Contemporary Heart Failure Treatment Based on Improved Knowledge and Personalized Care of Comorbidities

Chronic diseases are the leading cause of mortality and morbidity. A significant contribution to the burden of chronic diseases is the concurrence of co-morbidities. Heart failure (HF) is a complex, chronic medical condition frequently associated with co-morbidities. The current care approach for HF patients with co-morbidities is neither capable to deliver personalised care nor to halt the on-going increase of its socio-economic burden. Our approach aims to improve the complete care process for HF patients and related co-morbidities to improve outcome and quality of life. This will be achieved by the proposed standardised yet personalised patient-oriented ICT system that supports evidence-based clinical decision making as well as interaction and communication between all stakeholders with focus on the patients and their relatives to improve self-management. We propose that such a system should be build upon a novel European-wide data standard for clinical input and outcome and that it should facilitate decision making and outcome tracking by new collective intelligence algorithms.

Notifiable Disease Databases for Client Management and Surveillance

The spread of certain infectious diseases, many of which are preventable, is widely acknowledged to have a detrimental effect on society. Reporting cases of these infections has been embodied in public health laws since the 1800s. Documenting client management and monitoring numbers of cases are the primary goals in collecting these data. A sample notifiable disease database is presented, including database structure, elements and rationales for collection, sources of data, and tabulated output. This chapter is a comprehensive guide to public health professionals on the content, structure, and processing of notifiable disease data for regional, provincial, and federal use.

Geography of Female Suicide

Suicide is a complex structure and also affects the families whose members commit suicide, health care professionals and society. Suicide is accepted as a form of death of external causes. It can be predicted and majority of suicides can be prevented. Suicide shows a big amount of differences depending on time, region, age level, gender and race. In order to understand and prevent suicide, several geographical, medical, psychosocial, cultural and socioeconomic factors have been studied. A tiny disorder in one of these factors may cause a significant change that results in severe outcomes. In preventing suicide, it is important to determine the subgroups that have high risk. Strategies to prevent suicide can be developed through searching and understanding the suicide geography. In this study, the spatial pattern of female suicide is examined with suicide maps. With suicide maps, it is aimed to clarify the spatial alteration of the deaths caused by female suicide, to help in focusing on female suicide, to increase the awareness of the specific regions and groups that have a high risk and to guide those who are dealing with decreasing the death ratios, public health experts and decision makers. In Turkey, according to the suicide rate averages of ten years (2002-2011), mostly the young age groups are at risk among women. The ratio of suicides caused by family incompatibility, educational failure and emotional relationship and not forced marriage is higher in females than in males. Turkey is a northern hemisphere country and features subtropical climate types, where females mostly commit suicide in summer and spring seasons. It is observed that there is no peak period in female suicide in Turkey. When the distribution of suicide based death ratios are examined, it is seen that the highest ratios are in the eastern and western parts of Turkey. It is seen that suicide occurs in the provinces with low socioeconomic status as well as the provinces with high socioeconomic status and in provinces with both a large population and a small population. And also it is determined that for those provinces, detailed studies should immediately be started. It is seen that the ratio of female suicide is getting higher and approaching to the ratio of male suicide from western parts to eastern parts of Turkey. Between these years, 75% of the suicides were committed by means of violent methods and 25% of them were committed by means of nonviolent methods. The provinces where the ratio of using violent suicide methods is higher than the standard deviation are located in the eastern part of the country. It is noteworthy that the ratio of female suicide victims who are single is close to the ratio of those who are married. The suicide ratio of married women is decreasing from west to east.

Strategic Healthcare Service Management

Healthcare is a service industry and it consists of health organizations (hospitals, clinics etc.), people (patients, doctors and nurses) and health technologies. Healthcare organizations are complex in nature and need to improve quality while maintaining optimum cost. Patient is final consumer of health services and he is the customer hence healthcare service quality is nothing but perceived satisfaction by patient. Prevalent trends in healthcare industry such as emerging healthcare technology, increasing demand, changing disease patterns and growing government support are contributing to a need to achieve efficiency and set benchmarks by overcoming challenges in healthcare service sector being underserved and under-consumed. There is a scope to improve quality and efficiency using various strategies like adopting advanced technologies and positioning in order to achieve delight in delivery of healthcare services. Major healthcare players are adopting unique strategies irrespective of their diverse geographical presence and range of services from single specialty, super-specialty or multispecialty to deliver healthcare services efficiently.

