Caring for Quality in Health0 تومان
Between 2012 and 2016, the OECD conducted a series of in-depth reviews of the policies and institutions that underpin the measurement and improvement of health care quality in 15 different health care systems (Australia, Czech Republic, Denmark, England, Israel, Italy, Japan, Korea, Northern Ireland, Norway, Portugal, Scotland, Sweden, Turkey and Wales). The 15 settings examined are highly diverse, encompassing the high-tech, hospital-centric systems of Japan and Korea, the community-focussed Nordic systems, the unique challenges of Australia’s remote outback, and the historically underfunded systems of Turkey and the Czech Republic, now undergoing rapid modernisation. What unites these and all other OECD health care systems, however, is that all increasingly care about quality. In a time of multiple, unprecedented pressures on health care systems – many of which are beyond health care systems’ control – central and local governments as well as professional and patient groups are renewing their focus on one issue that they can control and one priority that they equally share: health care quality and outcomes. In the OECD’s work to measure and improve health care system performance, health care quality is understood to comprise three dimensions: effectiveness, safety and patientcentredness (or responsiveness). These dimensions are applied across the key stages of the care pathway: staying well (preventive care), getting better (acute care), living with illness or disability (chronic care) and care at the end of life (palliative care). This conceptual framework is illustrated in Figure 0.1.
Cognitive Informatics in Health and Biomedicine0 تومان
The felds of behavioral medicine and biomedical informatics, each with its own theories and methods, have been developing in parallel with little connection until recently. The convergence of research in these disciplines, cognitive informatics, provides enormous opportunities and challenges in addressing the prevention of public health problems and managing disease, as well as in maintaining healthy lifestyles. The limitations of such models in addressing digital health interventions are discussed within the context of cognitive models of behavior and methods of encouraging behavioral change.
Environmental, Health, and Safety Guidelines for Fish Processing0 تومان
The Environmental, Health, and Safety (EHS) Guidelines are technical reference documents with general and industryspecific examples of Good International Industry Practice (GIIP)1. When one or more members of the World Bank Group are involved in a project, these EHS Guidelines are applied as required by their respective policies and standards. These industry sector EHS guidelines are designed to be used together with the General EHS Guidelines document, which provides guidance to users on common EHS issues potentially applicable to all industry sectors. For complex projects, use of multiple industry-sector guidelines may be necessary. A complete list of industry-sector guidelines can be found at: www.ifc.org/ifcext/enviro.nsf/Content/EnvironmentalGuidelines The EHS Guidelines contain the performance levels and measures that are generally considered to be achievable in new facilities by existing technology at reasonable costs. Application of the EHS Guidelines to existing facilities may involve the establishment of site-specific targets, with an appropriate timetable for achieving them. The applicability of the EHS Guidelines should be tailored to the hazards and risks established for each project on the basis of the results of an environmental assessment in which site-specific variables, such as host country context, assimilative capacity of the environment, and other project factors, are taken into account.
Exploring the role of sedentary behavior and physical activity in depression and anxiety symptom severity among patients with substance use disorders0 تومان
Research has consistently shown that regular physical activity may protect against the development and maintenance of depression and anxiety, whereas sedentary behavior may exacerbate depression and anxiety. However, much of the past research in this area has focused on non-clinical populations. Therefore, the goal of this study was to examine the relations of physical activity and sedentary behavior to depression and anxiety symptom severity among an understudied patient population, patients in residential substance use disorder (SUD) treatment. This study also sought to determine the extent to which physical activity and sedentary behavior relate to depression and anxiety symptom severity above and beyond an established transdiagnostic risk factor for depression and anxiety, emotion dysregulation. A sample of 41 patients from a residential SUD treatment facility completed a variety of self-report measures focused on physical activity, sedentary behavior, emotion dysregulation, and depression and anxiety symptom severity. Physical activity, but not sedentary behavior, was found to significantly predict depression symptom severity above and beyond emotion dysregulation. Physical activity and sedentary behavior did not significantly predict anxiety symptom severity above and beyond emotion dysregulation. In addition to providing additional support for the relevance of emotion dysregulation to depression and anxiety symptom severity, results suggest that physical activity may be another factor to consider in evaluating risk for depression among patients with SUDs. Although additional research in this area is warranted, results also suggest the potential utility of targeting physical activity in reducing risk for depression among patients with SUDs.
