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PubMedDate not supplied

A regional integrated information system to assure maternal-child health services: a progress report.

Priorities for improving the health of our nation include rebuilding the public health infrastructure through increasing assessment, policy development, and assurance capacities in our communities. Capacity building necessitates formalizing and strengthening public health practice linkages to achieve Year 2000 objectives. Determining progress in achieving objectives requires development of public health infrastructure surveillance and data system capabilities. The Tracking Center of Tracking and Outreach Program for St. Louis (TOPS), through unique collaboration among academic and practice partners, laid the foundation for a Regional Integrated Information System (RIIS) by developing a centralized maternal-child health data base for prenatal and pediatric care providers. The RIIS model provides an example of a capacity building system designed to provide public health surveillance, assessment, planning, and evaluation capabilities. Medical Subject Headings (MeSH): health information systems, prenatal care, immunization, maternal-child health care, public health surveillance.

Child↗
PubMed1993

The racial integration of health facilities.

No published measures of racial integration in health facilities in the United States exist. This article reviews the problems with possible sources of data. It then derives estimates of the degree of integration in nursing homes and hospitals from the 1985 National Nursing Home and National Hospital Discharge surveys. Nursing homes were less racially integrated than hospitals. Health facilities in the South were more integrated than in any other region of the country. There was little difference in the degree of racial segregation of publicly financed patients and those whose care was financed from private sources. Data on nursing homes in Pennsylvania illustrate in more detail some of the consequences of such patterns of segregation. The article discusses some of the reasons for the lack of easy access to such information and makes recommendations for addressing it.

Black or African American↗
PubMed1997

Outcomes measurement across the continuum of care.

Outcomes management can only be truly achieved if it is conducted using data obtained from every possible care delivery site--the entire continuum of care. The author emphasizes that designing the most appropriate information infrastructure for an integrated health system requires a thorough understanding of the needs of the organization as reflected in its strategic business goals and objectives.

Continuity of Patient Care↗
PubMed2005

Children's exposure to environmental pollutants and biomarkers of genetic damage. I. Overview and critical issues.

In the last decade, molecular epidemiological studies have provided new perspectives on studying environmental risks in pediatric populations, based on the growing understanding that children may be more susceptible to toxicants than adults. Protecting children's health is a social priority, and specific research programs have been initiated with this purpose in the United States and Europe. These programs address the development of (i) less invasive methods for biological specimens collection, (ii) specific tools for interpretation and validation of biomarkers, (iii) methods for translating biomarker results into intervention strategies and for integrating them with environmental monitoring and health data, (iv) optimal ways to obtain consent and provide information to children and/or their parents participating in the studies and (v) techniques for the effective communication with policy makers and the public. Critical issues in children's environmental research discussed in this paper include specific needs of study design, exposure assessment, sample collection and ethics. Special consideration is given to the autonomy of the child in giving consent, the details and nature of the information provided, and the need to warrant controlled access to sensitive information. The use of incentives such as gifts and payment to ensure the participation of school-aged children is specifically discussed. Examples of field studies that are focused on the effects of pesticides, air pollution and formaldehyde are used to illustrate advantages and limitations of biomarker studies in children.

Biomarkers↗
PubMed2003

Health information systems challenges: the Heidelberg conference and the future.