Influence of Patent Law on Price of Medicines

There is a great deal of disparity between the availability and affordability of medicines in least developed, developing and developed nations. Patents are one of the major reasons of this difference. The pharmaceutical industry spends over US$10 billion to fund some 90% of 40,000-80,000 randomised controlled trails being conducted across the world at any given time. A United Nations AIDS study reported that the number of people in poor countries who have access to anti-retroviral medicines remains extremely low; only 30,000 received medication in 2002, out of an estimated 5 million in need. The proposed chapter aims to study effect of patent law on pricing of medicines. The legal and regulatory policies such as TRIPs jointly introduced by various nations to regulate the pricing of patented products will be elaborated in this chapter. Apart from national and international policies, the behaviour of pharmaceutical companies also affect price of patented products. The chapter will also cover various techniques pharmaceutical industry adopt to control price of patented products such as proliferation of me-too drugs, product reformulation, prolonging patent rights, biasing research and large promotional expenditures.

Rural Mental Health Workforce Development in Hawai'i and the US-Affiliated Pacific Islands

Working in Hawai'i and the U.S.-Affiliated Pacific Islands presents unique challenges and opportunities for mental health workforce development. This chapter presents previous, current, and future efforts aimed at not only increasing the size of the workforce but also developing a better trained workforce for existing professionals. The authors draw from their experiences at the Hawaii/Pacific Basin Area Health Education Centers (AHEC), one of the only organizations performing medical, public health, and mental health workforce development across the Pacific Region, to explore culturally appropriate initiatives and interventions. Programs targeting a range of audiences from youth to adults, students to professionals, and patients/clients to caregivers are discussed. The chapter emphasizes health career pathway programs for youth and young adults wishing to enter the health workforce and a variety of educational development and continuing education opportunities for professionals. Specific mental health workforce initiatives are described.

Interactive Digital Mobile Gaming as a Strategic Tool in the Fight Against Childhood Obesity

The introduction of new technologies into childrenʼs daily routines is in many cases associated with negative health impacts. However, technology may also be used to promote healthy practices by way of so-called serious games. Several studies have confirmed that the use of such tools can result in significant health gains, the adoption of healthy eating habits, the practice of an active lifestyle, increased energy expenditure and decreased adiposity. In this context, the authors report a case study that portrays the process of designing and developing an interactive digital mobile game, designed to motivate children to adopt exercise and healthy eating habits. The player interacts with the game through health metrics, the evolution of the main character, notifications/messages about healthy foods and exercise, and virtual and real-life rewards. The development of a health promotion game is not a simple task and requires a multidisciplinary team.

Adolescence Surveillance System for Obesity Prevention (ASSO) in Europe

Adolescents' obesity is a major concern in our modern life that could lead to significant increase in the rate of obese future generations and consequently in the health budget. The ASSO (Adolescence Surveillance System for Obesity prevention) project in Italy is tackling this new pandemic using the new e-technology through a multi facets monitoring system on life style including food consumptions, meal patterns and habits, alcohol, smoking, physical activity, fitness and sedentariness, and biological/genetic, and socio-cultural/environmental characteristics of adolescents. The project has been recently piloted in the South of the country. This chapter summarizes the design and structure of the ASSO system, its implementation and the results of an evaluation process for its possible extension to the whole Italian territory and to other European realities as a national surveillance system.

Health Professionals Can Protect Water Quality

Emerging research shows adverse health outcomes such as diabetes, obesity, cancer, and neurotoxicity from water pollutants such as flame retardants, endocrine disruptors, and pharmaceuticals. Medical waste and energy use affects water quality and quantity. This chapter provides strategies for health professionals to promote water stewardship at personal, organizational and policy levels. Organizations such as Health Care Without Harm, Alliance of Nurses for Healthy Environments and the Ecology Center offer resources for improving education of health professionals and provide allies for change. Individual advocacy through writing op-eds, policy briefs, meeting with legislators and participation in coalitions allows health professionals to interpret the science behind the need for policy changes. Recommendations for health care curricula prepare students to develop sustainable practices through inter-professional collaboration. Environmentalists can use this information to better engage health professionals in promoting change.

Case Study

In 2009, the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) counted over 10 different health facility lists managed by donors, government ministries, agencies and implementing partners. These function-specific lists were not integrated or linked. The ministry's Health Sector Strategic Plan included the development of an authoritative source for all health facility information, called the Master Facility List (MFL). During development, the ministry adopted the term Health Facility Registry (HFR), an online tool providing public access to a database about all officially recognized health facilities (public and private). The MFL, which includes the health facility list at any specific point in time can be exported from the HFR. This chapter presents the Tanzanian case study describing the work and lessons learned in building the HFR—focusing on software development, introducing geographic positioning systems and harmonizing MFL data. MoHCDGEC launched the HFR public portal in September 2015.