Archive for the 'Health' Category

Health Issues Resolved

Tuesday, September 22nd, 2009
LAVON SCHULL asked:


WELCOME TO THIS HEALTH SITE

Health issues are among the top related topics of today’s society. Many people reach out to physicians and doctors for related remedies, treatments and cures.

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 Have you, or someone you know, ever had a problem with one, or more, of the following health Issues?

Poor Functioning of Internal Organs,  Asthma,  Tracheal Inflamation,  Menstrual Cramps,  Anemia,  Being Over Weight,  Chronic Conditions,  Heart Weakness,  Adrenal Failure,  Kidney or Liver Failure,  Lymphatic Problems,  Allergies, Curing Cancer,  Diabetes,  Alzheimers,  Difficulty standing a long time , Dizziness,  Tired and Sore Muscles , Insomnia , Tight Shoulders,  Injuries,  Joint Pain,  Leg Pain, Stress,  Arthritis , Back Pain,  Bone Spurs,  Poor Circulation,  Lack of Appetite,  Numb Arm,  Muscle Fatigue,  Poor Digestion , Constipation,  Poor Attention , Toenail Fungus , Carpal Tunnel. Circulation, Ulcers, Pancreatic Cancer, Prostate Cancer, Wrinkles.

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1 877 239 1231 Toll free — Talk to either Steve or LaVon

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Wednesday, June 24th, 2009
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Imbalance of Ecosystems and Its Effect on Public and Livestock Health

Wednesday, June 24th, 2009
Dr.Kedar Karki asked:


Imbalance of Ecosystems and Its effect on Public and Livestock health

Dr.Kedar Karki M.V.St. (Preventive veterinary Medicine)

Central Veterinary Laboratory Tripureshwor

The health of humans, like all living organisms, is dependent on an ecosystem that sustains life. Healthy ecosystems are the sine qua non for healthy organisms. Yet there is abundant evidence that many life-support systems are far from healthy, placing an increased burden on human health. In some areas of the world, gains in life expectancy and quality of life made during the twentieth century are at risk of being reversed in the twenty-first century. The consequences of ecosystem degradation to human health are numerous, and include health risks from unsafe drinking water, polluted air, climate change, emerging new diseases, and the resurgence of old diseases owing to ecological imbalances. Reversing this damage is possible in some cases, but not in others. Prevention of ecological damage is by far the most efficient strategy.

DEFINING ECOSYSTEMS

An ecological system may be defined as a community of plants and animals interacting with each other and their abiotic, or natural, environment. Typically, ecosystems are differentiated on the basis of dominant vegetation, topography, climate, or some other criteria. Boreal forests, for example, are characterized by the predominance of coniferous trees; prairies are characterized by the predominance of grasses; the Arctic tundra is determined partly by the harsh climatic zone. In most areas of the world, the human community is an important and often dominant component of the ecosystem. Ecosystems include not only natural areas (e.g., forests, lakes, marine coastal systems) but also human-constructed systems (e.g., urban ecosystems, agro-ecosystems, impoundments). Human populations are increasingly concentrated in urban ecosystems, and it is estimated that, by the year 2010, 50 percent of the world’s population will be living in urban areas.

A landscape comprises a mosaic of ecosystems, including towns, rivers, lakes, agricultural systems, and so on. Precise boundaries between ecosystems are often difficult to establish. Often regions slide into one another gradually, over a protracted “transition” zone, as for example between the boreal forest and the Taiga regions of Canada.

ECOSYSTEM HEALTH

It is important to recognize the inherent difficulties in defining “health,” whether at the level of the individual, population, or ecosystem. The concept of health is somewhat of an enigma, being easier to define in its absence (sickness) than in its presence. Perhaps partially for that reason, ecologists have resisted applying the notion of “health” to ecosystems. Yet, ecosystems can become dysfunctional, particularly under chronic stress from human activity.Example for this can be cited the discharge of nutrients from sewage, industrial waste, or agricultural runoff into lakes or rivers affects the normal functioning of the ecosystem, and can result in severe impairment. Excessive nutrient inputs from human activity was one of the major factors that severely compromised the health of the lower Laurentian Great Lakes (Lake Erie and Lake Ontario) and regions of the upper Great Lakes (Lake Michigan). Unfortunately, degraded ecosystems are becoming more the rule than the exception.

The study of the features of degraded systems, and comparisons with systems that have not been altered by human activity, makes it possible to identify the characteristics of healthy ecosystems. Healthy ecosystems may be characterized not only by the absence of signs of pathology, but also by signs of health, including measures of vigor (productivity), organization, and resilience.

Vigor can be assessed in terms of the metabolism (activity and productivity) of the system. Ecosystems differ greatly in their normal ranges of productivity. Estuaries are far more productive than open oceans, and marshes have higher productivity than deserts. Health is not evaluated by applying one standard to all systems. Organization can be assessed by the structure of the biotic community that forms an ecosystem and by the nature of the interactions between the species (both plants and animals). Invariably, healthy ecosystems have more diversity of biota than ecologically compromised systems. Resilience is the capacity of an ecosystem to maintain its structure and functions in the face of natural disturbances. Systems with a history of chronic stress are less likely to recover from normal perturbations such as drought than those systems that have been relatively less stressed.

Healthy ecosystems can also be characterized in economic, social, and human health terms. Healthy ecosystems support a certain level of economic activity. This is not to say that the ecosystem is necessarily self-sufficient, but rather that it supports economic productivity to enable the human community to meet reasonable needs. Inevitably, ecosystem degradation impinges on the long-term sustainability of the human economy that is associated with it, although in the short-term this may not be evident, as natural capital (e.g., soils, renewable resources) may be overexploited and temporarily enhance economic returns. Similarly, with respect to social well-being, healthy ecosystems provide a basis for and encourage community integration. Historically, for example, native Hawaiian groups managed their ecosystem through a well-developed social cohesiveness that provided a high degree of cooperation in fishing and farming activity.

Another reflection of ecosystem health lies directly in the public health domain. In spring 2000, a deadly strain of the bacterium E-coli (0157:H7) entered the public water supply in Walkerton, Ontario, Canada, causing seven deaths and making thousands sick. This small town, with a population of five thousand, is in a farming community. Inadequate manure management from cattle operations was the likely source of this tragedy.

HOW HEALTHY ECOSYSTEMS BECOME PATHOLOGICAL

Stress from human activity is a major factor in transforming healthy ecosystems to sick ecosystems. Chronic stress from human activity differs from natural disturbances. Natural disturbances (fires, floods, periodic insect infestations) are part of the dynamics of most ecosystems. These processes help to “reset” ecosystems by recycling nutrients and clearing space for recolonization by biota that may be better adapted to changing environments. Thus, natural perturbations help keep ecosystems healthy. In contrast, chronic and acute stress on ecosystems resulting from human activity (e.g., construction of large dams, release of nutrients and toxic substances into the air, water, and land) generally results in long-term ecological dysfunction.

Five major sources of human-induced (anthropogenic) stresses have been identified by D. J. Rapport and A. M. Friend (1979): physical restructuring, overharvesting, waste residuals, introduction of exotic species, and global change.

Physical Restructuring. Activities such as wetland drainage, removal of shoals in lakes, damming of rivers, and road construction fragment the landscape and alter and damage critical habitat. These activities also disrupt nutrient cycling, and cause the loss of biodiversity.

Overharvesting. Overexploitation is commonplace when it comes to harvesting of wildlife, fisheries, and forests. Over long periods of time, stocks of preferred species are reduced. For example, the giant redwoods that once thrived along the California coast now exist only in remnant patches because of overharvesting. When dominant species like the giant redwoods (arguably the world’s tallest tree—one specimen was recorded at 110 meters tall with a circumference of 13.4 meters) are lost, the entire ecosystem becomes transformed. Overharvesting often results in reduced biodiversity of endemic species, while facilitating the invasion of opportunistic species.

Waste Residuals. Discharges from municipal, industrial, and agricultural sources into the air, water, and land have severely compromised many of the earth’s ecosystems. The effects are particularly apparent in aquatic ecosystems. In some lakes that lack a natural buffering capacity, acid precipitation has eliminated most of the fish and other organisms. While the visual effect appears beneficial (water clarity goes up) the impact on ecosystem health is devastating. Systems that once contained a variety of organisms and were highly productive (biologically) become devoid of most lifeforms except for a few acid-tolerant bacteria and sediment-dwelling organisms.

Introduction of Exotic Species. The spread of exotics has become a problem in almost every ecosystem of the world. Transporting species from their native habitat to entirely new ecosystems can wreck havoc, as the new environments are often without natural checks and balances for the new species. In the Great Lakes Basin, the accidental introduction of two small pelagic fishes, the alewife and the rainbow smelt, combined with the simultaneous overharvesting of natural predators, such as the lake trout, led to a significant decline in native fish species. The introduction of the sea lamprey, an eel-like predacious fish that attacks larger fish, into Lake Erie and the upper Great Lakes further destabilized the native fish community. The sea lamprey contributed to the demise of the deepwater benthic fish community by preying on lake trout, whitefish, and burbot. This contributed to a shift in the fish community from one that had been dominated by large benthics to one dominated by small pelagics (fish found in the upper layers of the lake profile). This shift from bottom-dwelling fish (benthic) to surface-dwelling fish (pelagic) has now been partially reversed by yet another accidental introduction of an exotic: the zebra mussel. As the zebra mussel is a highly efficient filter of both phtyoplankton and zooplankton, its presence has reduced the available food in the surface waters for pelagic fish. However, while the benthic fish community has gained back its dominance, the preferred benthic fish species have not yet recovered owing to the degree of initial degradation. Overall, the increasing dominance by exotics not only altered the ecology, but also reduced significantly the commercial value of the fisheries.

Global Change. Rapid climate change (or climate warming) is an emerging potential global stress on all of the earth’s ecosystems. In evolutionary time, there have of course been large fluctuations in climate. However, for the most part these fluctuations have occurred gradually over long periods of time. Rapid climate change is an entirely different matter. By altering both averages and extremes in precipitation, temperature, and storm events, and by destabilizing the El Niño Southern Oscillation (ENSO), which controls weather patterns over much of the southern Pacific region, many ecosystem processes can become significantly altered. Excessive periods of drought or unusually heavy rains and flooding will exceed the tolerance for many species, thus changing the biotic composition. Flooding and unusually high winds contribute to soil erosion, and at the same time add to nutrient load in rivers and coastal waters.

These anthropogenic stresses have compromised ecosystem function in most regions of the world, resulting in ecosystem distress syndrome (EDS). EDS is characterized by a group of signs, including abnormalities in nutrient cycling, productivity, species diversity and richness, biotic structure, disease prevalence, soil fertility, and so on. The consequences of these changes for human health are not inconsiderable. Impoverished biotic communities are natural harbors for pathogens that affect humans and other species.

