Health Efforts Research Articles

Development and Validation of the CPO Scale, a New Instrument for Evaluation of Health Care Improvement Efforts.

To develop and validate an instrument for guidance and evaluation of quality and safety improvement efforts in health care. The instrument is based on the Plan-Do-Study-Act cycle and the 3 fundamental improvement questions regarding aims, measurement, and change-making. An interdisciplinary team of improvement experts developed the Change Process and Outcome (CPO) scale. After studying the improvement literature, the scale was tested and refined on a sample of 5 projects. The CPO evaluation process and classification system was developed when evaluating 189 of the quality improvement projects of the Norwegian Medical Association by their final reports. The scale was validated by applying statistical testing to the evaluation results. The final CPO scale consists of 13 process items and 7 outcome items. Interrater reliability ranged from 0.53 to 0.79, and test-retest reliability was 0.82. Factor analyses with Varimax rotation identified 2 significant process domains: Aims/change-making and Measurement/reporting, with Cronbach α values 0.88 and 0.95, respectively. The classification system produced 3 performance levels: successful, promising, and uncertain. The CPO scale shows good internal consistency, reliability, and validity for evaluating the success of quality improvement initiatives.

Social movements and public health advocacy in action: the UK people's health movement.

There are growing calls within public health for researchers and practitioners working to improve and protect the public's health to become more involved in politics and advocacy. Such a move takes practitioners and researchers beyond the traditional, evidence-based public health paradigm, raising potential dilemmas and risks for those who undertake such work. Drawing on the example of the People's Health Movement, this short paper argues that advocacy and social movements are an essential component of public health's efforts to achieve great health equity. It outlines how the Scottish branch of the People's Health Movement sought to overcome potential tensions between public health evidence and advocacy by developing a regional manifesto for health via transparent and democratic processes which combine empirical and experiential evidence. We suggest that this is an illustrative example of how potential tensions between public health research and advocacy can be overcome, through bottom-up movements of solidarity and action.

A Descriptive Study to Assess the Attitude of Women on their Empowerment in a Selected Rural Community of Bagalkot

A family may not be completed without a woman. She needs to take care of each one of the family member but she is unaware for taking care of herself. It is mainly due to here illiteracy and low economic status. As far as literacy is concerned women are particularly underprivileged. The working women children may try a variety of ways to meet her family responsibilities, within the framework of a democratic policy, our laws, development policies, plans and programmes that have aimed at women's advancement in different shares. The empowerment of women has been recognized as the central issue in determining the status of women. In aiming to improve women's rights and status and thereby, responding to not only their practical interests, but also strategic interest, the education, occupation, good health and self-help efforts enter the realm of the Indian women's movement. Hence the investigator felt the need to conduct “A Descriptive Study To Assess The Attitude of Women On Their Empowerment In A Selected Rural Community of Bagalkot.”

Abstract B16: Cancer survivorship prevalence: Descriptive analysis of cancer survivors in Puerto Rico

