Occupational health legislation and practices related to seafarers on passenger ships focused on communicable diseases: results from a European cross-sectional study (EU SHIPSAN PROJECT)

<p>Abstract</p> <p>Background</p> <p>Seafarers play an important role in the transmission of communicable diseases. The aim of the present study is to draw information and identify possible gaps on occupational health practices related to seafarers sailing on ships within the European Union Member States (EU MS) with focus on communicable diseases.</p> <p>Methods</p> <p>A structured questionnaire was sent to competent authorities from 21 EU MS. The questionnaire included questions about occupational health policies, medical certification of seafarers, communicable diseases reporting and relevant legislation. Descriptive analysis of the data was conducted by the use of Epi Info software: EU MS were categorized in four priority groups (A, B, C, D) based on: number of passenger ships visits, volume of passengers, and number of ports in each country. Moreover, EU MS were categorized to old and new, based on the date of entry in the EU.</p> <p>Results</p> <p>All 21 countries with relevant competent authorities responded to the questionnaire. The existence of specific national legislation/regulation/guidelines related to vaccination of seafarers was reported by three out of the 21 (14%) responding authorities. Surveillance data of communicable diseases related to seafarers are collected and analyzed by 4 (19%) authorities. Five out of 21 of the responding countries (24%) reported that tuberculin test result is required for the issuance of seafarer's medical certificate while a great variety of medical examination is required for the issuance of this certificate among countries.</p> <p>Gaps on occupational health services focused on communicable diseases related to maritime occupation have been reported by 33% of the responding countries.</p> <p>Responding authorities from Group A and B had the highest percentage of reported gaps followed by groups C and D. Old MS reported a higher frequency regarding gaps on occupational health services in comparison to new MS.</p> <p>Conclusion</p> <p>Our results revealed heterogeneity regarding occupational health of maritime employees in EU MS. This work provides some evidence that further work at international and European level could be considered, in order to explore the potential for harmonized initiatives regarding occupational health of seafarers.</p

Designing Scalable Business Models

Digital business models are often designed for rapid growth, and some relatively young companies have indeed achieved global scale. However despite the visibility and importance of this phenomenon, analysis of scale and scalability remains underdeveloped in management literature. When it is addressed, analysis of this phenomenon is often over-influenced by arguments about economies of scale in production and distribution. To redress this omission, this paper draws on economic, organization and technology management literature to provide a detailed examination of the sources of scaling in digital businesses. We propose three mechanisms by which digital business models attempt to gain scale: engaging both non- paying users and paying customers; organizing customer engagement to allow self- customization; and orchestrating networked value chains, such as platforms or multi-sided business models. Scaling conditions are discussed, and propositions developed and illustrated with examples of big data entrepreneurial firms

Doing Better by Doing Less: Approaches to Tackle Overuse of Services

Experts have projected that as much as a third of U.S. health care spending is unnecessary and wasteful. Of the estimated $765 billion of health care dollars wasted in 2009, a quarter --$210 billion -- was spent on the overuse of services, which includes services that are provided more frequently than necessary or services that are higher-cost, but no more beneficial than lower-cost alternatives.This paper provides a summary of the problem of overuse in the U.S. health care system. The analysis gives an overview of the provision of medically inappropriate and unnecessary services that drive up health care spending without making a positive impact on patients' health outcomes. It also describes approaches that have already been used to address overuse of health care services and outlines the broader payment reforms needed to minimize incentives to overdiagnose and overtreat.This overuse of services has implications for both health care costs and outcomes. There is substantial variation in the level of inappropriate use across different health care services. Research shows that the rates at which particular procedures, tests, and medications were performed or prescribed when clinically inappropriate ranged from a low of 1 percent to a high of 89 percent

Uses of routine data sets in the evaluation of health promotion interventions: opportunities and limitations

Practitioners are under constant pressure to evaluate their work. In the current environment, health professionals frequently have limited time and financial resources, and opportunities for using existing data sets must be exploited. Routinely collected data provide a potentially useful resource for use in this context. The aim of this paper is to discuss the potential uses of routinely collected data in the evaluation of health promotion interventions. Opportunities for and limitations of routine data are discussed, drawing on examples primarily from the field of sexual health, to demonstrate principles which are also relevant in other areas of health care

Promotion and provision of colorectal cancer screening: a comparison of colorectal cancer control program grantees and nongrantees, 2011-2012.