Handbook of Life Course Health Development0 تومان
Over the past several decades, countless studies have linked early life events and experiences with adult health conditions, delineating the developmental origins of common chronic health conditions and specifying the processes by which both adversity and opportunity are integrated into developing biobehavioral systems (Baltes et al .2006; Bronfenbrenner 2005; Elder et al. 2015). As a result, there is a greater understanding of how health and disease develop, which is leading to new kinds of individual- and population-level strategies that have the potential to prevent disease and optimize health by minimizing the impact of adversity, increasing protective factors, and targeting health-promoting interventions to coincide with sensitive periods of health development. Insights and evidence from life course chronic disease epidemiology have converged with research from the felds of developmental biology, neuroscience, and developmental science, with studies of typical and atypical development and with new fndings from research examining the developmental origins of chronic disease. This wide-ranging research, all focused on understanding how health and disease develop, has involved researchers from a wide variety of disciplines. Life-span developmental psychologists, life course-focused sociologists, human capitalfocused economists, and political scientists studying the structure of social institutions are not only studying the same developmental processes; they are also working alongside epidemiologists, physicians, and basic scientists to better understand how health develops over the life course and how these health development processes promote human ﬂourishing.
Health Advisory for Fish and Shellfish from Clear Lake, Cache Creek, and Bear Creek (Lake, Yolo, and Colusa Counties)0 تومان
Why has OEHHA developed a new health advisory for fish from the Clear Lake and Cache Creek watersheds ?A fish consumption advisory was issued for Clear Lake in 1987. Since that time, many more samples of fish have been collected as part of studies on mercury contamination in the Clear Lake and Cache Creek atersheds. The Office of Environmental Health Hazard Assessment (OEHHA) used the information from these studies to update the advisory for Clear Lake and develop new consumption guidelines that reflect current scientific information on mercury. Also, fish were tested for mercury from nearby Cache Creek and Bear Creek. OEHHA used these results to develop guidelines for sport fish consumption from these water bodies as well. One set of guidelines applies to women of childbearing age and children age 17 years and younger, who are particularly sensitive to methylmercury (the most prevalent form of mercury in fish). A second set applies to women beyond their childbearing years and men.
HEALTH PROMOTION PROGRAMS0 تومان
The World Health Organization (WHO, 1947) defined health as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” While most of us can identify when we are sick or have some infirmity, identifying the characteristics of complete physical, mental, and social well- being is often a bit more difficult. What does complete physical, mental, and social well-being look like? How will we know when or if we arrive at that state? If it is achieved, does it mean that we will not succumb to any disease, from the common cold to cancer? In 1986, the first International Conference of Health Promotion, held in Ottawa, Canada, issued the Ottawa Charter for Health Promotion, which defined health in a broader perspective: “health has been considered less as an abstract state and more as a means to an end which is expressed in functional terms as a resource which permits people to lead an individually, socially, and economically productive life” (WHO, 1986). Accordingly, health in this view is a resource for everyday life, not the object of living. It is a positive concept emphasizing social and personal resources as well as physical capabilities.
Human Retrotransposons in Health and Disease0 تومان
Retrotransposons are a class of mobile genetic elements that make up around 40% of the sequenced mammalian genome (Chinwalla et al. 2002; Lander et al. 2001). Retrotransposons contribute to genomic instability in mammalian genomes by providing interspersed repeats of homologous sequences that can act as substrates for recombination causing deletions, duplications and structural rearrangements in the genome (Romanish et al. 2010). Retrotransposons are thought to be the only active class of mobile genetic element in most mammalian genomes, and can also cause genome instability through jumping to new locations in the genome. These de novo retrotransposon insertions have been reported as the causal mutation in various human genetic diseases (Crichton et al. 2014; Hancks and Kazazian 2012). The copy-and-paste mechanism that retrotransposons use to jump to new locations in the genome involves reverse-transcription of retrotransposon RNA, and integration of the resulting cDNA into new locations in the genome. There are typically a few hundred different types of retrotransposon annotated in each mammalian genome, with each type of retrotransposon being present in up to 10,000 copies. However, the types of retrotransposon, their copy numbers and their genomic locations vary signifcantly between species.
Introduction to Health Care Quality0 تومان
Health care is changing—its delivery, its structures, even its underlying phi- losophy. Wellness, rather than sickness, is now the focus of government concern. The patient experience of health and well-being, rather than the physician’s interpretation, is now central, and patient expectations are measured, communicated, and meaningful for fnancial success. Smaller health care organizations are banding together to become larger health care systems because fnancial effciencies dictate such collaborations. Data are abundantly available to track various aspects of care. All these changes encourage new ways of thinking about health care and the organizations that deliver that care; those professionals who hope to understand and thrive in this new environment require quality tools, techniques, information, and education.
