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Health planning

Oren Schwartz, Itzik Malka, Cara H Olsen, Israel Dudkiewicz, Tarif Bader
Introduction: Integration of females in combat units poses a unique challenge for army commanders around the world. The purpose of this study is to provide a detailed up-to-date situation report regarding overuse injuries among combat female warriors in the IDF (Israeli Defense Forces) in order to enable evidence-based decision-making, prevention policy, and further research of this highly significant military public health issue. Methods: A cross-sectional descriptive study was conducted including 2,519 females recruited to combat duties during the year of 2013...
March 14, 2018: Military Medicine
Carla T Murray, Matthew Schmit
Introduction: We estimate the effect on health care spending of an option to change TRICARE. Under the option, which is based on a proposal made by the Military Compensation and Retirement Modernization Commission (MCRMC), most beneficiaries could choose from a range of commercial health networks instead of the current TRICARE plans. Military treatment facilities would become network providers under the commercial plans. Materials and Methods: We used data from the Department of Defense (DoD) to estimate the cost of providing the current health care benefit to working-age retirees and their dependents and survivors, and active duty family members...
March 14, 2018: Military Medicine
Uzochukwu C Ugochukwu, Alfred Ochonogor, Chika M Jidere, Chizoba Agu, Frida Nkoloagu, John Ewoh, Virginia U Okwu-Delunzu
In this study, the human and livestock (cattle) health risks of exposure to polycyclic aromatic hydrocarbons (PAHs) in a wetland of Obuaku, Abia State Nigeria contaminated by hydrocarbon spill due to incidents of hydrocarbon theft and pipeline vandalization were assessed. Gas chromatography-flame ionization detector and gas chromatography-mass spectrometry were employed in analyzing the TPH and PAHs respectively. The contaminated soil was delineated into sub-locations AOC-1, AOC-2, AOC-3, AOC-4, AOC-5 and AOC-6 to reflect the discrete patches (areas) of the contaminated site and for effective planning of remedial actions...
March 13, 2018: Environment International
Erika Obikane, Tomohiro Shinozaki, Daisuke Takagi, Norito Kawakami
BACKGROUND: Childhood abuse is associated with adult suicidal behaviors, partially mediated by mental disorders. However, the direct effect of childhood abuse not mediated by mental disorders is uncertain because the same risk factors serve as mediators and confounders of mental disorders and suicidal behaviors. The aim of the study was to estimate the direct effect of childhood abuse not mediated by mental disorders on suicidal behaviors using marginal structural models. METHODS: We used cross-sectional data of Japanese adults in Tokyo and neighboring prefectures (The Japanese Study on Stratification, Health, Income, and Neighborhood)...
February 22, 2018: Journal of Affective Disorders
Sohail Ahmed Rajper, Sana Ullah, Zhongqiu Li
Air pollution causes severe physical and psychological health complications. Considering China's continuously-deteriorating air quality, this study aimed to assess the self-reported effects of air pollution on the behavior and physical health of the students of 13 densely populated cities, and their awareness, practices, and perception of air pollution and its associated public health risks. A detailed, closed-ended questionnaire was administered to 2100 students from 54 universities and schools across China...
2018: PloS One
Shuai Yang, Yu Wang, Wengang Ao, Yun Bai, Chuan Li
Based on the consumption of fossil energy, the CO₂ emissions of Chongqing are calculated and analyzed from 1997 to 2015 in this paper. Based on the calculation results, the consumption of fossil fuels and the corresponding CO₂ emissions of Chongqing in 2020 are predicted, and the supporting data and corresponding policies are provided for the government of Chongqing to reach its goal as the economic unit of low-carbon emission in the '13th Five-Year Plan'. The results of the analysis show that there is a rapid decreasing trend of CO₂ emissions in Chongqing during the '12th Five-Year Plan', which are caused by the adjustment policy of the energy structure in Chongqing...
March 16, 2018: International Journal of Environmental Research and Public Health
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
Kimberly Coughlin, R David Hayward, Mary Fessler, Elango Edhayan
OBJECTIVES: Although individual socioeconomic status has been linked with risk of traumatic injury, there has been relatively little research into the question of how economic changes may impact trauma admission rates in neighborhoods with different socioeconomic backgrounds. METHODS: This study pairs ZIP code-level data on trauma admissions with county-level data on unemployment to assess differences in the type of changes experienced in more and less affluent neighborhoods of the Detroit metropolitan area between 2006 and 2014...
March 15, 2018: International Journal of Public Health
Andras P Durko, Ruben L Osnabrugge, Nicolas M Van Mieghem, Milan Milojevic, Darren Mylotte, Vuyisile T Nkomo, A Pieter Kappetein
Aims: The number of transcatheter aortic valve implantation (TAVI) procedures is rapidly increasing. This has a major impact on health care resource planning. However, the annual numbers of TAVI candidates per country are unknown. The aim of this study was to estimate current and future number of annual TAVI candidates in 27 European countries, the USA and Canada. Methods and results: Systematic literature searches and meta-analyses were performed on aortic stenosis (AS) epidemiology and decision-making in severe symptomatic AS...