ECOSYSTEM HEALTH AND HUMAN HEALTH

An important aspect of ecosystem degradation is the associated increased risk to human health. Traditionally, the concern has been with contaminants, particularly industrial chemicals that can have adverse impacts on human development, neurological functions, reproductive functions, and that appear to be causative agents in a variety of carcinomas. In addition to these serious environmental concerns (where the remedies are often technological, including engineering solutions to reduce the release of contaminants), there are a large number of other risks to human health stemming from ecological imbalance.

Ecosystem distress syndrome results in the loss of valued ecosystem services, including flood control, water quality, air quality, fish and wildlife diversity, and recreation. One of the major signs of EDS is increased disease incidence, both in humans and other species. Human population health should thus be viewed within an ecological context as an expression of the integrity and health of the life-supporting capacity of the environment.

Ecological imbalances triggered by global climate change and other causes are responsible for increased human health risks.

Climate Change and Vector-Borne Diseases. The global infectious disease burden is on the order of several hundred million cases per year. Many vector-borne diseases are climate sensitive. Malaria, dengue fever, hantavirus pulmonary syndrome, and various forms of viral encephalitis are all in this category. All these diseases are the result of arthropod-borne viruses (arboviruses) which are transmitted to humans as a result of bites from blood-sucking arthropods.

Global climate change—particularly as it impacts both temperatures and precipitation—is highly correlated with the prevalence of vector-borne diseases. For example, viruses carried by mosquitoes, ticks, and other blood-sucking arthropods generally have increased transmission rates with rising temperatures. St. Louis encephalitis (SLE) serves as an example. The mosquito Culex tarsalis carries this virus. The percentage of bites that results in transmission of SLE is dependent on temperature, with greater transmission at higher temperatures.

The temperature dependence of vector-borne diseases is also well illustrated with malaria. Malaria is endemic throughout the tropics, with a high prevalence in Africa, the Indian subcontinent, Southeast Asia, and parts of South and Central America and Mexico. Approximately 2.4 billion people live in areas of risk, with some 350 million new infections occurring annually, resulting in approximately 2 million deaths, predominantly in young children. Untreated malaria can become a life-long affliction—general symptoms include fever, headache, and malaise.

The climate sensitivity of malaria arises owing to the nature of the interactions of parasites, vectors, and hosts, all of which impact the ultimate transmission rates to humans. The gestation time required for the parasite to become fully developed within the mosquito host (a process termed sporogony) is from eight to thirty-five days. When temperatures are in the range of 20°C to 27°C, the gestation time is reduced. Rainfall and humidity also have an influence. Both drought and heavy rains tend to reduce the population of mosquitoes that serve as vectors for malaria. In drier regions of the tropics, low rainfall and humidity restricts the survival of mosquitoes. Severe flooding can result in scouring of rivers and destruction of the breeding habitats for the mosquito vector, while intermediate rainfall enhances vector production.

Ecological Imbalances. Cholera is a serious and potentially fatal disease that is caused by the bacterium Vibrio cholerae. While not nearly so prevalent as malaria, cases are nonetheless numerous. In 1993, there were 296,206 new cases of cholera reported in South America; 9,280 cases were reported in Mexico; 62,964 cases in Africa; and 64,599 cases in Asia. Most outbreaks in Asia, Africa, and South America have originated in coastal areas. Symptoms of cholera include explosive watery diarrhea, vomiting, and abdominal pain. The most recent pandemic of cholera involved more regions than at any previous time in the twentieth century. The disease remains endemic in India, Bangladesh, and Africa. Vibrio cholerae has also been found in the United States—in the Gulf Coast region of Texas, Louisiana, and Florida; the Chesapeake Bay area; and the California coast.

The increase in prevalence of V. cholerae has been strongly linked to degraded coastal marine environments. Nutrient-enriched warmer coastal waters, resulting from a combination of climate change and the use of fertilizers, provides an ideal environment for reproduction and dissemination of V. cholerae. Recent outbreaks of cholera in Bangladesh, for example, are closely correlated with higher sea surface temperatures. V. cholerae attach to the surface of both freshwater and marine copepods (crustaceans), as well as to roots and exposed surfaces of macrophytes (aquatic plants) such as the water hyacinth, the most abundant aquatic plant in Bangladesh. Nutrient enrichment and warmer temperatures give rise to algae blooms and an abundance of macrophytes. The algae blooms provide abundant food for copepods, and the increasing copepod and macrophyte populations provide V. cholerae with habitat. Subsequent dispersal of V. cholerae into estuaries and fresh water bodies allows contact with humans who use these waters for drinking and bathing. Global distribution of marine pathogens such as V. cholerae is further facilitated by ballast water discharged from vessels. Ballast water contains a virtual cocktail of pathogens, including V. cholerae.

Two other examples of how ecological imbalances lead to human health burdens concern the increased prevalence of Lyme disease and hantavirus pulmonary disease. Lyme disease, sonamed because it was first positively identified in Lyme, Connecticut, is a crippling arthritic-type disease that is transmitted by spirochete-infected Ixodes ticks (deer ticks). Ticks acquire the infection from rodents, and spend part of their life cycle on deer. Three factors have combined to increase the risk to humans of contracting Lyme disease, particularly in North America: (1) the elimination of natural deer predators, particularly wolves; (2) reforestation of abandoned farmland has created more favorable habitat for deer; and (3) the creation of suburban estates, which the deer find ideal habitat for browsing. The net result is a rising deer population, which increases the chances of humans coming into more contact with ticks.

By 1995, in the southwestern United States, hantavirus infection was confirmed in ninety-four persons in twenty states, with 48 percent mortality. Variants of the strain that causes hantavirus pulmonary syndrome have also been found in other areas of the country, as well as in Asia and Europe. The virus is apparently asymptomatic in rodents, and it is transmitted in their saliva and excreta. In humans it has a flu-like presentation, which is followed by acute respiratory distress syndrome. The primary reservoir in the Four Corners area of the southwestern United States is the deer mouse. Climatic disturbances, which in recent years are thought to be exacerbated by human activity (e.g., global warming), appear to set up conditions that trigger outbreaks. In the early 1990s, ENSO events initially caused drought conditions to develop in the southwestern United States. This led to a decline in plant and animal populations, including natural predators of the deer mouse. Heavy rains followed the drought in 1993, resulting in a bumper crop of piñon nuts, a major food supply for the deer mouse. Subsequently the deer mouse population greatly increased, bringing about increased contact with humans and triggering the outbreak of hantavirus.

Antibiotic Resistance and Agricultural Practice Antibiotic resistance is a growing threat to public health. Antibiotic resistant strains of Streptococcus pneumoniae, a common bacterial pathogen in humans and a leading cause of many infections, including chronic bronchitis, pneumonia, and meningitis, have greatly increased in prevalence since the mid-1970s. In some regions of the world, up to 70 percent of bacterial isolates taken from patients proved resistant to penicillin and other b-lactam antibiotics. The use of large quantities of antibiotics in agriculture and aquaculture appears to have been a key factor in the development of antibiotic resistance by pathogens in farm animals that subsequently may also infect humans. One of the most serious risks to human health from such practices is vancomycin-resistant enterococci. The use of avoparcin, an animal growth promoter, appears to have compromised the utility of vancomycin, the last antibiotic effective against multi-drug-resistant bacteria. In areas where avoparcin has been used, such as on farms in Denmark and Germany, vancomycin-resistant bacteria have been detected in meat sold in supermarkets. Avoparcin was subsequently banned by the European Union. Another example is the use of ofloxacin to protect chickens from infection and thereby enhance their growth. This drug is closely related to ciprofloxacin, one of the most widely used antibiotics in the year 2000. There have been cases of resistance to ciprofloxacin directly related to its veterinary use. In the United Kingdom, ciprofloxacin resistance developed in strains of campylobacter, a common cause of diarrhea. Multi-drug-resistant strains of salmonella have been traced to European egg production.

Food and Water Security. Agricultural practices are also responsible for a growing number of threats to public health. Some of these are related to inadequate waste management, which has resulted in parasites and bacteria entering water supplies. Others are of entirely different origins and involve apparent transfer across species of pathogens that affect both animals and humans. The most recent and spectacular example is mad cow disease, known as variant Creutzfeldt-Jakob disease in humans, a neuro-degenerative condition that, in humans, is ultimately fatal. The first case of Bovine Spongiform Encephalopathy (BSE), the animal form of the disease, was identified in Southern England in November 1981. By the fall of 2000, an outbreak had also occurred in France, and isolated cases appeared in Germany, Switzerland, and Spain. More than one hundred deaths in Europe were attributed to what has come to be commonly called mad cow disease.

Improper manure management was the likely source of the outbreak of E. coli 0157:H7 in Walkerton, Ontario, Canada. Other health risks associated with malfunctioning agroecosystems include periodic outbreaks of cryptosporidiosis, a parasitic disease that is spread by surface runoff contaminated by ***** of infected cattle. This parasite causes fever and diarrhea in immunocompetent individuals and severe diarrhea and even death in immunocompromised individuals.

ECOSYSTEM RESTORATION

Ecosystem pathology in some cases can be reversed simply by removing the source of stress. In cases, for example, where ecosystem degradation is the result of point-source additions of nutrients or toxic chemicals, removal of these stresses may result in considerable recovery of ecosystem health. A classic case is Lake Washington (near Seattle, Washington). This lake had become highly anoxic (oxygen-depleted) owing to a sewage outfall entering the lake. Redirecting the sewage outfall away from the lake reversed many of the signs of pathology.

In cases where it is not feasible to remove the source of stress, more innovative engineering solutions have been tried. For example, in the Kyrönjoki and Lestijoki Rivers in western Finland, spring and fall runoff leads to sharp pulses of acidity. Spring runoff from snowmelt, which releases acid from tilled or dug soils, has been particularly damaging to fish, during the critical time of year for spawning. Fish reproduction is severely curtailed, if not all together eliminated in highly acidic water. Further there have been massive fish kills resulting from the highly acidic waters. One possible remedy is to replace the original drains which take runoff from the land to the rivers with new limed drains that can neutralize the acidity. This solution has been implemented on an experimental basis and appears to substantially reduce acidic runoff.

More radical treatments for damaged ecosystems involve “ecosystem surgery.” In some cases, invading exotic vegetation (such as mangroves in Hawaii) have been removed from regions, and native vegetation has been replanted. In areas of North America where wetlands have been severely depleted owing to farming, urbanization, and industrial activity, efforts have been made to establish new wetlands.

