Martha, Jennifer Hall, and Address Malata. "Introduction to maternal and reproductive health." In Oxford Textbook of Global Health of Women, Newborns, Children, and Adolescents, edited by Delan Devakumar, Jennifer Hall, Zeshan Qureshi, and Joy Lawn, 89–94. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198794684.003.0018.
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Pregnancy and childbirth have a huge impact on the physical, mental, emotional, and socioeconomic health of women and their families. Poor maternal health remains a significant problem both in developed and developing countries. While motherhood offers a rewarding experience, for too many women it is associated with suffering, ill health, and even death. Many women, including adolescents, die from preventable causes related to pregnancy and childbirth. Maternal deaths are classified as direct or indirect. Direct causes are those related to obstetric complications of pregnancy, labour, delivery, and the postnatal period, while indirect causes are those relating to pre-existing medical conditions that may be aggravated by the physiological demands of pregnancy. Opportunities to prevent and control diseases occur at multiple stages of life. Identifying which groups of women experience poorer physical and mental health, and understanding risk factors, will enable midwives and other health professionals to better support women before, during, and after pregnancy and childbirth.
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Kriti, Charu. "Selective Mutism." In Advances in Psychology, Mental Health, and Behavioral Studies, 363–80. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-4955-0.ch019.
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Selective mutism is a disorder that is characterized by a failure to speak in certain social settings, like the school, while speaking normally in other settings, like home. The settings in which the failure to speak occur are those where speech is expected from the individual. It is a disorder that onsets in childhood, and if left untreated, may go well into adolescence. For a very long time, this disorder has been overlooked and understudied. Though rare, the disorder may pose a potential threat to the social and academic development of a child suffering from it. The DSM-5 has classified selective mutism as an anxiety disorder. The present chapter intends to cover the psychosocial approach to the disorder, the diagnostic criteria, the etiology, the treatment of the disorder, and the management by respective caregivers. An analysis of case studies has also been given in the chapter.
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Plant, Jane A., and Barry Smith. "Environmental Geochemistry on a Global Scale." In Geology and Health. Oxford University Press, 2003. http://dx.doi.org/10.1093/oso/9780195162042.003.0028.
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Recent population growth and economic development are extending the problems associated with land degradation, pollution, urbanization, and the effects of climate change over large areas of the earth’s surface, giving increasing cause for concern about the state of the environment. Many problems are most acute in tropical, equatorial, and desert regions where the surface environment is particularly fragile because of its long history of intense chemical weathering over geological timescales. The speed and scale of the impact of human activities are now so great that, according to some authors, for example, McMichael (1993), there is the threat of global ecological disruption. Concern that human activities are unsustainable has led to the report of the World Commission on Environment and Development Our Common Future (Barnaby 1987) and the establishment of a United Nations Commission on Sustainable Development responsible for carrying out Agenda 21, the action plan of the 1992 Earth Summit in Rio de Janeiro, Brazil. Considerable research into the global environment is now being undertaken, especially into issues such as climate change, biodiversity, and water quality. Relatively little work has been carried out on the sustainability of the Earth’s land surface and its life support systems, however, other than on an ad-hoc basis in response to problems such as mercury poisoning related to artisanal gold mining in Amazonia or arsenic poisoning as a result of water supply problems in Bangladesh (Smedley 1999). This chapter proposes a more strategic approach to understanding the distribution and behavior of chemicals in the environment based on the preparation of a global geochemical baseline to help to sustain the Earth’s land surface based on the systematic knowledge of its geochemistry. Geochemical data contain information directly relevant to economic and environmental decisions involving mineral exploration, extraction, and processing; manufacturing industries; agriculture and forestry; many aspects of human and animal health; waste disposal; and land-use planning. A database showing the spatial variations in the abundance of chemical elements over the Earth’s surface is, therefore, a key step in embracing all aspects of environmental geochemistry. Although environmental problems do not respect political boundaries, data from one part of the world may have important implications elsewhere.
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Huda, Ahmed Samei. "Final conclusions." In The Medical Model in Mental Health, 305–18. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198807254.003.0016.