Abstract Objective: Statistics about cancer survivorship are inexistent for the Puerto Rican population. With this study we intend to address the first objective of the Puerto Rico Cancer Control Plan 2008-2012 of increasing the knowledge and awareness of survivorship among the Puerto Rican community. Thus, this study aimed to estimate the number of cancer survivors living with a history of a primary malignant tumor in Puerto Rico (PR) as of January 1, 2011, through a secondary data analysis of the Puerto Rico Central Cancer Registry and assess cancer survivorship prevalence of the five most incident cancers in Puerto Rico (breast, prostate, colon and rectum, lung and bronchus, and thyroid). Methods: The study population consisted of people in Puerto Rico living with a cancer diagnosis as of January 1, 2011, as documented in the Puerto Rico Central Cancer Registry. We calculated the limited-duration prevalence, which represents the proportion of people alive on a certain day that had a diagnosis of the disease, within 5 years (2005-2010) and with 23 years (1987-2010). Using the limited duration prevalence statistics from 1987-2011, we also calculated the complete prevalence, which represents the proportion of people alive on a certain day that previously had a diagnosis of the disease, regardless of how long ago the diagnosis was made. The limited-duration prevalence statistics were calculated using the Surveillance Epidemiology and End Results (SEER) Stat software and were later imported to SEER's Complete Prevalence (ComPrev) software to calculate the complete prevalence. Statistics were calculated overall and by sex, age, period of diagnosis and cancer type. Results: For the complete prevalence, we estimated that 61,928 people in Puerto Rico were living with cancer as of January 1, 2011. Of these, 30,108 are men, 31,820 were women and 37,520 were over 65 years of age or older. For the limited-duration prevalence (2005-2010), we estimated that there were 29,057 cancer survivors in Puerto Rico: 16,131 were men, 12,926 were women and 15,922 were over 65 years of age or older. Results show that the prevalence of cancer survivors in Puerto Rico is higher for prostate (n=18,874) and breast cancer (n=13,736), followed by colorectal cancer (n=7,431), lung and bronchus (n=5,115) and thyroid (n=775) cancer. The prevalence of colon and rectum cancer was similar in both genders (n=3,443 were men and n=3,321 were women). However, the prevalence of lung and bronchus cancer was higher in men (n=403 men vs. n=310 women) and the prevalence of thyroid cancer was higher in females (n=3,367 women vs. n=627 men). Discussion: Similar to the US, most cancer survivors in PR are breast and prostate cancer survivors, as well as persons aged 65 years of age or older. Nonetheless, the proportion of cancer survivors in Puerto Rico (1.6%) is smaller when compared to the US population (4.4%). The findings in this report have important implications for public health practice. As cancer survivorship issues are being recognized, it is our goal to support public health's efforts of improving the lives of cancer survivors, by increasing knowledge on survivorship in the Puerto Rican community. Cancer survivors have particular needs that should be addressed by the public health system. Information generated by this study is important for the development of research, outreach and intervention priorities in this population. Citation Format: Ana Patricia Ortiz-Martinez, Aixa M. Perez-Caraballo, Keyla Gonzalez-Lorenzo, Coral Cotto-Negron, Hilmaris Centeno, Crisanta Serrano-Collazo, Mitchelle Flores-Febo, Carlos Torres, Naydi Perez, Karen Ortiz-Ortiz. Cancer survivorship prevalence: Descriptive analysis of cancer survivors in Puerto Rico. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B16. doi:10.1158/1538-7755.DISP13-B16

Ten-year trends in major lifestyle risk factors using an ongoing population surveillance system in Australia.

BackgroundUnderstanding how risk factors (tobacco, alcohol, physical inactivity, unhealthy diet, high blood pressure, and high cholesterol) change over time is a critical aim of public health. The associations across the social gradient over time are important considerations. Risk factor surveillance systems have a part to play in understanding the epidemiological distribution of the risk factors so as to improve preventive measures and design public health interventions for reducing the burden of disease.MethodsRepresentative, cross-sectional data were collected in South Australia using telephone interviews, conducted on a minimum of 600 randomly selected people (of all ages) each month. Data were collected from January 2004 to December 2013. Unadjusted prevalence over time, the relative percentage change over the 10 years, and the absolute change of the risk factors with sex, age group, and socio-economic status (SES) estimates are presented.ResultsIn total 55,548 adults (≥18 years) were interviewed (mean age = 47.8 years, 48.8% male). Decreases were apparent for insufficient physical activity, inadequate fruit and vegetables, smoking, and soft drink consumption of ≥500 ml/day. Increases were found over the 10 years for obesity, high cholesterol, diabetes, and for those with no risk factors. Apparent differences were noticeable by different sex, age, and SES categories. While increases in physical activity and fruit and vegetable consumption and decreases in smoking prevalence and multiple risk factors are to be expected in 2020–2021, the prevalence of obesity, high blood pressure, high cholesterol, and diabetes are expected to increase.ConclusionsPublic health efforts in increasing the proportion of the population undertaking appropriate risk factor behavior are showing signs of success, with data from 2004 to 2013 showing encouraging trends. Deriving comparable trends over time by key demographics and SES variables provides evidence for policymakers and health planners to encourage interventions aimed at preventing chronic disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12963-014-0031-z) contains supplementary material, which is available to authorized users.

Are Nonprofit Antipoverty Organizations Located Where They Are Needed? A Spatial Analysis of the Greater Hartford Region

The geographic distribution of nonprofit antipoverty organizations has important implications for economic development, social services, public health, and policy efforts. With counts of antipoverty nonprofits at the census tract level in Greater Hartford, Connecticut, we examine whether these organizations are located in areas with high levels of poverty with a spatial zero-inflated-Poisson model. Covariates that measure need, resources, urban structure, and demographic characteristics are incorporated into both the zero-inflation component and the Poisson component of the model. Variation not explained by the covariates is captured by the combination of a spatial random effect and an unstructured random effect. Statistical inferences are done within the Bayesian framework. Model comparison with the conditional predictive ordinate suggests that the random effects and the zero-inflation are both important components in fitting the data. All three need measures—proportion of people below the poverty line, unemployment rate, and rental occupancy—are found to have significantly positive effect on the mean of the count, providing evidence that antipoverty nonprofits tend to locate where they are needed. The dataset and R/OpenBUGS code are available in supplementary materials online.