IntroductionSince 2009, the Centers for Disease Control and Prevention (CDC) has awarded nearly $95 million to 29 states and tribes through the Colorectal Cancer Control Program (CRCCP) to fund 2 program components: 1) providing colorectal cancer (CRC) screening to uninsured and underinsured low-income adults and 2) promoting population-wide CRC screening through evidence-based interventions identified in the Guide to Community Preventive Services (Community Guide). CRCCP is a new model for disseminating and promoting use of evidence-based interventions. If the program proves successful, CDC may adopt the model for future cancer control programs. The objective of our study was to compare the colorectal cancer screening practices of recipients of CRCCP funding (grantees) with those of nonrecipients (nongrantees).MethodsWe conducted parallel Web-based surveys in 2012 with CRCCP grantees (N = 29) and nongrantees (N = 24) to assess promotion and provision of CRC screening, including the use of evidence-based interventions.ResultsCRCCP grantees were significantly more likely than nongrantees to use Community Guide-recommended evidence-based interventions (mean, 3.14 interventions vs 1.25 interventions, P &lt; .001) and to use patient navigation services (eg, transportion or language translation services) (72% vs 17%, P &lt; .001) for promoting CRC screening. Both groups were equally likely to use other strategies. CRCCP grantees were significantly more likely to provide CRC screening than were nongrantees (100% versus 50%, P &lt; .001).ConclusionResults suggest that CRCCP funding and support increases use of evidence-based interventions to promote CRC screening, indicating the program's potential to increase population-wide CRC screening rates

Filling a gap: would evidence-based school librarianship work in the UK?

School librarians in the UK have a lower status than librarians in other sectors, and research on school librarianship in the UK is sparse. Annual self-evaluation is one way the profession has tried to make itself more visible. Evidence-based school librarianship (EBSL) could assist school librarians in the UK improve their services, boost their profile, and build their portfolios as part of existing self-evaluation programmes. EBSL is an off-shoot of evidence-based librarianship, which aims to bridge the gap between research and practice, and encourages practitioners to conduct research in the workplace. Most of the current EBSL work is being done in the US, where school librarians are also typically trained teachers, however, EBSL is suitable for adaptation and use in the UK. Appropriate research methods must be chosen in order to make EBSL work in the UK, action research being one such method

Media Usage in Post-Secondary Education and Implications for Teaching and Learning

The Web 2.0 has permeated academic life. The use of online information services in post-secondary education has led to dramatic changes in faculty teaching methods as well as in the learning and study behavior of students. At the same time, traditional information media, such as textbooks and printed handouts, still form the basic pillars of teaching and learning. This paper reports the results of a survey about media usage in teaching and learning conducted with Western University students and instructors, highlighting trends in the usage of new and traditional media in higher education by instructors and students. In addition, the survey comprises part of an international research program in which 20 universities from 10 countries are currently participating. Further, the study will hopefully become a part of the ongoing discussion of practices and policies that purport to advance the effective use of media in teaching and learning

Impact of a 'diagonal' intervention on uptake of sexual and reproductive health services by female sex workers in Mozambique : a mixed-methods implementation study

CITATION: Lafort, Y. 2018. Impact of a diagonal intervention on uptake of sexual and reproductive health services by female sex workers in Mozambique : a mixed-methods implementation study. Frontiers in Public Health, 6:109, doi:10.3389/fpubh.2018.00109.The original publication is available at https://www.frontiersin.orgBackground: Female sex workers (FSWs) have high risks for adverse sexual and reproductive health (SRH) outcomes, yet low access to services. Within an implementation research project enhancing uptake of SRH services by FSWs, we piloted a “diagonal” intervention, which combined strengthening of FSW-targeted services (vertical) with making public health facilities more FSW-friendly (horizontal), and tested its effect. Methods: The study applied a convergent parallel mixed-methods design to assess changes in access to SRH services. Results of structured interviews with FSWs pre-intervention (N = 311) and thereafter (N = 404) were compared with the findings of eight post-intervention focus group discussions (FGDs) with FSWs and two with FSW-peer educators (PEs). Results: Marked and statistically significant rises occurred in consistent condom use with all partners (55.3–67.7%), ever use of female condoms (37.9–54.5%), being tested for HIV in the past 6 months (56.0–76.6%), using contraception (84.5–95.4%), ever screened for cervical cancer (0.0–16.9%) and having ≥10 contacts with a PE in the past year (0.5–24.45%). Increases mostly resulted from FSW-targeted outreach, with no rise detected in utilization of public health facilities. FGD participants reported that some facilities had become more FSW-friendly, but barriers such as stock-outs, being asked for bribes and disrespectful treatment persisted. Conclusion: The combination of expanding FSW-targeted SRH services with improving access to the public health services resulted in an overall increased uptake of services, but almost exclusively because of the strengthened targeted (vertical) outreach services. Utilization of public SRH services had not yet increased and many barriers to access remained. Our diagonal approach was thus only successful in its vertical component. Improving access to the general health services remains nevertheless important and further research is needed how to reduce barriers. Ideally, the combination approach should be maintained and more successful approaches to increase utilization of public services should be explored.https://www.frontiersin.org/articles/10.3389/fpubh.2018.00109/fullPublisher's versio