OBJECTIVES: To present a summary of the state of the art in Health Information Systems (HIS), as discussed during the Heidelberg HIS Working Group Conference, and to examine possible strategies for continuous improvement of the field. METHODS: The state of the art in HIS is briefly described, and the historical trends are examined that emerge from a review of the previous HIS Working Group conferences. To extrapolate from those trends and suggest possible new directions, we consider whether perceived difficulties in the diffusion of HIS systems are simply a product of technological factors, or whether fundamental social factors have been ignored. RESULTS: The experience with HIS environments is 'reasonably good' but not excellent, and true HIS success stories are not common. One of the apparent difficulties is that the typical HIS does not regard communication among clinical users as its core mission, even though repeated studies of information needs and practice patterns show that communication is the leading cost in today's health care environment. It is suggested that progress in the HIS arena will benefit from increased emphasis on the social aspects of health care, and better integration of diverse data to promote the organizational communication and workflow. Improvements could also come from a change to a highly participatory and evolutionary software engineering process, focusing on communication behavior and co-operative work practices. CONCLUSIONS: Future HIS development should view provider-provider and provider-patient communication as a core function, and incorporate features such as seamless support and tracking of communication, automatic gathering and presentation of data from multiple sources, data collection in atomic units by the most qualified provider, and integrated management, resource utilization, and tracking. The steps towards HIS that support these features might be smaller than generally suspected, once the appropriate changes in the reference point have been made.

Congresses as Topic↗
PubMed2026

Pneumococcal population structure influences the effects of air pollution on invasive disease risk in South Africa.

Streptococcus pneumoniae is highly diverse, comprising over 100 serotypes and hundreds of genomic lineages amid widespread vaccination. While it can cause invasive pneumococcal disease (IPD) which exhibits pronounced seasonal spikes, the interplay between pneumococcal diversity and environmental drivers remains unexplored. Here we analysed 59,017 IPD cases over 19 years from South Africa, incorporating 4,350 genome-sequenced isolates, using Bayesian spatiotemporal models to link environmental exposure and pneumococcal diversity. Cumulatively, across an 8-week period, moderate relative humidity (33-49%) and cold minimum temperatures (4-10 °C) increased IPD risk by 5% and 4%, respectively. Conversely, warm maximum temperatures (27-38 °C) were associated with up to a 10% increased risk within a week of exposure. There was a positive association between air pollution (PM2.5) and IPD, although it varied by age, disease presentation, and most notably serotype and lineage. Specifically, the lag time between PM2.5 exposure and disease onset varied by serotype, with only serotypes 4, 8 and 23F conferring an immediate IPD risk. High prevalence of GPSC21 lineage (serotype 19F) also modified the pollution response, shifting the lag structure to produce immediate risk of disease following high PM2.5 exposure. Our results demonstrate that pneumococcal population structure shapes air quality risk which in turn can shape the fitness landscape of microbial populations. Integration of these data may inform public health policy.

Journal Article↗
PubMed2000

General practice recruitment for people at risk of schizophrenia: the Buckingham experience.

OBJECTIVE: The process of detecting people at high risk of schizophrenia from a community sample is a major challenge for prevention of psychotic disorders. The aim of this paper is to describe early detection procedures that can be implemented in primary care settings. METHODS: A selected literature review is supplemented by experiences and data obtained during the Buckingham Integrated Mental Health Care Project. RESULTS: General medical practitioners have been favoured as the agents most likely to prove helpful in detecting the key risk factors that predict the onset of schizophrenic disorders, as well as in recognising the earliest signs and symptoms of these conditions. However, the practical problems of screening for multiple and subtle risk factors in general practice are substantial, and general practitioners (GPs) often have difficulty recognising the earliest signs of a psychotic episode. A range of strategies to assist GPs detect early signs of psychosis in their patients are considered. CONCLUSIONS: It is feasible to implement primary care setting early detection procedures for people at risk of schizophrenia. Implementation is aided by the use of a brief screening questionnaire, training sessions and case supervision; and increased collaboration with mental health services and other community agencies.

Family Practice↗
PubMed2006

Nurses and nursing education in Ghana: creating collaborative opportunities.