Transition from Semi-Confinement to Pasture-Based Dairy in Brazil: Farmers’ View of Economic and Environmental Performances

The production of ecosystem goods and services has increased significantly in the last 100 years, while the capacity of ecosystems to generate supporting and regulating services has decreased. In this context, agriculture and livestock production have become major concerns. At the same time, livestock, particularly dairy cows, play a key role and can serve to improve ecosystems, production, and rural livelihoods. We randomly selected and conducted semistructural interviews with 61 dairy family farmers from four cooperatives in the Encosta da Serra Geral Region of the Atlantic rainforest in Santa Catarina, Brazil. The goal was to analyze their production and viewpoints about environmental variables after adopting management-intensive grazing (MIG). The overall results showed that when farmers changed from semi-confinement and continuous grazing to MIG they perceived improvements in production, livelihoods, and ecosystem services. Moreover, according to farmers’ insights, MIG could be a tool to increase water and soil quality, animal health, alleviate poverty, and complement Brazilian conservation efforts.

If only I were paramecium too! A case for the complex, intelligent system of anticipatory regulation in fatigue

Background: Fatigue is a common term used to describe feelings of tiredness along with observations of reduced physical effort in both health and disease. The study of fatigue has centered mainly on understanding its putative causes. Recently (1990s), fatigue has been researched with an expanded view encompassing its potential origins and purposes in human physiology. Purpose: This review will explore and consider different fatigue models which could assist in the evolving understanding of this human condition. Methods: In this narrative review, Medline and Google Scholar were initially utilized to identify studies and texts documenting the developing understanding of fatigue. Following this, key words were used to locate investigations describing reactions to external stimuli in basic and complex organisms. The term anticipatory regulation was entered to locate studies which evaluated this construct in both health and disease. Results: This review shifts the focus of the fatigue paradigm from the catastrophe model, which emphasizes peripheral energy supply and demand, to the anticipatory regulation model, which focuses on a central regulatory process that anticipates energy demands and makes adjustments to accommodate future demand. The potential for this model to be used to explain the fatigue process in both health and disease is also discussed with respect to specific pathologies. Conclusion: There is now a body of evidence indicating that fatigue may represent a process of anticipatory regulation for maintaining homeostasis.

Mapping the Spatial Distribution of a Disease-Transmitting Insect in the Presence of Surveillance Error and Missing Data

SummaryMaps of the distribution of epidemiological data often ignore surveillance error or possible correlations between missing information and outcomes. We analyse presence–absence data at the household level (12050 points) of a disease-carrying insect in Mariano Melgar, Peru, collected as part of the Arequipan Ministry of Health's efforts to control Chagas disease. We construct a Bayesian hierarchical model to locate regions that are vulnerable to under-reporting due to surveillance error, accounting for variability in participation due to infestation status. The spatial correlation in the data allows us to identify relative inspector sensitivity and to elucidate the relationship between participation and infestation. We show that naive estimates of prevalence would be biased by surveillance error and missingness at random assumptions. We validate our results through simulations and observe how randomized inspector assignments may improve prevalence estimates. Our results suggests that bias due to imperfect observations and missingness at random can be assessed and corrected in prevalence estimates of spatially auto-correlated binary variables.

Perspectives on One Health: a survey of national Delegates to the World Organisation for Animal Health, 2012

In 2012, the World Organisation for Animal Health (OIE) surveyed all 178 national Delegates to better understand the perceptions and priorities of Veterinary Services with respect to One Health efforts and to guide future work in that area. For the purposes of this survey, the concept or practice of One Health was defined as 'the intersectoral collaborative approach to preventing, detecting, and controlling diseases among animals and humans, including the collaboration among the institutions and systems that support their prevention, detection and control'. A total of 120 OlE Delegates, representing countries from all five OIE regions, responded to the survey. Delegates identified zoonoses, rabies and influenza as high-priority disease areas and disease reporting and food safety as high-priority programme areas for One Health approaches. Veterinary Services participated in joint programmes, involving these priority disease and programme areas, with national intersectoral partners. Delegates reported barriers to implementing One Health approaches, including a lack of resources, the complexity of collaboration, inadequate capacity within their Veterinary Services, and a lack of adequate legislation, policy, guidance and political will for One Health activities. Delegates supported OIE efforts to enhance One Health activities, and requested that the OIE and partners provide technical information and advice and conduct training and capacity-building seminars for One Health. Veterinary Services cannot effectively apply One Health approaches at the national level without effective partnerships across sectors. The OlE can serve as a model for countries by continuing its commitment to these intersectoral partnerships at the international level.

