Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 973 records · Page 54Linked to original sources
PubMed1993

Adolescent health services in North Carolina's local health departments.

The purpose of this study was to assess availability of clinical health services and special adolescent health programs for those aged 10-19 years administered by local health departments in North Carolina, and to evaluate factors that were associated with the existence of specialized adolescent programs, comprehensive services, and school services. We used self-report surveys mailed to 100 county health directors. All counties responded. One in five (21%) North Carolina youth received one or more health department service in 1990. Thirty-four health departments have programs or services specifically designed for adolescents; 7 health departments provide comprehensive services. The majority of health departments (85%) provide services in public schools, most often health education or counseling. Counties with more adolescents and with higher per capita income were more likely to have adolescent programs and more likely to provide comprehensive clinics. Health departments with school services served proportionally twice as many of their county's adolescents as those without school services. We concluded that few local health departments in North Carolina provide comprehensive health services to their youth. Community-wide participation and state support are needed to improve public sector access to comprehensive health care for adolescents in North Carolina and in other states with decentralized, county-controlled public health systems.

Adolescent↗
PubMed1998

Knowledge of and attitudes to the health outcomes approach among community mental health professionals.

A focus on health outcomes has significant potential for increasing health gain if adopted by health care staff as part of their professional practice. Understanding health care staff attitudes and receptiveness towards health outcomes may facilitate uptake of this workplace innovation. Community mental health clinicians (n = 101) were sent a questionnaire assessing their knowledge of and attitudes to the health outcomes approach, their expectations as to its likely impact on them, as well as features of their workplace in general. Analysis of the 65 returned questionnaires identified some pessimism about what focusing on health outcomes would achieve for community mental health clinicians or their clients. Training in practical applications of health outcomes measures, involvement in and ownership of health outcomes projects and recognition of health outcomes achievements would facilitate adoption of a health outcomes approach by community mental health clinicians.

Adult↗
PubMed2003

Building integrated health systems in central and eastern Europe: an analysis of WHO and World Bank views and their relevance to health systems in transition.

BACKGROUND: Two questions are addressed. i) What are the views on health and health systems as expressed in the World Development Report 2000/2001 of the WB and the World Health Report 2000 and Health 21 of the World Health Organization, and how compatible are those views? ii) To what extent will compliance of CEEC and NIS with the WHO and WB recommendations result in health systems that produce maximum health for all by adequately addressing the needs of their populations? METHOD: The reports prepared by the World Bank and the World Health Organization were assessed against the theoretical framework of a needs-based public health approach. RESULTS: It is observed that the WHO and WB approaches are currently converging, although there remain differences in their respective focuses. The main merit of the WHO approach is its focus on performance and the systems approach towards health (care). The merit of the WB view is the integrated approach to health, education and poverty. It is argued that CEEC and NIS need to anticipate an ageing population and growing numbers of chronically ill. This calls for integrated health care systems and more integrated funding and payment systems. CONCLUSION: The recommendations provided in the WHR and the WDR with regard to integrated care and integrated financing remain rather abstract. Advisors of CEEC and NIS on health care reform and Western assistance projects should focus more on future needs, in order to avoid building health systems that consistently lag behind the needs of their populations.

Delivery of Health Care, Integrated↗
PubMed2001

Social class inequalities in the use of and access to health services in Catalonia, Spain: what is the influence of supplemental private health insurance?

OBJECTIVE: To analyse social class inequalities in the access to and utilization of health services in Catalonia (Spain), and the influence of having private health insurance supplementing the National Health System (NHS) coverage. DESIGN: 1994 Catalan Health Interview Survey, a cross-sectional survey conducted in 1994. SETTING: Catalonia (Spain). STUDY PARTICIPANTS: The participants were a representative sample of people aged over 14 years from the non-institutionalized population of Catalonia (n = 12,245). MAIN OUTCOME MEASURES: Health services utilization, perceived health, having only NHS or NHS plus a private health insurance, and social class. RESULTS: Although one-quarter of the population of Catalonia had a supplemental private health insurance, percentages were very different according to social class, ranging from almost 50% for classes I and II to 16% for classes IV and V in both sexes. No inequalities by social class were observed for the utilization of non-preventive health care services (consultation with a health professional in the last 2 weeks and hospitalization in the last year) among persons with poor self-perceived health status, i.e. those in most need. However, social inequalities still remain in the use of health services provided only partially by the NHS, and when characteristics of last consultation are taken into account. Subjects who paid for a private service waited an average of 18.8 minutes less than those attending the NHS. Within the NHS, social classes IV and V waited longer (35.5 minutes) than social classes I and II (28.4 minutes). CONCLUSION: The NHS in Catalonia, Spain, has reduced inequalities in the use of health services. Social inequalities remain in the use of those health services provided only partially by the NHS.

