Health Assurance Research Articles

Optimum energy use to satisfy indoor air quality needs

Indoor air quality is important to occupant health. Ventilation is a widely used technique for improving indoor air quality. However, improper ventilation results in heat losses up to 70.0% and is often the source of energy usage problems. According to the final report of the HOPE [11], the simultaneous assurance of ventilation, energy reduction and occupant health remains a design challenge. In addition, CO2 is a pollutant which is largely impacted by air exchange, the effects of which cannot be neglected in indoor air quality. Therefore, this study focuses on levels of CO2 and calculates the makeup air rate and recirculation air rate of indoor spaces. The optimum ratio of makeup air and recirculation air is evaluated in Korea to maintain acceptable indoor air quality and to save energy.

Implants in the severely resorbed mandibles: whether or not to augment? What is the clinician’s preference?

IntroductionThe aim of this study is to inventory in the Netherlands which therapy is the clinician’s first choice when restoring the edentulous mandible.Material and methodsA questionnaire was sent to all Dutch Oral and Maxillofacial surgeons. As part of this, the surgeons were invited to treat five virtual edentulous patients, differing only in mandibular residual height.ResultsIn cases of a sufficient residual height of 15 mm, all surgeons were in favour to insert solely two implants to anchor an overdenture. In case of a residual height of 12 mm, 10% of the surgeons choose for an augmentation procedure. If a patient was presented with a mandibular height of 10 mm, already 40% of the OMF surgeons executed an augmentation procedure. Most (80%) surgeons prefer the (anterior) iliac crest as donor site. The choice of ‘whether or not to augment’ was not influenced by the surgeon’s age; however, the hospital, where he was trained, did. Surgeons trained in Groningen were more in favour of installing short implants in mandibles with reduced vertical height.DiscussionAs the option overdenture supported on two interforaminal implants is reimbursed by the Dutch health assurance, this treatment modality is very popular in the Netherlands. From a point of costs and to minimize bypass comorbidity, surgeons should be more reluctant in executing augmentation procedures to restore the resorbed edentulous mandible as it is dated in literature that also in mandibles with a residual height of 10 mm or less, solely placing implants, thus without an augmentation procedure in advance, is a reliable treatment option.Electronic supplementary materialThe online version of this article (doi:10.1007/s10006-011-0285-6) contains supplementary material, which is available to authorized users.

Quality of Life among Adult Patients with Peptic Ulcer in the City of Sulaimani

Objectives: To assess the quality of life for adult patients with peptic ulcers in the city of Sulaimani.Methodology: A descriptive study, using the assessment approach was conducted on patients with peptic ulcerdisease from January 12th, 2009 to September 30th, 2009. A purposive "non-probability" sample of (100) paƟents(males and females) with peptic ulcers who attended Kurdistan Center for Gastroenterology and Hepatology wereselected for the study. A questionnaire was adapted from the World Health Organization quality of life questionnaire(1998) for the purpose of the study. It is comprised of (3) parts that included sociodemographic characteristics form,medical history form and adult peptic ulcers patients' quality of life (QoL) questionnaire. A pilot study was carried outon (10) paƟents for the period of January 12th through January 28th, 2009 to determine the study quesƟonnaire'sreliability through the use of stability (test-retest method). A panel of (14) experts was involved in the determinationof the questionnaire's content validity. Data were analyzed through the application of the descriptive statistical dataanalysis approach (frequency, percentage, mean of scores) and inferential statistical data analysis approach (Pearsoncorrelation coefficient and chi-square).Results: The findings of the study indicated that quality of life was affected in physical domain and that age, gender,marital status, and monthly income had significant relationship with quality of life domains.Recommendations: The study recommends that young adults, particularly Individuals with blood group (O) should behighly aware from gastrointestinal (GI) symptoms and avoids risk factors for the development of peptic ulcer disease(PUD). Also, the study recommends providing health assurance and conducting further multi centers studies in orderto demonstrate the differences in QoL issues for PUD patients.