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The medical model in mental health uses diagnostic constructs with attached useful information (e.g. on prognosis or response to treatments) that often identifies areas of spectrums rather than diseases or syndromes. Diagnostic constructs in psychiatry and general medicine overlap for attributes such as clinical utility (e.g. predicting likely outcomes), validity (e.g. whether boundaries exist between different diagnostic constructs), and importance of social factors. There is an overlap in effectiveness between psychiatric and general medicine treatments, and many general medicine medications do not reverse disease processes. Describing the nature of diagnostic constructs can be done by describing the basis of classification and nature of the classified condition. Different mental health classifications have particular strengths and weaknesses for clinical, research, and social functions. Research in mental health may need classifications other than diagnosis to improve understanding of causes and mechanisms and also to develop better diagnostic constructs. As doctors in all specialties will encounter mental health problems there will always be psychiatric diagnostic constructs compatible with their training. The medical model of mental health allows doctors to assess and offer effective treatments to large numbers of patients and provide emergency cover. Mental health research and service provision will always need to address psychosocial issues.
Conference papers on the topic "Other health not elsewhere classified"
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LUO, XI, JIA GUO, and KAMYAB ZANDI. "AN IMAGE-BASED CONCRETE CRACK DETECTION METHOD USING CONVOLUTIONAL NEURAL NETWORKS." In Structural Health Monitoring 2021. Destech Publications, Inc., 2022. http://dx.doi.org/10.12783/shm2021/36325.
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This paper proposes a CNN-based crack detection method that can recognize and extract cracks from photos of concrete structures. The algorithm consists of two subsequent procedures, classification, and segmentation, achieved by two convolutional neural networks respectively. First, full images are divided into patches and classified as positive and negative. Then, those sub-images classified as positive are further processed by the image segmentation procedure to obtain the pixel level geometry of the cracks. For the classification part, the performance of transfer learning models based on pre-trained VGG16, Inception V3, MobileNet and DenseNet169 is compared with different classifier. Finally, the CNN based on MobileNet was trained with 30,000 training images and reached 97% testing accuracy and 0.96 F1 score on testing image. For the segmentation part, different neural networks based on the elegant U-net architecture are built and tested. The models are trained with 3840 crack images and annotated ground truth and compared quantitatively and qualitatively. The model with the best performance reached 88% sensitivity on test data set. The combination of the classification and segmentation neural networks achieves an image-based crack detection method with high efficiency and accuracy. The algorithm can process any full image size as input. Compared with most machine learning based crack detection algorithms using sub-image classification, a relatively larger patch size is used in this paper and in this way the classification is more robust and accurate. On the other hand, the negative areas in the full image will not be concerned in the segmentation procedure and this fact not only saves a lot of computational power but also significantly increases the accuracy compared to the segmentation performed on full images.
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Veselova, T. V., and D. V. Chentsov. "COMPARISON OF THE STRUCTURE OF MORBIDITY BY THE RESULTS OF PREVENTIVE MEDICAL EXAMINATIONS AND OF PROFESSIONAL MEDICAL EXAMINATIONS." In The 16th «OCCUPATION and HEALTH» Russian National Congress with International Participation (OHRNC-2021). FSBSI “IRIOH”, 2021. http://dx.doi.org/10.31089/978-5-6042929-2-1-2021-1-110-113.
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Abstract. The aim of the study was to compare the structure of morbidity revealed by the results of preventive medical examination with the structure of morbidity revealed by the results professional examination. Group 1 included 146 999 men aged 20-60, who underwent professional examination, group 2 - 424 770 men aged 21-60 who had undergone preventive medical examinations. In both groups, diseases of the circulatory system are in first place in terms of detection (group 1 – 24,37%, 2 – 41,41%). In second place in the course of preventive medical examinations are diseases of the endocrine system, nutritional disorders and metabolic disorders (16,94%), and in case of professional examination - diseases of the eye and its adnexa (15,46%). The third place in the course of professional examination is - diseases of the respiratory system (14,65%), with preventive medical examinations - diseases of the digestive system (9.83%). Since the diseases of the musculoskeletal system are not separately taken into account during the clinical examination, they are classified in the category «Other diseases». However, it should be noted that during the professional examination, this group of diseases is detected in 21% of cases. Taking into account the figures obtained for the detection of diseases of the musculoskeletal system, it seems important to focus the attention of occupational medicine specialists on this in order to develop and introduce measures to improve the health of the musculoskeletal system into corporate programs. These differences are associated with a different volume of research conducted for different types of medical examinations, as well as with the fact that a number of diseases of the circulatory system and the endocrine system are a contraindication for employment in contact with harmful labor factors. A higher level of detection of infectious pathology and neoplasms in case of professional examination requires a more thorough analysis.
