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National Health Insurance or Incremental Reform: Aim High, or at Our Feet?

Himmelstein, David U.; Woolhandler, Steffie
Fonte: © American Journal of Public Health 2003 Publicador: © American Journal of Public Health 2003
Tipo: Artigo de Revista Científica
Publicado em /01/2003 EN
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55.68%
Single-payer national health insurance could cover the uninsured and upgrade coverage for most Americans without increasing costs; savings on insurance overhead and other bureaucracy would fully offset the costs of improved care. In contrast, proposed incremental reforms are projected to cover a fraction of the uninsured, at great cost.

A baseline survey on use of drugs at the primary health care level in Bangladesh.

Guyon, A. B.; Barman, A.; Ahmed, J. U.; Ahmed, A. U.; Alam, M. S.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
Publicado em //1994 EN
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45.8%
The drug use pattern and the quality of care were assessed in 80 public sector facilities throughout rural Bangladesh. A total of 40 thana health complexes and 40 union subcentres, the lowest level in primary health care facilities, were selected at random. A total of 2880 prescriptions, consultations, and drug-dispensing practices were studied, and the availability and use of essential drugs and of the essential drugs list were recorded. The average consulting time (54 seconds), the proportion of adequate examinations (37%), and prescription of drugs according to standard treatment guidelines (41%) were unsatisfactory. The mean number of drugs prescribed per patient was 1.44; 25% were treated with antibiotics, and 17% with metronidazole, irrespective of the diagnoses. The availability of drugs (54%) and the presence of an essential drugs list (16%) in the health facilities were low. However, 78% of the drugs were prescribed by their generic names, 85% complied with the essential drugs list, and 81% were dispensed according to prescription. The average dispensing time (23 seconds) and the proportion of patients who correctly understood the dosage (55%) were poor.

National Health Insurance or Incremental Reform: Aim High, or at Our Feet?

Himmelstein, David U.; Woolhandler, Steffie
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Publicado em /09/2008 EN
Relevância na Pesquisa
55.7%
Single-payer national health insurance could cover the uninsured and upgrade coverage for most Americans without increasing costs; savings on insurance overhead and other bureaucracy would fully offset the costs of improved care. In contrast, proposed incremental reforms are projected to cover a fraction of the uninsured, at great cost.

Air Pollution and Acute Respiratory Response in a Panel of Asthmatic Children along the U.S.–Mexico Border

Sarnat, Stefanie Ebelt; Raysoni, Amit U.; Li, Wen-Whai; Holguin, Fernando; Johnson, Brent A.; Luevano, Silvia Flores; Garcia, Jose Humberto; Sarnat, Jeremy A.
Fonte: National Institute of Environmental Health Sciences Publicador: National Institute of Environmental Health Sciences
Tipo: Artigo de Revista Científica
EN
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45.77%
Background: Concerns regarding the health impact of urban air pollution on asthmatic children are pronounced along the U.S.–Mexico border because of rapid population growth near busy border highways and roads.

Determination of the historical changes in primary and secondary risk factors for cancer using U.S. public health records

Herrero Jimenez, Pablo, 1972-
Fonte: Massachusetts Institute of Technology Publicador: Massachusetts Institute of Technology
Tipo: Tese de Doutorado Formato: 354 p.
ENG
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Overall cancer mortality rates have risen from about 4% of all deaths in the early 20th century to about 25% of all deaths by the end of the century in the United States. To assess any potential hypotheses for this increase required knowledge of the mortality rate changes specific to each form of cancer, and the time points when these rates had changed. For this purpose, population and cancer mortality data of the U.S. were collected and organized to create age-specific mortality rates for each birth decade from the 1800s forward, delineated by the organ of incidence. Concurrently, cancer survival data were collected so as to correct for any effect of improved treatment on historical changes in cancer mortality rates. To analyze these data, a mathematical model for the three-stage process of carcinogenesis (initiation, promotion, and progression) was developed to estimate for each birth decade cohort the value of the fraction of the cohort at lifetime risk for that cancer, the value of the growth rate of the respective precancerous lesion, and the values for the mutation rates of normal and precancerous cells in the organ of incidence. This methodology permits the analysis of the potential historical effect of new chemical exposures during the last century on cancer mortality rates. These chemical exposures represent potential risk factors that determine the fraction of the population at risk of developing cancer (lifetime...

