Terms Of Health Improvement Research Articles

Usage of a workplace health promotion app: an evaluation of app usage data and medical check-up results.

Smartphone applications (apps) have been used and evaluated in the context of workplace health promotion (WHP) programs. However, there is a lack of studies analyzing actual app usage data and measuring changes in medical markers to evaluate the effectiveness of WHP apps in terms of health improvements in practice. In this study, we evaluated data from 555 employees of an IT company who participated in a WHP program over the course of one year. Participants of the program received a medical check-up as well as a health app to understand their medical results and receive advice for a healthier lifestyle. In addition, 99 of these employees underwent a follow-up medical check-up. It was found that the smartphone app for healthy lifestyle promotion in combination with onsite medical check-ups was effective in improving various health indicators, for example, BMI, body fat, blood pressure and triglycerides. The study further identified influence factors for sustained app usage, and analyzed different usage behaviors among gender and age groups.

THE EFFECT OF UNEMPLOYMENT BENEFİTS ON HEALTH OF INDİVİDUALS: EVİDENCE FROM TURKEY

Unemployment can negatively affect individuals and families in various ways. When individuals are unemployed, they may experience mental and physical health problems as well as loss of income. This study aims to examine the impact of unemployment benefits on health. Turkish Statistical Institute (TURKSTAT) "Income and Living Conditions Survey Micro Panel Dataset (2015-2018)" is used for the analysis. In analysis "Fixed Effects Method", which is one of the important panel data methods, is used. Findings have shown that unemployment benefits have a positive effect on health. Moreover, we show that unemployment benefits play an important role in terms of health improvement. Another important finding is that the health of individuals worsens with the increase in education level and income. Since it was concluded in the study that unemployment benefits improve the health of individuals, policies for developing countries such as Turkey to increase the budget allocated to unemployment benefits are among the recommendations of the study.

Patient Satisfaction Survey in Hospitals Providing SPA Care in Hungary

"Introduction: Balneotherapy and hydrotherapy treatments with a proven therapeutic effect are of great help to patients in early recovery. Objective: The aim of our study is to assess patient satisfaction in two health care institutions in Hungary. Methods: We conducted a questionnaire survey among the patients of two spas and other hospitals (H1: n=69 H2: n=59) in Hungary in 2019. The obtained results were evaluated with SPSS 25.0 software. Results: 74.22% of the respondents were female (n=95) and 25.78% were male (n=33), of whom 46.78% (n=60) were between 61 and 70 years of age. 71.88% (n=92) of the respondents were informed about the discounted treatments by their specialist and the majority were patients who return annually (n=106), who come again mainly (43.75%) for previous good experiences. They thought they would discover an 88.5% improvement in both the quality of care and treatments. Results of H1 and H2 hospital staff: help (H1: 6.61, H2: 6.05, p=0.001), pain relief (H1: 6.08, H2: 4.95, p=0.015) problem solving (H1: 6.16, H2: 5.46 p=0.009), information provision (H1: 5.82, H2: 5.05, p=0.050) were significantly higher in H1 hospital than in H2 hospital. In the overall picture of the institution, H2 achieved a higher result in terms of health improvement, despite the former lower evaluations, but there was no significance (H1: 5.86, H2: 6.00, p=0.584). Conclusions: Learning the use of treatments and patient satisfaction, constructive suggestions can be made to improve the quality of patient care. Keywords: patient satisfaction, spa, spa service, quality patient care "

Evolution of the Indian Health Insurance Sector: A review

Health insurance is a mechanism that provides financial coverage for sickness or injury. Over the past few decades, India’s achievement in terms of health improvement has been remarkable but health insurance industry is still way behind many other developing countries. This study examines the changes that have taken place in the Indian health insurance industry over a period of time and the issues and challenges the industry faces. The study utilized available data from more than 35 researches and relative studies conducted with respect to the health insurance sector. Not even a quarter of population in India is covered under any health insurance scheme. The penetration rate and expenditure on health insurance has been quite low. Penetration rate can be increased by means of micro-insurance, group insurance, government regulations over private sector and more schemes to reach out the rural masses with high competitive and service oriented delivery mechanism. However, the recent schemes and initiatives by government targeting the rural areas are becoming popular and may prove to be the appropriate way of supporting the society as a whole thereby saving it from the ruinous expenditure. Keywords: Health insurance, Health care system, Penetration, Evolution of health insurance