Adolescent↗
PubMed1992

Restructuring the American health care system: an analysis of Nursing's Agenda for Health Care Reform.

Equal access to health care for all citizens is a hotly debated issue of the American health care system. Different plans for reform that would allow equal access to health care have been proposed, but few include nurses as key health care providers. To correct this oversight, a coalition of more than 60 national nursing and health care organizations has created Nursing's Agenda for Health Care Reform, a blueprint for restructuring the health care system. This article reviews the agenda within the framework of the ethical theory of distributive justice. Distributive justice allows for the allocation of health care resources in a manner that is fair but not necessarily equal for all. The agenda addresses the basic level of health care needed by all Americans and supports the provision of primary care by nurse practitioners. Nurse practitioners need to be aware of plans to reform the health care system and should be supportive of those plans that enhance nurse participation in the health care system. Nursing's Agenda for Health Care Reform is a plan that encourages the health care consumer's participation and promotes nursing care as the link between the consumer and the health care system.

Delivery of Health Care↗
PubMed2006

Historical and current policy efforts to eliminate racial and ethnic health disparities in the United States: future opportunities for public health education research.

In the summer of 2005, the Society for Public Health Education convened a meeting, Health Disparities and Social Inequities, with the task of setting the minority health disparities research agenda for public health educators. The article provides a history of minority health efforts beginning with the Negro Health Improvement Week in 1915 and an overview of National Institutes of Health's (NIH) current 5-year strategic research plan to eliminate health disparities. The plan's goals represent a significant investment in minority health research and the emergence of NIH as the leading federal agency funding health disparity research. Understanding the history of minority health efforts and current health disparity research offers a perspective that will help guide public health educators in reaching the Healthy People 2010 goal of eliminating racial and ethnic health disparities.

Black or African American↗
PubMed2002

[Health economics: should it concern the health sector?].

This paper addresses the most important features of health economics, especially its scope and applications within the sphere of health. Health economics is a field of study which allows countries to gear their health policies toward making more rational use of their resources and expanding and improving their health care services. Such policies should, on the other hand, aim to generate strategies for adequately managing human, technical, economic, and financial resources so as to reap the finest health benefits possible. A knowledge of how economics can be applied to health will enable health professionals to introduce an economics culture into their daily work. In other words, it will allow them to keep in mind the scope of their various working tools--health planning, national health accounts and accounting, and economic assessment methods, which include health and pharmaceutical technology assessment and pharmacoeconomics--as well as the place that economics has in health research. Hopefully, a knowledge of these aspects of economic analysis will provide decision-makers with one more tool they can apply in selecting more efficient options and attaining the highest health benefits at the lowest possible cost for the national health system.

Delivery of Health Care↗
PubMed2004

[Importance of the modern health management for the success of health reform in Lithuania].

Reform of the Lithuanian health system is a challenging process. The aim of this article is to assess the role of health managers in the process of health reform, evaluating the perception of health management and their training needs, as the possible determinants for the success of the reform. The results of several questionnaire surveys of Lithuanian health managers, particularly the one carried out in 2002 are used. The studies demonstrate great diversity in the conceptual understanding of health management, with prevailing rational and technical understanding. This might be associated with the rapid structural and organizational changes in the early stages of health reform and insufficient involvement of health managers in the planning and management of changes. General management, health policy, economic and law are considered as the most important study areas for health managers. The major lacking knowledge is in the subjects of law, economics and health financing. Health managers should act as mediators between politicians and health professionals. Enlargement of the area of competences, increasing autonomy in solving problems and meeting of the training needs of health managers is essential.

Attitude of Health Personnel↗
PubMed2006

Developing research capacity building for Aboriginal & Torres Strait Islander health workers in health service settings.