Report of the Department of Health of the Panama Canal; Report of the Health Department of the Panama Canal

Canal Zone -- Board of Health; Mason, Charles F
Fonte: U.S. G.P.O.; U.S. G.P.O. ( Washington, DC ) Publicador: U.S. G.P.O.; U.S. G.P.O. ( Washington, DC )
Tipo: Artigo de Revista Científica Formato: v. : ill. ; 20 cm.
Publicado em /1917/1914 ENGLISH
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45.79%
(Dates or Sequential Designation) Began with: Apr. 1914; Ceased with: Dec. 1917.

New perspectives in health care for older Americans (recommendations and policy directions of the Subcommittee on Health and Long-Term Care)

United States -- Congress. -- House. -- Select Committee on Aging. -- Subcommittee on Health and Long-Term Care
Fonte: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington ) Publicador: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington )
Tipo: Artigo de Revista Científica Formato: x, 92 p. : ; 24 cm.
Publicado em //1976 ENGLISH
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45.79%
(Bibliography) Includes bibliographical references.; At head of title: Committee print.; (Statement of Responsibility) by the Subcommittee on Health and Long-Term Care of the Select Committee on Aging, House of Representatives, Ninety-fourth Congress, second session, January 1976.

Reimbursement of the providers of health services

United States -- Congress. -- House. -- Committee on Interstate and Foreign Commerce. -- Subcommittee on Health and the Environment
Fonte: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington ) Publicador: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington )
Tipo: Artigo de Revista Científica Formato: v, 23 p. : ; 24 cm.
Publicado em //1976 ENGLISH
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45.76%
At head of title: Subcommittee print.

Report on Indian health : final report to the American Indian Policy Review Commission

United States -- American Indian Policy Review Commission. -- Task Force Six
Fonte: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington ) Publicador: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington )
Tipo: Artigo de Revista Científica Formato: vi, 264 p. : ill. ; 24 cm.
Publicado em //1976 ENGLISH
Relevância na Pesquisa
45.79%
(Bibliography) Bibliography: p. 197-204.; (Additional Physical Form) Also available in electronic format.; Reuse of record except for individual research requires license from LexisNexis Academic & Library Solutions.; CIS Microfiche Accession Numbers: CIS 77 J892-6; At head of title: Committee print.; Reuse of record except for individual research requires license from Congressional Information Service, Inc.; (Statement of Responsibility) Task Force Six: Indian Health.

Public assessment of expiring Public health service act authorities : background report

United States -- Congress. -- House. -- Committee on Interstate and Foreign Commerce. -- Subcommittee on Health and the Environment; United States -- Congress. -- House. -- Committee on Interstate and Foreign Commerce; Library of Congress -- Education and
Fonte: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington ) Publicador: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington )
Tipo: Artigo de Revista Científica Formato: v, 62 p. : ; 24 cm.
Publicado em //1979 ENGLISH
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55.79%
(Bibliography) Includes bibliographical references.; (Additional Physical Form) Also available in electronic format.; Reuse of record except for individual research requires license from LexisNexis Academic & Library Solutions.; CIS Microfiche Accession Numbers: CIS 79 H502-24; Reuse of record except for individual research requires license from Congressional Information Service, Inc.; Mar. 1979.; Prepared with the assistance of the Education and Public Welfare Division of Congressional Research Service.; At head of title: 96th Congress, 1st session. Committee print. Committee print 96-IFC 10.; (Statement of Responsibility) prepared for the use of the Committee on Interstate and Foreign Commerce, House of Representatives, and its Subcommittee on Health and the Environment, Ninety-sixth Congress, first session.