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Janay, Abdullahi Ibrahim, and 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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Marchenko, Nataliya. "Navigation in the Russian Arctic: Sea Ice Caused Difficulties and Accidents." In ASME 2013 32nd International Conference on Ocean, Offshore and Arctic Engineering. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/omae2013-10546.
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The 5 Russian Arctic Seas have common features, but differ significantly from each other in the sea ice regime and navigation specifics. Navigation in the Arctic is a big challenge, especially during the winter season. However, it is necessary, due to limited natural resources elsewhere on Earth that may be easier for exploitation. Therefore sea ice is an important issue for future development. We foresee that the Arctic may become ice free in summer as a result of global warming and even light yachts will be able to pass through the Eastern Passage. There have been several such examples in the last years. But sea ice is an inherent feature of Arctic Seas in winter, it is permanently immanent for the Central Arctic Basin. That is why it is important to get appropriate knowledge about sea ice properties and operations in ice conditions. Four seas, the Kara, Laptev, East Siberian, and Chukchi have been examined in the book “Russian Arctic Seas. Navigation Condition and Accidents”, Marchenko, 2012 [1]. The book is devoted to the eastern sector of the Arctic, with a description of the seas and accidents caused by heavy ice conditions. The traditional physical-geographical characteristics, information about the navigation conditions and the main sea routes and reports on accidents that occurred in the 20th century have reviewed. An additional investigation has been performed for more recent accidents and for the Barents Sea. Considerable attention has been paid to problems associated with sea ice caused by the present development of the Arctic. Sea ice can significantly affect shipping, drilling, and the construction and operation of platforms and handling terminals. Sea ice is present in the main part of the east Arctic Sea most of the year. The Barents Sea, which is strongly influenced and warmed by the North Atlantic Current, has a natural environment that is dramatically different from those of the other Arctic seas. The main difficulties with the Barents Sea are produced by icing and storms and in the north icebergs. The ice jet is the most dangerous phenomenon in the main straits along the Northern Sea Route and in Chukchi Seas. The accidents in the Arctic Sea have been classified, described and connected with weather and ice conditions. Behaviour of the crew is taken into consideration. The following types of the ice-induced accidents are distinguished: forced drift, forced overwintering, shipwreck, and serious damage to the hull in which the crew, sometimes with the help of other crews, could still save the ship. The main reasons for shipwrecks and damages are hits of ice floes (often in rather calm ice conditions), ice nipping (compression) and drift. Such investigation is important for safety in the Arctic.
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Machado, José, Nicolás Lori, Ana Cecilia Coimbra, Filipe Miranda, and António Abelha. "Medical Diagnosis Classification Using WEKA." In Human Interaction and Emerging Technologies (IHIET-AI 2022) Artificial Intelligence and Future Applications. AHFE International, 2022. http://dx.doi.org/10.54941/ahfe100880.
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The use of data mining techniques is not new—commonly it is used in various other industries, such as financial services, marketing and manufacturing. The main goal of data mining is to find patterns in a large dataset that yield insight and expertise. Thus, in terms of healthcare, data mining methods have a wide range of uses, including diagnosing cancers, pattern recognition and prognosticating patient health outcomes. Each patient's diagnosis at the University of Porto Hospital (Centro Hospitalar Universitário Universitário do Porto) has an ICD-10-CM code. This data can be used to build a predictive model to classify diagnosis using secondary diagnosis. Three datasets were then created to be tested using data mining techniques. As a result, the algorithm that had the best performance was the Random Tree (99.8% corrected classified instances) using the third dataset with the five main diagnoses of each patient as parameters.
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Stillwell, Ashlynn S., and Michael E. Webber. "Feasibility of Wind Power for Brackish Groundwater Desalination: A Case Study of the Energy-Water Nexus in Texas." In ASME 2010 4th International Conference on Energy Sustainability. ASMEDC, 2010. http://dx.doi.org/10.1115/es2010-90158.