INTRODUCTION: Aboriginal and Torres Strait Islander health workers (hereafter called health workers) can play a major role in facilitating culturally appropriate health care delivery and program development through the acquisition of improved skills in the planning, monitoring and evaluation of these programs (RCB). However, many Aboriginal and Torres Strait Islander people and communities remain concerned about research and related activities. Health workers are well placed to assist communities to not only embrace research, but to be active players and promoters of relevant, appropriate and acceptable research. One means of achieving the twin goals of RCB and community acceptance and involvement in research, is through health workers undertaking research of health priority issues and evaluation of activities, such as program delivery, that are of direct relevance to their community's aim of improving or enhancing service delivery. This article outlines the development and content of a community-based RCB framework for health workers. The focus is on the major issues that enhance a proactive service delivery model using culturally appropriate research methods. Development process: The RCB framework described here was developed, over a period of time, through community workshops and consultations aimed at deriving general consensus on the key issues and components of a culturally-appropriate, community-based training process. The framework has subsequently been reviewed by Aboriginal and Torres Strait Islander community representatives from across Australia. The overall aim of the framework is to supplement current (institutionally-based) education and training resources for health workers with community-based research training modules. These modules can be tailored to provide research and evaluation skills relevant to health workers taking a more proactive role in facilitating health and wellbeing programs in their own communities. The use of collaborative consultation and participatory methods are intended to be a two-way education process. Course content: A visual pathway is used that encompasses the impact of health and practice in the community for health workers at a grass-roots level. This enables elements of the RCB process to be divided into a series of connected modules. These are: (i 'assessing' Existing Services; (ii) methods and measures for Identifying Need at various levels; (iii) important issues in Program Development; (iv) how the former contributes to Service Improvement; (v) resultant Outcomes that will impact on community and service provision; and (vi) Evaluation Methods and applying findings to service delivery. CONCLUSIONS: Active participation by the Aboriginal and Torres Strait Islander community is fundamental for effective research practices and outcomes. The aim is to provide health workers and community members with a working knowledge of research ethics and methods so that they can assist, monitor and steer the development of culturally appropriate research activities that will lead to provision of the highest quality services 'back' to the community. This RCB framework will enable health workers to be more proactive, self-reliant and self-sufficient within their community and healthcare settings.

Community Health Planning↗
PubMedDate not supplied

Public health week: marketing the concept of public health.

The Public Health Programs and Services (PHP&S) Branch of the Los Angeles County Department of Health Services began a strategic planning effort in January 1986 to meet new disease trends, curb rising health care costs, consolidate limited resources, and handle shifting demographics. A strategic plan was designed to assess the opportunities and challenges facing the agency over a 5-year horizon. Priority areas were recognized, and seven strategic directives were formulated to guide PHP&S in expanding public health services to a changing community. Health promotion was acknowledged as a critical target of the strategic planning process. Among the most significant results of the health promotion directive was the establishment of an annual Public Health Week in Los Angeles County. Beginning in 1988, 1 week per year was selected to enhance the community's awareness of public health programs and the leadership role PHP&S plays in providing these programs to nearly 9 million residents of Los Angeles County. Events in Public Health Week include a professional lecture series and the honoring of an outstanding public health activist and a media personality who has fostered health promotion. Other free community activities such as mobile clinics, screenings, and health fairs are held throughout the county. With intensive media coverage of Public Health Week, PHP&S has been aggressive in promoting its own services and accomplishments while also educating the community on vital wellness issues. The strategic methodology employed by PHP&S, with its emphasis on long-range proactive planning, is receiving national recognition and could be adopted by similar agencies wishing to enhance their image and develop unique health promotion projects in their communities.

Anniversaries and Special Events↗
PubMed1986

The WHO European program of health legislation and the Health for All policy.

The purpose of this paper is to provide a comprehensive review of the work of the World Health Organization (WHO), begun a decade ago in Europe, in the field of health legislation. This program is the result of the interaction between two important factors: the trends in national health policy and legislation at the country level, and the implementation of the Health for All policy, which has been collectively adopted by the European Member States in various WHO fora. Health legislation has proved to be a valuable tool in supporting National Health Policies in European countries and a key element in international health activities. The paper will be presented in three main parts. The first examines the legislative implications of the Health for All policy and strategy. The second gives an overview of developments in health legislation in Europe, focusing on national achievements in three areas in which change is necessary to achieve Health for All: health care systems, the environment, and lifestyles. The third part gives an account of activities carried out by the Regional Office for Europe of WHO in the health legislation field, recalls the organization of the first WHO medium-term program in this field, and summarizes its four current subprograms on health policy, health situation, exchange of information, and training. The conclusion briefly outlines the prospects for further developments in Europe.

Delivery of Health Care↗
PubMed2004

Use, misuse and non-use of health care assistants: understanding the work of health care assistants in a hospital setting.