Non-coding genetic variation shaping mental health0 تومان
Over 98% of our genome is non-coding and is now recognised to have a major role in orchestrating the tissue specific and stimulus inducible gene expression pattern which underpins our wellbeing and mental health. The non-coding genome responds functionally to our environment at all levels, encompassing the span from psychological to physiological challenge. The gene expression pattern, termed the transcriptome, ultimately gives us our neurochemistry. Therefore a major modulator of mental wellbeing is how our genes are regulated in response to life experiences. Superimposed on the aforementioned non-coding DNA framework is a vast body of genetic variation in the elements that control response to challenges. These differences, termed polymorphisms, allow for a differential response from a specific DNA element to the same challenge thus potentially allowing ‘individuality’ in the modulation of our transcriptome. This review will focus on a fundamental mechanism defining our psychological and psychiatric wellbeing, namely how genetic variation can be correlated with differential gene expression in response to specific challenges, thus resulting in altered neurochemistry which consequently may shape behaviour.
Pharmacologic Treatment of Perinatal Depression0 تومان
Perinatal depression, defined as depressive symptoms occurring either during pregnancy (antenatal depression [AND]) or postpartum (postpartum depression [PPD])1,2 is exceedingly common and has serious implications when not adequately identified and treated. It has been estimated that between 14% and 23% of women experience AND,3 and up to 22% of women develop PPD within the first 12 months after delivery.4 Yet, it has also been estimated that only 30% to 50% of women with AND or PPD are identified in clinical settings, and an even smaller number (14%–16%) receive any treatment for their symptoms.
Pulmonary Vasculature Redox Signaling in Health and Disease0 تومان
Pulmonary arterial hypertension (PAH) is a progressive disease of the lung vasculature, which is characterized by sustained pulmonary arterial pressure, resulting in increased pulmonary vascular resistance, with eventual right heart failure . Vascular remodeling caused by the medial hyperplasia of pulmonary artery (PA) smooth muscle cells is a hallmark feature of PAH , which causes occlusion of the vessels . In most forms of PAH, muscularization of small distal PA occurs , and is further characterized by excessive vascular cell proliferation, inward remodeling, rarefaction, and a loss of compliance of the pulmonary blood vessels . Increased resistance to blood ﬂow and more rigid blood vessels (loss of vascular compliance) leads to failure of the right ventricle and eventual death. PAH is more frequent in women than men, and left untreated has a survival time of 5–7 years post diagnosis . From a therapeutic standpoint, there are a number of vasodilator drugs that are indicated for the treatment of PAH, but none of the current therapeutics offers long-term success for survival due to limited effectiveness and unwanted side effects , and more importantly, do not address the underlying causes of the disease.
The reciprocal relationship between physical activity and depression: Does age matter?0 تومان
The level of physical activity (PA) and the prevalence of depression both change across the lifespan. We examined whether the association between PA and depression is moderated by age. As sense of mastery and functional limitations have been previously associated with low PA and depression in older adults, we also examined whether these are determinants of the differential effect of age on PA and depression. Methods: 1079 patients with major depressive disorder (aged 18–88 years) were followed-up after twoyears; depression diagnosis and severity as well as PA were re-assessed. Linear and logistic regression analyses were used to test reciprocal prospective associations between PA and depression outcomes. In all models the interaction with age was tested. Results: PA at baseline predicted remission of depressive disorder at follow-up (OR = 1.43 [95% CI: 1.07– 1.93], p = .018). This effect was not moderated by age. PA predicted improvement of depression symptom severity in younger (B = 2.03; SE = .88; p = .022), but not in older adults (B = 2.24; SE = 1.48; p = .128) (p = .015 for the interaction PA by age in the whole sample). The level of PA was relatively stable over time. Depression, sense of mastery and functional limitation were for all ages not associated with PA at follow-up. Conclusions: Age did not moderate the impact of PA on depressive disorder remission. Only in younger adults, sufficient PA independently predicts improvement of depressive symptom severity after twoyear follow-up. Level of PA rarely changed over time, and none of the determinants tested predicted change in PA, independent of age.
What genome-wide association studies reveal about the association between intelligence and physical health, illness, and mortality0 تومان
The associations between higher intelligence test scores from early life and later good health, fewer illnesses, and longer life are recent discoveries. Researchers are mapping the extent of these associations and trying to understanding them. Part of the intelligence-health association has genetic origins. Recent advances in molecular genetic technology and statistical analyses have revealed that: intelligence and many health outcomes are highly polygenic; and that modest but widespread genetic correlations exist between intelligence and health, illness and mortality. Causal accounts of intelligence-health associations are still poorly understood. The contribution of education and socio-economic status—both of which are partly genetic in origin—to the intelligence-health associations are being explored. Until recently, an article on DNA-variant commonalities between intelligence and health would have been science fiction. Thirty years ago, we did not know that intelligence test scores were a predictor of mortality. Fifteen years ago, there were no genome- wide association studies. It was less than five years ago that the first molecular genetic correlations ere performed between intelligence and health outcomes. These former blanks have been filled in; however, the fast progress and accumulation of findings in the field of genetic cognitive epidemiology have raised more questions.
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