More often than not, however, reversing ecosystem pathology is not possible. Efforts to restore the indigenous grasslands in the Jornada Experimental Range in the southwestern United States provide an example. Overgrazing by cattle has severely degraded the landscape and has lead to replacement of the native grasses by largely inedible shrubs, dominated by mesquite. Erosion by wind and episodic heavy rains have left areas between shrubs largely bare, and subsequently underlying sands have developed in dune-like fashion over a large part of the area. The resulting mesquite dunes have proven highly resistant to efforts to restore the native grasslands, although almost every intervention has been tried, including highly toxic defoliants (Agent Orange), fire, and bulldozing.

Even where it has been possible to restore some of the ecological functions of degraded ecosystems, and thus improve ecosystem health, the restoration seldom results in reestablishment of the pristine biotic community. The best that can be achieved in most cases is reestablishment of the key ecological functions that provide the required ecosystem services, such as the regulation of water, primary and secondary productivity, nutrient cycling, and pollination. In all such efforts, key indicators of ecosystem health (vigor, productivity, and resilience) are essential to monitor progress. Standard ecological indicators can be used for this purpose (e.g., measures of productivity, species composition, nutrient flows, soil fertility) along with socioeconomic and human health indicators.

Experience in efforts to restore highly damaged ecosystems suggests that ecosystem-health prevention is far more effective than restoration. For marine ecosystems, setting aside protective zones that afford a sanctuary for fish and wildlife has considerable promise. Many countries are adopting policies to establish such areas with the prospect that these healthy regions can serve as a reservoir for biota that have become depleted in the unprotected areas. Yet this remedy is not without its limits. Restoring ecosystem health is not simply a matter of replenishing lost or damaged biota. It is also a matter of reestablishing the complex interactions among ecosystem lifeforms. Having a ready source of healthy biota that could potentially recolonize damaged ecosystems is important, but it is only part of the solution.

PREVENTION OF ECOSYSTEM DISRUPTIONS

Given the difficulties in reversing ecosystem degradation, and the many associated human health risks that arise with the loss of ecosystem health, the most effective approach is simply the prevention of ecosystem disruption. However, like many common-sense approaches, this is easier said than done. In both developed and developing countries there is a strong inclination to continue economic growth, even at the cost of severe environmental damage. Apart from selfish motivations, the argument is made that economic growth has many obvious health benefits, such as providing more efficient means of distributing food supplies, providing more plentiful food, and providing better health services and funding for research to improve standards of living. These are indeed benefits of economic development, and have led to substantial increases in health status worldwide.

However, at the dawn of the twenty-first century, the past is not necessarily the best guide to the future. The human population is at an all-time high, and associated pressures of human activity have led to increasing degradation of the earth’s ecosystems. As ultimately healthy ecosystems are essential for life of all biota, including humans, current global and regional trends are ominous. Under these circumstances, a tradeoff between immediate material gains and long-term sustainability of humans on the planet may be the only option. If so, the solution to sustaining human health and ecosystem health becomes one of devising a new politic that places sustaining life support systems as a precondition for betterment of the human condition.

BIBLIOGRAPHY

Aldhous, P. (2000). “Inquiry Blames Missed Warnings for Scale of Britain’s BSE Crisis.” Nature 408:3–5.

Baquero, R., and Blazquez, J. (1997). “Evolution of Antibiotic Resistance.” Trends in Ecology and Evolution 12:482–487.

Bright, C. (1998). Life Out of Bounds: Bioinvasion in a Borderless World. New York: W. W. Norton.

Colwell, R. R. (1996). “Global Climate and Infectious Disease: The Cholera Paradigm.” Science 274:2025–2031.

Colwell, R. R., and Patz, J. A. (1998). Climate, Infectious Disease and Health: An Interdisciplinary Perspective. Washington, DC: American Academy of Microbiology.

Epstein, P. R. (1995). “Emerging Diseases and Ecosystem Instability: New Threats to Public Health.” American Journal of Public Health 85(2):168–172.

Huq, A., and Colwell, R. R. (1996). “Vibrios in the Marine and Estuarine Environment: Tracking Vibrio Cholerae.” Ecosystem Health 2:198–214.

Mageau, M. T.; Costanza, R.; and Ulanowicz, R. E. (1995). “The Development and Initial Testing of a Quantitative Assessment of Ecosystem Health.” Ecosystem Health 1:201–213.

Rapport, D. J. (1989). “What Constitutes Ecosystem Health?” Perspectives in Biology and Medicine 33:120–132.

Rapport, D. J., and Friend, A. M. (1979). Towards a Comprehensive Framework for Environmental Statistics: A Stress-Response Approach. Ottawa: Statistics Canada.

Rapport, D. J., and Regier, H. A. (1980). “An Ecological Approach to Environmental Information.” Ambio 9:22–27.

—— (1995). “Disturbance and Stress Effects on Ecological Systems.” In Complex Ecology: The Part-Whole Relation in Ecosystems, ed. B. C. Patten and S. E. Jorgensen. Englewood Cliffs, NJ: Prentice Hall.

Rapport, D. J.; Costanza, R.; and McMichael, A. J. (1998). “Assessing Ecosystem Health: Challenges at the Interface of Social, Natural, and Health Sciences.” Trends in Ecology and Evolution 13(10):397–401.

Rapport, D. J.; Christensen, N.; Karr, J. R.; and Patil, G. P. (1998). “The Centrality of Ecosystem Health in Achieving Sustainability in the Twenty-First Century: Concepts and Approaches to Environmental Management.” In Human Survivability in the Twenty-First Century, ed. D. M. Hayne. Toronto: University of Toronto Press.

Rapport, D. J.; Costanza, R.; Epstein, P. R.; Gaudet, R.; and Levins, R., eds. (1998). Ecosystem Health. Malden, MA: Blackwell Science.

Rapport, D. J., and Whitford, W. (1999). “How Ecosystems Respond to Stress: Common Properties of Arid and Aquatic Systems.” Bio Science 49(3):193–203.

Rapport, D. J.; Regier, H. A.; and Hutchinson, T. C. (1985). “Ecosystem Behavior under Stress.” American Naturalist 125:617–640.

Reeves, W. C.; Hardy, J. L.; Reisen, W. K.; and Milby, M. M. (1994). “The Potential Effect of Global Warming on Mosquito-Borne Arboviruses.” Journal of Medical Entomology 31(3):323–332.

Ruiz, G. M.; Rawlings, T. K.; Dobbs, F. C.; Drake, L. A.; Mullady, T.; Huq, A.; and Colwell, R. R.. (2000). “Global Spread of Microorganisms by Ships.” Nature 408:49–50.

Watson R. T.; Zinyowera, M. C.; and Moss, R. H., eds. (1996). Second Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge, UK: Cambridge University Press.



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Texas Health Insurance - Texas Moveable Health Insurance Plan

Wednesday, June 17th, 2009
Bestinsurance George asked:


The laws of Texas health insurance, also known as the portability and the Health Insurance Accountability Act, were established in 1996 by Congress to protect workers and their families to health insurance and establish standards for insurance providers and employers. Title I to protect workers if they change jobs or get fired from a current job. The protection extends to employees as family members. Title II covers a different aspect of the legislation on health insurance, requiring health care facilities, employees, insurance providers and health to meet the standards set nationally. Title II is also known as Administrative Simplification (AS), using electronic data systems in Texas and across the United States to issues of health care much more efficient than in the past.

Title I of the Texas Health Insurance main objective is to change the law on service of public health and retirement income of employees of the Security Act. Under Title I, the providers of health insurance in Texas and across the United States cannot judge eligible workers or not simply based on disability, genetics, or their medical history. Health insurance companies in Texas and other states to be able to impose restrictions on health insurance plans for workers who had pre-existing conditions. However, Title I limits of these restrictions that insurers are allowed to put on benefits for workers who fall into this category. In addition, Title I also prohibits providers of health insurance restrictions on coverage or refuse workers to pre-existing conditions.

Title II of HIPPA was created first for the simplification of administrative rules, which require the Department of Health and Human Services to help promote efficiency and effectiveness of health care system in Texas and all other states. Title II also includes two sets of criminal and civil penalties for those who violate the laws. The Department of Health and Human Services has established five key rules: security, privacy, laws, unique identifiers, and transactions and code sets rules.

The safety rule consists of three sections: administrative, physical and technical. Protective measures administrative guidelines for health care to be met, particularly regarding security issues. The Privacy Rule expands on this, imposing restrictions on disclosure of information concerning a person’s health care status. The application of the Article sets of sanctions, primarily civil violations and fines for those who have violated HIPAA. The article attributes the unique ten-digit National Provider Identifier number to entities such as hospitals or doctors to promote the effectiveness of the health care system in Texas and across the U.S. Finally, the Code operations and establishes rules cover many aspects of health care such as requests for information on eligibility and benefits and the transmission of information on health care.

The HIPAA originally charged health care facilities at a cost to get “in conformity” with the HIPAA. Since its inception, the HIPAA laws have affected research and clinical care. Because HIPAA call for details on many forms, some patients complain that many things are extremely user-hostile. Other studies suggest that the HIPAA privacy rules May have adverse effects on costs and results of health research. The implementation of HIPAA also had effects on clinical care as well. Research shows that health facilities are often uncertain of privacy restrictions, so that May be made for patients as a very reluctant to disclose individual information.