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With dwindling water supplies and the impacts of climate change, many cities are turning to water sources previously considered unusable. One such source for inland cities is brackish groundwater. With prolonged drought throughout Texas, cities such as El Paso, Lubbock, and San Antonio are desalinating brackish groundwater to supplement existing water sources. Similar projects are under consideration elsewhere in Texas. While brackish groundwater contains fewer total dissolved solids than seawater, desalination of brackish groundwater is still an energy-intensive process. Brackish water desalination using reverse osmosis, the most common desalination membrane treatment process, consumes 20 to 40 times more energy than traditional surface water treatment using local water sources. This additional energy consumption leads to increased carbon emissions when using fossil fuel-generated electricity. As a result of concern over greenhouse gas emissions from additional energy consumption, some desalination plants are powered by wind-generated electricity. West Texas is a prime area for desalination of brackish groundwater using wind power, since both wind and brackish groundwater resources are abundant in the area. Most of the Texas Panhandle and Plains region has wind resource potential classified as Class 3 or higher. Additionally, brackish groundwater is found at depths less than 150 m in most of west Texas. This combination of wind and brackish groundwater resources presents opportunities for the production of alternative drinking water supplies without severe carbon emissions. Additionally, since membrane treatment is not required to operate continuously, desalination matches well with variable wind power. Implementing a brackish groundwater desalination project using wind-generated electricity requires economic feasibility, in addition to the geographic availability of the two resources. Using capital and operating cost data for wind turbines and desalination membranes, we conducted a thermoeconomic analysis for three parameters: 1) transmission and transport, 2) geographic proximity, and 3) aquifer volume. Our first parameter analyzes the cost effectiveness of tradeoffs between building infrastructure to transmit wind-generated electricity to the desalination facility versus pipelines to transport brackish groundwater to the wind turbines. Secondly, we estimate the maximum distance between the wind turbines and brackish groundwater at which desalination using wind power remains economically feasible. Finally, we estimate the minimum available brackish aquifer volume necessary to make such a project profitable. Our analysis illustrates a potential drinking water option for Texas (and other parts of the world with similar conditions) using renewable energy to treat previously unusable water. Harnessing these two resources in an economically efficient manner may help reduce future strain on the energy-water nexus.
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Oliveira, Paloma Fernandes de, Matheus Gomes Diniz e. Silva, Daniel Rocha Diniz Teles, Sabrina de Freitas Barros Soares, and Antônio Fernando Soares Menezes Segundo. "Study of underreporting of cases of meningitis during a Covid-19 pandemic in the state of São Paulo." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.034.
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Introduction: In 2020, the World Health Organization declared the COVID-19 pandemic, which brought an overload on the health system. This also impacted the care of other diseases such as meningitis. Meningitis is classified into infectious and non-infectious meningitis, and its prognosis changes with the etiology. Objective: To assess notifications of meningitis in São Paulo compared to the country before and during the COVID-19 pandemic. Methods: An analytical epidemiological study was carried out, from the DATASUS platform, of meningitis notifications, from 2016 to September 2020 in the state of São Paulo in comparison to the country. Results: In 2020 there was a drop in meningitis notifications in São Paulo regarding the average of cases between 2016-2019, where 1,837 cases were reported in 2020, while the average of 2016-2019 was 6,800 notifications, a decrease of approximately 27%. What was also observed in the country, where in 2020, 4,718 cases were reported compared to the 2016- 2019 average of 16,603 cases, a drop of 28.4%. There was a slight increase in the mortality from meningitis in the state from 6% to 7%. Conclusions: Knowing that there was a significant drop in notifications of cases of meningitis in the state of São Paulo and in the country, we can suspect a correlation with the coronavirus pandemic. Therefore, there are some possibilities for this phenomenon: the population with meningitis, for fear of becoming infected, did not seek health services or the overload of health services to monitor patients with COVID-19 led to underreporting of meningitis cases.
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Zhong, Mengqi, Yuanyi Shen, and Yifan Yu. "Association between Neighborhood Built Environment and Body Mass Index among Chinese Adults: Hierarchical Linear Model." In 55th ISOCARP World Planning Congress, Beyond Metropolis, Jakarta-Bogor, Indonesia. ISOCARP, 2019. http://dx.doi.org/10.47472/bfwj3902.