Compensatory Neuroprotective Response of Thioredoxin Reductase against Oxidative-Nitrosative Stress Induced by Experimental Autoimmune Encephalomyelitis in Rats: Modulation by Theta Burst Stimulation.

Cortical theta burst stimulation (TBS) structured as intermittent (iTBS) and continuous (cTBS) could prevent the progression of the experimental autoimmune encephalomyelitis (EAE). The interplay of brain antioxidant defense systems against free radicals (FRs) overproduction induced by EAE, as well as during iTBS or cTBS, have not been entirely investigated. This study aimed to examine whether oxidative-nitrogen stress (ONS) is one of the underlying pathophysiological mechanisms of EAE, which may be changed in terms of health improvement by iTBS or cTBS. Dark Agouti strain female rats were tested for the effects of EAE and TBS. The rats were randomly divided into the control group, rats specifically immunized for EAE and nonspecifically immuno-stimulated with Complete Freund’s adjuvant. TBS or sham TBS was applied to EAE rats from 14th–24th post-immunization day. Superoxide dismutase activity, levels of superoxide anion (O2•–), lipid peroxidation, glutathione (GSH), nicotinamide adenine dinucleotide phosphate (NADPH), and thioredoxin reductase (TrxR) activity were analyzed in rat spinal cords homogenates. The severity of EAE clinical coincided with the climax of ONS. The most critical result refers to TrxR, which immensely responded against the applied stressors of the central nervous system (CNS), including immunization and TBS. We found that the compensatory neuroprotective role of TrxR upregulation is a positive feedback mechanism that reduces the harmfulness of ONS. iTBS and cTBS both modulate the biochemical environment against ONS at a distance from the area of stimulation, alleviating symptoms of EAE. The results of our study increase the understanding of FRs’ interplay and the role of Trx/TrxR in ONS-associated neuroinflammatory diseases, such as EAE. Also, our results might help the development of new ideas for designing more effective medical treatment, combining neuropsychological with noninvasive neurostimulation–neuromodulation techniques to patients living with MS.

An insight on superoxide dismutase (SOD) from plants for mammalian health enhancement

• Superoxide dismutase (SOD) supplementation is a current approach for mammalian health enhancement. • Oral administration of encapsulated SOD has shown pharmacological significance in animals and humans. • Underutilized plants could serve as the source of SOD and soluble dietary fiber. • Soluble dietary fiber has the potential to be used as encapsulating agent for SOD. Superoxide dismutase (SOD) is an antioxidant enzyme functional for physiological defense strategies in animals and plants against free radicals and reactive oxygen species (ROS) generated from biotic and abiotic stress. Supplementation of SOD from plants in mammalian diet is a new approach in terms of health improvement against pathological conditions. There is a research gap about the feasibility of including plant-derived SOD in animal diet as health enhancer due to poor bioavailability upon oral administration. Commercially available wheat gliadin encapsulated melon SOD has been proven to enhance mammalian health, but gluten/gliadin intolerance in certain animals and human may limit its marketability. Therefore, this review aims to highlight the sources of SOD from underutilized plants and potential encapsulation of SOD using soluble dietary fibers to be incorporated in animal diet as health enhancing supplements. This review provides a sustainable solution for the development of therapeutic approaches in agricultural industry.