One of the most important areas of HIPAA for those with pre-existing is to cover the requirements in Title I. Title I of the Texas forces individual insurance companies to offer guaranteed issue Texas HIPAA portability of health insurance plans for TX residents who meet certain criteria. If you have any major pre-existing conditions and feel that you May be eligible for a TX HIPAA health insurance plan then be sure and speak with a licensed insurance agent health in Texas to verify your eligibility.



health

Health Sector Reforms In Andhra Pradesh

Sunday, May 31st, 2009
Dr.v.sudhakaram asked:


Health sector Reforms in Andhra Pradesh

    A review on Health sector reforms in India   The health sector reforms in India were started way back in 1970s .The Govt. of India identifies the need HSR and stated in the eighth five year plan. The Eighth Five Year Plan (1992-1997) was the first plan document to state the need for re-structuring of economic management systems, following the macro developments of the 1990s. During this period in the health sector, the concept of free medical care was revoked and people were required to pay, even if partially, for the health services (1). The Ninth Five Year Plan (1997-2002) emphasized the need to review the response of the public, voluntary and private sector health care providers as well as the population themselves to the changing health scenario, to reorganize health services to bring about greater efficiency and effectiveness and to introduce health system reforms to enable the population to obtain optimum care at affordable cost The Ninth Plan sought to increase the involvement of voluntary, private organizations and self-help groups in the provision of health care and ensure inter-sectoral coordination in implementation of health programmes and health-related activities as well as enable the Panchayati Raj Institutions (PRI) in planning and monitoring of health programmes at the local level so as to bring about greater responsiveness to health needs of the people and greater accountability; to promote inter-sectoral coordination and utilise local and community resources for health care(2) .The Tenth Five Year Plan (2002-2007) touches upon reforms at primary, secondary and tertiary level(3).                         Politics influence health systems in significant manner. The goals, priorities, and the strategies, variations in the commitment are largely decided through the political contingencies. There are competing demands on the health systems. The evolution of the health systems is largely shaped by the culture, history, and norms. Client satisfaction is very high. As per NFHS-2 data, an overwhelming majority of clients are satisfied by the services delivered by the public systems. May be the expectations are low or may be our people are so courteous. But on the hand, we have the report from Transparent International, ranked the health system in India is the most corrupt system (4)   The Government has taken several steps for improving the public health care institutions and Strengthening the primary health care infrastructure. However, the situation is compounded by severe resource constraints - financial, technical and human power related, which has resulted in policy makers as well as programme managers at differing levels being faced with difficult choices. In such a situation, attempts are being made through various reform initiatives to ensure that the health needs of the people are met One of the major reform initiatives underway is the Secondary Health System Strengthening Project funded by the World Bank in seven states (Andhra Pradesh, Karnataka, Punjab, West Bengal, Maharashtra, Orissa and Uttar Pradesh). The projects include strengthening FRUs/CHCs and district hospitals so as to improve the availability of emergency care services to patients, to reduce overcrowding at district and tertiary care hospitals, construction works, procurement of equipment, increased availability of ambulances, drugs; improvement in quality of services following skill up gradation training in clinical management, changes in attitudes and behavior of health care providers; reduction in mismatches in health personnel / infrastructure; improvement in hospital waste management, disease surveillance and response system. It is essential to assess both progress and problems in implementation of the reforms in each state and to appropriately modify the content and pace of implementation. Such an overview and analysis of all related issues is necessary to provide evidence to policy makers and other stakeholders in terms of the various dimensions and impact of health sector reform.(5) In the Indian Constitution, health is a state responsibility. During Adjustment, many state governments in India had recourse to Health Systems Development Project loans from the World Bank for carrying out health sector reforms (HSR), of which one of the key policies has been to raise public spending on health care from the abysmally low levels seen up to then. The Health Systems Development Project seeks to develop strategic management capacity; strengthen performance, accountability, and efficiency; and build implementation capacity. Further, it seeks to improve clinical service quality by renovating and expanding district, sub district, and community hospitals and improving access to services. In all seven reforming states, around 15% of the total project cost is borne by the state governments. All the project documents note the low levels of funding for secondary hospitals in the reforming states. This is attributed to the small share of overall public spending allotted to health, the limited portion of total health spending going to hospitals, and, within this, a skewed distribution of funds in favour of the tertiary hospitals. After analysis of the problems of the health sector, the governments of the reforming states have agreed-using terminology ranging from “assurances” to “commitments”-to several undertakings. These are: (i) to enhance the overall size of the health budget; (ii) to redress imbalances in public expenditure between secondary and tertiary care levels; (iii) to safeguard the operations and maintenance components of current expenditure allocations for the secondary health-care sector; (iv) to charge user fees for selected services; and (v) to address workforce issues. The Health Systems Development Project initiated in the seven states recognizes the need for enhanced public spending on health and identifies it as the foremost policy reform to be pursued. Nevertheless, such assurances and conditions have not succeeded in enhancing health sector budgets in states implementing HSR. Worse, HSR has not been able to arrest the decline in the share of health spending within total government spending. The Indian system is especially complicated, as the larger tax resources are controlled by the central government but the major responsibility for health-care spending is bestowed on the states (6).Andhra Pradesh is the first state to go with the HSR.               Health sector reforms in Andhra Pradesh   The state of Andhra Pradesh was formed on 1st November, 1956 under the States’ reorganization scheme. It is the fifth largest State with an area of 2, 76, 754 sq. km, accounting for 8.4 % of India’s territory and also the fifth most populous state with a Population of 75 crores. The state has varied physiographic features ranging from high hills, undulating plains to a coastal deltaic environment. Administratively, Andhra Pradesh is divided into 23 districts, 79 revenue divisions, 1123 mandals, about 27000 villages and 264 towns. AP’s economy grew at 7.2% during 2006-07 — the fourth consecutive year of 6% plus growth. The latest poverty headcount ratio stands at 16%, compared to 23% for India . the third-highest credit rating among the major Indian states; the third best investment climate in the country; and the fourth-lowest corruption level among Indian states Andhra Pradesh was the first Indian state to receive a multi-sector Bank operation - the Andhra Pradesh Economic Restructuring Program for US$ 550 million in 1997 - aimed at helping the state accelerate policy and institutional reforms across a wide range of sectors under a common fiscal framework. It is also the only Indian state where the Bank has disbursed three budget support operations - the First Andhra Pradesh Economic Reform Loan (APERL-1) in March 2002, the Second APERL in February 2004, and the Third APERL in January 2007 - that sought to support the state’s development program.(12) Within AP there are regional, social and gender disparities. Health outcomes are worst among Scheduled Castes (16% of population) and Scheduled Tribes (7% of population), especially those living in underserved areas in North tribal and South drought prone districts, and for women. Effective delivery of quality basic health services is hampered by demand and supply side issues, including poor health infrastructure and staffing.(15)     The reform history in health sector in the State can be traced to Andhra Pradesh First Referral Health System Project, one of the first World Bank aided health system projects in the country. This project, launched in 1995 had been implemented by AP Vaidya Vidhana Parishad (APVVP). Agencies like World Bank and DFID are supporting the reform process in the State. The Bank supported the AP Economic Restructuring Project which included improvement of primary health care as one of the component.(7) The priority reforms focus on improved access to quality and responsive health services, strengthened governance and management in health sector, improved institutional mechanisms for community participation and systems for accountability; and strengthened financial management systems.(15)  The government of Andhra Pradesh [GoAP 1999] Vision 2020 document identifies a seven-point set of priorities for health sector reform: providing universal access to primary healthcare; encouraging private investment in tertiary healthcare; focusing on specific programmes to promote family planning; focusing on improving health levels in disadvantaged groups and backward regions; ensuring a strong prevention focus; enhancing the performance of the public health system; and formulating a state information education and communication (IEC) programme to broadcast information on preventive healthcare.(13) The Government of Andhra Pradesh is embarking on a major health sector reforms to improve health care delivery in the State. D.F.I.D. has expressed its willingness to support these initiatives with a grant of 100 Million pounds over the next five years (2006-2011). The reform initiative will include measures to improve the effectiveness and accountability of public health services, measures to focus on community centric preventive healthcare system and enhance access to quality healthcare for the poorer sections of the population(14) DFID will provide up to £40 million health sector budget support to the DoHMFW, GoAP, over 3 years 2007 - 2010. The sector support will build synergy with National Rural Health Mission (NRHM) which is a health sector reform program of the central government for decentralisation, pro-poor focus, strengthening service delivery(15)     The health sector support will be provided over three years (2007-08 - 2009- 10). It aims at increased use of quality health services, especially by the poorest people and in underserved areas.(16) The main outputs will be: a) Improved access to quality and responsive services, especially in remote and interior areas; b) Governance and management of health sector strengthened; c) Institutional mechanisms for community participation and systems for accountability in functioning; and Financial management systems strengthened and improved public expenditure on health.   The performance of health services would be measured against(17)

* greater effectiveness and improved outcomes of existing programs;

* improved efficiency in the allocation of resources;

* greater access and equity; and

* consumer satisfacfion

Reforms underway in health sector   The major reforms underway are classified under these categories and the activities are noted below and we will look each of them in detail    (I) Reorganization and restructuring of existing government health care system

Establishment of Andhra Pradesh Vaidya Vidhana Parishad Strengthening of referral institutions and fixing of service norms Improvement in drug supplies Formation of Andhra Pradesh Health, Medical & Housing Infrastructure Development Corporation (APHM&HIDC) Strengthening of PHCs as 24-hour MCH centers Establishment of Comprehensive Obstetric & Neonatal Care (CEmONC) centres

(II) Changes in health system organisation, delivery and Management

Formation of Hospital Advisory Committee/ Hospital Development Societies for all PHCs and FRUs/ teaching hospitals Provision of free travel bus passes to pregnant women for antenatal check ups Public Private Partnership

(III) Changes in financing methods

Sukhibhava Scheme (Improvement of Institutional Delivery Services Scheme) User fees

(IV) Reforms related to human resources

Integration and responsibilities of functionaries for planning, implementation and monitoring of programmes of HM & FW department

(V) Involving community in health service delivery and Provision

Women Health Volunteers Scheme

(VI) Reforms to quality of care

Performance indicators for grading the PHCs Performance rating of secondary hospitals