WSAVA Nutritional Assessment Guidelines

WSAVA Nutritional Assessment Guidelines

Health assurance in school, matter of care in vaccinations and surgical operation for asthmatic children

Health assurance in school, matter of care in vaccinations and surgical operation for asthmatic children

Renovation of sanitary engineering study programme

While the Bologna process has not been 100% successfully applied all over Europe and a new reform of higher education system is already in sight, it is crucial to expose examples of good renovation practices which have been applied during the Bologna process. In the article, the authors present a concept, steps and activities carried out in the process of renovation of the study programme Sanitary Engineering at University of Ljubljana, Slovenia. Results of the survey among graduate sanitary engineers and their employers were used as a starting point for the preparation of the content and the concept (4+1) of the renewed study program. Activities (inquiry among graduates, meetings with employers, public promotions etc.) carried out in the process of renovation proved to be optimal for the renovation of this, the field of public and environmental health assurance, very important study programme.

Education and Religious Beliefs: Supportive Determinants in the Understanding of Health Issues in Sub-Saharan Africa

In the aftermath of the 1978 WHO conference where the Alma Ata Declaration on primary health care was issued, the Cameroonian government was striving to guarantee equity in health care by developing a policy targeting social justice and assurance of health for by 2000s. From this, a research programme based on health in the urban milieu was conceived in 2000 to address the population's state of health. The epidemiological and transversal study was carried out in April-May 2005 on children aged between 6 and 59 months in Yaounde (Cameroon). The objectives of this study were to identify risk factors predisposing people to diarrheas in the city, to measure their prevalence, and ascertain their spatial distribution, all in a bid to evaluate the progress made in infant health since 1978. The microbiological analyses carried out revealed an average diarrhea prevalence rate of 14.4% (437 cases of diarrhea on the 3034 infants tested). Amongst many other factors, the level of education and the religious belief of the household head were seen to be associated with the occurrence of infants' diarrhea. In addition, it was acknowledged that the level of diarrhea infection in the city varies considerably from one household to another.

Evaluability Assessment to Improve Public Health Policies, Programs, and Practices

Evaluability assessment, also commonly known as exploratory evaluation, has assisted the field of public health to improve programs and to develop a pragmatic, practice-based research agenda. Evaluability assessment was originally developed as a low-cost pre-evaluation activity to prepare better for conventional evaluations of programs, practices, and some policies. For public health programs, however, it serves several other important purposes: (a) giving program staff rapid, constructive feedback about program operations; (b) assisting the core public health planning and assurance functions by helping to develop realistic objectives and providing low-cost, rapid feedback on implementation; (c) navigating federal performance measurement requirements; (d) translating research into practice by examining the feasibility, acceptability, and adaptation of evidence-based practices in new settings and populations; and (e) translating practice into research by identifying promising new approaches to achieve public health goals.

Online Consultations in Cyberpharmacies: Completeness and Patient Safety

Many online pharmacies that serve as a substitute for original or personal medical prescriptions use a health questionnaire for consumers to complete on their Web site for buying prescription-only medicines. A content analysis of online medical questionnaires from a sample of online pharmacies (OPs) examined their completeness. Fifty-seven questionnaires were identified in which online pharmacies sought health status assessment from online purchasers. To evaluate the questionnaires, a checklist tallied their characteristics, including general features, medical history requested, and involvement of the consumer's doctor. Drug allergies were queried in 55 OPs (96.5%) and other allergies in 40 (70.2%). All of the questionnaires asked whether the consumer had suffered or was currently suffering from a particular illness, but a question about past surgery was present in 23 sites (40.3%) only; 40 sites (70.2%) asked women if they were pregnant or breastfeeding. Only 30 pharmacies out of 57 (52.6%) asked if the consumer's family doctor was aware of his/her intention of buying online and an even lower percentage (19.3%) asked if the purchase was based on a medical diagnosis rendered by a physician. Less than 20% of the pharmacies asked for the name, address, or telephone number of the consumer's family doctor. The results confirm the inadequacy of online pharmacy medical questionnaires in the assessment of health status for prescribing drugs. The results suggest that these questionnaires aim more at giving the consumer a false sense of health assurance than performing an effective assessment of his or her health status relative to the drug purchase.

A Series of Studies of the Health Effects and Its Protection Measures of the Miners' Inhaled Thorium Dusts

Environment, Safety, Health and Quality Assurance Division; Argonne National Laboratory; Argonne, IL 60439; [email protected]

Field services : eradication and control of animal diseases : animal health management in the 21st century

Prevention, eradication and control of animal diseases, as well as public health assurance are major functions of veterinary authorities. The strategies to control animal diseases differ from disease to disease but are often similar on a disease basis from country to country depending on the main objective of the measure employed. These measures include among others movement control and quarantine, vaccination, treatment and mass slaughtering. However, not every country uses all these control measures at the same time. A combination of measures may be employed to avoid spreading of the disease from infected to clean animals and success is dependent on a variety of factors, including the strength and capacity of the veterinary services, cross border efforts for disease surveillance, political will, diagnostic facilities and financial support.