Opinion of health professionals and drug users before the forthcoming opening of the first drug consumption room in Paris: a quantitative cross-sectional study

BackgroundOn the brink of the opening of the first French drug consumption room in Paris, the general opinion of the local involved health care professionals and drug users was not known. The objective of this study was to determine their expectations and to search for influencing factors.MethodWe carried out a quantitative cross-sectional study. A multiple choice questionnaire was proposed to the surrounding willing general practitioners (GPs) and pharmacists, to the emergency doctors of Lariboisière hospital, and to the professionals of the harm reduction facilities and their drug users (PWUD). For each question, there was a choice between seven answers, from “− 3” (very negative impact) to “+ 3” (very positive impact). The influence of the characteristics of each group on its mean answers was explored by Mann-Whitney, Kruskal-Wallis, and Spearman’s tests.ResultsThe median expectations among the groups of responding GPs (N = 62), other health care professionals (N = 82), and PWUD (N = 57) were mainly positive. They thought that the drug consumption room (DCR) would improve the health of PWUD, reduce their at-risk behaviors, would not increase drug use or drug dealing in the neighborhood, and would reduce nuisance in the public space. Only the group of GPs expressed that the DCR could decrease the quietness of the neighborhood, and only the group of PWUD had higher expectations that the DCR would decrease the number of arrests and the number of violent behavior. GPs’ expectations were significantly better in terms of health improvement of PWUD and reducing their precariousness if they had a previous experience in addiction medicine (Mann-Whitney, p = 0.004 and p = 0.019), with a longer practice (Spearman’s rho, p = 0.021 and p = 0.009), and if they were currently prescribing opioid substitution treatments (Mann-Whitney, p = 0.030 and p = 0.002).Among non-GPs, those who were working in addiction medicine centers had significantly better expectations than pharmacists, and the professionals of the local emergency department had intermediate expectations.ConclusionsHealth care professionals and drug users had a positive opinion of the to-be-created Parisian drug consumption room. Experience in addiction medicine influenced positively health professionals’ expectations.

The effect of health care model on health systems' responses to economic crises

Motivation: The paper is concerned with relationships between model of health care and the responses of health systems to economic crises in OECD countries (1970–2013). The institutional arrangements are considered to affect the operation and performance of health systems in several ways; however, so far the topic has not been investigated in the economic crises context. Aim: This research attempts to bridge this gap by comparing the dynamics of health systems measures (male and female life expectancy; health expenditure; and doctors’ density) during years of recession with the average annual growth rate of the same measures for the countries clustered in four model groups. Results: The results show that the health care model applied is related with the systems’ responses to economic downturns. The Bismarck-type countries perform poorly in terms of health improvement and are incapable of containing costs during recessions. The Beveridge-type countries perform better in health improvement during stagnation; they also have effective cost-containment policies but they provide less security in terms of human resources for health than the Bismarck-type states. The market-oriented countries are in a superior position in health improvement when economies collapse; however, they fail to restrict health expenditure increase and to sustain the dynamics of doctors’ availability. The systems in transitions are characterized by a relatively low performance in female health improvement during recessions, a moderate situation in securing access to physicians and the greatest possibilities of containing costs. For the policymakers, the results imply that there is no universally superior model of health care organization.

Leveraging the Social Determinants of Health: What Works?

We summarized the recently published, peer-reviewed literature that examined the impact of investments in social services or investments in integrated models of health care and social services on health outcomes and health care spending. Of 39 articles that met criteria for inclusion in the review, 32 (82%) reported some significant positive effects on either health outcomes (N = 20), health care costs (N = 5), or both (N = 7). Of the remaining 7 (18%) studies, 3 had non-significant results, 2 had mixed results, and 2 had negative results in which the interventions were associated with poorer health outcomes. Our analysis of the literature indicates that several interventions in the areas of housing, income support, nutrition support, and care coordination and community outreach have had positive impact in terms of health improvements or health care spending reductions. These interventions may be of interest to health care policymakers and practitioners seeking to leverage social services to improve health or reduce costs. Further testing of models that achieve better outcomes at less cost is needed.

Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

BackgroundStudies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed.ObjectiveThe aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa.ResultsNotwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains in life expectancy from the 1950s through the 1990s in a context of preponderant communicable diseases in all African countries; 5) the salient role of adult mortality, mostly ascribed to HIV/AIDS and co-morbidities, since the 1990s in reversing trends in mortality decline, its interruption of life expectancy improvements, and its reversal of gender differences in life expectancies disadvantaging women in several countries with the highest prevalence of HIV/AIDS; 6) the huge impact of wars in reversing the trends in under-five mortality decline in sub-Saharan countries in the 1990s and beyond. These assessments of these transition frameworks and these phenomena were not well documented to date for all five regions and 57 countries of Africa.ConclusionPrevailing frameworks of demographic, epidemiological, and health transitions as descriptive and predictive models are incomplete or irrelevant for charting the population and health experiences and prospects of national populations in the African context.

The effectiveness of local child weight management programmes: an audit study

Many different child weight management programmes exist, with varying degrees of evaluation to provide evidence of their success. The purpose of this research was to use a standardized approach to audit the effectiveness of weight management intervention programmes in the West Midlands region of the UK, specifically to assess the benefits to participating children in terms of health improvement and behaviour change. An audit of seven family-based intervention programmes currently in place in the West Midlands. Programmes were audited against the Standard Evaluation Framework. The programmes provided a partial data set relating to a change in weight from the baseline to the end of the programme; none of the programmes provided all of the measures indicated by the Standard Evaluation Form as being essential for evaluation. Weight change ranged from an increase in group mean of 0.4 kg to a decrease of 0.9 kg. Body Mass Index SD decreased by 0.1-0.2 points in four programmes and remained unchanged in two programmes. Four programmes collected long-term follow-up data at 6 months. This was often limited because of participant dropout. Improvement in diet and exercise were reported by participants in all programmes which measured these behaviours. Ongoing evaluation of all programmes, using a standard approach, is essential in order to improve the evidence base and support future commissioning.

Scaling up health policies and services in low- and middle-income settings

“Scaling up” effective health services is high on the policy agendas of many countries and international agencies. The current concern has been driven by growing recognition both of the challenges of achieving the health-related Millennium Development Goals (MDGs) in many countries, and of the need to ensure that the increased resources for health channelled through disease-specific health initiatives are able generate health gain at scale. Effective and cost-effective interventions exist to address many of the major causes of disease burden in the developing world, but coverage of many of these services remains low. There is a substantial gap between what could be achieved and what is actually being achieved in terms of health improvement in low- and middle-income countries.

How can the worlds of social marketing and healthcare communications join forces to enhance health service reputation?

There has been a noticeable policy shift towards customer-centric healthcare service in recent years in England, both for patients in terms of choice, information and service and for the community in terms of health improvement. This will reflect on the roles of the commissioner and provider. Social marketing aims to improve health and reduce health inequalities in the community through influencing behaviour. Choosing the right partners to build trust and engagement can significantly improve the reputation of the health service in the community. Social marketing has much in common with relationship marketing, in that it develops a continued dialogue with the target audience and builds a deeper insight into their lives — their motivations, fears, influences and access to services. This paper provides case studies which demonstrate social marketing principles that help build these relationships. It argues that the concurrent growth of social marketing inspired through the work of the National Social Marketing Centre, and the changing paradigm of health communications skills implied by World Class Commissioning in the UK, provide a natural place to explore the fusion of social marketing and health communications within the health service. It emphasises that social marketing requires teamwork — the right mix of skills — for best impact, and that public health improvement professionals working closely with health communication professionals can go a long way to providing the required blend of skills.

“Structure-size me:” Weight and health changes in a four week residential program

The prevalence of obesity has been drastically increasing over the past 20 years. Other obesity related conditions, including type 2 diabetes mellitus, have also increased in a corresponding manner and, in 2005, the American Diabetes Association (ADA) reduced the cut-off for defining impaired blood glucose. Evidence suggests that just a modest amount of weight loss can improve obesity related co-morbidities. The present study first, investigated changes in health measures after participation in a four week residential weight loss program. Second, individuals were classified according to the 2005 criteria for the diagnosis of type 2 diabetes to determine if glucose regulation changed after weight loss. A total of 93 individuals were categorized as normal glucose ( n = 56), impaired fasting glucose ( n = 23) or diabetic range ( n = 14) after initial blood laboratory screening. After four weeks and a 6.5% weight reduction, participants showed significant improvements in health risks. Further, most participants with elevated fasting glucose shifted into a healthier range. Findings are discussed in terms of health improvements that occur after weight loss within a four week lifestyle intervention.