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Obesity is becoming a global health problem. With the living standards of residents have improved rapidly in China, the problem of obesity becomes a serious threat to people’s health. Although obesity effected by many factors, the role of the built environment in relation to obesity among population should be taken into consideration. This paper examines the association of built environment and body mass index with the hierarchical linear model, based on the data from 2016 China Labor-force Dynamics Survey (CLDS), which involves 29 provinces in China and investigates 401 villages or communities as well as 14226 families. In this paper, the village or community is used as the basic analysis unit, and the body mass index of the residents is used as the dependent variable, and neighborhood built environment (e.g. density of exercise facilities, square or park and distance to them) is as independent variables, socioeconomic status (e.g. age, gender, education, marital status, income and employment status) and health and exercise characteristics (e.g. self-rated health, average weekly exercise time and frequency) are as control variables. Participants are adults aged 15-65 years (n = 21086; 63.30% rural vs urban). With the independent variables from both individual and residential levels, hierarchical linear model is applied respectively to examine how body mass index is affected. Additionally, samples are classified by age group, urban/rural neighborhood and we figure out which factor mainly effected different groups. We explore that BMI is higher in high- vs. low-facility density neighborhoods but not significantly differ by neighborhood income. Overweight/obesity (BMI >= 25) is lower in high-developed districts. Physical fitness is higher in high-income neighborhoods but unrelates income. We conclude that living in walkable neighborhoods is associated with more physical activity and lower overweight/obesity but not with other benefits. Adults in higher-income neighborhoods have lower BMI and higher mental condition. These findings have important implications for urban planning and the corresponding improvement strategy is proposed
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Atmaca, Serhat, and 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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Banerjee, Amit, Juan C. Quiroz, and Issam Abu-Mahfouz. "Statistical Comparison of Feature Sets for Time Series Classification of Dynamical System Response." In ASME 2015 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/imece2015-51455.
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The use of classification techniques for machine health monitoring and fault diagnosis has been popular in recent years. System response in form of time series data can be used to identify type of defect, severity of defect etc. However, a central issue with time series classification is that of identifying appropriate features for classification. In this paper, we explore a new feature set based on a delay differential equations (DDEs). DDEs have been used recently for extracting features for classification but have never been used to classify system responses. The Duffing oscillator and Van der Pol–Duffing (VDP-D) oscillator are used as dynamic systems, and the responses are classified into self-similar groups. Responses with the same period should belong to the same group. Misclassification rate is used as an indicator of the efficacy of the feature set. The proposed feature set is compared to a statistical feature set, a power spectral coefficient feature set and a wavelet coefficient feature set. In work described in this paper, a density estimation algorithm called DBSCAN is used as the classification algorithm. The proposed DDE-based feature set is found to be significantly better than the other feature sets for the classifying responses generated by the Duffing system. The wavelet and the power spectral coefficient data sets are not found to be significantly better than the statistical feature set for the Duffing system. None of the feature sets tested are discerning enough on the VDP-D system.
Reports on the topic "Other health not elsewhere classified"
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Treadwell, Jonathan R., James T. Reston, Benjamin Rouse, Joann Fontanarosa, Neha Patel, and Nikhil K. Mull. Automated-Entry Patient-Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepctb38.
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Background. Automated-entry consumer devices that collect and transmit patient-generated health data (PGHD) are being evaluated as potential tools to aid in the management of chronic diseases. The need exists to evaluate the evidence regarding consumer PGHD technologies, particularly for devices that have not gone through Food and Drug Administration evaluation. Purpose. To summarize the research related to automated-entry consumer health technologies that provide PGHD for the prevention or management of 11 chronic diseases. Methods. The project scope was determined through discussions with Key Informants. We searched MEDLINE and EMBASE (via EMBASE.com), In-Process MEDLINE and PubMed unique content (via PubMed.gov), and the Cochrane Database of Systematic Reviews for systematic reviews or controlled trials. We also searched ClinicalTrials.gov for ongoing studies. We assessed risk of bias and extracted data on health outcomes, surrogate outcomes, usability, sustainability, cost-effectiveness outcomes (quantifying the tradeoffs between health effects and cost), process outcomes, and other characteristics related to PGHD technologies. For isolated effects on health outcomes, we classified the results in one of four categories: (1) likely no effect, (2) unclear, (3) possible positive effect, or (4) likely positive effect. When we categorized the data as “unclear” based solely on health outcomes, we then examined and classified surrogate outcomes for that particular clinical condition. Findings. We identified 114 unique studies that met inclusion criteria. The largest number of studies addressed patients with hypertension (51 studies) and obesity (43 studies). Eighty-four trials used a single PGHD device, 23 used 2 PGHD devices, and the other 7 used 3 or more PGHD devices. Pedometers, blood