La carga de enfermedad y lesiones en el Perú y las prioridades del plan esencial de aseguramiento universal

for the implementation of universal health assurance in Peru, we must have a package of benefits coverage to be financed on a obligatory, which is called the Health Assurance Essential Plan (PEAS, Plan Esencial de Aseguramiento en Salud). The development of the PEAS must correspond to the conditions that major cause of burden of disease. This is a review of the main results of the study of burden of disease and injury in Peru, noting that non-communicable diseases are those that generate the greatest amount of healthy life years lost (DALys) are neuropsychiatric diseases category that comes first and the diagnosis of greatest loss of DAL ys are traffic accidents. This information has been used to regularly include diseases not covered by basic insurance packages in the PEAS.

LEY MARCO DE ASEGURAMIENTO UNIVERSAL EN SALUD, BAJO LA LUPA

The framework Law on universal Health Assurance was drawn having a background of a neo-liberal model, which generates exclusion and polarization, it was approved under circumstances in which great contrasts between the health systems prevail. On one hand, countries that keep isolated and private subsystems, and on the other, those who, unified under the State responsibility, guarantee everybody integral, free, quality access to the health services. In the Americas and Caribbean, there are countries whose citizens don’t have rights and possibilities, which unmasks the deep inequities that keep excluded the most who are poor and extremely poor. Among these, Peru shows health indicators that still have alarming numbers, much below those of other places in the world. In the last three decades, there were frustrated rehearsals of changes, such as the functional integration between the Ministry of Health and the Peruvian Institute of Social Security, or the Coordinated and Decentralized National System. Nowadays, the framework Law on universal Health Assurance is being formulated, keeping the actual subsystems without any change and with their own autonomies, trying out pilots, establishing partial plans, implementing it in a progressive fashion, giving priority to privatization and weakening the rector function of the Ministry of Health, creating an omnipotent superintendence, which will continue allowing the social exclusion of more than 9 million of Peruvians. There is, in conclusion, the need to raise the unification of the subsystems, in order to construct a unique System of Health, capable of giving a complete, integral, quality and cost-free health to the 100% citizens.

El aseguramiento universal en el Perú: la reforma del financiamiento de la salud en perspectiva de derechos

This article exposes the main aspects of the Law 29344, framework Law on universal Health Assurance, and then approaches three key aspects related to its approval, from a rights point of view: the programmatic readjustment of the doctrine about social security and health that held the Interamerican Development Bank; the System of the Health Maintenance Organizations, as models of regulation and financing, and the continuity of the speeches about assurance plans. We conclude that the emphasis in the economic and financial aspects that the assurance poses, as the law develops, limits healthy public policies and health rights to what is concrete, with an external-user logic, very close to the speech about quality of services or speeches on prevention of risks in individual health.

Hacia el aseguramiento universal en salud en el Perú

Recently approved the framework Law on universal Health Assurance, however, the name of this law far exceeds its content because no highlights a significant improvement in the social and financial protection in health for all Peruvians. In this article we present the proposed Peruvian Medical College to provide universal assurance, and insist that it must undertake real health sector financial reform, which translates into effective universal health insurance as part of a comprehensive social protection policy based on rights, to the universal social security.

응급의료센터를 보유한 의료기관 입원 중 응급실경유입원 관련 요인

Objectives : The purpose of this study is to analyze the proportion of admission via the emergency room(the rest is ER) in an emergency medical center and to examine the factors related to admission. Methods : This study used 2005 National Health Insurance claims data for admitted patients of 112 hospitals having emergency medical centers in Korea. The study sample had 2,335,610 patients. The data was classified into emergency admission and non-emergency admission. To investigate the factors affecting the type of admission, the following were included as independent variables: type of health assurance_(national health insurance beneficiaries or medical aid beneficiaries), demographic characteristics_ (sex, age), cause of admission_ (disease or injury), whether an operation was performed or not, DRG severity level, the number of beds, and the location of the hospital. Data were analyzed using the Chi-square test for the differences in emergency admission rates for each variables, and multiple logistic regression analysis was used for identifying the factors affecting admission type. Results : The proportion of admission via the ER accounted for 40.6% of the total admission among hospitals having emergency medical centers. The risk of admission via ER was relatively high for patients who were male, the aged, the injured, the surgical patients, the patients having more severe symptoms, and the patients admitted the hospitals located in metropolitan areas, and the patients admitted the hospitals having 300-699 beds. Medical aid patients were more likely admitted through the emergency room than health insurance patients after other variables ware adjusted. Conclusions and Discussion : We analyzed the proportion of admission via the ER for the total admission rate of hospitals having an emergency medical center in Korea. And we explored the factors related to admission via the ER. This proportion may be used as an indicator of the adequacy of medical utilization or low accessibility to hospitals of patients with low socioeconomic status.