    1.Reorganization and restructuring of existing government health care system   A)Andhra Pradesh Vaidya Vidhana Parishad   AP, has created the Andhra Pradesh Vaidya Vidhana Parishad (APVVP) by enacting an Act in the Legislative Assembly in 1986(8) This was done with the objective to lay greater emphasis on development of both preventive as well as curative health care  and to strengthen necessary linkages at appropriate levels to ensure comprehensive medical and health care services. APVVP has undertaken World Bank assisted Andhra Pradesh First Referral Health Systems Project (APFRHSP) in 1994 for a period of seven years. This has been one of the major projects undertaken by APVVP. The objectives of the project included improvement of efficiency in the allocation and use of health resources through policy and institutional developments and enhanced performance of health system by improving the quality, effectiveness and coverage of health services at the first referral level.   B)Strengthening of referral institutions and fixing of service norms   basic service norms for various categories of hospitals under the administrative control of APVVP have been fixed thereby creating a hierarchy of hospitals according to services and facilities. This system of service norms and referral linkages had been developed with a view to optimise utilisation of resources, avoid duplication and wastage of resources, regulate patient flow and reduce cost of treatment by reduction of patient burden at tertiary hospitals. the district hospital has been prescribed to provide services in eleven specialties for which 9 civil surgeon specialists, 18-20 civil assistant surgeons, 54-84 paramedical staff and other supporting staff have been Posted. C)Improvement in drug supplies To ensure regular supply of drugs at all times and in all situations, a system of three sources of drug supply has been put in place for the hospitals under APVVP: (a) centralised drug procurement system under which the institution has been allotted drugs worth a particular amount based on bed strength (Rs 2000 per bed per quarter); (b) an emergency provision for drugs (Rs 100 per bed per month) has been made to every institution from where emergency procurement of drugs is made; (c) drugs which are in short supply and for which regular rate contract suppliers are not available have been stocked at the office of District Coordinators of Health Service. Under the APFRHSP, const-ruction and repair of 160 hospitals including 81 CHCs, 58 area hospitals and 21 district hospitals had been undertaken.(10)         D)Formation of Andhra Pradesh Health, Medical & Housing Infrastructure Development Corporation (APHM&HIDC)   a separate corporation has been set up in 1987 exclusively for developing housing and other infrastructure for medical and paramedical staff and constructing sub centers, PHCs, hospitals, dispensaries, clinics and other health care centers One of the major projects undertaken by APHM&HIDC has been the World Bank assisted India Population Project-VIII launched for improving the medical care facilities in urban slums in 74 municipalities.   E)Strengthening of PHCs as 24-hour MCH centers   In a move to make available maternal and child health care at all times, 470 PHCs in backward districts have been designated as round the clock Mother and Child Health Centre (earlier called women health centres). One staff nurse, one ANM and three support staff have been appointed in each centre on contractual basis. Staff nurses have been trained to conduct normal deliveries and refer emergency cases. Additional facilities like telephone and vehicle have been provided to the PHCs in order to assist communication and transport for referral of emergency cases. Provision has been made to conduct fortnightly specialist clinics of gynaecology and paediatrics in these centres to detect high risk pregnancies and neonates for referral to FRUs.   F)Establishment of Comprehensive Obstetric & Neonatal Care (CEmONC) centres   The State Government has decided to establish 108, CEmONC centres spread across every district so that pregnant mothers requiring emergency care do not have to travel more than 40-50 kms to receive specialist care. Training of MBBS doctors in anaesthesia, neonatal care and blood transfusion is also planned to support this scheme.   2)Changes in health system organisation, delivery and Management A)Formation of Hospital Advisory Committee/ Hospital Development Societies for all PHCs and FRUs/ teaching hospitals   Hospital Development Societies have been constituted in all tertiary hospitals under the control of Directorate of Medical Education.(18) and after implementing NRHM rogi kalyam samithi at every PHC were formed to ensure the adequate participation of local institution,with an aim to improve effective and efficient services with allowed flexible financial powers. These societies are examples for decentralization . Activities of the society include maintenance of the hospital (including sanitation & water supply, electricity, building & civil works and equipment), purchase of drugs & medicine supplies and equipment. The government has set norms and limits for undertaking these works which are to be adhered to by the Society. The ‘system works’, observed an Unicef team which assessed the impact of RKS towards the end of 2000. The system, however, is not without any lacunae. For, it was pointed out that “overall control of the local RKS bodies remain in the hands of the collector and if he is not interested in health care then the whole thing might just drift(13)   B)Provision of free travel bus passes to pregnant women for antenatal check ups(19)   The Government of Andhra Pradesh has started an innovative scheme in order to enable pregnant women in rural areas to avail antenatal check ups at the nearest PHC/area hospital or FRU. It has tied up with the State Road and Transport Corporation to issue free transportation bus tickets pass to be utilised for three visits. The ANM issues the bus passes to the pregnant women on her house visits.       C)Public Private Partnership(20)   ·         Management of Urban Health Centers by NGOs   Under the World Bank assisted Andhra Pradesh Urban Slum Health Care Project (APUSHCP), 192 urban health centers (UHCs) have been established in 74 municipal towns in 21 districts covering 1848 slums. After withdrawal of support by the World Bank, the project has been funded by the state government since 2002. The outcomes of the project show marked improvement in ANC coverage, institutional deliveries, post natal care and immunisation in the slum population.   ·         108 emergency services                           Govt. has tied up with satyam computers to provide emergency transportation which proved to a most successful programme and many states are following the same like Gujarath. The objective of 108 Ambulances is to save people in life emergency . One ambulance is given for three mandals. Each ambulance fitted with equipment worth Rs.17 lakhs renders its services in life emergencies, road and fire accidents (22)   ·         Rajiv arogya sree    The innovative Govt. insurance scheme to serve people of  poor from the serious ailments now attracting the nation as this programme succeeded. this scheme provides financial support to families of BPL upto 2 lakhs per anum for treating serious ailments. it is proposed to cover the entire state by 2nd October 2008 with the govt. paying the insurance premium for all the beneficiaries .an amount of rs.450 crores are provided to implement the scheme during 2008-09. (21)       3)Changes in financing methods   A)Sukhibhava Scheme(23)   Under the Scheme, a cash assistance of Rs.300 (Rs 200 towards transportation charges and Rs 100 for food and incidental expenses) is paid to pregnant women belonging to below poverty line families who come to government hospitals/APVVP hospitals/ teaching hospitals/PHCs/CHCs for delivery serv-ices. This assistance is payable only to those women with no living children or with one living child.   B)User fees:-   If user fees are charged their main use may lie in optimization of expenditure patterns and better allocation between facilities and within facilities(24). Reddy and Vandemoortele (1996), based on a comprehensive review of user financing of basic social services carried out for UNICEF, point to three other discouraging features of user fees: (1) user financing can result in a sharp reduction in the utilization of services, particularly among the poor; (2) gender biases, seasonal variations and regional economic disparities can aggravate the effects of user financing on equity; (3) user financing  quires adequate capacities, effective decentralisation and continued government support; and (4) user financing can undermine political support for the goal of universal coverage of basic social services. In 2001, the Commission on Macroeconomics and Health (2001) also reached a similar conclusion that user fees end up excluding the poor from essential healthservices, in 2005, the Millennium Project’s recent Report to the UN Secretary General (2005) titled “Investing in Development - A Practical Plan to Achieve the Millennium Development Goals” also forcefully argues for abandoning user fees. The health sector in India has acquired a notorious reputation for inefficiency and corruption at all levels. There is little accountability in both the public and private sectors. Quality standards are practically non-existent as are performance measures and honest reporting. A recent report on human resources for health brought out by Harvard University’s Global Equity Initiative (2004) argues that it is people - health workers alone - who can produce an effective health system and deliver good ealth.(25) 4)Reforms related to human resources Integration and responsibilities of functionaries for planning, implementation and monitoring of programmes of HM & FW department At district level, District Health Coordination Committee (DHCC) has been constituted to ensure proper planning, implementation and monitoring of all programmes/activities of HM&FW Department in the district.  The Committee has been entrusted with the primary responsibility of planning, finalizing, implementing and monitoring the District Health Action Plans and institutionwise health plans in a participatory manner including all concerned officials, other concerned departments and NGOs.   5)Involving community in health service delivery and Provision  

Women Health Volunteers Scheme

  One of the key components of the National Rural Health Mission is to provide every village in the country with a trained female community health activist - ‘ASHA’ or Accredited Social Health Activist. Selected from the village itself and accountable to it, the ASHA will be trained to work as an interface between the community and the public health system. Following are the key components of ASHA(26) A woman, usually a daughter-in-law of a house who has studied upto 7th class and preferably from SC/ST community has been selected as WHV by the Gram Panchayat Health Committee. The selected WHV has been given one month training in health care aspects of pregnancy, antenatal, delivery, post natal and new born care, immunisation, diarrhoea, acute respiratory infections, first-aid and treatment of minor ailments. The training has been provided at Telugu Mahila Pranganams for three weeks and one week field level training at PHCs. Academy of Nursing Studies has been designated as the nodal agency for providing training to WHVs.   6)Reforms to quality of care   A)Performance indicators for grading the PHCs   One of the components of World Bank assisted AP Economic Restructuring Project is improvement of primary health care. In order to improve the quality of primary health care services, a system of performance rating has been developed to rate PHCs and CHCs. The grading has been accorded A to C in descending order   B)Performance rating of secondary hospitals   A performance rating system for secondary hospitals under APVVP has been  introduced. The indicators related to general services (outpatients, inpatients, bed occupancy), emergency services (emergency-OP, emergency-IP, emergency major operations, emergency minor operations), clinical services (major/minor operations, tubectomy, deliveries) and diagnostic services (X-ray, ECG, lab tests and USG) have been developed for the purpose. Normative targets for each type of hospital (district hospital, area hospital, community health center) have been fixed against which the performance is measured and rating assigned. Highest grading is A while lowest grading is C.(27)   Conclusion:-   Introduction of user charges and subcontracting of services to the private sector are the main elements of health sector reforms. The health sector reforms are only a part of drastic reforms in other major sectors undertaken as a part of Andhra Pradesh Economic Restructuring Project (APERP) and the overall impact on the health conditions of people and their access to medical care depend more on the changes proposed outside the health sector. For instance, while exempting the white ration card holders i.e. the poor from the user charges in the government hospitals, it proposes to drastically reduce the number of white card holders to half in the state. The net affect would be to reduce the percent of population eligible for free treatment.(29)   On the other hand the success of 108 EMRI services and overwhelming response from Rajiv Arogya sree scheme are the examples for HSR success. Just like every thing has gots its own pros and cons HSR should be done in such a way where the need exist and according to necessities .   Referances:-   (Note:-most part of the article was taken from ref.no 28 otherwise reference specified)

 