AIM(S): This study is concerned with understanding the work of non-registered nurses (health care assistants) in a UK hospital setting. BACKGROUND: There are increasing numbers of health care assistants employed by the National Health Service in the UK to support registered nurses providing nursing care. However, little is known about the make-up of the health care assistant workforce and the changing nature of their role. This study addresses some of these gaps in the research-based literature. METHODS: A single case study design using mixed methods (survey, interviews, participant observations, focus groups and documents) was used to generate an in-depth account of health care assistants' work in one organization. The study is built upon what health care assistants say they do, compared with what they actually do in practice. It explores how and whether the work of health care assistants is adequately supervised, tensions between the work of health care assistants and registered nurses and the subsequent effects on teamwork and patient care. FINDINGS: There are policy expectations associated with the work of health care assistants. However, this study reveals significant deviations from these goals. The workplace arena and the negotiations between health care assistants and registered nurses that take place within it, actively shape the health care assistants' work. Findings suggest dynamic patterns of use, misuse and non-use of the health care assistants as a resource to patient care. DISCUSSION AND IMPLICATIONS FOR PRACTICE: The changing roles of registered nurses have direct implications for the roles of health care assistants: as registered nurses take on extra duties and responsibilities they are conceding some of their role to health care assistants. This has implications for nurse managers. The competence of health care assistants to carry out nursing work needs to be reassessed and there also needs to be ongoing monitoring and supervision of their work to maximize, and further develop, their contribution to patient care and to ensure quality standards. Managers also need to be aware of the importance of workplace negotiations in the interpretation of formal policies and the subsequent shaping of health care assistants' work at the level of service delivery.

Adult↗
PubMed2006

Building health research systems to achieve better health.

Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above priorities on which we hope to feature further articles in HARPS and thus contribute to an informed debate on how best to achieve such progress.

Editorial↗
PubMed1988

[Selective health systems: a trap for health politics in the Third World].

The authors examine the evolution of the PHC approach in historical perspective, present definitions and criteria of what PHC actually means, look upon deviations of conceptual content and practice of PHC and end up with a socio-political as well as a technical critique of the so-called 'selective' PHC. Modern health systems evolved in developing countries modelled on the 'western' biomedical health care systems. Yet even colonial medical services contained also progressive elements, as e.g. the acceptance of the need to de-centralise hospital care to peripheral health posts, or the stress on more rational distribution and utilisation of drugs. The vertical programmes developed under this approach showed clearly their limitations and the conference of Alma-Ata can be looked at as a turning point, where a new model of health care, i.e. PHC, was designed. Though there exists a widespread resistance in industrialised countries against adopting this new model, it was not at all limited only to developing countries. As with every innovative idea, the PHC strategy provoked contradictory views and large differences in interpretation. But, the authors stress, PHC is neither a doctrine, or a theory but the outcome of decades of field-experience of concerned scientists and practitioners. The essential criteria of PHC include: Accessibility: need for improved first contact with the health care system, demanding efforts of decentralising the existing health system without neglecting the quality of care on higher-level medical services. PHC is essentially an action-programme designed around the well-known eight PHC elements, designed to meet effective demand and to rationalise medical offer. The eight elements rather underline the multiplicity of health action required--they are not considered to serve as 'chapters' of PHC policy. PHC is a strategy for re-organising health services. The hospitals should serve the peripheral health centres and not the other way round. At the same time, curative preventive and promotive actions have to be integrated. This necessitates community participation, as the global health problems cannot be solved by the health services alone. PHC in so far re-defines the role of medicine and looks at health in a holistic way. Medicine is being de-mystified and individuals and communities are encouraged to take over responsibility for their own health. This is not at all the consequence of an idealistic view, but derived from field experiences in various circumstances. PHC as a new philosophy of health services delivery therefore, stresses: holistic action for global health issues, equity, participation, and cost/efficiency.(ABSTRACT TRUNCATED AT 400 WORDS)

Developing Countries↗
PubMed2006

Patients using the Internet to obtain health information: how this affects the patient-health professional relationship.