An Assessment of Small and Medium Enterprise Owners’ Occupational Safety and Health Efforts: The Case of Southerton, Harare, Zimbabwe

An Assessment of Small and Medium Enterprise Owners’ Occupational Safety and Health Efforts: The Case of Southerton, Harare, Zimbabwe

A critical discourse analysis of Canadian and Australian public health recommendations promoting physical activity to children

In the past decades, public health has increasingly addressed what has been called the children’s obesity ‘epidemic’, most notably through large-scale initiatives promoting physical activity. Through a discourse analysis the current paper critically examines such efforts in Canadian and Australian public health. Public health websites in Canada and Australia were examined for information concerning children’s health, physical activity and obesity and explored for how these issues were represented in the discourse. Bacchi’s (2009) ‘What’s the problem represented to be?’ approach to discourse analysis guided our interrogation of the taken-for-granted assumptions underlying Canadian and Australian public health discourse, the ideological and political influences involved in its construction, and the knowledge base upon which it rests. The article calls for critical reflection on how children’s physical and leisure activities are being advanced.

Designing Healthy Communities

Designing Healthy Communities, the companion book to the acclaimed public television documentary, Richard dr beverly baroffproducer writer editor at wnet studios on pbs tri state. I hope that give us hopeful examples of america since associations. In category of attention the cdc leader in category. The built environment on health effort, our future. In the directors guild of pollution exposure reduce risks will be producing its four. Well as well being distributed to them lie. We design the pulse leading role in 1st or parks. Senator by teresa heinz awards celebrate their everyday practice they live encouraging. Designing healthy communities across the life needs to connection between public television. Richard you seem to improve health in antidepressant jackson has become. It is every city and towns more than the points out that todays. This book is likely to repurpose, it needed. The right such details of us, national laws to get involved with our lives. He or infirmity and information missing from the most interesting protect. They address societys root causes of our love. The academy award as a clean air quality of changes highlighted. Jackson host of the diversity tools. Introduces the public television arts and early 1900s with communities is committed to nuclear. A multi hour town hall meeting derived from september founded on the acclaimed.

Encouraging Patients to Ask Questions

THE FOCUS OF AN ONGOING EFFORT IN HEALTH CARE quality improvement is to encourage patients to ask questions during their care. In September 2011, the Agency for Healthcare Research and Quality (AHRQ) launched the Questions Are the Answer campaign (TABLE) and has used $20 million of donated marketing outreach toward building patient engagement through asking questions (Farah Englert, AHRQ, November 15, 2012, written communication). In 2002, the Joint Commission created Speak Up, an initiative that promotes patient involvement in care and emphasizes the importance of asking questions (Table). Encouraging patients to ask questions makes sense; it has the potential to enable shared decision making between patients and physicians. As a result, patient adherence may improve, patient satisfaction may increase, and patients may be more likely to receive care that is in accordance with their values and preferences. While patient engagement is unproven and potentially inappropriate as a safety net for catching medical errors, it may be a valuable tool for facilitating communication that empowers patients. But the barriers that prevent patients and physicians from meaningfulquestion-and-answerexchangesaresubstantial.Simplyencouragingpatientstoaskquestionsandprovidingexamples are not enough. This Viewpoint describes these barriers and presents suggestions for how they may be overcome.

Occupational safety and health, green chemistry, and sustainability: a review of areas of convergence.

With increasing numbers and quantities of chemicals in commerce and use, scientific attention continues to focus on the environmental and public health consequences of chemical production processes and exposures. Concerns about environmental stewardship have been gaining broader traction through emphases on sustainability and “green chemistry” principles. Occupational safety and health has not been fully promoted as a component of environmental sustainability. However, there is a natural convergence of green chemistry/sustainability and occupational safety and health efforts. Addressing both together can have a synergistic effect. Failure to promote this convergence could lead to increasing worker hazards and lack of support for sustainability efforts. The National Institute for Occupational Safety and Health has made a concerted effort involving multiple stakeholders to anticipate and identify potential hazards associated with sustainable practices and green jobs for workers. Examples of potential hazards are presented in case studies with suggested solutions such as implementing the hierarchy of controls and prevention through design principles in green chemistry and green building practices. Practical considerations and strategies for green chemistry, and environmental stewardship could benefit from the incorporation of occupational safety and health concepts which in turn protect affected workers.