Hospital expense data, 1976-1977 : a partial response by the American Hospital Association to the request of the Subcommittee on Health and the Environment

American Hospital Association; United States -- Congress. -- House. -- Committee on Interstate and Foreign Commerce; United States -- Congress. -- House. -- Committee on Interstate and Foreign Commerce. -- Subcommittee on Health and the Environment
Fonte: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington ) Publicador: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington )
Tipo: Artigo de Revista Científica Formato: ii, 251 p. : ; 24 cm.
Publicado em //1979 ENGLISH
Relevância na Pesquisa
45.76%
(Additional Physical Form) Also available in electronic format.; Reuse of record except for individual research requires license from Congressional Information Service, Inc.; May 1979.; At head of title: 96th Congress, 1st session. Committee print. Committee print 96-IFC 16.; Reuse of record except for individual research requires license from LexisNexis Academic & Library Solutions.; CIS Microfiche Accession Numbers: CIS 79 H502-30; (Statement of Responsibility) prepared for the use of the Committee on Interstate and Foreign Commerce, House of Representatives, and its Subcommittee on Health and the Environment, Ninety-sixth Congress, first session.

The teamwork study: enhancing the role of non-GP staff in chronic disease management in general practice

Black, D.; Taggart, J.; Jayasinghe, U.; Proudfoot, J.; Crookes, P.; Beilby, J.; Powell Davies, G.; Wilson, L.; Harris, M.
Fonte: Australian Journal Primary Health, Australian Institute Primary Care & School Public Health Publicador: Australian Journal Primary Health, Australian Institute Primary Care & School Public Health
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
45.82%
There is evidence for a team-based approach in the management of chronic disease in primary health care. However, the standard of care is variable, probably reflecting the limited organisational capacity of health services to provide the necessary structured and organised care for this group of patients. This study aimed to evaluate the impact of a structured intervention involving non-GP staff in GP practices on the quality of care for patients with diabetes or cardiovascular disease. A cluster randomised trial was undertaken across 60 GP practices. The intervention was implemented in 30 practices with staff and patients interviewed at baseline and at 12–15 months follow up. The change in team roles was evaluated using a questionnaire completed by practice staff. The quality of care was evaluated using the Patient Assessment of Chronic Illness Care questionnaire. We found that although the team roles of staff improved in the intervention practices and there were significant differences between practices, there was no significant difference between those in the intervention and control groups in patient-assessed quality of care after adjusting for baseline-level score and covariates at the 12-month follow up. Practice team roles were not significantly associated with change in Patient Assessment of Chronic Illness Care scores. Patients with multiple conditions were more likely to assess their quality of care to be better. Thus...

An Evaluation Method for Context-Aware Systems in U-Health

Sánchez-Pi, Nayat; Carbó, Javier; Molina, José M.
Fonte: Springer Publicador: Springer
Tipo: info:eu-repo/semantics/acceptedVersion; info:eu-repo/semantics/conferenceObject; info:eu-repo/semantics/bookPart
Publicado em //2012 ENG
Relevância na Pesquisa
55.81%
Evaluations for context-aware systems can not be conducted in the same manner evaluation is understood for other software systems where the concept of large corpus data, the establishment of ground truth and the metrics of precision and recall are used. Evaluation for changeable systems like context-aware and specially developed for AmI environments needs to be conducted to assess the impact and awareness of the users. E-Health represents a challenging domain where users(patients, patients' relatives and healthcare professionals) are very sensitive to systems' response. If system failure occurs it can conducts to a bad diagnosis or medication, or treatment. So a user-centred evaluation system is need to provide the system with users' feedback. In this paper, we present an evaluation method for context aware systems in AmI environments and specially to u-Heatlh domain; Funded by projects CICYT TIN2008-06742-C02-02/TSI, CICYTTEC2008-06732 C02-02/TEC, SINPROB, CAM MADRINET S-0505/TIC/0255 and DPS2008-07029-C02-02.; Proceedings of: 3rd International Symposium on Ambient Intelligence (ISAmI 2012) Salamanca, March 28-30, 2012