March 12, 2018: European Heart Journal
Luís P Carmo, Liza R Nielsen, Lis Alban, Paulo M da Costa, Gertraud Schüpbach-Regula, Ioannis Magouras
Reducing antimicrobial use (AMU) in livestock is requested by Public Health authorities. Ideally, this should be achieved without jeopardizing production output or animal health and welfare. Thus, efficient measures must be identified and developed to target drivers of AMU. Veterinarians play a central role in the identification and implementation of such efficient interventions. Sixty-seven veterinarians with expertise in livestock production in Denmark, Portugal, and Switzerland participated in an expert opinion study aimed at investigating experiences and opinions of veterinarians about the driving forces and practices related to AMU in the main livestock sectors (broiler, dairy cattle, fattening/veal calf, and pig industry) of the aforementioned countries...
2018: Frontiers in Veterinary Science
Jenny Q Ouyang, Scott Davies, Davide Dominoni
Alternation between day and night is a predictable environmental fluctuation that organisms use to time their activities. Since the invention of artificial lighting, this predictability has been disrupted and continues to change in a unidirectional fashion with increasing urbanization. As hormones mediate individual responses to changing environments, endocrine systems might be one of the first systems affected, as well as being the first line of defense to ameliorate any negative health impacts. In this Review, we first highlight how light can influence endocrine function in vertebrates...
March 15, 2018: Journal of Experimental Biology
Joshua W Joseph, Samuel Davis, Elissa H Wilker, Matthew L Wong, Ori Litvak, Stephen J Traub, Larry A Nathanson, Leon D Sanchez
OBJECTIVES: Emergency physician productivity, often defined as new patients evaluated per hour, is essential to planning clinical operations. Prior research in this area considered this a static quantity; however, our group's study of resident physicians demonstrated significant decreases in hourly productivity throughout shifts. We now examine attending physicians' productivity to determine if it is also dynamic. METHODS: This is a retrospective cohort study, conducted from 2014 to 2016 across three community hospitals in the north-eastern USA, with different schedules and coverage...
March 15, 2018: Emergency Medicine Journal: EMJ
Emily Andrew, Eric Mercier, Ziad Nehme, Stephen Bernard, Karen Smith
INTRODUCTION: Understanding the prognosis of elderly out-of-hospital cardiac arrest (OHCA) patients is vital to informing resuscitation and advanced care planning decisions. However, short-term outcomes such as survival to hospital discharge do not account for post-arrest quality of life. We describe the 12-month functional recovery and health-related quality of life (HR-QOL) of elderly OHCA survivors, including those arresting in aged care facilities. METHODS: We conducted a retrospective analysis of Victorian Ambulance Cardiac Arrest Registry data for all OHCA survivors to hospital discharge aged ≥65 years between 1 January 2010 and 30 June 2016...
March 12, 2018: Resuscitation
Ashley H Snyder, Carol S Weisman, Guodong Liu, Douglas Leslie, Cynthia H Chuang
OBJECTIVES: The Affordable Care Act (ACA) contraceptive coverage mandate issued in August 2012 requires most private health insurance plans to cover all U.S. Food and Drug Administration-approved contraceptive methods without cost sharing. We evaluate the impact of this policy on out-of-pocket costs and use of long-acting reversible contraceptives (LARCs) and other prescription methods through 2014. METHODS: Data from Truven Health MarketScan were used to examine out-of-pocket costs and contraceptive use patterns for all reversible prescription contraceptives before and after the implementation of the contraceptive mandate for privately insured women ages 13 to 45...
March 2, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Aida Kamišalić, David Riaño, Tatjana Welzer
BACKGROUND: In medical practice, long term interventions are common and they require timely planning of the involved processes. Unfortunately, evidence-based statements about time are hard to find in Clinical Practice Guidelines (CPGs) and in other sources of medical knowledge. At the same time, health care centers use medical records and information systems to register data about clinical processes and patients, including time information about the encounters, prescriptions, and other clinical actions...
May 2018: Computer Methods and Programs in Biomedicine
Samuel Johnson, Sharmala Thuraisingam, John Furler, Jo-Anne Manski Nankervis
Insulin initiation is often delayed in primary care partly because of clinician concerns about the additional clinical work. This study describes health services usage (HSU) pre- and post-insulin initiation in people with type 2 diabetes and out-of-target glycaemic levels. Secondary analysis of participant data from the Stepping Up randomised controlled trial of a model of care for insulin initiation in general practice was undertaken. For 142 people who commenced insulin, HSU in the 6 months prior was compared to that in the 12 months following insulin initiation...
March 16, 2018: Australian Journal of Primary Health
Sorath Noorani Siddiqui, Abdul Hannan, Hassan Mansoor, Muhammad Asif, Umair Wakeel
OBJECTIVE: To evaluate the state of refraction in children with bilateral congenital nasolacrimal duct obstruction (CNLDO). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan, from April 2014 to April 2016. METHODOLOGY: Children with bilateral CNLDO were studied. Patients' refractive status were evaluated by performing cycloplegic refraction, followed by appropriate management plan...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Minerva Kyei-Onanjiri, Mary Carolan-Olah, John Koku Awoonor-Williams, Terence V McCann
BACKGROUND: Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies...
March 15, 2018: BMC Health Services Research
M Elizabeth Snow, Katherine Tweedie, Ann Pederson
BACKGROUND: Recently, patient engagement has been identified as a promising strategy for supporting healthcare planning. However, the context and structure of universalistic, "one-size-fits-all" approaches often used for patient engagement may not enable diverse patients to participate in decision-making about programs intended to meet their needs. Specifically, standard patient engagement approaches are gender-blind and might not facilitate the engagement of those marginalized by, for example, substance use, low income, experiences of violence, homelessness, and/or mental health challenges-highly gendered health and social experiences...
March 15, 2018: BMC Health Services Research
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