(Government of India, Eighth Five Year Plan, (1992-1997) Planning Commission, New Delhi.) (Government of India, Ninth Five Year Plan, (1997- 2002) Planning Commission, New Delhi ) ( Government of India, Tenth Five Year Plan (2002-2007) Planning Commission, New Delhi) ( D. Agarwal Health Sector Reforms: Relevance in India, Indian Journal of Community Medicine Vol. 31, No. 4, October-December, 2006) Health Sector Reforms in India, Initiatives from Nine States ( http://www.idrc.ca/en/ev-118491-201-1-DO_TOPIC.html.The international development research centre) http://www.worldbank.org.in  (The Andhra Pradesh Vaidya Vidhana Parishad Act 1986 (Act No. 29 of 1986 with Amendaments upto 31.03.1989  Dr. MCR Human Resource Development Institute of Andhra Pradesh (Undated). “Andhra Pradesh Vaidya Vidhana Parishad Departmental Manual”  6http://www.aponline.gov.in/apportal/departments/ departments.asp?dep=16&org=98 GoAP (2006), Response to Questionnaire on Health Sector Reforms from MOHFW, GoI. http://www.worldbank.org.in/WBSITE/EXTERNAL/COUNTRIES/SOUTHASIAEXT/INDIAEXTN/0,,contentMDK:20970681~pagePK:141137~piPK:141127~theSitePK:295584,00.html#Ongoing_projects Grish kumar,promoting PPP in health services,EPW commentary,july19,2002  (G.O.Ms.No.130, HEALTH MEDICAL AND FAMILY WELFARE (K2) DEPARTMENT. Dated the 24th April, 2006)  ANDHRA PRADESH HEALTH SECTOR REFORM PROGRAMME (APHSRP) Terms of reference for Technical Cooperation (TC) to DoHMFW, GoAP  PRESS INFORMATION BUREAU GOVERNMENT OF INDIA, HEALTHCARE PROJECT IN AP FUNDED BY DFID, New Delhi, March 5, 2008) http://lnweb90.worldbank.org/oed/oeddoclib.nsf/DocUNIDViewForJavaSearch/0CFD6217A8A5BDA2852567F5005D32BD  G.O.Ms.No.403, dated Sept 7th 1998  GoAP (2006), Response to Questionnaire on Health Sector Reforms from MOHFW, GoI. Power Point Presentation of Govt of AP at the 2nd Regional Workshop on Health Sector Reforms: Experiences of Select States at Hyderabad, 14-15th February 2005 and ECTA Working paper 2002/61 Public-Private Partnership: Operational Framework used in Andhra Pradesh and Assam http://www.scribd.com/doc/2208678/AP-Budget-Speech  http://pibhyd.ap.nic.in/er27070702.pdf  Dept. of Health Medical Family Welfare, GoAP (undated), “Sukhibhava (Improvement of Institutional Delivery Services Scheme): Implementation Guidelines to PHC/Hospital  http://mohfw.nic.in/NRHM/Documents/CRM_report_full_report_version.pdf   (A.K.Shiv Kumar,,Budgeting for health ,some considerations) Economic and Political Weekly April 2, 2005  http://mohfw.nic.in/NRHM/asha.htm#abt http://health.ap.nic.in/apvvp/apvvp_stat.html  (http://www.whoindia.org/linkfiles/health_sector_reform_hsr_vol_ii_-_andhra_pradesh.pdf)  (Impact Of Health Sector Reforms On Hospital Services In Andhra Pradesh - A Study Of Trends In The Structures Of Provision And Utilisation Pattern)(centre for economic and social studies) (http://www.cess.ac.in/cesshome/research6b.html)

       

 



Caffeinated Content

New York Health Insurance

Friday, May 29th, 2009
Maria asked:


New York Health Insurance

Health insurance is insurance that pays for all or part of a person’s health care bills. A health insurance policy is an annually renewable contract between an insurance company and an individual. With health insurance claims, the individual policy-holder pays a deductible plus co-payment (for instance, a hospital stay might require the first 1000 dollar of fees to be paid by the policy-holder plus 100 dollar per night stayed in hospital). Usually there is a maximum out-of-pocket payment for any single year, and there can be a lifetime maximum.

The purpose of health insurance is to help people cover their health care costs which usually include doctor visits, hospital stays, surgery, procedures, tests, home care, and other treatments and services.

According to the latest United States Census Bureau figures, around 85% of citizens have health insurance. 59.5% of these people receive their health insurance coverage through an employer, and about 9% purchase it directly from the market. Government sources cover 27.3% of the population. Those without health insurance coverage are expected to pay privately for medical services.

Types of New York Health Insurance (http://new-york.ixs.net/General/New-York-Health-Insurance/index.aspx ) The types of health insurance in New York are group health plans, individual plans, and government health plans such as Medicare and Medicaid. In the United States, government-funded Medicare programs help to insure the elderly and end stage renal disease patients.

Group Health Plans

A group health plan offers health care coverage for employers, student organizations, professional associations, religious organizations, and other groups. The employer may pay for part or all of the insurance cost (premium).

Individual and Family Health Insurance

Individual and family health insurance is a type of health insurance coverage that is made available to individuals and families, rather than to employer groups or organizations. These types of health care plans are sold directly to individuals. For those of you who are unemployed or self-employed, an individual health insurance policy is always an option. Unfortunately rates for these policies are high and the coverage is usually less comprehensive than a managed care plan. The good news is that, in many cases, your insurance premium will be tax deductible. Of course, if you’re married, you can always try to catch a ride on your spouse’s group health insurance benefits plan.

Health insurance can be further classified into fee-for-service or indemnity (traditional insurance) and managed care. Both group and individual insurance plans can be either fee-for-service or managed care plans.

Managed Care Health Insurance

These include HMO, PPO, and POS plans. Managed-care plans typically make use of healthcare provider networks. Healthcare providers within a network agree to perform services for managed-care plan patients at pre-negotiated rates and will usually submit the claim to the insurance company for you. In general, you’ll have less paperwork and lower out-of-pocket costs with a managed care health insurance plan and a broader choice of healthcare providers with an indemnity plan.

There are three main types of managed care plans:

• Health Maintenance Organizations (HMO)

• Point-of-Service (POS)

• Preferred Provider Organizations (PPO)

All of these plans offer substantial health insurance benefits to members and their families. If you’re fortunate enough to have a choice of plan, consider the advantages, and disadvantages, of each. Compare the cost of care, the difference in premiums, deductible amounts and your freedom to choose a doctor outside the plan. There are numerous other coverages to compare as well — from prescription drugs to dental to alternative therapies. Be sure you understand the fine points of each.

Indemnity or Fee-For-Service Plan

Normally it covers the same expenses as managed care. The difference is your doctor is paid for each visit with the claim filed by either the patient or the medical provider. A big advantage– unlike some managed care plans, Fee-for-Service allows the patient a great deal of freedom in choosing which doctors and hospitals to use, but will probably involve higher out-of-pocket costs and more paperwork.

However, you’ll likely be required to pay an annual deductible before the insurance company begins to pay on your claims. An Indemnity plan may also require that you pay up front for services and then submit a claim to the insurance company for reimbursement.

Short-Term Health Insurance

Short-term health insurance plans are designed to protect against unforeseen accidents or illnesses, rather than to provide comprehensive coverage, and, as such, typically do not include coverage for preventive care, physicals, immunizations, dental or vision care. It covers for a limited period of time, and may be an ideal solution for those between jobs or those waiting for other health insurance to start. Typically, short-term plans offer coverage up to six months, although some plans may offer coverage up to 12 months. Purchasing a short-term medical insurance plan will make you ineligible for any guaranteed issue individual health plans commonly referred to as HIPAA (Health Insurance Portability and Accountability Act) Plans. HIPAA plans are usually very expensive and are generally intended for people with pre-existing medical conditions who would have trouble getting health insurance otherwise.

Medical Savings Account (MSA)

Medical savings account (MSA) is the most recent development in the area of health insurance. The principle behind the MSA is to take the bulk of the financial risk, and premium payments, away from the managed care and indemnity insurers, and allow individuals to save money, tax free, in a savings account for use for medical expenses. Individuals or their employers purchase major-medical policies, medical insurance policies with no coverage for medical expenses until the amount paid by the patient exceeds a predetermined maximum amount, such as 2500 dollar per year. These policies have extremely high deductibles and correspondingly low monthly premiums and the participants take the money that they would have spent on higher premiums and deposit it in an MSA. This money accrues through monthly deposits and also earns interest, and can be spent only to pay for medical care

What’s The Best Health Insurance Plan?

There is no one “best” plan for everyone. The best match for you and your family may be different than the best match for someone else. In order to help you answer this question, here are a few things to consider:

1. Are you going to need long-term coverage or just something for the short-term?

If you’re between jobs for 1-6 months, you may want to go for short-term coverage options. Alternatively, if you have no prospects of receiving group health insurance coverage through an employer, you may value the stability and increased benefits offered through an individual and family health insurance plan which will provide longer term coverage.

2. Are you looking for basic coverage or more comprehensive coverage?

Some insurance plans offer basic coverage (i.e., primarily inpatient hospitalization and outpatient surgery coverage) to cover you in case of a major accident or illness. These insurance plans typically have a lower monthly premium than plans with more comprehensive coverage, and may be appropriate for people who intend to use their insurance primarily in the event of a serious accident or illness. Other insurance plans that offer more comprehensive coverage may include benefits such as preventative care, physician services, prescription drug benefits and routine office visits. These insurance plans typically have a higher monthly premium than plans that only offer basic coverage, and may be appropriate for people who intend to use their insurance on a regular basis.

3. Would you pay for your services before you use them or when you use them?

If you choose a health insurance plan with a low monthly premium, you’re likely to have a higher co-payment or deductible. If you don’t anticipate making frequent use of your health insurance coverage, a higher-deductible plan with a lower monthly premium may suit you best.

4. How important to you is easy access to specialists?

Health insurance plans that require you to coordinate your care through a primary care physician typically require that you obtain a referral before seeing a specialist. So, if you prefer easier access to specialists, you may wish to consider a different type of plan.

5. Do you have a specific doctor or hospital that you would like to visit for healthcare?

Some insurance plans utilize provider networks. Pay special attention to the network of doctors or facilities that each health insurance plan utilizes. Also note that networks utilized by health insurance plans can change, so there is no guarantee that your doctor will always be contracted with your chosen health insurance plan.

6. What is the most you could pay out in case of a serious illness or injury?

Health insurance plans typically place limits on how much a member is required to pay out per year for his or her healthcare. This limit is often referred to as an out-of-pocket maximum. Once you’ve contributed this maximum amount toward your healthcare, the health insurance company typically covers all other costs for the remainder of the benefit year. If you’re concerned about what may happen to you in case of a serious illness or injury, you may wish to pay special attention to the out-of-pocket maximums for the health insurance plans you’re considering.

No matter what insurance plan you may choose, educate yourself and understand all the basics of the health insurance before finalizing anything.

For more information about New York Health Insurance visit: http://new-york.ixs.net



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Health Maintenance Through Positive Thinking

Monday, May 11th, 2009
Mohd. Faim A. Ansari asked:


Health Maintenance Through Positive Thinking

Paper presented in National Seminar on Positive Perspectives of Health and Behaviour, Department of Psychology, M.D. University, Rohtak, February, 1&2, 2008.

 

M. FAIM A. ANSARI (RESEARCH SCHOLAR)       

ASIYA AIJAZ (READER)

DEPARTMENT OF PSYCHOLOGY             

THE ALIGARH MUSLIM UNIVERSITY                                     

ALIGARH

            



Health:

Psychological resources such as hope, optimism, personal control, sense of meaning, and subjective well-being are known to exercise a protective influence on health. The Greek physician Hippocrates anticipated that positive emotions and health outcomes may be linked through multiple pathways. In the developed and developing countries, health is seen as the most valuable asset for a good quality of life, particularly in later years of life. Good health of the citizen is key facilitator to contribute to society. Smith (1990) said, “In the past, good health meant the absence of disease.” Today the definition of health is high level wellness that goes beyond the absence of disease toward one’s maximum potential which includes mind, body and sprit. High level wellness is the integration of health component, i.e. emotional, physical, social, spiritual and mental.