IMPLEMENTACIÓN DEL ASEGURAMIENTO UNIVERSAL EN SALUD EN REGIONES PILOTO DEL PERÚ

In April 2009, the Law No. 29344: framework Law on universal Health Assurance was enacted, its implementation will be gradual in the number of insured as coverage of benefits and explicit guarantees. first will be implemented in nine pilot areas of the poorest provinces and districts of Peru, for which the State has made budgetary changes to allow its implementation.

Derivation and external validation of a simple prediction model for the diagnosis of type 2 Diabetes Mellitus in the Brazilian urban population

A risk score model was developed based in a population of 1,224 individuals from the general population without known diabetes aging 35 years or more from an urban Brazilian population sample in order to select individuals who should be screened in subsequent testing and improve the efficacy of public health assurance. External validation was performed in a second, independent, population from a different city ascertained through a similar epidemiological protocol. The risk score was developed by multiple logistic regression and model performance and cutoff values were derived from a receiver operating characteristic curve. Model's capacity of predicting fasting blood glucose levels was tested analyzing data from a 5-year follow-up protocol conducted in the general population. Items independently and significantly associated with diabetes were age, BMI and known hypertension. Sensitivity, specificity and proportion of further testing necessary for the best cutoff value were 75.9, 66.9 and 37.2%, respectively. External validation confirmed the model's adequacy (AUC equal to 0.72). Finally, model score was also capable of predicting fasting blood glucose progression in non-diabetic individuals in a 5-year follow-up period. In conclusion, this simple diabetes risk score was able to identify individuals with an increased likelihood of having diabetes and it can be used to stratify subpopulations in which performing of subsequent tests is necessary and probably cost-effective.

NOISE POLLUTION AND HEALTH IMPACT IN URBAN ARGES AREA

Economical development in the Arges district, in the recent years, presents some aspects regarding the compliance with noise environmental regulations. The noise and its impact on human health is one of the most important objectives of the health assurance policy. In this paper a comparative study of urban noise in the principal cities of the Arges district is performed. The data monitoring of noise polution were carried out by using of specific standard methods with a Sonometer Delta 2010. There are correlations between the activities highlighted monitoring pollution with noise and economical and social activities in the area. Similar areas registration of noise were selected for the measure of sound equivalent level, instantaneous peak level or maximum peak level: in nearby schools, hospitals, roads and parks. These results are been presented by comparing parameters of noise witch were determinated in the similar conditions, but in different periods of time.

Study on an on-line molecularly imprinted solid-phase extraction coupled to high-performance liquid chromatography for separation and determination of trace estrone in environment

Estrone is one of the important potential endocrine-disrupting compounds, and the sensitive and reliable analytical methods for the determination of estrone are required for the assurance of human health. In this paper, using estrone as template molecule, 3-aminopropyltriethoxysilane as function monomer, and tetraethoxysilicane as cross-linker, a highly selective molecularly imprinted microsphere was synthesized by surface molecular imprinting technique combined with a sol-gel process. The imprinted material was characterized by the Fourier transform infrared and static adsorption experiments, and the results showed that it exhibited good recognition and selective ability for estrone. A novel method for separation and determination of trace estrone in environmental sample was developed using on-line molecularly imprinted solid-phase extraction coupled to high-performance liquid chromatography. With a sample loading flow rate of 2.6 mL min(-1) for a 9.6-min extraction, the enrichment factor obtained by the slopes of the linear portion in comparison with the direct injection of 10 microL standard sample solution was 1,045. The detection limit (S/N = 3) was 5.7 ng L(-1), and the relative standard deviations for nine replicate extractions of 5.0 microg L(-1) estrone was less than 10.0%. This method was evaluated for quantitative determination of estrone in well and lake water samples spiked at two levels (0.5 and 1.0 microg L(-1)) with recoveries ranging from 86% to 95%.