pressure (BP) monitors, and scales were commonly used in the same studies. Overall, we found a “possible positive effect” of PGHD interventions on health outcomes for coronary artery disease, heart failure, and asthma. For obesity, we rated the health outcomes as unclear, and the surrogate outcomes (body mass index/weight) as likely no effect. For hypertension, we rated the health outcomes as unclear, and the surrogate outcomes (systolic BP/diastolic BP) as possible positive effect. For cardiac arrhythmias or conduction abnormalities we rated the health outcomes as unclear and the surrogate outcome (time to arrhythmia detection) as likely positive effect. The findings were “unclear” regarding PGHD interventions for diabetes prevention, sleep apnea, stroke, Parkinson’s disease, and chronic obstructive pulmonary disease. Most studies did not report harms related to PGHD interventions; the relatively few harms reported were minor and transient, with event rates usually comparable to harms in the control groups. Few studies reported cost-effectiveness analyses, and only for PGHD interventions for hypertension, coronary artery disease, and chronic obstructive pulmonary disease; the findings were variable across different chronic conditions and devices. Patient adherence to PGHD interventions was highly variable across studies, but patient acceptance/satisfaction and usability was generally fair to good. However, device engineers independently evaluated consumer wearable and handheld BP monitors and considered the user experience to be poor, while their assessment of smartphone-based electrocardiogram monitors found the user experience to be good. Student volunteers involved in device usability testing of the Weight Watchers Online app found it well-designed and relatively easy to use. Implications. Multiple randomized controlled trials (RCTs) have evaluated some PGHD technologies (e.g., pedometers, scales, BP monitors), particularly for obesity and hypertension, but health outcomes were generally underreported. We found evidence suggesting a possible positive effect of PGHD interventions on health outcomes for four chronic conditions. Lack of reporting of health outcomes and insufficient statistical power to assess these outcomes were the main reasons for “unclear” ratings. The majority of studies on PGHD technologies still focus on non-health-related outcomes. Future RCTs should focus on measurement of health outcomes. Furthermore, future RCTs should be designed to isolate the effect of the PGHD intervention from other components in a multicomponent intervention.
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Kelly, Luke. Characteristics of Global Health Diplomacy. Institute of Development Studies (IDS), June 2021. http://dx.doi.org/10.19088/k4d.2021.09.
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This rapid review focuses on Global Health Diplomacy and defines it as a method of interaction between the different stakeholders of the public health sector in a bid to promote representation, cooperation, promotion of the right to health and improvement of health systems for vulnerable populations on a global scale. It is the link between health and international relations. GHD has various actors including states, intergovernmental organizations, private companies, public-private partnerships and non-governmental organizations. Foreign policies can be integrated into national health in various ways i.e., designing institutions to govern practices regarding health diplomacy (i.e., health and foreign affairs ministries), creating and promoting norms and ideas that support foreign policy integration and promoting policies that deal with specific issues affecting the different actors in the GHD arena to encourage states to integrate them into their national health strategies. GHD is classified into core diplomacy – where there are bilateral and multilateral negotiations which may lead to binding agreements, multistakeholder diplomacy – where there are multilateral and bilateral negotiations which do not lead to binding agreements and informal diplomacy – which are interactions between other actors in the public health sector i.e., NGOs and Intergovernmental Organizations. The US National Security Strategy of 2010 highlighted the matters to be considered while drafting a health strategy as: the prevalence of the disease, the potential of the state to treat the disease and the value of affected areas. The UK Government Strategy found the drivers of health strategies to be self-interest (protecting security and economic interests of the state), enhancing the UK’s reputation, and focusing on global health to help others. The report views health diplomacy as a field which requires expertise from different disciplines, especially in the field of foreign policy and public health. The lack of diplomatic expertise and health expertise have been cited as barriers to integrating health into foreign policies. States and other actors should collaborate to promote the right to health globally.
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Gorina, Marta, Sonia Lorente, Jaume Vives, and Josep-Maria Losilla. Women´s experiences during childbirth: a systematic review protocol. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0123.
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Review question / Objective: General aim of this systematic review is to synthesize available evidence on women´s experiences during childbirth in health institutions and formal care settings. Specific objectives are to: 1. Describe women´s experiences during childbirth in institutional health centers. 2. Classify women´s experiences according to the Mother and Baby Friendly Birth Facility (MBFBF) criteria. 3. Describe prevalence of these experiences across different countries and cultures. 4. Determine the impact of childbirth experiences on self-perceived women's health on aspects related to physical, psychological and social domains. Condition being studied: This review will be framed within the context of the Mother and Baby Friendly Birth Facility (MBFBF). Women´s experiences during childbirth will be classified according to the categories defined by the MBFBF. Other actions or experiences, as interventionism or different procedures applied during childbirth, will be also analyzed (Mena-Tudela et al., 2020).