Short-term economic and health benefits of smoking cessation: myocardial infarction and stroke.

Most analyses of the economic benefits of smoking cessation consider long-term effects, which are often not of interest to public and private policy makers. These analyses fail to account for the time course of the short-run cost savings from the rapid decline in risk of acute myocardial infarction (AMI) and stroke. We estimate the time course of the fall in risk of AMI and stroke after smoking cessation and simulate the impact of a 1% absolute reduction in smoking prevalence on the number of and short-term direct medical costs associated with the prevented AMIs and strokes. In the first year, there would be 924+/-679 (mean+/-SD) fewer hospitalizations for AMI and 538+/-508 for stroke, resulting in an immediate savings of $44+/-26 million. A 7-year program that reduced smoking prevalence by 1% per year would result in a total of 63,840+/-15,521 fewer hospitalizations for AMI and 34,261+/-9133 fewer for stroke, resulting in a total savings of $3.20+/-0.59 billion in costs, and would prevent approximately 13,100 deaths resulting from AMI that occur before people reach the hospital. Creating a new nonsmoker reduces anticipated medical costs associated with AMI and stroke by $47 in the first year and by $853 during the next 7 years (discounting 2.5% per year). Although primary prevention of smoking among teenagers is important, reducing adult smoking pays more immediate dividends, both in terms of health improvements and cost savings.

How Can Care for Depression Become More Cost-effective?

To determine the cost and health effects of changes in the content and quality of care for depressed patients treated in prepaid general medical practices (internal and family medicine) and mental health specialty practices and shifts in the proportion of patients treated in general medicine. Cost-effectiveness analysis and simulations, which are empirically based on data from the Medical Outcomes Study. Change in serious functional limitations, annual treatment costs per patient, and costs per reduction in one functional limitation. More appropriate care for depression (increased counseling, use of appropriate antidepressant medications, or avoidance of regular minor tranquilizer use) improves functioning outcomes. Although this approach increases total costs of care, it also improves the value of care because each dollar spent on care now provides more benefits in terms of health improvements. In contrast with the effects of more appropriate care for depression, the trend away from mental health specialty care and toward general medical provider care under current treatment patterns reduces costs, worsens outcomes, and does not increase the value of health care spending in terms of health improvement per dollar. Quality improvement measures that roughly follow practice guidelines for depression can improve outcomes and the value or cost-effectiveness of care, but at increased treatment costs; shifting patients away from mental health specialists decreases costs but worsens functioning outcomes. The best strategy for making care for depression more cost-effective is through quality improvement, not through changing specialty mix. Yet combining these strategies may achieve better outcomes, lower treatment costs, and better value of care compared with current practice patterns. To realize this potential, however, substantial quality improvement of care for depression is necessary in general medical practice.

Why health improves: Defining the issues concerning ‘comprehensive primary health care’ and ‘selective primary health care’

What is the impact of technology on improving the life situations of people, especially the poor? How is this impact analyzed in terms of health improvements? These questions are paramount in the minds of health planners as they pursue national policies of primary health care, a policy popularized by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) and accepted by over 150 governments at Alma Ata in 1978. The purpose of this paper is to explore these questions in depth. It begins by giving the background to the debate, then examines the origins of two concepts which have dominated the field, those of ‘primary health care’ and ‘selective primary health care.’ On this basis it suggests areas of differences in the two concepts and discusses the policy and practical implications of confusing the two approaches. The paper suggests that the differences are firstly who controls the outcome of technological interventions and the perceived time frame in which plans can be carried out.