OBJECTIVE: Health information is one of the most frequently sought topics on the Internet. A review of the literature was carried out to determine the use of the Internet for health information by the patient and how this could affect the patient-health professional relationship. METHODS: This study is a literature review, summarizing multiple empirical studies on a single subject and is not intended to be a meta-analysis. RESULTS: The review showed that the majority of health related Internet searches by patients are for specific medical conditions. They are carried out by the patient: (1) before the clinical encounter to seek information to manage their own healthcare independently and/or to decide whether they need professional help; (2) after the clinical encounter for reassurance or because of dissatisfaction with the amount of detailed information provided by the health professional during the encounter. CONCLUSION: There has been a shift in the role of the patient from passive recipient to active consumer of health information. Health professionals are responding to the more 'Internet informed' patient in one or more of three ways: (1) the health professional feels threatened by the information the patient brings and responds defensively by asserting their 'expert opinion' (health professional-centred relationship). (2) The health professional and patient collaborate in obtaining and analysing the information (patient-centred relationship). (3) The health professional will guide patients to reliable health information websites (Internet prescription). PRACTICE IMPLICATIONS: It is important that health professionals acknowledge patients' search for knowledge, that they discuss the information offered by patients and guide them to reliable and accurate health websites. It is recommended that courses, such as 'patient informatics' are integrated in health professionals' education.

Attitude of Health Personnel↗
PubMed2006

Do health behaviors mediate the association between social capital and health?

INTRODUCTION: There is increasing evidence that social capital is important for people's health. However, there is still considerable disagreement about the specific pathways that links social capital to health. This study investigates the hypothesis that the association between social capital and health is mediated by people's health behaviors. METHOD: Data from the 2002 Health Survey for England (n = 7394) were used and analyzed from a multilevel perspective. The association between social capital and self-rated health were examined before and after controlling for smoking, alcohol intake, and fruit/vegetable consumption. RESULTS: Social capital was found to be associated with self-rated health, as well as with the different health behaviors. In addition, the health behaviors were significantly related to self-rated health. However, controlling for smoking, alcohol intake, and fruit/vegetable consumption did not substantially affect the association between social capital and self-rated health. CONCLUSIONS: The results demonstrate that social capital and support are important determinants of self-rated health and health behaviors. But only limited support was found for the hypothesis that health behaviors mediate the association between social capital and health.

Adolescent↗
PubMed2004

Three year health outcomes among older women at risk of elder abuse: women's health Australia.

BACKGROUND: Older women are at increasing risk of various forms of familial violence, yet detection is poor and very little is known of the long-term health effects of this psychosocial problem. The effectiveness of the 'Vulnerability to Abuse' Screening Scale (VASS) in predicting three year health outcomes was investigated among women enrolled in the Australian Longitudinal Study on Women's Health, now known as Women's Health Australia. METHODS: The sample comprised a cohort of 10,421 women aged 73-78 who completed the 1996 and 1999 postal surveys (attrition rate 19.5%). The Time 2 sample had a small bias towards lower risk for elder abuse at Time 1 and better health on SF-36 and self-rated health. The VASS is a 12-item self-report measure with 4 factors: vulnerability, coercion, dependence and dejection. RESULTS: Overall, physical health (PCS) declined while mental health (MCS) increased over the three year period. Decline in physical health was predicted by only the dejection factor, but not by factors which seem to more directly measure abuse. The predictive validity of the VASS for three year mental health outcomes was given partial support. Three of the four VASS factors (dejection, vulnerability, and coercion) predicted decline in mental health at the univariate level, however, after adjusting for confounders, only one VASS factor (dejection) independently predicted decline in mental health. CONCLUSIONS: While the VASS shows some promise as a marker of health risk in older women, only the dejection factor proved consistently predictive of declining health status. Further research is needed to determine longer term predictive validity of the scale and to gain a clearer picture of how abusive experiences impact on older women's health.

Aged↗
PubMed1999

Health beliefs and their influence on United Kingdom nurses' health-related behaviours.

BACKGROUND: Because there is a demonstrated empirical link between nurses' personal health habits and their tendency to raise health issues with clients, researchers suggest that nurses can improve their health promotion role if they adopt health-related behaviours. Few researchers, however, have identified the factors that influence nurses' health-related behaviours. AIMS: To describe nurses' beliefs about the importance of health-related behaviours, and investigate the relationship between these beliefs and their health-related behaviours. DESIGN: A cross-sectional survey from which nested-case control comparisons were made. SAMPLE: One hundred and thirteen nurses attending tertiary level education courses in London and Essex. MEASURES: Health Behaviour Survey and a scale measuring nurses' beliefs about the importance of health-related behaviours. RESULTS: Nurses' health beliefs significantly influenced the practice of 14 health-related behaviours. CONCLUSIONS: The findings from this study support the view that nurses' practice of many behaviours linked to health and longevity are influenced significantly by their beliefs about the importance of these behaviours. Changing nurses' beliefs about the importance of health-related behaviours through specific health promotion sessions are meaningful as they may improve nurses' health promotion role.

Adult↗