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Bayley, Stephen, Darge Wole Meshesha, Paul Ramchandani, Pauline Rose, Tassew Woldehanna, and Louise Yorke. Socio-Emotional and Academic Learning Before and After COVID-19 School Closures: Evidence from Ethiopia. Research on Improving Systems of Education (RISE), November 2021. http://dx.doi.org/10.35489/bsg-rise-wp_2021/082.
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This paper presents the findings of research undertaken in Ethiopia to examine the effects of COVID-19 school closures on children’s holistic learning, including both socio-emotional and academic learning. It draws on data collected in 2019 (prior to the pandemic) and 2021 (after schools reopened) to compare primary pupils’ learning before and after the school closures. In particular, the study adapts self-reporting scales that have been used in related contexts to measure Grade 3 and 6 children’s social skills, self-efficacy, emotional regulation and mental health and wellbeing, along with literacy and numeracy. Lesson observations were also undertaken to explore teachers’ behaviours to foster socio-emotional learning (SEL) in the classroom. The findings advance current knowledge in several respects. First, they quantify the decline in Ethiopian pupils’ social skills over the period of the school closures. Second, they identify a significant and strong relationship between learners’ social skills and their numeracy, even after taking other factors into account. Third, they reveal a significant association between children’s social skills and their mental health and wellbeing, highlighting the importance of interpersonal interactions to safeguard children’s holistic welfare. The paper concludes by proposing a model for understanding the relationship between learners’ SEL and academic outcomes, and with recommendations for education planning and practice, in Ethiopia and elsewhere.
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Washbum, Brian E. Hawks and Owls. U.S. Department of Agriculture, Animal and Plant Health Inspection Service, December 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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Chou, Roger, Rongwei Fu, Tracy Dana, Miranda Pappas, Erica Hart, and Kimberly M. Mauer. Interventional Treatments for Acute and Chronic Pain: Systematic Review. Agency for Healthcare Research and Quality (AHRQ), September 2021. http://dx.doi.org/10.23970/ahrqepccer247.
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Objective. To evaluate the benefits and harms of selected interventional procedures for acute and chronic pain that are not currently covered by the Centers for Medicare & Medicaid Services (CMS) but are relevant for and have potential utility for use in the Medicare population, or that are covered by CMS but for which there is important uncertainty or controversy regarding use. Data sources. Electronic databases (Ovid® MEDLINE®, PsycINFO®, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews) to April 12, 2021, reference lists, and submissions in response to a Federal Register notice. Review methods. Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) for 10 interventional procedures and conditions that evaluated pain, function, health status, quality of life, medication use, and harms. Random effects meta-analysis was conducted for vertebral compression fracture; otherwise, outcomes were synthesized qualitatively. Effects were classified as small, moderate, or large using previously defined criteria. Results. Thirty-seven randomized trials (in 48 publications) were included. Vertebroplasty (13 trials) is probably more effective at reducing pain and improving function in older (>65 years of age) patients, but benefits are small (less than 1 point on a 10-point pain scale). Benefits appear smaller (but still present) in sham-controlled (5 trials) compared with usual care controlled trials (8 trials) and larger in trials of patients with more acute symptoms; however, testing for subgroup effects was limited by imprecision. Vertebroplasty is probably not associated with increased risk of incident vertebral fracture (10 trials). Kyphoplasty (2 trials) is probably more effective than usual care for pain and function in older patients with vertebral compression fracture at up to 1 month (moderate to large benefits) and may be more effective at >1 month to ≥1 year (small to moderate benefits) but has not been compared against sham therapy. Evidence on kyphoplasty and risk of incident fracture was conflicting. In younger (below age for Medicare eligibility) populations, cooled radiofrequency denervation for sacroiliac pain (2 trials) is probably more effective for pain and function versus sham at 1 and 3 months (moderate to large benefits). Cooled radiofrequency for presumed facet joint pain may be similarly effective versus conventional radiofrequency, and piriformis injection with corticosteroid for piriformis syndrome may be more effective than sham injection for pain. For the other interventional procedures and conditions addressed, evidence was too limited to determine benefits and harms. Conclusions. Vertebroplasty is probably effective at reducing pain and improving function in older patients with vertebral compression fractures; benefits are small but similar to other therapies recommended for pain. Evidence was too limited to separate effects of control type and symptom acuity on effectiveness of vertebroplasty. Kyphoplasty has not been compared against sham but is probably more effective than usual care for vertebral compression fractures in older patients. In younger populations, cooled radiofrequency denervation is probably more effective than sham for sacroiliac pain. Research is needed to determine the benefits and harms of the other interventional procedures and conditions addressed in this review.