The common origin of the word health from “hoelth”, an English word meaning safe or sound and whole of body (Dolfman, 1973). There is no one contemporary meaning for the term. A nursing oriented definition of health consistent with the theme that the health is a subjective phenomenon that is operationalizable has been proposed by the Lynn. Lynn, 1990 defined health as a subjective representation of a person’s composite evaluation of somatic sense of self (how one is feeling) and functional ability (how one is doing).As such, health is manifested in the subjective judgment that one is experiencing wellness or illness. These subjective experiences are dynamic and are an outgrowth of person and environment interactions. As long as a person is capable of evaluating how he/she is feeling and doing at some level, the person has health.

The World Health Organization (WHO, 1948) defines health as a “state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”. Thus, the World Health Organization (WHO) has very clearly indicated that the absence of disease is not enough for health. This, definition emphasizes on positive and negative dimensions of health. Negative health or ill health has a subjective component expressed in the concept of illness and discomforts and an objective component express in concept of disease, injury, handicap or deformity. Positive health has two components: wellbeing and fitness. This state entails an appropriate balance of the physical, mental, social ingredients. Fitness can be considered as the objective physical components, where as, wellbeing can indicate the psychosocial component of positive health.

Lau (1995) found that when young healthy adults were asked to describe in their own words “what being healthy means to you?” their beliefs about health could be understood within the following dimensions:-

Ø     Physiological/Physical- good condition, having energy.

 

Ø     Pathological-happy, energetic, feels good psychologically.

 

Ø     Behavioural-eat and sleep properly.

 

Ø     Future consequence-live longer.

 

Ø     The absence of, e.g., sickness, disease & symptoms.

Kasl and Cobb (1966) states that health behaviour is any activity undertaken by a person believing himself to be healthy for the purpose of preventing disease or detecting it at an asymptomatic stage. Therefore, positive health can be defined as activities that may prevent disease, detect disease and disability at an early stage, promote and enhance health, or protect from risk of injury. Thus, “positive health can be defined as any activity undertaken by individual with a frequency or intensity that increases health or reduces disease”

As, we all know that the good health is a gift of God, but having good health is not sufficient but to maintain it also equally important. For this reason one should also focus on healthy lifestyle and positive thinking.

 

  ADOPT A HEALTHY LIFESTYLE

 



Exercise regularly. Physical activity plays a key role in reducing and preventing the effects of stress. Make time for at least 30 minutes of exercise, three times per week. Nothing beats aerobic exercise for releasing pent-up stress and tension.

Eat a healthy diet. Well-nourished bodies are better prepared to cope with stress, so be mindful of what you eat. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day.

Reduce caffeine and sugar. The temporary “highs” caffeine and sugar provide often end in with a crash in mood and energy. By reducing the amount of coffee, soft drinks, chocolate, and sugar snacks in your diet, you’ll feel more relaxed and you’ll sleep better.

Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. Don’t avoid or mask the issue at hand; deal with problems head on and with a clear mind.

Get enough sleep. Adequate sleep fuels your mind, as well as your body. Feeling tired will increase your stress because it may cause you to think irrationally.



 

The positive aspect of health is reflected in the Arabian proverb, “A man, who is healthy, has an optimistic view and who has an optimistic view, has everything” (Husain, 2005).

 

POSITIVE THINKING FOR GOOD HEALTH:

Happy people are always focusing on good events and worthy quality of life; they have optimistic view of life. Positive thinking can help people to gain peace of mind, obtain better health and attain an unceasing stream of energy. Positive thinking can have a beneficial effect on people’s health by increasing a person’s intellectual, physical, psychological, and social resources. Positive thinking leads to opportunity, Positive thinking is healthy. By practicing positive thinking one can enhance positive emotions, feeling and positive mental attitude which improve the quality of peoples lives and heal their bodies from illness and stresses.

According to Frederickson (2001) Positive emotions increase people’s physical, cognitive and social resources, which in turn help them cope more effectively with stressful experiences and live healthier.

   According to Nudel and Nudel, positive thinking is an effective way to achieve mastery of bio-energy healing. Maintenance of a positive energy level in a healer’s own bio-energy field reduces stress and emotional tension in the healer and in others positive emotions and feelings and a positive mental attitude can improve the quality of people’s lives and heal their bodies of illnesses and stresses.

 On the other hand, negative emotions and feelings bring poisonous toxins to the organism. Strong negative emotions such as anger, spite, envy, jealousy, and fear make the endocrine system accumulate poisons in the blood. Anxiety, depression, and doubt can also cause poisoning of the blood. Passive and lengthy negative emotions are even more dangerous for health than for active, sudden and momentary negative emotions. Negative emotions shorten the span of life. Treatment of physical symptoms with positive thoughts and statements was popularized in France a century ago, and it still has the power to overcome unwanted states (stress, tension, and unhappiness). Thoughts and feelings make up reality and add color to it. So, unhappiness brings a gray world and reality. To change a gray world and to overcome the feeling of unhappiness, anxiety, or tension, one needs to refocus the mind on positive, healing thoughts. When people predict that something wrong is going to happen to them, it is more likely to happen because negative thoughts will be reflected in their unconscious. Moreover, the person may develop psychosomatic illnesses (about 70% of all illnesses are psychosomatic, or caused by mental stress). Psychosomatic illnesses worsen when given special attention. Instead of paying direct attention to pain or illness, every time a negative thought occurs, say something like, “It will be better than I think.” When a wish of any desired condition is established in the mind, somehow the unconscious mind leads the wish to realization-not magically, but through mental programming. Besides healing illnesses, positive attitudes help one to withstand troubles and problems, make correct decisions, and overcome obstacles. Do not focus on negative events; try to discover a positive perspective. For example, individuals should understand that they need to read more or think more of others in order to find the ways of perfect communications. Because the thoughts of individuals are either positive or negative, they are reflected in their social or asocial behaviors. People should observe and conceive the world around them, as well as their inner worlds, with positive perceptions. Healers should have “a positive mind state” before they begin practicing bio-energy healing. Healers communicate with other people giving them energy. “Negative” energy cannot bring healing; only damage and it is destructive for both a healer and a healee. Healing energy is “a positive energy” sent by “a positive mind.” Your thoughts are in your control, and they can be very powerful.

Positive thoughts can motivate healthy behaviors, such as eating healthy food and being active. It’s simple really. If you believe you can take 10,000 steps a day, you will be more likely to take an extra walk to meet your goal. If you know you can avoid holiday weight gain, you’ll feel great when you pass the tempting dessert buffet, and fit comfortably in your winter clothes. If you set your mind to do something, you can do it. Positive thinking can also help you achieve and maintain healthy behaviors, such as becoming more physically active or limiting your sugar intake.

Peale (1996) has measured the success of positive-thinkers and found that those who think positively they can lose weight, or increase their physical activity, these people are more successful than people with less faith in themselves. The confidence you have in performing a certain behavior is called self-efficacy; and self-efficacy is a key in successful behavior change.

A “can-do” attitude may be just what it takes to jumpstart a healthier lifestyle. Best of all, your attitude is something you can control. You have the choice to have a positive outlook. Chances are when you choose to think positively, you’ll feel better about yourself and be able to perform better in whatever you do.

 HOW TO STAY POSITIVE:

Positive thinkers admit when they feel frustrated or depressed. They don’t ignore it. But they also don’t blame themselves. Instead, they try to understand the negative thoughts and feelings and counter them with more positive ones. So how do you stay positive, maintain momentum and sustain healthy behaviors? Here are few tips given by Peale (1996):-

 Ø     Look for a good role model. There is always someone who seems to be doing just what you want to be doing. Maybe they’ve scheduled exercise into their workday and switched from coffee to herbal tea. Learn from a successful friend, family member or colleague. Ask them how they keep healthy and follow in their footsteps.

 Ø     Try some positive self-talk and avoid negative-talk. Take a minute to give yourself an ego boost. Repeat some motivational words out loud or to yourself. Negative talk, “I can’t do it,” “I’m fat,” is dangerous for your well-being and healthy goals. Try to avoid the negative self-talk before it harms you. Remind yourself that you deserve happiness and can make positive changes.

 Ø     Get support. Tell your friends and family about your healthy habits. It helps to have an encouraging network.

 Ø     Reward yourself. Give yourself a pat on the back for your healthy efforts. Take a nice bath, get a massage, and enjoy a new DVD or CD.

 Ø     Have a plan. Making a plan to exercise or eat healthy lunches with a friend can mean the difference of sticking with your goals or falling off track. If you’ve planned for an activity, you’ll likely stick with it. You may even find that writing down your goals and steps to achieve them can help you stay on track. Take it day by day or week by week. The process of writing down your personal action plan is a good way to keep you honest and watch your progress or pitfalls.

Positive thinking is mental attitude that enters into the mind through words and images that are conducive to growth, expansion and success. It is mental attitude that expects good and favorable results. A positive mind anticipates happiness, joy, health and a successful outcome of every situation and action, whatever the mind expects, it finds.

The power of positive thinking can change and improve your life. Maintaining positive thinking and attitude will drive you to success, healthy life and happiness. Positive thinking is a habit that is right practice. Positive thinking is something you have to do everyday as often as possible and whenever you can. By practicing positive thinking everyday, you create a state of mind where you are constantly positive- it becomes a state of being positive. By doing this at last you will find an amount of positive energy that will create a positive situation for you everyday. Positive emotions and feelings and a positive mental attitude can improve the quality of people’s lives and heal their bodies of illnesses and help to regain health.

One approach to positive thinking given by Martin (1991) is called the three C’s: Commitment, Control and Challenge.

 Commitment: Make a positive commitment to yourself, to learning, work, family, friends, nature, and other worthwhile causes. Praise yourself and others, Always dream of success, Be enthusiastic.

Control: Keep your mind focused on important things. Set goals and priorities for what you think and do. Visualize practicing your actions. Develop a strategy for dealing with problems. Learn to relax. Enjoy successes. Be honest with yourself.

Challenge: Be courageous. Change and improve each day. Do your best and don’t look back. See learning and change as opportunities. Try new things. Consider several options. Meet new people. Ask lots of questions. Keep track of your mental and physical health. Be optimistic.

Martin (1991) has shown that people with these characteristics are winners in good times and survivors in hard times. “……People who begin consciously to modify their inner conversations and assumptions report an almost immediate improvement in their performance. Their energy increases and things seem to go better…”

Commitment, control and challenge help build self-esteem, reduce stress, live healthier and promote positive thinking.

Mental and emotional expectations can influence medical outcomes. The effectiveness of any medical treatment depends in part on how useful you expect it to be. As we know that our feeling of ineffectiveness of recourses lead us to stressful situation, we can overcome this situation by maximizing our efforts and our positive thoughts like “I can do it, even with limited resources” “So what, if I am running short of recourses, I can manage this.” This thinking can only be developed through positive thinking.