Dual effects of phytoestrogens result in u-shaped dose-response curves

Almstrup, Kristian; Fern??ndez, Mariana F.; Petersen, J??rgen; Olea, Nicol??s; Skakkeb??k, Niels; Leffers, Henrik
Fonte: National Institute of Environmental Health Sciences Publicador: National Institute of Environmental Health Sciences
Tipo: Artigo de Revista Científica
ENG
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45.77%
'Reproduced with permission from Environmental Health Perspectives'; Endocrine disruptors can affect the endocrine system without directly interacting with receptors, for example, by interfering with the synthesis or metabolism of steroid hormones. The aromatase that converts testosterone to 17??-estradiol is a possible target. In this paper we describe an assay that simultaneously detects aromatase inhibition and estrogenicity. The principle is similar to that of other MCF-7 estrogenicity assays, but with a fixed amount of testosterone added. The endogenous aromatase activity in MCF-7 cells converts some of the testosterone to 17??-estradiol, which is assayed by quantifying differences in the expression level of the estrogen-induced pS2 mRNA. Potential aromatase inhibitors can be identified by a dose-dependent reduction in the pS2 mRNA expression level after exposure to testosterone and the test compound. Using this assay, we have investigated several compounds, including synthetic chemicals and phytoestrogens, for aromatase inhibition. The phytoestrogens, except genistein, were aromatase inhibitors at low concentrations (< 1 ??M) but estrogenic at higher concentrations (??? 1 ??M), resulting in U-shaped dose???response curves. None of the tested synthetic chemicals were aromatase inhibitors. The lowdose aromatase inhibition distinguished phytoestrogens from other estrogenic compounds and may partly explain reports about antiestrogenic properties of phytoestrogens. Aromatase inhibition may play an important role in the protective effects of phytoestrogens against breast cancer.

A 21st century national public health system

Jones, Mary J.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: xvi, 127 p. : col. ill., col. maps ;
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CHDS State/Local; The attention that SARS created in 2003 has influenced public and political perceptions about the risks associated with infectious diseases and the role the public health system should play in national security. This comparative case study was conducted to examine the Canadian public health's system response to SARS in order to formulate recommendations for the U.S. public health system. This analysis demonstrated that the governmental organizational structure of the U.S. public health system does not support its current mission or its new responsibilities for public health security. A national public health system is needed to support dual missions: the traditional mission of tailoring public health programs specific to the social and demographic needs of the citizens; and the new mission of public health security. In order to transform the current U.S. public health system into a national public health system two critical components must be addressed at the federal, state, and local level: 1) organizational capacity and 2) service delivery. Recommendations are provided regarding the way forward at the federal level and work needing to be done at the state and local level towards building a national system capable of meeting the public health threats of the 21st century.; Deputy Director and Division Director...

The Environmental Protection Agency's research program with primary emphasis on the Community Health and Environmental Surveillance System (CHESS), an investigative report

Dillaway, R. B; Byerly, Radford ( jt. auth ); United States -- Congress. -- House. -- Committee on Science and Technology. -- Subcommittee on Special Studies, Investigations, and Oversight; United States -- Congress. -- House. -- Committee on Science and
Fonte: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington ) Publicador: U.S. Govt. Print. Off.; U.S. Govt. Print. Off. ( Washington )
Tipo: Artigo de Revista Científica Formato: viii, 110 p. : ; 24 cm.
Publicado em //1976 ENGLISH
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45.77%
(Bibliography) Includes bibliographical references.; At head of title: Committee print.; (Statement of Responsibility) prepared [by R. B. Dillaway and Radford Byerly, Jr.] for the Subcommittee on the Environment and the Atomsphere of the Committee on Science and Technology, U. S. House of Representatives, Ninety-fourth Congress, second session.

Maternal Fish Consumption, Hair Mercury, and Infant Cognition in a U.S. Cohort

Hu, Howard; Oken, Emily; Wright, Robert O.; Kleinman, Ken Paul; Bellinger, David C.; Amarasiriwardena, Chitra J.; Rich-Edwards, Janet Wilson; Gillman, Matthew William
Fonte: National Institute of Environmental Health Sciences Publicador: National Institute of Environmental Health Sciences
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
45.76%
Fish and other seafood may contain organic mercury but also beneficial nutrients such as n-3 polyunsaturated fatty acids. We endeavored to study whether maternal fish consumption during pregnancy harms or benefits fetal brain development. We examined associations of maternal fish intake during pregnancy and maternal hair mercury at delivery with infant cognition among 135 mother–infant pairs in Project Viva, a prospective U.S. pregnancy and child cohort study. We assessed infant cognition by the percent novelty preference on visual recognition memory (VRM) testing at 6 months of age. Mothers consumed an average of 1.2 fish servings per week during the second trimester. Mean maternal hair mercury was 0.55 ppm, with 10% of samples > 1.2 ppm. Mean VRM score was 59.8 (range, 10.9–92.5). After adjusting for participant characteristics using linear regression, higher fish intake was associated with higher infant cognition. This association strengthened after adjustment for hair mercury level: For each additional weekly fish serving, offspring VRM score was 4.0 points higher [95% confidence interval (CI), 1.3 to 6.7]. However, an increase of 1 ppm in mercury was associated with a decrement in VRM score of 7.5 (95% CI, –13.7 to –1.2) points. VRM scores were highest among infants of women who consumed > 2 weekly fish servings but had mercury levels ≤1.2 ppm. Higher fish consumption in pregnancy was associated with better infant cognition...