AIM: This is a story intended to motivate the reader to become immersed in 'verbal snapshots' depicting the reality of nursing in Ghana as experienced by the writer. Its purpose is to encourage dialogue and creative collaboration between nurse educators in radically different settings, which would serve to enrich all those involved. BACKGROUND: During the summer of 2003, a faculty member from the School of Nursing at Georgia Southern University (GSU) travelled to Africa to establish a relationship between GSU and a nursing school in Ghana, West Africa. This paper is based on the daily journal kept by that faculty member who engaged in clinical practice experiences as well as discussions with nursing educators in Ghana. Integrated in this subjective account are health data specific to Ghana. These serve to underscore health issues and situations of urgent concern in Ghana as well as to the global community, and which will assist in highlighting the potential contribution of such collaboration to strengthening the health system of the country. CONCLUSIONS: The outcome of the relationship established during this visit was intended to be a meaningful interchange of resources and experiences for both faculty and students at the two schools. It was successful in that regard. Funding is now being sought to enable further collaboration.

Adaptation, Psychological↗
PubMed2004

Reproductive and sexual health among young adults in Uzbekistan.

Since 1991, contraceptive use has risen significantly in Uzbekistan while reliance on abortion has declined; yet reproductive health improvements have not translated into better conditions for sexual health. The prevalence of sexually transmitted diseases increased significantly in the 1990s, and UNAIDS currently identifies the Central Asian region as a high HIV-growth zone. Structural, institutional, and attitudinal factors have contributed to the disconnection between reproductive and sexual health in Uzbekistan, even though family planning programs have been well established during the HIV pandemic. Integrating state statistics, Demographic and Health Survey data, and focus-group-discussion results, we highlight the ways in which a heavily centralized program focusing on reproductive health did little to better sexual health, especially among young adults. The example of Uzbekistan reveals pathways by which reproductive health efforts may continue to be compartmentalized, decreasing their potential contributions to sexual health, especially among young adults.

Adolescent↗
PubMedDate not supplied

[Domestic and institutional violence in health services: women's experiences].

Developed in state capitals Recife, Salvador and Aracaju, in three state maternity hospitals, this quantitative study aimed at identifying the manifestations of domestic and institutional violence suffered by women assisted in subprograms of the Program of Integral Assistance to the Woman's Health. Data collection was performed by using a semi-structured form. The sample featured young women, housewives, and those that are economically dependant on their significant others. Most women experience matrimonial violence, and financial dependency is the most often mentioned reason to bear it. The lack of vacancies characterized institutional violence due to omission. Research showed that experiencing such violence brings health problems to women, or aggravates them.

Adult↗
PubMed2026

Beyond the clinic: a community-embedded, multidomain framework for early detection of glaucoma.

Glaucoma remains one of the leading causes of acquired irreversible blindness worldwide, with normal-tension glaucoma representing the dominant subtype in Japan and several East Asian populations. The insidious, asymptomatic progression of this condition, combined with the demonstrated inadequacy of intraocular pressure alone as a screening criterion, creates a critical gap between disease burden and case detection. Population-based epidemiological studies consistently reveal that the majority of individuals with glaucoma are undiagnosed. Two responses have been suggested: incorporation of retinal imaging into annual health checkups, which warrants formal prospective evaluation, and characterization of individuals at higher risk - integrating genomic risk, oxidative stress biomarkers, systemic lifestyle factors, and ocular blood flow dynamics - which may help identify those in whom damage is most likely to occur. The principal contribution of this Perspective is therefore the implementation model rather than the individual screening components. We introduce the Living Lab ('neighborhood health lab'), a community co-creation platform established under the Japan Science and Technology Agency COI-NEXT 'Vision to Connect' hub at Tohoku University, as a scalable model for operationalizing this framework. Embedded within commercial retail environments, the Living Lab integrates non-invasive screening, longitudinal health data collection, and evidence-based health product development-exemplified by the Ronbun Recipe® concept-within a stakeholder-aligned ecosystem encompassing citizens, researchers, industry, and municipal authorities. Conceived as a platform for well-being rather than as a disease-specific screening service, it engages individuals who are asymptomatic, undiagnosed, and outside existing screening pathways, and who would not otherwise be assessed at all.

Humans↗
PubMed1997

Back to the drawing board.

An integrated delivery system in Mississippi prepares for managed care with a massive information systems overhaul that scraps old systems in favor of new.

Community Networks↗