Positive affirmations are created through positive thinking to counter negative thoughts. These affirmations neutralize negative thoughts and build your self confidence. Positive affirmations give ways to the opportunities that are always present to some degree in a difficult situation.

Positive thinking help one to withstand troubles and problems, make correct decisions and overcome obstacles, stresses, and remains healthy. People should observe and conceive the world around them, as well as their inner worlds, with positive perceptions.

Spiritual strength promotes positive thinking, positive ideas, positive habits, positive attitudes, and positive efforts. There are qualities that promote wisdom, physical and mental well-being. Positive emotions stimulate the nervous system that protects the heart and reduces blood pressure. A realistic assessment of one’s limitations, the development of autonomy, and an ability to cope effectively with stress enable individuals to boost their positive thinking. The ability to recognize, accept and manage our feelings plays an integral role in our emotional development.

Meaning in life is very important for developing positive thinking. Those who are having meaning in their life are more likely to develop positive thinking. It has been observed that people who have meaning in their lives are keener to reduce stress for healthy life.

To develop positive thinking the person should be open to new ideas, activities and doing new things and new innovations, so that they can be more positive in their thinking.

The positive thinking can be developed by positive self talk, healthy attitudes, following effective fitness programmes (healthy diet), financially sound, hopefulness, new ideas, sense of responsibility etc. we can also develop positive thinking by acquiring new knowledge through stimulating mental activities that allows us to create environment in which useful and productive lives can be enjoyed.

Practicing positive self-talk will improve your outlook. When your state of mind is generally optimistic, you’re able to handle everyday stress in a constructive way. That ability may contribute to the widely observed health benefits of positive thinking. Positive thinking decreased negative stress. As it is very much clear that the people who think positively are more optimistic than the people who don’t.

 CONCLUSION:

It is very much clear from the above discussion that the people who think positively enjoy better and healthy life. Positive thoughts can motivate healthy behaviors, such as eating healthy food and being active. Positive thinking is the process of creating thoughts, that creates and focus energy into reality, to bring into creation a positive outcome, which you see as a benefit to yourself or others. This is a powerful gift that we all have but a lot of people are not aware of it.

Thus, we can say positive events are even sweeter when you see them as evidence of more to come, and see yourself as the master of your own fate.  Therefore, we can say those who habitually practice positive thinking tend to experience more success, which can add up to a less stressful and healthier life. The power of positive thinking can change and improve your life. Maintaining positive thinking and attitude will drive you to success, healthy life and happiness.

REFERENCES:

 

1.      Dolfman, M.L. (1973). The concept of health: A historic and Analytic examination. Journal of School Health, 43 (8), 491-497.

 

2.      Frederickson, B.L. (2001). The role of positive emotions in positive psychology: the broaden-and-build theory of positive emotions. American Psychologist, 56, 218-226.

 

3.      Husain, A. (2005). Islamic life styles: The right path for the maintenance of health. In R. Singh, A. Yadava and N.R. Sharma (Eds.) Health Psychology (pp. 329-339). New Delhi: Global Vision.

 

4.      Kasl, S. V. & Cobb, S. (1966). Health behaviour, illness behaviour and sick role behaviour I: Health & illness behaviour. Archives of Environmental Health, 12, 246-266.

 

5.      Lau, R.R. (1995). Cognitive representation of health and illness. In D. Gockman (Ed.), Handbook of Health Behaviour Research, Vol.I

 

6.      Lynn, B. (1990). Getting back on Track: Nursing’s autonomous Scope of Practice. In N. Chaska (Ed.), the nursing profession: Turning points (267-274). St. Louis, MO: C.V. Mosby.

 

7.      Martin, D (1991). How to be a Successful Student. http://www.suddenlyseparated.com/sub_menu.php?id=12

 

8.      Nudel, M. & Nudel, E. Positive Thinking for Your Health. http://www.bioenergy-services.com

 

9.      Peale, N.V. (1996). The Power of Positive Thinking. {Books available online at Barnes & Noble.com}, Random House Publications. http://www.aarp.org/health/fitness/get_motivated/positive_thinking.html

 

10.  Smith, S. (1990). Personal Health Choices. Boston: Jones and Bartlett Publishers.

11.  World Health Organization (1948). World Health Organization Constitution. In Basic documents, Geneva: Author.

 

 

       



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Do You Need to Obtain a College Health Care Plan?

Wednesday, April 22nd, 2009
Health Care asked:


Upon graduation from high school, there is no doubt that you will surely start your tertiary education in college or university. At age twenty, children will not be covered by health insurance of their parents and this can be disastrous if they are merely study and do not do part-time job. Some universities or colleges may have insurance plan offered to students. These insurance may not answer all your needs but you need to be meticulously considered it.

Most of the universities and colleges offer student health insurance plans. These plans should absolutely be at reasonable price, and can give you the school’s nearest hospitals. This option is one that you should definitely think of, if your son or daughter is enrolled in a college far away from home.

College health care scheme may vary from college to college due to laws and some other factors. Many students may think medical services are free of charge, but it is not always true. In term of clinic visit or routine checkups they may be free, however students still require to pay for special kinds of lab tests and other specialties such as x-rays, prescriptions, and a wound treatment. Compensation usually covers some types of service stated in the health care offered at college health centre. When you are referred to see an outside doctor, then the coverage will cover only 70% of your total expense and you are at risk to pay high medical cost.

You may have a problem getting treatment at the campus health centre if you have pre-existing condition. Having a pre-existing condition or illness does not mean to prevent you from obtaining health insurance plan, but you may not be eligible to have your treatment on your pre-existing condition. It can be troublesome if your new symptoms develop from a pre-existing one.

Health schemes are different, so be sure you find out everything about your health insurance plans. Be sure that your health plan stretch to summer break when you or your child do not take classes. This is vital for you because you don’t want to find out that your health care does not cover when you need it most. Some college health insurances may not cover during summer break, while others do.

Be certain that you study your plan thoroughly. Is it an HMO, or can the member utilise any service provider they went? This is critical. You need to know where you can go in case of emergency, and there is nothing worse than discovering that you will have to pay off the bill yourself.

There is no definitive solution to whether you should or should not commit yourself to college health insurance. Be certain that you study your plan thoroughly so that it answer to your need when you need it most. Although there is no free health insurance scheme, surely it will save you a lot of money in time of illness or accident.

For more information, please visit http://www.health-care-central.com



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Finding Better Health Insurance Company To Deal With

Sunday, April 19th, 2009
Laxmi Wadhwa asked:


You want to buy the best health insurance plan, which will not only give you excellent policy benefits but also render you maximum tax savings. Choosing the right health insurance company should be the first step of applying for health insurance policies and plans. You need to know about the rate and quote of the health insurance company, in order to choose the best insurance plan.

India has witnessed major growth and development in the area of insurance, since 2001. National players have tied up with global insurance companies to earn more recognition. ICICI Lmobard, Tata AIG, BajajAllianz and others are some of the major players in the insurance sector. Some of best health insurance plan are offered by these major private health insurance companies.

ICICI Lombard GIC Ltd is a globally recognized company that provides General Insurance. The company is rewarded for the kind of service it provides to the customers and it offers a range of plans for people in various categories. Health Advantage Plus launched by ICICI Lombard is tax saving plan while Family Floater Health Insurance covers health needs of your entire family. Personal Accident policy protects you against accidental hospitalization. The chief benefits offered by these plans include coverage against terrorism and convenient online buying process without any paperwork.

A private health insurance company, Tata AIG Life Insurance Company Limited or Tata AIG Life is a tie up between the Tata group and the American International Group (AIG). It offers a variety of health plans and policies. Some of the major products of this private health insurance company include Tata AIG Life Health First, Tata AIG Life InvestAssure Care, Tata AIG Life Health Protector - 5 Year Guaranteed Renewal Accident and Health Plan, Tata AIG Life Health Investor and Tata AIG Life InvestAssure Health. The Tata AIG Health Insurance policy offers you benefits under Section 80D of the Income Tax Policy.    

You can insure the future of you and your family with a health insurance policy from Bajaj Allianz. Bajaj Allianz Life Insurance Company Limited is another big name amongst the private health insurance companies. The company is a tie-up between Allianz SE, a life insurance company and the Bajaj Auto, a leading name producing two and three-wheelers. This private player offers some of the best health care plans and policies.  Family Care First, Care First and Health Care are some of the major health care products offered by this company.

Get a quote and rate on health insurance to compare health care products. You can then take your decision accordingly. Browse online for the same, make a smart choice and save money!



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How To Get mediclaim Health Insurance Coverage For A Family

Friday, April 10th, 2009
Laxmi Wadhwa asked:


Family comes first and so does their health. We all care for our family memebrs and it’s important to secure their health by buying the best mediclaim health insurance coverage that can meet the health related needs of your family. Mediclaim health insurance coverage comes with a variety of benefits to ensure your family’s wellbeing. If your major concern is availing cheap and quality health care services and coverage, we have perfect solutions for you.

The family health insurance services cover the entire health care expenses and long-term nursing or custodial care requirements. The most affordable mediclaim health insurance policies come with easy health care premiums these days. The health insurance coverage for families includes medical care and treatment of ailments and accidents. Some companies also feature critical illness cost within the mediclaim health insurance coverage. Diagnosis, lodging, surgery and ICU charges are covered by the family health insurance policies. Family health insurance plans also include benefits of tax exemption as stated under Section 80D of the Income Tax Act.

The leading health insurance companies today, offer affordable group health insurance and family health insurance coverage.  What’s more! In the time of ascending health care costs, mediclaim health insurance companies are charging easy premiums. Most of the famous health insurance companies offer a wide variety of floater plans ideal for the health care of families. Family floater plans are ideal to cover health care expenses for an entire family. This unique policy allows you to cover your family’s medical expenses under one umbrella. The sum insured remains fixed, while the premium keeps changing. Tax saving benefits is calculated on basis of the changing premium.

Apart from covering costs on illness and surgeries, the family floater health insurance includes coverage for emergencies arising out of acts of terrorism. Cashless facility comes to you across the network hospitals listed on your insurance company’s coverage list. As additional benefits, the floater plan offers you a 2-year continuous coverage with no change in premium in the second year.

Go through the rates and premiums of insurance policies online before you purchase a mediclaim health insurance plan for your family! Family health insurance plans offered by the various companies include coverage for emergency illness as well as regular health check up expenses. Premium discounts are offered for every claim free year. Some insurance companies offer you Standard, Exclusive and Premium Family health insurance coverage. These plans vary in premiums and coverage. You can select from health care premiums ranging between Rs 1 lac to Rs 10 lacs. This way you can make sure that you have chosen a best health plan for your family. Insure your family members and ensure peace of mind.



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