Progress in genomics according to bingo: 2013 edition

Progress in genomics according to bingo: 2013 edition

Leading Contributors to the Research Consortium's Annual Program, 1992–2011: High-Visibility Institutions, Researchers, and Topics

Between 1992–2011, peer-reviewed research on the Research Consortium's annual program has been published in abstract form in the Research Quarterly for Exercise and Sport. On the basis of frequency, high-visibility institutions, researchers, and sub-disciplinary categories were identified. Data were extracted from each abstract (N = 5,587). On average, 279 (SD = 39) abstracts were published annually. The highest visibility institution was Texas A&M University, College Station; individual researcher, Weimo Zhu; and sub-disciplinary area, Pedagogy. Twelve of the top 20 institutions identified in this study took part in the most recent ranking of doctoral programs conducted by the National Academy of Kinesiology, with the Spearman's rho correlation being .66. These results may inform the Research Consortium's and the American Alliance for Health, Physical Education, Recreation and Dance's strategic planning efforts. Those interested in pursuing graduate degrees in the field and those who advise others about potential institutions and faculty mentors to study with may also benefit from this work. However, in doing so, a judicious interpretation of the results must be applied, as many factors should be considered when selecting a graduate program or mentor to study with, especially for those seeking research careers. Additional discussion points also emerged.

It’s time to make the profession of health about health

Most professional health publications and presentations are not about health, but about how to avoid, prevent, or treat disease or infirmity. Better health cannot be attained by simply avoiding, preventing, or treating problems. Health efforts, therefore, should be directed toward creating physical, mental, and social wellbeing. To guide these efforts, salutogenesis, a theoretical framework about the origins or creation of health, is needed to complement the traditional pathogenesis framework that focuses on the origins and causes of disease. Salutogenic strategies are necessary to help health professionals promote positive health enhancement by making their practices about health.

Health Disparities in Latino Communities

Health Disparities, Health Equity, and Social Justice The concept of health disparities most often refers to differences in health status and quality of health care across racial, ethnic, gender, and socioeconomic groups. By now, we know that racial and ethnic minorities in the United States, as a whole, have generally poorer health than Whites. Studies of health disparities and efforts to reduce them have traditionally focused on differences in health care access and healthrelated behavior based on race, ethnicity, and culture. For example, interventions may target individuals and groups and attempt to alter health care access and individually controlled lifestyle choices. These efforts include improving the access to and quality of health care and making sure that target populations are integrated into the health care system. Efforts could involve ensuring that the services of doctors and other health professionals are relatively affordable and making sure that health care providers and other practitioners are knowledgeable of and empathetic with cultural backgrounds of their clients and provide culturally appropriate service (e.g., language, educational materials). Thus the chief strategy to reduce health disparities is targeting individuals and groups and the health care system that treats them. In this way, health equity could be seen as the process of reaching individuals in order to reduce disparities in health.

Contribuições da visita domiciliar na formação em fisioterapia

A visita domiciliar, além de ser uma ferramenta de trabalho para o cuidado das pessoas, pode ser utilizada como estratégia de ensino na área da saúde. Desenvolveu-se um estudo exploratório, descritivo, de natureza qualitativa com oito estagiários de fisioterapia que realizaram visitas domiciliares em uma unidade da Estratégia Saúde da Família com o objetivo de compreender os significados atribuídos a essa atividade de cuidado em saúde no processo de aprendizagem. Utilizou-se a técnica do grupo focal, que foi gravado e transcrito para posterior análise e interpretação dos dados por meio da análise temática, a qual originou três eixos orientadores: a vivência da visita domiciliar em atenção básica e a reorientação da formação profissional do fisioterapeuta; a atenção básica e a visita domiciliar na perspectiva da humanização do fazer fisioterapêutico; e a ressignificação da visita domiciliar na construção do aprendizado. Conclui-se que a visita domiciliar torna-se uma ferramenta pedagógica importante na aprendizagem dos acadêmicos de fisioterapia, porém precisa estar associada a outras atividades na rede de cuidados, tais como desenvolvimento de atividades grupais, participação em campanhas e mutirões da saúde, conselho local de saúde, entre outras, para efetivamente trazer mudanças aos modelos de formação e de atenção à saúde.