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Mäkelä, Antti, Tapio Tourula, Heikki Tuomenvirta, Pauli Jokinen, Terhi Laurila, Ari-Juhani Punkka, Minna Huuskonen, Tuomo Brgman, and Hannu Valta. Climate change impacts to the security of supply. Finnish Meteorological Institute, 2023. http://dx.doi.org/10.35614/isbn.9789523361645.
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Serious disruptions and exceptional circumstances for society, that the society tries to prepare for and act in them are at the center of security of supply. Current examples are the COVID pandemic and the ongoing energy crisis for which Finland's security of supply has also been strongly highlighted. Disturbances can also be caused by weather phenomena: in Finland, such examples are windstorms, severe thunderstorms, floods, and droughts, which can, at least in principle, paralyze the society. It is possible to prepare for the impacts of weather phenomena, but the ongoing rapid climate change makes it more complicated. Some of the weather phenomena that cause impacts are fast and violent (e.g. intense thunderstorms) and some occur more slowly (e.g. long heat waves), and climate change affects the phenomena in different ways. In this work, the estimated impacts of climate change on Finland's security of supply were investigated. The starting point was to gain an understanding of which weather phenomena and weather situations are central to security of supply and which sectors of security of supply are the most vulnerable. The work constituted of workshops and expert interviews organized with the National Emergency Supply Agency. In addition to the interviews, the work covered past significant weather situations in Finland that are known to have had significant societal impacts. Information was also extracted from recent literature, especially regarding the vulnerabilities and adaptability of different sectors in Finland. Estimates of the climate change impacts on the identified phenomena were combined with the collected information, resulting in a first understanding of how climate change affects Finland's security of supply. Based on the results, it can be concluded that the impacts of climate change on security of supply are quite complex, especially due to the wide spectrum of weather phenomena and their different impact mechanisms. In addition, the matter becomes more complicated by the fact that there is no clear distinction of what weather phenomenon actually is critical to security of supply and what is not. For example, could the increasing adverse impacts on health care due to the increasingly common heat conditions reach a serious societal disturbance situation at some point, if it is not sufficiently prepared in advance? Another key result is that in terms of security of supply, the direct effects of climate change are very small in Finland compared to many other countries. Although the climate in Finland has already changed considerably and will continue to change in the future, the biggest impacts to security of supply seem to be reflected from elsewhere: the experts of the National Emergency Supply Agency consider the worst situation to be a lack of food, water and habitable living environment in the world, which would also be reflected to Finland. Among the sectors, food/water and energy supply and logistics are perceived as the most vulnerable. The work mainly focused on the direct effects of climate change, i.e. the effects of climate change on the occurrence of various weather phenomena. However, the work also considers to some extent indirect effects, i.e. those reflected from other parts of the world, and transitional effects that result from climate change mitigation measures, especially from the rapid energy transition.
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 2022. http://dx.doi.org/10.57022/qpsm1481.
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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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Workshop report: Launching of the revised reproductive health policy guidelines and standards. Population Council, 1998. http://dx.doi.org/10.31899/rh1998.1017.
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The Government of Kenya recently revised its Policy Guidelines and Standards for family planning (FP) and other reproductive health (RH) services to encourage service providers to undertake a more comprehensive approach to service delivery. Some of the recommendations, especially those relating to the integration of STI/HIV/AIDS services into MCH/FP services, and to safe motherhood, include new practices and procedures. A number of research studies have been conducted in Kenya and elsewhere that provide data pertinent to many of these recommendations, and the Division of Primary Health Care (DPHC) used the results to provide a framework within which the guidelines were discussed during a workshop in Nairobi, February 23–25, 1998. The Africa OR/TA Project II had documented and synthesized these lessons. In addition, the DPHC, with support from the Department for International Development (DfID), had compiled a review of safe motherhood issues in Kenya based on research studies conducted in the country on maternal mortality and morbidity. The DPHC collaboration with the Africa OR/TA Project of the Population Council, and with support from USAID and DfID, organized a workshop for program managers. Results are described in this report.
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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.