Public Health and Economic Consequences of Methyl Mercury Toxicity to the Developing Brain

Trasande, Leonardo; Landrigan, Philip J.; Schechter, Clyde
Fonte: National Institue of Environmental Health Sciences Publicador: National Institue of Environmental Health Sciences
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
45.79%
Methyl mercury is a developmental neurotoxicant. Exposure results principally from consumption by pregnant women of seafood contaminated by mercury from anthropogenic (70%) and natural (30%) sources. Throughout the 1990s, the U.S. Environmental Protection Agency (EPA) made steady progress in reducing mercury emissions from anthropogenic sources, especially from power plants, which account for 41% of anthropogenic emissions. However, the U.S. EPA recently proposed to slow this progress, citing high costs of pollution abatement. To put into perspective the costs of controlling emissions from American power plants, we have estimated the economic costs of methyl mercury toxicity attributable to mercury from these plants. We used an environmentally attributable fraction model and limited our analysis to the neurodevelopmental impacts—specifically loss of intelligence. Using national blood mercury prevalence data from the Centers for Disease Control and Prevention, we found that between 316,588 and 637,233 children each year have cord blood mercury levels > 5.8 μg/L, a level associated with loss of IQ. The resulting loss of intelligence causes diminished economic productivity that persists over the entire lifetime of these children. This lost productivity is the major cost of methyl mercury toxicity...

Exposure to Environmental Tobacco Smoke and Cognitive Abilities among U.S. Children and Adolescents

Yolton, Kimberly; Dietrich, Kim; Auinger, Peggy; Lanphear, Bruce P.; Hornung, Richard
Fonte: National Institue of Environmental Health Sciences Publicador: National Institue of Environmental Health Sciences
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
45.76%
We used the Third National Health and Nutrition Examination Survey (NHANES III), conducted from 1988 to 1994, to investigate the relationship between environmental tobacco smoke (ETS) exposure and cognitive abilities among U.S. children and adolescents 6–16 years of age. Serum cotinine was used as a biomarker of ETS exposure. Children were included in the sample if their serum cotinine levels were ≤15 ng/mL, a level consistent with ETS exposure, and if they denied using any tobacco products in the previous 5 days. Cognitive and academic abilities were assessed using the reading and math subtests of the Wide Range Achievement Test–Revised and the block design and digit span subtests of the Wechsler Intelligence Scale for Children–III. Analyses were conducted using SUDAAN software. Of the 5,365 6- to 16-year-olds included in NHANES III, 4,399 (82%) were included in this analysis. The geometric mean serum cotinine level was 0.23 ng/mL (range, 0.035–15 ng/mL); 80% of subjects had levels < 1 ng/mL. After adjustment for sex, race, region, poverty, parent education and marital status, ferritin, and blood lead concentration, there was a significant inverse relationship between serum cotinine and scores on reading (β= −2.69, p = 0.001)...

Health impact assessment needs in south-east Asian countries

Caussy,Deoraj; Kumar,Priti; Than Sein,U.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2003 EN
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55.7%
A situation analysis was undertaken to assess impediments to health impact assessment (HIA) in the South-East Asia Region of WHO (SEARO). The countries of the region were assessed on the policy framework and procedures for HIA, existing infrastructure required to support HIA, the capacity for undertaking HIA, and the potential for intersectoral collaboration. The findings show that environmental impact assessment (EIA) is being used implicitly as a substitute for HIA, which is not explicitly or routinely conducted in virtually all countries of the Region. Therefore, policy, infrastructure, capacity, and intersectoral collaboration need strengthening for the routine implementation of HIA.